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https://www.readbyqxmd.com/read/27913473/first-line-therapy-for-young-patients-with-cll
#1
Nitin Jain, Susan O'Brien
A 61-year-old man with a history of chronic lymphocytic leukemia (CLL) presents with complaints of worsening fatigue and night sweats. He was diagnosed with CLL 3 years ago on routine blood count testing. He has no major medical comorbidities. On examination, he has several 2- to 3-cm lymph nodes in the cervical and axillary area. Spleen is palpable 5 cm below the costal margin. Blood counts show lymphocytosis with thrombocytopenia and anemia. Prognostic markers include deletion 13q by fluorescence in situ hybridization analysis and mutated IGHV You are asked by the hematology fellow you are supervising about the best treatment of this patient...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27896330/biventricular-thrombus-in-hypereosinophilic-syndrome-presenting-with-shortness-of-breath
#2
Abdul Baqi, Shahan Waheed, Fateh Ali Tipoo, Aamir Hameed Khan
A 48 years old male presented to clinic with 12 months of low grade fever with shortness of breath which has progressively worsened with no associated weight loss, night sweats or loss of appetite. There was no prior history of chronic illness before the current illness. Laboratory workup revealed a high white blood cell count with predominant eosinophils. Chest X-ray was normal. Transthoracic echocardiography and Cardiac Magnetic Resonance showed biventricular thrombi. On further extensive workup the findings were consistent with hypereosinophilic syndrome...
June 2016: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27887581/design-of-a-randomized-controlled-trial-of-internet-based-cognitive-behavioral-therapy-for-treatment-induced-menopausal-symptoms-in-breast-cancer-survivors
#3
Vera Atema, Marieke van Leeuwen, Hester S A Oldenburg, Valesca Retèl, Marc van Beurden, Myra S Hunter, Neil K Aaronson
BACKGROUND: Menopausal symptoms are common and may be particularly severe in younger women who undergo treatment-induced menopause. Medications to reduce menopausal symptoms are either contra-indicated or have bothersome side effects. Previous studies have demonstrated that face-to-face cognitive behavioral therapy (CBT) is effective in alleviating menopausal symptoms in women with breast cancer. However, compliance with face-to-face CBT programs can be problematic. A promising approach is to use the Internet to make this form of CBT more accessible and feasible for patients...
November 25, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27866494/brucellosis-as-a-neglected-disease-in-a-neglected-population-a-seroepidemiological-study-of-migratory-nomads-in-the-fars-province-of-iran
#4
B Honarvar, M Moghadami, K B Lankarani, M A Davarpanah, M Ataolahi, A Farbod, E Eskandari, M Panahi, A Ghorbani, Z Zahiri, R Tabrizi, M Pourjafar, S M M Heidari
This study assessed the seroprevalence of brucellosis and its risk factors in migratory nomads in the Fars province of Iran. Active brucellosis was defined as the combination of clinical symptoms, including fever, chills, night sweats, headache, low back pain, arthralgia, or myalgia, and positive laboratory testing, including either a serum agglutination test (SAT) ⩾1:80 with a 2-mercaptoethanol (2-ME) test ⩾1:40, or a SAT <1:80 combined with a positive Coombs Wright test (CWT) at a titre of at least threefold higher than SAT titre results...
November 21, 2016: Epidemiology and Infection
https://www.readbyqxmd.com/read/27858987/the-efficacy-and-safety-of-continued-hydroxycarbamide-therapy-versus-switching-to-ruxolitinib-in-patients-with-polycythaemia-vera-a-randomized-double-blind-double-dummy-symptom-study-relief
#5
Ruben Mesa, Alessandro M Vannucchi, Abdulraheem Yacoub, Pierre Zachee, Mamta Garg, Roger Lyons, Steffen Koschmieder, Ciro Rinaldi, Jennifer Byrne, Yasmin Hasan, Francesco Passamonti, Srdan Verstovsek, Deborah Hunter, Mark M Jones, Huiling Zhen, Dany Habr, Bruno Martino
The randomized, double-blind, double-dummy, phase 3b RELIEF trial evaluated polycythaemia vera (PV)-related symptoms in patients who were well controlled with a stable dose of hydroxycarbamide (also termed hydroxyurea) but reported PV-related symptoms. Patients were randomized 1:1 to ruxolitinib 10 mg BID (n = 54) or hydroxycarbamide (prerandomization dose/schedule; n = 56); crossover to ruxolitinib was permitted after Week 16. The primary endpoint, ≥50% improvement from baseline in myeloproliferative neoplasm -symptom assessment form total symptom score cytokine symptom cluster (TSS-C; sum of tiredness, itching, muscle aches, night sweats, and sweats while awake) at Week 16, was achieved by 43·4% vs...
November 8, 2016: British Journal of Haematology
https://www.readbyqxmd.com/read/27842535/rapid-urine-lipoarabinomannan-assay-as-a-clinic-based-screening-test-for-active-tuberculosis-at-hiv-diagnosis
#6
Paul K Drain, Elena Losina, Sharon M Coleman, Janet Giddy, Douglas Ross, Jeffrey N Katz, Ingrid V Bassett
BACKGROUND: World Health Organization (WHO) recommends tuberculosis (TB) screening at HIV diagnosis. We evaluated the inclusion of rapid urine lipoarabinomannan (LAM) testing in TB screening algorithms. METHODS: We enrolled ART-naïve adults who screened HIV-infected in KwaZulu-Natal, assessed TB-related symptoms (cough, fever, night sweats, weight loss), and obtained sputum specimens for mycobacterial culture. Trained nurses performed clinic-based urine LAM testing using a rapid assay...
November 14, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27832897/a-7-year-old-boy-with-sudden-onset-of-loud-snoring
#7
Lourdes M DelRosso
A 7-year-old boy was referred for evaluation of loud nightly snoring. Snoring started suddenly 2 weeks prior to presentation and grew progressively worse. Currently, the parents witnessed breathing pauses and gasping at night. The parents moved the child to a recliner to be able to breathe better, but the snoring and apneas persisted. There was no sleepwalking, night terrors, or nocturnal enuresis. During the day, the boy did not endorse symptoms of excessive sleepiness. The review of systems was negative for fever, weight loss, night sweats, sore throat, dysphagia, nasal congestion, ear pain, chest pain, shortness of breath, stridor, and abdominal pain...
November 2016: Chest
https://www.readbyqxmd.com/read/27832718/mind-body-interventions-for-vasomotor-symptoms-in-healthy-menopausal-women-and-breast-cancer-survivors-a-systematic-review
#8
Evgenia Stefanopoulou, Elizabeth Alice Grunfeld
Mind-body therapies are commonly recommended to treat vasomotor symptoms, such as hot flushes and night sweats (HFNS). The purpose of this systematic review was to evaluate the available evidence to date for the efficacy of different mind-body therapies to alleviate HFNS in healthy menopausal women and breast cancer survivors. Randomized controlled trials (RCTs) were identified using seven electronic search engines, direct searches of specific journals and backwards searches through reference lists of related publications...
November 11, 2016: Journal of Psychosomatic Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27830112/mycoplasma-pneumonia-with-persistent-lymphadenopathy-and-severe-cold-agglutinin-haemolysis
#9
Mit Shah, Sajid Khan, Kenneth Chan
Mycoplasma pneumonia is an atypical pneumonia commonly affecting young patients with generally mild clinical course. We present a case of a 66-year-old female presenting with weight loss, night sweats and low-grade pyrexia. She acquired symptomatic haemolytic anaemia requiring blood transfusion, markedly raised erythrocyte sedimentation rate (ESR) to 114 mm/hr and extensive peri-hilar lymphadenopathy on computed tomography (CT) scan. After excluding malignancy and granulomatous diseases, she made good recovery although a 4 week follow-up CT scan showed persistent but resolving lymphadenopathy...
2016: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27825464/prognostic-factors-and-indications-for-treatment-of-waldenstr%C3%A3-m-s-macroglobulinemia
#10
REVIEW
Robert A Kyle, Stephen M Ansell, Prashant Kapoor
Waldenström's Macroglobulinemia (WM) is characterized by the presence of an IgM monoclonal protein regardless of its size, 10% or more bone marrow infiltration by small lymphocytes with a plasmacytoid or plasma cell differentiation. These cells usually have the following markers: IgM+, CD5(-), CD10(-), CD19(+), CD20(+) and CD23(-). Chronic lymphocytic leukemia as well as other lymphoproliferative disorders such as mantle cell, marginal zone and mucosa-associated lymphoid tissue (MALT) lymphoma must be excluded...
June 2016: Best Practice & Research. Clinical Haematology
https://www.readbyqxmd.com/read/27823734/predictors-of-sleep-disturbance-in-menopausal-transition
#11
Laura Lampio, Tarja Saaresranta, Janne Engblom, Olli Polo, Päivi Polo-Kantola
OBJECTIVE: This follow-up study aimed to evaluate risk factors for menopausal sleep disturbances already identifiable before menopause. METHODS: At baseline, all 81 women were premenopausal. At year-five follow-up, 27 of the women were premenopausal, 40 postmenopausal, and 14 postmenopausal and using hormone therapy. We used the Basic Nordic Sleep Questionnaire to study sleep; additional questionnaires evaluated risk factors for sleep impairment. RESULTS: Sleep quality differed only marginally between the groups...
December 2016: Maturitas
https://www.readbyqxmd.com/read/27822491/primary-gynecological-non-hodgkin-s-lymphoma-a-differential-diagnosis-of-a-pelvic-mass
#12
Shilpa Vijayakumar, Eli Serur, Bahar Bybordi, Nisha Lakhi
Primary Non-Hodgkin's lymphoma (NHL) can mimic gynecological malignancy, presenting as a pelvic mass in any organ of the female genital tract. Patients can present with elevated CA-125 and may lack the classical symptoms associated with lymphoma, such as fatigue, fever, night sweats and weight loss. We describe five patients that presented with primary NHL of the genital tract. Patients 1, 2, and 3 were not diagnosed pre-operatively, and underwent unnecessary cytoreductive surgery, while patients 4 and 5 were diagnosed by pre-operative biopsy...
November 2016: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/27817806/factors-which-influence-treatment-initiation-for-pulmonary-non-tuberculous-mycobacterium-infection-in-hiv-negative-patients-a-multicentre-observational-study
#13
Timothy M Rawson, Aula Abbara, Katharina Kranzer, Andrew Ritchie, James Milburn, Tim Brown, David Adeboyeku, Jim Buckley, Robert N Davidson, Matthew Berry, Onn Min Kon, Laurence John
BACKGROUND: Clinical, radiological and microbiological criteria inform diagnosis of pulmonary Non-Tuberculous Mycobacteria (NTM) disease and treatment decisions. This multicentre, review aims to characterise NTM disease meeting ATS/IDSA criteria and define factors associated with initiation of treatment. METHODS: Sputum samples growing NTM from 5 London hospitals between 2010 and 2014 were identified. Data for HIV-negative individuals meeting ATS/IDSA guidelines for pulmonary NTM disease were extracted...
November 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27807553/a-rare-case-of-isolated-pancreatic-tuberculosis
#14
Daniel J Waintraub, Lionel S D'Souza, Emilio Madrigal, Manju Harshan, Gil I Ascunce
Pancreatic tuberculosis (TB) is a rare but important entity to consider when evaluating a pancreatic mass, especially in patients from endemic areas. Its clinical and radiologic features may mimic those of a pancreatic neoplasm, making it a difficult clinical diagnosis. We present a case of a 31-year-old Indian man who presented with fevers, night sweats, weight loss, and epigastric pain. Abdominal magnetic resonance imaging (MRI) showed a pancreatic head mass. Biopsy of the mass was consistent with pancreatic tuberculosis...
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/27803821/hemophagocytic-lymphohistiocytosis-in-a-patient-with-classical-hodgkin-lymphoma
#15
G Hyun, K J Robbins, N Wilgus, L Grosso, S D Goyal
Introduction. Hemophagocytic lymphohistiocytosis (HLH) is a rare hyperinflammatory syndrome that can be associated with inherited genetic mutations, malignancy, autoimmune disorders, and viral infections. Though the pathogenesis is not fully known, HLH is understood to be a reactive process in the setting of uncontrolled activation of macrophages, CD8+ cytotoxic lymphocytes, and other immune cells. Hallmark clinicopathological features of HLH include fevers, cytopenias, hepatosplenomegaly, and hemophagocytosis in the bone marrow...
2016: Case Reports in Hematology
https://www.readbyqxmd.com/read/27797813/hoarse-voice-a-rare-presentation-of-tuberculosis-lymphadenitis
#16
Laurie Rigueros Springford, Krishan Ramdoo, Dilip Nair, Ali Taghi
A man aged 37 years from Indian descent presented to an inner city London hospital with hoarseness of voice, fatigue, night sweats and a 2 kg weight loss. Laryngoscopy demonstrated a left vocal fold palsy. Extensive investigations were undertaken with disseminated malignancy being primarily investigated. CT/MRI scanning showed non-specific necrotic mediastinal lymph nodes. Tuberculin skin testing, cytology and PCR were eventually undergone. Tests yielded results consistent with tuberculosis (TB) infection and the patient was started on standard TB treatment protocol, with excellent results...
October 24, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27796129/-diagnosis-and-treatment-of-polycythaemia-vera-state-of-the-art
#17
Imelda Marton, Zsófia Simon, Zita Borbényi
Polycythaemia vera (PV), a condition characterized by blood hyperviscosity due to the expansion of the erythrocyte mass is the most common entity among all Philadelphia chromosome-negative myeloproliferative neoplasms. Arterial and venous thrombotic events are leading determinants of morbidity and mortality but impairment of quality of life due to vasomotor symptoms (erythromelalgia, pruritus) and disease-associated symptoms (tiredness, fatigue, pruritus, night sweats, vision problems, headache, concentration loss, abdominal discomfort, early satiety, fever, weight loss) are also present...
October 2016: Orvosi Hetilap
https://www.readbyqxmd.com/read/27795799/-thyroid-abscess-revealing-graves-basedow-disease-about-a-case-and-review-of-the-literature
#18
Meriem Chenguir, Hajar Souldi, Fatima Zahra Loufad, Sami Rouadi, Reda Abada, Mohamed Roubal, Mohamed Mahtar
Thyroid abscess is a very rare clinical entity. It accounts for 0.1% of the surgical pathologies of the thyroid gland. The anatomical and physiological characteristics of the gland give it resistance to pathogens. Streptococcal and Staphylococcal are the most common. Tuberculosis is rarely reported in the literature. The occurrence of infection associated with toxic goiter is exceptional. The authors report a rare case of a 22-year-old young patient with thyroid abscess revealing a toxic goitre. He presented to our otorhinolaryngology emergency unit with anterior cervical swelling, slightly lateralized to the left, moving on swallowing, associated with hemoptysis, signs of thyroid dysfunction, fever, night sweats...
2016: Pan African Medical Journal
https://www.readbyqxmd.com/read/27784885/tuberculosis
#19
Madhukar Pai, Marcel A Behr, David Dowdy, Keertan Dheda, Maziar Divangahi, Catharina C Boehme, Ann Ginsberg, Soumya Swaminathan, Melvin Spigelman, Haileyesus Getahun, Dick Menzies, Mario Raviglione
Tuberculosis (TB) is an airborne infectious disease caused by organisms of the Mycobacterium tuberculosis complex. Although primarily a pulmonary pathogen, M. tuberculosis can cause disease in almost any part of the body. Infection with M. tuberculosis can evolve from containment in the host, in which the bacteria are isolated within granulomas (latent TB infection), to a contagious state, in which the patient will show symptoms that can include cough, fever, night sweats and weight loss. Only active pulmonary TB is contagious...
October 27, 2016: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/27781103/ageing-and-menopause-considerations-for-women-with-hiv-in-the-uk
#20
EDITORIAL
L Sherr, A Molloy, A Macedo, N Croome, M A Johnson
OBJECTIVES: Treatment rollout has dramatically improved life expectancy for people with HIV and AIDS. Women represent a substantial proportion of patients in the UK (approximately one-third of patients in care are female according to the HIV Annual Report 2014). This study examines psychosocial and biomedical issues for women diagnosed with HIV in the UK, comparing those above and below 45 years of age to examine menopause and ageing issues. METHODS: Consecutive clinic attenders in a large outpatient London HIV clinic were invited to participate in the study...
October 5, 2016: Journal of Virus Eradication
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