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https://www.readbyqxmd.com/read/29333023/nivolumab-pearls-of-evidence
#1
REVIEW
Pratishtha B Chaudhari
Purpose: Nivolumab is one of the most extensively studied immune checkpoint inhibitors across various tumor types. In this narrative review, the current clinical efficacy and safety data of anti-programmed death-1 (PD-1) nivolumab for nonsmall cell lung cancer (NSCLC) and renal cell cancer (RCC) are elucidated. Methods: Systematic search was done on Pubmed, Medline, Embase, Web of Knowledge, and Cochrane Central through September 2016 for controlled prospective interventional studies of nivolumab across two indications - NSCLC and RCC...
October 2017: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/29288262/rate-or-rhythm-control-of-atrial-fibrillation-pearls-for-the-internist
#2
Weiting Huang, Felix Yj Keng, Chi Keong Ching
Atrial fibrillation is an epidemic in Asia that is increasingly prevalent. Apart from stroke risk stratification and management of anticoagulation, physicians managing this group of patients also need to determine an optimal strategy in terms of rate or rhythm control. With new techniques of catheter ablation to maintain patients in sinus rhythm, patients with atrial fibrillation now have more options for treatment, on top of pharmacological methods. This paper aims to review the current evidence for rate and rhythm control in both general patients and subgroups of interest commonly encountered in clinical practices such as obesity, heart failure and thyroid disease...
November 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/29261271/managing-dislocations-of-the-hip-knee-and-ankle-in-the-emergency-department-digest
#3
Caylyne Arnold, Zane Fayos, David Bruner, Dylan Arnold, Nachi Gupta, Jeffrey Nusbaum
Dislocation of the major joints of the lower extremities--hip, knee, and ankle--can occur due to motor-vehicle crashes, falls, and sports injuries. Hip dislocations are the most common, and they require emergent management to prevent avascular necrosis of the femoral head. Knee dislocations are uncommon but potentially dangerous injuries that can result in amputation due to the potential for missed secondary injury, especially if they are reduced spontaneously. Isolated ankle dislocations are relatively rare, as most ankle dislocations involve an associated fracture...
December 20, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29250979/pharmacokinetic-drug-evaluation-of-ulipristal-acetate-for-the-treatment-of-uterine-fibroids
#4
Simone Ferrero, Valerio Gaetano Vellone, Fabio Barra
Uterine fibroids are the most common form of benign gynecological tumors in women of reproductive ages. Although surgery is the main option to treat them, alternative pharmacological approaches are being investigated to control their symptoms. Among them, ulipristal acetate (UPA) has been the first selective progesterone-receptor modulator (SPRM) approved for the pre-operative and long-term treatment of uterine fibroids. Areas covered: The aim of this article is to review the literature on the pharmacodynamics, pharmacokinetics (PK), clinical efficacy and safety of UPA for the treatment of uterine fibroids...
January 2018: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/29247482/commonalities-in-epileptogenic-processes-from-different-acute-brain-insults-do-they-translate
#5
REVIEW
Pavel Klein, Raymond Dingledine, Eleonora Aronica, Christophe Bernard, Ingmar Blümcke, Detlev Boison, Martin J Brodie, Amy R Brooks-Kayal, Jerome Engel, Patrick A Forcelli, Lawrence J Hirsch, Rafal M Kaminski, Henrik Klitgaard, Katja Kobow, Daniel H Lowenstein, Phillip L Pearl, Asla Pitkänen, Noora Puhakka, Michael A Rogawski, Dieter Schmidt, Matti Sillanpää, Robert S Sloviter, Christian Steinhäuser, Annamaria Vezzani, Matthew C Walker, Wolfgang Löscher
The most common forms of acquired epilepsies arise following acute brain insults such as traumatic brain injury, stroke, or central nervous system infections. Treatment is effective for only 60%-70% of patients and remains symptomatic despite decades of effort to develop epilepsy prevention therapies. Recent preclinical efforts are focused on likely primary drivers of epileptogenesis, namely inflammation, neuron loss, plasticity, and circuit reorganization. This review suggests a path to identify neuronal and molecular targets for clinical testing of specific hypotheses about epileptogenesis and its prevention or modification...
December 15, 2017: Epilepsia
https://www.readbyqxmd.com/read/29246254/disclosure-of-domestic-violence-and-sexual-assault-within-the-context-of-abortion-meta-ethnographic-synthesis-of-qualitative-studies-protocol
#6
Lydia Mainey, Annabel Taylor, Kathleen Baird, Catherine O'Mullan
BACKGROUND: One third of women will have an abortion in their lifetime (Kerr, QUT Law Rev 14:15, 2014; Aston and Bewley, Obstetrician & Gynaecologist 11:163-8, 2009). These women are more likely to have experienced domestic violence or sexual assault than women who continue with their pregnancies. Frontline health personnel involved in the care of women seeking abortions are uniquely positioned to support patients who choose to disclose their violence. Yet, the disclosure of domestic violence or sexual assault within the context of abortion is not well understood...
December 15, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/29208815/managing-the-posterior-polar-cataract-an-update
#7
REVIEW
Abhay R Vasavada, Vaishali A Vasavada
Posterior polar cataracts (PPC) have always been a challenge for cataract surgeons due to their inherently higher propensity for posterior capsule rupture. Over the years, several technical modifications have been suggested to enhance safety and reduce posterior capsule rupture rates in these polar cataracts. This review article tries to present the various techniques and strategies to published in literature to manage PPCs. It also discusses pearls for making surgery more reproducible and consistent, as well as the role of newer diagnostic and surgical technology based on the published literature on the subject...
December 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/29200245/management-of-inflammatory-bowel-disease-flares-in-the-emergency-department-digest
#8
Michael D Burg, Steven T Riccoboni, Jeffrey Nusbaum, Nachi Gupta
Because of the chronic relapsing nature of inflammatory bowel disease (IBD), emergency clinicians frequently manage patients with acute flares and complications. IBD patients present with an often-broad range of nonspecific signs and symptoms, and it is essential to differentiate a mild flare from a life-threatening intra-abdominal process. Recognizing extraintestinal manifestations and the presence of infection are critical. This issue reviews the literature on management of IBD flares in the emergency department, including laboratory testing, imaging, and identification of surgical emergencies, emphasizing the importance of coordination of care with specialists on treatment plans and offering patients resources for ongoing support...
November 22, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29200114/neuroradiologic-pearls-for-neuro-oncology
#9
Joshua P Klein, Jorg Dietrich
PURPOSE OF REVIEW: This article reviews key principles in the identification of tumors of the central nervous system (CNS) using standard and advanced imaging modalities. This article highlights the pitfalls and pearls of the imaging evaluation of patients with cancer at time of diagnosis and during cancer therapy and discusses the challenges of the imaging evaluation of treatment-related toxicities. RECENT FINDINGS: Treatment of CNS tumors with surgery, chemotherapy, or radiation alters the imaging appearance of the tumor and can be associated with a variety of treatment-related toxicities...
December 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/29185005/larger-range-of-motion-and-increased-return-to-activity-but-higher-revision-rates-following-unicompartmental-versus-total-knee-arthroplasty-in-patients-under-65-a-systematic-review
#10
REVIEW
Laura J Kleeblad, Jelle P van der List, Hendrik A Zuiderbaan, Andrew D Pearle
PURPOSE: Due to the lack of comparative studies, a systematic review was conducted to determine revision rates of unicompartmental and total knee arthroplasty (UKA and TKA), and compare functional outcomes, range of motion and activity scores in patients less than 65 years of age. METHODS: A literature search was performed using PubMed, Embase, and Cochrane systems since 2000. 27 UKA and 33 TKA studies were identified and included. Annual revision rate (ARR), functional outcomes, and return to activity were assessed for both types of arthroplasty using independent t tests...
November 28, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29166132/imaging-of-iatrogenic-esophageal-injuries-using-optimized-ct-esophageal-leak-protocol-pearls-and-pitfalls
#11
Rachna Madan, Olga Laur, Breland Crudup, Latia Peavy, Brett W Carter
Iatrogenic injury to the esophagus is a serious complication which is increasingly seen in clinical practice secondary to expansion and greater acceptability of surgical and endoscopic esophageal procedures. Morbidity and mortality following such injury is high. This is mostly due to an inflammatory response to gastric contents in the mediastinum, and the negative intra-thoracic pressures that may further draw out esophageal contents into the mediastinum leading to mediastinitis. Subsequently, pulmonary complications such as pneumonia or abscess may ensue leading to rapid clinical deterioration...
November 22, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/29142340/clinical-pearls-etiologies-of-superscan-appearance-on-fluorine-18-fludeoxyglucose-positron-emission-tomography-computed-tomography
#12
REVIEW
John Joseph Manov, Patrick J Roth, Russ Kuker
The term "superscan" usually refers to a characteristic pattern on skeletal scintigraphy consisting of symmetrically intense and diffuse radiotracer uptake in the skeleton with absent or diminished visualization of the genitourinary system and soft tissues. Superscans and superscan-like appearances have also been described on fluorine-18-fludeoxyglucose positron emission tomography-computed tomography (18-F-FDG PET/CT). We review reported cases of 18-F-FDG PET/CT superscans and propose criteria for differentiating pathologic superscans from physiologic causes...
October 2017: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
https://www.readbyqxmd.com/read/29138201/effect-of-iron-and-zinc-biofortified-pearl-millet-consumption-on-growth-and-immune-competence-in-children-aged-12-18-months-in-india-study-protocol-for-a-randomised-controlled-trial
#13
Saurabh Mehta, Julia L Finkelstein, Sudha Venkatramanan, Samantha L Huey, Shobha A Udipi, Padmini Ghugre, Caleb Ruth, Richard L Canfield, Anura V Kurpad, Ramesh D Potdar, Jere D Haas
INTRODUCTION: Biofortified crops represent a sustainable agricultural solution for the widespread micronutrient malnutrition in India and other resource-limited settings. This study aims to investigate the effect of the consumption of foods prepared with iron- and zinc-biofortified pearl millet (FeZn-PM) by children on biomarkers of iron and zinc status, growth, and immune function. METHODS AND ANALYSIS: We will conduct a randomised controlled feeding trial in identified slums of Mumbai, India among 200 children aged between 12 and 18 months...
November 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/29132578/major-trauma-outside-a-trauma-center-prehospital-emergency-department-and-retrieval-considerations
#14
REVIEW
Preston J Fedor, Brian Burns, Michael Lauria, Clare Richmond
Care of the critically injured begins well before the patient arrives at a large academic trauma center. It is important to understand the continuum of care from the point of injury in the prehospital environment, through the local hospital and retrieval, until arrival at a trauma center capable of definitive care. This article highlights the important aspects of trauma assessment and management outside of tertiary or quaternary care hospitals. Key elements of each phase of care are reviewed, including management pearls and institutional strategies to facilitate effective and efficient treatment of trauma patients from the point of injury forward...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29131768/from-inguinal-hernias-to-spermatic-cord-lipomas-pearls-pitfalls-and-mimics-of-abdominal-and-pelvic-hernias
#15
Miguel C Cabarrus, Benjamin M Yeh, Andrew S Phelps, Jao J Ou, Spencer C Behr
Abdominal and pelvic hernias may be indolent and detected incidentally, manifest acutely with pain and distress, or cause chronic discomfort. Physical examination findings are often ambiguous and insufficient for optimal triage. Therefore, accurate anatomic delineation and identification of complications are critical for effective treatment planning. Imaging, particularly computed tomography, provides a vital understanding of the hernia's location and size, involved viscera, and severity of associated complications...
November 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29105584/is-ulipristal-acetate-the-new-drug-of-choice-for-the-medical-management-of-uterine-fibroids-res-ipsa-loquitur
#16
Funlayo Odejinmi, Reeba Oliver, Rebecca Mallick
Ulipristal acetate (Esmya(©)) has been hailed the new wonder drug with regard to the medical management of uterine fibroids, and many postulate that it will remove the need for surgical treatment in the future. While the results from the PEARL studies are certainly promising and its amenorrhoeic rates and reduction in fibroid size are unquestionable, there is still a paucity of data with regard to its long-term effects, the effects on its usage prior to surgery and its variable efficacy in different ethnic populations...
November 1, 2017: Women's Health
https://www.readbyqxmd.com/read/29095394/mri-arthroscopy-correlation-of-the-rotator-cuff-a-case-based-review
#17
Rafael A Buerba, Armin Arshi, Kim M Lee, Benjamin D Levine, Frank A Petrigliano
With significant advancements over recent decades, magnetic resonance imaging (MRI) and shoulder arthroscopy are important complementary tools in guiding orthopedic surgeons to diagnosis, decision making, and treatment of rotator cuff pathology. The objective of this article is to review the basic principles and pearls of MRI-arthroscopy correlation of the rotator cuff through an overview of our approach to reading shoulder MRI followed by a case-based review of selected conditions. By understanding and comparing the subtleties of these modalities, radiologists and clinicians can better appreciate both the utility and limitations of MRI in predicting operative findings...
December 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/29081785/finger-on-the-pulse-pumping-iron-into-chickpea
#18
REVIEW
Grace Z H Tan, Sudipta S Das Bhowmik, Thi M L Hoang, Mohammad R Karbaschi, Alexander A T Johnson, Brett Williams, Sagadevan G Mundree
Iron deficiency is a major problem in both developing and developed countries, and much of this can be attributed to insufficient dietary intake. Over the past decades several measures, such as supplementation and food fortification, have helped to alleviate this problem. However, their associated costs limit their accessibility and effectiveness, particularly amongst the financially constrained. A more affordable and sustainable option that can be implemented alongside existing measures is biofortification...
2017: Frontiers in Plant Science
https://www.readbyqxmd.com/read/29068641/pediatric-wound-care-and-management-in-the-emergency-department-digest
#19
Jennifer E Sanders, Kathryn H Pade
Traumatic wounds and lacerations are common pediatric presenting complaints to emergency departments. Although there is a large body of literature on wound care, many emergency clinicians base management of wounds on theories and techniques that have been passed down over time. Therefore, controversial, conflicting, and unfounded recommendations are prevalent. This issue reviews evidence-based recommendations for wound care and management, including wound cleansing and irrigation, anxiolysis/sedation techniques, closure methods, and post-repair wound care...
October 23, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/29064976/considerations-when-treating-cosmetic-concerns-in-men-of-color
#20
REVIEW
Olabola Awosika, Cheryl M Burgess, Pearl E Grimes
BACKGROUND: Men of color include a diverse population encompassing individuals with Fitzpatrick skin Types IV through VI. Yet, there is a paucity of data describing the cosmetic concerns of this population. OBJECTIVE: To review the basic science of advantages and disadvantages of skin of color and pathophysiology, incidence, and treatment of disorders of cosmetic concern in men of color. METHODS: A MEDLINE search was performed for publications on sex and racial differences in basic science of skin, common disorders in men of color, and evidence-based treatments...
November 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
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