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The rational clinical examination

P Gresele, E Falcinelli, L Bury
Inherited platelet function disorders (IPFDs) represent a significant fraction of congenital hemorrhagic disorders, and may be associated with bleeding of considerable severity. IPFDs may be difficult to diagnose and a preliminary accurate clinical examination and an objective evaluation of the severity of the bleeding history are mandatory. The laboratory investigation of IPFDs should follow a rational algorithm based on a streamlined panel of laboratory tests with subsequent steps of increasing levels of complexity...
May 2018: International Journal of Laboratory Hematology
Lei Chen, Hongwen Cao, Chao Yu, Yigeng Feng
Lobaplatin is the third-generation platinum drug that has been shown promising antitumor activity in preclinical studies and clinical trials for multiple human cancers except prostate cancer. In the present study, we investigated the role of lobaplatin on prostate cancer progression and the underlying molecular mechanism. We treated a variety of prostate cancer cell lines with different doses of lobaplatin and examined cell cycle progression, cell apoptosis, cell proliferation and cell migration. Moreover, we also assessed the in vivo antitumor activity of lobaplatin by using xenograft mouse model...
May 7, 2018: Fundamental & Clinical Pharmacology
Xiaolei Pei, Lauriel Freya Earley, Yi He, Xiaojing Chen, Nikita Elexa Hall, Richard Jude Samulski, Chengwen Li
Adeno-associated virus (AAV) vectors have been successfully applied in clinical trials for hemophilic patients. Although promising, the clinical results suggest that the capsid-specific CD8+T cell response has a negative effect on therapeutic success. In an in vitro analysis using an engineered AAV virus carrying immune-dominant SIINFEKL peptide in the capsid backbone, we have previously demonstrated that capsid antigen presentation from full (genome containing) AAV capsids requires endosome escape and is proteasome dependent and that no capsid antigen presentation is induced from empty virions...
2018: Frontiers in Immunology
Dandan Sun, Yupeng Wu, Yan Liu, Jun Yang
BACKGROUND: Primary cardiac myxofibrosarcoma is a very rare cardiac malignancy. The majority of publications are limited to case reports. No pooled analyses of primary cardiac myxofibrosarcoma cases are available. Little clinical features and outcome patterns are acknowledged. The purpose of this study is to identify the clinical characteristics and prognostic factors of primary cardiac myxofibrosarcoma. CASE PRESENTATION: A case report of primary cardiac myxofibrosarcoma was presented, and a review of English language literatures of primary cardiac myxofibrosarcomas were performed electronically...
May 2, 2018: BMC Cancer
Carmen Lage, Andrea Gonzalez Suarez, Ana Pozueta, Javier Riancho, Martha Kazimierczak, Maria Bravo, Julio Jimenez Bonilla, Marıa de Arcocha Torres, Remedios Quirce, Ignacio Banzo, Jose Luis Vazquez-Higuera, Gil D Rabinovici, Eloy Rodriguez-Rodriguez, Pascual Sánchez-Juan
The clinical utility of amyloid positron emission tomography (PET) has not been fully established. Our aim was to evaluate the effect of amyloid imaging on clinical decision making in a secondary care unit and compare our results with a previous study in a tertiary center following the same methods. We reviewed retrospectively 151 cognitively impaired patients who underwent amyloid (Pittsburgh compound B [PiB]) PET and were evaluated clinically before and after the scan in a secondary care unit. One hundred and fifty concurrently underwent fluorodeoxyglucose (FDG)-PET...
April 27, 2018: Journal of Alzheimer's Disease: JAD
Cristina Mora, Valentina Zonca, Marco A Riva, Annamaria Cattaneo
Millions of people worldwide suffer from depression, but despite advances in pharmacological therapies, many patients do not experience symptomatic remission or treatment response, even after treatments with several medications. As such, there is an urgent need to identify biomarkers that can not only predict the treatment response, but also allow a rational selection of optimal therapy for each patient. Areas covered: This review examines the recent findings, coming from different "omic sciences", in human blood-based biomarkers associated with antidepressant treatment response with particular attention on genetic/epigenetic and biochemical biomarkers...
April 27, 2018: Expert Review of Molecular Diagnostics
Virimchi Pillutla, Hannah Maslen, Julian Savulescu
BACKGROUND: In the United Kingdom (UK), a number of National Health Service (NHS) Clinical Commissioning Groups (CCG) have proposed controversial measures to restrict elective surgery for patients who either smoke or are obese. Whilst the nature of these measures varies between NHS authorities, typically, patients above a certain Body Mass Index (BMI) and smokers are required to lose weight and quit smoking prior to being considered eligible for elective surgery. Patients will be supported and monitored throughout this mandatory period to ensure their clinical needs are appropriately met...
April 24, 2018: BMC Medical Ethics
Margaret Brunton, Catherine Cook
BACKGROUND: Several earlier studies have provided evidence of the difficulties nurses have had adapting to foreign workplaces, however few have considered wider perspectives of the workplace communication environment. OBJECTIVE: The aim of this study was to examine the viewpoints and experience of both New Zealand qualified nurses and internationally qualified nurses in managing communication within teams and the clinical practice context in an increasingly diverse healthcare workplace in New Zealand...
April 6, 2018: International Journal of Nursing Studies
Rachel K Rowe, Jordan L Harrison, Timothy W Ellis, P David Adelson, Jonathan Lifshitz
OBJECTIVE Experimental traumatic brain injury (TBI) models hold significant validity to the human condition, with each model replicating a subset of clinical features and symptoms. TBI is the leading cause of mortality and morbidity in children and teenagers; thus, it is critical to develop preclinical models of these ages to test emerging treatments. Midline fluid percussion injury (FPI) might best represent mild and diffuse clinical brain injury because of the acute behavioral deficits, the late onset of behavioral morbidities, and the absence of gross histopathology...
April 20, 2018: Journal of Neurosurgery. Pediatrics
Joseph Piatt
OBJECTIVE An implicit expectation of the pioneers of trauma system design was that high clinical volume at select centers could lead to superior outcomes. There has been little study of the regionalization of pediatric craniospinal trauma care, and whether it continues to trend in the direction of regionalization is unknown. The motivating hypothesis for this study was that trauma system design in the United States is proceeding on a rational basis, producing hospital caseloads that are increasing over time and, because of geographic siting appropriate to the needs of catchment areas, in an increasingly uniform manner...
April 20, 2018: Journal of Neurosurgery. Pediatrics
Vincenzo Manna, Francesca Dicuonzo
In recent years, mature industrial countries are rapidly changing from production economies to service economies. In this new socio-economic context, particular attention has been paid to mental health problems in the workplace. The risk of burnout is significantly higher for certain occupations, in particular for health workers. Doctors and psychiatrists, in particular, quite frequently have to make quick decisions by dealing with a huge amount of requests, which often require considerable assumptions of responsibility...
March 2018: Rivista di Psichiatria
Jiao Mo, Renhua Yang, Fan Li, Xiaochao Zhang, Bo He, Yue Zhang, Peng Chen, Zhiqiang Shen
BACKGROUND: Scutellarin is the major constituent responsible for the clinical benefits of Erigeron breviscapus (Vant.) Hand.-Mazz which finds a long history of ethnopharmacological use in Traditional Chinese Medicine. Scutellarin as a pure compound is now under investigation for its protections against various tissue injuries. PURPOSE: This study aims to examine the effects of scutellarin on oxidative stress-induced vascular endothelial dysfunction and endothelial cell damage, and then to evaluate the therapeutic efficacy of scutellarin in preventing atherosclerosis in rats...
March 15, 2018: Phytomedicine: International Journal of Phytotherapy and Phytopharmacology
Antonio Russo, Marcello Silvestro, Alessandro Tessitore, Gioacchino Tedeschi
INTRODUCTION: in current migraine clinical practice conventional neuroimaging examinations are often sought to exclude possible causes of secondary headaches or migraine-associated disorders. Contrariwise, although advanced magnetic resonance imaging (MRI) has improved tremendously our understanding of human brain processes in migraine patients, to the state of the art they have not superseded the conventional neuroimaging techniques in the migraine clinical setting. METHODS: a comprehensive review was conducted of PubMed citations by entering the key word "marker" AND/OR "biomarker" combined with "migraine" AND/OR "headache...
April 5, 2018: Current Medicinal Chemistry
Arnt Erik Tjønna, Joyce S Ramos, Axel Pressler, Martin Halle, Klaus Jungbluth, Erika Ermacora, Øyvind Salvesen, Jhennyfer Rodrigues, Carlos Roberto Bueno, Peter Scott Munk, Jeff Coombes, Ulrik Wisløff
BACKGROUND: Metabolic syndrome substantially increases risk of cardiovascular events. It is therefore imperative to develop or optimize ways to prevent or attenuate this condition. Exercise training has been long recognized as a corner-stone therapy for reducing individual cardiovascular risk factors constituting the metabolic syndrome. However, the optimal exercise dose and its feasibility in a real world setting has yet to be established. The primary objective of this randomized trial is to investigate the effects of different volumes of aerobic interval training (AIT) compared to the current exercise guideline of moderate-intensity continuous training (MICT) on the composite number of cardiovascular disease risk factors constituting the metabolic syndrome after a 16 week, 1-year, and 3-year follow-up...
April 2, 2018: BMC Public Health
Claudia Fuchs, Norma Fustini, Stefania Trazzi, Laura Gennaccaro, Roberto Rimondini, Elisabetta Ciani
Cyclin-dependent kinase-like 5 (CDKL5) disorder is a severe neurodevelopmental disorder characterized by early-onset epileptic seizures, severe developmental delay, and intellectual disability. To date, no effective pharmacological treatments are available to improve the neurological phenotype that is due to mutations in the CDKL5 gene. Murine models of CDKL5 disorder have recently been generated, making the preclinical testing of pharmacological interventions possible. Using a Cdkl5 knockout (KO) mouse model, we recently demonstrated that deficiency of Cdkl5 causes defects in postnatal hippocampal development and hippocampus-dependent learning and memory...
March 30, 2018: European Journal of Neuroscience
Thomas B Luttrell, Brian Distelberg, Colwick Wilson, Carmen Knudson-Martin, Mary Moline
Assessments of power in couples' relationships often only survey one partner, but they do not take into consideration both partners' perceptions. Thus, many assumptions about power and equality in relationships have not been quantitatively tested due to a lack of dyadic measures of power. Therefore, the purpose of the Gender and Relationships Study was to develop and test a new scale of equality and relative power for couples, the Relationship Balance Assessment (RBA). The RBA may be useful for research and for clinical work with couples to help raise awareness of the balance of power in their relationship...
2018: Contemporary Family Therapy
Chao Cheng, Li Deng, Rongxiu Li
BACKGROUND/AIMS: The abnormally activated EGFR promotes tumor growth, invasion and metastasis. Current therapeutics targeting EGFR have markedly improved the clinical outcome, but they are limited in use due to transient efficacy, frequent administration, high cost and significant toxicity. METHODS: We rationally designed a multiepitope immunogen against EGFR, named as DEGFRm. The immunogen is composed of an epitope peptide (EGFR265-283) and the extracellular domain III (EGFR334-505) of mouse EGFR...
March 20, 2018: Cellular Physiology and Biochemistry
Allah Bukhsh, Muhammad Sarfraz Nawaz, Hafiz Sajjad Ahmed, Tahir Mehmood Khan
BACKGROUND: Diabetes self-care activities, like, healthy diet, regular exercise, self-monitoring of blood glucose, and rational use of medicines are considered to play a vital role in establishing euglycemia. Health literacy among type 2 diabetes mellitus (T2DM) patients in Pakistan is very low, which is the most likely cause for poor clinical outcomes. This study is designed to investigate the impact of pharmacist-led educational intervention on glycemic control, self-care activities and disease knowledge among T2DM patients in Pakistan...
March 2018: Medicine (Baltimore)
Lisanna Lamb, Nadja Affenzeller, Lynn Hewison, Kevin James McPeake, Helen Zulch, Daniel S Mills
Adherence to the advice of medical practitioners is critical to successful treatment outcomes and has been much researched in human health, but is less well studied in the veterinary and clinical animal behavior fields. Given that the management of behavior problems often requires substantial change in established client behavior, it is likely that adherence is a substantive issue affecting success. However, little is known about the relationships between relevant factors, and there is no established way of assessing these...
2018: Frontiers in Veterinary Science
Helen M Golder, Jennifer M Thomson, Stuart E Denman, Chris S McSweeney, Ian J Lean
Dairy heifers were subjected to a non-life-threatening challenge designed to induce ruminal acidosis by feeding grain and sugar. Large among animal variation in clinical signs of acidosis, rumen metabolite concentrations, and the rumen microbiome occurred. This exploratory study investigates sources of the variation by examining associations between the genome, metabolome, and microbiome, albeit with a limited population. The broader objective is to provide a rationale for a larger field study to identify markers for susceptibility to ruminal acidosis...
2018: Frontiers in Genetics
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