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https://www.readbyqxmd.com/read/28527261/-posterior-reversible-encephalopathy-syndrome-report-of-a-fatal-case-and-analysis-of-predictive-factors-of-a-poor-prognosis
#1
Moisés Ulises Torres, Ligia Victoria Delgado, Natalia Giraldo, Piedad Urueña, Sergio Franco, Olga Helena Hernández
Posterior reversible encephalopathy syndrome is an illness with multiple causes and distinctive clinicalradiological characteristics that should be known by intensivists and emergency room physicians for a timely diagnosis and treatment. A fatal case of posterior reversible encephalopathy syndrome is presented, and the risk factors related to the outcome are identified.A 60-year-old man without a relevant medical history arrived at the emergency room presenting with depressed consciousness, seizures, and high blood pressure...
April 1, 2017: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/28527040/fundamental-principles-of-an-anti-vegf-treatment-regimen-optimal-application-of-intravitreal-anti-vascular-endothelial-growth-factor-therapy-of-macular-diseases
#2
REVIEW
Paolo Lanzetta, Anat Loewenstein
BACKGROUND: Intravitreal anti-vascular endothelial growth factor (VEGF) therapy is now considered the gold standard for the treatment of various retinal disorders. As therapy has evolved, so too have the treatment regimens employed by physicians in clinical practice; however, visual outcomes observed in the real world have typically not reflected those reported in clinical trials. Possible reasons for this include a lack of consensus on treatment regimens and a lack of clarity about what the aims of treatment should be...
May 19, 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/28526765/factors-associated-with-ischemic-stroke-survival-and-recovery-in-older-adults
#3
Divya Thekkethala Winovich, William T Longstreth, Alice M Arnold, Ravi Varadhan, Adina Zeki Al Hazzouri, Mary Cushman, Anne B Newman, Michelle C Odden
BACKGROUND AND PURPOSE: Little is known about factors that predispose older adults to poor recovery after a stroke. In this study, we sought to evaluate prestroke measures of frailty and related factors as markers of vulnerability to poor outcomes after ischemic stroke. METHODS: In participants aged 65 to 99 years with incident ischemic strokes from the Cardiovascular Health Study, we evaluated the association of several risk factors (frailty, frailty components, C-reactive protein, interleukin-6, and cystatin C) assessed before stroke with stroke outcomes of survival, cognitive decline (≥5 points on Modified Mini-Mental State Examination), and activities of daily living decline (increase in limitations)...
May 19, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28526718/p16-hpv-and-cetuximab-what-is-the-evidence
#4
James A Bonner, Ricard Mesia, Jordi Giralt, Amanda Psyrri, Ulrich Keilholz, David I Rosenthal, Frank Beier, Jeltje Schulten, Jan B Vermorken
Squamous cell carcinoma of the head and neck (SCCHN) is the sixth most common cancer worldwide. It has recently been appreciated that human papillomavirus (HPV) status (or p16 status, which is a frequently used surrogate for HPV status) is prognostic for oropharyngeal SCCHN. Here, we review and contextualize existing p16 and HPV data, focusing on the cetuximab registration trials in previously untreated, locoregionally advanced, nonmetastatic SCCHN (LA SCCHN) and in recurrent and/or metastatic SCCHN (R/M SCCHN): the IMCL-9815 and EXTREME clinical trials, respectively...
May 18, 2017: Oncologist
https://www.readbyqxmd.com/read/28526644/simple-tumor-localization-scale-for-estimating-management-outcome-of-intracranial-meningioma
#5
Bruno Splavski, Irina Bagic, Vjenceslav Vrtaric, Brano Splavski
OBJECTIVE: Intracranial meningiomas are typically benign extracerebral tumors derived from dural arachnoid cells. Predominantly, these tumors are effectively managed surgically, but the prognosis is heavily dependent on tumors' histological heterogeneity and its location. It is known that reproductive and hormonal factors increase the risk for meningioma in adult females, but their prognostic value still remains controversial. This study's aim was to examine possible correlation between tumor location and outcome, and to evaluate prognostic value of the proposed simple tumor localization scale in predicting the management outcome of intracranial meningioma...
May 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28526416/treatment-strategy-for-type-2-diabetes-with-obesity-focus-on-glucagon-like-peptide-1-receptor-agonists
#6
REVIEW
Qiuhe Ji
PURPOSE: The progressive nature of type 2 diabetes mellitus (T2DM) calls for step-wise intensification of therapy for maintaining normal glycemic levels and lowering cardiovascular (CV) risk. Because obesity is a prominent risk factor and comorbidity of T2DM, it further elevates the CV risk in T2DM. Therefore, it is vital to manage weight, obesity, and glycemic parameters for effective T2DM management. Few oral antidiabetic drugs (sulfonylureas and thiazolidinediones) and insulin are not suitable for obese patients with T2DM because these drugs cause weight gain...
May 16, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28526186/cardiovascular-protection-in-the-treatment-of-type-2-diabetes-a-review-of-clinical-trial-results-across-drug-classes
#7
Francesco Paneni, Thomas F Lüscher
Patients with type 2 diabetes (T2DM) have a significantly higher risk of developing cardiovascular disease (CVD)-namely myocardial infarction, heart failure, and stroke. Despite clear advances in the prevention and treatment of CVD, the impact of T2DM on CVD outcome remains high and continues to escalate. Available evidence indicates that the risk of macrovascular complications increases with the severity of hyperglycemia, thus suggesting that the relation between metabolic disturbances and vascular damage is approximately linear...
May 15, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28526182/pharmacologic-management-of-type-2-diabetes-mellitus-available-therapies
#8
James Thrasher
Choices for the treatment of type 2 diabetes mellitus (T2DM) have multiplied as our understanding of the underlying pathophysiologic defects has evolved. Treatment should target multiple defects in T2DM and follow a patient-centered approach that considers factors beyond glycemic control, including cardiovascular risk reduction. The American Association of Clinical Endocrinologists/American College of Endocrinology and the American Diabetes Association recommend an initial approach consisting of lifestyle changes and monotherapy, preferably with metformin...
May 12, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28526144/pulmonary-vasodilators-and-anesthesia-considerations
#9
REVIEW
Jeremy B Green, Brendon Hart, Elyse M Cornett, Alan D Kaye, Ali Salehi, Charles J Fox
Pulmonary hypertension (PH) is a complex disease process of the pulmonary vasculature system characterized by elevated pulmonary arterial pressures. Patients with PH are at increased risk for morbidity and mortality, including intraoperatively and postoperatively. Appreciation by the clinical anesthesiologist of the pathophysiology of PH is warranted. Careful and meticulous strategy using appropriate anesthetic medications, pulmonary vasodilator and inotropic agents, and careful fluid management all increase the likelihood of the best possible outcome in this challenging patient population...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28526014/the-use-of-lipid-lowering-therapy-and-effects-of-antihyperglycaemic-therapy-on-lipids-in-subjects-with-type-2-diabetes-with-or-without-cardiovascular-disease-a-pooled-analysis-of-data-from-eleven-randomized-trials-with-insulin-glargine-100%C3%A2-u-ml
#10
Markolf Hanefeld, Louise Traylor, Ling Gao, Wolfgang Landgraf
BACKGROUND: Dyslipidaemia is a major contributor to the increased risk of cardiovascular disease (CVD) associated with type 2 diabetes (T2D). This study aimed to characterize the extent of lipid-lowering therapy use and its impact on lipid and glycaemic outcomes in people with T2D uncontrolled on oral agents who were enrolled in insulin glargine 100 units/mL (Gla-100) randomized controlled trials (RCTs). METHODS: A post hoc patient-level pooled analysis of eleven RCTs (≥24 weeks' duration) comparing Gla-100 (±oral antidiabetes drugs [OADs]) with OADs alone in people with T2D was performed...
May 19, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28525644/risk-factors-and-clinical-outcomes-of-breakthrough-yeast-bloodstream-infections-in-patients-with-hematological-malignancies-in-the-era-of-newer-antifungal-agents
#11
Si-Hyun Kim, Jae-Ki Choi, Sung-Yeon Cho, Hyo-Jin Lee, Sun Hee Park, Su-Mi Choi, Dong-Gun Lee, Jung-Hyun Choi, Jin-Hong Yoo, Jong-Wook Lee
Although yeast bloodstream infections (BSIs) are increasingly being reported in patients with hematological malignancies undergoing antifungal therapy, clinical information regarding breakthrough infections is scarce. The aim of this study was to determine the risk factors for and clinical outcomes of breakthrough yeast BSIs in patients with hematological malignancies in the era of newer antifungal agents. Between 2011 and 2014, all consecutive patients with hematological malignancies who developed yeast BSIs were included in a case-control study wherein breakthrough infections (cases) and de novo infections (controls) were compared...
May 19, 2017: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/28525401/glidescope-versus-airtraq-dl-for-double-lumen-tracheal-tube-insertion-in-patients-with-a-predicted-or-known-difficult-airway-a-randomised-study
#12
Olivier Belze, Evan Lepage, Yvan Bazin, Pierre Kerourin, Jacques Fusciardi, Francis Remérand, Fabien Espitalier
BACKGROUND: Double-lumen tracheal tube (DLT) insertion can be managed with videolaryngoscopes such as the Glidescope or indirect laryngoscopes like the Airtraq DL. No study has compared both devices when a difficult intubation is predicted. OBJECTIVE: Our hypothesis was that the Glidescope is superior to the Airtraq for double-lumen tube insertion in patients with a predicted or known difficult airway. DESIGN: Adult patients scheduled for elective thoracic surgery with a predicted risk (evaluated preoperatively using the Arné score) or history of difficult intubation were allocated randomly to one of two groups: a Glidescope group and an Airtraq group...
May 19, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28524795/long-term-risk-of-recurrence-and-regrowth-after-gross-total-and-subtotal-resection-of-sporadic-vestibular-schwannoma
#13
Hirofumi Nakatomi, Jeffrey T Jacob, Matthew L Carlson, Shota Tanaka, Minoru Tanaka, Nobuhito Saito, Christine M Lohse, Colin L W Driscoll, Michael J Link
OBJECTIVE The management of vestibular schwannoma (VS) remains controversial. One commonly cited advantage of microsurgery over other treatment modalities is that tumor removal provides the greatest chance of long-term cure. However, there are very few publications with long-term follow-up to support this assertion. The purpose of the current study is to report the very long-term risk of recurrence among a large historical cohort of patients who underwent microsurgical resection. METHODS The authors retrospectively reviewed the medical records of patients who had undergone primary microsurgical resection of unilateral VS via a retrosigmoid approach performed by a single neurosurgeon-neurotologist team between January 1980 and December 1999...
May 19, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28524737/utilizing-next-generation-sequencing-in-the-management-of-multiple-myeloma
#14
Marta Lionetti, Antonino Neri
Multiple myeloma (MM) is a bone marrow plasma cell malignancy characterized by wide clinical presentation and heterogeneous genetic background. Despite the recent advances in patient outcome, new markers are needed for improving risk prediction and choice of a more appropriate therapy. In this perspective, the genetic makeup of MM cells is being better characterized by means of next-generation sequencing (NGS) technologies. Areas covered: The authors discuss how the application of NGS has improved our knowledge of MM biology by discovering its mutational landscape, identifying the operating mutational processes, and revealing the clonal composition of tumors and the dynamics of its evolution; and how this can have important clinical implications in terms of prognostication, therapeutic choices, and response assessment...
May 19, 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/28524061/immediate-hypersensitivity-reaction-to-pegylated-liposomal-doxorubicin-management-and-outcome-in-four-patients
#15
Saskia Ingen-Housz-Oro, Anne Pham-Ledard, Pauline Brice, Bénédicte Lebrun-Vignes, Ouidad Zehou, Delphine Reitter, Caroline Ram-Wolff, Nicolas Dupin, Martine Bagot, Olivier Chosidow, Marie Beylot-Barry
Hypersensitivity reactions (HSR) to pegylated liposomal doxorubicin (PLD; Caelyx(®)) have been reported, and symptoms usually resolve with drug withdrawal. However, the risk of relapse of severe HSR and prevention remain poorly described. To report the management and outcome in four patients with HSR due to PLD. Patient characteristics, premedication regimen, rate of infusion, time between onset and HSR, clinical manifestations, and management were documented. A first cycle of PLD was received for cutaneous T-cell lymphoma (n = 3) and Kaposi sarcoma (n = 1)...
May 19, 2017: European Journal of Dermatology: EJD
https://www.readbyqxmd.com/read/28524032/-preoperative-risk-factors-analysis-of-pulmonary-hypertension-crisis-during-perioperative-period-for-caesarean-section-of-woman-with-severe-pulmonary-hypertension
#16
Chunlei Zhang, Yaguang Liu, Enming Qing, Jun Ma
OBJECTIVE: To analyze preoperative risk factors of perioperative pulmonary hypertension crisis (PHC) for pregnant woman with severe pulmonary artery hypertension (PAH), and approach its clinical value. METHODS: A retrospective analysis was conducted. The clinical data from 152 pregnant women with severe PAH underwent cesarean delivery admitted to Beijing Anzhen Hospital from January 1st 2008 to December 31st 2016 was collected. The patients were divided into two groups according to with perioperative PHC or not...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28523989/effects-of-exercise-on-cardiovascular-risk-factors-following-stroke-or-transient-ischemic-attack-a-systematic-review-and-meta-analysis
#17
Natalie Teresa D'Isabella, Daria Alex Shkredova, Julie Anne Richardson, Ada Tang
OBJECTIVE: This review aimed to investigate the effects of exercise-based interventions on cardiovascular risk factors in individuals with stroke or transient ischemic attack. DATA SOURCES: MEDLINE, EMBASE, PsycINFO, and CINAHL were searched from inceptions to 28 December 2016. REVIEW METHODS: Randomized controlled trials were included that involved exercise with or without other interventions, included participants of any age, with diagnosis of transient ischemic attack or stroke, at any stage of severity or time period following the event, and reported cardiovascular risk factor outcomes...
May 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28523364/-structured-patient-handovers-in-perioperative-medicine-rationale-and-implementation-in-clinical-practice
#18
M J Merkel, V von Dossow, B Zwißler
Clear and consistent communication is pivotal for well-functioning teamwork, in operating theatres as well as intensive care units. However, patient handovers significantly vary between specialties and locations. If communication is not well structured, it might increase the risk for mishaps and malpractice. Therefore, implementing structured handover protocols is pivotal. The perioperative setting is a high-risk environment that is prone to communication failures due to operational design (frequent change of shift due to working time restrictions) and a high work load and multitasking (operating room management, short surgery times, concurrent emergencies)...
May 18, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28523136/phenotypic-presentation-of-chronic-cough-in-children
#19
EDITORIAL
Ahmad Kantar
Chronic cough in children is increasingly defined as a cough that lasts more than four weeks. It is recognized as a different entity than cough in adults. As a result, the diagnostic approach and management of chronic cough in children are no longer extrapolated from adult guidelines. These differences are attributed to the various characteristics of the respiratory tract, immunological system and nervous system in children. Specific paediatric guidelines and algorithms for chronic cough are now widely applied...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28522953/clinical-outcome-of-endoscopic-management-in-delayed-postpolypectomy-bleeding
#20
Jeong-Mi Lee, Wan Soo Kim, Min Seob Kwak, Sung-Wook Hwang, Dong-Hoon Yang, Seung-Jae Myung, Suk-Kyun Yang, Jeong-Sik Byeon
BACKGROUND/AIMS: The clinical course after endoscopic management of delayed postpolypectomy bleeding (DPPB) has not been clearly determined. This study aimed to assess clinical outcomes after endoscopic hemostasis of DPPB and evaluate risk factors for rebleeding after initial hemostasis. METHODS: We reviewed medical records of 198 patients who developed DPPB and underwent endoscopic hemostasis between January 2010 and February 2015. The performance of endoscopic hemostasis was assessed...
April 2017: Intestinal Research
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