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https://www.readbyqxmd.com/read/29155973/tapering-versus-steady-state-methotrexate-in-combination-with-tocilizumab-for-rheumatoid-arthritis-a-randomized-double-blind-trial
#1
Christopher J Edwards, Andrew J K Östör, Barbara Naisbett-Groet, Patrick Kiely
Objective: To explore whether tocilizumab + tapering MTX has comparable efficacy and safety vs tocilizumab + stable MTX in adult RA patients with inadequate response to MTX. Methods: This randomized, placebo-controlled non-inferiority study involved patients with severe active RA [28-joint DAS (DAS28) >5.1] who had initiated tocilizumab + MTX at the study start. Patients received open-label tocilizumab (8 mg/kg i.v. every 4 weeks) and open-label MTX. At week 24, patients achieving good/moderate EULAR response were randomized to group A (double-blind MTX taper) or group B (double-blind MTX maintenance); both arms continued open-label tocilizumab...
October 9, 2017: Rheumatology
https://www.readbyqxmd.com/read/29152599/a-novel-clinical-sign-in-intraocular-tuberculosis-active-chorioretinitis-within-chorioretinal-atrophy
#2
Avinash Pathengay, Bhavik Panchal, Himadri Choudhury, Soumyava Basu, Nidhi Relhan, Harry W Flynn
Purpose: To report a novel clinical sign in patients with intraocular tuberculosis. The current study is an observational consecutive case series of patients diagnosed with intraocular tuberculosis managed at a tertiary eye care centre from June 1, 2012 to December 31, 2015. Observations: The diagnosis of intraocular tuberculosis was made in 6 patients based on ocular features suggestive of tuberculosis along with a positive tuberculin skin testing and chest X-ray consistent with tuberculosis...
September 2017: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/29151337/coexistence-of-idiopathic-granulomatous-mastitis-and-erythemanodosum-successful-treatment-with-corticosteroids
#3
Murat Akın, Harun Karabacak, Güldal Esendağlı, Aydın Yavuz, Serap Gültekin, Kürşat Dikmen, Hasan Bostancı
Background/aim: Idiopathic granulomatous mastitis (IGM) is a rare, chronic inflammatory disease of the breast. Erythema nodosum (EN) is a rare extramammary manifestation of IGM. The purpose of this study is to determine the clinical and demographic characteristics of 11 IGM and EN patients and to evaluate the efficacy of methylprednisolone treatment. Materials and methods: In our series, ten patients had EN bilaterally, whereas one patient had a lesion of the right pretibial area. The mean age of the patients was 35...
November 13, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29150875/treatment-of-acquired-thrombotic-thrombocytopenic-purpura-in-the-u-s-remains-heterogeneous-current-and-future-points-of-clinical-equipoise
#4
Marshall A Mazepa, Jay S Raval, Mark E Brecher, Yara A Park
BACKGROUND: The purpose of this survey was to describe current practices in the U.S. for treatment of acquired Thrombotic Thrombocytopenic Purpura (TTP), compare these with prior U.S. and current Canadian practices, and identify areas of clinical equipoise. STUDY DESIGN AND METHODS: A research team member administered the survey by telephone. Questions included an estimate of the annual patient volume treated, apheresis and medical therapy practices for acquired TTP...
November 18, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/29148432/a-singular-value-decomposition-linear-programming-svdlp-optimization-technique-for-circular-cone-based-robotic-radiotherapy
#5
Bin Liang, Yongbao Li, Wei Ran, Bin Guo, Xuang Xu, Bo Liu, Jiafeng Li, Qiuwen Wu, Fugen Zhou
With robot-controlled linac positioning, the robotic radiotherapy system such as CyberKnife significantly increases the freedom in radiation beam placement, but also imposes more challenges on treatment plan optimization. The resampling mechanism in vendor supplied treatment planning system (MultiPlan) could not fully explore the increased beam direction search space. Besides, a sparse treatment plan (using fewer beams) is desired to improve the treatment efficiency. This study proposes a singular value decomposition linear programming (SVDLP) optimization technique for circular collimator based robotic radiotherapy...
November 17, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29147571/a-surprising-treatment-response-in-a-patient-with-rare-isolated-growth-hormone-deficiency-type-ib
#6
Jordan Yardain Amar, Kimberly Borden, Elizabeth Watson, Talin Arslanian
Isolated Growth Hormone Deficiency (IGHD) is a rare cause of short stature, treated with the standard regimen of subcutaneous synthetic growth hormone (GH). Patients typically achieve a maximum height velocity in the first year of treatment, which then tapers shortly after treatment is stopped. We report a case of a 9-year-old male who presented with short stature (<3rd percentile for age and race). Basal hormone levels showed undetectable serum IGF1. Skeletal wrist age was consistent with chronologic age...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29145318/an-unusual-cause-of-fever-of-unknown-origin-with-enlarged-lymph-nodes-relapsing-polychondritis-a-case-report
#7
Wei Liu, Hongli Jiang, Han Jing, Bing Mao
INTRODUCTION: Fever of unknown origin (FUO) is a common initial presentation leading to a diagnostic challenge. PATIENT CONCERNS: A 3-month history of moderate-to-high fever was reported in an otherwise healthy 54-year-old man. Enhanced computed tomography (CT) scans of his chest showed a remarkable progressive enlargement of bilateral cervical, supraclavicular, hilar, and mediastinal lymph nodes within 2 weeks. Bronchofibroscopy manifested obvious luminal stenosis with swelling, thick pale mucosa, and disappearing of structures of trachea cricoid cartilage, followed by a 18F-fluorodeoxyglucose positron-emission tomography-computed tomography (18F-FDG PET/CT) with intense symmetric FDG uptake in larynx, tracheobronchial tree, and hilar, mediastinal, and axillary lymph nodes being demonstrated...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29142875/quantification-of-the-tug-back-by-measuring-the-pulling-force-and-micro-computed-tomographic-evaluation
#8
Su-Jin Jeon, Young-Mi Moon, Min-Seock Seo
Objectives: The aims of this study were to quantify tug-back by measuring the pulling force and investigate the correlation of clinical tug-back pulling force with in vitro gutta-percha (GP) cone adaptation score using micro-computed tomography (µCT). Materials and Methods: Twenty-eight roots from human single-rooted teeth were divided into 2 groups. In the ProTaper Next (PTN) group, root canals were prepared with PTN, and in the ProFile (PF) group, root canals were prepared using PF (n = 14)...
November 2017: Restorative Dentistry & Endodontics
https://www.readbyqxmd.com/read/29142621/mechanical-thrombectomy-with-solitaire-stent-retrieval-for-acute-cardioembolic-stroke
#9
Hokyun Han, Hyunho Choi, Keun-Tae Cho, Byong-Cheol Kim
Objective: Few studies have reported the outcome of mechanical thrombectomy with Solitaire stent retrival (MTSR) in subtypes of acute ischemic stroke. The purpose of this study was to evaluate the efficacy and result of MTSR in acute cardioembolic stroke. Methods: Twenty consecutive patients with acute cardioembolic stroke were treated by MTSR. The angiographic outcome was assessed by thrombolysis in cerebral infarction (TICI) grade. TICI grade 2a, 2b, or 3 with a measurable thrombus that was retrieved was considered as a success when MTSR was performed in the site of primary vessel occlusion, and TICI grade 2b or 3 was considered as a success when final result was reported...
November 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29142523/steroid-refractory-extensive-enteritis-complicated-by-ulcerative-colitis-successfully-treated-with-adalimumab
#10
Shinji Okabayashi, Taku Kobayashi, Tomohisa Sujino, Ryo Ozaki, Satoko Umeda, Takahiko Toyonaga, Eiko Saito, Masaru Nakano, Maria Carla Tablante, Shojiroh Morinaga, Toshifumi Hibi
Extracolonic involvement of the gastrointestinal tract is extremely uncommon in ulcerative colitis (UC) and rarely found in the upper gastrointestinal tract or in postoperative cases since it typically responds to steroids. Here we report a case of UC complicated by extensive ileal inflammation that was refractory to steroids. A 20-year-old man was diagnosed with UC of typical pancolitis without ileal involvement and started treatment with pH-dependent mesalazine and oral prednisolone. Although his symptoms transiently resolved, the condition flared when the steroid dose was tapered down...
October 2017: Intestinal Research
https://www.readbyqxmd.com/read/29140604/simultaneous-measurements-of-geometric-and-viscoelastic-properties-of-hydrogel-microbeads-using-continuous-flow-microfluidics-with-embedded-electrodes
#11
Ye Niu, Xu Zhang, Ting Si, Yuntian Zhang, Lin Qi, Gang Zhao, Ronald X Xu, Xiaoming He, Yi Zhao
Geometric and mechanical characterizations of hydrogel materials at the microscale are attracting increasing attention due to their importance in tissue engineering, regenerative medicine, and drug delivery applications. Contemporary approaches for measuring the these properties of hydrogel microbeads suffer from low-throughput, complex system configuration, and measurement inaccuracy. In this work, a continuous-flow device is developed to measure geometric and viscoelastic properties of hydrogel microbeads by flowing the microbeads through a tapered microchannel with an array of interdigitated microelectrodes patterned underneath the channel...
November 15, 2017: Small
https://www.readbyqxmd.com/read/29140377/influence-of-the-prosthetic-index-on-fracture-resistance-of-morse-taper-dental-implants
#12
Karla Zancopé, Caio César Dias Resende, Carolina Guimarães Castro, Rafael Calixto Salatti, Flávio Domingues das Neves
PURPOSE: Manufacturers have inserted a prosthetic index, an internal hexagon to guide prosthetic components inside Morse taper implants. However, it is still unclear if this mechanism could decrease the mechanical strength of Morse taper implants. The aim of this study was to evaluate the influence of the prosthetic index inside Morse taper implants on fracture resistance compared with nonindexed implants. MATERIALS AND METHODS: Fifty-seven Morse taper implants, with 11...
November 2017: International Journal of Oral & Maxillofacial Implants
https://www.readbyqxmd.com/read/29140345/optimized-optical-coupling-to-silica-clad-photonic-crystal-waveguides
#13
Yosuke Terada, Kenji Miyasaka, Keisuke Kondo, Norihiro Ishikura, Takuya Tamura, Toshihiko Baba
Silica-clad silicon photonic crystal waveguides (PCWs) are promising components for various applications because of their simple fabrication and generation of slow light. However, an optical loss higher than 4 dB occurs when they are simply coupled to input/output silicon wire waveguides. To reduce the optical loss, we proposed a junction structure in which light in the waveguide is first coupled to a high-group-velocity radiation mode at an expanded core and subsequently converted to the slow-light mode in a tapered core of the PCW...
November 15, 2017: Optics Letters
https://www.readbyqxmd.com/read/29140336/whispering-gallery-modes-in-a-liquid-filled-hollow-glass-microsphere
#14
Shuangqiang Liu, Bojian Shi, Yan Wang, Lugui Cui, Jun Yang, Weimin Sun, Hanyang Li
We develop a hydrofluoric (HF) etching process to open a microhole on the hollow glass microsphere (HGM). The typical whispering gallery mode (WGM) resonance was observed by coupling the HGM with a tapered fiber. Dioctyl phthalate was filled into the HGM, and the resonance wavelength decreased at elevated temperatures. We analyzed the WGM resonance properties inside the liquid-filled HGM with a higher or lower refractive index in comparison to the HGM wall. Four different liquids were also injected into the HGM to investigate the influence of the thermo-optic coefficient on the temperature sensitivity...
November 15, 2017: Optics Letters
https://www.readbyqxmd.com/read/29138434/generating-localized-plasmonic-fields-on-an-integrated-photonic-platform-using-tapered-couplers-for-biosensing-applications
#15
Gurpreet Singh, Renzhe Bi, U S Dinish, Malini Olivo
A theoretical design and analysis of a tapered-coupler structure on a silicon nitride integrated-photonic platform for coupling optical energy from a dielectric waveguide to a plasmonic tip is presented. The proposed design can be considered as a hybrid photonic-plasmonic structure that generally supports hybrid symmetric and asymmetric modes. Along the taper, one of the hybrid modes approaches the cut-off, while the other approaches the short-range surface plasmon mode that generates localized fields. Potential use of the proposed novel tapered-coupler plasmonic structure for highly sensitive biosensing applications using surface enhanced Raman scattering (SERS) and metal enhanced fluorescence (MEF) techniques is discussed...
November 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29138153/deprescribing-antihyperglycemic-agents-in-older-persons-evidence-based-clinical-practice-guideline
#16
Barbara Farrell, Cody Black, Wade Thompson, Lisa McCarthy, Carlos Rojas-Fernandez, Heather Lochnan, Salima Shamji, Ross Upshur, Manon Bouchard, Vivian Welch
OBJECTIVE: To develop an evidence-based guideline to help clinicians make decisions about when and how to safely taper, stop, or switch antihyperglycemic agents in older adults. METHODS: We focused on the highest level of evidence available and sought input from primary care professionals in guideline development, review, and endorsement processes. Seven clinicians (2 family physicians, 3 pharmacists, 1 nurse practitioner, and 1 endocrinologist) and a methodologist comprised the overall team; members disclosed conflicts of interest...
November 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29137908/no-evidence-found-for-an-association-between-prednisone-dose-and-fvc-change-in-newly-treated-pulmonary-sarcoidosis
#17
Caroline E Broos, Linda H C Poell, Caspar W N Looman, Johannes C C M In 't Veen, Marco J J H Grootenboers, Roxane Heller, Leon M van den Toorn, Monique Wapenaar, Henk C Hoogsteden, Mirjam Kool, Marlies S Wijsenbeek, Bernt van den Blink
BACKGROUND: Prednisone is used as first-line therapy for pulmonary sarcoidosis. What dosing strategy has the best balance between effect and side-effects is largely unknown. We analyzed change in forced vital capacity (FVC) and weight during different prednisone doses used in daily practice for treatment naïve pulmonary sarcoidosis patients. METHODS: Multilevel models were used to describe FVC and weight change over time. Correlations were calculated using linear regression models...
October 31, 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/29137901/impact-of-femoral-stem-design-on-failure-after-anterior-approach-total-hip-arthroplasty
#18
Krishna R Cidambi, Steven L Barnett, Paige R Mallette, Jay J Patel, Nader A Nassif, Robert S Gorab
BACKGROUND: An increased rate of complications related to femoral component failure has been described with less invasive total hip arthroplasty (THA). This study evaluated the incidence of femoral complications associated with the direct anterior approach for THA. METHODS: Retrospective review was performed of the initial 1120 consecutive patients who underwent direct anterior THA by 2 surgeons. RESULTS: A total of 899 patients (80.3%) had a 2-year follow-up (range, 2-8 years)...
November 11, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29137563/stem-anteversion-mismatch-to-the-anatomical-anteversion-causes-loss-of-periprosthetic-bone-density-after-tha
#19
Shinya Hayashi, Shingo Hashimoto, Tomoyuki Matsumoto, Koji Takayama, Kotaro Nishida, Kazunari Ishida, Ryosuke Kuroda
The short tapered-wedge stem is popular worldwide because it potentially preserves more bone stock during total hip arthroplasty (THA). However, stem version mismatch may affect physiological stress distribution. In this study, we analyzed the correlations between periprosthetic bone mineral density (BMD) changes and anteversion mismatch in patients who underwent THA using a short tapered-wedge stem. The study included 44 patients (44 joints) who underwent THA with a Tri-Lock stem. At baseline and at 6 and 24 months postoperatively, the BMDs in the seven Gruen zones were evaluated using dual-energy X-ray absorptiometry...
September 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/29136309/comparison-of-fit-of-dentures-fabricated-by-traditional-techniques-versus-cad-cam-technology
#20
J Bryan McLaughlin, Van Ramos, Douglas P Dickinson
PURPOSE: To compare the shrinkage of denture bases fabricated by three methods: CAD/CAM, compression molding, and injection molding. The effect of arch form and palate depth was also tested. MATERIALS AND METHODS: Nine titanium casts, representing combinations of tapered, ovoid, and square arch forms and shallow, medium, and deep palate depths, were fabricated using electron beam melting (EBM) technology. For each base fabrication method, three poly(vinyl siloxane) impressions were made from each cast, 27 dentures for each method...
November 14, 2017: Journal of Prosthodontics: Official Journal of the American College of Prosthodontists
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