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Medical therapy management

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https://www.readbyqxmd.com/read/28324867/blood-glucose-levels-and-glycaemic-burden-in-76-341-patients-attending-primary-care-bittersweet-findings-from-a-9-year-cohort-study
#1
Melinda J Carrington, Neale Cohen, Joshua F Wiley
AIMS: Diabetes care is principally applied in the primary care setting whereby we examined trends in glycaemic levels and goals and estimated avoidable glycaemic burden. METHODS: We retrieved glycated haemoglobin (HbA1C) results and glucose-lowering prescription records from a patient-based medical database during 2005-2013. There were 275,480 available HbA1C measurements from 76,341 individuals managed by 960 general practitioners from 321 clinics across Australia...
February 27, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28324302/huntington-s-disease-update-on-treatments
#2
REVIEW
Kara J Wyant, Andrew J Ridder, Praveen Dayalu
Huntington's disease (HD) is an autosomal dominantly inherited neurodegenerative disease characterized by progressive motor, behavioral, and cognitive decline, ending in death. Despite the discovery of the underlying genetic mutation more than 20 years ago, treatment remains focused on symptomatic management. Chorea, the most recognizable symptom, responds to medication that reduces dopaminergic neurotransmission. Psychiatric symptoms such as depression and anxiety may also respond well to symptomatic therapies...
April 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28324047/functional-imaging-in-the-follow-up-of-enteropancreatic-neuroendocrine-tumors-clinical-usefulness-and-indications
#3
Elettra Merola, Marianne E Pavel, Francesco Panzuto, Gabriele Capurso, Noemi Cicchese, Anja Rinke, Thomas M Gress, Elsa Iannicelli, Daniela Prosperi, Patrizia Pizzichini, Vikas Prasad, Patrizia Kump, Rainer Lipp, Stefano Partelli, Massimo Falconi, Bertram Wiedenmann, Gianfranco Delle Fave
Context: Functional imaging tests (FITs) detecting somatostatin receptors expression (i.e., Somatostatin Receptor Scintigraphy, 68Ga-DOTA-peptide positron emission tomography/computed tomography) have a pivotal role in the diagnosis of neuroendocrine tumors (NETs), while their indication during follow-up still needs to be clarified. Objective: Investigate the role of FITs after diagnosis of metastatic enteropancreatic NETs, identifying patients who might benefit from these exams...
January 13, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28323662/hvad-flow-waveform-morphologies-theoretical-foundation-and-implications-for-clinical-practice
#4
Jonathan D Rich, Daniel Burkhoff
Continuous flow ventricular assist device (cfVAD) performance and patient hemodynamic conditions are intimately interrelated and dynamic, changing frequently with alterations in physiologic conditions, particularly pre- and after-loading conditions. The Heartware cfVAD (HVAD) provides a unique feature among currently approved VADs of providing an estimated instantaneous flow waveform, the characteristics of which can provide significant insights into patient and device properties. Despite being readily available, HVAD waveforms are poorly understood, underutilized and insufficiently leveraged, even by clinicians who regularly manage HVAD patients...
March 16, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28319561/pediatric-enteric-neuropathies-diagnosis-and-current-management
#5
Maggie L Westfal, Allan M Goldstein
PURPOSE OF REVIEW: Neurointestinal diseases are increasingly recognized as causes of significant gastrointestinal morbidity in children. This review highlights the most common pediatric enteric neuropathies and their diagnosis and management, emphasizing insights and discoveries from the most recent literature available. RECENT FINDINGS: The embryologic and histopathologic causes of enteric neuropathies are varied. They range from congenital aganglionosis in Hirschsprung disease, to autoimmune-mediated loss of neuronal subtypes in esophageal achalasia and Chagas disease, to degenerative neuropathies in some cases of chronic intestinal pseudo-obstruction and gastroparesis...
March 17, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28319287/iatrogenic-thyrotoxicosis-and-the-role-of-therapeutic-plasma-exchange
#6
Kabeer K Shah, Michael M Mbughuni, Edwin A Burgstaler, Darci R Block, Jeffrey L Winters
Thyroid storm or severe thyrotoxicosis results from extreme thyroid hormone elevation. Therapy includes medical management to prevent hormone production, release, recycling, and peripheral conversion while stabilizing adrenergic tone. Thyroid dysfunction is the usual cause but it can be due to excessive thyroid hormone ingestion. Therapeutic plasma exchange (TPE) has been used to rapidly remove protein-bound thyroid hormone. American Society for Apheresis guidelines make a weak recommendation to perform TPE in selected patients in the treatment of thyrotoxicosis based on low quality evidence...
March 20, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28319269/withdrawn-trimetazidine-for-stable-angina
#7
REVIEW
Agustín Ciapponi, Rudolf Pizarro, Jeff Harrison
BACKGROUND: Patients with stable angina not controlled by monotherapy with nitrates, beta blockers, or calcium channel blockers are often treated with combinations of these drugs. There may be adverse effects from, or contraindications to, the use of combinations. In low risk groups, medical treatment appears to be as good an option as percutaneous transluminal coronary angioplasty in terms of averting myocardial infarction, death, or subsequent revascularization. Revascularization procedures are too costly or inaccessible for many patients in developing countries therefore effective and safe medical treatment is needed...
March 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28318831/refractory-aqueous-misdirection-syndrome-a-possible-complication-of-penetrating-keratoplasty
#8
I Gama, W M Rodrigues, H P Filipe, M Y Faria, L D Almeida
CLINICAL CASE: An 85 year-old woman presented with a flat anterior chamber of the left eye, severe ocular hypertension, and a normal ultrasound examination in the day following a penetrating keratoplasty (PK). The clinical status did not respond to maximum medical therapy, laser posterior capsulotomy, anterior hyaloidotomy, and complete 23 G vitrectomy. The patient refused further intervention, and light perception was lost after 6 months of follow-up. DISCUSSION: This is the first report of refractory aqueous misdirection syndrome following primary PK...
March 16, 2017: Archivos de la Sociedad Española de Oftalmología
https://www.readbyqxmd.com/read/28318287/findings-from-a-couple-based-open-trial-for-adult-anorexia-nervosa
#9
Donald H Baucom, Jennifer S Kirby, Melanie S Fischer, Brian R Baucom, Robert Hamer, Cynthia M Bulik
Adult anorexia nervosa (AN) often is persistent, significantly erodes quality of life for both the patient and loved ones, and carries high medical and psychiatric comorbidity. Whereas individual psychotherapy for adult AN leads to improvement in some patients, recent findings indicate that the magnitude of improvement is limited: Only a small percentage of individuals fully recover and dropout rates are high. Thus, it is important to build upon current interventions to improve treatment response. We present results from an open trial of a couple-based intervention for adult anorexia nervosa as an adjunct treatment to standard multidisciplinary care...
March 20, 2017: Journal of Family Psychology: JFP
https://www.readbyqxmd.com/read/28317530/depigmentation-therapies-for-vitiligo
#10
REVIEW
Pearl E Grimes, Rama Nashawati
The general goals of medical management of vitiligo are to repigment vitiliginous areas of skin and to stabilize the progression of depigmentation. However, for some patients with vitiligo affecting extensive body surface areas who are unresponsive to repigmentation therapies, depigmentation of the remaining normal skin may be a better choice. Candidates for depigmentation therapy should be carefully screened and patient education is essential. Permanent topical therapies used for depigmentation include monobenzyl ether of hydroquinone, 4-methoxyphenol, and 88% phenol...
April 2017: Dermatologic Clinics
https://www.readbyqxmd.com/read/28316944/human-amnion-membrane-potential-applications-in-oral-and-periodontal-field
#11
REVIEW
Ranjana Mohan, Aashima Bajaj, Mohan Gundappa
Human amniotic membrane (HAM) is derived from the fetal membranes which consist of the inner amniotic membrane made of single layer of amnion cells fixed to collagen-rich mesenchyme attached to chorion. HAM has low immunogenicity, anti-inflammatory properties and their cells can be isolated without the sacrifice of human embryos. Amniotic membrane has biological properties which are important for the experimental and clinical applications in managing patients of various medical specialties. Abundant, natural and wonderful biomembrane not only protects the foetus but also has various clinical applications in the field of dermatology, ophthalmology, ENT surgery, orthopedics and dental surgery...
January 2017: Journal of International Society of Preventive & Community Dentistry
https://www.readbyqxmd.com/read/28316064/depression-among-hiv-aids-patients-on-highly-active-antiretroviral-therapy-in-the-southwest-regional-hospitals-of-cameroon-a-cross-sectional-study
#12
Pleasure Atoh Ngum, Peter Nde Fon, Roland Cheofor Ngu, Vincent Siysi Verla, Henri Namme Luma
INTRODUCTION: HIV patients are now having longer life expectancies with the use of antiretroviral therapy (ART). However, the issue of mental illness has surfaced with depression being the most common in these patients, which has markedly reduced patient adherence to ART. In Cameroon, the management of HIV/AIDS does not incorporate psychiatric manifestations and depression is therefore underdiagnosed. The aim of our study was to determine the prevalence and determinants of depressive symptoms and their association with adherence to ART among HIV/AIDS patients on HAART in the Southwest Regional Hospitals of Cameroon...
March 18, 2017: Neurology and Therapy
https://www.readbyqxmd.com/read/28315947/impact-of-18-f-fdg-pet-ct-on-surgical-management-in-patients-with-advanced-melanoma-an-outcome-based-analysis
#13
Andrea Forschner, Susann-Cathrin Olthof, Brigitte Gückel, Peter Martus, Werner Vach, Christian la Fougère, Konstantin Nikolaou, Ulrike Keim, Thomas Kurt Eigentler, Claus Garbe, Christina Pfannenberg
PURPOSE: To evaluate the influence of (18)F-FDG-PET/CT on clinical decision making and outcome in advanced melanoma patients planned for radical metastasectomy. METHODS AND MATERIALS: A cohort of 333 patients with mainly stage III/IV melanoma having a PET/CT for clinical reasons was prospectively enrolled in our oncologic PET/CT registry between 2013 and 2015. Referring physicians completed questionnaires regarding their intended management for each patient before and after PET/CT...
March 18, 2017: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28315545/oral-anticancer-agents-an-intervention-to-promote-medication-adherence-and-symptom-management%C3%A2
#14
Sandra L Spoelstra, Alla Sikorskii, Atreyee Majumder, Peggy S Burhenn, Monica Schueller, Barbara Given
Symptom burden and poor adherence to oral anticancer agents remain significant clinical problems. This study examined feasibility, preliminary efficacy, and satisfaction with ADHERE, a nurse practitioner intervention that promotes symptom management and adherence among patients prescribed oral agents. The intervention group (which received one semistructured, face-to-face session followed by three weekly telephone sessions using motivational interviewing, brief cognitive-behavioral therapy, and a toolkit to promote self-management) had significantly lower symptom severity postintervention...
April 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28314835/endocrine-therapy-in-the-current-management-of-postmenopausal-estrogen-receptor-positive-metastatic-breast-cancer
#15
Virginia G Kaklamani, William J Gradishar
Metastatic breast cancer (MBC) results in substantial morbidity and mortality for women afflicted with this disease. A majority of MBCs are hormone-responsive and estrogen receptor-positive, making endocrine therapy (ET) an integral component of systemic therapy. With a primary goal of minimizing the effects of estrogen on hormone-responsive MBC, ETs are among the first targeted treatments that aim to inhibit the influence of estrogen receptor activation on tumor proliferation. Several biochemical mechanisms have been the focus of drug development for treatment, including selective estrogen-receptor modulation, aromatase inhibition, and selective estrogen-receptor degradation...
March 17, 2017: Oncologist
https://www.readbyqxmd.com/read/28314783/umbilical-infections-in-foals-microbiological-investigation-and-management
#16
E Rampacci, F Passamonti, M Bottinelli, V Stefanetti, M Cercone, S Nannarone, R Gialletti, F Beccati, M Coletti, M Pepe
This study aims to investigate the bacteria involved in equine omphalitis and their susceptibility to antimicrobial drugs, and consequently to provide guidelines concerning the most suitable treatment protocol in accordance with the clinical, ultrasound and laboratory findings. Forty foals aged between one and 30 days were evaluated in the course of this investigation. An ultrasound examination of all umbilical remnants was carried out carefully in all foals; umbilical swabs were collected for bacteriological examination, and blood samples were collected for blood culture from 19 foals with fever and abnormal blood values...
March 17, 2017: Veterinary Record
https://www.readbyqxmd.com/read/28314093/clinical-impact-of-pharmacogenetic-guided-treatment-for-patients-exhibiting-neuropsychiatric-disorders-a-randomized-controlled-trial
#17
Marilyn C Olson, Alejandra Maciel, Jean Francois Gariepy, Ali Cullors, Juan-Sebastian Saldivar, David Taylor, Joel Centeno, Jorge A Garces, Sandeep Vaishnavi
Objective: Pharmacogenetic testing holds promise as a personalized medicine tool by permitting individualization of pharmacotherapy in accordance with genes influencing therapeutic response, side effects, and adverse events. The authors evaluated the effect on outcomes for patients diagnosed with neuropsychiatric disorders of pharmacogenetics (PGx)-guided treatment compared to usual standard of care. Methods: This was a prospective, randomized study of 237 patients at an outpatient community-based psychiatric practice conducted between April 2015 and October 2015...
March 16, 2017: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/28306587/comparison-of-the-american-college-of-cardiology-american-heart-association-and-the-european-society-of-cardiology-guidelines-for-the-management-of-patients-with-non-st-segment-elevation-acute-coronary-syndromes
#18
Aya J Alame, Aris Karatasakis, Judit Karacsonyi, Barbara A Danek, Erica Resendes, Jose R Martinez Parachini, Pratik Kalsaria, Michele Roesle, Bavana V Rangan, Paul Sorajja, Hani Jneid, Subhash Banerjee, Emmanouil S Brilakis
INTRODUCTION: The American College of Cardiology (ACC), the American Heart Association (AHA), and the European Society of Cardiology (ESC) have been developing guidelines to assist clinicians in making evidence-based decisions. MATERIALS AND METHODS: The current ACC/AHA and ESC guidelines for non-ST-segment elevation acute coronary syndromes (NSTE-ACS) that were updated in 2014 and 2015, respectively, were compared to assess the number of recommendations on the basis of class of recommendation and level of evidence (LOE), the sources cited, and the content...
March 16, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28306333/efficacy-and-safety-of-naftopidil-in-the-medical-expulsion-therapy-for-distal-ureteral-stone-a-systematic-review-and-meta-analysis
#19
Jun Li, Zhuang Tang, Liang Gao, Jinhong Li, Feng Qin, Jiuhong Yuan
PURPOSE: The selective α-adrenoceptor blocker is widely used as a cost-effective treatment option for medical expulsive therapy (MET) of ureteral stones. In this review, we aimed to assess the efficacy and safety of naftopidil for MET compared with control or tamsulosin. METHODS: A systematic literature search was performed in PubMed, Cochrane Library, Embase, and Google Scholar to identify randomized controlled trials that compared naftopidil with either control or tamsulosin for the management of distal ureteral stones...
March 17, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28304099/impact-of-shoulder-sonography-on-clinical-decision-making
#20
Michael V Friedman, Travis J Hillen, David V Holland, James M Essenberg, Jennifer L Demertzis
OBJECTIVES: To assess the impact of musculoskeletal shoulder sonography (US) on clinical decision making. METHODS: This Health Insurance Portability and Accountability Act-compliant retrospective study received Institutional Review Board approval with a waiver of informed consent. Consecutive musculoskeletal shoulder US examinations ordered over a 12-month period were retrospectively reviewed. The medical records of each patient were analyzed, recording immediate pre- and post-US treatment plans...
March 17, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
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