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Medication withdrawal

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https://www.readbyqxmd.com/read/27918356/refractory-tamoxifen-induced-keratopathy-despite-drug-withdrawal
#1
Konstantinos Andreanos, Konstantinos Oikonomakis, Konstantinos Droutsas, Myrsini Petreli, George Kymionis
PURPOSE: To report a case with refractory tamoxifen-induced keratopathy despite drug withdrawal. METHODS: Case report. RESULTS: A 50-year-old woman, diagnosed with bilateral breast cancer underwent mastectomy in 2005. She was treated with tamoxifen citrate from 2005 to 2012. According to her medical history, no corneal abnormalities had been documented during past ophthalmological examinations except low myopia, before initiation of tamoxifen treatment...
December 1, 2016: Cornea
https://www.readbyqxmd.com/read/27915965/systematic-review-on-role-of-mammalian-target-of-rapamycin-inhibitors-as-an-alternative-to-calcineurin-inhibitors-in-renal-transplant-challenges-and-window-to-excel
#2
Jayant Kumar, Julie M Bridson, Ajay Sharma, Ahmed Halawa
OBJECTIVES: This review focuses on the current limited evidence of graft function and graft survival in various immunosuppressive regimens involving mammalian target of rapamycin inhibitors with or without calcineurin inhibitors. MATERIALS AND METHODS: We evaluated the current literature for describing the role of mammalian target of rapamycin inhibitors as an alternative to calcineurin inhibitors by searching the PubMed, EMBASE, Cochrane, Crossref, and Scopus databases using medical subject heading terms...
December 2, 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27914999/dual-therapy-for-refractory-overactive-bladder-in-children-a-prospective-open-label-study
#3
Fannie Morin, Anne-Sophie Blais, Geneviève Nadeau, Katherine Moore, Lucie Genois, Stéphane Bolduc
PURPOSE: Mirabegron (β3-adrenoreceptor agonist) is a new molecule with a distinct mechanism of action from antimuscarinics. Combination therapy with solifenacin was recently studied in adult population. Our objective was to evaluate the efficacy and safety of mirabegron as add-on therapy, to treat urinary incontinence in children with idiopathic OAB, refractory/intolerant to antimuscarinics. MATERIALS AND METHODS: A prospective off-label study using add-on regimens of mirabegron was conducted with pediatric patients presenting no symptom improvement under intensive behavioural and medical therapies and/or significant side effects (S/E) on antimuscarinic dose escalation...
November 30, 2016: Journal of Urology
https://www.readbyqxmd.com/read/27911381/a-novel-approach-for-the-administration-of-medications-and-fluids-in-emergency-scenarios-and-settings
#4
Akilesh Honasoge, Neal Lyons, Kathleen Hesse, Braden Parker, Robert Mokszycki, Kelly Wesselhoff, Rolla Sweis, Erik B Kulstad
The available routes of administration commonly used for medications and fluids in the acute care setting are generally limited to oral, intravenous, or intraosseous routes, but in many patients, particularly in the emergency or critical care settings, these routes are often unavailable or time-consuming to access. A novel device is now available that offers an easy route for administration of medications or fluids via rectal mucosal absorption (also referred to as proctoclysis in the case of fluid administration and subsequent absorption)...
November 9, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/27907965/movement-disorders-in-the-intensive-care-unit
#5
Sara M Schaefer, Rezvan Rostami, David M Greer
Movement disorders are common; yet to those without subspecialty experience they can be difficult to recognize, categorize, and manage. Although most frequently encountered in an outpatient setting, patients with movement disorders are commonly hospitalized and often admitted to the intensive care unit, leading to possible confusion about their proper care. In addition, movement disorders can arise in critical care settings for several reasons, including medication side effects, substance withdrawal, or development of a new syndrome...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907936/early-treatment-for-neonatal-abstinence-syndrome-a-palliative-approach
#6
Jennifer Hudson, Rachel Mayo, Lori Dickes, Liwei Chen, Windsor Westbrook Sherrill, Julie Summey, Bradley Dalton, Kindal Dankovich
Objective To describe medical, safety, and health care utilization outcomes associated with an early treatment model for neonatal opioid withdrawal. Study Design This is a retrospective review of 117 opioid-exposed infants born in a large regional hospital and treated in the level I nursery with methadone initiated within 48 hours of birth. Results For this cohort, mean length of stay was 8.3 days. Hospital safety events were infrequent; there were no medication errors or deaths. Within 30 days of discharge, 14% of infants visited the emergency department; 7% were readmitted...
December 1, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27905916/study-protocol-a-dose-escalating-phase-2-study-of-oral-lisdexamfetamine-in-adults-with-methamphetamine-dependence
#7
Nadine Ezard, Adrian Dunlop, Brendan Clifford, Raimondo Bruno, Andrew Carr, Alexandra Bissaker, Nicholas Lintzeris
BACKGROUND: The treatment of methamphetamine dependence is a continuing global health problem. Agonist type pharmacotherapies have been used successfully to treat opioid and nicotine dependence and are being studied for the treatment of methamphetamine dependence. One potential candidate is lisdexamfetamine, a pro-drug for dexamphetamine, which has a longer lasting therapeutic action with a lowered abuse potential. The purpose of this study is to determine the safety of lisdexamfetamine in this population at doses higher than those currently approved for attention deficit hyperactivity disorder or binge eating disorder...
December 1, 2016: BMC Psychiatry
https://www.readbyqxmd.com/read/27894343/post-marketing-withdrawal-of-anti-obesity-medicinal-products-because-of-adverse-drug-reactions-a-systematic-review
#8
Igho J Onakpoya, Carl J Heneghan, Jeffrey K Aronson
BACKGROUND: We identified anti-obesity medications withdrawn since 1950 because of adverse drug reactions after regulatory approval, and examined the evidence used to support such withdrawals, investigated the mechanisms of the adverse reactions, and explored the trends over time. METHODS: We conducted searches in PubMed, the World Health Organization database of drugs, the websites of drug regulatory authorities, and selected full texts, and we hand searched references in retrieved documents...
November 29, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27893014/durability-of-the-rituximab-response-in-acetylcholine-receptor-autoantibody-positive-myasthenia-gravis
#9
Kimberly R Robeson, Aditya Kumar, Benison Keung, Daniel B DiCapua, Emily Grodinsky, Huned S Patwa, Panos A Stathopoulos, Jonathan M Goldstein, Kevin C O'Connor, Richard J Nowak
Importance: Myasthenia gravis (MG), an autoimmune disorder of neuromuscular transmission, is treated by an array of immunotherapeutics, many of which are nonspecific. Even with current therapies, a subset of patients has medically refractory MG. The benefits of B-cell-targeted therapy with rituximab have been observed in MG; however, the duration of these benefits after treatment is unclear. Objective: To evaluate the durability of response to rituximab in the treatment of acetylcholine receptor autoantibody-positive (AChR+) generalized MG...
November 21, 2016: JAMA Neurology
https://www.readbyqxmd.com/read/27891229/nicotine-replacement-therapy-for-agitation-and-delirium-management-in-the-intensive-care-unit-a-systematic-review-of-the-literature
#10
Melanie Kowalski, Andrew A Udy, Hayden J McRobbie, Michael J Dooley
BACKGROUND: Active smokers are prevalent within the intensive care setting and place a significant burden on healthcare systems. Nicotine withdrawal due to forced abstinence on admission may contribute to increased agitation and delirium in this patient group. The aim of this systematic review was to determine whether management of nicotine withdrawal, with nicotine replacement therapy (NRT), reduces agitation and delirium in critically ill patients admitted to the intensive care unit (ICU)...
2016: Journal of Intensive Care
https://www.readbyqxmd.com/read/27891152/venipuncture-induced-complex-regional-pain-syndrome-presenting-as-inflammatory-arthritis
#11
Punit Pruthi, Pramod Arora, Manoj Mittal, Anugrah Nair, Waqia Sultana
Venipuncture is one of the most commonly done medical procedures. We report a unique case of a 23-year-old young male who presented with features suggestive of inflammatory arthritis. The symptoms, which initially started on the right side, also involved the other side after a few weeks. Although the patient's symptoms and signs were simulating inflammatory arthritis, he had atypical features like poor response to anti-inflammatory medicines and normal laboratory parameters. His musculoskeletal ultrasonography was also not suggestive of arthritis...
2016: Case Reports in Medicine
https://www.readbyqxmd.com/read/27890648/bupropion-sustained-release-for-pregnant-smokers-a%C3%A2-randomized-placebo-controlled-trial
#12
Tatiana N Nanovskaya, Cheryl Oncken, Valentina M Fokina, Richard S Feinn, Shannon M Clark, Holly West, Sunil K Jain, Mahmoud S Ahmed, Gary D V Hankins
BACKGROUND: Bupropion is used to treat depression during pregnancy. However, its usefulness as a smoking cessation aid for pregnant women is not fully known. OBJECTIVE: The objective of the study was to evaluate the preliminary efficacy of bupropion sustained release for smoking cessation during pregnancy. STUDY DESIGN: We conducted a randomized, prospective, double-blind, placebo-controlled, pilot trial. Pregnant women who smoked daily received individualized behavior counseling and were randomly assigned to a 12 week, twice-a-day treatment with 150 mg bupropion sustained release or placebo...
November 25, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27888818/high-altitude-illness
#13
Anna Hartman-Ksycińska, Jolanta Kluz-Zawadzka, Bogumił Lewandowski
High-altitude illness is a result of prolonged high-altitude exposure of unacclimatized individuals. The illness is seen in the form of acute mountain sickness (AMS) which if not treated leads to potentially life-threatening high altitude pulmonary oedema and high-altitude cerebral oedema. Medical problems are caused by hypobaric hypoxia stimulating hypoxia-inducible factor (HIF) release. As a result, the central nervous system, circulation and respiratory system function impairment occurs. The most important factor in AMS treatment is acclimatization, withdrawing further ascent and rest or beginning to descent; oxygen supplementation, and pharmacological intervention, and, if available, a portable hyperbaric chamber...
2016: Przegla̧d Epidemiologiczny
https://www.readbyqxmd.com/read/27888715/making-a-case-for-controlled-organ-donation-after-cardiac-death-the-story-of-italy-s-first-experience
#14
Marco Vergano, Emma Magavern, Francesca Baroncelli, Valeria Frisenda, Alessia Fonsato, Diego Artusio, Carlo Alberto Castioni, Maria Elena De Piero, Massimo Abelli, Elena Ticozzelli, Sergio Livigni
Donation after circulatory death (DCD) is a valuable option for the procurement of organs for transplantation. In Italy, organ procurement after controlled DCD is legally and ethically conceivable within the current legislative framework. However, although formal impediments do not exist, the health care team is faced with many obstacles that may hinder the implementation of such programs. We report the case of Italy's first controlled DCD, specifically discussing the role of the patient's family in the shared decision-making process...
November 5, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27888427/taiwanese-medical-students-narratives-of-intercultural-professionalism-dilemmas-exploring-tensions-between-western-medicine-and-taiwanese-culture
#15
Ming-Jung Ho, Katherine Gosselin, Madawa Chandratilake, Lynn V Monrouxe, Charlotte E Rees
In an era of globalization, cultural competence is necessary for the provision of quality healthcare. Although this topic has been well explored in non-Western cultures within Western contexts, the authors explore how Taiwanese medical students trained in Western medicine address intercultural professionalism dilemmas related to tensions between Western medicine and Taiwanese culture. A narrative interview method was employed with 64 Taiwanese medical students to collect narratives of professionalism dilemmas...
November 26, 2016: Advances in Health Sciences Education: Theory and Practice
https://www.readbyqxmd.com/read/27887032/provider-perception-of-pharmacy-services-in-the-patient-centered-medical-home
#16
Nicole P Albanese, Alyssa M Pignato, Scott V Monte
BACKGROUND: Despite the positive data on clinical outcomes, cost savings, and provider experience, no study has surveyed providers to evaluate what pharmacy services they find to be worthwhile. OBJECTIVE: To determine what clinical, cost/access, and educational pharmacy services providers in a patient-centered medical home (PCMH) consider worthwhile and the perceived barriers to successful pharmacist incorporation. METHODS: A cross-sectional online survey was distributed to primary care physicians, nurse practitioners, and physician assistants in a PCMH physician group...
November 24, 2016: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/27885650/anti-il-12-23p40-antibodies-for-induction-of-remission-in-crohn-s-disease
#17
REVIEW
John K MacDonald, Tran M Nguyen, Reena Khanna, Antje Timmer
BACKGROUND: Ustekinumab (CNTO 1275) and briakinumab (ABT-874) are monoclonal antibodies that target the standard p40 subunit of the cytokines interleukin-12 and interleukin-23 (IL-12/23p40), which are involved in the pathogenesis of Crohn's disease. OBJECTIVES: The objectives of this review were to assess the efficacy and safety of anti-IL-12/23p40 antibodies for induction of remission in Crohn's disease. SEARCH METHODS: We searched the following databases from inception to 12 September 2016: PubMed, MEDLINE, EMBASE, and the Cochrane Library (CENTRAL)...
November 25, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27879954/comparison-of-terminal-extubation-and-terminal-weaning-as-mechanical-ventilation-withdrawal-in-icu-patients
#18
Damien Thellier, Pierre Y Delannoy, Olivier Robineau, Agnès Meybeck, Nicolas Boussekey, Arnaud Chiche, Olivier Leroy, Hugues Georges
BACKGROUND: Terminal extubation (TE) is applied in some intensive care unit (ICU) patients when a decision of withdrawal of mechanical ventilation is decided. Other units prefer terminal weaning (TW) with no removal of the endotracheal tube. We report our experience with these two procedures. METHODS: We conducted a retrospective study analyzing patients deceased in our ICU after a decision of life sustained therapy (LST) during the year 2013. TE was proposed to family members for patients presenting with two medical conditions: lack of vasoactive drugs (VAD) and SaO2 > 95% with a FIO2 < 50%...
November 23, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27879298/withdrawals-and-retirements-in-professional-tennis-players-an-analysis-of-2013-united-states-tennis-association-pro-circuit-tournaments
#19
Matthew J Hartwell, Sandra M Fong, Alexis C Colvin
BACKGROUND: Injuries and illnesses for professional tennis athletes disrupt training, competition, and progression in the sport and represent a major reason for athlete withdrawal or retirement from a tournament. Few descriptive epidemiological studies have focused on these trends in elite tennis athletes. PURPOSE: To examine the causes of professional tennis player withdrawal or retirement from United States Tennis Association (USTA) Pro Circuit tournaments during 2013...
November 22, 2016: Sports Health
https://www.readbyqxmd.com/read/27875769/status-epilepticus-in-pregnant-women-with-epilepsy-after-valproate-adjustment-a-case-series
#20
Mengqian Wu, Nanya Hao, Bo Yan, Xiaosa Chi, Dong Zhou
PURPOSE: Valproate is an effective wide-spectrum anti-epileptic drug that is also known to be teratogenic. Its administration in epileptic women remains controversial. This report aims to draw more attention to valproate adjustment before and during pregnancy. METHODS: We collected medical records of pregnant women with epilepsy at West China Hospital in Chengdu, China who developed status epilepticus during pregnancy after valproate withdrawal or reduction in dose from January 2013 to July 2015...
November 14, 2016: Seizure: the Journal of the British Epilepsy Association
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