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https://www.readbyqxmd.com/read/29903693/mechanical-circulatory-support-in-patients-with-cardiogenic-shock-in-intensive-care-units-a-position-paper-of-the-unit%C3%A3-de-soins-intensifs-de-cardiologie-group-of-the-french-society-of-cardiology-endorsed-by-the-groupe-ath%C3%A3-rome-et-cardiologie-interventionnelle
#1
REVIEW
Laurent Bonello, Clement Delmas, Guillaume Schurtz, Guillaume Leurent, Eric Bonnefoy, Nadia Aissaoui, Patrick Henry
Cardiogenic shock (CS) is a major challenge in contemporary cardiology. Despite a better understanding of the pathophysiology of CS, its management has only improved slightly. The prevalence of CS has remained stable over the past decade, but its outcome has seen few improvements, with the 1-month mortality rate still in the range of 40-60%. Inotropes and vasopressors are the first-line therapies for CS, but they are associated with significant hazards, and have well-known deleterious effects. Furthermore, a significant number of patients develop refractory CS with haemodynamic instability, causing critical organ hypoperfusion and/or pulmonary congestion, despite increasing doses of catecholamines...
June 11, 2018: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29899889/acute-myeloid-leukemia-chimeric-antigen-receptor-t-cell-immunotherapy-how-far-up-the-road-have-we-traveled
#2
REVIEW
Sarah K Tasian
Chemotherapy resistance and relapse remain significant sources of mortality for children and adults with acute myeloid leukemia (AML). Further intensification of conventional cytotoxic chemotherapy is likely not feasible due to the severity of acute and long-term side effects upon normal tissues commonly induced by these drugs. Successful development and implementation of new precision medicine treatment approaches for patients with AML, which may improve leukemia remission and diminish toxicity, is thus a major priority...
June 2018: Therapeutic Advances in Hematology
https://www.readbyqxmd.com/read/29896891/succeed-supporting-a-comprehensive-coordinated-evaluation-of-the-elderly-with-diabetes-integrating-cognitive-physical-assessment-into-the-evaluation-process
#3
Rachel Natovich, Noa Gayus, Michal Azmon, Hila Michal, Omri Gury Twito, Tomer Yair, Romi Noy Achiron, Neta Kraviz, Nadia Mordenfeld, Tali Cukierman-Yaffe
BACKGROUND: Successful aging with diabetes is challenged by co-morbidities which may present barriers to self-care. Currently, measurement of physical and cognitive status is not part of routine care of the older person with diabetes and these are not taken into account when devising the treatment plan. OBJECTIVE: To describe a novel approach that integrates cognitive and physical assessment into the routine evaluation of the older person with diabetes & the tailor-made treatment plan devised accordingly...
June 13, 2018: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/29894495/assessment-of-the-relationship-between-diabetes-treatment-intensification-and-quality-measure-performance-using-electronic-medical-records
#4
Renée J G Arnold, Shuo Yang, Edward J Gold, Sepehr Farahbakhshian, John J Sheehan
AIMS: Assess the relationship between timely treatment intensification and hemoglobin A1C (HbA1C) control quality-of-care performance measures, i.e., HbA1C levels, among patients with uncontrolled type 2 diabetes. MATERIALS AND METHODS: Electronic medical records and diabetes registry data from a large, accountable care organization (ACO) were used to isolate a sample of adult patients with type 2 diabetes who received at least one oral antidiabetes agent and had at least one HbA1C level measurement ≥8...
2018: PloS One
https://www.readbyqxmd.com/read/29890171/weight-loss-strategies-for-treatment-of-obesity-lifestyle-management-and-pharmacotherapy
#5
REVIEW
Robert F Kushner
Obesity is one of the most serious and prevalent non-communicable diseases of the twenty-first century. It is also a patient-centered condition in which affected individuals seek treatment through a variety of commercial, medical and surgical approaches. Considering obesity as a chronic medical disease state helps to frame the concept of using a three-stepped intensification of care approach to weight management. As a foundation, all patients should be counseled on evidence-based lifestyle approaches that include diet, physical activity and behavior change therapies...
June 8, 2018: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29871814/potential-of-memory-t-cells-in-bridging-preoperative-chemoradiation-and-immunotherapy-in-rectal-cancer
#6
REVIEW
Sven de Mey, Heng Jiang, Hui Wang, Benedikt Engels, Thierry Gevaert, Inès Dufait, Olivier Feron, Joeri Aerts, Valeri Verovski, Mark De Ridder
The management of locally advanced rectal cancer has passed a long way of developments, where total mesorectal excision and preoperative radiotherapy are crucial to secure clinical outcome. These and other aspects of multidisciplinary strategies are in-depth summarized in the literature, while our mini-review pursues a different goal. From an ethical and medical standpoint, we witness a delayed implementation of novel therapies given the cost/time consuming process of organizing randomized trials that would bridge an already excellent local control in cT3-4 node-positive disease with long-term survival...
June 2, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/29807374/-diabetes-mellitus-type-2-recent-publications-and-new-drugs
#7
Ulf Elbelt
Since 2013 several placebo-controlled cardiovascular outcomes trails on new classes of glucose-lowering agents in addition to standard care have been reported. These trails were designed to demonstrate non-inferiority to placebo with regard to cardiovascular safety for patients with type 2 diabetes mellitus at high cardiovascular risk.For the glucagon-like peptide 1 (GLP-1)-receptor agonists liraglutide and semaglutide as well as for the sodium-glucose cotransporter-2 (SGLT-2) inhibitors empagliflozin and canagliflozin statistically significant reductions of the primary composite outcome (nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death) were demonstrated...
June 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29794644/increased-survival-for-children-with-acute-myeloid-leukemia-results-from-improved-postrelapse-treatment
#8
Aditi Vedi, Richard Mitchell, Sunita Shanmuganathan, Cecilia Oswald, Glenn M Marshall, Toby Trahair, Siva Sivarajasingam, David S Ziegler
BACKGROUND: The treatment for pediatric acute myeloid leukemia (AML) has not changed significantly over the past 3 decades, yet outcomes have improved with cure rates increasing from 30% to over 60% of all newly diagnosed children over this period. This improvement in survival has been attributed to both treatment intensification and improved supportive care over the decades, although the precise impact of each remains unknown. PATIENTS AND METHODS: We retrospectively analyzed a unique cohort of 276 patients with de novo AML diagnosed in childhood, all treated with the same chemotherapy protocol over a 25-year period from 1986 to 2012...
May 22, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29788908/perceptions-of-insulin-use-in-type-2-diabetes-in-primary-care-a-thematic-synthesis
#9
Kathy Ellis, Henrietta Mulnier, Angus Forbes
BACKGROUND: Increasing numbers of patients with type 2 diabetes mellitus are progressing to insulin therapy, and despite its potency many such individuals still have suboptimal glycaemic control. Insulin initiation and intensification is now often conducted by Practice Nurses and General Practitioners in many parts of the UK. Therefore, gaining insight into perspectives of patients and primary care clinicians is important in determining self-management and engagement with insulin. A thematic synthesis of studies was conducted exploring the views and experiences of people with type 2 diabetes and of healthcare professionals on insulin use and management in the context of primary care...
May 22, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29768945/pharmacist-impact-on-treatment-intensification-and-hemoglobin-a-1c-in-patients-with-type-2-diabetes-mellitus-at-an-academic-health-center
#10
Kevin Cowart, Karen Sando
BACKGROUND: Achievement of treatment goals for patients with type 2 diabetes mellitus (T2DM) is suboptimal. This is in part driven by a lack of treatment intensification when warranted, termed "clinical inertia." OBJECTIVES: To investigate time to treatment intensification and changes in A1C among pharmacist-physician managed (PPM) patients compared to usual medical care (UMC) in patients with T2DM. METHODS: Retrospective matched cohort study at 2 academic family medicine clinics...
January 1, 2018: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29764405/urinary-iodine-concentration-and-thyroid-volume-of-pregnant-women-attending-antenatal-care-in-two-selected-hospitals-in-ashanti-region-ghana-a-comparative-cross-sectional-study
#11
Daniel Gyamfi, Yaw Amo Wiafe, Kwabena Owusu Danquah, Ernest Adankwah, Gertrude Akua Amissah, Angela Odame
BACKGROUND: Iodine deficiency is a major public health problem affecting people worldwide, particularly pregnant women. Iodine requirements increase substantially during pregnancy making pregnant women vulnerable to iodine deficiency and its disorders such as abortions, stillbirths and pregnancy goitre as well as congenital abnormalities, cretinism and mental retardation in their children. The primary aim of this study was to evaluate the prevalence of iodine deficiency and goitre among pregnant women attending antenatal sessions at two selected hospitals in Ashanti region, Ghana...
May 15, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29753733/coronary-computed-tomographic-angiography-findings-and-their-therapeutic-implications-in-asymptomatic-patients-with-familial-hypercholesterolemia-lessons-from-the-safeheart-study
#12
Leopoldo Pérez de Isla, Rodrigo Alonso, Ovidio Muñiz-Grijalvo, José Luis Díaz-Díaz, Daniel Zambón, José Pablo Miramontes, Francisco Fuentes, José Juan Gómez de Diego, Aurora González-Estrada, Nelva Mata, Adriana Saltijeral, Manuel Barreiro, Marta Tomás, Raimundo de Andrés, Rosa Argüeso, Maria Pilar Serrano Gotarredona, Silvia Navarro Herrero, Rosario J Perea Palazón, Teresa M de Caralt, Luisa Arrojo Suárez de Centi, Svetlana Zhilina, Simona Espejo Pérez, Teresa Padró, Pedro Mata
BACKGROUND: Familial hypercholesterolemia (FH) confers an increased risk of premature atherosclerotic disease. Coronary computed tomographic angiography (CTA) can assess preclinical coronary atherosclerosis. OBJECTIVES: To describe coronary CTA findings in asymptomatic molecularly defined FH individuals, to identify those factors related to its presence and extension, and to assess the impact of these results in patients' care and estimated risk. METHODS: Four hundred and forty individuals with FH, without clinical cardiovascular disease, were consecutively enrolled and underwent a coronary CTA that was used to analyze coronary atherosclerosis based on coronary calcium score (CCS), sum of stenosis severity, and plaque composition sum (PCS)...
April 17, 2018: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/29743340/androgen-and-estrogen-action-on-male-physical-activity-a-story-beyond-muscle
#13
Ferran Jardi, Michaël R Laurent, Vanessa Dubois, Nari Kim, Rougin Khalil, Brigitte Decallonne, Dirk Vanderschueren, Frank Claessens
Physical inactivity is a pandemic that contributes to several chronic diseases and poses a significant burden on health care systems worldwide. The search for effective strategies to combat sedentary behavior has led to an intensification of the research efforts to unravel the biological substrate controlling activity. A wide body of preclinical evidence makes a strong case for sex steroids regulating physical activity in both genders, albeit the mechanisms implicated remain unclear. The beneficial effects of androgens on muscle as well as on other peripheral functions might play a role in favoring adaptation to exercise...
May 9, 2018: Journal of Endocrinology
https://www.readbyqxmd.com/read/29727296/croi-2018-advances-in-antiretroviral-therapy
#14
Hong-Van Tieu, Barbara S Taylor, Joyce Jones, Timothy J Wilkin
The 2018 Conference on Retroviruses and Opportunistic Infections (CROI) showcased exciting data on new investigational agents including MK-8591 and tri-specific antibody targeting 3 highly conserved epitopes on HIV-1 in a single antibody. Clinical trials of initial antiretroviral therapy (ART) and switch studies involving bictegravir/emtricitabine/tenofovir alafenamide were presented. Intensification of initial ART with integrase strand transfer inhibitors did not increase the risk of immune reconstitution inflammatory syndrome...
May 2018: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/29707875/a-practical-approach-and-algorithm-for-intensifying-beyond-basal-insulin-in-type-2-diabetes
#15
REVIEW
Ronald M Goldenberg, Peter Assimakopoulos, Jeremy D Gilbert, Irving S Gottesman, Jean-François Yale
Despite the availability of long-term data demonstrating the benefits of timely and aggressive intensification of antihyperglycaemic regimens among individuals with type 2 diabetes, intensification beyond basal insulin continues to be suboptimal and a global challenge. This review summarises the evidence surrounding the various options of advancing glucose-lowering management beyond basal insulin and provides a practical algorithm to assist in optimising patient care and enhancing glycaemic target achievements...
April 29, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29672887/young-age-is-associated-with-increased-rates-of-residual-and-recurrent-paediatric-differentiated-thyroid-carcinoma
#16
Sarah Hampson, Derek Stephens, Jonathan D Wasserman
OBJECTIVE: Differentiated thyroid carcinoma is rare in young children. There are conflicting data as to whether disease in this age group differs from that in adolescents and specifically, if it is more aggressive. Current practice guidelines do not differentiate treatment between these groups, but speculate that differences may exist. We sought to compare clinical features, treatment and outcomes between children (<12 years) and adolescents (12-18 years) with thyroid nodules and thyroid malignancy over a 20-year period...
April 19, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29615967/therapeutic-inertia-in-the-new-landscape-of-multiple-sclerosis-care
#17
Gustavo Saposnik, Xavier Montalban
The landscape of multiple sclerosis (MS) treatment is constantly changing. Significant heterogeneity exists in the efficacy and risks associated with these therapies. Therefore, clinicians have the challenge to tailor treatment based on several factors (disease activity level, risk of progression, individual patient preferences and characteristics, personal expertise, etc.), to identify the optimal balance between safety and efficacy. However, most clinicians have limited education in decision-making and formal training in risk management...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29579770/acute-cellular-rejection-is-it-still-relevant
#18
Angela Koutsokera, Liran Levy, Prodipto Pal, Ani Orchanian-Cheff, Tereza Martinu
Despite significant progress in the field of transplant immunology, acute cellular rejection (ACR) remains a very frequent complication after lung transplantation (LTx), with almost 30% of LTx recipients experiencing at least one episode of treated ACR during the first year of follow-up. Most episodes respond to the first-line immunosuppressive treatment and are rarely a direct cause of death. However, the association of ACR with later adverse outcomes, such as chronic lung allograft dysfunction, bronchial stricture, and infectious complications associated with the intensification of immunosuppression, negatively impacts long-term survival...
April 2018: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29569380/modeling-missed-care-implications-for-evidence-based-practice
#19
Ian Blackman, Che Yee Lye, I Gusti Ngurah Darmawan, Julie Henderson, Tracey Giles, Eileen Willis, Luisa Toffoli, Lily Xiao, Claire Verrall
BACKGROUND: There is a growing nursing literature that views missed care as an inevitable consequence of work intensification associated with the rationing of nursing and material resources available to deliver care. Global studies recognize that missed care is now ubiquitous, although studies tend to be conducted in one region, rather than nationwide. This study seeks to understand the Australian context of missed care. AIMS: To explore self-reported reasons for missed care and to identify the main factors for predicting missed care within a sample of Australian nurses and midwives working in public and private hospitals in New South Wales, Victoria, Tasmania, and South Australia...
March 23, 2018: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/29535235/patient-centered-guidelines-for-geriatric-diabetes-care-potential-missed-opportunities-to-avoid-harm
#20
Ellen M McCreedy, Robert L Kane, Sarah E Gollust, Nathan D Shippee, Kirby D Clark
BACKGROUND: Clinicians strive to deliver individualized, patient-centered care. However, these intentions are understudied. This research explores how patient characteristics associated with an high risk-to-benefit ratio with hypoglycemia medications affect decision making by primary care clinicians. METHODS: Using a vignette-based survey, we queried primary care clinicians on their intended management of geriatric patients with diabetes. The patients' ages, disease durations, and comorbidities were systematically varied...
March 2018: Journal of the American Board of Family Medicine: JABFM
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