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Bridging therapy

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https://www.readbyqxmd.com/read/28325778/extracorporeal-life-support-as-a-bridge-to-lung-transplantation-a-single-center-experience-with-an-emphasis-on-health-related-quality-of-life
#1
Annemieke Oude Lansink-Hartgring, Wim van der Bij, Erik A Verschuuren, Michiel E Erasmus, Adrianus J de Vries, Karin M Vermeulen, Walter M van den Bergh
BACKGROUND: Extracorporeal life support (ECLS) as a bridge to lung transplantation is increasingly used, but information on long-term outcome is scarce. We aim to summarize our experience with an emphasis on health-related quality of life. Secondary outcomes include ICU and hospital stay and pre- and post-transplant mortality. METHODS: A retrospective cohort study of all adult subjects receiving ECLS as a bridge to lung transplantation from 2010 to 2014 was reviewed and compared with all adult subjects who underwent bilateral lung transplantation in the same period...
March 21, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28325104/communication-and-well-being-outcomes-of-a-hybrid-service-delivery-model-of-intensive-impairment-based-treatment-for-aphasia-in-the-hospital-setting-a-pilot-study
#2
Rachel Wenke, Elizabeth Cardell, Melissa Lawrie, Dana Gunning
PURPOSE: This pilot study aimed to evaluate the effects of an intensive hybrid service delivery model (i.e., combining face-to-face individual, computer and group therapy) on communication and well-being for people with aphasia (PWA) in the hospital setting. MATERIALS AND METHODS: The study explored two different intensities of the hybrid model, 4 h/week (Hybrid-4) and 8 h/week (Hybrid-8) both for 8 weeks. Participants ranging from 1 month to 5 years post-onset were allocated using matched-pair randomisation to receive either Hybrid-4 (n = 5) or Hybrid-8 (n = 4) and assessed using a comprehensive language battery by a blinded assessor, as well as selected activity, participation and well-being measures before, immediately after and 4-week post-treatment...
March 21, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28323337/treatment-pathway-of-bone-sarcoma-in-children-adolescents-and-young-adults
#3
REVIEW
Damon R Reed, Masanori Hayashi, Lars Wagner, Odion Binitie, Diana A Steppan, Andrew S Brohl, Eric T Shinohara, Julia A Bridge, David M Loeb, Scott C Borinstein, Michael S Isakoff
When pediatric, adolescent, and young adult patients present with a bone sarcoma, treatment decisions, especially after relapse, are complex and require a multidisciplinary approach. This review presents scenarios commonly encountered in the therapy of bone sarcomas with the goal of objectively presenting a consensus, multidisciplinary management approach. Little variation was found in the authors' group with respect to local control or systemic therapy. Clinical trials were universally prioritized in all settings...
March 21, 2017: Cancer
https://www.readbyqxmd.com/read/28323195/left-ventricular-assist-device-related-infections-a-multicentric-study
#4
S Siméon, E Flécher, M Revest, M Niculescu, J-C Roussel, M Michel, P Leprince, P Tattevin
OBJECTIVES: Implantable left ventricular assist device (LVAD) is a major therapeutic progress for end-stage heart failure in selected patients. As their use is expanding, infectious complications are emerging, with limited data available to guide their management. We aimed to better characterize LVAD-related infections. METHODS: We enrolled all consecutive patients diagnosed with LVAD-related infections in 3 referral centers in France, using standardized definition of infections in patients with LVAD...
March 18, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28322827/structural-divergence-of-essential-triad-ribbon-synapse-proteins-among-placental-mammals-implications-for-preclinical-trials-in-photoreceptor-transplantation-therapy
#5
Christopher R J Laver, Joanne A Matsubara
As photoreceptor transplantation rapidly moves closer to the clinic, verifying graft efficacy in animal models may have unforeseen xenogeneic barriers. Although photoreceptor transplants have most convincingly exhibited functional synaptogenesis in conspecific studies, such evidence (while ruling out false-positives due to: viral graft labeling, fusion/cytosolic transfer, or neuroprotection) has not yet been shown for discordant xenografts. From this, a fundamental question should be raised: is useful xenosynaptogenesis likely between human photoreceptors and mouse retina? The triad ribbon synapse (TRS) that would normally form is unique and contains trans-synaptic proteins essential to its formation and function...
March 18, 2017: Experimental Eye Research
https://www.readbyqxmd.com/read/28321866/bridging-worlds-participatory-thinking-in-jungian-context
#6
Robin S Brown
Introducing the 'participatory' paradigm associated with the work of transpersonalists Richard Tarnas and Jorge Ferrer, the author outlines an approach to Jung's archetypal thinking that might offer a more adequate basis in which to ground a non-reductive approach to practice. In order to demonstrate the relevance of this outlook at the present time, the author begins by examining recent debates concerning the nature of 'truth' in the clinical setting. Reflecting on the difficulties analysts face in attempting to maintain professional authority without falling into an implicit authoritarianism, it is argued that any approach to therapy seeking to orient itself towards 'the unconscious' must posit the challenges of pluralism as a central concern for practice...
April 2017: Journal of Analytical Psychology
https://www.readbyqxmd.com/read/28319240/two-paradigms-for-endovascular-thrombectomy-after-intravenous-thrombolysis-for-acute-ischemic-stroke
#7
Gaspard Gerschenfeld, Ioan-Paul Muresan, Raphael Blanc, Michael Obadia, Marie Abrivard, Michel Piotin, Sonia Alamowitch
Importance: Intravenous thrombolysis (IVT) followed by mechanical thrombectomy (MT) is recommended to treat acute ischemic stroke (AIS) with a large vessel occlusion (LVO). Most hospitals do not have on-site MT facilities, and most patients need to be transferred secondarily after IVT (drip and ship), which may have an effect on the neurologic outcome. Objective: To compare the functional independence at 3 months between patients treated under the drip-and-ship paradigm and those treated on site (mothership)...
March 20, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28318856/balloon-aortic-valvuloplasty-in-the-transcatheter-aortic-valve-implantation-era-a-single-center-registry
#8
Ana Rita G Francisco, Miguel Nobre Menezes, Pedro Carrilho Ferreira, Cláudia Jorge, Doroteia Silva, Eduardo Infante de Oliveira, Fausto J Pinto, Pedro Canas da Silva
INTRODUCTION: Percutaneous balloon aortic valvuloplasty (BAV) has been limited by the risk of complications and restenosis. However, growing use of transcatheter aortic valve implantation (TAVI) has revived interest in this technique. We analyzed the current indications for BAV and outcomes in a single center. METHODS: Acute results and long-term outcomes were analyzed in a retrospective single-center registry of patients undergoing BAV between January 2013 and January 2016...
March 16, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28316335/complement-in-anca-associated-vasculitis-mechanisms-and-implications-for-management
#9
REVIEW
Min Chen, David R W Jayne, Ming-Hui Zhao
Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a group of potentially life-threatening autoimmune diseases. The main histological feature in the kidneys of patients with AAV is pauci-immune necrotizing crescentic glomerulonephritis with little immunoglobulin and complement deposition in the glomerular capillary walls. The complement system was not, therefore, initially thought to be associated with the development of AAV. Accumulating evidence from animal models and clinical observations indicate, however, that activation of the complement system - and the alternative pathway in particular - is crucial for the development of AAV, and that the complement activation product C5a has a central role...
March 20, 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28316120/synergistic-effects-of-g-csf-and-bone-marrow-stromal-cells-on-nerve-regeneration-with-acellular-nerve-xenografts
#10
Hua Jia, Ying Wang, Tao Wang, Yi Dong, Wei-Li Li, Jun-Ping Li, Wen-Zhi Ma, Xiao-Jie Tong, Zhong-Yi He
Peripheral nerve defects result in severe denervation presenting sensory and motor functional incapacitation. Currently, a satisfactory therapeutic treatment promoting the repair of injured nerves is not available. As shown in our previous study, acellular nerve xenografts (ANX) implanted with bone marrow stromal cells (BMSCs) replaced allografts and promoted nerve regeneration. Additionally, granulocyte-colony stimulating factor (G-CSF) has been proven to mobilize supplemental cells and enhance vascularization in the niche...
March 18, 2017: Synapse
https://www.readbyqxmd.com/read/28304189/physiological-remodeling-of-bifurcation-aneurysms-preclinical-results-of-the-eclips-device
#11
Thomas R Marotta, Howard A Riina, Ian McDougall, Donald R Ricci, Monika Killer-Oberpfalzer
OBJECTIVE Intracranial bifurcation aneurysms are complex lesions for which current therapy, including simple coiling, balloon- or stent-assisted coiling, coil retention, or intrasaccular devices, is inadequate. Thromboembolic complications due to a large burden of intraluminal metal, impedance of access to side branches, and a high recurrence rate, due largely to the unmitigated high-pressure flow into the aneurysm (water hammer effect), are among the limitations imposed by current therapy. The authors describe herein a novel device, eCLIPs, and its use in a preclinical laboratory study that suggests the device's design and functional features may overcome many of these limitations...
March 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28303006/short-course-high-dose-rifampicin-achieves-wolbachia-depletion-predictive-of-curative-outcomes-in-preclinical-models-of-lymphatic-filariasis-and-onchocerciasis
#12
Ghaith Aljayyoussi, Hayley E Tyrer, Louise Ford, Hanna Sjoberg, Nicolas Pionnier, David Waterhouse, Jill Davies, Joanne Gamble, Haelly Metugene, Darren A N Cook, Andrew Steven, Raman Sharma, Ana F Guimaraes, Rachel H Clare, Andrew Cassidy, Kelly L Johnston, Laura Myhill, Laura Hayward, Samuel Wanji, Joseph D Turner, Mark J Taylor, Stephen A Ward
Lymphatic filariasis (LF) and onchocerciasis are priority neglected tropical diseases targeted for elimination. The only safe drug treatment with substantial curative activity against the filarial nematodes responsible for LF (Brugia malayi, Wuchereria bancrofti) or onchocerciasis (Onchocerca volvulus) is doxycycline. The target of doxycycline is the essential endosymbiont, Wolbachia. Four to six weeks doxycycline therapy achieves >90% depletion of Wolbachia in worm tissues leading to blockade of embryogenesis, adult sterility and premature death 18-24 months post-treatment...
March 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28302013/multicyclic-peptides-as-scaffolds-for-the-development-of-tumor-targeting-agents
#13
Anastasia Loktev, Uwe Haberkorn, Walter Mier
The lack of specificity of traditional cytotoxic drugs triggers the development of anticancer agents with high selectivity to tumor-specific proteins. The unveiling of target structures such as EGFR or Her2 allows the focused development of novel therapies and has strongly advanced tumor treatment. Tumor-specific high-affinity ligands can be identified by using display techniques such as phage, yeast surface, ribosome and mRNA display. These techniques enable the screening of huge libraries, consequently providing a valuable alternative to rational drug development...
March 16, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28301992/effect-of-downstaging-and-bridging-of-hepatocellular-carcinoma-on-survival-following-liver-transplant-a-single-center-experience
#14
Mohammed I Al Sebayel, Hussien Elsiesy, Waleed Al-Hamoudi, Saleh Alabbad, Yasser ElSheikh, Hany Elbeshbeshy, Isam Salih, Sarra Yousif, Yahia Saleh, Abdulmoneim Eldali, Faisal A Abaalkhail
OBJECTIVES: Hepatocellular carcinoma is among the leading causes of cancer death. The Milan criteria are the first and most widely used criteria for selecting patients with hepatocellular carcinoma for a good transplant outcome. Studies have shown that patients with hepatocellular carcinoma outside the Milan criteria have good outcomes if they are successfully downstaged before transplant. We report our experience with locoregional therapy for hepatocellular carcinoma, either for bridging or for downstaging prior to transplant...
March 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28301217/neuromodulation-with-percutaneous-electrical-nerve-field-stimulation-is-associated-with-reduction-in-signs-and-symptoms-of-opioid-withdrawal-a-multisite-retrospective-assessment
#15
Adrian Miranda, Arturo Taca
BACKGROUND: Finding an effective, non-pharmacological approach to treat opioid withdrawal could remove some of the barriers associated with pharmacotherapy. The BRIDGE® is a noninvasive, percutaneous electrical nerve field stimulator developed to target pain. OBJECTIVES: This pilot study aimed to determine (1) the effects of the BRIDGE on withdrawal scores during the induction phase of opioid withdrawal therapy, (2) the percentage of subjects who successfully transitioned to medication assisted therapy (MAT)...
March 16, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28299628/management-of-colon-stents-based-on-bernoulli-s-principle
#16
Yoshiharu Uno
BACKGROUND AND AIMS: The colonic self-expanding metal stent (SEMS) has been widely used for "bridge to surgery" and palliative therapy. However, if the spread of SEMS is insufficient, not only can a decompression effect not be obtained but also perforation and obstructive colitis can occur. The mechanism of occurrence of obstructive colitis and perforation was investigated by flow dynamics. METHODS: Bernoulli's principle was applied, assuming that the cause of inflammation and perforation represented the pressure difference in the proximal lumen and stent...
March 16, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28296034/emergency-valve-in-valve-transcatheter-aortic-valve-replacement-in-a-patient-with-degenerated-bioprosthetic-aortic-stenosis-and-cardiogenic-shock-on-veno-arterial-extracorporeal-membrane-oxygenation
#17
Matthew R Summers, Stephanie Mick, Samir R Kapadia, Amar Krishnaswamy
The use of transcatheter aortic valve replacement (TAVR) as an acute treatment in severe decompensated bioprosthetic aortic valve disease is not well documented. We describe herein a unique case in which valve-in-valve (ViV) TAVR was successfully used as both an emergency salvage therapy and a bridge to definitive fourth reoperative aortic valve replacement (AVR) in a young patient with cardiogenic shock secondary to bioprosthetic aortic valve stenosis who was dependent on veno-arterial extracorporeal membrane oxygenation (VA-ECMO)...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28295638/effect-of-direct-oral-anticoagulants-on-the-risk-of-delayed-bleeding-after-gastric-endoscopic-submucosal-dissection
#18
Toshiyuki Yoshio, Hideomi Tomida, Ryuichiro Iwasaki, Yusuke Horiuchi, Masami Omae, Akiyoshi Ishiyama, Toshiaki Hirasawa, Yorimasa Yamamoto, Tomohiro Tsuchida, Junko Fujisaki, Takuya Yamada, Eiji Mita, Tomoyuki Ninomiya, Kojiro Michitaka, Masahiro Igarashi
OBJECTIVES: Anticoagulants are used to prevent thromboembolic event. Direct oral anticoagulants (DOACs) are our new choice; however, their effect on the bleeding risk for endoscopic treatment has not been reported. We aimed to assess the clinical effect of DOACs compared to warfarin for gastric endoscopic submucosal dissection (ESD). METHODS: We retrospectively studied 97 patients on anticoagulants treated 108 gastric neoplasms with ESD in three referral institutes...
March 10, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28295201/thrombopoetin-receptor-agonist-therapy-in-thrombocytopenia-itp-and-beyond
#19
Alice Taylor, John Paul Westwood, Faidra Laskou, Siobhan McGuckin, Marie Scully
Eltrombopag is well established in treatment of severe immune thrombocytopenia (ITP) and is increasingly commonplace in second-line management. A role is also suggested for both bridging therapy for surgery, as well as treating thrombocytopenia due to non-immune aetiologies. We present the largest single-centre experience with eltrombopag, with our cohort of 62 patients. Patients with severe ITP (n = 34) had 91·2% response, which was sustained over a median of 18·5 months. In 41·4% of ITP cases (n = 14), complete response (CR- platelet count >100 × 10(9) /l) was achieved and in 2 cases, therapy was stopped and CR maintained...
March 14, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28294486/pd-l1-expression-at-tumor-invasive-front-is-associated-with-emt-and-poor-prognosis-in-esophageal-squamous-cell-carcinoma
#20
Satoshi Tsutsumi, Hiroshi Saeki, Yuichiro Nakashima, Shuhei Ito, Eiji Oki, Masaru Morita, Yoshinao Oda, Shinji Okano, Yoshihiko Maehara
Programmed death-ligand 1 (PD-L1) plays a crucial role in the host immune system in cancer progression. The gene promoter region of PD-L1 also contains a binding site for ZEB1, a transcription factor related to epithelial-mesenchymal transition (EMT). The purpose of this study was to clarify the relationship between PD-L1 and EMT and its clinical importance in esophageal squamous cell carcinoma (ESCC). PD-L1 and ZEB1 expression at the tumor invasive front was examined by immunohistochemistry in resected specimens from 90 patients with ESCC who underwent surgery without preoperative therapy, and their expression and clinicopathological factors were compared...
March 14, 2017: Cancer Science
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