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https://www.readbyqxmd.com/read/28741331/alignment-of-adherence-and-risk-for-hiv-acquisition-in-a-demonstration-project-of-pre-exposure-prophylaxis-among-hiv-serodiscordant-couples-in-kenya-and-uganda-a-prospective-analysis-of-prevention-effective-adherence
#1
Jessica E Haberer, Lara Kidoguchi, Renee Heffron, Nelly Mugo, Elizabeth Bukusi, Elly Katabira, Stephen Asiimwe, Katherine K Thomas, Connie Celum, Jared M Baeten
INTRODUCTION: Adherence is essential for pre-exposure prophylaxis (PrEP) to protect against HIV acquisition, but PrEP use need not be life-long. PrEP is most efficient when its use is aligned with periods of risk - a concept termed prevention-effective adherence. The objective of this paper is to describe prevention-effective adherence and predictors of adherence within an open-label delivery project of integrated PrEP and antiretroviral therapy (ART) among HIV serodiscordant couples in Kenya and Uganda (the Partners Demonstration Project)...
July 25, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28738044/survivorship-model-of-care-development-and-implementation-of-a-nurse-practitioner-led-intervention-for-patients-with-breast-cancer%C3%A2
#2
Kathryn E Post, Beverly Moy, Catherine Furlani, Elizabeth Strand, Jane Flanagan, Jeffrey M Peppercorn
BACKGROUND: Despite a call for action to improve survivorship care, no optimal model of care exists. 
. OBJECTIVES: To develop and evaluate the feasibility of a nurse practitioner (NP)-led model of care for survivorship visits after initial therapy. 
. METHODS: Patients received an NP-led survivorship bridge visit (NPSBV) following treatment for early-stage breast cancer. A cross-sectional survey was used to evaluate responses to the NPSBV and patient satisfaction with care...
August 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28736303/the-good-and-the-bad-collagens-of-fibrosis-their-role-in-signaling-and-organ-function
#3
M A Karsdal, S H Nielsen, D J Leeming, L L Langholm, M J Nielsen, T Manon-Jensen, A Siebuhr, N S Gudmann, S Rønnow, J M Sand, S J Daniels, J H Mortensen, D Schuppan
Usually the dense extracellular structure in fibrotic tissues is described as extracellular matrix (ECM) or simply as collagen. However, fibrosis is not just fibrosis, which is already exemplified by the variant morphological characteristics of fibrosis due to viral versus cholestatic, autoimmune or toxic liver injury, with reticular, chicken wire and bridging fibrosis. Importantly, the overall composition of the ECM, especially the relative amounts of the many types of collagens, which represent the most abundant ECM molecules and which centrally modulate cellular functions and physiological processes, changes dramatically during fibrosis progression...
July 20, 2017: Advanced Drug Delivery Reviews
https://www.readbyqxmd.com/read/28735156/adaptive-periodic-paralysis-allows-weaning-deep-sedation-overcoming-the-drowning-syndrome-in-ecmo-patients-bridged-for-lung-transplantation-a-case-series
#4
Irina Timofte, Michael Terrin, Erik Barr, June Kim, Joseph Rinaldi, Nicholas Ladikos, Jay Menaker, Ali Tabatabai, Zachary Kon, Bartley Griffith, Richard Pierson, Si Pham, Aldo Iacono, Daniel Herr
PURPOSE: Sedation in extracorporeal membrane oxygenation (ECMO) is challenging. Patients require deep sedation because of extremely high respiratory rates and increased work of breathing ("Drowning Syndrome") resulting in altered intra-thoracic pressure and reduced pump flow associated with hemodynamic compromise and decreased oxygenation. However, deep sedation impedes essential active rehabilitation with physical therapy. METHODS: We reviewed data on 3 ECMO patients for whom we used a novel approach to replace continuous drips with periodic sedation/paralysis...
July 17, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28735000/application-of-pharmacometrics-and-quantitative-systems-pharmacology-to-cancer-therapy-the-example-of-luminal-a-breast-cancer
#5
REVIEW
Brett Fleisher, Kayla Andrews, Ashley A Brown, Sihem Ait-Oudhia
Breast cancer (BC) is the most common cancer in women, and the second most frequent cause of cancer-related deaths in women worldwide. It is a heterogeneous disease composed of multiple subtypes with distinct morphologies and clinical implications. Quantitative systems pharmacology (QSP) is an emerging discipline bridging systems biology with pharmacokinetics (PK) and pharmacodynamics (PD) leveraging the systematic understanding of drugs' efficacy and toxicity. Despite numerous challenges in applying computational methodologies for QSP and mechanism-based PK/PD models to biological, physiological, and pharmacological data, bridging these disciplines has the potential to enhance our understanding of complex disease systems such as BC...
July 19, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28734595/arrhythmias-after-left-ventricular-assist-device-implantation-incidence-and-management
#6
REVIEW
Anis J Kadado, Joseph G Akar, James P Hummel
The use of mechanical circulatory support has become an increasingly common practice in patients with heart failure, whether used as bridge to transplantation or as destination therapy. The last couple of decades has seen a drastic change in the functioning of the left ventricular assist devices (LVAD), changing from the first generation devices running on pulsatile flow to the current continuous flow devices. Atrial and ventricular arrhythmias are common among heart failure patients, and though the systematic circulation is well supported in patients on mechanical circulatory support, these arrhythmias can still be the cause of detrimental symptoms and lead to potentially fatal outcomes...
July 10, 2017: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28731484/cpr-ecls-bvad-and-successful-heart-transplantation-within-2-months-a-single-centre-case-series-in-two-young-high-urgency-listed-patients
#7
Anna K Schmidt, Diyar Saeed, Arash Mehdiani, Bozena Sowinski, Ralf Westenfeld, Payam Akhyari, Artur Lichtenberg, Udo Boeken
INTRODUCTION: In times of organ shortage, death while on the heart waiting-list still represents a major problem. As a consequence, bridging to transplant as well as the decision when to escalate therapy play a very important role. METHODS AND RESULTS: We report on two young patients with dilated cardiomyopathy and acute decompensation who were successfully bridged to heart transplantation with both left and temporary right ventricular assist devices in just 2 months...
July 20, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28726495/use-of-adeno-associated-virus-vector-for-cardiac-gene-delivery-in-large-animal-surgical-models-of-heart-failure
#8
Michael G Katz, Anthony S Fargnoli, Thomas Weber, Roger Hajjar, Charles Bridges
The advancement of gene-therapy-based approaches to treat heart disease represents a need for clinically-relevant animal models with characteristics equivalent to human pathologies. Rodent models of cardiac disease do not precisely reproduce heart failure phenotype and molecular defects. This has motivated researchers to use large animals whose heart size and physiological processes more similar and comparable to those of humans. Today, adeno-associated viruses (AAV)-based vectors are undoubtedly among the most promising DNA delivery vehicles...
July 20, 2017: Human Gene Therapy. Clinical Development
https://www.readbyqxmd.com/read/28725087/psychosynthesis-a-foundational-bridge-between-psychology-and-spirituality
#9
Catherine Ann Lombard
Pastoral psychologists have long tried to establish a working model that encompasses the seemingly conflicting disciplines of science and religion. Psychosynthesis, a transpersonal psychology and therapeutic approach, offers such a model of the human personality, in which the psychological and spiritual perspectives can converge. This article explores psychosynthesis psychology and therapy as a theoretical framework for pastoral psychology. Although psychosynthesis psychotherapy relies on an array of techniques, it fundamentally works with the clients' will while emphasizing, exploring, and cultivating their relationships on all levels-intrapersonal, interpersonal, and with the Higher Self...
2017: Pastoral Psychology
https://www.readbyqxmd.com/read/28717981/effects-of-counselling-on-adherence-to-antiretroviral-treatment-among-people-with-hiv-in-estonia-a-randomized-controlled-trial
#10
Anneli Uusküla, Kaja-Triin Laisaar, Mait Raag, Liis Lemsalu, Liilia Lõhmus, Kristi Rüütel, K Rivet Amico
To assess the efficacy of an education- and strengths-based counselling programme to promote antiretroviral therapy (ART) adherence in a cohort of HIV-infected individuals with high prevalence of injection drug use in Estonia. Parallel-group randomized (1:1) controlled trial (RCT). Adults receiving ART in two clinics were followed for 12 months. The trial compared: (i) an intervention (three sessions) incorporated into routine clinic visits, providing education about HIV, ART, the role of adherence, and tailoring regimen to daily routines using problem-solving skills to address adherence barriers versus (ii) usual care (control)...
July 17, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/28714471/progression-through-mitosis-promotes-parp-inhibitor-induced-cytotoxicity-in-homologous-recombination-deficient-cancer-cells
#11
Pepijn M Schoonen, Francien Talens, Colin Stok, Ewa Gogola, Anne Margriet Heijink, Peter Bouwman, Floris Foijer, Madalena Tarsounas, Sohvi Blatter, Jos Jonkers, Sven Rottenberg, Marcel A T M van Vugt
Mutations in homologous recombination (HR) genes BRCA1 and BRCA2 predispose to tumorigenesis. HR-deficient cancers are hypersensitive to Poly (ADP ribose)-polymerase (PARP) inhibitors, but can acquire resistance and relapse. Mechanistic understanding how PARP inhibition induces cytotoxicity in HR-deficient cancer cells is incomplete. Here we find PARP inhibition to compromise replication fork stability in HR-deficient cancer cells, leading to mitotic DNA damage and consequent chromatin bridges and lagging chromosomes in anaphase, frequently leading to cytokinesis failure, multinucleation and cell death...
July 17, 2017: Nature Communications
https://www.readbyqxmd.com/read/28711755/palliative-care-clinicians-caring-for-patients-before-and-after-continuous-flow-left-ventricular-assist-device
#12
Sara E Wordingham, Colleen K McIlvennan, Timothy J Fendler, Amy L Behnken, Shannon M Dunlay, James N Kirkpatrick, Keith M Swetz
Left ventricular assist devices (LVADs) are an available treatment option for carefully-selected patients with advanced heart failure. Initially developed as a bridge to transplantation, LVADs are now also offered to patients ineligible for transplantation as destination therapy (DT). Individuals with a DT-LVAD will live the remainder of their lives with the device in place. While survival and quality of life improve with LVADs compared to medical therapy, complications persist including bleeding, infection, and stroke...
July 12, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28711453/a-roadmap-for-evaluating-the-use-and-value-of-durable-ventricular-assist-device-therapy
#13
EDITORIAL
Sarah T Ward, Qixing Liang, Francis D Pagani, Min Zhang, Robert L Kormos, Keith D Aaronson, Andrew D Althouse, Brahmajee K Nallamothu, Donald S Likosky
Heart failure is a disease characterized by profound human suffering with limitations in survival despite treatment with guideline-directed medical therapies. Patients with heart failure frequently progress to advanced stages and often require cardiac transplantation or implantation of left ventricular assist devices (LVADs) to extend survival and improve quality of life. As the number of suitable heart donors, number of experienced medical centers and patient comorbidities place restrictions on the feasibility of cardiac transplantation, implantation of LVADs has emerged as a more frequently applied treatment as either a bridge to transplantation or as permanent therapy...
June 23, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28711221/the-evolution-of-lung-transplantation-for-cystic-fibrosis-a-2017-update
#14
REVIEW
Gregory Snell, Anna Reed, Marc Stern, Denis Hadjiliadis
Lung transplantation (LTx) is an established therapy for patients with end-stage cystic fibrosis (CF). Indeed, CF is the commonest indication for those aged<50years of age needing LTx. CF LTx is associated with a 45% 10year survival - according to the world's largest registry. It is important all otherwise suitable CF patients with severe lung disease have a timely referral for discussion and consideration of the possibility of LTx. LTx discussions must carefully consider colonisation or infection with Burkholderia cenocepacia, Mycobacterium abscessus and Scediosporium - as good LTx outcomes cannot be guaranteed...
July 12, 2017: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/28706588/wearable-cardioverter-defibrillator-bridge-or-alternative-to-implantation
#15
REVIEW
Jeremie Barraud, Jennifer Cautela, Morgane Orabona, Johan Pinto, Olivier Missenard, Marc Laine, Franck Thuny, Franck Paganelli, Laurent Bonello, Michael Peyrol
The implantable cardioverter-defibrillator (ICD) is effective to prevent sudden cardiac death (SCD) in selected patients with heart disease known to be at high risk for ventricular arrhythmia. Nevertheless, this invasive and definitive therapy is not indicated in patients with potentially transient or reversible causes of sudden death, or in patients with temporary contra-indication for ICD placement. The wearable cardioverter defibrillator (WCD) is increasingly used for SCD prevention both in patients awaiting ICD implantation or with an estimated high risk of ventricular arrhythmia though to be transient...
June 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28706587/management-of-ventricular-tachycardia-storm-in-patients-with-structural-heart-disease
#16
REVIEW
Daniele Muser, Pasquale Santangeli, Jackson J Liang
Electrical storm (ES) is a medical emergency characterized by repetitive episodes of sustained ventricular arrhythmias (VAs) in a limited amount of time (at least 3 within a 24-h period) leading to repeated appropriate implantable cardioverter defibrillator therapies. The occurrence of ES represents a major turning point in the natural history of patients with structural heart disease being associated with poor short- and long-term survival particularly in those with compromised left ventricular ejection fraction (LVEF) that can develop hemodynamic decompensation and multi-organ failure...
June 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28702769/short-and-long-term-outcomes-after-combined-intravenous-thrombolysis-and-mechanical-thrombectomy-versus-direct-mechanical-thrombectomy-a-prospective-single-center-study
#17
Giovanni Merlino, Massimo Sponza, Benedetto Petralia, Alessandro Vit, Vladimir Gavrilovic, Andrea Pellegrin, Michele Rana, Iacopo Cancelli, Sara Naliato, Simone Lorenzut, Roberto Marinig, Ferdinando Calzolari, Roberto Eleopra
Recent clinical trials demonstrated that mechanical thrombectomy (MT) using second-generation endovascular devices has beneficial effects in acute ischemic stroke (AIS) due to large vessel occlusion (LVO). However, it remains controversial if intravenous thrombolysis (IVT) prior to MT is superior compared to direct mechanical thrombectomy (DMT). The aims of this study were to compare short and long-term outcomes between IVT + MT and DMT patients. We prospectively recruited AIS patients with LVO in the anterior or posterior circulation eligible for MT with and without prior IVT...
August 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28699408/bridging-the-gap-between-heart-failure-and-the-device-clinic
#18
John Rickard, Bruce L Wilkoff
While cardiac resynchronization therapy (CRT) is a mainstay in the management of selected patients with chronic systolic dysfunction, many patients are noted to experience less than expected or no benefit at all from the therapy. Multidisciplinary care has been shown to provide benefit in follow up for patients receiving CRT devices. Areas Covered: This review will focus on the apparent reasons behind less than optimal outcomes following CRT as well as multidisciplinary approaches to treating patients with CRT devices...
July 12, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28699083/a-therapy-system-for-post-traumatic-stress-disorder-using-a-virtual-agent-and-virtual-storytelling-to-reconstruct-traumatic-memories
#19
Myrthe L Tielman, Mark A Neerincx, Rafael Bidarra, Ben Kybartas, Willem-Paul Brinkman
Although post-traumatic stress disorder (PTSD) is well treatable, many people do not get the desired treatment due to barriers to care (such as stigma and cost). This paper presents a system that bridges this gap by enabling patients to follow therapy at home. A therapist is only involved remotely, to monitor progress and serve as a safety net. With this system, patients can recollect their memories in a digital diary and recreate them in a 3D WorldBuilder. Throughout the therapy, a virtual agent is present to inform and guide patients through the sessions, employing an ontology-based question module for recollecting traumatic memories to further elicit a detailed memory recollection...
August 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28698663/medical-devices-for-the-treatment-of-obesity
#20
REVIEW
Phong Ching Lee, John Dixon
Obesity is a major public health concern that leads to numerous metabolic, mechanical and psychological complications. Although lifestyle interventions are the cornerstone of obesity management, subsequent physiological neurohormonal adaptations limit weight loss, strongly favour weight regain and counteract sustained weight loss. A range of effective therapies are therefore needed to manage this chronic relapsing disease. Bariatric surgery delivers substantial, durable weight loss but limited access to care, perceived high risks and costs restrict uptake...
July 12, 2017: Nature Reviews. Gastroenterology & Hepatology
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