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https://www.readbyqxmd.com/read/28431186/unfractionated-heparin-versus-low-molecular-weight-heparins-for-avoiding-heparin-induced-thrombocytopenia-in-postoperative-patients
#1
REVIEW
Daniela R Junqueira, Liliane M Zorzela, Edson Perini
BACKGROUND: Heparin-induced thrombocytopenia (HIT) is an adverse drug reaction presenting as a prothrombotic disorder related to antibody-mediated platelet activation. It is a paradoxical immune reaction resulting in thrombin generation in vivo, which leads to a hypercoagulable state and the potential to initiate venous or arterial thrombosis. A number of factors are thought to influence the incidence of HIT including the type and preparation of heparin (unfractionated heparin (UFH) or low molecular weight heparin (LMWH)) and the heparin-exposed patient population, with the postoperative patient population at higher risk...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28430816/possible-increase-in-insulin-resistance-and-concealed-glucose-coupled-potassium-lowering-mechanisms-during-acute-coronary-syndrome-documented-by-covariance-structure-analysis
#2
Satoshi Ito, Tomohisa Nagoshi, Kosuke Minai, Yusuke Kashiwagi, Hiroshi Sekiyama, Akira Yoshii, Haruka Kimura, Yasunori Inoue, Kazuo Ogawa, Toshikazu D Tanaka, Takayuki Ogawa, Makoto Kawai, Michihiro Yoshimura
OBJECTIVE: Although glucose-insulin-potassium (GIK) therapy ought to be beneficial for ischemic heart disease in general, variable outcomes in many clinical trials of GIK in acute coronary syndrome (ACS) had a controversial impact. This study was designed to examine whether "insulin resistance" is involved in ACS and to clarify other potential intrinsic compensatory mechanisms for GIK tolerance through highly statistical procedure. METHODS AND RESULTS: We compared the degree of insulin resistance during ACS attack and remission phase after treatment in individual patients (n = 104)...
2017: PloS One
https://www.readbyqxmd.com/read/28428883/response-after-treatment-with-pembrolizumab-in-a-patient-with-myelophthisis-due-to-melanoma-the-role-of-checkpoint-inhibition-in-the-bone
#3
Samuel Rosner, Filiz Sen, Michael Postow
BACKGROUND: Myelophthisis due to melanoma is a rare phenomenon. Treatment strategies for patients with this serious complication of malignancy have not been well documented, and none have previously reported efficacy of immune checkpoint inhibition. Since bone metastases are not measurable lesions per standard response criteria, the efficacy of immune checkpoint inhibition in the bones is also not well described. CASE PRESENTATION: We describe a patient with widespread melanoma metastases involving the bone marrow causing myelophthisis and pancytopenia who responded to immune checkpoint inhibition with the anti-programmed cell death-1 (PD-1) inhibitor pembrolizumab...
2017: Journal for Immunotherapy of Cancer
https://www.readbyqxmd.com/read/28427319/mechanobiological-modelling-of-tendons-review-and-future-opportunities
#4
Mark S Thompson, M Nazri Bajuri, Hanifeh Khayyeri, Hanna Isaksson
Tendons are adapted to carry large, repeated loads and are clinically important for the maintenance of musculoskeletal health in an increasing, actively ageing population, as well as in elite athletes. Tendons are known to adapt to mechanical loading. Also, their healing and disease processes are highly sensitive to mechanical load. Computational modelling approaches developed to capture this mechanobiological adaptation in tendons and other tissues have successfully addressed many important scientific and clinical issues...
May 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28426825/levels-of-hiv-1-persistence-on-antiretroviral-therapy-are-not-associated-with-markers-of-inflammation-or-activation
#5
Rajesh T Gandhi, Deborah K McMahon, Ronald J Bosch, Christina M Lalama, Joshua C Cyktor, Bernard J Macatangay, Charles R Rinaldo, Sharon A Riddler, Evelyn Hogg, Catherine Godfrey, Ann C Collier, Joseph J Eron, John W Mellors
Antiretroviral therapy (ART) reduces levels of HIV-1 and immune activation but both can persist despite clinically effective ART. The relationships among pre-ART and on-ART levels of HIV-1 and activation are incompletely understood, in part because prior studies have been small or cross-sectional. To address these limitations, we evaluated measures of HIV-1 persistence, inflammation, T cell activation and T cell cycling in a longitudinal cohort of 101 participants who initiated ART and had well-documented sustained suppression of plasma viremia for a median of 7 years...
April 2017: PLoS Pathogens
https://www.readbyqxmd.com/read/28424766/the-need-for-hematology-nurse-education-in-low-and-middle-income-countries-a-community-case-study-in-tanzania
#6
Julie M Buser
Hematology-related diseases, such as anemia, malaria, sickle cell disease (SCD), and blood cancers, have differing rates of survival between high-income and low- and middle-income countries (LMICs). Nurses in LMICs have an unmet need for specialty training and education to address hematology and hemato-oncology disorders. A gap in the literature exists about hematology nurse education and clinical service demands in LMICs. This community case study documents a collaborative hematology and basic hemato-oncology education program to sustainably strengthen nurse capacity at a national referral hospital and university in Tanzania...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28424055/how-participation-in-surgical-mortality-audit-impacts-surgical-practice
#7
Chi-Wai Lui, Frances M Boyle, Arkadiusz Peter Wysocki, Peter Baker, Alisha D'Souza, Sonya Faint, Therese Rey-Conde, John B North
BACKGROUND: Surgical mortality audit is an important tool for quality assurance and professional development but little is known about the impact of such activity on professional practice at the individual surgeon level. This paper reports the findings of a survey conducted with a self-selected cohort of surgeons in Queensland, Australia, on their experience of participating in the audit and its impact on their professional practice, as well as implications for hospital systems. METHODS: The study used a descriptive cross-sectional survey design...
April 19, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28421842/the-management-of-ventricular-dysrhythmia-in-aconite-poisoning
#8
James M Coulson, Thomas M Caparrotta, John P Thompson
INTRODUCTION: Aconite poisoning is relatively rare but is frequently complicated by ventricular dysrhythmias, which may be fatal. Molecular basis of aconite alkaloid ventricular arrhythmogenicity: Aconite exerts its toxic effects due to the presence of an admixture of alkaloids present in all parts of the plant. The major target of these aconite alkaloids is the fast voltage-gates sodium channel, where they cause persistent activation. This blockade of the channel in the activated state promotes automaticity within the ventricular myocardium and the generation of ventricular arrhythmias...
June 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28421529/suppression-of-methamphetamine-self-administration-by-ketamine-pre-treatment-is-absent-in-the-methylazoxymethanol-mam-rat-model-of-schizophrenia
#9
Jana Ruda-Kucerova, Zuzana Babinska, Tibor Stark, Vincenzo Micale
Ketamine may prove to be a potential candidate in treating the widespread drug addiction/substance abuse epidemic among patients with schizophrenia. Clinical studies have shown ketamine to reduce cocaine and heroin cravings. However, the use of ketamine remains controversial as it may exacerbate the symptoms of schizophrenia. Therefore, the aim of this study is to characterize the effects of ketamine on drug addiction in schizophrenia using the methylazoxymethanol (MAM) acetate rat model on operant IV methamphetamine (METH) self-administration...
April 18, 2017: Neurotoxicity Research
https://www.readbyqxmd.com/read/28420279/responses-of-blood-mononucleated-cells-and-clinical-outcome-of-non-celiac-gluten-sensitive-pediatric-patients-to-various-cereal-sources-a-pilot-study
#10
Patrizia Alvisi, Luigia De Fazio, Maria Chiara Valerii, Elena Cavazza, Angela Salerno, Doriana Lacorte, Giovanni Dinelli, Enzo Spisni
Non-celiac gluten sensitivity (NCGS) is a clinical entity recently documented by the scientific community in pediatric patients. Nevertheless, its triggering mechanisms remain largely unsettled. We studied 11 children with NCGS who were diagnosed based on a clear-cut relationship between wheat consumption and development of symptoms, after excluding celiac disease (CD) and wheat allergy, matched with 18 children with active CD. Sixteen pediatric patients were also enrolled as controls. Cultured peripheral blood mononucleated cells (PBMCs) obtained from NCGS, CD and control patients were cultured in the presence of wheat proteins extracted from ancient and modern cultivars...
April 19, 2017: International Journal of Food Sciences and Nutrition
https://www.readbyqxmd.com/read/28420033/the-current-clinical-knowledge-on-the-treatment-of-gambling-disorder-a-summary
#11
REVIEW
Karel Hloch, Přemysl Mladěnka, Martin Doseděl, Walter Adriani, Francesca Zoratto
Gambling disorder (GD) is a topical problem in developed countries and may be present in 1-3% of the general population. The pathophysiology of this disorder is largely unknown but it shares similarities to other behavioral addictions. Multiple neurotransmitter systems, including dopaminergic, serotonergic, noradrenergic, glutamatergic, and opioidergic, have been implicated in GD. Based on available articles, only the opioid antagonist naltrexone has been documented to demonstrate clinical efficacy in multiple studies including double-blind studies...
April 18, 2017: Synapse
https://www.readbyqxmd.com/read/28419817/objectively-measured-physical-activity-in-patients-after-anterior-cruciate-ligament-reconstruction
#12
David R Bell, Karin A Pfeiffer, Lisa A Cadmus-Bertram, Stephanie M Trigsted, Adam Kelly, Eric G Post, Joseph M Hart, Dane B Cook, Warren R Dunn, Christopher Kuenze
BACKGROUND: Returning to a healthy level of physical activity is among the most commonly discussed clinical goals for patients recovering from anterior cruciate ligament reconstruction (ACLR). However, physical activity has not been objectively measured in this population. PURPOSE: To investigate differences in the mean time (min/d) spent in moderate-to-vigorous physical activity (MVPA) as well as the daily step count (steps/d) between patients who underwent ACLR and matched controls...
April 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28419600/reformulations-of-well-known-active-ingredients-in-the-topical-treatment-of-psoriasis-vulgaris-can-improve-clinical-outcomes-for-patients
#13
REVIEW
L Iversen, E Dauden, S Segaert, K Freeman, S Magina, D Rigopoulos, D Thaci
BACKGROUND: Although the majority of patients with psoriasis vulgaris are treated exclusively with topical therapies, research to develop more effective topical therapies that are associated with higher patient satisfaction has lagged behind the development of systemic agents. OBJECTIVE: The aim of this literature review was to determine whether there is documented evidence that applying an innovative approach to improving the formulation of active ingredients commonly used in the topical treatment of psoriasis can have a positive effect on clinical outcomes and patient-reported outcomes (PROs)...
April 17, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28419179/the-intensity-of-brief-interventions-in-patients-with-acute-alcoholic-pancreatitis-should-be-increased-especially-in-young-patients-with-heavy-alcohol-consumption
#14
Jussi Nikkola, Johanna Laukkarinen, Heini Huhtala, Juhani Sand
Aims: After the first acute alcoholic pancreatitis (AAP), active repeated brief interventions (BIs) have been shown to protect against recurrent acute pancreatitis (RAP). However, in daily hospital practice the treatment of alcohol problems varies. Our aim was to study BIs performed in the clinic during AAP and whether this prevents from future RAP episodes. Methods: Data on all patients discharged between 10/2010 and 10/2012 with acute pancreatitis as the primary diagnosis were obtained from the hospital database...
April 13, 2017: Alcohol and Alcoholism: International Journal of the Medical Council on Alcoholism
https://www.readbyqxmd.com/read/28418205/it-s-not-just-what-you-know-junior-trainees-approach-to-follow-up-and-documentation
#15
Dani C Cadieux, Mark Goldszmidt
CONTEXT: In teaching hospitals, junior trainees (first-year residents and third-year medical students) are responsible for patient follow-up and documentation under the supervision of senior team members. In order to support trainees in their role, supervisors need to understand how trainees approach these tasks and how they can be coached to develop best practices. OBJECTIVES: The purpose of our study was to explore the range of practices used by junior trainees in clinical settings...
April 18, 2017: Medical Education
https://www.readbyqxmd.com/read/28416780/new-onset-epilepsy-in-the-elderly-clinical-radiological-and-electroencephalographic-features-and-treatment-responses
#16
Erum M Shariff, Fahd A AlKhamis
OBJECTIVE: To evaluate new onset epilepsy characteristics, etiology, radiological and electroencephalographic features and to document treatment response in the elderly. METHODS: This was a retrospective study carried out in King Fahd Medical City, Riyadh, Kingdom of Saudi Arabia, from 2010 to 2013. Medical records were searched to recruit patients. Hundred and nineteen patients were enrolled who fulfill the inclusion criteria. Clinical data with respect to seizure semiology, etiology, electroencephalographic findings, radiological findings, co-morbidities, and anti-epileptic drug (AED) therapy were assessed...
April 2017: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
https://www.readbyqxmd.com/read/28416483/sfk-fak-signaling-attenuates-osimertinib-efficacy-in-both-drug-sensitive-and-drug-resistant-models-of-egfr-mutant-lung-cancer
#17
Eiki Ichihara, David Westover, Catherine B Meador, Yingjun Yan, Joshua A Bauer, Pengcheng Lu, Fei Ye, Amanda Kulick, Elisa De Stanchina, Robert McEwen, Marc Ladanyi, Darren Cross, William Pao, Christine M Lovly
Mutant-selective epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI), such as osimertinib, are active agents for the treatment of EGFR-mutant lung cancer. Specifically, these agents can overcome the effects of the T790M mutation, which mediates resistance to first and second-generation EGFR TKI, and recent clinical trials have documented their efficacy in patients with EGFR-mutant lung cancer. Despite promising results, therapeutic efficacy is limited by development of acquired resistance...
April 17, 2017: Cancer Research
https://www.readbyqxmd.com/read/28415828/melatonin-for-the-prevention-and-treatment-of-cancer
#18
REVIEW
Ya Li, Sha Li, Yue Zhou, Xiao Meng, Jiao-Jiao Zhang, Dong-Ping Xu, Hua-Bin Li
The epidemiological studies have indicated a possible oncostatic property of melatonin on different types of tumors. Besides, experimental studies have documented that melatonin could exert growth inhibition on some human tumor cells in vitro and in animal models. The underlying mechanisms include antioxidant activity, modulation of melatonin receptors MT1 and MT2, stimulation of apoptosis, regulation of pro-survival signaling and tumor metabolism, inhibition on angiogenesis, metastasis, and induction of epigenetic alteration...
March 18, 2017: Oncotarget
https://www.readbyqxmd.com/read/28414607/cardiac-arrest-in-an-american-cocker-spaniel-during-a-deep-ear-flush-procedure
#19
Alexandra Gould, Fernando L Garcia-Pereira, W Dunbar Gram
CASE DESCRIPTION A 14-year-old spayed female American Cocker Spaniel with bilateral otitis media and no evidence of cardiovascular instability was anesthetized to allow performance of a deep ear flush. CLINICAL FINDINGS Otoscopic examination of the left ear revealed evidence of chronic inflammation; the ear was flushed with sterile saline (0.9% NaCl) solution. Examination of the right ear revealed more severe chronic inflammation than in the left ear, including a ruptured tympanum (timing of rupture unknown)...
May 1, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28412960/a-randomised-controlled-trial-to-determine-the-clinical-and-cost-effectiveness-of-thulium-laser-transurethral-vaporesection-of-the-prostate-thuvarp-versus-transurethral-resection-of-the-prostate-turp-in-the-national-health-service-nhs-the-unblocs-trial-a-study
#20
Jo Worthington, Hilary Taylor, Paul Abrams, Sara T Brookes, Nikki Cotterill, Sian M Noble, Tobias Page, K Satchi Swami, J Athene Lane, Hashim Hashim
BACKGROUND: Transurethral resection of the prostate (TURP) has been the standard operation for benign prostatic obstruction (BPO) for 40 years, with approximately 25,000 procedures performed annually, and has remained largely unchanged. It is generally a successful operation, but has well-documented risks for the patient. Thulium laser transurethral vaporesection of the prostate (ThuVARP) vaporises and resects the prostate using a surgical technique similar to TURP. The small amount of study data currently available suggests that ThuVARP may have certain advantages over TURP, including reduced blood loss and shorter hospital stay, earlier return to normal activities, and shorter duration of catheterisation...
April 17, 2017: Trials
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