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https://www.readbyqxmd.com/read/29792734/clinical-updates-on-perianal-fistulas-in-crohn-s-disease
#1
Ori Rackovsky, Robert Hirten, Ryan Ungaro, Jean-Frederic Colombel
Perianal fistulizing disease is an aggressive and debilitating phenotype of Crohn's disease (CD), representing a significant therapeutic challenge. New work has led to advancement in epidemiology and long term outcomes of perianal disease. The range of therapeutic options continues to expand, including new biologic agents, biosimilars, and stem cell therapy. Areas covered: We discuss updates to all aspects of management of perianal disease, with a focus on the last three years of published data. Areas considered include new data on epidemiology and prognostication, medical and surgical therapy, and stem cell therapy...
May 24, 2018: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29792540/cerebral-amyloid-angiopathy-diagnosis-and-potential-therapies
#2
Stewart A Weber, Ranish K Patel, Helmi L Lutsep
Cerebral amyloid angiopathy (CAA) is characterized by the pathologic deposition of amyloid-beta within cortical and leptomeningeal arteries, arterioles, capillaries and, in rare cases, the venules of the brain. It is often associated with the development of lobar intracerebral hemorrhages but may cause other neurologic symptoms or be asymptomatic. Magnetic resonance imaging characteristics, such as lobar microbleeds, support a diagnosis of CAA and assist with hemorrhage risk assessments. Immunosuppressants are used to treat rarer inflammatory forms of CAA...
May 24, 2018: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/29791677/multifactorial-intervention-for-diabetes-control-among-older-users-of-insulin
#3
Rafael Vaz Machry, Henrique Umpierre Pedroso, Luthiele Silva Vasconcellos, Rafaela Ramos Nunes, Cibelle de Abreu Evaldt, Eduardo Bardou Yunes Filho, Ticiana da Costa Rodrigues
OBJECTIVE: To evaluate if the closer follow-up with the supply of insulin pens and the measurement of capillary blood glucose improve the management of older patients with type 2 diabetes without adequate glycemic control despite extensive therapy. METHODS: This is a prospective, non-randomized, quasi-experimental study. We have included 45 patients over 60 years old, from both sexes, with glycated hemoglobin (HbA1c) > 8.5% using oral hypoglycemic agents and insulin...
2018: Revista de Saúde Pública
https://www.readbyqxmd.com/read/29791455/national-patterns-of-physician-management-of-sleep-apnea-and-treatment-among-patients-with-hypertension
#4
Rebecca Robbins, Azizi Seixas, Girardin Jean-Louis, Sairam Parthasarathy, David M Rapoport, Gbenga Ogedegbe, Joseph A Ladapo
STUDY OBJECTIVES: Sleep apnea is associated with hypertension, and treatment may improve outcomes. We examine national burden of sleep apnea, rates of sleep apnea treatment, and whether racial/ethnic disparities exist among patients with hypertension. METHODS: Data from the National Ambulatory Medical Care Survey/National Hospital Ambulatory Medical Care Survey (NAMCS/NHAMCS), 2005-2012, were analyzed (N = 417,950). We identified hypertension patient visits where sleep apnea diagnosis or complaint was recorded...
2018: PloS One
https://www.readbyqxmd.com/read/29791243/amcp-partnership-forum-managing-care-in-the-wave-of-precision-medicine
#5
(no author information available yet)
Precision medicine, the customization of health care to an individual's genetic profile while accounting for biomarkers and lifestyle, has increasingly been adopted by health care stakeholders to guide the development of treatment options, improve treatment decision making, provide more patient-centered care, and better inform coverage and reimbursement decisions. Despite these benefits, key challenges prevent its broader use and adoption. On December 7-8, 2017, the Academy of Managed Care Pharmacy convened a group of stakeholders to discuss these challenges and provide recommendations to facilitate broader adoption and use of precision medicine across health care settings...
May 23, 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29791238/low-dose-ketamine-infusion-for-adjunct-management-during-vaso-occlusive-episodes-in-adults-with-sickle-cell-disease-a-case-series
#6
Nicole Palm, Catherine Floroff, Tanna B Hassig, Alice Boylan, Julie Kanter
The optimal management of recurrent painful episodes in individuals living with sickle cell disease (SCD) remains unclear. Currently, the primary treatment for these episodes remains supportive, using fluids and intravenous opioid and anti-inflammatory medications. Few reports have described the use of adjunct subanesthetic doses of ketamine to opioids for treatment of refractory pain in SCD. This article reports a retrospective case series of five patients admitted to the intensive care unit (ICU) with prolonged vaso-occlusive episodes (VOEs)...
May 23, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/29790841/guidelines-for-the-management-of-paediatric-cholera-infection-a-systematic-review-of-the-evidence
#7
Phoebe C M Williams, James A Berkley
Background Vibrio cholerae is a highly motile Gram-negative bacterium which is responsible for 3 million cases of diarrhoeal illness and up to 100,000 deaths per year, with an increasing burden documented over the past decade. Current WHO guidelines for the treatment of paediatric cholera infection (tetracycline 12.5 mg/kg four times daily for 3 days) are based on data which are over a decade old. In an era of increasing antimicrobial resistance, updated review of the appropriate empirical therapy for cholera infection in children (taking account of susceptibility patterns, cost and the risk of adverse events) is necessary...
November 2018: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/29790140/-the-relationship-between-quality-of-life-and-psychological-and-behavioral-factors-in-patients-with-heart-failure-following-cardiac-resynchronization-therapy
#8
Jing Huang, Jin-Bo Fang, Yi-Heng Zhao
BACKGROUND: While cardiac resynchronization therapy improves the quality of life of patients with heart failure, some psychological and behavioral factors still affect the quality of life of these patients. However, information on the factors that affect the quality of life of these patients is limited. PURPOSE: To describe the quality of life and investigate the relationship between quality of life and behavioral and psychological factors such as depression, smoking, drinking, water and sodium restrictions, exercise, and adherence in patients with chronic heart failure following cardiac resynchronization therapy...
June 2018: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29789983/principles-of-fluid-management-and-stewardship-in-septic-shock-it-is-time-to-consider-the-four-d-s-and-the-four-phases-of-fluid-therapy
#9
REVIEW
Manu L N G Malbrain, Niels Van Regenmortel, Bernd Saugel, Brecht De Tavernier, Pieter-Jan Van Gaal, Olivier Joannes-Boyau, Jean-Louis Teboul, Todd W Rice, Monty Mythen, Xavier Monnet
In patients with septic shock, the administration of fluids during initial hemodynamic resuscitation remains a major therapeutic challenge. We are faced with many open questions regarding the type, dose and timing of intravenous fluid administration. There are only four major indications for intravenous fluid administration: aside from resuscitation, intravenous fluids have many other uses including maintenance and replacement of total body water and electrolytes, as carriers for medications and for parenteral nutrition...
May 22, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29789890/surveillance-magnetic-resonance-imaging-for-isolated-optic-pathway-gliomas-is-gadolinium-necessary
#10
Ezekiel Maloney, A Luana Stanescu, Francisco A Perez, Ramesh S Iyer, Randolph K Otto, Sarah Leary, Lotte Steuten, Amanda I Phipps, Dennis W W Shaw
BACKGROUND: Pediatric optic pathway gliomas are typically indolent but have a variable clinical course. Treatment is dictated by symptoms and changes on contrast-enhanced MRI examinations. Gadolinium retention in children has motivated parsimonious use of gadolinium-based contrast agents. OBJECTIVES: To determine surveillance MR factors that motivate changes in tumor-directed therapies and extrapolate cost-efficacy of a non-contrast follow-up protocol. MATERIALS AND METHODS: Using an imaging database search we identified children with isolated optic pathway gliomas and ≥3 follow-up contrast-enhanced MRIs...
May 22, 2018: Pediatric Radiology
https://www.readbyqxmd.com/read/29788876/exploiting-significance-of-physical-exercise-in-prevention-of-gastrointestinal-disorders
#11
Jan Bilski, Agnieszka Mazur-Bialy, Marcin Magierowski, Slawomir Kwiecien, Dagmara Wojcik, Agata Ptak-Belowska, Marcin Surmiak, Aneta Targosz, Katarzyna Magierowska, Tomasz Brzozowski
BACKGROUND: Physical activity can be involved in the prevention of gastrointestinal (GI)-tract diseases, however, the results regarding the volume and the intensity of exercise considered as beneficial for protection of gastrointestinal organs are conflicting. AIMS AND METHODS: The main objective of this review is to provide a comprehensive and updated overview on the beneficial and harmful effects of physical activity on the gastrointestinal tract. We attempted to discuss recent evidence regarding the association between different modes and intensity levels of exercise and physiological functions of the gut and gut pathology...
May 21, 2018: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29788675/anti-tumor-necrosis-factor-therapy-in-intestinal-beh%C3%A3-et-s-disease
#12
REVIEW
Jihye Park, Jae Hee Cheon
Intestinal Behçet's disease is a rare, immune-mediated chronic intestinal inflammatory disease; therefore, clinical trials to optimize the management and treatment of patients are scarce. Moreover, intestinal Behçet's disease is difficult to treat and often requires surgery because of the failure of conventional medical treatment. Administration of anti-tumor necrosis factor α, a potential therapeutic strategy, is currently under active clinical investigation, and evidence of its effectiveness for both intestinal Behçet's disease and inflammatory bowel diseases has been accumulating...
May 24, 2018: Gut and Liver
https://www.readbyqxmd.com/read/29788469/influences-and-impact-of-anxiety-and-depression-in-the-setting-of-inflammatory-bowel-disease
#13
Seyedehsan Navabi, Venkata Subhash Gorrepati, Sanjay Yadav, Jaykrishna Chintanaboina, Sarah Maher, Peter Demuth, Benjamin Stern, August Stuart, Andrew Tinsley, Kofi Clarke, Emmanuelle D Williams, Matthew D Coates
Background: Individuals with inflammatory bowel disease (IBD) are at increased risk of developing anxiety or depression (A&D). Crohn's disease (CD) and ulcerative colitis (UC) with comorbid A&D are both more challenging to manage. IBD providers need to better understand the causes and impact of A&D in order to improve care for IBD patients. We sought to identify clinical factors that influence development of A&D and healthcare utilization in IBD. Methods: This is a retrospective analysis using an IBD natural history registry from a single tertiary care referral center...
May 17, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29788007/knowledge-about-stroke-in-belo-horizonte-brazil-a-community-based-study-using-an-innovative-video-approach
#14
Fidel Meira, Daiane Magalhães, Luiz Sérgio da Silva, Ana Clara Mendonça E Silva, Gisele Sampaio Silva
BACKGROUND AND PURPOSE: Stroke is a leading cause of death in Brazil. Knowledge about the clinical manifestations of stroke as well as its risk factors and its management is still poor in the country. We intended to assess the stroke knowledge of an urban population in Belo Ho-rizonte, Brazil. METHODS: Individuals assisted by a basic health unit were interviewed between February and August 2014. After demographic data collection, the participants were asked to watch a video that consisted of a person presenting stroke signals and they were asked to answer questions about the condition shown on the video...
May 22, 2018: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/29787372/current-use-of-medical-expulsive-therapy-among-endourologists
#15
Donald Charles Fedrigon, Rajat Jain, Sri Sivalingam
INTRODUCTION: We aimed to characterize current practice patterns among endourologists on medical expulsive therapy (MET) for treatment of ureteral calculi. METHODS: An online survey was administered to Endourological Society members. Respondents' MET usage, index case management, and awareness of recent guidelines and literature were compared based on international status, practice setting, interval since training, and endourological fellowship training. RESULTS: Of the 237 complete responses, 65% were international, 61% were academic, 66% had >10 years in practice, and 71% were endourology fellowship-trained...
May 14, 2018: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/29787324/provider-perspectives-on-topical-analgesics
#16
Michael A Smith, Katherine Cho, Phillip Rodgers
Topical analgesics are effective and alternative means to systemic therapy, often minimizing the adverse drug effects and complications of systemic analgesic use. Despite the number of available topical analgesics, there is little direction provided in practice guidelines on their appropriate use and little is known about patterns of their prescribing. To begin understanding these knowledge gaps, we sought provider perspectives on topical analgesic use at a large academic medical center. This electronic survey seeks to explore the perceptions and prescription patterns of topical analgesics among prescribers in a large academic medical center, where the availability of topical analgesics varies...
May 22, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/29786679/-the-rationale-for-the-application-of-photomagnetic-therapy-in-the-treatment-of-dermatitis
#17
N I Schastnaya, V S Ulashchyk
BACKGROUND: in spite of the fact that photomagnetic therapy with the use of the FotoSPOK device (Magnomed Ltd., Belarus) is already used in the medical practice, the application of this method for the management of many diseases remains to be substantiated on the scientifically sound grounds. AIM: The objective of the present study was to evaluate the effectiveness of photomagnetic therapy in the treatment of the local inflammatory process in the skin and to elaborate the rationale for the application of this technique in the treatment of contact dermatitis...
May 21, 2018: Voprosy Kurortologii, Fizioterapii, i Lechebnoĭ Fizicheskoĭ Kultury
https://www.readbyqxmd.com/read/29786677/-combined-rehabilitation-in-the-patients-presenting-with-dorsopathies-of-the-lumbar-spine-and-concomitant-irritable-bowel-syndrome-based-at-a-therapeutic-clinic
#18
E V Sevostyanova, Y A Nikolaev, N V Bogdankevich, V G Lusheva, N A Dolgova, V Y Polyakov
BACKGROUND: Comorbidity constitutes a serious challenge for rehabilitative medicine. The comorbidity of the dorsopathy of the lumbar spine and irritable bowel syndrome mutually complicates the clinical course of both conditions, significantly reduces the patients' quality of life. and increases the costs of diagnostic procedures and restoration of the working capacity. The approaches to the non-pharmacological management of the patients presenting with these diseases remain to be developed...
May 21, 2018: Voprosy Kurortologii, Fizioterapii, i Lechebnoĭ Fizicheskoĭ Kultury
https://www.readbyqxmd.com/read/29785886/treatment-of-homozygous-familial-hypercholesterolaemia-in-paediatric-patients-a-monocentric-experience
#19
Paola S Buonuomo, Marina Macchiaiolo, Giovanna Leone, Paola Valente, Gerarda Mastrogiorgio, Maria Gnazzo, Ippolita Rana, Michaela V Gonfiantini, Maria G Gagliardi, Francesca Romano, Andrea Bartuli
Background Homozygous familial hypercholesterolaemia is a rare life-threatening disease characterized by markedly elevated low-density lipoprotein cholesterol (LDL-C) concentrations and accelerated atherosclerosis. The presence of double gene defects in the LDL-Receptor, either the same defect (homozygous) or two different LDL-raising mutations (compound heterozygotes) or other variants, identify the homozygous phenotype (HopFH). Apheresis is a procedure in which plasma is separated from red blood cells before the physical removal of LDL-C or the LDL-C is directly removed from whole blood...
January 1, 2018: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/29785843/insulin-therapy-weight-gain-and-prognosis
#20
REVIEW
Israel Hodish
Insulin therapy is mainly used by patients with type 2 diabetes who have failed other therapeutic modalities and have become insulin deficient. This group of patients represents about a quarter of all patients with type 2 diabetes. Almost all patients with type 2 diabetes who start insulin therapy or intensify it gain weight, which may potentially diminish the prognostic advantage of improved glycaemia. To date, all available guidelines emphasize both the attainment of A1c goals and weight control, without directing clinician which element is of a higher priority...
May 21, 2018: Diabetes, Obesity & Metabolism
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