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https://www.readbyqxmd.com/read/28922704/direct-acting-antivirals-for-chronic-hepatitis-c
#1
REVIEW
Janus C Jakobsen, Emil Eik Nielsen, Joshua Feinberg, Kiran Kumar Katakam, Kristina Fobian, Goran Hauser, Goran Poropat, Snezana Djurisic, Karl Heinz Weiss, Milica Bjelakovic, Goran Bjelakovic, Sarah Louise Klingenberg, Jian Ping Liu, Dimitrinka Nikolova, Ronald L Koretz, Christian Gluud
BACKGROUND: Millions of people worldwide suffer from hepatitis C, which can lead to severe liver disease, liver cancer, and death. Direct-acting antivirals (DAAs), e.g. sofosbuvir, are relatively new and expensive interventions for chronic hepatitis C, and preliminary results suggest that DAAs may eradicate hepatitis C virus (HCV) from the blood (sustained virological response). Sustained virological response (SVR) is used by investigators and regulatory agencies as a surrogate outcome for morbidity and mortality, based solely on observational evidence...
September 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28922445/position-paper-on-treatment-of-hepatitis-c-in-romania-2017-part-two
#2
Liana Gheorghe, Ioan Sporea, Speranta Iacob, Roxana Sirli, Anca Trifan, Mircea Diculescu, Carol Stanciu, Oliviu Pascu, Monica Acalovschi, Ciprian Brisc, Cristina Cijevschi, Cristian Gheorghe, Zeno Spârchez, Ion Rogoveanu, Daniela Dobru, Dan L Dumitrascu
BACKGROUND AND AIMS: Hepatitis C virus (HCV) infection is a common condition with endemic prevalence in some areas of the world. In Romania, the mean prevalence is about 3%. New treatments have become available on the market in recent years and new drugs are in the pipeline. A re-evaluation of HCV therapy was considered mandatory. The Romanian Society of Gastroenterology and Hepatology undertook this task for the practitioners of this country. METHODOLOGY: A group of recognized experts was created who screened the available literature and the major available guidelines...
September 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28922440/real-life-use-of-3-direct-acting-antiviral-regimen-in-a-large-cohort-of-patients-with-genotype-1b-hcv-compensated-cirrhosis
#3
Liana Gheorghe, Speranta Iacob, Manuela Curescu, Ciprian Brisc, Cristina Cijevschi, Florin Caruntu, Carol Stanciu, Iulia Simionov, Ioan Sporea, Cristian Gheorghe, Razvan Iacob, Victoria Arama, Roxana Sirli, Anca Trifan
BACKGROUND AND AIMS: Ombitasvir/Paritaprevir/ritonavir/Dasabuvir (OBV/PTV/r+DSV) is one of the elective direct-acting antivirals (DAAs) recommended by international guidelines and the only one covered by the National Insurance System in Romania until November 2016. Our aim was to present the first prospective Romanian cohort evaluating the effectiveness and safety in clinical practice of this 3DAA combination in patients with HCV genotype-1b Child A liver cirrhosis. METHODS: 681 patients received OBV/PTV/r+DSV+RBV for 12 weeks and were assessed clinically and biologically at baseline, week 4, 8, 12 (end of treatment, EOT), and 12 weeks after therapy (sustained viral response, SVR)...
September 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28919755/synthetic-high-density-lipoprotein-nanodisks-for-targeted-withalongolide-delivery-to-adrenocortical-carcinoma
#4
Rui Kuai, Chitra Subramanian, Peter T White, Barbara N Timmermann, James J Moon, Mark S Cohen, Anna Schwendeman
Adrenocortical carcinoma (ACC) is a rare endocrine malignancy and has a 5-year survival rate of <35%. ACC cells require cholesterol for steroid hormone production, and this requirement is met via expression on the cell surface of a high level of SRB1, responsible for the uptake of high-density lipoproteins (HDLs), which carry and transport cholesterol in vivo. Here, we describe how this natural lipid carrier function of SRB1 can be utilized to improve the tumor-targeted delivery of a novel natural product derivative - withalongolide A 4,19,27-triacetate (WGA-TA) - which has shown potent antitumor efficacy, but poor aqueous solubility...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/28919539/the-nexus-between-the-documentation-of-end-of-life-wishes-and-awareness-of-dying-a-model-for-research-education-and-care
#5
Deborah P Waldrop, Jacqueline M McGinley, Brian Clemency
The convergence of medical treatment that can extend life with written medical orders that make it possible to refuse such treatment brings the differential dynamics of contemporary end-of-life decision-making into sharp focus. Communication between families and clinicians can be confusing, uncertain and pressured when death is imminent. These situations create distress that ultimately influences the end-of-life experience for people who are dying and those who care for them. This paper presents the analysis of the decisional dynamics that emerge from the intersection of the patient-family-provider awareness that death is near with the presence or absence of documentation of expressed wishes for end-of-life care...
September 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28918421/macrophage-activation-syndrome-at-the-onset-of-glucocorticoid-resistant-systemic-lupus-erythematosus-a-case-report
#6
Delia Tulbă, Marius Balea, Cristian Băicuș
INTRODUCTION: Macrophage activation syndrome (MAS) is a life-threatening hyperinflammatory state mediated by uncontrolled cytokine storm and haemophagocytosis. Although rarely reported, MAS might occur in systemic lupus erythematosus (SLE), notably as an inaugural manifestation. Glucocorticoids (GCs) are the cornerstone of SLE therapy. However, in some cases high doses of GCs are required to achieve remission (i.e. glucocorticoid-resistance), leading to significant side effects. CASE REPORT: A 28-year-old Romani male was admitted to our hospital for polyarthralgia, polyserositis and fatigability...
September 16, 2017: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
https://www.readbyqxmd.com/read/28918078/assessment-of-environmental-impacts-and-operational-costs-of-the-implementation-of-an-innovative-source-separated-urine-treatment
#7
Elorri Igos, Mathilde Besson, Tomás Navarrete Gutiérrez, Ana Barbara Bisinella de Faria, Enrico Benetto, Ligia Barna, Aras Ahmadi, Mathieu Spérandio
Innovative treatment technologies and management methods are necessary to valorise the constituents of wastewater, in particular nutrients from urine (highly concentrated and can have significant impacts related to artificial fertilizer production). The FP7 project, ValuefromUrine, proposed a new two-step process (called VFU) based on struvite precipitation and microbial electrolysis cell (MEC) to recover ammonia, which is further transformed into ammonium sulphate. The environmental and economic impacts of its prospective implementation in the Netherlands were evaluated based on life cycle assessment (LCA) methodology and operational costs...
September 8, 2017: Water Research
https://www.readbyqxmd.com/read/28916640/clinical-profile-and-consequences-of-atrial-fibrillation-in-hypertrophic-cardiomyopathy
#8
Ethan J Rowin, Anais Hausvater, Mark S Link, Patrick Abt, William Gionfriddo, Wendy Wang, Hassan Rastegar, N A Mark Estes, Martin S Maron, Barry J Maron
Background -Atrial fibrillation (AF), the most common sustained arrhythmia in hypertrophic cardiomyopathy (HCM), is capable of producing symptoms that impact quality of life and is associated with risk for embolic stroke. However, the influence of AF on clinical course and outcome in HCM remains incompletely resolved. Methods -Records were accessed of 1558 consecutive patients followed at the Tufts Medical Center Hypertrophic Cardiomyopathy Institute for 4.8 ± 3.4 years, from 2004 to 2014. Results -Of the 1558 HCM patients, 304 (20%) had episodes of AF, of which 226 (74%) were confined to symptomatic paroxysmal AF (PAF; average 5 ± 5; range 1 to > 20), while 78 (26%) developed permanent AF, preceded by 7 ± 6 PAF episodes...
September 15, 2017: Circulation
https://www.readbyqxmd.com/read/28915288/successful-treatment-of-keloid-with-fractionated-carbon-dioxide-co2-laser-and-laser-assisted-drug-delivery-of-triamcinolone-acetonide-ointment-in-an-african-american-man
#9
Ekaterina Kraeva, Derek Ho, Jared Jagdeo
Keloids are fibrous growths that occur as a result of abnormal response to dermal injury. Keloids are cosmetically disfiguring and may impair function, often resulting in decreased patient quality-of-life. Treatment of keloids remains challenging, and rate of recurrence is high. We present a case of a 39-year-old African-American man (Fitzpatrick VI) with a 10-year history of keloid, who was successfully treated with eight sessions of fractionated carbon dioxide (CO2) laser immediately followed by laser-assisted drug delivery (LADD) of topical triamcinolone acetonide (TAC) ointment and review the medical literature on fractionated CO2 laser treatment of keloids...
September 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28915287/efficacy-and-safety-of-desoximetasone-0-25-spray-in-adult-atopic-dermatitis-subjects-pilot-study
#10
Lauren K Hoffman, Leon Kircik
BACKGROUND: Atopic dermatitis (AD) is a chronic, relapsing, inflammatory skin disorder. One of the most disturbing symptoms of AD is pruritus. The first line treatment for AD is topical corticosteroids, topical immunomodulators, topical barrier creams, oral antihistamines, and systemic treatments. Desoximetasone 0.25% spray is a superpotent topical corticosteroid delivered in a novel way and it may be a suitable option for the treatment of pruritus in adult atopic dermatitis patients...
September 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28913634/emergency-neurological-life-support-intracranial-hypertension-and-herniation
#11
Rhonda Cadena, Michael Shoykhet, Jonathan J Ratcliff
Sustained intracranial hypertension and acute brain herniation are "brain codes," signifying catastrophic neurological events that require immediate recognition and treatment to prevent irreversible injury and death. As in cardiac arrest, a brain code mandates the organized implementation of a stepwise management algorithm. The goal of this Emergency Neurological Life Support protocol is to implement an evidence-based, standardized approach to the evaluation and management of patients with intracranial hypertension and/or herniation...
September 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28912937/relieving-pain-in-oral-lesions-of-pemphigus-vulgaris-using-the-non-ablative-non-thermal-co2-laser-therapy-ntclt-preliminary-results-of-a-novel-approach
#12
Nasrin Zand, Parvin Mansouri, Mohsen Fateh, Leila Ataie-Fashtami, Samad Rezaee Khiabanloo, Farid Safar, Reza Chalangari, Katalin Martits, Afshan Shirkavand
Introduction: Pemphigus vulgaris (PV) is a chronic, serious autoimmune mucocutaneous bullous disease. Oral lesions in PV may be extremely painful. This pain may adversely affect the patients' oral intake and quality of life. This before-after clinical trial was designed to assess the pain relieving effects of single session of non-ablative, non-thermal CO2 laser therapy (NTCLT) in oral lesions of PV. Methods: Fifty painful oral lesions of fourteen patients with PV were illuminated by CO2 laser (power: 1 W, scanning the lesions with rapid circular motion of the handpiece) passing through a thick layer of transparent gel with high water content...
2017: Journal of Lasers in Medical Sciences
https://www.readbyqxmd.com/read/28910473/optimization-of-simulation-and-moulage-in-military-related-medical-training
#13
Christopher Petersen, Stephen C Rush, Isabelle Gallo, Bryan Dalere, Brian Staak, Litt Moore, Win Kerr, Matthew Chandler, Will Smith
Preparation of Special Operations Forces (SOF) Medics as first responders for the battle space and austere environments is critical to optimize survival and quality of life for our Operators who may sustain serious and complex wounding patterns and illnesses. In the absence of constant clinical exposure for these medics, it is necessary to maximize all available training opportunities. The incorporation of scenario-based training helps weave together teamwork and the ability to practice treatment protocols in a tactical, controlled training environment to reproduce, to some degree, the environment in and stressors under which care will need to be delivered...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28905271/pharmacokinetics-of-a-new-oral-vitamin-d-receptor-activator-2-methylene-19-nor-20s-1%C3%AE-25-dihydroxyvitamin-d3-in-patients-with-chronic-kidney-disease-and-secondary-hyperparathyroidism-on-hemodialysis
#14
Richa Pandey, Julia B Zella, Jinge G Zhu, Lori A Plum, Margaret Clagett-Dame, William J Blaser, Wendy Bedale, Hector F DeLuca, Daniel W Coyne
BACKGROUND: 2-Methylene-19-nor-(20S)-1α,25-dihydroxyvitamin D3 (DP001 or 2MD) is a novel, potent 1α-hydroxylated vitamin D analog that binds to the vitamin D receptor and suppresses parathyroid hormone synthesis and secretion with potential for an improved safety profile compared to existing active vitamin D analogs. The purpose of this study was to evaluate the pharmacokinetics of DP001 given orally after hemodialysis. METHODS: DP001 (550 ng) was given orally to 11 hemodialysis patients with secondary hyperparathyroidism after each dialysis session (3 times/week) for 4 weeks...
September 13, 2017: Drugs in R&D
https://www.readbyqxmd.com/read/28904683/-pertrochanterian-fracture-revealing-multiple-myeloma-how-is-it-treated
#15
Hicham Bousbaa, Mourad Bennani, Naoufal Elghoul, Mohammed Ouahidi, Jamal Louaste, Laarbi Amhaji
Skeletal involvement is the major clinical complication of multiple myelomas, resulting in pathological fractures. Proximal femoral fractures are very frequent during multiple myeloma evolution and they seriously compromise survival and quality of life of patients with cancer. Early surgical treatment allows mortality and morbidity improvement. Cervicomedullary Gamma locking nail osteosynthesis allows efficient, sustainable and stable fixation associated with early patient mobilization and survival improvement...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28902866/5-year-long-term-efficacy-of-120-w-greenlight-photoselective-vaporization-of-the-prostate-for-benign-prostate-hyperplasia
#16
Juhyun Park, Sung Yong Cho, Min Chul Cho, Hyeon Jeong, Hwancheol Son
PURPOSE: To investigate 5-year long-term postoperative efficacy in benign prostate hyperplasia (BPH) following 120-W GreenLight high-performance system photoselective vaporization of the prostate (HPS-PVP). METHODS: This was a retrospective study of surgical outcomes in 159 men who underwent HPS-PVP and were followed over 60 months postoperatively. Definitions of treatment success were established based on the following three variables: international prostate symptom scores (IPSS), maximum flow rates (Qmax), and quality of life scores QoL)...
2017: PloS One
https://www.readbyqxmd.com/read/28902102/post-traumatic-spinal-hygroma-causing-cord-compression-in-type-iii-odontoid-fracture-with-vertical-atlantoaxial-instability
#17
Salvatore Russo, Antonio Belli, Andy Eynon, Ali Nader-Sepahi
STUDY DESIGN: Case report. OBJECTIVE: To report the first case in the literature of a traumatic cervical spine subdural cerebrospinal fluid (CSF) collection (hygroma) under tension causing cord compression. We suggest etiopathogenesis and modality of treatment. SUMMARY OF BACKGROUND DATA: Hygromas are subdural cranial CSF collection. A literature review showed no previous published case of post-traumatic spinal hygroma. This was a potential life-threatening sequelae of a high cervical injury that warranted early diagnosis and emergency treatment...
September 15, 2017: Spine
https://www.readbyqxmd.com/read/28898685/avoidance-of-the-vaginal-incision-site-for-mesh-placement-in-vaginal-wall-prolapse-surgery-a-prospective-study
#18
Alfred Robichaud, Mathieu Bélanger, Martine Poirier, Frank Cloutier, Jeffrey Gaudet, Caroline Jose
OBJECTIVE: To evaluate efficacy of a minimal surface area, vaginally-installed polypropylene tape (VPT), avoiding insertion on the incision line to treat an anterior, posterior or anteroposterior vaginal wall prolapse. STUDY DESIGN: Patients with an anterior, posterior or anteroposterior vaginal wall prolapse waiting for surgical treatment were included in the study. Primary outcome was the incidence of prolapse recurrence reported with combined outcome measures and was reported with Kaplan-Meier cumulative incidence...
September 1, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28898530/a-cost-effectiveness-analysis-of-intradiscal-electrothermal-therapy-idet-compared-with-circumferential-lumbar-fusion
#19
Eugena Stamuli, Withawin Kesornsak, Michael P Grevitt, John Posnett, Karl Claxton
STUDY DESIGN: Cost-effectiveness analysis. OBJECTIVE: To evaluate the cost-effectiveness of intradiscal electrothermal therapy (IDET) relative to circumferential lumbar fusion with femoral ring allograft (FRA) in UK. SUMMARY OF BACKGROUND DATA: Circumferential lumbar fusion is an established treatment for discogenic low back pain. However, IDET could be a cost-effective treatment alternative as it can be carried out as a day case. METHODS: Patient-level data were available for patients with discogenic low back pain treated with FRA (n=37) in a randomized trial of FRA vs titanium cage, and for patients recruited to a separate study evaluating the use of IDET (n=85)...
September 12, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28898283/sustained-effectiveness-and-cost-effectiveness-of-the-healthy-activity-programme-a-brief-psychological-treatment-for-depression-delivered-by-lay-counsellors-in-primary-care-12-month-follow-up-of-a-randomised-controlled-trial
#20
Benedict Weobong, Helen A Weiss, David McDaid, Daisy R Singla, Steven D Hollon, Abhijit Nadkarni, A-La Park, Bhargav Bhat, Basavraj Katti, Arpita Anand, Sona Dimidjian, Ricardo Araya, Michael King, Lakshmi Vijayakumar, G Terence Wilson, Richard Velleman, Betty R Kirkwood, Christopher G Fairburn, Vikram Patel
BACKGROUND: The Healthy Activity Programme (HAP), a brief behavioural intervention delivered by lay counsellors, enhanced remission over 3 months among primary care attendees with depression in peri-urban and rural settings in India. We evaluated the sustainability of the effects after treatment termination, the cost-effectiveness of HAP over 12 months, and the effects of the hypothesized mediator of activation on clinical outcomes. METHODS AND FINDINGS: Primary care attendees aged 18-65 years screened with moderately severe to severe depression on the Patient Health Questionnaire 9 (PHQ-9) were randomised to either HAP plus enhanced usual care (EUC) (n = 247) or EUC alone (n = 248), of whom 95% completed assessments at 3 months, and 91% at 12 months...
September 2017: PLoS Medicine
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