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https://www.readbyqxmd.com/read/29448987/the-refeeding-syndrome-importance-of-phosphorus
#1
REVIEW
Marta Araujo Castro, Clotilde Vázquez Martínez
Refeeding syndrome (RS) is a complex disease that occurs when nutritional support is initiated after a period of starvation. The hallmark feature is the hypophosphataemia, however other biochemical abnormalities like hypokalaemia, hypomagnesaemia, thiamine deficiency and disorder of sodium and fluid balance are common. The incidence of RS is unknown as no universally accepted definition exists, but it is frequently underdiagnosed. RS is a potentially fatal, but preventable, disorder. The identification of patients at risk is crucial to improve their management...
February 12, 2018: Medicina Clínica
https://www.readbyqxmd.com/read/29447079/flucloxacillin-induced-hypokalaemia-a-case-report
#2
Eva De Backer, Heidi Hannon
Objective and importance Flucloxacillin is a narrow-spectrum beta-lactam antibiotic with activity against penicillinase producing staphylococci and streptococci. Severe hypokalaemia is an uncommon, but serious adverse effect in patients treated with penicillin derivates. Clinical presentation We report a case of severe hypokalaemia in a patient treated with high dose intravenous flucloxacillin. Conclusion This case report highlights the importance of monitoring electrolytes during treatment with high dose flucloxacillin...
February 15, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29369537/evaluation-of-an-individualized-dose-titration-regimen-of-patiromer-to-prevent-hyperkalaemia-in-patients-with-heart-failure-and-chronic-kidney-disease
#3
Bertram Pitt, David A Bushinsky, Dalane W Kitzman, Frank Ruschitzka, Marco Metra, Gerasimos Filippatos, Patrick Rossignol, Charles Du Mond, Dahlia Garza, Lance Berman, Mitja Lainscak
AIMS: Hyperkalaemia risk precludes optimal renin-angiotensin-aldosterone system inhibitor use in patients with heart failure (HF), particularly those with chronic kidney disease (CKD). Patiromer is a sodium-free, non-absorbed potassium (K+ )-binding polymer approved for the treatment of hyperkalaemia. In PEARL-HF, patiromer 25.2 g (fixed dose) prevented hyperkalaemia in HF patients with or without CKD initiating spironolactone. The current study evaluated the effectiveness of a lower starting dose of patiromer (16...
January 25, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29363235/e7777-in-japanese-patients-with-relapsed-refractory-peripheral-and-cutaneous-t-cell-lymphoma-a-phase-1-study
#4
Ken Ohmachi, Kiyoshi Ando, Michinori Ogura, Toshiki Uchida, Kensei Tobinai, Dai Maruyama, Masayuki Namiki, Tadashi Nakanishi
E7777, a recombinant cytotoxic fusion protein comprising diphtheria toxin fragments A and B and human interleukin-2, shares an amino acid sequence with denileukin diftitox but has improved purity and an increased percentage of active protein monomer species. A phase 1 study was conducted to evaluate the tolerability, safety, pharmacokinetics and anti-tumour activity of E7777 in Japanese patients with relapsed/refractory peripheral and cutaneous T-cell lymphoma. E7777 (6, 12 and expanded 9 μg/kg/day) was administered to 13 patients via intravenous infusion on 5 consecutive days per 21-day cycle...
January 24, 2018: Cancer Science
https://www.readbyqxmd.com/read/29352703/inotuzumab-ozogamicin-in-combination-with-low-intensity-chemotherapy-for-older-patients-with-philadelphia-chromosome-negative-acute-lymphoblastic-leukaemia-a-single-arm-phase-2-study
#5
Hagop Kantarjian, Farhad Ravandi, Nicholas J Short, Xuelin Huang, Nitin Jain, Koji Sasaki, Naval Daver, Naveen Pemmaraju, Joseph D Khoury, Jeffrey Jorgensen, Yesid Alvarado, Marina Konopleva, Guillermo Garcia-Manero, Tapan Kadia, Musa Yilmaz, Gautam Bortakhur, Jan Burger, Steven Kornblau, William Wierda, Courtney DiNardo, Alessandra Ferrajoli, Jovitta Jacob, Rebecca Garris, Susan O'Brien, Elias Jabbour
BACKGROUND: Inotuzumab ozogamicin, an anti-CD22 monoclonal antibody bound to a toxin, calicheamicin, has shown single-agent activity in relapsed or refractory acute lymphoblastic leukaemia. We aimed to assess the activity and safety of inotuzumab ozogamicin in combination with low-intensity chemotherapy in older patients with acute lymphoblastic leukaemia. METHODS: We did a single-arm, phase 2 study at the MD Anderson Cancer Center (Houston, TX, USA). Eligible patients were aged 60 years or older and had newly diagnosed, Philadelphia chromosome-negative, acute lymphoblastic leukaemia, and an Eastern Cooperative Oncology Group performance status of 3 or lower...
January 15, 2018: Lancet Oncology
https://www.readbyqxmd.com/read/29338765/infantile-hypertrophic-pyloric-stenosis-a-4-year-experience-from-two-tertiary-care-centres-in-cameroon
#6
Rene Ndongo, Paul Nkemtendong Tolefac, Faustin Félicien Mouafo Tambo, Matin Hongieh Abanda, Marcelin Ngowe Ngowe, Olivier Fola, Bonaventure Dzekem, Patrick Eroyl Weledji, Maurice Aurelien Sosso, Jacqueline Ze Minkande
OBJECTIVE: This study aimed to describe the clinical characteristics of patients with infantile hypertrophic stenosis, management and its outcome in two tertiary care centres in Cameroon. RESULTS: A total of 21 patients were included from the two centres. The mean age at presentation was 5.2 ± 1.2 weeks, predominantly male with a male-to-female ratio of 4.25:1. The triad of vomiting, visible peristalsis and palpable mass was present in only 7 (33.3%) of the participants...
January 16, 2018: BMC Research Notes
https://www.readbyqxmd.com/read/29326401/efficacy-and-tolerability-of-trastuzumab-emtansine-in-advanced-human-epidermal-growth-factor-receptor-2-positive-breast-cancer
#7
W Yeo, M Y Luk, I S Soong, T Ys Yuen, T Y Ng, F Kf Mo, K Chan, S Y Wong, J Tsang, C Leung, J Js Suen, R Kc Ngan
INTRODUCTION: The management of human epidermal growth factor receptor 2 (HER2)-positive breast cancer has changed dramatically with the introduction and widespread use of HER2-targeted therapies. There is, however, relatively limited real-world information about the effectiveness and safety of trastuzumab emtansine (T-DM1) in the Hong Kong Chinese patients. We assessed the efficacy and toxicity profiles among local patients with HER2-positive advanced breast cancer who had received T-DM1 therapy in the second-line setting and beyond...
January 12, 2018: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/29319266/gitelman-syndrome-presenting-during-pregnancy-with-adverse-foetal-outcome
#8
N Nand, A R Deshmukh, R Mathur, V Chauhan, Brijlal
Gitelman syndrome (GS) is a rare autosomal recessive salt-losing tubulopathy. The incidence of Gitelman syndrome is 25 cases in 1 million among western population. This patient presented with loose stool, vomiting and sudden onset quadriparesis. Investigations revealed hypokalaemia, metabolic acidosis, hypomagnesaemia, hypocalciuria, hypermagnesuria. Symptoms and hypokalemia improved after starting oral magnesium and potassium supplements. But the patient again presented with symptomatic hypokalemia and delivered a still born foetus with hydrocephalus...
October 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29305081/extending-knowledge-of-the-clinical-picture-of-balkan-adder-vipera-berus-bosniensis-envenoming-the-first-photographically-documented-neurotoxic-case-from-south-western-hungary
#9
Csaba Varga, Tamás Malina, Viktória Alföldi, Gergely Bilics, Ferenc Nagy, Tibor Oláh
We report a severe envenoming associated with minimal local symptoms following a Balkan adder (Vipera berus bosniensis) bite in South-Western Hungary. A 63-year-old male with a history of hypertension and sinus bradycardia (45/min) was bitten by a sub-adult specimen of V. b. bosniensis in Somogy County on 04 May 2017. The patient was transported to and treated at the Emergency Department of Somogy County "Moritz Kaposi" General Hospital, Kaposvár. Locally only pain and minimal swelling with a small haematoma developed on the bitten finger...
January 2, 2018: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/29304463/management-of-qt-prolongation-induced-by-anti-cancer-drugs-target-therapy-and-old-agents-different-algorithms-for-different-drugs
#10
REVIEW
Carmela Coppola, Anna Rienzo, Giovanna Piscopo, Antonio Barbieri, Claudio Arra, Nicola Maurea
The side effects of anticancer drugs still play a critical role in survival and quality of life. Although the recent progresses of cancer therapies have significantly improved the prognosis of oncologic patients, side effects of antineoplastic treatments are still responsible for the increased mortality of cancer survivors. Cardiovascular toxicity is the most dangerous adverse effect induced by anticancer therapies. A survey conducted by the National Health and Nutrition Examination, showed that 1807 cancer survivors followed up for seven years: 51% died of cancer and 33% of heart disease (Vejpongsa and Yeh, 2014)...
February 2018: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/29248587/enhanced-case-management-can-be-delivered-for-patients-with-evd-in-africa-experience-from-a-uk-military-ebola-treatment-centre-in-sierra-leone
#11
S J Dickson, K A Clay, M Adam, C Ardley, M S Bailey, D S Burns, A T Cox, D G Craig, M Espina, G Fitchett, J Grindrod, D E Hinsley, S Horne, E Hutley, A M Johnston, R L C Kao, L E Lamb, S Lewis, D Marion, A J Moore, T C Nicholson-Roberts, A Phillips, J Praught, P S Rees, I Schoonbaert, T Trinick, D R Wilson, A J Simpson, D Wang, M K O'Shea, T E Fletcher
BACKGROUND: Limited data exist describing supportive care management, laboratory abnormalities and outcomes in patients with EVD (Ebola virus disease) in West Africa. We report data which constitute the first description of the provision of enhanced EVD case management protocols in a West African setting. METHODS: Demographic, clinical and laboratory data were collected by retrospective review of clinical and laboratory records of patients with confirmed EVD admitted between 5 November 2014 and 30 June 2015...
December 14, 2017: Journal of Infection
https://www.readbyqxmd.com/read/29241762/eltrombopag-for-advanced-myelodysplastic-syndromes-or-acute-myeloid-leukaemia-and-severe-thrombocytopenia-aspire-a-randomised-placebo-controlled-phase-2-trial
#12
Moshe Mittelman, Uwe Platzbecker, Boris Afanasyev, Sebastian Grosicki, Raymond S M Wong, Achilles Anagnostopoulos, Benjamin Brenner, Claudio Denzlinger, Giuseppe Rossi, Arnon Nagler, Regina Garcia-Delgado, Maria Socorro O Portella, Zewen Zhu, Dominik Selleslag
BACKGROUND: Thrombocytopenia is a life-threatening complication in patients with advanced myelodysplastic syndromes (MDS) and acute myeloid leukaemia (AML). In this study (ASPIRE), we aimed to assess eltrombopag, an oral thrombopoietin receptor agonist, for thrombocytopenia (grade 4) treatment in adult patients with advanced MDS or AML. METHODS: ASPIRE consisted of an open-label, double-blind phase for 8 weeks and a randomised, double-blind phase (parts 1 and 2, reported here) for 12 weeks, and an open-label extension (part 3)...
December 11, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/29219824/thyrotoxic-periodic-paralysis-an-unusual-presentation-of-hyperthyroidism
#13
M Salih, C M J van Kinschot, R P Peeters, W W de Herder, E J J Duschek, J van der Linden, C van Noord
Thyrotoxic periodic paralysis (TPP) is a complication of hyperthyroidism among Asians, characterised by sudden onset of hypokalaemia and muscle paralysis. Several factors may contribute to a delay in diagnosis, including the subtlety of hyperthyroidism, the transient nature of the events and the rarity of this disease in the West. As life-threatening arrhythmias may occur during an attack, awareness among physicians is necessary for early recognition and treatment. Advances have been made in understanding the pathophysiological mechanism leading to hypokalaemia, which include recently identified mutations of the inwardly rectifying potassium channel Kir2...
October 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/29214737/efficacy-safety-and-patient-reported-outcomes-of-ledipasvir-sofosbuvir-in-ns3-4a-protease-inhibitor-experienced-individuals-with-hepatitis-c-virus-genotype-1-and-hiv-coinfection-with-and-without-cirrhosis-anrs-hc31-softrih-study
#14
E Rosenthal, C Fougerou-Leurent, A Renault, M P Carrieri, F Marcellin, R Garraffo, E Teicher, H Aumaitre, K Lacombe, F Bailly, E Billaud, S Chevaliez, S Dominguez, M A Valantin, J Reynes, A Naqvi, L Cotte, S Metivier, V Leroy, M Dupon, T Allegre, P De Truchis, V Jeantils, J Chas, D Salmon-Ceron, P Morlat, D Neau, P Perré, L Piroth, S Pol, M Bourlière, G P Pageaux, L Alric, D Zucman, P M Girard, I Poizot-Martin, Y Yazdanpanah, F Raffi, E Le Pabic, C Tual, A Pailhé, I Amri, E Bellissant, J M Molina
OBJECTIVES: Studies evaluating the efficacy and safety of the fixed-dose combination ledipasvir (LDV)/sofosbuvir (SOF) in patients coinfected with HIV-1 and hepatitis C virus (HCV) have mainly included treatment-naïve patients without cirrhosis. We aimed to evaluate the efficacy and safety of this combination in treatment-experienced patients with and without cirrhosis. METHODS: We conducted a multicentre, open-label, double-arm, nonrandomized study in patients coinfected with HIV-1 and HCV genotype 1 with and without cirrhosis, who had good viral suppression on their antiretroviral regimens...
December 7, 2017: HIV Medicine
https://www.readbyqxmd.com/read/29175149/neoadjuvant-trastuzumab-pertuzumab-and-chemotherapy-versus-trastuzumab-emtansine-plus-pertuzumab-in-patients-with-her2-positive-breast-cancer-kristine-a-randomised-open-label-multicentre-phase-3-trial
#15
Sara A Hurvitz, Miguel Martin, W Fraser Symmans, Kyung Hae Jung, Chiun-Sheng Huang, Alastair M Thompson, Nadia Harbeck, Vicente Valero, Daniil Stroyakovskiy, Hans Wildiers, Mario Campone, Jean-François Boileau, Matthias W Beckmann, Karen Afenjar, Rodrigo Fresco, Hans-Joachim Helms, Jin Xu, Yvonne G Lin, Joseph Sparano, Dennis Slamon
BACKGROUND: HER2-targeted treatments have improved outcomes in patients with HER2-positive breast cancer in the neoadjuvant, adjuvant, and metastatic settings; however, some patients remain at risk of relapse or death for many years after treatment of early-stage disease. Therefore, new strategies are needed. We did a phase 3 trial to assess a neoadjuvant regimen for HER2-positive breast cancer that replaces traditional systemic chemotherapy with targeted treatment. METHODS: We did a randomised, open-label phase 3 KRISTINE trial in 68 Translational Research In Oncology centres (hospitals and specialty cancer centres in Asia, Europe, USA, and Canada)...
November 23, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/29155816/liposomal-amphotericin-b-in-travelers-with-cutaneous-and-muco-cutaneous-leishmaniasis-not-a-panacea
#16
Romain Guery, Benoit Henry, Guillaume Martin-Blondel, Claire Rouzaud, Florence Cordoliani, Gundel Harms, Jean-Pierre Gangneux, Françoise Foulet, Emmanuelle Bourrat, Michel Baccard, Gloria Morizot, Paul-Henri Consigny, Antoine Berry, Johannes Blum, Olivier Lortholary, Pierre Buffet
BACKGROUND: Complex cutaneous and muco-cutaneous leishmaniasis (CL and MCL) often requires systemic therapy. Liposomal amphotericin B (L-AmB) has a strong potential for a solid clinical benefit in this indication. METHODS: We conducted a retrospective analysis of data from a French centralized referral treatment program and from the "LeishMan" European consortium database. All patients with parasitologically proven CL or MCL who received at least one dose of L-AmB were included...
November 20, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29144530/liddle-s-syndrome-in-an-african-male-due-to-a-novel-frameshift-mutation-in-the-beta-subunit-of-the-epithelial-sodium-channel-gene
#17
Robert Freercks, Surita Meldau, Erika Jones, Jason Ensor, Clarise Weimers-Willard, Brian Rayner
Resistant hypertension is a common clinical problem in South Africa and is frequently associated with low renin and aldosterone levels, especially in black Africans. In South Africa, novel variants in the epithelial sodium channel (ENaC) have been described to be associated with varying degrees of hypokalaemia and hypertension due to primary sodium retention. We report here a case of Liddle's syndrome due to a novel c.1709del11 (p.Ser570Tyrfs*20) deletion in the beta-subunit of the ENaC in a young black African male...
September 23, 2017: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/29127128/all-sorts-of-tests-only-one-question-an-unexpected-cause-of-hypertension
#18
Sarah Foster, Rachel Foster, Peter Jackson, Soon Song
A 48-year-old woman presented to the Accident and Emergency department with a 4 month history of headaches, nausea and dizziness. She was found to have severe hypertension and hypokalaemia. Extensive investigations did not find any secondary cause for hypertension. The patient was discharged with oral doxazosin therapy which controlled the blood pressure. Before the follow-up appointment at the hypertension clinic, the patient and her husband identified that her headaches coincided with liquorice tea consumption of up to three cups per day...
November 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29090271/oral-rehydration-of-malnourished-children-with-diarrhoea-and-dehydration-a-systematic-review
#19
Kirsty A Houston, Jack G Gibb, Kathryn Maitland
Background: Diarrhoea complicates over half of admissions to hospital with severe acute malnutrition (SAM). World Health Organization (WHO) guidelines for the management of dehydration recommend the use of oral rehydration with ReSoMal (an oral rehydration solution (ORS) for SAM), which has lower sodium (45mmols/l) and higher potassium (40mmols/l) content than old WHO ORS. The composition of ReSoMal was designed specifically to address theoretical risks of sodium overload and potential under-treatment of severe hypokalaemia with rehydration using standard ORS...
2017: Wellcome Open Research
https://www.readbyqxmd.com/read/29069937/the-safety-of-high-dose-insulin-euglycaemia-therapy-in-toxin-induced-cardiac-toxicity
#20
Colin B Page, Nicole M Ryan, Geoffrey K Isbister
CONTEXT: High-dose insulin euglycaemia (HIE) is recommended in the management of toxin-induced cardiac toxicity, with increasing insulin doses now being used. We aimed to investigate the safety of HIE in toxin-induced cardiac toxicity. METHODS: This was a retrospective review of cases from two clinical toxicology units. Demographics, toxin(s) ingested, clinical effects, investigations (serum glucose, electrolytes), treatments (insulin, glucose, electrolyte replacement), length of stay (LOS) and outcomes were extracted from the patients' medical records...
October 26, 2017: Clinical Toxicology
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