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Medicine, clinical

F Salamanna, V Borsari, D Contartese, N Nicoli Aldini, M Fini
Different fields of cancer management consider bone health to be of increasing clinical importance for patients: 1) presence of bone metastases in many solid tumors, 2) use of bone-targeted treatments in the reduction of bone metastasis, 3) effects of cancer treatment on reproductive hormones, critical for normal bone remodeling maintenance. Additionally, bone microenvironment is further complicated by the decline of ovarian sex steroid production and by the related increase in inflammatory factors linked to menopause, which result in accelerated bone loss and increased risk of osteoporosis (OP)...
June 22, 2018: Breast: Official Journal of the European Society of Mastology
Ilana Dubovi
BACKGROUND: Online computer-based simulations are becoming more widespread in nursing education. Therefore, an understanding of when and how to implement the variety of instructional strategies related to these simulations is fundamental. OBJECTIVES: This study compares the effectiveness of online computer-based simulations designed using two alternative instructional approaches-Productive Failure and Simple-to-Complex sequencing-on learning of clinical reasoning skills...
July 6, 2018: Nurse Education Today
Omid Ghafari, Aram Sharifi, Ali Ahmadi, Bahar Nayeri Fasaei
Streptococcus pneumoniae (pneumococcus) is recognized as one of the major cause of infections in communities and hospitals. In this study, anti-pneumococcal and anti-efflux pump activity of two medicinal plants (Thymus daenensis and Origanum vulgare) essential oils were evaluated. Checkerboard assay test was performed for investigation of the effects of selected EOs on ciprofloxacin and ethidium bromide uptake in pmrA overexpressed fluoroquinolone resistant pneumococcus. Using quantitative real-time RT-PCR the PmrA efflux pump gene (pmrA) expression was evaluated following treatment with selected EOs...
July 14, 2018: Letters in Applied Microbiology
Dee Mangin, Gülistan Bahat, Beatrice A Golomb, Laurie Herzig Mallery, Paige Moorhouse, Graziano Onder, Mirko Petrovic, Doron Garfinkel
Globally, the number of drug prescriptions is increasing causing more adverse drug events, which is now a significant cause of mortality, morbidity, and disability that has reached epidemic proportions. The risk of adverse drug events is correlated to very old age, multiple co-morbidities, dementia, frailty, and limited life expectancy, with the major contributor being polypharmacy. Each characteristic alters the risk-benefit balance of medications, typically reducing anticipated benefits and amplifying risk...
July 14, 2018: Drugs & Aging
Peter Valent, Emir Hadzijusufovic, Thomas Grunt, Heidrun Karlic, Barbara Peter, Harald Herrmann, Gregor Eisenwort, Gregor Hoermann, Axel Schulenburg, Michael Willmann, Rainer Hubmann, Medhat Shehata, Edgar Selzer, Karoline V Gleixner, Thomas Rülicke, Wolfgang R Sperr, Brigitte Marian, Michael Pfeilstöcker, Hubert Pehamberger, Felix Keil, Ulrich Jäger, Christoph Zielinski
In 2008 the Ludwig Boltzmann Cluster Oncology (LBC ONC) was established on the basis of two previous Ludwig Boltzmann Institutes working in the field of hematology and cancer research. The general aim of the LBC ONC is to improve treatment of hematopoietic neoplasms by eradicating cancer-initiating and disease-propagating cells, also known as leukemic stem cells (LSC) in the context of leukemia. In a first phase, the LBC ONC characterized the phenotype and molecular aberration profiles of LSC in various malignancies...
July 13, 2018: Wiener Klinische Wochenschrift
Paolo Fusar-Poli, Joaquim Radua
OBJECTIVE: Evidence syntheses such as systematic reviews and meta-analyses provide a rigorous and transparent knowledge base for translating clinical research into decisions, and thus they represent the basic unit of knowledge in medicine. Umbrella reviews are reviews of previously published systematic reviews or meta-analyses. Therefore, they represent one of the highest levels of evidence synthesis currently available, and are becoming increasingly influential in biomedical literature...
July 13, 2018: Evidence-based Mental Health
Betsy Rolland, Jordan Eschler
Background: Cancer survivorship presents unique medical, psychosocial, and logistical challenges for survivors, their caregivers, and clinicians. NCI-designated Comprehensive Cancer Centers (CCCs) serve a unique role in the delivery of cancer care because they not only provide care but also serve as a model for community oncologists and clinics through the development and dissemination of standards of care. Survivors, their caregivers, and clinicians look to CCCs to provide information about how to navigate the transition from active to posttreatment care...
July 2018: Journal of the National Comprehensive Cancer Network: JNCCN
Fanyi Li, Vinh X Truong, Philipp Fisch, Clara Levinson, Veronica Glattauer, Marcy Zenobi-Wong, Helmut Thissen, John S Forsythe, Jessica E Frith
Current clinical approaches to treat articular cartilage degeneration provide only a limited ability to regenerate tissue with long-term durability and functionality. In this application, injectable bulk hydrogels and microgels containing stem cells can provide a suitable environment for tissue regeneration. However insufficient cell-cell interactions, low differentiation efficiency and poor tissue adhesion hinder the formation of high-quality hyaline type cartilage. Here, we have designed a higher order tissue-like structure using injectable cell-laden microgels as the building blocks to achieve human bone marrow-derived mesenchymal stem cell (hBMSC) long-term maintenance and chondrogenesis...
July 10, 2018: Acta Biomaterialia
Nicolas Broguiere, Florian Formica, Gonçalo Barreto, Marcy Zenobi-Wong
The bacterial ligase Sortase A (SA) and its mutated variants have become increasingly popular over the last years for post-translational protein modifications due to their unparalleled specificity and efficiency. The aim of this work was to study SA as a cross-linking enzyme for hydrogel-based tissue engineering. For this, we optimized SA pentamutant production and purification from E. coli to achieve high yields and purity. Then using hyaluronan (HA) as a model biopolymer and modifying it with SA-substrate peptides, we studied the cross-linking kinetics obtained with SA, the enzyme stability, cytocompatibility, and immunogenicity, and compared those to state-of-the-art standards...
July 10, 2018: Acta Biomaterialia
Kamil Piska, Agnieszka Gunia-Krzyżak, Paulina Koczurkiewicz, Katarzyna Wójcik-Pszczoła, Elżbieta Pękala
Piperlongumine, also known as piplartine, is an amide alkaloid of Piper longum L. (long piper), a medical plant known from Ayurvedic medicine. Although was discovered well over fifty years ago, its pharmacological properties have been uncovered in the past decade. In particular, piperlongumine has been most extensively studied as a potential anticancer agent. Piperlongumine has exhibited cytotoxicity against a broad spectrum of human cancer cell lines, as well as demonstrated antitumor activity in rodents. Piperlongumine has also been found to be a proapoptotic, anti-invasive, antiangiogenic agent and synergize with modern chemotherapeutic agents...
June 25, 2018: European Journal of Medicinal Chemistry
Sreekanth Thota, Daniel A Rodrigues, Pedro de Sena Murteira Pinheiro, Lídia M Lima, Carlos A M Fraga, Eliezer J Barreiro
Over the last two decades, N-acylhydrazone (NAH) has been proven to be a very versatile and promising motif in drug design and medicinal chemistry. Herein, we discuss the current and future challenges in the emergence of bioactive NAH-based scaffolds and to developing strategies to overcome the failures in drug discovery. The NAH-related approved drugs nitrofurazone, nitrofurantoin, carbazochrome, testosterone 17-enanthate 3-benzilic acid hydrazine, nifuroxazide, dantrolene, and azumolene are already used as therapeutics in various countries...
July 9, 2018: Bioorganic & Medicinal Chemistry Letters
Entcho Klenske, Markus F Neurath, Raja Atreya, Timo Rath
With the rapid expansion and diversification of the repertoire of biological agents utilized in inflammatory bowel diseases and cancer and the increase in oncological patients in gastroenterology, visualization of single receptor or molecular target expression and the subsequent initiation of expression tailored therapy are gaining increasing attention. Through the combination of utilizing fluorescently labeled probes with high specificity towards defined molecular targets and their subsequent detection and visualization with endoscopic devices, molecular imaging is a new emerging field focusing on the receptor expression within the mucosa on a cellular level rather than on macroscopic changes...
June 23, 2018: Digestive and Liver Disease
Yoshihiro Asano
No abstract text is available yet for this article.
July 10, 2018: EBioMedicine
Marco Viceconti, Enrico Dall'Ara
Driven by the raising ethical concerns surrounding animal experimentation, there is a growing interest for non-animal methods, in vitro or in silico technologies that can be used to reduce, refine, and replace animal experimentation. In addition, animal experimentation is being critically revised in regard to its ability to predict clinical outcomes. In this manuscript we describe an initial exploration where a set of in vivo imaging based subject-specific technologies originally developed to predict the risk of femoral strength and hip fracture in osteoporotic patients, were adapted to assess the efficacy of bone drugs pre-clinically on mice...
July 10, 2018: Mechanisms of Ageing and Development
Lars Bossen, Alessio Gerussi, Vasiliki Lygoura, George F Mells, Marco Carbone, Pietro Invernizzi
Autoimmune liver diseases (AILDs) are complex conditions, which arise from the interaction between a genetic susceptibility and unknown environmental triggers. They represent a relevant cause of liver failure and liver transplantation worldwide. As a testimony of our progress in understanding the biology of AILDs and the disease progression is the overall median survival which has increased over the last decade. However, there are still major challenges such as the lack of therapies and surveillance strategies in primary sclerosing cholangitis (PSC), the management and treatment of non-responders to first-line therapies in primary biliary cholangitis (PBC) and the need for tailoring immunosuppressive drugs in autoimmune hepatitis (AIH)...
July 10, 2018: Autoimmunity Reviews
Alessandra Ferrario
OBJECTIVES: First, to quantify the median time from European Union (EU)-wide approval to first use (launch) for a sample of cancer medicines and number of launches in Belgium, Estonia, Scotland, and Sweden as of June 2015. Second, to assess whether longer times to launch or lack of launches affected medicines with high or low expected additional clinical benefit. Third, to identify possible determinants of the probability of a cancer medicine to be launched. METHODS: Correlation between time to launch and a set of variables hypothesized to affect launch was tested using a complementary log-log model for a sample of 46 cancer medicines that obtained EU-wide marketing authorization between 2000 and 2014...
July 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Maria Schubert, Roger Schürch, Soenke Boettger, David Garcia Nuñez, Urs Schwarz, Dominique Bettex, Josef Jenewein, Jasmina Bogdanovic, Marina Lynne Staehli, Rebecca Spirig, Alain Rudiger
BACKGROUND: Delirium is a well-known complication in cardiac surgery and intensive care unit (ICU) patients. However, in many other settings its prevalence and clinical consequences are understudied. The aims of this study were: (1) To assess delirium prevalence in a large, diverse cohort of acute care patients classified as either at risk or not at risk for delirium; (2) To compare these two groups according to defined indicators; and (3) To compare delirious with non-delirious patients regarding hospital mortality, ICU and hospital length of stay, nursing hours and cost per case...
July 13, 2018: BMC Health Services Research
Yuki Maruchi, Masanobu Tsuda, Hisatake Mori, Nobuyoshi Takenaka, Takayoshi Gocho, Muhammad A Huq, Naoshi Takeyama
BACKGROUND: Recent studies have suggested that excessive formation of neutrophil extracellular traps (NETs) plays a critical role in the pathogenesis of sepsis. Although elevation of the plasma level of cell-free DNA (cf-DNA) has been reported in sepsis patients, there has been little direct measurement of circulating free NETs such as myeloperoxidase-conjugated DNA (MPO-DNA). The objectives of this study were to detect NETs in the bloodstream of patients with septic shock, and to assess the correlations of circulating NET levels with organ dysfunction, disease severity, and mortality...
July 13, 2018: Critical Care: the Official Journal of the Critical Care Forum
Wendell W Hoffman
All social reform, as evidenced by Martin Luther, requires disrupters who are willing to speak truth to power. Donald Berwick, as the most Lutheresque figure in the healthcare reform debate, has been doing just that, having defined the singular truth of patient-centeredness and its implications for both the regulated and unregulated parts of medicine. He has consequently been asking wicked questions concerning unproven assumptions, such as competition driven by the integer, over cooperation driven by the immortal...
July 2018: South Dakota Medicine: the Journal of the South Dakota State Medical Association
Jan Valentini, Katharina Glassen, Christiane Eicher, Phoebe Washington-Dorando, Stefan Weinschenk, Berthold Musselmann, Jost Steinhaeuser, Stefanie Joos
BACKGROUND:  In 2002, the new version of the German Medical Licensure Act integrated Naturopathy and Complementary Medicine into the cross-sectoral unit 12 "Rehabilitation, Physical Medicine and Naturopathy" (QB12) of the medical undergraduate course. At the University of Heidelberg, Complementary Medicine (CAM) is an obligatory clinical subject of the medical undergraduate curriculum and is delivered in the form of lectures and small group work. As a central educational objective, medical students should be able to explain the principles of classical Naturopathy and the most commonly used CAM procedures...
July 2018: Deutsche Medizinische Wochenschrift
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