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https://www.readbyqxmd.com/read/28748385/effect-of-implementation-of-guidelines-on-assessment-and-diagnosis-of-vertebral-fractures-in-patients-older-than-50%C3%A2-years-with-a-recent-non-vertebral-fracture
#1
R Y van der Velde, S P G Bours, C E Wyers, W F Lems, P P M M Geusens, J P W van den Bergh
We evaluated the impact of a new Dutch guideline on systematic implementation of densitometric Vertebral Fracture Assessment (VFA) in patients with a recent non-vertebral fracture. Systematic implementation resulted in a significant increase of VFA, diagnosis of vertebral fractures (VFs), and percentage of patients eligible for treatment. INTRODUCTION: VFs are underdiagnosed although they are important predictors of fracture risk, independent of age and bone mineral density (BMD). The Dutch guideline on osteoporosis and fracture prevention recommends VFA in all patients aged >50 years with a recent non-VF...
July 26, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28748266/treatment-of-chronic-heart-failure-in-germany-a-retrospective-database-study
#2
Stefan Störk, Renate Handrock, Josephine Jacob, Jochen Walker, Frederico Calado, Raquel Lahoz, Stephan Hupfer, Sven Klebs
BACKGROUND: Adherence to treatment guidelines affects outcomes in patients with chronic heart failure (HF). We investigated patient pathways and treatment patterns for HF in Germany. METHODS: This retrospective study used anonymous healthcare claims data from the German Health Risk Institute on individuals with statutory health insurance. Patients with uninterrupted data from 1 January 2009 to 31 December 2013 or death (whichever occurred first), and ≥2 recorded HF-related diagnoses in 2011, were included...
July 26, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28747306/how-i-treat-new-agents-in-myeloma
#3
Philippe Moreau
At present, multiple classes of agents with distinct mechanisms of action are available for the treatment of patients with multiple myeloma (MM), including alkylators, steroids, immunomodulatory agents (IMiDs), proteasome inhibitors (PIs), histone deacetylase inhibitors (DACIs) and monoclonal antibodies (mAbs). Over the last 5 years, several new agents, such as the third-generation IMiD pomalidomide, the second generation PIs carfilzomib and ixazomib, the DACI panobinostat and two monoclonal antibodies, elotuzumab and daratumumab, have been approved, incorporated into clinical guidelines and have transformed our approach to the treatment of patients...
July 26, 2017: Blood
https://www.readbyqxmd.com/read/28746931/treatment-outcomes-for-metastatic-melanoma-of-unknown-primary-in-the-new-era-a-single-institution-study-and-review-of-the-literature
#4
Kierstin Utter, Chloe Goldman, Sarah A Weiss, Richard L Shapiro, Russell S Berman, Melissa Ann Wilson, Anna C Pavlick, Iman Osman
BACKGROUND: Metastatic melanoma of unknown primary (MUP) is uncommon, biologically ill defined, and clinically understudied. MUP outcomes are seldom reported in clinical trials. In this study, we analyze responses of MUP patients treated with systemic therapy in an attempt to inform treatment guidelines for this unique population. METHODS: New York University (NYU)'s prospective melanoma database was searched for MUP patients treated with systemic therapy. PubMed and Google Scholar were searched for MUP patients treated with immunotherapy or targeted therapy reported in the literature, and their response and survival data were compared to the MUP patient data from NYU...
July 27, 2017: Oncology
https://www.readbyqxmd.com/read/28746570/brazilian-guidelines-for-the-clinical-management-of-paracoccidioidomycosis
#5
Maria Aparecida Shikanai-Yasuda, Rinaldo Pôncio Mendes, Arnaldo Lopes Colombo, Flávio de Queiroz-Telles, Adriana Satie Gonçalves Kono, Ana Maria Paniago, André Nathan, Antonio Carlos Francisconi do Valle, Eduardo Bagagli, Gil Benard, Marcelo Simão Ferreira, Marcus de Melo Teixeira, Mario León Silva-Vergara, Ricardo Mendes Pereira, Ricardo de Souza Cavalcante, Rosane Hahn, Rui Rafael Durlacher, Zarifa Khoury, Zoilo Pires de Camargo, Maria Luiza Moretti, Roberto Martinez
Paracoccidioidomycosis is a systemic fungal disease occurring in Latin America that is associated with rural environments and agricultural activities. However, the incidence and prevalence of paracoccidiodomycosis is underestimated because of the lack of compulsory notification. If paracoccidiodomycosis is not diagnosed and treated early and adequately, the endemic fungal infection could result in serious sequelae. While the Paracoccidioides brasiliensis ( P. brasiliensis ) complex has been known to be the causal agent of paracoccidiodomycosis, a new species, Paracoccidioides lutzii ( P...
July 20, 2017: Revista da Sociedade Brasileira de Medicina Tropical
https://www.readbyqxmd.com/read/28746534/brazilian-guidelines-for-the-diagnosis-and-treatment-of-cystic-fibrosis
#6
Rodrigo Abensur Athanazio, Luiz Vicente Ribeiro Ferreira da Silva, Alberto Andrade Vergara, Antônio Fernando Ribeiro, Carlos Antônio Riedi, Elenara da Fonseca Andrade Procianoy, Fabíola Villac Adde, Francisco José Caldeira Reis, José Dirceu Ribeiro, Lídia Alice Torres, Marcelo Bicalho de Fuccio, Matias Epifanio, Mônica de Cássia Firmida, Neiva Damaceno, Norberto Ludwig-Neto, Paulo José Cauduro Maróstica, Samia Zahi Rached, Suzana Fonseca de Oliveira Melo
Cystic fibrosis (CF) is an autosomal recessive genetic disorder characterized by dysfunction of the CFTR gene. It is a multisystem disease that most often affects White individuals. In recent decades, various advances in the diagnosis and treatment of CF have drastically changed the scenario, resulting in a significant increase in survival and quality of life. In Brazil, the current neonatal screening program for CF has broad coverage, and most of the Brazilian states have referral centers for the follow-up of individuals with the disease...
May 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/28745729/highlights-of-skin-disease-education-foundation-s-41st-annual-hawaii-dermatology-seminar%C3%A2
#7
Kenneth B Gordon, Craig L Leonardi, Daniel E Furst, Neal Bhatia, Lawrence F Eichenfield, Katie Beleznay
New therapies, recent pathophysiological findings, and updated guidelines combined to create compelling presentations at the Skin Disease Education Foundation's 41st Annual Hawaii Dermatology Seminar™. This educational supplement summarizes the highlights of clinical sessions presented during this CME/CE conference. A growing understanding of the biology of psoriasis has facilitated the development of increasingly efficacious medications. Skin clearance used to be regarded as an impractical goal for psoriasis therapy...
June 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28743646/sepsis-and-septic-shock-new-definitions-new-diagnostic-and-therapeutic-approaches
#8
REVIEW
Silvano Esposito, Giuseppe De Simone, Giovanni Boccia, Francesco De Caro, Pasquale Pagliano
Sepsis and septic shock are common life-threatening pathologies associated with high mortality and substantial costs for healthcare system. Clinical guidelines and bundles for the management of patients with sepsis have recently been updated. Herein, we review the history of sepsis and related conditions definitions from the first consensus conference in 1991 to nowadays, the epidemiologic data resulting from worldwide studies on incidence and mortality, the diagnostic approaches including the microbiological assessment of infection and the use of several prognostic and diagnostic biomarkers and finally we review the main therapeutic measures as the intravenous immunoglobulin therapy and the administration of appropriate antibiotic treatment to provide patients with sepsis a favourable outcome in the antibiotic-resistance era...
July 22, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28742291/evaluating-the-effect-of-the-changes-in-fda-guidelines-for-clozapine-monitoring
#9
Ryan S Sultan, Mark Olfson, Christoph U Correll, Erica J Duncan
BACKGROUND: Concerns exist that clozapine is underutilized in the management of treatment-resistant schizophrenia. Although a 2015 change in the US Food and Drug Administration (FDA) monitoring recommendations lowered the threshold of the absolute neutrophil count for treatment interruption from 1,500/μL to 1,000/μL and removed white blood cell count thresholds from the monitoring algorithm, the implications of this policy change on clozapine interruptions remain unknown. METHODS: We analyzed outpatient prescribing records for antipsychotic medications in the Veterans Integrated Service Network 7 (VISN 7) database between 1999 and 2012 to assess the potential impact of the recent changes in FDA neutropenia monitoring recommendations on clozapine treatment discontinuation...
July 18, 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28742290/infant-related-intrusive-thoughts-of-harm-in-the-postpartum-period-a-critical-review
#10
Elke C Brok, Patricia Lok, Desiree B Oosterbaan, Aart H Schene, Indira Tendolkar, Philip F van Eijndhoven
BACKGROUND: Besides the expected warm and joyful thoughts, a new mother can be disturbed by sudden frightening thoughts or images of harm done to her baby: harming intrusions, an obsessive phenomenon. Its high prevalence and possible consequences in functioning and in mother-child bonding makes it desirable that clinicians are well informed regarding the current state of knowledge about harming intrusions. OBJECTIVE: To provide a comprehensive review of all studies that have investigated harming intrusions in postpartum women...
July 18, 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28742187/pulmonell-hypertension-vanligt-vid-kronisk-lungsjukdom-europeiska-riktlinjer-kring-utredning-och-behandling
#11
David Kylhammar, Göran Rådegran
Pulmonary hypertension due to lung diseases In 2015 the European Society of Cardiology and European Respiratory Society published new guidelines on the diagnosis and treatment of pulmonary hypertension (PH). PH due to lung diseases and/or hypoxia was classified as a separate entity. PH is common in lung diseases, but seldom severe. Nevertheless, the presence of PH in a patient with lung disease is associated with worse outcome. If there is clinical suspicion of PH in a patient with lung disease, echocardiography is recommended, and if there are signs of severe PH and/or severe right ventricular dysfunction the patient should be referred to a PH expert centre...
July 21, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28741188/-sexually-transmitted-infections-in-germany-the-current-epidemiological-situation
#12
Viviane Bremer, Sandra Dudareva-Vizule, Susanne Buder, Matthias An der Heiden, Klaus Jansen
Sexually transmitted infections (STIs) can impair sexual health. Surveillance and study data were used to provide an overview over STIs in Germany. We estimated 3900 new HIV diagnoses in 2015. Of newly diagnosed infections, 57% were attributed to men who have sex with men (MSM). It was further estimated that there were 3200 new HIV infections and 84,700 people living with HIV in 2015. A total of 6834 syphilis infections were recorded in 2015, which corresponds to an increase of 149% since 2009. The incidence in men was 16-times higher than in women...
July 24, 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/28738794/escaschool-study-trial-protocol-of-an-adaptive-treatment-approach-for-school-age-children-with-adhd-including-two-randomised-trials
#13
Manfred Döpfner, Christopher Hautmann, Christina Dose, Tobias Banaschewski, Katja Becker, Daniel Brandeis, Martin Holtmann, Thomas Jans, Carolin Jenkner, Sabina Millenet, Tobias Renner, Marcel Romanos, Elena von Wirth
BACKGROUND: The ESCAschool study addresses the treatment of school-age children with attention-deficit/hyperactivity disorder (ADHD) in a large multicentre trial. It aims to investigate three interrelated topics: (i) Clinical guidelines often recommend a stepped care approach, including different treatment strategies for children with mild to moderate and severe ADHD symptoms, respectively. However, this approach has not yet been empirically validated. (ii) Behavioural interventions and neurofeedback have been shown to be effective, but the superiority of combined treatment approaches such as medication plus behaviour therapy or medication plus neurofeedback compared to medication alone remains questionable...
July 24, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28738754/pralatrexate-a-comprehensive-update-on-pharmacology-clinical-activity-and-strategies-to-optimize-use
#14
Owen A O'Connor, Jennifer Amengual, Donald Colbourn, Changchun Deng, Ahmed Sawas
It has been nearly 8 years since pralatrexate became the first drug approved by the U.S. Food and Drug Administration for the treatment of relapsed or refractory peripheral T-cell lymphoma (PTCL). Like most drugs approved for a particular clinical indication, as much or more is learned once it enters mainstream use as in the years leading up to regulatory approval. Over the past several years, many diverse lines of research have shed new insight into both the agent, and the diseases it treats. In this review, we will bring the reader up to date on the many new aspects related to pralatrexate's pharmacology, activity across the panoply of T-cell lymphoproliferative malignancies, as well as some new and emerging guidelines that are likely to improve its safety profile...
November 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28737621/baroreflex-activation-therapy-a-new-approach-to-the-management-of-advanced-heart-failure-with-reduced-ejection-fraction
#15
Edoardo Gronda, Darrel Francis, Faiez Zannad, Christian Hamm, Josep Brugada, Emilio Vanoli
: Chronic heart failure is a common clinical condition characterized by persistent excessive sympathetic nervous system activation. The derangement of the sympathetic activity has relevant implications for disease progression and patient survival. Aiming to positively impact patient outcome, autonomic nervous system modulatory therapies have been developed and tested in animal and clinical studies. As a general gross assumption, direct vagal stimulation and baroreflex activation are considered equivalent. This assumption does not take into account the fact that direct cervical vagal nerve stimulation involves activation of both afferent and efferent fibers innervating not only the heart, but the entire visceral system, leading to undesired responses to and from this compartment...
July 21, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28737128/bioequivalence-of-two-oseltamivir-formulations-in-healthy-chinese-volunteers%C3%A2
#16
Yun-Lei Yun, Shou-Hong Gao, Yan Wen, Zhi-Peng Wang, Hai-Jun Miao, Wan-Sheng Chen
BACKGROUND: The aim of this study was to compare the bioavailability of a new generic formulation of oseltamivir 75-mg capsule (test) and a branded formulation Tamiflu® (reference) to meet regulatory criteria for marketing the test product in healthy Chinese male volunteers. METHODS: This single-dose, randomized-sequence, open-label, two-period crossover study was conducted in fasted healthy Chinese male volunteers, who first received a single oral dose of the test or reference formulation with a 7-day washout period, and then the alternative formulation...
July 24, 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28736057/regional-variation-in-breast-cancer-surgery-results-from-the-national-cancer-database-ncdb
#17
Alexander S Chiu, Princess Thomas, Brigid K Killelea, Nina Horowitz, Anees B Chagpar, Donald R Lannin
BACKGROUND: Early studies have shown significant regional differences in the utilization of breast-conserving therapy (BCT) and mastectomy with reconstruction. It is expected that with the passage of time and the adoption of national treatment guidelines, these disparities would disappear. METHODS: Patients with non-metastatic breast cancer who underwent surgery between 2004 and 2013 were analyzed using the National Cancer Database (NCDB). Trends in BCT and reconstruction were evaluated and multivariate logistic regression performed...
July 18, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28735135/endoscope-assisted-abscess-drainage-secondary-to-endoscope-assisted-tlif-1-year-follow-up
#18
Karthik Madhavan, Steven Shelby Burks, Lee Onn Chieng, Anand Veeravagu, Michael Y Wang
INTRODUCTION: Endoscopic discectomy and fusions have been gaining popularity in the recent past and are noted to be safe for its application in elderly population. It involves ultra-small incision for discectomy followed by placement of percutaneous screws in awake patients. Treatment of advanced spinal pathology using endoscope-assisted techniques are challenging. Although not common with endoscopic approach, post-operative infection can be problematic as there are no established guidelines on its management...
July 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28734709/worldwide-fracture-prediction
#19
Ghada El-Hajj Fuleihan, Marlene Chakhtoura, Jane A Cauley, Nariman Chamoun
The substantial increase in the burden of non-communicable diseases in general and osteoporosis in particular, necessitates the establishment of efficient and targeted diagnosis and treatment strategies. This chapter reviews and compares different tools for osteoporosis screening and diagnosis; it also provides an overview of different treatment guidelines adopted by countries worldwide. While access to dual-energy X-ray absorptiometry to measure bone mineral density (BMD) is limited in most areas in the world, the introduction of risk calculators that combine risk factors, with or without BMD, have resulted in a paradigm shift in osteoporosis screening and management...
July 19, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28733378/is-it-time-to-change-the-type-2-diabetes-treatment-paradigm-no-metformin-should-remain-the-foundation-therapy-for-type-2-diabetes
#20
Silvio E Inzucchi
Most treatment guidelines, including those from the American Diabetes Association/European Association for the Study of Diabetes and the International Diabetes Federation, suggest metformin be used as the first-line therapy after diet and exercise. This recommendation is based on the considerable body of evidence that has accumulated over the last 30 years, but it is also supported on clinical grounds based on metformin's affordability and tolerability. As such, metformin is the most commonly used oral antihyperglycemic agent in the U...
August 2017: Diabetes Care
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