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https://www.readbyqxmd.com/read/29223989/geographic-variation-of-adjuvant-breast-cancer-therapy-initiation-in-the-united-states-lessons-from-medicare-part-d
#1
John A Charlson, Emily L McGinley, Ann B Nattinger, Joan M Neuner, Liliana E Pezzin
Background: Drug utilization under Medicare Part D varies significantly by geographic region. This study examined the extent to which geographic variation in Part D plan characteristics contributes to the variation in choice of initial endocrine therapy agent among women with incident breast cancer. Methods: Two-stage multivariate regression analyses were applied to the 16,541 women identified from Medicare claims as having incident breast cancer in 2006-2007. The first stage determined the effect of state of residence on the probability of having an aromatase inhibitor (AI), as opposed to tamoxifen, as initial endocrine therapy...
December 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29223724/vasoplegia-after-cardiovascular-procedures-pathophysiology-and-targeted-therapy
#2
REVIEW
Shahzad Shaefi, Aaron Mittel, John Klick, Adam Evans, Natalia S Ivascu, Jacob Gutsche, John G T Augoustides
Vasoplegic syndrome, characterized by low systemic vascular resistance and hypotension in the presence of normal or supranormal cardiac function, is a frequent complication of cardiovascular surgery. It is associated with a diffuse systemic inflammatory response and is mediated largely through cellular hyperpolarization, high levels of inducible nitric oxide, and a relative vasopressin deficiency. Cardiopulmonary bypass is a particularly strong precipitant of the vasoplegic syndrome, largely due to its association with nitric oxide production and severe vasopressin deficiency...
October 27, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29223532/new-insights-into-the-influence-of-monofluorination-on-dimyristoylphosphatidylcholine-membrane-properties-a-solid-state-nmr-study
#3
Marie-Claude Gagnon, Erik Strandberg, Anne S Ulrich, Jean-François Paquin, Michèle Auger
Solid-state 19F NMR spectroscopy is a method of choice to study the interactions between lipid membranes and other molecules such as peptides, proteins or drugs. Numerous fluorine-labeled NMR probes have been developed over the last few years, especially fluorine-labeled peptides. In order to develop a new kind of NMR reporter molecule and a complementary approach to fluorine-labeling of peptides, we synthesized six monofluorinated derivatives of the lipid dimyristoylphosphatidylcholine (F-DMPC), with the fluorine atom located along the acyl chain linked to the central glycerol position...
December 6, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/29222299/management-of-multiple-myeloma-in-the-relapsed-refractory-patient
#4
REVIEW
Pieter Sonneveld
The approach to the patient with relapsed or relapsed/refractory multiple myeloma requires a careful evaluation of the results of previous treatments, the toxicities associated with it, and an assessment of prognostic factors. The majority of patients will have received prior therapy with drug combinations, including a proteasome inhibitor and an immune-modulatory agent. It is the physician's task to choose the right moment for the start of therapy and decide with the patient which goals need to be achieved...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222275/the-mutational-landscape-of-chronic-lymphocytic-leukemia-and-its-impact-on-prognosis-and-treatment
#5
REVIEW
Gianluca Gaidano, Davide Rossi
The typical genome of chronic lymphocytic leukemia (CLL) carries ∼2000 molecular lesions. Few mutations recur across patients at a frequency >5%, whereas a large number of biologically and clinically uncharacterized genes are mutated at lower frequency. Approximately 80% of CLL patients carry at least 1 of 4 common chromosomal alterations, namely deletion 13q14, deletion 11q22-23, deletion 17p12, and trisomy 12. Knowledge of the CLL genome has translated into the availability of molecular biomarkers for prognosis and treatment prediction...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222016/the-toxin-bjussulaao-ii-induces-oxidative-stress-and-dna-damage-upregulates-the-inflammatory-cytokine-genes-tnf-and-il6-and-downregulates-the-apoptotic-related-genes-bax-bcl2-and-rela-in-human-caco-2-cells
#6
A R T Machado, A F Aissa, D L Ribeiro, L C Hernandes, C S Machado, M L P Bianchi, S V Sampaio, L M G Antunes
Colorectal carcinoma is one of the most common cancers in adults. As chemotherapy, the first-choice treatment for colorectal carcinoma, is often infeasible due to acquired tumor resistance and several adverse effects. It is important to discover and explore new molecules with better therapeutic action. Snake venom toxins have shown promising results with high cytotoxicity against tumor cells, but their mechanisms of action remain unclear. Here we examined how BjussuLAAO-II, an L-amino acid oxidase isolated from Bothrops jararacussu snake venom, exerts cytotoxicity towards colorectal adenocarcinoma human cells (Caco-2) and in human umbilical vein endothelial cell line (HUVEC)...
December 5, 2017: International Journal of Biological Macromolecules
https://www.readbyqxmd.com/read/29221974/criteria-for-postoperative-mechanical-ventilation-after-thymectomy-in-patients-with-myasthenia-gravis-a-retrospective-analysis
#7
Keerthi Chigurupati, Shrinivas Gadhinglajkar, Rupa Sreedhar, Muraleedharan Nair, Madathipat Unnikrishnan, Manjusha Pillai
OBJECTIVE: To determine the criteria for postoperative mechanical ventilation after thymectomy in patients with Myasthenia Gravis. DESIGN: Retrospective study. SETTING: Teritiary care centre. PARTICIPANTS: 77 Myasthenia gravis patients operated for thymectomy were studied. INTERVENTIONS: After obtaining clearance from Institutional ethics committee, medical records of 77 patients with MG, who were operated for thymectomy between January 2005 and December 2015 were reviewed in a retrospective manner...
June 27, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29221659/cardiovascular-outcomes-with-glucagon-like-peptide-1-receptor-agonists-in-patients-with-type-2-diabetes-a-meta-analysis
#8
M Angelyn Bethel, Rishi A Patel, Peter Merrill, Yuliya Lokhnygina, John B Buse, Robert J Mentz, Neha J Pagidipati, Juliana C Chan, Stephanie M Gustavson, Nayyar Iqbal, Aldo P Maggioni, Peter Öhman, Neil R Poulter, Ambady Ramachandran, Bernard Zinman, Adrian F Hernandez, Rury R Holman
BACKGROUND: Glucagon-like peptide-1 (GLP-1) receptor agonists are effective glucose-lowering drugs. Findings from cardiovascular outcome trials showed cardiovascular safety of GLP-1 receptor agonists, but results for cardiovascular efficacy were varied. We aimed to examine overall cardiovascular efficacy for lixisenatide, liraglutide, semaglutide, and extended-release exenatide. METHODS: In this systematic review and meta-analysis, we analysed data from eligible trials that assessed the safety and efficacy of GLP-1 receptor agonists compared with placebo in adult patients (aged 18 years or older) with type 2 diabetes and had a primary outcome including, but not limited to, cardiovascular mortality, non-fatal myocardial infarction, and non-fatal stroke...
December 5, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29219790/hepatitis-c-virus-infection-in-kidney-transplant-patients-current-treatment-options
#9
Pavlina Dzekova-Vidimliski, Aleksandar Sikole
Hepatitis C virus infection is highly prevalent among kidney transplant recipients, occurring consequently to their previous treatment with hemodialysis. Hepatitis C virus infection has been associated with lower graft and patient survival compared with that shown in patients without infection. The lower survival has been associated with the posttransplant progression of liver disease and increased risk for development of extrahepatic complications. The choice of immunosuppressive drugs could significantly affect the course of the infection with an accelerated viral replication after kidney transplant...
December 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29219628/penetration-enhancer-containing-spanlastics-pecss-for-transdermal-delivery-of-haloperidol-in-vitro-characterization-ex-vivo-permeation-and-in-vivo-biodistribution-studies
#10
Abdurrahman M Fahmy, Doaa Ahmed El-Setouhy, Ahmed B Ibrahim, Basant A Habib, Saadia A Tayel, Noha A Bayoumi
Haloperidol (Hal) is one of the widely used antipsychotic drugs. When orally administered, it suffers from low bioavailability due to hepatic first pass metabolism. This study aimed at developing Hal-loaded penetration enhancer-containing spanlastics (PECSs) to increase transdermal permeation of Hal with sustained release. PECSs were successfully prepared using ethanol injection method showing reasonable values of percentage entrapment efficiency, particle size, polydispersity index and zeta potential. The statistical analysis of the ex vivo permeation parameters led to the choice of F1L - made of Span® 60 and Tween® 80 at the weight ratio of 4:1 along with 1% w/v Labrasol® - as the selected formula (SF)...
November 2018: Drug Delivery
https://www.readbyqxmd.com/read/29218625/diuretic-or-beta-blocker-for-hypertensive-patients-already-receiving-acei-arb-and-calcium-channel-blocker
#11
Min-Shan Tsai, Chao-Hsiun Tang, Chia-Ying Lin, Po-Ya Chuang, Nai-Chuan Chen, Chien-Hua Huang, Wei-Tien Chang, Tzung-Dau Wang, Ping-Hsun Yu, Wen-Jone Chen
BACKGROUND: In patients already receiving combination of angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB) and calcium channel blocker (CCB), whether the choice of additional diuretic or beta-blocker affects the cardiovascular and cerebrovascular outcomes remains unclear. METHODS: A total of 13,551 patients who were concurrently receiving three anti-hypertensive agents of different classes through outpatient clinics during 2004-2006 were identified from the National Health Insurance Research Database of Taiwan...
December 8, 2017: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/29216997/the-state-of-the-absorb-bioresorbable%C3%A2-scaffold-consensus-from-an-expert-panel
#12
REVIEW
Sripal Bangalore, Hiram G Bezerra, David G Rizik, Ehrin J Armstrong, Bruce Samuels, Srihari S Naidu, Cindy L Grines, Malcolm T Foster, James W Choi, Barry D Bertolet, Atman P Shah, Rebecca Torguson, Surendra B Avula, John C Wang, James P Zidar, Aziz Maksoud, Arun Kalyanasundaram, Steven J Yakubov, Bassem M Chehab, Anthony J Spaedy, Srini P Potluri, Ronald P Caputo, Ashok Kondur, Robert F Merritt, Amir Kaki, Ramon Quesada, Manish A Parikh, Catalin Toma, Fadi Matar, Joseph DeGregorio, William Nicholson, Wayne Batchelor, Raghava Gollapudi, Ethan Korngold, Riyaz Sumar, George S Chrysant, Jun Li, John B Gordon, Rajesh M Dave, Guilherme F Attizzani, Tom P Stys, Osvaldo S Gigliotti, Bruce E Murphy, Stephen G Ellis, Ron Waksman
Significant progress has been made in the percutaneous coronary intervention technique from the days of balloon angioplasty to modern-day metallic drug-eluting stents (DES). Although metallic stents solve a temporary problem of acute recoil following balloon angioplasty, they leave behind a permanent problem implicated in very late events (in addition to neoatherosclerosis). BRS were developed as a potential solution to this permanent problem, but the promise of these devices has been tempered by clinical trials showing increased risk of safety outcomes, both early and late...
December 11, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29215329/chemotherapeutics-of-visceral-leishmaniasis-present-and-future-developments
#13
Shyam Sundar, Anup Singh
Treatment of Visceral Leishmaniasis (VL), a neglected tropical disease, is very challenging with few treatment options. Long duration of treatment and drug toxicity further limit the target of achieving VL elimination. Chemotherapy remains the treatment of choice. Single dose of liposomal amphotericin B (LAmB) and multidrug therapy (LAmB + miltefosine, LAmB + paromomycin (PM), or miltefosine + PM) are recommended treatment regimen for treatment of VL in Indian sub-continent. Combination therapy of pentavalent antimonials (Sbv) and PM in East Africa and LAmB in the Mediterranean region/South America remains the treatment of choice...
December 7, 2017: Parasitology
https://www.readbyqxmd.com/read/29214756/serum-cytokine-profile-in-patients-with-chronic-rhinosinusitis-with-nasal-polyposis-infected-by-aspergillus-flavus
#14
Gargi Rai, Mohammad Ahmad Ansari, Sajad Ahmad Dar, Shyama Datt, Neelima Gupta, Sonal Sharma, Shafiul Haque, Vishnampettai Ganapathysubramanian Ramachandran, Arpeeta Mazumdar, Shivprakash Rudramurthy, Arunaloke Chakrabarti, Shukla Das
BACKGROUND: Fungi, especially Aspergillus flavus, can cause chronic rhinosinusitis with nasal polyposis and modulate host innate immune components. The objective of this study was to examine the serum levels of T helper (Th) cell subset Th1, Th2, and Th17 cytokines and total IgE in patients having chronic rhinosinusitis with nasal polyposis and Aspergillus flavus infection. METHODS: A case-control study including 40 patients with chronic rhinosinusitis with nasal polyposis and 20 healthy controls was conducted...
March 2018: Annals of Laboratory Medicine
https://www.readbyqxmd.com/read/29214574/evidence-based-medicine-and-rare-diseases
#15
Simon Day
This chapter discusses the meaning of evidence-based medicine and where it relates to randomised controlled trials, but also where it does not. The need for good quality evidence is stressed through a discussion of high failure rates in drug development and arguments against access to unlicensed (and largely untested) treatments are set out (despite the good intentions of those who advocate such access to treatments).Good quality, reliable evidence does not always have to come from clinical trials. Other forms of evidence are discussed...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29214511/managing-gout-flares-in-the-elderly-practical-considerations
#16
Abhishek Abhishek
Gout is common in the elderly, affecting an estimated 4.7 million people aged > 60 years in the USA alone. The incidence and prevalence of gout increases, and male predisposition to gout reduces, with increasing age. The elderly have more comorbidities, and gout manifests differently, with more frequent involvement of knees, ankles, and wrists at disease onset, systemic upset, and tophi. Comorbidities and polypharmacy make the management of gout flares challenging in this population. Intra-articular corticosteroid injection remains the treatment of choice for accessible joints, oral prednisolone is preferred over low-dose colchicine, and non-steroidal anti-inflammatory drugs (NSAIDs) are best avoided...
December 6, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29213224/pro-arrhythmogenic-effects-of-the-v141m-kcnq1-mutation-in-short-qt-syndrome-and-its-potential-therapeutic-targets-insights-from-modeling
#17
Hsiang-Chun Lee, Yoram Rudy, Hongwu Liang, Chih-Chieh Chen, Ching-Hsing Luo, Sheng-Hsiung Sheu, Jianmin Cui
Gain-of-function mutations in the pore-forming subunit of IKs channels, KCNQ1, lead to short QT syndrome (SQTS) and lethal arrhythmias. However, how mutant IKs channels cause SQTS and the possibility of IKs-specific pharmacological treatment remain unclear. V141M KCNQ1 is a SQTS associated mutation. We studied its effect on IKs gating properties and changes in the action potentials (AP) of human ventricular myocytes. Xenopus oocytes were used to study the gating mechanisms of expressed V141M KCNQ1/KCNE1 channels...
October 2017: Journal of Medical and Biological Engineering
https://www.readbyqxmd.com/read/29213041/-perampanel-in-the-treatment-of-patients-with-epilepsy
#18
F K Rider
Development of new antiepileptic drugs (AED) does not stop due to the fact that the number of patients with pharmacoresistant epilepsy remains at about 30%. One of the newest AEDs is perampanel (PER), a selective, non-competitive AMPA receptor antagonist to target post-synaptic glutamate transmission. PER is approved in the Russian Federation as adjunctive treatment for focal seizures with or without secondarily generalized seizures and for primary generalized tonic-clonic (PGTC) seizures in idiopathic generalized epilepsy (IGE) in patients with epilepsy aged ≥12 years...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/29213035/-problems-of-juvenile-myoclonic-epilepsy-a-view-through-the-prism-of-time
#19
V A Karlov, V S Zolovkina
The authors present a comparative analysis of the results of the study of 72 adolescent patients with juvenile myoclonic epilepsy (JME), which were published in 2010, and a new sample of patients over the last 5 years with the publications of domestic and foreign authors. Difficult clinical cases are described. These data indicate positive shifts in the diagnosis and treatment of JME. However, the question of diagnosis is still a hard problem for neurologists. The questions to be resolved are: gender aspect of the disease, to what extent levetiracetam could be a drug of first choice and to what extent valproats could be replaced; monitoring of children born to mothers with JME, a role of paternal inheritance...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/29212373/propensity-score-matched-analysis-comparing-retrograde-intrarenal-surgery-with-percutaneous-nephrolithotomy-for-large-stones-in-patients-with-a-solitary-kidney
#20
Xiaolei Shi, Yonghan Peng, Xiao Li, Qi Wang, Ling Li, Min Liu, Xiaofeng Gao, Yinghao Sun
PURPOSES: To evaluate the clinical efficacy, safety, and cost of retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) in the treatment for large renal stones in patients with a solitary kidney. PATIENTS AND METHODS: In this study, 117 patients with a solitary kidney who had undergone PCNL or RIRS for renal stones larger than 2 cm between January 2010 and December 2016 were retrospectively evaluated. The patients' demographic data, clinical characteristics, and perioperative outcomes were collected through a review of their medical records...
December 6, 2017: Journal of Endourology
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