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https://www.readbyqxmd.com/read/28646426/eftrenonacog-alfa-a-review-in-haemophilia-b
#1
Sheridan M Hoy
Eftrenonacog alfa (Alprolix™) is a recombinant fusion protein comprising human factor IX (FIX) covalently linked to the constant region (Fc) domain of human IgG1 (i.e. rFIXFc). The presence of the Fc domain extends the terminal half-life (t½) of rFIXFc, permitting prolonged treatment intervals. rFIXFc is available for intravenous use for the prophylaxis and treatment of bleeding in patients with haemophilia B. In two multinational, phase III studies in previously treated children, adolescents and adults with severe haemophilia B, rFIXFc prophylaxis resulted in low median annualized bleeding rates (ABRs), and was associated with reductions in median weekly factor consumption and dosing frequency compared with pre-study FIX regimens...
June 23, 2017: Drugs
https://www.readbyqxmd.com/read/28645446/cost-effectiveness-analysis-of-two-treatment-strategies-for-chronic-hepatitis-c-before-and-after-access-to-direct-acting-antivirals-in-spain
#2
Juan Turnes, Raquel Domínguez-Hernández, Miguel Ángel Casado
OBJECTIVE: To evaluate the cost-effectiveness of a strategy based on direct-acting antivirals (DAAs) following the marketing of simeprevir and sofosbuvir (post-DAA) versus a pre-direct-acting antiviral strategy (pre-DAA) in patients with chronic hepatitis C, from the perspective of the Spanish National Health System. METHODS: A decision tree combined with a Markov model was used to estimate the direct health costs (€, 2016) and health outcomes (quality-adjusted life years, QALYs) throughout the patient's life, with an annual discount rate of 3%...
June 20, 2017: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/28644706/advance-care-planning-and-palliative-care-integration-for-patients-undergoing-hematopoietic-stem-cell-transplantation
#3
Winnie S Wang, Joseph D Ma, Sandahl H Nelson, Carolyn Revta, Gary T Buckholz, Carolyn M Mulroney, Eric J Roeland
PURPOSE: Advance care planning (ACP) in hematopoietic stem-cell transplantation (HSCT) is challenging, given the potential for cure despite increased morbidity and mortality risk.The aim of this study was to evaluate ACP and palliative care (PC) integration for patients who underwent HSCT. METHODS: A retrospective analysis was conducted and data were extracted from electronic medical records of patients who underwent HSCT between January 2011 and December 2015. Patients who received more than one transplant and who were younger than 18 years of age were excluded...
June 23, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28639319/diet-physical-activity-and-behavioural-interventions-for-the-treatment-of-overweight-or-obese-children-from-the-age-of-6-to-11-years
#4
REVIEW
Emma Mead, Tamara Brown, Karen Rees, Liane B Azevedo, Victoria Whittaker, Dan Jones, Joan Olajide, Giulia M Mainardi, Eva Corpeleijn, Claire O'Malley, Elizabeth Beardsmore, Lena Al-Khudairy, Louise Baur, Maria-Inti Metzendorf, Alessandro Demaio, Louisa J Ells
BACKGROUND: Child and adolescent overweight and obesity has increased globally, and can be associated with significant short- and long-term health consequences. This is an update of a Cochrane review published first in 2003, and updated previously in 2009. However, the update has now been split into six reviews addressing different childhood obesity treatments at different ages. OBJECTIVES: To assess the effects of diet, physical activity and behavioural interventions (behaviour-changing interventions) for the treatment of overweight or obese children aged 6 to 11 years...
June 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28639039/a-novel-endoscopic-surgery-for-dysphagia-after-stroke
#5
Jian Wang, Wuyi Li, Yongjin Li, Xiaofeng Jin, Yanyan Niu, Xu Tian, Hong Huo
BACKGROUND: Dysphagia is a common complication in stroke patients, which severely affects quality of life. This study aimed to evaluate the effectiveness and safety of temperature-controlled plasma radiofrequency (coblation)-assisted endoscopic cricopharyngeal myotomy (CAECPM) for the treatment sustained (>6 months) dysphagia in stroke patients. METHODS: This retrospective case-control study included a total of 24 stroke patients with sustained dysphagia, who were either treated with transcervical cricopharyngeal myotomy (CPM) (n = 16) or CAECPM (n = 12)...
June 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28638242/cost-utility-of-a-single-injection-combined-corticosteroid-hyaluronic-acid-formulation-vs-a-2-injection-regimen-of-sequential-corticosteroid-and-hyaluronic-acid-injections
#6
Etienne L Belzile, Robert T Deakon, Christopher Vannabouathong, Mohit Bhandari, Martin Lamontagne, Robert McCormack
Research has shown early and sustained relief with a combination therapy of a corticosteroid (CS) and hyaluronic acid (HA) in knee osteoarthritis (OA) patients. This can be administered via a single injection containing both products or as separate injections. The former may be more expensive when considering only product cost, but the latter incurs the additional costs and time of a second procedure. The purpose of this study was to compare the cost-utility of the single injection with the 2-injection regimen...
2017: Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28638216/role-of-surgery-in-pancreatic-cancer
#7
EDITORIAL
Trond A Buanes
Treatment of pancreatic cancer is multimodal and surgery is an essential part, mandatory for curative potential. Also chemotherapy is essential, and serious postoperative complications or rapid disease progression may preclude completion of multimodal treatment. The sequence of treatment interventions has therefore become an important concern, and numerous ongoing randomized controlled trials compare clinical outcome after upfront surgery and neoadjuvant treatment with subsequent resection. In previous years, borderline resectable and locally advanced pancreatic cancer was most often considered unresectable...
June 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28635066/consensus-development-of-quality-indicators-for-end-of-life-care-for-elders-in-japan
#8
Harue Masaki, Nobuko Kawai, Keiko Matsumoto, Miyoko Kuwata, Sachiko Yoshioka, Midori Nishiyama, Ryoko Uchino, Hiroko Nagae, Megumi Teshima, Sayuri Sakai, Kazuko Endo
AIMS AND OBJECTIVES: Quality indicators for end-of-life care have been published; however, none have been developed specifically for nursing in the cultural and traditional context of Japan. This study aimed to develop and build a consensus of quality indicators for end-of-life care for elders in Japan from the perspective of nursing science. METHODS: To develop the quality indicators, we used a literature review, expert panel process, and the Delphi technique among clinical nurse specialists in geriatrics...
June 2017: International Journal of Nursing Practice
https://www.readbyqxmd.com/read/28634768/futile-treatment-a-review
#9
Lenko Šarić, Ivana Prkić, Marko Jukić
The main goal of intensive care medicine is helping patients survive acute threats to their lives, while preserving and restoring life quality. Because of medical advancements, it is now possible to sustain life to an extent that would previously have been difficult to imagine. However, the goals of medicine are not to preserve organ function or physiological activity but to treat and improve the health of a person as a whole. When dealing with medical futilities, physicians and other members of the care team should be aware of some ethical principles...
June 20, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/28630410/investigating-the-life-expectancy-and-proteolytic-degradation-of-engineered-skeletal-muscle-biological-machines
#10
Caroline Cvetkovic, Meghan C Ferrall-Fairbanks, Eunkyung Ko, Lauren Grant, Hyunjoon Kong, Manu O Platt, Rashid Bashir
A combination of techniques from 3D printing, tissue engineering and biomaterials has yielded a new class of engineered biological robots that could be reliably controlled via applied signals. These machines are powered by a muscle strip composed of differentiated skeletal myofibers in a matrix of natural proteins, including fibrin, that provide physical support and cues to the cells as an engineered basement membrane. However, maintaining consistent results becomes challenging when sustaining a living system in vitro...
June 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28625092/factors-affecting-outcome-in-ocular-myasthenia-gravis
#11
Marco Mazzoli, Alessandra Ariatti, Franco Valzania, Shaniko Kaleci, Manuela Tondelli, Paolo F Nichelli, Giuliana Galassi
AIM OF THE STUDY: 50% to 60% of patients with ocular Myasthenia Gravis (OMG) progress to generalized disease (GMG) within 2 years.Aim of our study was to explore factors affecting prognosis of OMG and to test the predictive role of several independent clinical variables. MATERIALS AND METHODS: We reviewed a cohort of 168 Caucasian patients followed from September 2000 and January 2016. Several independent variables were considered as prognostic factors: gender, age of onset, results on electrophysiological tests, presence and level of antibodies against acetylcholine receptors (AChR-Abs), treatments, thymic abnormalities...
June 19, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28624760/how-do-smoking-cessation-medicines-compare-with-respect-to-their-neuropsychiatric-safety-a-protocol-for-a-systematic-review-network-meta-analysis-and-cost-effectiveness-analysis
#12
Kyla H Thomas, Deborah Caldwell, Michael N Dalili, David Gunnell, Marcus R Munafò, Matt Stevenson, Nicky J Welton
INTRODUCTION: Cigarette smoking is one of the leading causes of early death in the UK and worldwide. Public health guidance recommends the use of varenicline, bupropion and nicotine replacement therapy (NRT) as smoking cessation aids in the UK. Additionally, the first electronic cigarette has been licensed for use as a smoking cessation medicine. However, there are ongoing concerns about the safety of these medicines. We present a protocol for a systematic review and network meta-analysis (NMA) to determine how these smoking cessation medicines compare to each other with respect to their neuropsychiatric safety in adult smokers...
June 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28624194/sustained-inhibition-of-hbv-replication-in%C3%A2-vivo-after-systemic-injection-of-aavs-encoding-artificial-antiviral-primary-micrornas
#13
Mohube Betty Maepa, Abdullah Ely, Wayne Grayson, Patrick Arbuthnot
Chronic infection with hepatitis B virus (HBV) remains a problem of global significance and improving available treatment is important to prevent life-threatening complications arising in persistently infected individuals. HBV is susceptible to silencing by exogenous artificial intermediates of the RNA interference (RNAi) pathway. However, toxicity of Pol III cassettes and short duration of silencing by effectors of the RNAi pathway may limit anti-HBV therapeutic utility. To advance RNAi-based HBV gene silencing, mono- and trimeric artificial primary microRNAs (pri-miRs) derived from pri-miR-31 were placed under control of the liver-specific modified murine transthyretin promoter...
June 16, 2017: Molecular Therapy. Nucleic Acids
https://www.readbyqxmd.com/read/28623051/decision-proposals-in-the-family-conference
#14
Kristen E Pecanac, Roger L Brown
OBJECTIVES: To explore how clinicians make decision proposals about life-sustaining treatments and to determine if certain decision proposals are more likely to lead surrogates to align with or resist the proposal. METHODS: We audio-recorded 36 family conferences between clinicians and surrogates and analyzed the interactions using conversation analysis (a qualitative method) and event sequence analysis (a quantitative method). RESULTS: The transitional probability of a proposal that incorporates the patient's previously described preferences leading to alignment with the proposal was ...
June 9, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28623036/-arrhythmogenic-right-ventricular-cardiomyopathy-dysplasia-literature-review-and-case-report
#15
William Alejandro Camargo-Ariza, Silvia Juliana Galvis-Blanco, Tatiana Del Pilar Camacho-Enciso, Carlos Alberto Quiroz-Romero, Juan José Bermudez-Echeverry
Arrhythmogenic right ventricular cardiomyopathy/dysplasia is an inherited autosomal dominant pathology with an estimated prevalence of 1:2,500 to 1:5,000, being higher in males (3:1). It is characterized histologically by replacement of cardiomyocytes by fibro-adipose tissue, which predisposes to ventricular arrhythmias, right ventricular failure, and sudden cardiac death. The main goal of treatment is to reduce the risk of sudden death and improve the quality of life of patients. We present the case of a 23 year old woman whose clinical symptoms started with palpitations, chest pain with physical activity, syncope and headache 6 years ago during her first pregnancy...
June 13, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28622767/praziquantel-decreases-fecundity-in-schistosoma-mansoni-adult-worms-that-survive-treatment-evidence-from-a-laboratory-life-history-trade-offs-selection-study
#16
Poppy H L Lamberton, Christina L Faust, Joanne P Webster
BACKGROUND: Mass drug administration of praziquantel is the World Health Organization's endorsed control strategy for schistosomiasis. A decade of annual treatments across sub-Saharan Africa has resulted in significant reductions of infection prevalence and intensity levels, although 'hotspots' remain. Repeated drug treatments place strong selective pressures on parasites, which may affect life-history traits that impact transmission dynamics. Understanding drug treatment responses and the evolution of such traits can help inform on how to minimise the risk of drug resistance developing, maximise sustainable control programme success, and improve diagnostic protocols...
June 16, 2017: Infectious Diseases of Poverty
https://www.readbyqxmd.com/read/28622155/triad-ix-can-a-patient-testimonial-safely-help-ensure-prehospital-appropriate-critical-versus-end-of-life-care
#17
Ferdinando Mirarchi, Christopher Cammarata, Timothy E Cooney, Kristin Juhasz, Stanley A Terman
OBJECTIVE: The present study sought to assess the clarity of Physician Orders for Life-Sustaining Treatment (POLST) or Living Will (LW) documents alone or in combination with a video message/testimonial (VM). METHODS: Emergency medical services (EMS) personnel responded to survey questions about the meaning of stand-alone POLST and LW documents and those used in conjunction with emergent care scenarios. Personnel were randomized to receive documents only or documents with VM...
June 16, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28617756/optimizing-thiopurine-therapy-in-inflammatory-bowel-disease-among-2-real-life-intercept-cohorts-effect-of-allopurinol-comedication
#18
Berrie Meijer, Margien L Seinen, Remco van Egmond, Gerd Bouma, Chris J J Mulder, Adriaan A van Bodegraven, Nanne K H de Boer
BACKGROUND: Thiopurines (azathioprine and mercaptopurine) are frequently used immunosuppressive drugs to maintain remission in patients with inflammatory bowel disease. Half of the conventional thiopurine-derivative users have to discontinue treatment within 5 years, mainly because of intolerable adverse events. Over recent years, different strategies to optimize thiopurine treatment were suggested, yet, studies describing the clinical effectiveness of these strategies remain scarce. The aims of this study were to compare tolerability and sustained clinical benefit of conventional thiopurine derivatives therapy among two 5-year real-life intercept cohorts and to assess the clinical value of specifically allopurinol cotherapy...
June 14, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28615196/withdrawing-clinically-assisted-nutrition-and-hydration-canh-in-patients-with-prolonged-disorders-of-consciousness-is-there-still-a-role-for-the-courts
#19
Veronica English, Julian C Sheather
Currently, in England and Wales, Court of Protection's Practice Directive 9E (PD9E) requires all cases of proposed withdrawal or withholding of life-sustaining treatment in relation to adults in a permanent vegetative state (PVS) or minimally conscious state be referred to the Court. This paper looks at the origins of PD9E and contrasts the routine requirement to refer cases to court with the complex clinical terrain that comprises those suffering from prolonged disorders of consciousness. We look at the role of the court in decision making in these contexts and we ask what role the courts are called on to play in these decisions...
June 14, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28614077/structure-operation-and-experience-of-clinical-ethics-consultation-2007-2013-a-report-from-the-massachusetts-general-hospital-optimum-care-committee
#20
Ellen M Robinson, Wendy Cage, Kimberly Erler, Sharon Brackett, Julia Bandini, Alexandra Cist, M Cornelia Cremens, Eric L Krakauer, Andrew Courtwright
We describe the structure, operation, and experience of the Massachusetts General Hospital ethics committee, formally called the Edwin H. Cassem Optimum Care Committee, from January 2007 through December 2013. Founded in 1974 as one of the nation's first hospital ethics committees, this committee has primarily focused on the optimum use of life-sustaining treatments. We outline specific sociodemographic and clinical characteristics of consult patients during this period, demographic differences between the adult inpatient population and patients for whom the ethics committee was consulted, and salient features of the consults themselves...
2017: Journal of Clinical Ethics
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