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Pharmacological management

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https://www.readbyqxmd.com/read/28732252/update-on-medical-treatment-of-uterine-fibroids
#1
REVIEW
Fátima Faustino, Margarida Martinho, José Reis, Fernanda Águas
OBJECTIVES: In this review paper, the pros and cons of the available pharmacological options for the treatment of uterine fibroids are explored, including oral progestogens, levonorgestrel intra-uterine device, gonadotropin-releasing hormone analogs and progesterone receptor modulators with an emphasis on ulipristal acetate. STUDY DESIGN: The choice of the appropriate therapeutic approach for uterine fibroids depends on several factors, including women's age, parity, childbearing aspirations and wish to preserve fertility, extent and severity of symptoms, size, number and location of myomas, risk of malignancy and proximity to menopause...
July 8, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28731778/a-pharmacologic-algorithm-for-youth-who-are-at-high-risk-for-bipolar-disorder
#2
Christopher D Schneck, Kiki D Chang, Manpreet K Singh, Melissa P DelBello, David J Miklowitz
OBJECTIVE: Depression and brief periods of manic symptoms are linked to a significant risk of progression to bipolar disorder (BD) in children who have a first-degree relative with BD I or II. However, little evidence exists to guide the pharmacologic management of children with these high-risk phenotypes. We propose a pharmacological treatment algorithm for high-risk youth and present results on its use in a study of children with a first-degree relative with BD. METHODS: Subjects were 40 youth (mean 12...
July 21, 2017: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/28730562/therapeutical-approaches-to-paroxysmal-hemicrania-hemicrania-continua-and-short-lasting-unilateral-neuralgiform-headache-attacks-a-critical-appraisal
#3
Carlo Baraldi, Lanfranco Pellesi, Simona Guerzoni, Maria Michela Cainazzo, Luigi Alberto Pini
BACKGROUND: Hemicrania continua (HC), paroxysmal hemicrania (PH) and short lasting neuralgiform headache attacks (SUNCT and SUNA) are rare syndromes with a difficult therapeutic approach. The aim of this review is to summarize all articles dealing with treatments for HC, PH, SUNCT and SUNA, comparing them in terms of effectiveness and safety. METHODS: A survey was performed using the pubmed database for documents published from the 1st January 1989 onwards. All types of articles were considered, those ones dealing with symptomatic cases and non-English written ones were excluded...
December 2017: Journal of Headache and Pain
https://www.readbyqxmd.com/read/28730507/can-we-use-diet-to-effectively-treat-esophageal-disease-a-review-of-the-current-literature
#4
REVIEW
Carolyn Newberry, Kristle Lynch
PURPOSE OF REVIEW: Esophageal diseases represent a wide variety of conditions affecting esophageal anatomy, physiology, and motility. Therapy focuses on pharmacotherapy and endoscopic or surgical management. Dietary therapy can be considered in management algorithms for specific esophageal diseases. This review focuses on outlining the literature related to dietary therapy in gastroesophageal reflux disease, eosinophilic esophagitis, Barrett's esophagus, and esophageal adenocarcinoma...
August 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28729815/symposium-report-an-evidence-based-approach-to-ibs-and-cic-applying-new-advances-to-daily-practice-a-review-of-an-adjunct-clinical-symposium-of-the-american-college-of-gastroenterology-meeting-october-16-2016-%C3%A2-las-vegas-nevada
#5
William D Chey
Many nonpharmacologic and pharmacologic therapies are available to manage irritable bowel syndrome (IBS) and chronic idiopathic constipation (CIC). The American College of Gastroenterology (ACG) regularly publishes reviews on IBS and CIC therapies. The most recent of these reviews was published by the ACG Task Force on the Management of Functional Bowel Disorders in 2014. The key objective of this review was to evaluate the efficacy of therapies for IBS or CIC compared with placebo or no treatment in randomized controlled trials...
February 2017: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28729304/effectiveness-of-the-management-of-major-depressive-episodes-disorder-in-adults-with-comorbid-chronic-physical-diseases-a-protocol-for-a-systematic-review-and-meta-analysis
#6
Pablo Martínez, Ariel Castro, Diego Alonso, Paul A Vöhringer, Graciela Rojas
INTRODUCTION: Depression is a global-scale public health problem, and a significant association has been established between depression and chronic physical diseases. This growing comorbidity poses a challenge to healthcare systems. We aim to assess the effectiveness of the management of major depressive episodes/disorder in adults with comorbid chronic physical diseases. METHODS AND ANALYSIS: We will conduct a systematic review and meta-analysis of randomised clinical trials...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28729062/pharmacological-activation-of-ampk-inhibits-incision-evoked-mechanical-hypersensitivity-and-the-development-of-hyperalgesic-priming-in-mice
#7
Michael D Burton, Dipti V Tillu, Khadijah Mazhar, Galo L Mejia, Marina N Asiedu, Kufreobong Inyang, Travis Hughes, Bo Lian, Gregory Dussor, Theodore J Price
New therapeutics to manage post-surgical pain are needed to mitigate the liabilities of opioid and other analgesics. Our previous work shows that key modulators of excitability in peripheral nociceptors, such as extracellular signal-regulated kinases (ERK) are inhibited by activation of adenosine monophosphate activated protein kinase (AMPK). We hypothesized that AMPK activation would attenuate acute incision-evoked mechanical hypersensitivity and the development of hyperalgesic priming caused by surgery in mice...
July 17, 2017: Neuroscience
https://www.readbyqxmd.com/read/28728802/-psychotherapies-for-the-treatment-of-phantom-limb-pain
#8
Katherine Cárdenas, Mariana Aranda
INTRODUCTION: The phantom limb pain has been described as a condition in which patients experience a feeling of itching, spasm or pain in a limb or body part that has been previously amputated. Such pain can be induced by a conflict between the representation of the visual and proprioceptive feedback of the previously healthy limb. The phantom limb pain occurs in at least 42 to 90% of amputees. Regular drug treatment of phantom limb pain is almost never effective. METHODS: A systematic review of the literature was conducted in Medline and Cochrane using the MESH terms "phantom limb pain" and "psychotherapy", published in the last 10 years, in English and Spanish, finding 49 items...
July 2017: Revista Colombiana de Psiquiatría
https://www.readbyqxmd.com/read/28727700/therapeutic-role-of-placebo-evolution-of-a-new-paradigm-in-understanding-research-and-clinical-practice
#9
Laxmaiah Manchikanti, Mark V Boswell, Alan D Kaye, Standiford Helm Ii, Joshua A Hirsch
Research into interventional techniques in managing chronic spinal pain continues to be challenging, mystifying, confusing, and biased. Insight, or lack thereof, into placebo and nocebo phenomena contributes mightily to these difficulties. Unfortunately, placebo-nocebo responses are the subject of numerous controversies and challenges from not only a research perspective, but also clinical perspective. While interventionalists consider the biggest threat to interventional pain management research is inappropriate and outdated interpretation of the data, a greater problem is the misuse of the placebo response in research, with the declaration that all and everything as a placebo effect: with a misinterpretation of the nature of the placebo the, associated conclusions can be inaccurate...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28725617/post-vasectomy-pain-syndrome-diagnosis-management-and-treatment-options
#10
REVIEW
Varsha Sinha, Ranjith Ramasamy
Vasectomy is the most effective form of sterilization for men. With approximately 500,000 vasectomies performed each year in the United States, 1-2% of these patients will experience chronic testicular pain for greater than three months after the procedure. Post-vasectomy pain syndrome (PVPS) is diagnosis of exclusion, and may be caused by direct damage to spermatic cord structures, compression of nerves in the spermatic cord via inflammation, back pressure from epididymal congestion, and perineural fibrosis...
May 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28725195/vitamin-e-as-a-potential-interventional-treatment-for-metabolic-syndrome-evidence-from-animal-and-human-studies
#11
REVIEW
Sok Kuan Wong, Kok-Yong Chin, Farihah Hj Suhaimi, Fairus Ahmad, Soelaiman Ima-Nirwana
A constellation of medical conditions inclusive of central obesity, hyperglycemia, hypertension, and dyslipidemia is known as metabolic syndrome (MetS). The safest option in curtailing the progression of MetS is through maintaining a healthy lifestyle, which by itself, is a long-term commitment entailing much determination. A combination of pharmacological and non-pharmacological approach, as well as lifestyle modification is a more holistic alternative in the management of MetS. Vitamin E has been revealed to possess anti-oxidative, anti-inflammatory, anti-obesity, anti-hyperglycemic, anti-hypertensive and anti-hypercholesterolemic properties...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28724306/new-psychological-therapies-for-irritable-bowel-syndrome-mindfulness-acceptance-and-commitment-therapy-act
#12
Beatriz Sebastián Sánchez, Jesús Gil Roales-Nieto, Nuno Bravo Ferreira, Bárbara Gil Luciano, Juan José Sebastián Domingo
The current goal of treatment in irritable bowel syndrome (IBS) focuses primarily on symptom management and attempts to improve quality of life. Several treatments are at the disposal of physicians; lifestyle and dietary management, pharmacological treatments and psychological interventions are the most used and recommended. Psychological treatments have been proposed as viable alternatives or compliments to existing care models. Most forms of psychological therapies studied have been shown to be helpful in reducing symptoms and in improving the psychological component of anxiety/depression and health-related quality of life...
July 14, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28724200/effect-of-memantine-on-serum-levels-of-neuron-specific-enolase-and-on-the-glasgow-coma-scale-in-patients-with-moderate-traumatic-brain-injury
#13
Majid Mokhtari, Hossein Nayeb-Aghaei, Mehran Kouchek, Mir Mohammad Miri, Reza Goharani, Arash Amoozandeh, Sina Akhavan Salamat, Mohammad Sistanizad
Traumatic brain injury (TBI) is a major cause of disability and death globally. Despite significant progress in neuromonitoring and neuroprotection, pharmacological interventions have failed to generate favorable results. We examined the effect of memantine on serum levels of neuron-specific enolase (NSE), a marker of neuronal damage, and the Glasgow Coma Scale (GCS) in patients with moderate TBI. Patients were randomly assigned to the control group (who received standard TBI management) and the treatment group (who, alongside their standard management, received enteral memantine 30 mg twice daily for 7 days)...
July 19, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28723416/unravelling-the-pharmacologic-opportunities-and-future-directions-for-targeted-therapies-in-gastro-intestinal-cancers-part-2-neuroendocrine-tumours-hepatocellular-carcinoma-and-gastro-intestinal-stromal-tumours
#14
REVIEW
Cindy Neuzillet, Louis de Mestier, Benoît Rousseau, Olivier Mir, Mohamed Hebbar, Hemant M Kocher, Philippe Ruszniewski, Christophe Tournigand
Until the 1990s, cytotoxic chemotherapy has been the cornerstone of medical therapy for gastrointestinal (GI) cancers. Better understanding of the cancer cell molecular biology has led to the therapeutic revolution of targeted therapies, i.e. monoclonal antibodies or small molecule inhibitors directed against proteins that are specifically overexpressed or mutated in cancer cells. These agents, being more specific to cancer cells, were expected to be less toxic than conventional cytotoxic agents. However, their effects have sometimes been disappointing, due to intrinsic or acquired resistance mechanisms, or to an activity restricted to some tumour settings, illustrating the importance of patient selection and early identification of predictive biomarkers of response to these therapies...
July 16, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28722758/asthma-in-the-elderly-and-late-onset-adult-asthma
#15
REVIEW
Ryan M Dunn, Paula J Busse, Michael E Wechsler
Elderly asthmatics are at a higher risk for morbidity and mortality from their asthma than younger patients. There are important age-related physiologic and immunologic changes that complicate the presentation, diagnosis and management of asthma in the aged population. Evidence suggests that elderly asthmatics are more likely to be under-diagnosed and under-treated. Additionally, elderly patients with asthma have highest rates of morbidity and mortality from their disease than younger patients. The underlying airway inflammation of asthma in this age group likely differs from younger patients and is felt to be non-Type 2 mediated...
July 19, 2017: Allergy
https://www.readbyqxmd.com/read/28721509/maintaining-patency-of-vascular-access-for-haemodialysis
#16
Nicholas Inston, J Al Shakarchi, A Khawaja, R Jones
All types of vascular access, a necessity for haemodialysis, are prone to thrombosis and if untreated this results in failure. Thrombosis results from the combination of impaired blood flow, endothelial and vessel wall injury and a propensity towards pro-coagulative states, either intrinsic or aggravated by dialysis or dehydration. The treatment of access thrombosis relies on removal of the clot (thrombectomy) and treatment of the underlying problem. In most cases this is stenosis secondary to neointimal hyperplasia which can occur early (failure to mature) or later...
July 18, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28721461/influence-of-adjuvant-detached-mindfulness-and-stress-management-training-compared-to-pharmacologic-treatment-in-primiparae-with-postpartum-depression
#17
Mohammad Ahmadpanah, Marzieh Nazaribadie, Elham Aghaei, Ali Ghaleiha, Azade Bakhtiari, Mohammad Haghighi, Dena Sadeghi Bahmani, Amineh Akhondi, Hafez Bajoghli, Leila Jahangard, Edith Holsboer-Trachsler, Serge Brand
Ten to 15% of mothers experience postpartum depression (PPD). If untreated, PPD may negatively affect mothers' and infants' mental health in the long term. Accordingly, effective treatments are required. In the present study, we investigated the effect of detached mindfulness (DM) and stress management training (SMT) as adjuvants, compared to pharmacologic treatment only, on symptoms of depression in women with PPD. Forty-five primiparae (mean age: M = 24.5 years) with diagnosed PPD and treated with an SSRI (citalopram; CIT) took part in the study...
July 18, 2017: Archives of Women's Mental Health
https://www.readbyqxmd.com/read/28721340/post-intensive-care-syndrome-an-overview
#18
Gautam Rawal, Sankalp Yadav, Raj Kumar
Survival of critically unwell patients has improved in the last decade due to advances in critical care medicine. Some of these survivors develop cognitive, psychiatric and /or physical disability after treatment in intensive care unit (ICU), which is now recognized as post intensive care syndrome (PICS). Given the limited awareness about PICS in the medical faculty this aspect is often overlooked which may lead to reduced quality of life and cause a lot of suffering of these patients and their families. Efforts should be directed towards preventing PICS by minimizing sedation and early mobilization during ICU...
June 2017: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/28719515/anaesthetic-management-of-patients-with-myopathies
#19
Mark Schieren, Jerome Defosse, Andreas Böhmer, Frank Wappler, Mark U Gerbershagen
: The anaesthetic management of patients with myopathies is challenging. Considering the low incidence and heterogeneity of these disorders, most anaesthetists are unfamiliar with key symptoms, associated co-morbidities and implications for anaesthesia. The pre-anaesthetic assessment aims at the detection of potentially undiagnosed myopathic patients and, in case of known or suspected muscular disease, on the quantification of disease progression. Ancillary testing (e.g. echocardiography, ECG, lung function testing etc...
July 15, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28717115/coronary-artery-disease-and-type-2-diabetes-mellitus
#20
Ryo Naito, Katsumi Miyauchi
Type 2 diabetes mellitus (T2DM) is a major risk factor of coronary artery diseases (CAD). Clinical outcomes in CAD with T2DM are poor despite improvement in medications and intervention devices. Coronary artery bypass grafting (CABG) is superior to percutaneous coronary intervention (PCI) in treating diabetic patients with multivessel coronary artery diseases (MVD). However, selecting a revascularization strategy should depend not only on the lesion complexity but also on the patient's background and comorbidities...
July 14, 2017: International Heart Journal
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