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https://www.readbyqxmd.com/read/27924645/cardiovascular-outcomes-and-tumour-necrosis-factor-antagonists-in-chronic-inflammatory-rheumatic-disease-a-focus-on-rheumatoid-arthritis
#1
Giuliano Tocci, Delia Goletti, Valentina Marino, Andrea Matucci, Giuseppe Maria Milano, Fabrizio Cantini, Raffaele Scarpa
Many chronic rheumatic diseases have an inflammatory etiology, leading to accelerated atherosclerosis and increased occurrence of vascular diseases. In rheumatoid arthritis (RA), a reduction in cardiovascular (CV) events has been reported under treatments reducing systemic inflammation. Areas covered: Given the central role of tumour necrosis factor alpha (TNFα) in chronic inflammatory conditions and in atherosclerosis, it has been suggested that TNFα-antagonists may reduce CV risk and mortality. Although there are no randomized controlled or head-to-head trials investigating the effect of specific anti-TNF-agents on CV outcomes, observational cohort studies, national registry data, and meta-analyses in RA have reported improved CV outcomes with anti-TNF therapy...
December 2016: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/27923809/role-of-autonomic-nervous-system-in-chronic-cns-mediated-antidiabetic-action-of-leptin
#2
Alexandre A da Silva, John E Hall, Sydney P Moak, Jackson Browning, Haley J Houghton, Giovana C Micheloni, Jussara M do Carmo
This study tested whether chronic ganglionic blockade or hepatic vagotomy attenuates the chronic CNS-mediated antidiabetic and cardiovascular effects of leptin. Male Sprague-Dawley rats were instrumented with telemetry probes and arterial and venous catheters for determination of blood pressure (BP), heart rate (HR), blood sampling and intravenous (IV) infusions. An intracerebroventricular (ICV) cannula was placed into the brain lateral ventricle for infusion of leptin or vehicle. After control measurements, streptozotocin (STZ) was injected IV (50 mg/kg) to induce diabetes and 5 days later leptin (n=6) or saline vehicle (n=5) was infused ICV for 12 days via osmotic pumps...
December 6, 2016: American Journal of Physiology. Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27922183/the-significance-of-sampling-time-in-therapeutic-drug-monitoring-of-clozapine
#3
M I Jakobsen, J R Larsen, C K Svensson, S S Johansen, K Linnet, J Nielsen, A Fink-Jensen
OBJECTIVE: Therapeutic drug monitoring (TDM) of clozapine is standardized to 12-h postdose samplings. In clinical settings, sampling time often deviates from this time point, although the importance of the deviation is unknown. To this end, serum concentrations (s-) of clozapine and its metabolite N-desmethyl-clozapine (norclozapine) were measured at 12 ± 1 and 2 h postdose. METHOD: Forty-six patients with a diagnosis of schizophrenia, and on stable clozapine treatment, were enrolled for hourly, venous blood sampling at 10-14 h postdose...
December 6, 2016: Acta Psychiatrica Scandinavica
https://www.readbyqxmd.com/read/27920864/clinical-case-report-discitis-osteomyelitis-complicated-by-inferior-vena-cava-venous-thrombosis-and-septic-pulmonary-emboli
#4
Zerwa Farooq, Brooke Devenney-Cakir
Viridans group streptococcus is an infrequent cause of osteomyelitis that is found in association with infective endocarditis. Only a few studies report viridans osteomyelitis in the absence of endocarditis. Vertebral pyogenic osteomyelitis can sometimes be complicated by psoas or paraspinal abscesses. These intra-abdominal and/or pelvic collections can very rarely result in venous thrombosis. A paraspinal abscess resulting in inferior vena cava (IVC) thrombosis has only been reported once in the literature...
December 2016: Radiology case reports
https://www.readbyqxmd.com/read/27920655/deep-vein-thrombosis-as-initial-manifestation-of-whipple-disease
#5
Mônica Souza de Miranda Henriques, Alexandre Rolim da Paz, Ana Beatriz Person Gaertner, Cibelle Ingrid Stephen Melo, Priscyanne Lins Filgueiras, Rafaella Alencar Jerome
INTRODUCTION: Wipple disease (WD) is a rare chronic disease caused by the bacillus Tropheryma whipplei. Constitutive, rheumatologic, gastrointestinal, cardiac, cerebral, lymphatic, cutaneous, and ophthalmological signs are possible systemic symptoms. However, thrombotic manifestations are rarely described as "stroke-like syndrome" or arterial thrombosis. Diagnosis is based on clinical manifestations and pathological examination. Laboratory findings may include anemia, leukocytosis, and thrombocytosis...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27919609/randomised-controlled-trial-potential-benefit-of-a-footplate-neuromuscular-electrical-stimulation-device-in-patients-with-chronic-venous-disease
#6
R Ravikumar, K J Williams, A Babber, T R A Lane, H M Moore, A H Davies
OBJECTIVES: Chronic venous disease (CVD) is common, affecting a quarter of the population. Current conservative methods of treatment aim to prevent progression of disease by reducing ambulatory venous pressure. Neuromuscular electrical stimulation (NMES) refers to the use of electrical impulses to elicit muscle contraction. This pilot randomised controlled trial investigates the effect of a footplate NMES device (REVITIVE) on venous flow parameters, limb oedema, and quality of life outcome measures in patients with CVD...
December 2, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27916673/pathophysiology-of-the-pericardium
#7
REVIEW
Brian D Hoit
Pericardial heart disease includes pericarditis, (an acute, subacute, or chronic fibrinous, noneffusive, or exudative process), and its complications, constriction, (an acute, subacute, or chronic adhesive or fibrocalcific response), and cardiac tamponade. The pathophysiology of cardiac tamponade and constrictive pericarditis readily explains their respective findings on clinical examination, Doppler echocardiography, and at cardiac catheterization. The primary abnormality of cardiac tamponade is pan-cyclic compression of the cardiac chambers by increased pericardial fluid requiring that cardiac chambers compete for a fixed intrapericardial volume...
December 1, 2016: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/27916046/-a-comparative-study-of-unrelated-donor-and-matched-sibling-donor-allogeneic-hematopoietic-stem-cell-transplantation-in-children-and-adolescents-with-acquired-severe-aplastic-anemia
#8
J Zhou, Y W Fu, L J Liang, Q Wang, L J Han, Y L Zu, Yanli Zhang, X H Zhu, F K Yu, B J Fang, X D Wei, Y P Song
Objective: To evaluate the efficacy of unrelated donor allogeneic hematopoietic stem cell transplantation(URD allo-HSCT) for children and adolescents with severe aplastic anemia (SAA). Methods: Clinical data of 34 SAA children and adolescents undergoing allo-HSCT were retrospectively analyzed from October 2001 to October 2015. According to the source of donor, the patients were divided into matched sibling donor allo-HSCT group (MSD group) and unrelated donor group (URD group). The clinical outcome of SAA children and adolescents receiving URD allo-HSCT was assessed, and patients in MSD allo-HSCT group were enrolled as control at the same period...
December 1, 2016: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/27914110/physical-exercise-for-the-treatment-of-non-ulcerated-chronic-venous-insufficiency
#9
REVIEW
Diego N Araujo, Cibele Td Ribeiro, Alvaro Cc Maciel, Selma S Bruno, Guilherme Af Fregonezi, Fernando Al Dias
BACKGROUND: Chronic venous insufficiency (CVI) is a common disease that causes discomfort and impairs the quality of life of affected persons. Treatments such as physical exercise that aim to increase the movement of the ankle joint and strengthen the muscle pump in the calf of the leg may be useful to reduce the symptoms of CVI. OBJECTIVES: To assess and summarise the existing clinical evidence on the efficacy and safety of physical exercise programmes for the treatment of individuals with non-ulcerated CVI...
December 3, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27913478/thrombosis-in-the-setting-of-obesity-or-inflammatory-bowel-disease
#10
Steven R Lentz
Obesity and inflammatory bowel disease (IBD) are systemic inflammatory disorders that predispose to arterial and venous thrombosis through similar prothrombotic mechanisms. Obesity and IBD are chronic risk factors that lead to a persistently elevated risk of thrombosis, although the thrombotic risk with IBD appears to wax and wane with disease severity. Because of the lack of high-quality evidence to guide management decisions, approaches to the prevention and treatment of thrombosis in patients with obesity or IBD are based on extrapolation from general guidelines for antithrombotic therapy...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27911916/incidence-of-deep-vein-thrombosis-and-venous-thromboembolism-following-tka-in-rheumatoid-arthritis-versus-osteoarthritis-a-meta-analysis
#11
Do-Kyung Lee, Hyun-Jung Kim, Dae-Hee Lee
This meta-analysis was designed to compare the incidence of deep vein thrombosis (DVT) and venous thromboembolism (VTE) following total knee arthroplasty (TKA) in patients with rheumatoid arthritis (RA) and osteoarthritis (OA). All studies directly comparing the post-TKA incidence of DVT and/or VTE in patients with RA and OA were included. For all comparisons, odds ratios and 95% confidence intervals (CI) were calculated for binary outcomes. Six studies were included in the meta-analysis. The pooled data showed that the combined rates of asymptomatic and symptomatic DVT did not differ significantly in the RA and OA groups (1065/222,714 [0...
2016: PloS One
https://www.readbyqxmd.com/read/27911229/c-2-arteriovenous-fistula-presenting-as-a-pathologic-hangman-s-fracture-case-report
#12
Rajeev D Sen, Carolina Gesteira Benjamin, Howard A Riina, Donato Pacione
The authors report on an 81-year-old woman with a pathologic hangman's fracture secondary to a complex arteriovenous fistula (AVF). The patient presented with severe, unremitting neck pain and was found to have fractures bilaterally through the pars interarticularis of C-2 with significant anterior subluxation of C-2 over C-3 along with widening of the left transverse foramen. Due to an abnormally appearing left vertebral artery (VA) on CT angiography, the patient underwent conventional angiography, which revealed a complex AVF stemming from the left VA at the level of C-2 with dilated posterior cervical veins and a large venous varix...
December 2, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27910004/dabigatran-overdose-a-case-report-of-acute-hepatitis-extracorporeal-treatment
#13
Mariagrazia Porru, Antonella Mameli, Maria E Cianchetti, Mario Musu, Paola Schirru, Maria F Ruberto, Doris Barcellona, Francesco Marongiu
Dabigatran is an oral, direct thrombin inhibitor approved by international regulatory agencies for stroke prevention in patients with paroxysmal or persistent non-rheumatic atrial fibrillation (AF). The benefits of dabigatran are widely described, but its use in the geriatric population is not without risk. Chronic kidney disease is a common comorbidity with AF, and thus frequent checks of renal function in elderly patients are recommended. We report a case of dabigatran intoxication in an elderly man affected by heart failure and worsening renal function, who developed acute hepatitis and coma, which was successfully treated with continuous veno-venous hemodiafiltration...
December 1, 2016: International Journal of Hematology
https://www.readbyqxmd.com/read/27909641/a-case-series-of-complex-recalcitrant-wounds-treated-with-epidermal-grafts-harvested-from-an-automated-device
#14
Stephen S Cai, Arvind U Gowda, Karan Chopra, Rachel Waldman, Ronald P Silverman, Yvonne M Rasko
INTRODUCTION: Epidermal grafting has several advantages over full-thickness or split-thickness grafts in the treatment of complex non-healing wounds. These include the low risk of donor site complications, minimal patient discomfort, and abstention from the operating room. Traditionally, the lack of reliable epidermal harvesting techniques has limited its clinical utilization. The development of an automated suction blister epidermal graft (SBEG) harvesting device may facilitate clinical utilization of this technique...
October 30, 2016: Curēus
https://www.readbyqxmd.com/read/27908680/the-effect-of-contralateral-kidney-volume-on-renal-function-after-radical-nephroureterectomy-implications-for-eligibility-for-neoadjuvant-chemotherapy-for-upper-tract-urothelial-cancer
#15
Wan Song, Hyun Hwan Sung, Deok Hyun Han, Byong Chang Jeong, Seong Il Seo, Seong Soo Jeon, Hyun Moo Lee, Han Yong Choi, Hwang Gyun Jeon
PURPOSE: We investigated the effect of preoperative contralateral kidney (CK) volume on renal function after radical nephroureterectomy (RNU). METHODS: We reviewed 630 patients who underwent RNU between September 1994 and December 2013. Of these 630 patients, 135 patients with advanced upper tract urothelial cancer were ultimately included. Preoperative CK volume was measured from computed tomography images of the venous phase using a specialized volumetric program...
November 28, 2016: Urologic Oncology
https://www.readbyqxmd.com/read/27904840/surgical-experience-on-chronic-constrictive-pericarditis-in-african-setting-review-of-35-years-experience-in-cote-d-ivoire
#16
Koffi Herve Yangni-Angate, Yves Tanauh, Christophe Meneas, Florent Diby, Anicet Adoubi, Manga Diomande
BACKGROUND: Surgical experience with chronic constrictive pericarditis (CCP) is rarely documented in Africa; the aim of this study is therefore to review our African experience with CCP from 1977 to 2012 in terms of clinical and surgical outcomes and risk factors of early death after pericardiectomy. METHODS: This retrospective study is related to 120 patients with CCP; there were 72 men and 48 women with an average age at 28.8±10.4 years standard deviation (SD) (8-51 years)...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27902585/long-term-complications-of-splenectomy-in-adult-immune-thrombocytopenia
#17
Lan-Huong Thai, Matthieu Mahévas, Françoise Roudot-Thoraval, Nicolas Limal, Laetitia Languille, Guillaume Dumas, Mehdi Khellaf, Philippe Bierling, Marc Michel, Bertrand Godeau
The recent large decrease in splenectomy use for chronic immune thrombocytopenia (ITP) is partly due to still-unsolved questions about long-term safety. We performed the first single-center exposed/unexposed cohort study evaluating the long-term incidence of splenectomy complications in patients with primary ITP. Overall, 83 patients who underwent splenectomy more than 10 years ago (exposed) were matched with 83 nonsplenectomized patients (unexposed) on the date of ITP diagnosis ±5 years, age and gender. After a median follow-up of 192 months (range 0...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27900955/serum-levels-of-n-terminal-pro-b-type-natriuretic-peptide-as-a-diagnostic-marker-for-left-ventricular-dysfunction-in-children-with-end-stage-renal-disease-on-hemodialysis
#18
Amr Mohamed Zoair, Maher Ahmed Abdel-Hafez, Wegdan Mawlana, Mohamed Abdel-Rahman Sweylam
The objective of this study was to determine the diagnostic cutoff value of N-terminal-pro B-type natriuretic peptide (NT-pro BNP) as a marker of left ventricular (LV) dysfunction in children with end-stage renal disease (ESRD) on regular hemodialysis (HD). The study was carried out on thirty children with ESRD on regular HD and thirty healthy controls. Echocardiographic studies were done, including a conventional mode for ejection fraction, fractional shortening, tissue Doppler imaging, and longitudinal global strain by speckle tracking...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27900063/elephantiasis-nostras-verrucosa-excision-with-full-thickness-skin-grafting-of-the-penis-scrotum-and-perineal-area
#19
Nathan Judge, Ali Kilic
BACKGROUND: Elephantiasis nostras verrucosa is a rare cutaneous complication of chronic lymphatic obstruction. It is most commonly caused by bacterial infection, trauma, neoplasia, obesity, and venous stasis. MAIN OBSERVATIONS: In this report, we describe a case of elephantiasis nostras verrucosa involving the scrotum and perineal area in a 32-year-old. The lesions were excised, and full-thickness skin grafting of the penis, scrotum, and perineal skin was performed...
November 13, 2016: Journal of Dermatological Case Reports
https://www.readbyqxmd.com/read/27892890/trial-design-rivaroxaban-for-the-prevention-of-major-cardiovascular-events-after-transcatheter-aortic-valve-replacement-rationale-and-design-of-the-galileo-study
#20
Stephan Windecker, Jan Tijssen, Gennaro Giustino, Ana H C Guimarães, Roxana Mehran, Marco Valgimigli, Pascal Vranckx, Robert C Welsh, Usman Baber, Gerrit-Anne van Es, Peter Wildgoose, Albert A Volkl, Ana Zazula, Karen Thomitzek, Melanie Hemmrich, George D Dangas
BACKGROUND: Optimal antithrombotic treatment after transcatheter aortic valve replacement (TAVR) is unknown and determined empirically. The direct factor Xa inhibitor rivaroxaban may potentially reduce TAVR-related thrombotic complications and premature valve failure. DESIGN: GALILEO is an international, randomized, open-label, event-driven, phase III trial in more than 1,520 patients without an indication for oral anticoagulation who underwent a successful TAVR (ClinicalTrials...
October 31, 2016: American Heart Journal
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