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https://www.readbyqxmd.com/read/29232273/practice-bulletin-no-191-tubal-ectopic-pregnancy
#1
(no author information available yet)
Ectopic pregnancy is defined as a pregnancy that occurs outside of the uterine cavity. The most common extrauterine site of ectopic pregnancy is the fallopian tube. Most cases of tubal ectopic pregnancy that are detected early can be treated successfully either with minimally invasive surgery or with medical management using methotrexate. However, tubal ectopic pregnancy in an unstable patient is a medical emergency that requires prompt surgical intervention. The purpose of this document is to review information on the current understanding of tubal ectopic pregnancy and to provide guidelines for timely diagnosis and management that are consistent with the best available scientific evidence...
December 5, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29231235/the-perioperative-use-of-synthetic-and-biological-disease-modifying-antirheumatic-drugs-in-patients-with-rheumatoid-arthritis
#2
Gregory Fleury, Silvano Mania, Didier Hannouche, Cem Gabay
Disease-modifying antirheumatic drugs (DMARDs) have become essential treatments in the management of patients with inflammatory rheumatic diseases. Their use has resulted in a marked improvement of disease control and a limitation of joint damage, although some patients still require subsequent corrective or joint replacement surgery. Due to their immunosuppressive effects, some DMARDs are associated with an increased risk of infection. The aim of this review is to discuss the available literature on the management of DMARDs during the perioperative period, particularly in the case of orthopaedic surgery...
December 12, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29231165/polyvalent-immunoglobulins-with-vitamin-d3-and-vitamin-b12-in-the-treatment-of-sjogren-s-syndrome-in-a-vegetarian-with-stomatitis-glossodynia-xerostomia-and-elevated-antinuclear-antibodies-case-report%C3%A2
#3
Clemens Cuny, Barbara Vaerst, Jennis Gabrielpillai, Aykut Tahtali, Sven Balster, Reinhard Lissner, Barry G Woodcock
BACKGROUND: Sjogren's syndrome, involving sicca symptoms with xerostomia, stomatitis, and considerable pain is a difficult-to-treat autoimmune disease where the treatment options are limited and, as in the case of methotrexate, have a low therapeutic index. CASE REPORT: This case report concerns a male patient, aged 75 years and vegetarian, with Sjogren's syndrome subsequently confirmed by salivary gland biopsy. Serum antinuclear antibodies (ANA) were elevated (1 : 320)...
December 12, 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29229546/changes-in-cognition-and-dendritic-complexity-following-intrathecal-methotrexate-and-cytarabine-treatment-in-a-juvenile-murine-model
#4
Tyler C Alexander, Christy M Simecka, Frederico Kiffer, Thomas Groves, Julie Anderson, Hannah Carr, Jing Wang, Gwendolyn Carter, Antiño R Allen
Acute lymphoblastic leukemia (ALL) is the most prevalent childhood cancer and accounts for 26.8% of cancer diagnoses among children, worldwide-approximately 3,000 children each year. While advancements in treating ALL have led to a remission rate of more than 90%, many survivors experience adverse neurocognitive and/or neurobehavioral effects as a result of intrathecal chemotherapy. Methotrexate (MTX) is commonly administered with cytosine arabinoside (AraC, cytarabine) during intrathecal chemotherapy for ALL...
December 8, 2017: Behavioural Brain Research
https://www.readbyqxmd.com/read/29229311/an-extra-priming-dose-of-hepatitis-a-vaccine-to-adult-patients-with-rheumatoid-arthritis-and-drug-induced-immunosuppression-a-prospective-open-label-multi-center-study
#5
Anja Rosdahl, Christian Herzog, Gert Frösner, Torbjörn Norén, Lars Rombo, Helena H Askling
BACKGROUND: Previous studies have indicated that a pre-travel single dose of hepatitis A vaccine is not sufficient as protection against hepatitis A in immunocompromised travelers. We evaluated if an extra dose of hepatitis A vaccine given shortly prior to traveling ensures seroconversion. METHOD: Patients with rheumatoid arthritis (n = 69, median age = 55 years) treated with Tumor Necrosis Factor inhibitor(TNFi) and/or Methotrexate (MTX) were immunized with two doses of hepatitis A vaccine, either as double dose or four weeks apart, followed by a booster dose at six months...
December 8, 2017: Travel Medicine and Infectious Disease
https://www.readbyqxmd.com/read/29228799/calprotectin-in-patients-with-chronic-rheumatoid-arthritis-correlates-with-disease-activity-and-responsiveness-to-methotrexate
#6
Ulla Bregendahl Nielsen, Laerke Valsøe Bruhn, Torkell Ellingsen, Kristian Stengaard-Pedersen, Nete Hornung
OBJECTIVE: Calprotectin (myeloid-related protein 8/14) is elevated in inflammatory diseases and a correlation of serum calprotectin and disease activity in rheumatoid arthritis (RA) has been shown. In this study, we investigated plasma calprotectin as a disease marker in patients with chronic RA treated with methotrexate (MTX) monotherapy and compared plasma calprotectin with C-reactive protein (CRP) in this matter. METHODS: Seventy-six patients with chronic RA were included in this open prospective study and of these 40 were included prior to initiation of MTX therapy...
December 11, 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/29228590/precision-and-recall-oncology-combining-multiple-gene-mutations-for-improved-identification-of-drug-sensitive-tumours
#7
Stefan Naulaerts, Cuong C Dang, Pedro J Ballester
Cancer drug therapies are only effective in a small proportion of patients. To make things worse, our ability to identify these responsive patients before administering a treatment is generally very limited. The recent arrival of large-scale pharmacogenomic data sets, which measure the sensitivity of molecularly profiled cancer cell lines to a panel of drugs, has boosted research on the discovery of drug sensitivity markers. However, no systematic comparison of widely-used single-gene markers with multi-gene machine-learning markers exploiting genomic data has been so far conducted...
November 14, 2017: Oncotarget
https://www.readbyqxmd.com/read/29228558/1-palmitoyl-2-linoleoyl-3-acetyl-rac-glycerol-ameliorates-arthritic-joints-through-reducing-neutrophil-infiltration-mediated-by-il-6-stat3-and-mip-2-activation
#8
Young-Jun Kim, Jae Min Shin, Su-Hyun Shin, Joo Heon Kim, Ki-Young Sohn, Heung-Jae Kim, Jong-Koo Kang, Sun Young Yoon, Jae Wha Kim
The pathogenesis of rheumatoid arthritis (RA) has been implicated neutrophil extracellular traps (NETs) formation which could generate autoantigen. Neutrophil contributes to initiate and maintain the inflammatory process in the joint. In this study, we show that 1-palmitoyl-2-linoleoyl-3-acetyl-rac-glycerol (PLAG) decreases neutrophil migration by regulating the activity of STAT3, a regulator of IL-6 and MIP-2 expression. PLAG caused a decrease in IL-6 production in the RAW264.7 macrophage cell line and in rheumatoid arthritis-fibroblast-like synoviocytes via the regulation of STAT3 signaling without affecting NF-κB signaling...
November 14, 2017: Oncotarget
https://www.readbyqxmd.com/read/29226354/liquid-chromatographic-methods-for-the-therapeutic-drug-monitoring-of-methotrexate-as-clinical-decision-support-for-personalized-medicine-a-brief-review
#9
REVIEW
Mónica Francisco Silva, Cláudia Ribeiro, Virgínia M F Gonçalves, Maria Elizabeth Tiritan, Áurea Lima
Methotrexate (MTX) is an antifolate drug used for several diseases. Depending on the disease, MTX can be administered at low-dose (LDMTX) in some autoimmune diseases, like rheumatoid arthritis, or at high-dose (HDMTX) in some cancers, such as acute lymphoblastic leukaemia. After absorption, MTX is metabolized in the liver to 7-hydroxymethotrexate (7-OH-MTX) and in the intestine to 2,4-diamino-N10-methylpteroic acid (DAMPA). Moreover, inside red blood cells (RBCs), MTX is converted to active metabolites, MTX polyglutamates (MTXPGs), contributing to its pharmacodynamics...
December 11, 2017: Biomedical Chromatography: BMC
https://www.readbyqxmd.com/read/29225245/oral-methotrexate-related-lymphoproliferative-disease-presenting-with-severe-osteonecrosis-of-the-jaw-a-case-report-and-literature-review
#10
Sachiko Furukawa, Kazunari Oobu, Masafumi Moriyama, Shintaro Kawano, Saori Sako, Jun-Nosuke Hayashida, Ryota Matsubara, Ken-Ichi Ogata, Tamotsu Kiyoshima, Seiji Nakamura
Long-term methotrexate (MTX) treatment can cause MTX-related lymphoproliferative disorder (MTX-LPD). We experienced a case of MTX-LPD that was associated with severe osteonecrosis of the jaw mimicking medication-related osteonecrosis of the jaw. The patient was an 81-year-old woman with rheumatoid arthritis (RA) who was treated with MTX and bisphosphonate. After 7 years, she was referred to our department for the assessment of giant ulcer and exposure of the alveolar bone of the left maxilla. Histopathological and immunological analyses confirmed a diagnosis of MTX-LPD...
December 8, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29224791/antioxidant-and-anti-inflammatory-effects-of-virgin-coconut-oil-supplementation-abrogate-acute-chemotherapy-oxidative-nephrotoxicity-induced-by-anticancer-drug-methotrexate-in-rats
#11
Ademola C Famurewa, Patrick M Aja, Ekenechukwu K Maduagwuna, Chima A Ekeleme-Egedigwe, Odomero G Ufebe, Sharon O Azubuike-Osu
BACKGROUND: Methotrexate (MTX) is an efficacious anticancer agent constrained in clinical use due to its toxicity on non-targeted tissue, a considerable source of worry to clinicians. Because the toxicity is associated with oxidative stress and inflammation, the study explored antioxidant and anti-inflammatory effect of virgin coconut oil (VCO) supplementation in nephrotoxicity induced by MTX in rats. METHODS: Rats were randomized into 4 groups (n=6) as follows: Control group; MTX group injected with single dose of MTX (20mg/kg, ip) on day 14; VCO (5%)+MTX and VCO (15%)+MTX groups were pre-treated with VCO diet and injected with single dose of MTX (20mg/kg, ip) on day 14...
December 7, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/29224127/defining-and-characterizing-sustained-remission-in-patients-with-rheumatoid-arthritis
#12
Jeffrey R Curtis, Mona Trivedi, Boulos Haraoui, Paul Emery, Grace S Park, David H Collier, Girish A Aras, James Chung
The objective of this study is to characterize stability and clinical features of patients with rheumatoid arthritis (RA) in sustained remission. Combination therapy with methotrexate and tumor necrosis factor inhibitors (TNFi) has increased remission rates in RA but optimal regimens to maintain remission are unknown. We describe Study of Etanercept And Methotrexate in Combination or as Monotherapy in Subjects with Rheumatoid Arthritis (SEAM-RA) and data from a run-in period of longitudinal observation. Patients in Simplified Disease Activity Index (SDAI) remission (score ≤ 3...
December 9, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/29223759/methotrexate-loaded-gellan-gum-microparticles-for-drug-delivery
#13
Mukesh Dhanka, Chaitra Shetty, Rohit Srivastava
Recently, polysaccharides based microparticles have been found to offer an attractive potential as a carrier in drug delivery field. In this study, bare gellan gum microparticles (GG MPs) and methotrexate (MTX) loaded gellan gum microparticles (MTX-GG MPs) prepared by using simple water-in-oil (W/O) emulsion solvent diffusion method. The developed microparticles (MPs) were found discretely distributed in a spherical shape. MTX has been encapsulated in microparticles with 84.8±1.68% encapsulation efficiency (%EE) and 6...
December 6, 2017: International Journal of Biological Macromolecules
https://www.readbyqxmd.com/read/29222448/effect-of-qianghuo-erhuang-decoction-on-t-regulatory-and-t-helper-17-cells-in-treatment-of-adjuvant-induced-arthritis-in-rats
#14
Can Qian, Mei Kuang, Yong Wang
QianghuoErhuang Decoction (QED) is an effective recipe in treating rheumatoid arthritis. The present study aimed to explore the effects of QED on Treg and Th17 in adjuvant arthritis (AA) model. The study included 6 group rats: normal control group, AA group, AA + methotrexate (MTX) group, AA + high, moderate, and low dose QED groups. The arthritis score was significantly decreased in the MTX and high-dose QED groups compared with the AA group on days 24 and 28 (P < 0.01), respectively. The synovial tissue inflammation was attenuated by histological observation, and the proliferation of splenocytes was significantly inhibited in MTX and high-dose QED groups (P < 0...
December 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29222307/secondary-cns-relapse-in-diffuse-large-b-cell-lymphoma-defining-high-risk-patients-and-optimization-of-prophylaxis-strategies
#15
REVIEW
Kerry J Savage
Despite improvement in survival in diffuse large B-cell lymphoma (DLBCL) with the introduction of rituximab, central nervous system (CNS) relapse continues to represent a clinical challenge. A number of studies have evaluated clinical risk factors in an attempt to identify high-risk patients to direct CNS staging investigations and consider prophylaxis strategies. The CNS International Prognostic Index is a robust and reproducible risk model that can identity patients at high risk of CNS relapse, but its specificity remains limited...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222306/therapy-of-primary-cns-lymphoma-role-of-intensity-radiation-and-novel-agents
#16
REVIEW
Andrés José María Ferreri
Primary central nervous system (CNS) lymphomas represent a subgroup of malignancies with specific characteristics, an aggressive course, and unsatisfactory outcome in contrast with other lymphomas comparable for tumor burden and histological type. Despite the high sensitivity to conventional chemotherapy and radiotherapy, remissions are frequently short lasting. Treatment efficacy is limited by several factors, including the biology and microenvironment of this malignancy and the "protective" effect of the blood-brain barrier, which limits the access of most drugs to the CNS...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222263/crisis-management-in-the-treatment-of-childhood-acute-lymphoblastic-leukemia-putting-right-what-can-go-wrong-emergency-complications-of-disease-and-treatment
#17
REVIEW
Rachael Hough, Ajay Vora
The improvement in overall survival in children with acute lymphoblastic leukemia (ALL) over the last 5 decades has been considerable, with around 90% now surviving long term. The risk of relapse has been reduced to such an extent that the risk of treatment-related mortality is now approaching that of mortality caused by relapse. Toxicities may also lead to the suboptimal delivery of chemotherapy (treatment delays, dose reductions, dose omissions), potentially increasing relapse risk, and short- and long-term morbidity, adding to the "burden of therapy" in an increasing number of survivors...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29220289/osteosarcoma-chondrosarcoma-and-chordoma
#18
Jeremy S Whelan, Lara E Davis
Osteosarcoma (OS), chondrosarcoma, and chordoma are characterized by multiple challenges to the investigator, clinician, and patient. One consequence of their rarity among sarcomas, as well as their biologic and clinical heterogeneity, is that management guidelines are inadequate to inform the range of individual patient-treatment decisions from diagnosis, approaches to surgery, chemotherapy, radiotherapy, treatment of recurrence, palliative care, and quality of survivorship. Of high-grade sarcomas, OSs are among the most curable, with more than two-thirds of patients with localized disease likely to achieve long-term survival...
December 8, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29218692/euro-b-o-s-s-a-european-study-on-chemotherapy-in-bone-sarcoma-patients-aged-over-40-outcome-in-primary-high-grade-osteosarcoma
#19
Stefano Ferrari, Stefan S Bielack, Sigbjørn Smeland, Alessandra Longhi, Gerlinde Egerer, Kirsten Sundby Hall, Davide Donati, Matthias Kevric, Otte Brosjö, Alessandro Comandone, Mathias Werner, Odd Monge, Emanuela Palmerini, Wolfgang E Berdel, Bodil Bjerkehagen, Anna Paioli, Sylvie Lorenzen, Mikael Eriksson, Marco Gambarotti, Per-Ulf Tunn, Nina L Jebsen, Marilena Cesari, Thekla von Kalle, Virginia Ferraresi, Rudolf Schwarz, Rossella Bertulli, Anne-Katrin Kasparek, Giovanni Grignani, Fatime Krasniqi, Benjamin Sorg, Stefanie Hecker-Nolting, Piero Picci, Peter Reichardt
INTRODUCTION: The EUROpean Bone Over 40 Sarcoma Study (EURO-B.O.S.S.) was the first prospective international study for patients 41-65 years old with high-grade bone sarcoma treated with an intensive chemotherapy regimen derived from protocols for younger patients with high-grade skeletal osteosarcoma. METHODS: Chemotherapy based on doxorubicin, cisplatin, ifosfamide, and methotrexate was suggested, but patients treated with other regimens at the investigators' choice were also eligible for the study...
December 5, 2017: Tumori
https://www.readbyqxmd.com/read/29216766/vanillin-mitigates-the-adverse-impact-of-cisplatin-and-methotrexate-on-rat-kidneys
#20
A A Fouad, W N Al-Melhim
The present study investigated the probable protective effect of vanillin (VLN) against kidney injury induced by cisplatin (CSN) and methotrexate (MTX) in rats. The rats received a single injection of either CSN (7.5 mg/kg, i.p.) or MTX (20 mg/kg, i.p.). VLN treatment (150 mg/kg/day, i.p.) was started 1 day before administration of the nephrotoxic agents and continued for 7 days. Both CSN and MTX significantly increased serum creatinine, cystatin C, and neutrophil gelatinase-associated lipocalin and kidney tissue renal malondialdehyde, inducible nitric oxide synthase, tumor necrosis factor-α, interleukin-18, nuclear factor-κB p65, cytosolic cytochrome C, and caspase-3 and significantly decreased renal total antioxidant capacity and Bcl-2/Bax ratio in rats...
January 1, 2017: Human & Experimental Toxicology
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