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https://www.readbyqxmd.com/read/28086758/toxoplasmosis-associated-iris-involving-the-cns-a-case-report-with-longitudinal-analysis-of-t-cell-subsets
#1
Rita Rb-Silva, Claudia Nobrega, Eugénia Reiriz, Soraia Almeida, Rui Sarmento-Castro, Margarida Correia-Neves, Ana Horta
BACKGROUND: HIV-infected patients may present an unforeseen clinical worsening after initiating antiretroviral therapy known as immune reconstitution inflammatory syndrome (IRIS). This syndrome is characterized by a heightened inflammatory response toward infectious or non-infectious triggers, and it may affect different organs. Diagnosis of IRIS involving the central nervous system (CNS-IRIS) is challenging due to heterogeneous manifestations, absence of biomarkers to identify this condition, risk of long-term sequelae and high mortality...
January 13, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28062372/uric-acid-may-be-protective-against-cognitive-impairment-in-older-adults-but-only-in-those-without-cardiovascular-risk-factors
#2
Busra Tuven, Pinar Soysal, Gulcin Unutmaz, Derya Kaya, Ahmet Turan Isik
Uric acid (UA) may not only prevent development of cognitive dysfunction owing to its antioxidant efficacy, but also may worsen cognitive functions by gaining pro-oxidant character. The present study attempts to uncover this paradoxical association between UA and cognitive impairment in elderly. 1374 elderly patients were retrospectively evaluated and included in the study. Participants underwent determination of circulating UA levels and comprehensive geriatric assessment. A serum UA concentration≥7.0mg/dL in males and ≥5...
January 3, 2017: Experimental Gerontology
https://www.readbyqxmd.com/read/28058156/paradoxical-worsening-of-tubercular-serpiginous-like-choroiditis-after-initiation-of-antitubercular-therapy
#3
Ebru Esen, Selçuk Sızmaz, Zeynep Kunt, Nihal Demircan
In this study, a case with tubercular choroiditis showing severe macular edema and progression of choroidal lesions following initiation of antitubercular treatment is presented and the management of posterior uveitis associated with tuberculosis is evaluated. A 40-year-old female patient was admitted with decreased vision in her right eye and her fundoscopic examination revealed serpiginous choroiditis. It was learned from her medical history that she had taken antitubercular therapy 9 years ago. Mantoux tuberculin skin test showed an area of induration measuring 15 mm and a positive interferon-gamma release assay was documented...
August 2016: Turkish Journal of Ophthalmology
https://www.readbyqxmd.com/read/28003028/worsening-cholestasis-and-possible-cefuroxime-induced-liver-injury-following-successful-therapeutic-endoscopic-retrograde-cholangiopancreatography-for-a-distal-common-bile-duct-stone-a-case-report
#4
Madunil Anuk Niriella, Ravindu Sujeewa Kumarasena, Anuradha Supun Dassanayake, Aloka Pathirana, Janaki de Silva Hewavisenthi, Hithanadura Janaka de Silva
BACKGROUND: Cefuroxime very rarely causes drug-induced liver injury. We present a case of a patient with paradoxical worsening of jaundice caused by cefuroxime-induced cholestasis following therapeutic endoscopic retrograde cholangiopancreatography for a distal common bile duct stone. CASE PRESENTATION: A 51-year-old, previously healthy Sri Lankan man presented to our hospital with obstructive jaundice caused by a distal common bile duct stone. Endoscopic retrograde cholangiopancreatography with stone extraction, common bile duct clearance, and stenting failed to improve the cholestasis, with paradoxical worsening of his jaundice...
December 21, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27998382/the-ptsd-osa-paradox-they-are-commonly-associated-and-they-worsen-outcomes-but-treatment-nonadherence-is-common-and-the-therapeutic-effect-limited-what-are-clinicians-to-do
#5
Christopher J Lettieri, Scott G Williams
No abstract text is available yet for this article.
December 16, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/27936971/drug-reaction-with-eosinophilia-and-systemic-symptoms-dress-incidence-pathogenesis-and-management
#6
Tetsuo Shiohara, Yoko Kano
Drug-induced hypersensitivity syndrome(DiHS), often referred to as drug reaction with eosinophilia and systemic symptoms (DRESS), is a life-threatening multi-organ system reaction induced by drugs and associated with sequential reactivations of herpesviruses. This syndrome has several unique features, creating uncertainty over whether it represents true drug eruption. Areas covered: A literature review of all the cases was made by a Pub Med search. The delayed onset, paradoxical worsening of clinical symptoms after withdrawal of the causative drug and unexplained cross-reactivity to multiple drugs are unique features of this syndrome, which could prompt infection to be an initial consideration...
December 21, 2016: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/27931553/change-in-left-ventricular-systolic-function-in-patients-with-st-elevation-myocardial-infarction-evidence-for-smoker-s-paradox-or-pseudo-paradox
#7
Burak Acar, Ozcan Ozeke, Sefa Unal, Mustafa Karakurt, Meryem Kara, Ozgur Kirbas, Fatih Sen, Ahmet Korkmaz, Dursun Aras, Sinan Aydogdu
BACKGROUND: The 'smoker's paradox' refers to the observation of favorable prognosis in current smokers following an acute ST elevation myocardial infarction (STEMI) in the era of fibrinolysis, however, several STEMI studies have demonstrated conflicting results in patients undergoing primary percutaneous coronary intervention (p-PCI). OBJECTIVE: Aim of the current study was to evaluate the impact of cigarette smoking on left ventricular function in STEMI patients undergoing p-PCI...
November 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27914574/biological-therapies-immunomodulatory-drugs-worsening-of-psoriasis-and-rebound-effect-new-evidence-of-similitude
#8
REVIEW
Marcus Zulian Teixeira
BACKGROUND: Employing the secondary action or adaptative reaction of the organism as therapeutic response, homeopathy uses the treatment by similitude (similia similibus curentur) administering to sick individuals the medicines that caused similar symptoms in healthy individuals. Such homeostatic or paradoxical reaction of the organism is scientifically explained through the rebound effect of drugs, which cause worsening of symptoms after withdrawal of several palliative treatments. Despite promoting an improvement in psoriasis at the beginning of the treatment, modern biological therapies provoke worsening of the psoriasis (rebound psoriasis) after discontinuation of drugs...
November 2016: Homeopathy: the Journal of the Faculty of Homeopathy
https://www.readbyqxmd.com/read/27904430/natalizumab-related-progressive-multifocal-leukoencephalopathy-immune-reconstitution-inflammatory-syndrome-a-case-report-highlighting-clinical-and-mri-features
#9
Bela Purohit, Eranga Ganewatte, Spyros S Kollias
Multiple sclerosis (MS) patients treated with natalizumab often face the uncommon but severe complication of developing progressive multifocal leukoencephalopathy (PML). PML may be further complicated by immune reconstitution inflammatory syndrome (IRIS) after the removal of the drug. Since both PML and IRIS are associated with high morbidity and mortality rates, early clinical and radiological diagnosis of these complications is of paramount importance. Here, we report a case of an adult male patient who was diagnosed with PML after receiving natalizumab therapy for 6 years for the treatment of MS...
September 2016: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/27865719/pre-load-induced-changes-in-forward-lv-stroke-and%C3%A2-functional-mitral%C3%A2-regurgitation-echocardiographic-detection-of-the-descending-limb%C3%A2-of%C3%A2-starling-s-curve
#10
Yukio Abe, Kanako Akamatsu, Atsuko Furukawa, Kazato Ito, Yoshiki Matsumura, Kazuo Haze, Takahiko Naruko, Minoru Yoshiyama, Junichi Yoshikawa
OBJECTIVES: To clarify the prognostic significance of diagnosing whether the failing heart is functioning on the descending limb of the Starling curve by using echocardiography with passive leg lifting (PLL). BACKGROUND: Patients with advanced heart failure can shift to the descending limb of the Starling curve, in which pre-load does not lead to an expected increase in forward left ventricular stroke volume (LVSV). METHODS: Thirty-five consecutive patients with left ventricular (LV) ejection fraction of <40% underwent echocardiography at rest during baseline and during PLL to increase pre-load...
November 10, 2016: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27856941/the-quest-to-extend-health-services-to-vulnerable-substance-users-in-rio-de-janeiro-brazil-in-the-context-of-an-unfolding-economic-crisis
#11
Noa Krawczyk, Deanna Kerrigan, Francisco Inácio Bastos
Calls to address crack-cocaine use in Brazil among homeless and street-frequenting populations who are in urgent need of health services have questioned the capacity of the Brazilian Unified Health System to attend to the nation's most marginalized citizens. In recent years, Brazil has launched several actions to escalate care for substance users, yet many obstacles hindering accessibility and effectiveness of services remain. Paradoxically, these actions have been implemented in the context of a growing economic crisis, and expanding services for a population of poor and stigmatized substance users while cutting other government programs tends to elicit harsh criticism from citizens...
November 16, 2016: International Journal of Health Services: Planning, Administration, Evaluation
https://www.readbyqxmd.com/read/27807490/a-case-of-tuberculous-meningitis-with-paradoxical-response-in-a-14-year-old-boy
#12
Murat Özer, Yasemin Özsürekci, Ali Bülent Cengiz, Nagehan Emiralioğlu, Deniz Doğru, Kader Karlı Oğuz, Onur Akça, Özgür Özkayar
A clinical or radiological worsening of already existing lesions or an emergence of new lesions after beginning treatment in patients with tuberculosis (TB) is referred to as the paradoxical response. This has aroused suspicion regarding the accuracy of diagnosis, the possibilities of treatment failure, or the presence of another underlying disease, and thus it is an important topic for clinicians to understand. In this article, the development of a paradox reaction in a 14-year-old male patient diagnosed with and treated for tuberculosis meningitis is reported...
2016: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/27793583/assessment-of-human-tribbles-homolog-3-genetic-variation-rs2295490-effects-on-type-2-diabetes-patients-with-glucose-control-and-blood-pressure-lowering-treatment
#13
Fazhong He, Mouze Liu, Zhangren Chen, Guojing Liu, Zhenmin Wang, Rong Liu, Jianquan Luo, Jie Tang, Xingyu Wang, Xin Liu, Honghao Zhou, Xiaoping Chen, Zhaoqian Liu, Wei Zhang
Effects of human tribbles homolog 3 (TRIB3) genetic variation (c.251 A>G, Gln84Arg, rs2295490) on the clinical outcomes of vascular events has not been evaluated in patients with type 2 diabetes after blood pressure lowering and glucose controlling treatment. We did an analysis of a 2×2 factorial (glucose control axis and blood pressure lowering axis) randomized controlled clinical trial at 61 centers in China, with a follow-up period of 5years. The major vascular endpoints were the composites of death from cardio-cerebral vascular diseases, non-fatal stroke and myocardial infraction, new or worsening renal and diabetic eye disease...
November 2016: EBioMedicine
https://www.readbyqxmd.com/read/27786246/hiv-associated-opportunistic-cns-infections-pathophysiology-diagnosis-and-treatment
#14
REVIEW
Lauren N Bowen, Bryan Smith, Daniel Reich, Martha Quezado, Avindra Nath
Nearly 30 years after the advent of antiretroviral therapy (ART), CNS opportunistic infections remain a major cause of morbidity and mortality in HIV-positive individuals. Unknown HIV-positive disease status, antiretroviral drug resistance, poor drug compliance, and recreational drug abuse are factors that continue to influence the morbidity and mortality of infections. The clinical and radiographic pattern of CNS opportunistic infections is unique in the setting of HIV infection: opportunistic infections in HIV-positive patients often have characteristic clinical and radiological presentations that can differ from the presentation of opportunistic infections in immunocompetent patients and are often sufficient to establish the diagnosis...
October 27, 2016: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/27783331/psoriasiform-eruption-and-worsening-of-pustulosis-palmoplantaris-after-treatment-with-two-anti-tnf-%C3%AE-inhibitors-followed-by-successful-treatment-with-ustekinumab
#15
Nathalie A Bogaards, Menno A de Rie
INTRODUCTION: Tumor necrosis factor (TNF)-α inhibitors are widely used for the treatment of inflammatory diseases. One of the side effects of TNF-inhibitors is the development of a psoriatiform eruption, also known as paradoxical psoriasis. In this case report, we describe a patient with this side effect after treatment with adalimumab and etanercept. CASE REPORT: A 45-year-old female was treated with adalimumab 40 mg once every 2 weeks for pustulosis palmoplantaris and psoriatic arthritis...
December 2016: Dermatology and Therapy
https://www.readbyqxmd.com/read/27780998/detention-of-people-lost-to-follow-up-on-tb-treatment-in-kenya-the-need-for-human-rights-based-alternatives
#16
Gitau Mburu, Enrique Restoy, Evaline Kibuchi, Paula Holland, Anthony D Harries
Adherence to treatment is a key element for global TB control. Public health laws can be used to enforce isolation, adherence, and completion of TB treatment. However, the practical application of public health laws can potentially range from voluntary measures to involuntary detention approaches. This paper explores the potential risks and impacts of using detention approaches to enforce TB treatment adherence. In August 2015, we conducted a literature search regarding the application of public health laws to enforce adherence to TB treatment globally, and specifically in Kenya...
June 2016: Health and Human Rights
https://www.readbyqxmd.com/read/27748793/paradoxical-worsening-of-truncal-acne-with-doxycycline
#17
Pei Ming Yeo, Wei Liang Koh, Chia Chun Ang, Regina Sp Lim
No abstract text is available yet for this article.
September 2016: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/27742504/skull-base-osseous-arteriovenous-fistula-a-rare-clinical-entity-case-report-and-literature-review
#18
Aneesh Mohimen, Santhosh Kumar Kannath, E R Jayadevan
PURPOSE: To describe a rare clinical entity of intraosseous skull base arteriovenous fistula managed with transvenous fistula embolization. CASE PRESENTATION: A 57-year-old woman presented with complaints of headache and episodic tinnitus with progressive left-sided visual deterioration. Cross-sectional imaging of the head revealed multiple vascular channels in the sphenoid bone and in bilateral masticator spaces. Catheter angiography showed the presence of a large osseous arteriovenous fistula epicentered in the body of sphenoid and left pterygoid plates with arterial feeders from bilateral external carotid arteries and venous drainage into bilateral cavernous sinuses and the pterygoid venous plexus...
October 11, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27727478/injections-of-intravenous-contrast-for-computerized-tomography-scans-precipitate-migraines-in-hereditary-hemorrhagic-telangiectasia-subjects-at-risk-of-paradoxical-emboli-implications-for-right-to-left-shunt-risks
#19
Trishan Patel, Amy Elphick, James E Jackson, Claire L Shovlin
OBJECTIVE: To evaluate if injection of intravenous particles may provoke migraines in subjects with right-to-left shunts due to pulmonary arteriovenous malformations (AVMs). BACKGROUND: Migraine headaches commonly affect people with hereditary hemorrhagic telangiectasia (HHT), especially those with pulmonary AVMs that provide right-to-left shunts. In our clinical practice, patients occasionally reported acute precipitation of migraine headaches following injection of technetium-labeled albumin macroaggregates for nuclear medicine scans...
November 2016: Headache
https://www.readbyqxmd.com/read/27722830/when-global-rating-of-change-contradicts-observed-change-examining-appraisal-processes-underlying-paradoxical-responses-over-time
#20
Carolyn E Schwartz, Victoria E Powell, Bruce D Rapkin
AIMS: Interpreting change scores is challenging when patients' global rating of change (GRC) scores contradict their observed change scores. We examine appraisal processes associated with having GRC-observed change contradictions. METHODS: This secondary analysis of longitudinal multiple sclerosis (MS) registry data examined predictors of GRC scores in the whole sample (n = 858). Logistic modeling then examined predictors of membership in one of two paradoxical subgroups (n = 525): (a) Worsened GRC with unchanged observed Rand-12 Mental Component scores (MCS) (Symptom-Maximizers, n = 171) versus no change GRC among stable MCS subsample; and (b) same GRC with declined observed MCS scores (Symptom-Minimizers, n = 84) versus declining GRC among declining MCS subsample...
October 8, 2016: Quality of Life Research
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