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Said Alyacoubi, Yousef Abuowda, Loai Albarqouni, Bettina Böttcher, Khamis Elessi
BACKGROUND: Disease severity scores such as CURB-65 are often used to guide the management of patients with community-acquired pneumonia. Early and adequate empirical antibiotic treatment reduces mortality. The aim of this study was to examine the severity assessment and management of patients presenting with community-acquired pneumonia at the European Gaza Hospital in the Gaza Strip and to compare this to the best available evidence. METHODS: Medical records of all patients admitted to the European Gaza Hospital with a diagnosis of community-acquired pneumonia between Dec 1, 2015, and March 31, 2016, were reviewed retrospectively...
February 21, 2018: Lancet
Jun-Hua Zhang, You-Ping Li, Bo-Li Zhang
The introduction and popularization of evidence-based medicine has opened up a new research field of clinical efficacy evaluation of traditional Chinese medicine(TCM), produced new research ideas and methods, and promoted the progress of clinical research of TCM. After about 20 years assiduous study and earnest practice, the evidence based evaluation method and technique, which conforms to the characteristics of TCM theory and practice, has been developing continuously. Evidence-based Chinese medicine (EBCM) has gradually formed and become an important branch of evidence-based medicine...
January 2018: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
Matthew Klinge, Tami Coppler, Jane M Liebschutz, Mohannad Dugum, Ajay Wassan, Andrea DiMartini, Shari Rogal
Purpose of review: The treatment of pain in patients with cirrhosis is complicated by unpredictable hepatic drug metabolism and a higher risk of adverse drug reactions. We aimed to conduct a scoping review regarding pain management in cirrhosis. Recent findings: Despite the high prevalence of pain in patients with cirrhosis, there is little literature to guide the management of pain in this population. Complex pain syndromes and disease-specific pain etiologies exist are common in patients with cirrhosis...
March 2018: Current Hepatology Reports
Michael E Reschen, Andrea Mazzella, Edward Sharples
Background and aims: Dysfunction of a kidney transplant often requires histological sampling by percutaneous ultrasound-guided core needle biopsy. Transplant biopsy is more specialized than native kidney biopsy, the indications and complications are less well defined and in England are performed mainly by nephrologists. The aims of the study were to evaluate the adequacy and complication rate in living and deceased donor recipients according to training status of the nephrologist, assess the accuracy of physicians in predicting rejection, the threshold creatinine rise for biopsy, and the change in drug management post-biopsy...
April 2018: Annals of Medicine and Surgery
Yuki Tanisaka, Shomei Ryozawa, Masanori Kobayashi, Maiko Harada, Tsutomu Kobatake, Kumiko Omiya, Hirotoshi Iwano, Shin Arai, Kouichi Nonaka, Yumi Mashimo
Lymphadenopathy may be difficult to diagnose using imaging results alone. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) may help to diagnose and determine the appropriate management of lymphadenopathy. EUS-FNA has been used as a safe and less invasive method for obtaining pathologic specimens from extraluminal lesions using endoscopic ultrasound. The present study evaluated the usefulness of EUS-FNA for lymphadenopathy. Between July 2013 and December 2016, 72 patients undergoing EUS-FNA for lymphadenopathy that could not be diagnosed solely using imaging were included...
April 2018: Oncology Letters
Qiang Zuo, Jing Liu, Liping Huang, Yifei Qin, Teresa Hawley, Claire Seo, Glenn Merlino, Yanlin Yu
Multiple genetic mutations within melanoma not only cause lesion-specific responses to targeted therapy but also alter the molecular route of resistance to that therapy. Inactivation of PTEN occurs in up to 30% of melanomas, frequently with a concurrent activating BRAF mutation. PTEN loss regulates both acquired and intrinsic drug resistance. Here we show that AXL/AKT axis mediated-resistance to BRAF inhibitor (BRAFi) depends upon PTEN status in melanoma. Hyperactivation of both ERK and AKT pathways was associated with BRAFi resistance in melanoma with wildtype PTEN...
March 19, 2018: Oncogene
Tiejun Zhang, Gang Bai, Yanqi Han, Jun Xu, Suxiao Gong, Yazhuo Li, Hongbing Zhang, Changxiao Liu
BACKGROUND: Quality of traditional Chinese medicine (TCM) plays a critical role in industry of TCM. Rapid development of TCM pharmaceutical areas is, however, greatly limited, since there are many issues not been resolved, concerning the quality study of TCM. HYPOTHESIS/PURPOSE: Core concept of TCM quality as well as the characteristics of TCM was discussed, in order to guide the quality research and evaluation of TCM, further improve the level of TCM quality control...
March 1, 2018: Phytomedicine: International Journal of Phytotherapy and Phytopharmacology
John F Brothers, Matthew Ung, Renan Escalante-Chong, Jermaine Ross, Jenny Zhang, Yoonjeong Cha, Andrew Lysaght, Jason Funt, Rebecca Kusko
The tremendous expansion of data analytics and public and private big datasets presents an important opportunity for pre-clinical drug discovery and development. In the field of life sciences, the growth of genetic, genomic, transcriptomic and proteomic data is partly driven by a rapid decline in experimental costs as biotechnology improves throughput, scalability, and speed. Yet far too many researchers tend to underestimate the challenges and consequences involving data integrity and quality standards. Given the effect of data integrity on scientific interpretation, these issues have significant implications during preclinical drug development...
March 15, 2018: Biochemical Pharmacology
Mohammad Zahidul Hasan, Md Safiur Rahman Mahdi, Md Nazmus Sadat, Noman Mohammed
Human genomic information can yield more effective healthcare by guiding medical decisions. Therefore, genomics research is gaining popularity as it can identify potential correlations between a disease and a certain gene, which improves the safety and efficacy of drug treatment and can also develop more effective prevention strategies [1]. To reduce the sampling error and to increase the statistical accuracy of this type of research projects, data from different sources need to be brought together since a single organization does not necessarily possess required amount of data...
March 14, 2018: Journal of Biomedical Informatics
Helen Cox, Jennifer Hughes, John Black, Mark P Nicol
Treatment for drug-resistant tuberculosis is largely delivered through standardised, empirical combination regimens in low-resource, high-burden settings. However, individualised treatment, guided by detailed drug susceptibility testing, probably results in improved individual outcomes and is the standard of care in well-resourced settings. Driven by the urgent need to scale up treatment provision, new tuberculosis drugs, incorporated into standardised regimens, are being tested. Although standardised regimens are expected to improve access to treatment in high-burden settings, they are also likely to contribute to the emergence of resistance, even with good clinical management...
March 13, 2018: Lancet Infectious Diseases
Sherine Ismail, Mohamed Osman, Rayf Abulezz, Hani Alhamdan, K H Mujtaba Quadri
Pharmacists possess pivotal competencies and expertise in developing clinical pathways (CPs). We present a tertiary care facility experience of pharmacists vis-a-vis interprofessional collaboration for designing and implementing CPs. We participated in the development of CPs as leading members of a collaborative team of healthcare professionals. We reviewed literature, aligning it with hospital formulary and institutional standards, and participated in weekly team meetings for six months. Several tools and services were adapted to guide prescribing and standardization of care through time-bound order sets...
March 16, 2018: Pharmacy (Basel, Switzerland)
Mona Mokhtari, Michael Jackson, Alistair Brown, David Ackerley, Nigel Ritson, Robert A Keyzers, Andrew Munkacsi
Pathogenic fungi continue to develop resistance against current antifungal drugs. To explore the potential of agricultural waste products as a source of novel antifungal compounds, we obtained an unbiased GC-MS profile of 151 compounds from 16 commercial and experimental cultivars of feijoa peels. Multivariate analysis correlated 93% of the compound profile with antifungal bioactivity. Of 18 compounds that significantly correlated with antifungal activity, five had not previously been described from feijoa...
March 16, 2018: Journal of Agricultural and Food Chemistry
Thomas Tängdén, Pier Giorgio Cojutti, Jason A Roberts, Federico Pea
BACKGROUND AND OBJECTIVES: Valganciclovir is used as oral prophylaxis for cytomegalovirus (CMV) infection in kidney transplant recipients. However, limited pharmacokinetic data exist to guide dosing in this patient group. This study aimed to describe the population pharmacokinetics of valganciclovir in a large sample of kidney transplant recipients and predict optimal dosing based on Monte Carlo simulations. METHODS: Therapeutic drug monitoring (TDM) data from adult kidney transplant recipients who received valganciclovir prophylaxis during a 10-year study period were collected retrospectively...
March 15, 2018: Clinical Pharmacokinetics
Katarzyna Morawska, Françoise Goirand, Laurine Marceau, Madeline Devaux, Adèle Cueff, Aurélie Bertaut, Julie Vincent, Leila Bengrine-Lefevre, François Ghiringhelli, Antonin Schmitt
Aims: 5-FU is used as the main backbone of chemotherapy regimens for patients with colorectal and other gastrointestinal cancers. Despite development of new strategies that allowed enhancing clinical effectiveness and tolerability of 5-FU, 10-30% of patients treated with 5-FU-based regimens experience severe treatment-related toxicity. In our study, we evaluated the 5-FU exposure-toxicity relationship and investigated the efficacy of PK-guided dosing in increasing tolerability of 5-FU-based chemotherapy...
February 20, 2018: Oncotarget
Anita H Clayton, Irwin Goldstein, Noel N Kim, Stanley E Althof, Stephanie S Faubion, Brooke M Faught, Sharon J Parish, James A Simon, Linda Vignozzi, Kristin Christiansen, Susan R Davis, Murray A Freedman, Sheryl A Kingsberg, Paraskevi-Sofia Kirana, Lisa Larkin, Marita McCabe, Richard Sadovsky
The International Society for the Study of Women's Sexual Health process of care (POC) for management of hypoactive sexual desire disorder (HSDD) algorithm was developed to provide evidence-based guidelines for diagnosis and treatment of HSDD in women by health care professionals. Affecting 10% of adult females, HSDD is associated with negative emotional and psychological states and medical conditions including depression. The algorithm was developed using a modified Delphi method to reach consensus among the 17 international panelists representing multiple disciplines...
March 9, 2018: Mayo Clinic Proceedings
Kednapa Thavorn, Howsikan Kugathasan, Darrell H S Tan, Nasheed Moqueet, Stefan D Baral, Becky Skidmore, Derek MacFadden, Anna Simkin, Sharmistha Mishra
BACKGROUND: Pre-exposure prophylaxis (PrEP) with antiretrovirals is an efficacious and effective intervention to decrease the risk of HIV (human immunodeficiency virus) acquisition. Yet drug and delivery costs prohibit access in many jurisdictions. In the absence of guidelines for the synthesis of economic evaluations, we developed a protocol for a systematic review of economic evaluation studies for PrEP by drawing on best practices in systematic reviews and the conduct and reporting of economic evaluations...
March 15, 2018: Systematic Reviews
Kuikun Yang, Yijing Liu, Yi Liu, Qian Zhang, Chuncai Kong, Chenglin Yi, Zijian Zhou, Zhantong Wang, Guofeng Zhang, Yang Zhang, Niveen M Khashab, Xiaoyuan Chen, Zhihong Nie
This article describes the fabrication of nanosized magneto-vesicles (MVs) comprising tunable layers of densely-packed superparamagnetic iron oxide nanoparticles (SPIONs) in membranes via cooperative assembly of polymer-tethered SPIONs and free poly(styrene)-b-poly(acrylic acid) (PS-b-PAA). The membrane thickness of MVs could be well controlled from 9.8 to 93.2 nm by varying the weight ratio of PS-b-PAA to SPIONs. The increase in membrane thickness was accompanied with the transition from monolayer MVs, to double-layered MVs and to multilayered MVs (MuMVs)...
March 15, 2018: Journal of the American Chemical Society
Xiaoye Yang, Xiaoqun Shi, Jianbo Ji, Guangxi Zhai
The development of imaging-guided smart drug delivery systems for combinational photodynamic/chemotherapy of the tumor has become highly demanded in oncology. Herein, redox-responsive theranostic polymeric nanoparticles (NPs) were fabricated innovatively using low molecular weight heparin (LWMH) as the backbone. Chlorin e6 (Ce6) and alpha-tocopherol succinate (TOS) were conjugated to LMWH via cystamine as the redox-sensitive linker, forming amphiphilic Ce6-LMWH-TOS (CHT) polymer, which could self-assemble into NPs in water and encapsulate paclitaxel (PTX) inside the inner core (PTX/CHT NPs)...
November 2018: Drug Delivery
Nikunjkumar Patel, Oliver Hatley, Alexander Berg, Klaus Romero, Barbara Wisniowska, Debra Hanna, David Hermann, Sebastian Polak
Drug-induced cardiac arrhythmia, especially occurrence of torsade de pointes (TdP), has been a leading cause of attrition and post-approval re-labeling and withdrawal of many drugs. TdP is a multifactorial event, reflecting more than just drug-induced cardiac ion channel inhibition and QT interval prolongation. This presents a translational gap in extrapolating pre-clinical and clinical cardiac safety assessment to estimate TdP risk reliably, especially when the drug of interest is used in combination with other QT-prolonging drugs for treatment of diseases such as tuberculosis...
March 14, 2018: AAPS Journal
Philip Carter, Costi Alifrangis, Pramodh Chandrasinghe, Biancastella Cereser, Lisa Del Bel Belluz, Cosimo Alex Leo, Nina Moderau, Neha Tabassum, Janindra Warusavitarne, Jonathan Krell, Justin Stebbing
We evaluated the benefit of tailoring treatments for a colorectal adenocarcinoma cancer cohort according to tumor molecular profiles, by analyzing data collected on patient responses to treatments that were guided by a tumor profiling technology from Caris Life Sciences. DNA sequencing and immunohistochemistry were the main tests that predictions were based upon, but also fragment analysis, and in situ hybridization. The status of the IHC biomarker for the thymidylate synthase receptor was a good indicator for future survival...
February 16, 2018: Oncotarget
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