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https://www.readbyqxmd.com/read/28088580/grand-round-anticoagulation-in-chronic-liver-disease
#1
REVIEW
Ameet Dhar, Benjamin H Mullish, Mark R Thursz
In this Grand Round, we first present a case of a man with decompensated liver disease who subsequently developed a fatal pulmonary embolism, having not been prescribed prophylactic anticoagulation to prevent venous thromboembolic disease. We go on to discuss the burden of thrombotic disease in those with chronic liver disease, before a more detailed discussion regarding the current evidence, safety data, and clinical dilemmas regarding the use of anticoagulation in patients with chronic liver disease, as well as discussing potential future directions within this field...
January 11, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28088035/diagnosis-treatment-and-outcomes-of-infantile-spasms-in-the-trisomy-21-population
#2
Christopher W Beatty, Joanna E Wrede, Heidi K Blume
PURPOSE: To determine if there are differences in the timing of diagnosis and response to treatment between infants with infantile spasms (IS) and Trisomy 21 (T21) and those with idiopathic IS. METHOD: This was a retrospective study evaluating the time from onset of IS to diagnosis, treatment of IS, time from treatment to resolution of IS, and development of epilepsy in children with T21 and IS compared to children with idiopathic IS. RESULTS: Thirteen children with T21 and IS were identified over a 10 year period and compared to 32 children in the control group...
December 23, 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28079061/progressive-decline-in-hippocampal-ca1-volume-in-individuals-at-ultra-high-risk-for-psychosis-who-do-not-remit-findings-from-the-longitudinal-youth-at-risk-study
#3
New Fei Ho, Daphne J Holt, Mike Cheung, Juan Eugenio Iglesias, Alex Goh, Mingyuan Wang, Joseph Kw Lim, Joshua de Souza, Joann S Poh, Yuen Mei See, Alison R Adcock, Stephen J Wood, Michael Wl Chee, Jimmy Lee, Juan Zhou
Most individuals identified as ultra high-risk for psychosis (UHR) do not develop frank psychosis. They continue to exhibit subthreshold symptoms, or go on to fully remit. Prior work has shown that the volume of CA1, a subfield of the hippocampus, is selectively reduced in the early stages of schizophrenia. Here, we aimed to determine whether patterns of volume change of CA1 are different in UHR individuals who do or do not achieve symptomatic remission. Structural MRI scans were acquired at baseline and at 1-2 follow-up time points (at 12-month intervals) from 147 UHR and healthy control subjects...
January 12, 2017: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28078997/lipoprotein-a-and-cardiovascular-risk-the-show-must-go-on
#4
Niki Katsiki, Khalid Al-Rasadi, Dimitri P Mikhailidis
Lipoprotein (a) [Lp(a)] is an independent but moderate, predictor for coronary heart disease (CHD) prevalence and severity. Several established and emerging cardiovascular (CV) risk factors including age, gender, ethnicity, smoking, dyslipidemia, hypertension, obesity, type 2 diabetes mellitus, alcohol consumption, arterial stiffness and hyperuricemia have been linked to Lp(a) metabolism. Apart from CHD, Lp(a) has been also associated with non-cardiac vascular diseases and diseases associated with increased CV risk such as chronic kidney disease, metabolic syndrome, non-alcoholic fatty liver disease, erectile dysfunction, obstructive sleep apnea syndrome, inflammatory bowel diseases and human immunodeficiency virus infection...
January 12, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28057262/cooperation-between-t-box-factors-regulates-the-continuous-segregation-of-germ-layers-during-vertebrate-embryogenesis
#5
G E Gentsch, R S Monteiro, J C Smith
A wild-type vertebrate embryo first generates its head and then extends its main body axis by successively appending trunk and tail. This rostro-caudal (head-to-tail) development is initiated by a set of morphogenetic movements known as gastrulation that recruits multipotent cells into one of the three morphologically distinct germ layers: ectoderm, endoderm, and mesoderm. These primordial tissues go on to form complementary sets of connective tissues and organs to build the head and at least some of the trunk...
2017: Current Topics in Developmental Biology
https://www.readbyqxmd.com/read/28056359/childhood-adversity-and-adult-depression-the-protective-role-of-psychological-resilience
#6
Julia C Poole, Keith S Dobson, Dennis Pusch
Adverse childhood experiences (ACEs), such as childhood abuse, neglect, and household dysfunction, have been identified as salient risk factors for adult depression. However, not all individuals who experience ACEs go on to develop depression. The extent to which resilience- or the ability to demonstrate stable levels of functioning despite adversity- may act as a buffer against depression among individuals with a history of ACEs has not been adequately examined. To address the associations between ACEs, depression, and resilience, 4006 adult participants were recruited from primary care clinics...
January 2, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/28045311/dental-fear-in-italy-what-is-going-on
#7
L Paglia
If your young patient doesn't feel comfortable and thinks something dreadful is going to happen when he comes to your office, maybe he will develop dental fear. Nowadays, children and teenagers' strong negative emotions related to dental treatment are defined as "Dental Fear and Anxiety" (DFA). Since DFA can result in children's avoidance or delay in undergoing dental visits, this problem represents a relevant social barrier as important as other well-known factors like low family income or parental education...
December 2016: European Journal of Paediatric Dentistry: Official Journal of European Academy of Paediatric Dentistry
https://www.readbyqxmd.com/read/28045053/complex-roles-of-solution-chemistry-on-graphene-oxide-coagulation-onto-titanium-dioxide-batch-experiments-spectroscopy-analysis-and-theoretical-calculation
#8
Shujun Yu, Xiangxue Wang, Rui Zhang, Tongtong Yang, Yuejie Ai, Tao Wen, Wei Huang, Tasawar Hayat, Ahmed Alsaedi, Xiangke Wang
Although graphene oxide (GO) has been used in multidisciplinary areas due to its excellent physicochemical properties, its environmental behavior and fate are still largely unclear. In this study, batch experiments, spectroscopy analysis and theoretical calculations were addressed to promote a more comprehensive understanding toward the coagulation behavior of GO onto TiO2 under various environmental conditions (pH, co-existing ions, temperature, etc.). The results indicated that neutral pH was beneficial to the removal of GO due to the electrostatic interaction...
January 3, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28040076/glenohumeral-arthritis-as-a-risk-factor-for-proximal-humerus-nonunion
#9
Mitchell R Klement, Brian T Nickel, Abiram Bala, Colin T Penrose, Robert D Zura, Grant E Garrigues
BACKGROUND: Proximal humerus fractures are common injuries and nonsurgical treatment has proven to yield good to excellent clinical results. A small percentage of these fractures go on to delayed or nonunion and the incidence and risk factors for this complication are poorly understood. We hypothesize that adjacent joint stiffness of the glenohumeral joint might lead to an increased rate of nonunion for proximal humerus fractures. METHODS: A search of the entire Medicare database from 2005 to 2011 was performed to identify 38,754 patients who sustained a proximal humerus fracture including 13,802 with co-existing ipsilateral shoulder osteoarthritis (OA) and 24,952 with co-existing diagnosis of rheumatoid arthritis (RA)...
December 2016: Injury
https://www.readbyqxmd.com/read/28033145/serving-others-through-mission-trips
#10
Deborah A Hassler
Nurses have the opportunity to share their knowledge and skills in a variety of settings. One of these is by going on mission trips. Cultural sensitivity, adequate preparation, and flexibility are crucial elements for a successful experience. The benefits far outweigh the initial hesitation that one may experience as he or she begins making his or her preparations. There is an opportunity to meet new people, learn about a culture that is not your own, explore new terrain, and share medical knowledge. Often these trips lead to future opportunities for service abroad and the development of lasting relationships...
January 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28029492/overdiagnosis-in-breast-imaging
#11
Andy Evans, Sarah Vinnicombe
The main harm of overdiagnosis is overtreatment. However a form of overdiagnosis also occurs when foci of cancer are found by imaging in addition to the symptomatic lesion when this leads to additional treatment which does not benefit the patient. Even if overtreatment is avoided, knowledge of the diagnosis can still cause psychological harm. Overdiagnosis is an inevitable effect of mammographic screening as the benefit comes from diagnosing breast cancer prior to clinical detectability. Estimates of the rate of overdiagnosis at screening are around 10%...
October 28, 2016: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28027373/new-onset-seizure-in-adults-and-adolescents-a-review
#12
Jay R Gavvala, Stephan U Schuele
Importance: Approximately 8% to 10% of the population will experience a seizure during their lifetime. Only about 2% to 3% of patients go on to develop epilepsy. Understanding the underlying etiology leading to an accurate diagnosis is necessary to ensure appropriate treatment and that patients with low risk for recurrence are not treated unnecessarily. Observations: Patients can present with new-onset seizure for a variety of reasons such as acute symptomatic seizures due to acute brain injury or metabolic derangements, or unprovoked seizures that are the initial manifestation of epilepsy...
27, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28007055/physiological-and-pathophysiological-aspects-of-incretin-hormones-and-glucagon
#13
Jonatan Ising Bagger
Infusion of oxyntomodulin and the separate and combined infusion of GLP-1 and glucagon inhibited food intake similarly in healthy individuals, with no superior effect of combining GLP-1 and glucagon. We confirm the inhibitory effects of oxyntomodulin and GLP-1, respectively, on GE and appetite scores observed previously, but by adding glucagon to the infusion of GLP-1 we found no additive effects. Unexpectedly, glucagon alone had no effect on GE and appetite scores, but inhibited food intake to the same extent as oxyntomodulin, GLP-1 and GLP-1 + glucagon...
January 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28004848/analysing-animal-social-network-dynamics-the-potential-of-stochastic-actor-orientated-models
#14
David N Fisher, Amiyaal Ilany, Matthew J Silk, Tom Tregenza
Animals are embedded in dynamically changing networks of relationships with conspecifics. These dynamic networks are fundamental aspects of their environment, creating selection on behaviours and other traits. However, most social network-based approaches in ecology are constrained to considering networks as static, despite several calls for such analyses to become more dynamic. There are a number of statistical analyses developed in the social sciences that are increasingly being applied to animal networks, of which stochastic actor-oriented models (SAOMs) are a principal example...
December 22, 2016: Journal of Animal Ecology
https://www.readbyqxmd.com/read/28003940/intraventricular-undifferentiated-pleomorphic-sarcoma-a-case-report
#15
Emily P Sieg, Hayk Stepanyan, Russell Payne, Elizabeth Frauenhoffer, Charles S Specht, Sara Langan, Elias Rizk
Undifferentiated pleomorphic sarcoma is a histologic diagnosis based on cell morphology. These tumors are found throughout the body. They are rarely found in the central nervous system and almost never occur as a primary intraventricular tumor. We present the unusual case of a 68-year-old woman with an intraventricular undifferentiated pleomorphic sarcoma. We go on to discuss the clinical presentation, radiographic characteristics, and management paradigm for these rare lesions. Our patient presented with acute confusion, inability to balance a checkbook, and gait imbalance...
November 14, 2016: Curēus
https://www.readbyqxmd.com/read/28000205/early-severe-acute-respiratory-distress-syndrome-what-s-going-on-part-ii-controlled-vs-spontaneous-ventilation
#16
Fabrice Petitjeans, Cyrille Pichot, Marco Ghignone, Luc Quintin
The second part of this overview on early severe ARDS delineates the pros and cons of the following: a) controlled mechanical ventilation (CMV: lowered oxygen consumption and perfect patient-to-ventilator synchrony), to be used during acute cardio-ventilatory distress in order to "buy time" and correct circulatory insufficiency and metabolic defects (acidosis, etc.); b) spontaneous ventilation (SV: improved venous return, lowered intrathoracic pressure, absence of muscle atrophy). Given a stabilized early severe ARDS, as soon as the overall clinical situation improves, spontaneous ventilation will be used with the following stringent conditionalities: upfront circulatory optimization, upright positioning, lowered VO2, lowered acidotic and hypercapnic drives, sedation without ventilatory depression and without lowered muscular tone, as well as high PEEP (titrated on transpulmonary pressure, or as a second best: "trial"-PEEP) with spontaneous ventilation + pressure support (or newer modes of ventilation)...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28000204/early-severe-acute-respiratory-distress-syndrome-what-s-going-on-part-i-pathophysiology
#17
Fabrice Petitjeans, Cyrille Pichot, Marco Ghignone, Luc Quintin
Severe acute respiratory distress syndrome (ARDS, PaO₂/FiO₂ < 100 on PEEP ≥ 5 cm H₂O) is treated using controlled mechanical ventilation (CMV), recently combined with muscle relaxation for 48 h and prone positioning. While the amplitude of tidal volume appears set < 6 mL kg⁻¹, the level of positive end-expiratory pressure (PEEP) remains controversial. This overview summarizes several salient points, namely: a) ARDS is an oxygenation defect: consolidation/ difuse alveolar damage is reversed by PEEP and/or prone positioning, at least during the early phase of ARDS b) ARDS is a dynamic disease and partially iatrogenic...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28000064/the-importance-of-assessing-behaviour-and-cognition-in-antiepileptic-drug-trials-in-children-and-adolescents
#18
REVIEW
Lieven Lagae
It has long been recognised that uncontrolled childhood epilepsy is detrimental to cognition and behaviour, impacting on a patient's ability to succeed academically. Patients who experience more frequent and serious seizures are at greater risk for cognitive decline, emphasising the need for more effective epilepsy treatments to bring seizures under control. That said, although more effective antiepileptic drugs (AEDs) have the potential to limit the impact of uncontrolled seizures on cognitive and behavioural function, recently it has been acknowledged that deficits in these functions may be caused by AEDs themselves...
December 20, 2016: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/27995377/novel-insights-into-the-molecular-mechanism-of-sperm-egg-fusion-via-izumo1
#19
Naokazu Inoue
When a spermatozoon fertilizes an oocyte in mammals, there must be an extremely precise regulation system for successful gamete fusion to occur, which is the final step of fertilization. Using gene-modified animals, IZUMO1 on the sperm side and its receptor, JUNO, on the ovum side, have been unveiled as indispensable factors for triggering membrane fusion. We recently analyzed the detailed molecular machinery of the IZUMO1-JUNO recognition system and clarified the tertiary architecture of the IZUMO1-JUNO complex based on the crystal structure...
December 19, 2016: Journal of Plant Research
https://www.readbyqxmd.com/read/27994647/cancer-immunotherapy-from-the-lab-to-clinical-applications-potential-impact-on-cancer-centres-organisation
#20
Linda Cairns, Sandrine Aspeslagh, Andrea Anichini, Jon Amund Kyte, Christian Blank, Paolo Ascierto, Nicolle Rekers, Per Thor Straten, Ahmad Awada
This report covers the Immunotherapy sessions of the 2016 Organisation of European Cancer Institutes (OECI) Oncology Days meeting, which was held on 15th-17th June 2016 in Brussels, Belgium. Immunotherapy is a potential cancer treatment that uses an individual's immune system to fight the tumour. In recent years significant advances have been made in this field in the treatment of several advanced cancers. Cancer immunotherapies include monoclonal antibodies that are designed to attack a very specific part of the cancer cell and immune checkpoint inhibitors which are molecules that stimulate or block the inhibition of the immune system...
2016: Ecancermedicalscience
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