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https://www.readbyqxmd.com/read/28646445/update-on-neurocritical-care-of-stroke
#1
Jason Siegel, Michael A Pizzi, J Brent Peel, David Alejos, Nnenne Mbabuike, Benjamin L Brown, David Hodge, W David Freeman
PURPOSE OF REVIEW: This review will highlight the recent advancements in acute ischemic stroke diagnosis and treatment, with special attention to new features and recommendations of stroke care in the neurocritical care unit. RECENT FINDINGS: New studies suggest that pre-hospital treatment of stroke with mobile stroke units and telestroke technology may lead to earlier stroke therapy with intravenous tissue plasminogen activator (tPA), and recent studies show tPA can be given in previously contraindicated situations...
August 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28645482/proton-pump-inhibitors-and-survival-outcomes-in-patients-with-metastatic-renal-cell-carcinoma
#2
Aly-Khan A Lalani, Rana R McKay, Xun Lin, Ronit Simantov, Marina D Kaymakcalan, Toni K Choueiri
INTRODUCTION: Proton pump inhibitors (PPIs) are potent inhibitors of gastric acid secretion and can affect the optimal absorption of concomitant oral medications, such as vascular endothelial growth factor (VEGF) tyrosine kinase inhibitors (TKIs). The purpose of this study was to investigate the effect of PPI use on survival in metastatic renal cell carcinoma (mRCC) patients treated in the targeted therapy era. MATERIALS AND METHODS: We conducted a pooled analysis of mRCC patients treated in phase II and III clinical trials...
May 31, 2017: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28644179/improving-heart-failure-patient-outcomes-utilizing-guideline-directed-therapy
#3
Beth Towery Davidson, Terri Lynn Allison
Heart failure (HF) prevalence continues to rise and remains a significant burden to patients, caregivers, providers, and the healthcare system. Guideline-directed medical therapy with standard neurohormonal blockade has been the cornerstone of medical management for many years. Despite aggressive utilization of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, and aldosterone antagonists, HF hospitalizations and readmissions are common and residual mortality remains high...
July 21, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/28643357/nut-carcinoma-in-children-and-adults-a-multicenter-retrospective-study
#4
Lauriane Lemelle, Gaëlle Pierron, Paul Fréneaux, Sophie Huybrechts, Alexandra Spiegel, Dominique Plantaz, Morbize Julieron, Sophie Dumoucel, Antoine Italiano, Fréderic Millot, Christophe Le Tourneau, Guy Leverger, Pascal Chastagner, Matthieu Carton, Daniel Orbach
BACKGROUND: Nuclear protein of the testis (NUT) carcinoma (formerly NUT midline carcinoma) is an aggressive tumor defined by the presence of NUT rearrangement with a poor prognosis. This rare cancer is underdiagnosed and poorly treated. OBJECTIVE: The primary objective of this study was to describe the clinical, radiologic, and biological features of NUT carcinoma. The secondary objective was to describe the various treatments and assess their efficacy. METHODS: This retrospective multicenter study was based on review of the medical records of children and adults with NUT carcinoma with specific rearrangement or positive anti-NUT nuclear staining (>50%)...
June 23, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28642125/safety-and-efficacy-of-dual-lead-thalamic-deep-brain-stimulation-for-patients-with-treatment-refractory-multiple-sclerosis-tremor-a-single-centre-randomised-single-blind-pilot-trial
#5
Seth F Oliveria, Ramon L Rodriguez, Dawn Bowers, Daniel Kantor, Justin D Hilliard, Erin H Monari, Bonnie M Scott, Michael S Okun, Kelly D Foote
BACKGROUND: Efficacy in previous studies of surgical treatments of refractory multiple sclerosis tremor using lesioning or deep brain stimulation (DBS) has been variable. The aim of this study was to investigate the safety and efficacy of dual-lead thalamic DBS (one targeting the ventralis intermedius-ventralis oralis posterior nucleus border [the VIM lead] and one targeting the ventralis oralis anterior-ventralis oralis posterior border [the VO lead]) for the treatment of multiple sclerosis tremor...
June 19, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28640591/managing-psychotropic-medications-in-complex-real-world-patients-using-comprehensive-therapeutic-drug-monitoring
#6
Jeffrey J Sutherland, Ryan D Morrison, J Scott Daniels, Stephen B Milne, Timothy P Ryan
There are multiple treatment options for depression, anxiety, psychosis, and other psychiatric disorders, and psychiatry patients are often comorbid with complex, polypharmacy treatment regimens. Unlike cardiovascular disease and diabetes, there are no readily available biomarkers to gauge treatment success with psychotropic medications, often resulting in subjective determination of medication therapy effectiveness. The physiochemical properties of psychiatric medications in general lend themselves to quantitative measurement in blood, offering an avenue to optimize treatment for each patient...
June 22, 2017: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/28640077/improvement-of-peripheral-artery-disease-with-sildenafil-and-bosentan-combined-therapy-in-a-patient-with-limited-cutaneous-systemic-sclerosis-a-case-report
#7
Loukman Omarjee, Cedric Fontaine, Guillaume Mahe, Vincent Jaquinandi
RATIONALE: Sildenafil, a phosphodiesterase-5-inhibitor and Bosentan, an endothelin-1-receptor antagonist combined therapy could have beneficial effect in systemic sclerosis (SSc) patients with peripheral artery disease. PATIENT CONCERNS: We report a case of a 48-year-old Black woman, who developed severe left limb claudication and walking limitation following a left femoropopliteal bypass occlusion in 2014. She was a heavy smoker and had a history of right middle cerebral artery ischemic stroke and bilateral Raynaud phenomenon...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28638374/azole-resistance-in-aspergillus-fumigatus-a-consequence-of-antifungal-use-in-agriculture
#8
REVIEW
Sarah Berger, Yassine El Chazli, Ambrin F Babu, Alix T Coste
Agricultural industry uses pesticides to optimize food production for the growing human population. A major issue for crops is fungal phytopathogens, which are treated mainly with azole fungicides. Azoles are also the main medical treatment in the management of Aspergillus diseases caused by ubiquitous fungi, such as Aspergillus fumigatus. However, epidemiological research demonstrated an increasing prevalence of azole-resistant strains in A. fumigatus. The main resistance mechanism is a combination of alterations in the gene cyp51A (TR34/L98H)...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28634003/spasticity-video-challenge-a-look-at-methods-for-addressing-difficult-cases
#9
Katharine E Alter, Mark Gormley, Atul T Patel
As seen in this CME online activity (available at http://courses.elseviercme.com/spasticity/662e), treatment of patients with spasticity due to upper motor neuron syndromes, including traumatic brain injury, stroke, and cerebral palsy, is multifaceted, involving chemodenervation, systemic medications, surgical therapy, rehabilitation efforts, and home care. Optimal care begins with the recognition that each patient's impairments are unique and must be assessed carefully to determine the impact of muscle overactivity, loss of dexterity, and weakness on passive and active function in the context of the patients' goals...
June 19, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28633756/immunotherapy-the-wave-of-the-future-in-bladder-cancer
#10
Daniel P Petrylak
Urothelial cell carcinoma (UC) is one of the most common cancers and one of the most deadly. Metastatic UC is particularly hard to treat, because it is typically diagnosed when patients are elderly and have medical comorbidities. Many patients with metastatic UC are unable to receive cisplatin-based chemotherapy, due to older age at diagnosis and comorbidities, and even when platinum chemotherapy can be administered, it has limited success in prolonging survival. Recently, improved understanding of molecular targets and immunologic characteristics of urothelial tumor cells has resulted in new therapeutic approaches that may help optimize first- and second-line therapy...
June 2017: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28632645/management-of-symptomatic-lumbar-disk-herniation-an-international-perspective
#11
Pravesh S Gadjradj, Mark P Arts, Maurits W van Tulder, Wim J R Rietdijk, Wilco C Peul, Biswadjiet S Harhangi
STUDY DESIGN: A questionnaire survey. OBJECTIVE: To evaluate the current practice patterns of surgeons regarding both the surgical and nonsurgical management of lumbar disk herniation (LDH) worldwide and to compare this with the current literature. SUMMARY OF BACKGROUND DATA: Sciatica is a common diagnosis in the general population. Sciatica is most frequently caused by LDH. Multiple surgical techniques and treatment modalities are available to treat LDH, albeit some with small effect sizes or without compelling evidence...
June 19, 2017: Spine
https://www.readbyqxmd.com/read/28631129/optimizing-the-deep-brain-stimulation-care-pathway-in-patients-with-parkinson-s-disease
#12
N J Thomas, P Mertens, T Danaila, G Polo, H Klinger, E Broussolle, S Thobois
Management of Parkinson's disease (PD) using deep brain stimulation (DBS) requires complex care in specialized, multidisciplinary centers. A well-organized, efficient patient flow is crucial to ensure that eligible patients can quickly access DBS. Delays or inefficiencies in patient care may impact a center's ability to meet demand, creating a capacity bottleneck. Analysis of the current practices within a center may help identify areas for improvement. After external audit of the DBS workflow of the Lyon Neurological Hospital and comparison with other European centers, manageable steps were suggested to restructure the care pathway...
June 19, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28630267/a-structured-review-of-antithrombotic-therapy-in-peripheral-artery-disease-with-a-focus-on-revascularization-a-tasc-intersociety-consensus-for-the-management-of-peripheral-artery-disease-initiative
#13
REVIEW
Connie N Hess, Lars Norgren, Gary M Ansel, Warren H Capell, John P Fletcher, F Gerry R Fowkes, Anders Gottsäter, Kerry Hitos, Michael R Jaff, Joakim Nordanstig, William R Hiatt
Peripheral artery disease affects >200 million people worldwide and is associated with significant limb and cardiovascular morbidity and mortality. Limb revascularization is recommended to improve function and quality of life for symptomatic patients with peripheral artery disease with intermittent claudication who have not responded to medical treatment. For patients with critical limb ischemia, the goals of revascularization are to relieve pain, help wound healing, and prevent limb loss. The baseline risk of cardiovascular and limb-related events demonstrated among patients with stable peripheral artery disease is elevated after revascularization and related to atherothrombosis and restenosis...
June 20, 2017: Circulation
https://www.readbyqxmd.com/read/28629905/2017-american-college-of-rheumatology-american-association-of-hip-and-knee-surgeons-guideline-for-the-perioperative-management-of-antirheumatic-medication-in-patients-with-rheumatic-diseases-undergoing-elective-total-hip-or-total-knee-arthroplasty
#14
Susan M Goodman, Bryan Springer, Gordon Guyatt, Matthew P Abdel, Vinod Dasa, Michael George, Ora Gewurz-Singer, Jon T Giles, Beverly Johnson, Steve Lee, Lisa A Mandl, Michael A Mont, Peter Sculco, Scott Sporer, Louis Stryker, Marat Turgunbaev, Barry Brause, Antonia F Chen, Jeremy Gililland, Mark Goodman, Arlene Hurley-Rosenblatt, Kyriakos Kirou, Elena Losina, Ronald MacKenzie, Kaleb Michaud, Ted Mikuls, Linda Russell, Alexander Sah, Amy S Miller, Jasvinder A Singh, Adolph Yates
OBJECTIVE: This collaboration between the American College of Rheumatology and the American Association of Hip and Knee Surgeons developed an evidence-based guideline for the perioperative management of antirheumatic drug therapy for adults with rheumatoid arthritis (RA), spondyloarthritis (SpA) including ankylosing spondylitis and psoriatic arthritis, juvenile idiopathic arthritis (JIA), or systemic lupus erythematosus (SLE) undergoing elective total hip (THA) or total knee arthroplasty (TKA)...
June 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28629462/treatment-decisions-for-older-adults-with-advanced-chronic-kidney-disease
#15
REVIEW
Steven J Rosansky, Jane Schell, Joseph Shega, Jennifer Scherer, Laurie Jacobs, Cecile Couchoud, Deidra Crews, Matthew McNabney
Dialysis initiation rates among older adults, aged 75 years or greater, are increasing at a faster rate than for younger age groups. Older adults with advanced CKD (eGFR < 30 ml/min/1.73 m(2)) typically lose renal function slowly, often suffer from significant comorbidity and thus may die from associated comorbidities before they require dialysis.A patient's pattern of renal function loss over time in relation to their underlying comorbidities can serve as a guide to the probability of a future dialysis requirement...
June 19, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28629442/treatment-patterns-healthcare-resource-utilization-and-costs-following-first-line-antidepressant-treatment-in-major-depressive-disorder-a-retrospective-us-claims-database-analysis
#16
Geneviève Gauthier, Annie Guérin, Maryia Zhdanava, William Jacobson, George Nomikos, Elizabeth Merikle, Clément François, Vanessa Perez
BACKGROUND: Although the symptoms of major depressive disorder (MDD) are often manageable with pharmacotherapy, response to first-line antidepressant treatment is often less than optimal. This study describes long-term treatment patterns in MDD patients in the United States and quantifies the economic burden associated with different treatment patterns following first-line antidepressant therapy. METHODS: MDD patients starting first-line antidepressant monotherapy and having continuous enrollment ≥12 months before and ≥24 months following the index date (i...
June 19, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28625670/carotid-occlusion-is-associated-with-more-frequent-neurovascular-events-than-moderately-severe-carotid-stenosis
#17
Matthew Janko, Ryan Moore, Ann H Kim, Andrew J Shevitz, Katherine L Morrow, David J Johnson, Vikram S Kashyap
OBJECTIVE: Asymptomatic internal carotid artery occlusion (CO) presents a clinical dilemma, and presently, the natural history, stroke risk, and optimal management remain ill defined. This study compared outcomes, including neurovascular events (NVEs) and health care costs, between patients with CO and patients with asymptomatic carotid artery stenosis (CS). METHODS: A prospectively maintained database was queried to identify patients with CO and CS with at least >50% carotid stenosis by duplex...
June 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28625025/-causative-bacterial-strains-and-sensitivityto-antimicrobial-agents-in-female-acute-uncomplicated-cystitis
#18
Takuya Owari, Tomoki Yamamoto, Shinichiro Mizobuchi, Yositaka Itami, Tomonori Nakahama, Yosihiro Matsumoto, Kaoru Yamada, Hitoshi Momose
Recently, wide spreading of fluoloquinolone resistant Escherichia coli is a serious problem inthe treatment of urinary tract infection. To investigate the causative bacterial strains of female acute uncomplicated cystitis (AUC) in the community and their sensitivity to antimicrobial agents, we retrospectively reviewed the medical records of 215 female AUC patients treated at our clinics from April 2014 to June 2015. Two hundred and nineteen strains were isolated as the causative bacteria from the patients'urine samples, including E...
May 2017: Hinyokika Kiyo. Acta Urologica Japonica
https://www.readbyqxmd.com/read/28622968/the-beneficial-effect-of-extracorporeal-shockwave-myocardial-revascularization-two-years-of-follow-up
#19
Gianluca Alunni, Umberto Barbero, Alessandro Vairo, Salvo D'Amico, Martina Pianelli, Domenica Zema, Federica Bongiovanni, Fiorenzo Gaita
OBJECTIVES: Despite the advancements achieved by revascularization technique and pharmacological therapies, the number of patients with refractory angina (RA) is still high, carrying together a poor prognosis. Experimental data and small clinical studies suggest that the use of extracorporeal shockwave myocardial revascularization (ESMR) might improve symptoms of angina in patients with RA. The aim of our study is to evaluate the efficacy of cardiac shock wave therapy in a long term follow-up of patients with coronary artery disease (CAD) otherwise not suitable for revascularization...
May 10, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28621834/from-intricate-to-integrated-biofabrication-of-articulating-joints
#20
Wilhelmina Margaretha Groen, Paweena Diloksumpan, Paul René van Weeren, Riccardo Levato, Jos Malda
Articulating joints owe their function to the specialized architecture and the complex interplay between multiple tissues including cartilage, bone and synovium. Especially the cartilage component has limited self-healing capacity and damage often leads to the onset of osteoarthritis, eventually resulting in failure of the joint as an organ. Although in its infancy, biofabrication has emerged as a promising technology to reproduce the intricate organization of the joint, thus enabling the introduction of novel surgical treatments, regenerative therapies, and new sets of tools to enhance our understanding of joint physiology and pathology...
June 16, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
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