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https://www.readbyqxmd.com/read/27926541/major-unanswered-questions-in-the-clinical-gout-field
#1
Lisa K Stamp
PURPOSE OF REVIEW: Although gout is one of the most common forms of inflammatory arthritis, it has been relatively neglected until recently. Despite progress in many areas of pathophysiology and genetics of gout and the development of new urate lowering therapies, there remain a number of unanswered clinical questions. With the resurgence of interest in gout it is important to recognize key aspects of gout management that remain challenging and require further research. RECENT FINDINGS: The unanswered clinical issues outlined in this review are basic aspects of gout management that clinicians treating people with gout face on a daily basis and include when urate lowering therapy should be commenced, the most appropriate target serum urate, use of prophylaxis when starting urate lowering therapy and the most appropriate urate lowering therapy, particularly for those with chronic kidney disease...
December 6, 2016: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/27926459/dietary-omega-3-polyunsaturated-fatty-acid-supplementation-in-an-animal-model-of-anxiety
#2
Brian M Ross, Imran Malik, Slim Babay
A large body of evidence suggests that dietary supplementation with omega-3 fatty acids may ameliorate depressed mood. The magnitude of the effect varies between studies, however, ranging from none at all to being of clinical significance. Given that substantial comorbidity occurs between mood and anxiety disorders, suggesting that they have one or more pathophysiological mechanisms in common, we hypothesized that omega-3 fatty acids may be acting primarily to reduce anxiety rather than depression per se, a possibility which could underlie their variable effects on mood...
November 2016: Prostaglandins, Leukotrienes, and Essential Fatty Acids
https://www.readbyqxmd.com/read/27926449/the-role-of-dopamine-in-the-pathophysiology-and-treatment-of-apathy
#3
T T-J Chong, M Husain
Disorders of diminished motivation, such as apathy, are common and prevalent across a wide range of medical conditions, including Parkinson's disease, Alzheimer's dementia, stroke, depression, and schizophrenia. Such disorders have a significant impact on morbidity and quality of life, yet their management lacks consensus and remains unsatisfactory. Here, we review laboratory and clinical evidence for the use of dopaminergic therapies in the treatment of apathy. Dopamine is a key neurotransmitter that regulates motivated decision making in humans and other species...
2016: Progress in Brain Research
https://www.readbyqxmd.com/read/27926440/fatigue-with-up-vs-downregulated-brain-arousal-should-not-be-confused
#4
U Hegerl, C Ulke
Fatigue is considered to be an important and frequent factor in motivation problems. However, this term lacks clinical and pathophysiological validity. Semantic precision has to be improved. Lack of drive and tiredness with increased sleepiness as observed in fatigue in the context of inflammatory and immunological processes (hypoaroused fatigue) has to be separated from inhibition of drive and tiredness with prolonged sleep onset latency as observed in major depression (hyperaroused fatigue). Subjective experiences as reported by patients, as well as clinical, behavioral, and neurobiological findings support the validity and importance of this distinction...
2016: Progress in Brain Research
https://www.readbyqxmd.com/read/27924629/gas6-as-a-putative-noninvasive-biomarker-of-hepatic-fibrosis
#5
Mattia Bellan, Gabriele Pogliani, Cecilia Marconi, Rosalba Minisini, Lisa Franzosi, Federica Alciato, Andrea Magri, Gian Carlo Avanzi, Mario Pirisi, Pier Paolo Sainaghi
AIM: To evaluate serum growth arrest-specific gene 6 (Gas6) concentration as a biomarker of liver fibrosis progression. MATERIALS & METHODS: One hundred and thirteen consecutive patients affected by chronic liver disease underwent transient elastography, Gas6 measurement and, if clinically indicated, liver biopsy. RESULTS: Gas6 concentration was directly correlated to liver stiffness (r = 0.67; p < 0.0001) and was significantly higher in patients with advanced fibrosis (Ishak 4-5; p < 0...
December 7, 2016: Biomarkers in Medicine
https://www.readbyqxmd.com/read/27924354/physiology-pathophysiology-and-clinical-impact-of-claudins
#6
EDITORIAL
Markus Bleich, Dorothee Günzel
No abstract text is available yet for this article.
December 6, 2016: Pflügers Archiv: European Journal of Physiology
https://www.readbyqxmd.com/read/27924216/atrial-fibrillation-management-in-older-heart-failure-patients-a-complex-clinical-problem
#7
REVIEW
Giovanni Pulignano, Donatella Del Sindaco, Maria Denitza Tinti, Stefano Tolone, Giovanni Minardi, Antonio Lax, Massimo Uguccioni
BACKGROUND: Atrial fibrillation (AF) and heart failure (HF), two problems of growing prevalence as a consequence of the ageing population, are associated with high morbidity, mortality, and healthcare costs. AF and HF also share common risk factors and pathophysiologic processes such as hypertension, diabetes mellitus, ischemic heart disease, and valvular heart disease often occur together. Although elderly patients with both HF and AF are affected by worse symptoms and poorer prognosis, there is a paucity of data on appropriate management of these patients...
January 2016: Heart International
https://www.readbyqxmd.com/read/27923792/the-fate-of-sulfate-in-chronic-heart-failure
#8
Anne Maria Koning, Wouter Meijers, Isidor Minović, Adrian Post, Martin Feelisch, Andreas Pasch, Henri Gd Leuvenink, Rudolf A de Boer, Stephan Jl Bakker, Harry van Goor
New leads to advance our understanding of heart failure (HF) pathophysiology are urgently needed. Previous studies have linked urinary sulfate excretion to a favourable cardiovascular risk profile. Sulfate is not only the end-product of hydrogen sulfide metabolism, but is also directly involved in various (patho)physiological processes, provoking scientific interest in its renal handling. This study investigates sulfate clearance in chronic HF (CHF) patients and healthy individuals and considers its relationship with disease outcome...
December 6, 2016: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/27923545/ten-plus-one-challenges-in-diseases-of-the-lysosomal-system
#9
Gregory A Grabowski, Chester Whitley
The advent of the first effective specific therapy for a lysosomal storage disease (LSDs), Gaucher disease type 1, by Roscoe O. Brady was foundational for development of additional treatments for this group of rare diseases. The past 26years, since the approval of enzyme therapy for Gaucher disease type 1, have witnessed a burgeoning understanding of LSDs at genetic, molecular, biochemical, cell biologic, and clinical levels. Simultaneously, this expansion of knowledge has exposed our incomplete understanding of the individual pathophysiologies of LSDs as well as difficult challenges for improvement in therapy and therapeutic outcomes for afflicted individuals...
November 29, 2016: Molecular Genetics and Metabolism
https://www.readbyqxmd.com/read/27923376/immunomodulation-after-ischemic-stroke-potential-mechanisms-and-implications-for-therapy
#10
REVIEW
Cynthia Santos Samary, Paolo Pelosi, Pedro Leme Silva, Patricia Rieken Macedo Rocco
Brain injuries are often associated with intensive care admissions, and carry high morbidity and mortality rates. Ischemic stroke is one of the most frequent causes of injury to the central nervous system. It is now increasingly clear that human stroke causes multi-organ systemic disease. Brain inflammation may lead to opposing local and systemic effects. Suppression of systemic immunity by the nervous system could protect the brain from additional inflammatory damage; however, it may increase the susceptibility to infection...
December 7, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27922635/increased-plasma-levels-of-circulating-cell-free-mitochondrial-dna-in-suicide-attempters-associations-with-hpa-axis-hyperactivity
#11
D Lindqvist, J Fernström, C Grudet, L Ljunggren, L Träskman-Bendz, L Ohlsson, Å Westrin
Preclinical data suggest that chronic stress may cause cellular damage and mitochondrial dysfunction, potentially leading to the release of mitochondrial DNA (mtDNA) into the bloodstream. Major depressive disorder has been associated with an increased amount of mtDNA in leukocytes from saliva samples and blood; however, no previous studies have measured plasma levels of free-circulating mtDNA in a clinical psychiatric sample. In this study, free circulating mtDNA was quantified in plasma samples from 37 suicide attempters, who had undergone a dexamethasone suppression test (DST), and 37 healthy controls...
December 6, 2016: Translational Psychiatry
https://www.readbyqxmd.com/read/27922501/an-overview-of-congenital-myopathies
#12
Jean K Mah, Jeffrey T Joseph
PURPOSE OF REVIEW: This article uses a case-based approach to highlight the clinical features as well as recent advances in molecular genetics, muscle imaging, and pathophysiology of the congenital myopathies. RECENT FINDINGS: Congenital myopathies refer to a heterogeneous group of genetic neuromuscular disorders characterized by early-onset muscle weakness, hypotonia, and developmental delay. Congenital myopathies are further classified into core myopathies, centronuclear myopathies, nemaline myopathies, and congenital fiber-type disproportion based on the key pathologic features found in muscle biopsies...
December 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27922498/inclusion-body-myositis
#13
Steven A Greenberg
PURPOSE OF REVIEW: Inclusion body myositis (IBM) is an enigmatic progressive disease of skeletal muscle. This review provides a summary of the clinical and pathophysiologic aspects of IBM. RECENT FINDINGS: The development of diagnostic blood testing for IBM followed from the discovery of a B-cell pathway in IBM muscle and circulating autoantibodies against NT5C1A, further establishing IBM's status as an autoimmune disease. The key role of cytotoxic T cells in IBM is further supported by the identification of a link between IBM and T-cell large granular lymphocytic leukemia...
December 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27922495/toxic-and-endocrine-myopathies
#14
Hans D Katzberg, Charles D Kassardjian
PURPOSE OF REVIEW: This article discusses the clinical features, pathophysiology, and management of toxic and endocrine myopathies. RECENT FINDINGS: Early detection and expeditious correction of metabolic disturbances in endocrinopathies such as Cushing syndrome, thyroid and parathyroid diseases, and acromegaly can minimize and prevent neurologic complications including myopathy. Recently proposed mechanisms of injury in patients with critical illness myopathy include inhibition of protein synthesis, mitochondrial dysfunction, disruption of the ubiquitin-proteasome system, oxidative stress, and disruption of intramuscular calcium homeostasis, which can cause a myosin-loss myopathy...
December 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27922176/dipeptidyl-peptidase-4-inhibitor-sitagliptin-reduces-inflammation-fibrosis-and-preserves-diastolic-function-in-a-rat-model-of-heart-failure-with-preserved-ejection-fraction
#15
Grazia Esposito, Donato Cappetta, Rosa Russo, Alessia Rivellino, Loreta Pia Ciuffreda, Fiorentina Roviezzo, Elena Piegari, L Liberato Berrino, Francesco Rossi, Antonella De Angelis, Konrad Urbanek
BACKGROUND AND PURPOSE: Heart failure with preserved ejection fraction (HFpEF) is a systemic syndrome driven by co-morbidities and its pathophysiology is poorly understood. Several studies suggesting that dipeptidyl peptidase 4 (DPP4) might be involved in the pathophysiology of heart failure prompted experimental and clinical investigations of DPP4 inhibitors on cardiovascular system. The aim of our study was to determine whether DPP4 inhibitor sitagliptin (SITA) affects the progression of HFpEF independently from the effects on glycaemia...
December 6, 2016: British Journal of Pharmacology
https://www.readbyqxmd.com/read/27921251/skin-manifestations-of-insulin-resistance-from-a-biochemical-stance-to-a-clinical-diagnosis-and-management
#16
REVIEW
Gloria González-Saldivar, René Rodríguez-Gutiérrez, Jorge Ocampo-Candiani, José Gerardo González-González, Minerva Gómez-Flores
Worldwide, more than 1.9 billion adults are overweight, and around 600 million people suffer from obesity. Similarly, ~382 million individuals live with diabetes, and 40-50% of the global population is labeled at "high risk" (i.e., prediabetes). The impact of these two chronic conditions relies not only on the burden of illnesses per se (i.e., associated increased morbidity and mortality), but also on their increased cost, burden of treatment, and decreased health-related quality of life. For this review a comprehensive search in several databases including PubMed (MEDLINE), Ovid EMBASE, Web of Science, and Scopus was conducted...
December 5, 2016: Dermatology and Therapy
https://www.readbyqxmd.com/read/27921035/genetics-underlying-an-individualized-approach-to-adult-spinal-disorders
#17
REVIEW
Corey T Walker, Phillip A Bonney, Nikolay L Martirosyan, Nicholas Theodore
Adult spinal disorders are a significant cause of morbidity across the world and carry significant health and economic burdens. Genetic predispositions are increasingly considered for these conditions and are becoming understood. Advances in molecular technologies since the mid-1990s have made possible genetic characterizations of these diseases in many populations, and recent findings have provided insight into the underlying pathophysiologic mechanisms. These studies have made clear the genetic heterogeneity producing clinical phenotypes and suggest that individualized treatments are possible in the future...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/27920678/diffuse-bullous-eruptions-in-an-elderly-woman-late-onset-bullous-systemic-lupus-erythematosus
#18
Prajwal Boddu, Mojtaba Nadiri, Owais Malik
Vesiculobullous eruptions in the elderly represent a diverse range of varying pathophysiologies and can present a significant clinical dilemma to the diagnostician. Diagnosis requires a careful review of clinical history, attention to detail on physical and histomorphological examination, and appropriate immunofluorescence testing. We describe the case of a 73-year-old female who presented to our hospital with a painful blistering skin rash developed over 2 days. Examination of the skin was remarkable for numerous flaccid hemorrhagic bullae on a normal-appearing nonerythematous skin involving both the upper and lower extremities...
September 2016: Case Reports in Dermatology
https://www.readbyqxmd.com/read/27920627/the-role-of-nsaids-in-breast-cancer-prevention-and-relapse-current-evidence-and-future-perspectives
#19
REVIEW
Demetrios Moris, Michalis Kontos, Eleftherios Spartalis, Ian S Fentiman
Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) have received considerable interest as potential chemopreventive agents. The aim of this review is to summarize the accumulated knowledge on the effect of NSAIDs on breast cancer incidence and natural history, and the underlying pathophysiology. NSAIDs mainly block inflammation by inhibiting cyclooxygenase enzymes, leading to lower prostaglandin synthesis. The latter has been reported to affect breast cancer risk through hormonal and inflammation-related pathways...
October 2016: Breast Care
https://www.readbyqxmd.com/read/27920237/von-willebrand-disease-a-concise-review-and-update-for-the-practicing-physician
#20
Arjun Swami, Varinder Kaur
von Willebrand disease (vWD) is the most common inherited disorder of hemostasis and comprises a spectrum of heterogeneous subtypes. Significant advances have been made in understanding von Willebrand factor (vWF) gene mutations, resultant physiologic deficits in the vWF peptide, and their correlation to clinical presentation. Diagnostic tests for this disorder are complex, and interpretation requires a thorough understanding of the underlying pathophysiology by the practicing physician. The objective of this review is to summarize our current understanding of pathophysiology, laboratory investigations, and evolving treatment paradigm of vWD with the availability of recombinant von Willebrand factor...
December 5, 2016: Clinical and Applied Thrombosis/hemostasis
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