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https://www.readbyqxmd.com/read/28812302/management-of-sleep-wake-disturbances-comorbid-with-cancer
#1
Ann M Berger Aprn, Ellyn E Matthews Cbsm, Ashley M Kenkel
It is critical that clinicians and healthcare systems adopt routine screening and affordable interventions to reduce chronic insomnia and improve the quality of life in cancer patients and survivors. We provide expert clinical advice on how to manage sleep-wake disturbances that occur comorbidly with cancer. Our discussion focuses on the etiology, screening, and assessment of sleep-wake disturbances, and on both nonpharmacologic and pharmacologic interventions to manage sleep disturbances, insomnia, and sleep-related breathing disorders...
August 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/28811743/retroperitoneal-bleeding-an-experience-during-prophylactic-anticoagulation-in-a-patient-with-nephrotic-syndrome
#2
Mari Okada, Tetsu Akimoto, Mutsumi Kawamata, Toshimi Imai, Erika Hishida, Marina Kohara, Atsushi Miki, Takuya Murakami, Taro Sugase, Takahiro Masuda, Yuko Ono, Yoshihiko Ueda, Osamu Saito, Shigeaki Muto, Daisuke Nagata
The association between nephrotic syndrome (NS) and a hypercoagulable state has been demonstrated. Controlling the blood clotting activity may therefore be attractive for patients with nephrosis in terms of thromboembolism prophylaxis. We herein report a 75-year-old woman with minimal change disease who developed pains in the right back, groin, and thigh because of retroperitoneal bleeding during prophylactic anticoagulation with unfractionated heparin. Although this procedure has not been accepted as the standard of care for patients with nephrosis, pharmacologic prophylaxis may already be practiced empirically, as in the present patient...
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/28811247/pharmacological-analysis-of-poecilotheria-spider-venoms-in-mice-provides-clues-for-human-treatment
#3
Alexander Andreev-Andrievskiy, Anfisa Popova, Evgeniia Lagereva, Daniil Osipov, Antonina Berkut, Eugene Grishin, Alexander Vassilevski
Bites of tiger spiders belonging to Poecilotheria genus cause moderate to severe pain and long-lasting local or generalized muscle cramps in humans. Bites occur in regions of the spiders' natural habitat, India and Sri Lanka, but the popularity of these colorful tarantulas as pets leads to reports of envenomation cases worldwide. Treatment is predominantly symptomatic and often inadequate since there is almost no clinical or toxicology research data available, and physicians outside India or Sri Lanka typically have no experience in treating such cases...
August 12, 2017: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/28808782/thromboembolic-events-following-splenectomy-risk-factors-prevention-management-and-outcomes
#4
Amihai Rottenstreich, Geffen Kleinstern, Galia Spectre, Nael Da'as, Esther Ziv, Yosef Kalish
BACKGROUND: Thromboembolic events following splenectomy are not uncommon. However, the role of thromboprophylaxis and risk factors for thrombosis, as well as the clinical course and outcomes, are not well characterized. METHODS: A retrospective review of individuals who underwent splenectomy between January 2006 and December 2015 in two university hospitals. RESULTS: Overall, 297 patients underwent splenectomy [open splenectomy (n = 199), laparoscopic splenectomy (n = 98)]...
August 14, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28808576/-awake-ecco2r-superseded-intubation-in-a-near-fatal-asthma-attack
#5
Thomas-Michael Schneider, Tibor Bence, Franz Brettner
BACKGROUND: Near-fatal asthma attacks are life threatening events that often require mechanical ventilation. Extracorporeal carbon dioxide removal (ECCO2R) is, beside extracorporeal membrane oxygenation (ECMO), a well-established rescue option whenever ventilation gets to its limits. But there seems to be very rare experience with those techniques in avoiding mechanical ventilation in severe asthma attacks. CASE PRESENTATION: A 67-year-old man with a near-fatal asthma attack deteriorated under non-invasive ventilation conditions...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28807459/rapidly-progressive-atherosclerosis-after-domino-liver-transplantation-from-a-teenage-donor-with-homozygous-familial-hypercholesterolemia
#6
Jessica R Golbus, Linda Farhat, Robert J Fontana, Melvyn Rubenfire
Familial hypercholesterolemia (FH) is an autosomal dominant disorder characterized by impaired clearance of low-density lipoprotein cholesterol. Given limitations in pharmacologic therapy and the significant morbidity and mortality associated with this disease, liver transplantation may be offered to select homozygous FH patients in childhood in an effort to slow progression of atherosclerotic cardiovascular disease. In rare cases, domino liver transplantation can be performed, transplanting the livers of patients with various metabolic disorders into elderly recipients whose projected survival precludes prolonged waiting on the transplant list...
July 22, 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/28805088/the-current-therapeutic-options-for-crohn-s-disease-from-medical-therapy-to-intestinal-transplantation
#7
Augusto Lauro, Francesco D'Amico, Gabriel Gondolesi
Crohn's disease (CD) has an annual incidence per 100.000 person-year of 20.2 in North America and 12.7 in Europe, and the purpose of this review is to evaluate its medical management, from diagnosis to transplant. Pharmacologic manipulation with nutritional care aims to achieve and maintain remission, but more than half of patients will undergo an intestinal resection, very often repeated over time. They could experience short bowel syndrome (SBS) requiring total parenteral nutrition (TPN). Intestinal transplantation (ITx) represents an alternative in case of irreversible intestinal failure (IF) with life-threatening TPN complications...
August 14, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28803953/fibrosis-stage-but-not-nash-predicts-mortality-and-time-to-development-of-severe-liver-disease-in-biopsy-proven-nafld
#8
Hannes Hagström, Patrik Nasr, Mattias Ekstedt, Ulf Hammar, Per Stål, Rolf Hultcrantz, Stergios Kechagias
BACKGROUND AND AIMS: Non-alcoholic fatty liver disease (NAFLD) is highly common in the general population, but identifying patients with increased risk for mortality and liver-specific morbidity remains a challenge. Non-alcoholic steatohepatitis (NASH) is thought to enhance this risk; therefore, resolution of NASH is a major endpoint in current pharmacologic studies. METHODS: We conducted a retrospective cohort study of 646 biopsy-proven NAFLD patients. Each case was matched for age, sex and municipality to ten controls...
August 10, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28801825/intractable-constipation-in-the-elderly
#9
REVIEW
Noemi Baffy, Amy E Foxx-Orenstein, Lucinda A Harris, Susan Sterler
Chronic constipation is a common gastrointestinal disorder disproportionately affecting the elderly. Immobility, polypharmacy, and physiologic changes contribute to its increased prevalence in this population. Unidentified and undertreated constipation leads to a significant negative impact on quality of life and an increase in healthcare spending. Careful physical examination and exploration of the clinical history can unmask primary and secondary forms of constipation, guiding diagnostic and therapeutic considerations...
August 11, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28800668/-epidemiology-risk-factors-and-risk-stratification-of-venous-thromboembolism-in-pregnancy-and-the-puerperium
#10
Panagiotis Tsikouras, Georg-Friedrich von Tempelhoff, Werner Rath
Venous thromboembolism (VTE) remains a leading cause of direct maternal deaths in the developed countries. The incidence of VTE has increased significantly during the past two decades. The absolute risk of VTE is estimated 0.6-2.2 per 1000 deliveries. Compared with age-matched non-pregnant women, the daily risk of VTE is increased 7- to 10-fold for antepartum VTE, but it is 15- to 35-fold for postpartum VTE. The incidence of pulmonary embolism (PE) during the first 6 weeks postpartum is nearly 15-fold higher compared to the incidence in pregnancy, and remains significantly increased up to 12 weeks postpartum...
August 2017: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/28799510/safety-profile-of-the-newest-antiepileptic-drugs-a-curated-literature-review
#11
Caterina Palleria, Giuseppe Cozza, Rajeshree Khengar, Vincenzo Libri, Giovambattista De Sarro
BACKGROUND: Despite the introduction of new antiepileptic drugs (AEDs), the quality of life and therapeutic response for patients with epilepsy remain unsatisfactory. In addition, whilst several antiepileptic drugs (AEDs) have been approved and consequently marketed in recent years, little is known about their long-term safety and tolerability. Availability of the newest AEDs, characterized by improved pharmacokinetic profiles, has positively impacted the treatment approach for patients with partial seizures in clinical practice...
August 9, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28797028/characterisation-of-the-cancer-associated-glucocorticoid-system-key-role-of-11%C3%AE-hydroxysteroid-dehydrogenase-type-2
#12
Nicola Cirillo, David J Morgan, Maria Carmela Pedicillo, Antonio Celentano, Lorenzo Lo Muzio, Michael J McCullough, Stephen S Prime
BACKGROUND: Recent studies have shown that production of cortisol not only takes place in several non-adrenal peripheral tissues such as epithelial cells but, also, the local inter-conversion between cortisone and cortisol is regulated by the 11β-hydroxysteroid dehydrogenases (11β-HSDs). However, little is known about the activity of this non-adrenal glucocorticoid system in cancers. METHODS: The presence of a functioning glucocorticoid system was assessed in human skin squamous cell carcinoma (SCC) and melanoma and further, in 16 epithelial cell lines from 8 different tissue types using ELISA, western blotting and immunofluorescence...
August 10, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28794912/sensorineural-hearing-loss-in-a-patient-affected-by-congenital-cytomegalovirus-infection-is-it-useful-to-identify-comorbid-pathologies
#13
P Fontana, D Melis, A D'Amico, G Cappuccio, G Auletta, P Vassallo, R Genesio, L Nitsch, W Buffolano
Sensorineural hearing loss (SNHL) is a common defect with a multifactorial etiology. Congenital cytomegalovirus infection (cCMV) is the most common infectious cause, and its early detection allows a prompt pharmacological treatment that can improve hearing prognosis. In a consistent percentage of profound SNHL, genetic causes and/or inner ear malformations are involved; their prompt diagnosis might change therapeutic options. This study reports a case of a 3- year-old female patient with symptomatic cCMV infection who also exhibits developmental delay, dysmorphic facial features, bilateral hearing loss, and cochlear incomplete partition, type 2, in 7q21...
September 2017: Journal of Pediatric Genetics
https://www.readbyqxmd.com/read/28794532/local-anaesthetic-systemic-toxicity-following-oral-ingestion-in-a-child-revisiting-dibucaine
#14
Raylene Dias, Nandini Dave, Milind S Tullu, Chandrahas T Deshmukh
Dibucaine, a potent and toxic local anaesthetic, although currently withdrawn by the United States Food and Drug Administration for use as a spinal anaesthetic, continues to remain available in many over-the-counter topical formulations. Systemic toxicity following oral ingestion of local anaesthetics is rare. We report a case of accidental ingestion of dibucaine (ear drops) in a 7-year-old child who developed diplopia, giddiness, ventricular premature contractions and a right bundle branch block. We also present a brief discussion on the pharmacologic and toxicity profile of dibucaine, the Naranjo algorithm for assessing causality in case of adverse drug reactions and a review of current guidelines on the management of local anaesthetic systemic toxicity...
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28793900/botanical-ethnoveterinary-therapies-used-by-agro-pastoralists-of-fafan-zone-eastern-ethiopia
#15
Teka Feyera, Endalkachew Mekonnen, Befekadu Urga Wakayo, Solomon Assefa
BACKGROUND: In Ethiopia, plant based remedies are still the most important and sometimes the only source of therapeutics in the management of livestock diseases. However, documentation of this indigenous knowledge of therapeutic system still remains at a minimum level. The aim of this study was, thus, to document the traditional knowledge of botanical ethnoveterinary therapies in the agro-pastoral communities of Fafan Zone, Eastern Ethiopia. METHODS: The study employed a cross-sectional participatory survey...
August 9, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/28792322/how-can-we-reduce-excessive-prescribing
#16
Matt Griffiths
Modern prescribing can be very easy. In many cases, we don't even have to write a prescription - just a few clicks can start a chain of events, affecting patients' lives more than we can imagine. Although it is easy to look for a quick pharmacological fix, consider carefully whether the patient really needs the medication you are prescribing.
August 9, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28791829/intravitreal-ocriplasmin-a-breakthrough-in-the-treatment-of-vitreomacular-traction
#17
REVIEW
Anna E Mec-Słomska, Joanna Adamiec-Mroczek, Ewa Kuźmicz, Marta Misiuk-Hojło
Vitreoretinal interface pathologies, such as vitreomacular traction syndrome, epiretinal membranes and macular holes are sight-threatening conditions and one of the important causes of vision defects and vision loss. To this date, vigilance with observation of how the vitreomacular traction resolves, or vitreoretinal surgery in more severe cases, were the only treatment options. Recent rapid progress in ophthalmology, especially in diagnostic and visualization techniques, provided better insight into the mechanisms taking place on the vitreoretinal surface, which enabled a more accurate selection of treatment options...
May 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28791820/evaluation-of-articular-disc-loading-in-the-temporomandibular-joints-after-prosthetic-and-pharmacological-treatment-in-model-studies
#18
Małgorzata E Pihut, Jerzy Margielewicz, Edward Kijak, Grażyna Wiśniewska
BACKGROUND: Temporomandibular joint dysfunction is often related to excessive load in the stomatognathic system. OBJECTIVES: The objective of the model tests, using numeric calculations, was to assess the articular disc loads in the temporomandibular joints after prosthetic and pharmacological treatment of functional disorders of the masticatory organ. MATERIAL AND METHODS: The study involved 10 patients, aged 21-48 years, of both sexes, randomly selected from a group of 120 patients treated with relaxation occlusal splints (60 patients, group I) and intramuscular injection of botulinum toxin type A (60 patients, group II), suffering from temporomandibular joint dysfunction with the dominant muscle component...
May 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28783942/codeine-precipitating-serotonin-syndrome-in-a-patient-in-therapy-with-antidepressant-and-triptan
#19
Giulia Milano, Werner Maria Natta, Alfredo Bello, Antonietta Martelli, Francesca Mattioli
The serotonin syndrome is a serioius medical condition due due to an intensive stimulation of setonin receptors. It is a rare, but severe, consequence of interaction between serotomimetic agents. This is a report of a 70-year-old woman steadily in therapy with venlafaxine and rizatriptan for migraine and major depressive syndrome. She was admitted to neurology unit for decreased light reflex with miotic pupils, global hyperreflexia, tremor, anxiety, ataxia and incoordination. The patient was diagnosed as a probable case of serotonin syndrome due to a pharmacological interaction between venlafaxine and rizatriptan trigged by opioid intake...
August 31, 2017: Clinical Psychopharmacology and Neuroscience: the Official Scientific Journal of the Korean College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28783481/fosaprepitant-for-the-management-of-refractory-pain-in-a-patient-with-cancer-related-dermatomyositis
#20
Jennifer D Dulin, Patrick J Coyne, Nicole M Bohm, Mary Adler
OBJECTIVE: Optimal pain management often requires multiple pharmacological interventions with the goal of disrupting the pain-signaling pathway and targeting the underlying pathophysiology. Off label use of nonpain medications may have a role in treating refractory pain syndromes. BACKGROUND: We report a case of a 60-year-old female with refractory nociceptive and neuropathic pain. Conventional therapies were either ineffective or fraught with side effects. Given the underlying inflammatory nature of her pain syndrome, and the role of substance P (SP) in pain transmission and modulation, we decided to use fosaprepitant, an SP and neurokinin-1 (NK1) receptor antagonist...
August 7, 2017: Journal of Palliative Medicine
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