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https://www.readbyqxmd.com/read/28230455/outcomes-of-pharmacy-led-hepatitis-c-direct-acting-antiviral-utilization-management-at-a-veterans-affairs-medical-center
#1
Sendra Yang, Rachel B Britt, Mohamed G Hashem, Jamie N Brown
BACKGROUND: The Veterans Affairs Health (VA) Administration has reported hepatitis C virus (HCV) infection rates among veterans to be twice that of the general U.S population. New HCV direct-acting antiviral (DAA) treatment options offer superior sustained virologic response (SVR) rates, improved side-effect profiles, and shortened treatment courses; yet, these new HCV DAAs are expensive, and utilization management strategies are needed to optimize use and improve clinical outcomes. A VA medical center uses pharmacist-led HCV DAA utilization management strategies that includes clinical guidance, optimizing operational flow, budget tracking and forecasting, and patient outcomes tracking...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28229223/levodopa-carbidopa-intestinal-gel-lcig-infusion-as-mono-or-combination-therapy
#2
Carsten Buhmann, R Hilker, P Lingor, C Schrader, J Schwarz, M Wolz, H Reichmann
Levodopa/carbidopa intestinal gel (LCIG) infusion is an effective escalating therapy in patients with Parkinson disease (PD) suffering from motor fluctuations and dyskinesia. Levodopa/carbidopa given continuously as infusion provides an optimized application of the most effective and best tolerable antiparkinsonian drug. It has been proven to have a superior motor effect compared with oral levodopa and to improve also non-motor symptoms. However, invasiveness, discomfort resulting from carrying an external device, and side effects associated with the way of administration limit its application in PD patients...
February 22, 2017: Journal of Neural Transmission
https://www.readbyqxmd.com/read/28228052/inhalation-therapy-in-patients-with-tracheostomy-a-guide-to-clinicians
#3
Arzu Ari, James B Fink
Inhalation therapy has become a popular procedure for the treatment of patients with tracheostomy. However, clinicians are faced with many challenges during inhalation therapy because of the many factors affecting aerosol therapy to this patient population, and the lack of literature providing guidance in this area of research. Areas covered: The purpose of this paper is to describe the factors affecting aerosol drug delivery to patients with tracheostomy and to explain how to optimize inhalation therapy through device selection, interface selection and delivery technique in this patient population...
March 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28225695/how-should-therapeutic-decisions-about-expensive-drugs-be-made-in-imperfect-environments
#4
Leonard M Fleck, Marion Danis
Clinicians must inevitably make therapeutic decisions under nonideal conditions. They practice in circumstances that involve incomplete evidence. They deliver care in health care systems that are complex and poorly coordinated. Each of the patients that they take care of is unique while research offers evidence regarding relatively homogeneous populations of patients. Under these circumstances, many parties-medical scientists, reviewing agencies, insurers, and accountable care organizations-can and should contribute to optimizing the development, approval, funding, and prescription of therapies-particularly expensive and marginally beneficial therapies...
February 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28225505/nonrevascularizable-buttock-claudication-improved-with-sildenafil-a-case-report
#5
Loukman Omarjee, Audrey Camarzana, Samir Henni, Pierre Abraham
RATIONALE: Sildenafil, a phosphodiesterase-5-inhibitor (PDE5i), could represent a new treatment in addition to the medical treatment and advice to walk in peripheral arterial disease (PAD). PATIENT CONCERNS AND DIAGNOSES: We report a case of a 62-year-old heavy smoker man who developed a buttock claudication and a severe walking limitation following an aorto-bi-femoral bypass in 1992. Since 2003, each year, he has been referred for investigation of bilateral buttock claudication on treadmill using transcutaneous oxygen pressure (tcpO2) measurement during exercise to argue for the vascular origin of the walking impairment...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28224107/risk-factors-for-mortality-in-postoperative-peritonitis-in-critically-ill-patients
#6
Yoann Launey, Benjamin Duteurtre, Raphaëlle Larmet, Nicolas Nesseler, Audrey Tawa, Yannick Mallédant, Philippe Seguin
AIM: To identify the risk factors for mortality in intensive care patients with postoperative peritonitis (POP). METHODS: This was a retrospective analysis using a prospective database that includes all patients hospitalized in a surgical intensive care unit for POP from September 2006 to August 2011. The data collected included demographics, comorbidities, postoperative severity parameters, bacteriological findings, adequacy of antimicrobial therapy and surgical treatments...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28223177/pneumocystis-pneumonia-in-patients-with-inflammatory-or-autoimmune-diseases-usefulness-of-lymphocyte-subtyping
#7
Yi Li, Marc Ghannoum, Chuntao Deng, Yanxia Gao, Huadong Zhu, Xuezhong Yu, Valery Lavergne
OBJECTIVES: No consensus currently exists on indications for Pneumocystis jirovecii prophylaxis in patients with inflammatory or autoimmune diseases. The main objective was to identify biomarkers associated with Pneumocystis jirovecii pneumonia (PcP) in this population. METHODS: A retrospective study was carried out at Beijing Union Medical College Hospital (2003-2014). All patients with an inflammatory or autoimmune diseases presenting with acute onset of fever and respiratory symptoms were included...
February 18, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28218247/laser-driven-ion-acceleration-from-plasma-micro-channel-targets
#8
D B Zou, A Pukhov, L Q Yi, H B Zhou, T P Yu, Y Yin, F Q Shao
Efficient energy boost of the laser-accelerated ions is critical for their applications in biomedical and hadron research. Achiev-able energies continue to rise, with currently highest energies, allowing access to medical therapy energy windows. Here, a new regime of simultaneous acceleration of ~100 MeV protons and multi-100 MeV carbon-ions from plasma micro-channel targets is proposed by using a ~10(20) W/cm(2) modest intensity laser pulse. It is found that two trains of overdense electron bunches are dragged out from the micro-channel and effectively accelerated by the longitudinal electric-field excited in the plasma channel...
February 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28217549/anticoagulation-control-among-patients-with-nonvalvular-atrial-fibrillation-a-single-tertiary-cardiac-center-experience
#9
Shaban Mohammed, Amer H S Aljundi, Mohamed Kasem, Mohammed Alhashemi, Ayman El-Menyar
There is a limited knowledge about the predictors of anticoagulation control in patients with nonvalvular atrial fibrillation (NVAF). Furthermore, few reports addressed the role of time in therapeutic range (TTR) that could reflect the safety and efficacy of anticoagulation therapy. We aimed to assess factors that affect the quality of anticoagulation therapy utilizing TTR in patients with NVAF. A retrospective observational study was conducted for patients with NVAF who were maintained on warfarin >6 months at a tertiary cardiac care hospital...
January 2017: Journal of Advanced Pharmaceutical Technology & Research
https://www.readbyqxmd.com/read/28217493/outcome-and-preferences-in-male-to-female-subjects-with-gender-dysphoria-experience-from-eastern-india
#10
Anirban Majumder, Debmalya Sanyal
CONTEXT: Gender dysphoria (GD) is an increasingly recognized medical condition in India, and little scientific data on treatment outcomes are available. AIMS: Our objective is to study the therapeutic options including psychotherapy, hormone, and surgical treatments used for alleviating GD in male-to-female (MTF) transgender subjects in Eastern India. SUBJECTS AND METHODS: This is a retrospective study of treatment preferences and outcome in 55 MTF transgender subjects who were presented to the endocrine clinic...
January 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28215024/pharmacogenomics-of-platinum-based-chemotherapy-in-non-small-cell-lung-cancer-focusing-on-dna-repair-systems
#11
REVIEW
Yi Xiong, Bi-Yun Huang, Ji-Ye Yin
Drug therapy for non-small cell lung cancer consists mainly of platinum-based chemotherapy regimens. However, toxicity, drug resistance, and high risk of death have been seen in the clinic, which means there is a need for optimizing the use of medications. Platinum resistance could be mediated by a series of DNA repair pathways, and therefore, these pathways should be taken into account for optimizing drug using. The goal of pharmacogenomics is to elucidate genetic factors, such as DNA repair genes, which might underlie drug efficacy and effectiveness, and to improve therapeutic effects or guide personalized therapy as well...
April 2017: Medical Oncology
https://www.readbyqxmd.com/read/28214127/functionalized-superparamagnetic-iron-oxide-nanoparticles-provide-highly-efficient-iron-labeling-in-macrophages-for-magnetic-resonance-based-detection-in-vivo
#12
Jack Sharkey, Philip J Starkey Lewis, Michael Barrow, Salamah M Alwahsh, June Noble, Eilidh Livingstone, Ross J Lennen, Maurits A Jansen, Jaime Garcia Carrion, Neill Liptrott, Shareen Forbes, Dave J Adams, Amy E Chadwick, Stuart J Forbes, Patricia Murray, Matthew J Rosseinsky, Christopher E Goldring, B Kevin Park
BACKGROUND AIMS: Tracking cells during regenerative cytotherapy is crucial for monitoring their safety and efficacy. Macrophages are an emerging cell-based regenerative therapy for liver disease and can be readily labeled for medical imaging. A reliable, clinically applicable cell-tracking agent would be a powerful tool to study cell biodistribution. METHODS: Using a recently described chemical design, we set out to functionalize, optimize and characterize a new set of superparamagnetic iron oxide nanoparticles (SPIONs) to efficiently label macrophages for magnetic resonance imaging-based cell tracking in vivo...
February 15, 2017: Cytotherapy
https://www.readbyqxmd.com/read/28214078/the-optimize-heart-failure-care-program-initial-lessons-from-global-implementation
#13
Martin R Cowie, Yuri M Lopatin, Clara Saldarriaga, Cândida Fonseca, David Sim, Jose Antonio Magaña, Denilson Albuquerque, Marcelo Trivi, Gustavo Moncada, Baldomero A González Castillo, Mario Osvaldo Speranza Sánchez, Edward Chung
Hospitalization for heart failure (HF) places a major burden on healthcare services worldwide, and is a strong predictor of increased mortality especially in the first three months after discharge. Though undesirable, hospitalization is an opportunity to optimize HF therapy and advise clinicians and patients about the importance of continued adherence to HF medication and regular monitoring. The Optimize Heart Failure Care Program (www.optimize-hf.com), which has been implemented in 45 countries, is designed to improve outcomes following HF hospitalization through inexpensive initiatives to improve prescription of appropriate drug therapies, patient education and engagement, and post-discharge planning...
February 12, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28213668/effect-of-percutaneous-coronary-intervention-on-survival-in-patients-with-stable-ischemic-heart-disease
#14
REVIEW
Francisco Ujueta, Ephraim N Weiss, Binita Shah, Steven P Sedlis
PURPOSE OF REVIEW: This study aims to determine if percutaneous coronary intervention (PCI) does improve survival in stable ischemic heart disease (SIHD). RECENT FINDINGS: The International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial will evaluate patients with moderate to severe ischemia and will be the largest randomized trial of an initial management strategy of coronary revascularization (percutaneous or surgical) versus optimal medical therapy alone for SIHD...
February 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28210908/updates-in-outcomes-of-stereotactic-radiation-therapy-in-acromegaly
#15
REVIEW
Monica Livia Gheorghiu
Purpose Treatment of acromegaly has undergone important progress in the last 20 years mainly due to the development of new medical options and advances in surgical techniques. Pituitary surgery is usually first-line therapy, and medical treatment is indicated for persistent disease, while radiation (RT) is often used as third-line therapy. The benefits of RT (tumor volume control and decreased hormonal secretion) are hampered by the long latency of the effect and the high risk of adverse effects. Stereotactic RT methods have been developed with the aim to provide more precise targeting of the tumor with better control of the radiation dose received by the adjacent brain structures...
February 16, 2017: Pituitary
https://www.readbyqxmd.com/read/28210634/potential-of-a-pharmacogenetic-guided-algorithm-to-predict-optimal-warfarin-dosing-in-a-high-risk-hispanic-patient-role-of-a-novel-nqo1-2-polymorphism
#16
Dagmar F Hernandez-Suarez, Karla Claudio-Campos, Javier E Mirabal-Arroyo, Bianca A Torres-Hernández, Angel López-Candales, Kyle Melin, Jorge Duconge
Deep abdominal vein thrombosis is extremely rare among thrombotic events secondary to the use of contraceptives. A case to illustrate the clinical utility of ethno-specific pharmacogenetic testing in warfarin management of a Hispanic patient is reported. A 37-year-old Hispanic Puerto Rican, non-gravid female with past medical history of abnormal uterine bleeding on hormonal contraceptive therapy was evaluated for abdominal pain. Physical exam was remarkable for unspecific diffuse abdominal tenderness, and general initial laboratory results-including coagulation parameters-were unremarkable...
October 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28210563/neoadjuvant-therapy-for-treatment-of-breast-cancer-the-way-forward-or-simply-a-convenient-option-for-patients
#17
COMMENT
Abhishek Chatterjee, John K Erban
The complexity of managing early stage breast cancer is well known. Optimal treatment is increasingly multidisciplinary and in the modern era informed by sophisticated molecular tools to help select and guide therapy. Major phase III trials have determined that the order of systemic therapy relative to surgery does not influence important endpoints such as event free survival and overall survival (OS), but questions remain as to how best to utilize these most essential services. For example, there is still uncertainty regarding the ideal timing, intensity, and duration of proposed therapy...
February 2017: Gland Surgery
https://www.readbyqxmd.com/read/28210202/mechanisms-and-effects-of-transcranial-direct-current-stimulation
#18
James Giordano, Marom Bikson, Emily S Kappenman, Vincent P Clark, H Branch Coslett, Michael R Hamblin, Roy Hamilton, Ryan Jankord, Walter J Kozumbo, R Andrew McKinley, Michael A Nitsche, J Patrick Reilly, Jessica Richardson, Rachel Wurzman, Edward Calabrese
The US Air Force Office of Scientific Research convened a meeting of researchers in the fields of neuroscience, psychology, engineering, and medicine to discuss most pressing issues facing ongoing research in the field of transcranial direct current stimulation (tDCS) and related techniques. In this study, we present opinions prepared by participants of the meeting, focusing on the most promising areas of research, immediate and future goals for the field, and the potential for hormesis theory to inform tDCS research...
January 2017: Dose-response: a Publication of International Hormesis Society
https://www.readbyqxmd.com/read/28209492/reproductive-considerations-in-the-setting-of-chronic-viral-illness
#19
REVIEW
Brent M Hanson, Jessie A Dorais
Special considerations must be taken when patients with human immunodeficiency virus (HIV), Hepatitis B, or Hepatitis C desire to achieve pregnancy. Patients with chronic viral illnesses desire children at rates similar to the general population, and options are available to decrease both vertical transmission and viral transmission between partners. Preconception counseling or consultation with fertility specialists is imperative in patients with HIV, Hepatitis B, and Hepatitis C so that reproductive goals can be addressed and optimized...
February 13, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28207493/treatment-of-lupus-nephritis-current-paradigms-and-emerging-strategies
#20
Maria Dall'Era
PURPOSE OF REVIEW: Lupus nephritis is the most common organ-threatening manifestation of lupus and continues to result in end-stage renal disease. This review describes the contemporary treatment of lupus nephritis as well as emerging therapeutic strategies. RECENT FINDINGS: Lupus nephritis management consists of an initial (induction) phase and a maintenance (extended) phase in which steroids are used in combination with another immunosuppressive medication. Current treatments are incompletely effective and associated with substantial toxicity...
February 15, 2017: Current Opinion in Rheumatology
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