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https://www.readbyqxmd.com/read/28526416/treatment-strategy-for-type-2-diabetes-with-obesity-focus-on-glucagon-like-peptide-1-receptor-agonists
#1
REVIEW
Qiuhe Ji
PURPOSE: The progressive nature of type 2 diabetes mellitus (T2DM) calls for step-wise intensification of therapy for maintaining normal glycemic levels and lowering cardiovascular (CV) risk. Because obesity is a prominent risk factor and comorbidity of T2DM, it further elevates the CV risk in T2DM. Therefore, it is vital to manage weight, obesity, and glycemic parameters for effective T2DM management. Few oral antidiabetic drugs (sulfonylureas and thiazolidinediones) and insulin are not suitable for obese patients with T2DM because these drugs cause weight gain...
May 16, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28523441/progress-in-the-presence-of-failure-updates-in-chronic-systolic-heart-failure-management
#2
REVIEW
Katie M Murphy, Julie L Rosenthal
The therapeutic heart failure armamentarium has evolved from drugs to transplantation to devices through further understanding of its complex pathophysiology and pathogenesis. Current medications capitalize on our evolving understanding of the sympathetic and renin-angiotensin-aldosterone systems that subsequently promote both beneficial and maladaptive responses that ultimately yield a decrease in cardiac function. Despite these advancements, the prevalence of heart failure continues to rise and carries a significant burden on our patients and health care system...
July 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28523162/a-preliminary-exploration-of-the-intravoxel-incoherent-motion-applied-in-the-preoperative-evaluation-of-mediastinal-lymph-node-metastasis-of-lung-cancer
#3
Xin Ye, Shuo Chen, Yaru Tian, Bin You, Wenqian Zhang, Yan Zhao, Tao Jiang, Bin Hu, Hui Li
BACKGROUND: The aim of this study was to investigate the diagnostic value of the intravoxel incoherent motion (IVIM) for distinguishing non-metastatic from metastatic mediastinal lymph nodes in lung cancer. METHODS: IVIM-diffusion weighted imaging (DWI) exams were performed preoperatively on 66 patients with lung cancer from October 2015 to June 2016 in Beijing Chao-Yang Hospital, Capital Medical University. Fifty patients underwent enhanced chest computed tomography (CT) in our hospital, while the other 16 patients already had enhanced chest CT images when they were admitted...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28515940/nivolumab-induced-autoimmune-diabetes-mellitus-presenting-as-diabetic-ketoacidosis-in-a-patient-with-metastatic-lung-cancer
#4
James Luke Godwin, Shuchie Jaggi, Imali Sirisena, Pankaj Sharda, Ajay D Rao, Ranee Mehra, Colleen Veloski
BACKGROUND: Advances in cancer immunotherapy have generated encouraging results in multiple malignancies refractory to standard chemotherapies. As the use of immune checkpoint inhibitors (ICI) proliferates, the incidence of autoimmune side effects associated with these agents, termed immune related adverse events (irAE), is expected to increase. The frequency of significant irAE in ICI treated patients is about 10-20% and early recognition is critical to prevent serious morbidity and even mortality...
2017: Journal for Immunotherapy of Cancer
https://www.readbyqxmd.com/read/28513407/-cardiac-resynchronization-therapy-who-is-a-candidate-and-who-is-not
#5
M Kloosterman, A H Maass, M Rienstra, I C Van Gelder
- Cardiac resynchronisation therapy (CRT) is a treatment for patients with impaired cardiac pump function (left ventricular ejection fraction ≤ 35%) and a wide QRS complex who, despite maximum tolerated medical therapy, remain symptomatic.- In addition to reducing symptoms, CRT can reduce hospital admissions and improve survival.- Selection of patients for CRT remains difficult. Despite the fact that predicting and influencing success of CRT has improved, ~30% of patients do not respond to the therapy.- Optimizing therapy and follow-up of patients after implantation requires a multidisciplinary approach tailored to the individual patient...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28513286/azelnidipine-is-a-useful-medication-for-the-treatment-of-heart-failure-preserved-ejection-fraction
#6
Shunsuke Kiuchi, Shinji Hisatake, Takayuki Kabuki, Takashi Oka, Shintaro Dobashi, Takahiro Fujii, Takanori Ikeda
BACKGROUND: The optimal therapy in patients with heart failure preserved ejection fraction (HFpEF) and hypertension (HT) has not been revealed. The beta blocker (BB) and the renin angiotensin aldosterone system inhibitor (RAAS-I) are recommend as class IIa in patients with HFpEF. The calcium channel blocker (CCB), a major anti-hypertensive drugs in Japan, is also recommend as class IIa in patients with HFpEF. However, the difference between azelnidipine, an L type CCB, and cilnidipine, an N type CCB, is unclear...
May 17, 2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/28511890/intratympanic-steroid-delivery-by-an-indwelling-catheter-in-refractory-severe-sudden-sensorineural-hearing-loss
#7
Diego Zanetti, Federica Di Berardino, Nader Nassif, Luca Oscar Redaelli De Zinis
OBJECTIVE: Many studies over the last decade showed favorable outcomes with intratympanic (IT) steroid treatment, alone as salvage treatment or in combination with conventional systemic therapy (ST). However, in severe to profound sensorineural hearing loss resistant to ST, the optimal infusion mode, the type and concentration of the solution, the preferable drug, its total amount, and the duration and fractionation of the treatment are still debated. Aim of the study was to investigate the feasibility and the outcomes of a direct and constant IT delivery of dexamethasone (DEX) by means of a new indwelling catheter...
May 13, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28511806/st-segment-elevation-myocardial-infarction-could-be-the-primary-presentation-of-acute-aortic-dissection
#8
Qing-Yi Zhu, Shi Tai, Liang Tang, Wen Peng, Sheng-Hua Zhou, Zhen-Guo Liu, Xin-Qun Hu
BACKGROUND: Stanford type A aortic dissection (TAAD) may lead to coronary artery occlusion and malfunction. However, TAAD manifesting as acute ST-segment elevation myocardial infarction (STEMI) has not been studied. In the present study, we reported 8 TAAD cases with STEMI as the primary presentation, and analyzed their clinical characteristics and outcome. METHODS: The records were reviewed for patients admitted to the large comprehensive university hospital for PCI due to STEMI from January 1, 2002 to January 1, 2017...
May 11, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28509889/the-role-of-nitrates-in-the-management-of-stable-ischemic-heart-disease-a-review-of-the-current-evidence-and-guidelines
#9
Mehul A Pragani, Karan P Desai, Doralisa Morrone, Mandeep S Sidhu, William E Boden
Coronary artery disease is the leading cause of mortality in the United States and can result in significant morbidity. In particular, stable ischemic heart disease (SIHD) is a condition that affects nearly 9 million individuals in the United States alone, with substantial annual health care costs related to recurrent medical visits and chronic disease management. Nitrates form a cornerstone of SIHD management by reducing myocardial oxygen consumption and increasing exercise capacity by several mechanisms, including increasing epicardial blood flow through vasodilation and decreased vascular resistance, blunting coronary steal, and reducing preload...
2017: Reviews in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28509817/modified-delphi-process-for-the-development-of-choosing-wisely-for-inflammatory-bowel-disease
#10
Geoffrey C Nguyen, Karen Boland, Waqqas Afif, Brian Bressler, Jennifer L Jones, Adam V Weizman, Sharyle Fowler, Smita Halder, Vivian W Huang, Gilaad G Kaplan, Reena Khanna, Sanjay K Murthy, Joannie Ruel, Cynthia H Seow, Laura E Targownik, Tanya Chawla, Luis Guimaraes, Aida Fernandes, Sherif Saleh, Gil Y Melmed
BACKGROUND AND AIMS: The prevalence and incidence of inflammatory bowel disease (IBD) in North America is among the highest in the world and imparts substantial direct and indirect medical costs. The Choosing Wisely Campaign was launched in wide variety of medical specialties and disciplines to reduce unnecessary or harmful tests or treatment interventions. METHODS: The Choosing Wisely list for IBD was developed by the Canadian IBD Network for Research and Growth in Quality Improvement (CINERGI) in collaboration with Crohn's and Colitis Canada (CCC) and the Canadian Association of Gastroenterology (CAG)...
June 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28509768/modified-delphi-process-for-the-development-of-choosing-wisely-for-inflammatory-bowel-disease
#11
Geoffrey C Nguyen, Karen Boland, Waqqas Afif, Brian Bressler, Jennifer L Jones, Adam V Weizman, Sharyle Fowler, Smita Halder, Vivian W Huang, Gilaad G Kaplan, Reena Khanna, Sanjay K Murthy, Joannie Ruel, Cynthia H Seow, Laura E Targownik, Tanya Chawla, Luis Guimaraes, Aida Fernandes, Sherif Saleh, Gil Y Melmed
BACKGROUND AND AIMS: The prevalence and incidence of inflammatory bowel disease (IBD) in North America is among the highest in the world and imparts substantial direct and indirect medical costs. The Choosing Wisely Campaign was launched in wide variety of medical specialties and disciplines to reduce unnecessary or harmful tests or treatment interventions. METHODS: The Choosing Wisely list for IBD was developed by the Canadian IBD Network for Research and Growth in Quality Improvement (CINERGI) in collaboration with Crohn's and Colitis Canada (CCC) and the Canadian Association of Gastroenterology (CAG)...
May 15, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28507969/core-decompression-with-synthetic-grafting-as-a-joint-preservation-strategy-in-humeral-avascular-necrosis-due-to-sickle-cell-anemia-a-case-report
#12
Andrew M Steffensmeier, Karen Kirkham, John M Wiemann
INTRODUCTION: Avascular necrosis (AVN) of the femoral or humeral heads in patients with sickle cell anemia is a common and painful condition. There is currently no gold standard treatment protocol for this condition. Typically, the pain is managed with narcotics and activity restriction until there has been collapse of the subchondral bone with a degree of arthrosis sufficient to warrant total joint arthroplasty. This method entails prolonged pain for the patient and decreases the ability to function occupationally and recreationally...
November 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28506946/maternal-mortality-due-to-hypertensive-disorders-in-pregnancy-childbirth-and-the-puerperium-between-2012-and-2015-in-turkey-a-nation-based-study
#13
Bekir Keskinkılıç, Yaprak Engin-Üstün, Sema Sanisoğlu, Dilek Şahin Uygur, Hüseyin Levent Keskin, Selma Karaahmetoğlu, Ayşe Özcan, Meral Esen, Afra Alkan, Aysun Kabasakal, İrfan Şencan
OBJECTIVE: To analyze maternal deaths in Turkey due to hypertensive disorders. MATERIAL AND METHODS: In this retrospective study 812 maternal deaths were analyzed. Maternal demographic features, presence of antenatal care, medical and obstetric history, mode of delivery, and use emergency antihypertensive therapy were recorded. The delay model for each case was investigated. RESULTS: Hypertensive disorders accounted for 15.5% (n=126) out of all maternal mortality...
March 15, 2017: Journal of the Turkish German Gynecological Association
https://www.readbyqxmd.com/read/28506913/predicting-determinants-of-atrial-fibrillation-or-flutter-for-therapy-elucidation-in-patients-at-risk-for-thromboembolic-events-predate-af-study
#14
Javed M Nasir, William Pomeroy, Adam Marler, Matthew Hann, Tina Baykaner, Ronald Jones, Richard Stoll, Katherine Hursey, Angela Meadows, Jennifer Walker, Steve Kindsvater
BACKGROUND: Atrial fibrillation (AF) is the most common clinically significant cardiac rhythm disorder. There is considerable interest in screening for AF, as it is a leading cause of stroke, and oral anticoagulants (OACs) have been shown to significantly reduce the risk of stroke in patients with AF. Improved screening for AF with subsequent treatment may help improve long-term outcomes, but the optimal patient population and screening intensity are unknown. OBJECTIVES: In this study, we prospectively evaluated the use of the CHA2DS2-VASc score for the prediction of new-onset AF using insertable cardiac monitors (ICMs) and examined whether this screening led to the initiation of OAC therapy...
May 12, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28506381/description-of-drug-therapy-problem-resolution-in-a-statewide-care-management-program
#15
Chelsea Phillips Renfro, Stefanie P Ferreri, Neil Williams, Cole Clark, Trista Pfeiffenberger
OBJECTIVE: To describe drug therapy problem (DTP) resolution as part of a statewide, team-based care management program. METHODS: This was a retrospective, observational study of DTPs documented between March 1 and August 31, 2015. Data were retrieved from a Web-based platform 5 months after the observation period. DTPs were placed into groups based on the credentials of the person who documented the DTP. Next, they were identified as being documented in a transitional or nontransitional care setting...
May 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28506154/seroadaptive-strategies-of-vancouver-gay-and-bisexual-men-in-a-treatment-as-prevention-environment
#16
Eric Abella Roth, Zishan Cui, Ashleigh Rich, Nathan Lachowsky, Paul Sereda, Kiffer Card, Jody Jollimore, Terry Howard, Heather Armstrong, David Moore, Robert Hogg
British Columbia's Treatment as Prevention policy has provided free access to Highly Active Antiretroviral Therapy (HAART) to all HIV-positive provincial residents since 1996. One outcome is an increase in HIV-positive gay and bisexual men (GBM) with suppressed viral loads. Previous cross-sectional analyses indicated that some Vancouver GBM now recognize condomless anal sex with men on HAART who report a suppressed viral load as a sero-adaptive strategy. To test the hypothesis that this new strategy, termed viral load sorting (VLS), is recognized and used among by GBM in the Momentum Health Study, we analyzed longitudinal data for HIV-negative/unknown (n = 556) and HIV-positive (n = 218) sero-status participants...
May 16, 2017: Journal of Homosexuality
https://www.readbyqxmd.com/read/28505045/resistant-hypertension-in-2017
#17
Sartaj Hans, John P Reilly
PURPOSE OF REVIEW: Hypertension (HTN) is a ubiquitous condition and cause for significant morbidity and mortality. Over 400 000 deaths in the United States are related to HTN every year, more than all the Americans who died through all of World War II. As many as half the patients with HTN in the United States have resistant HTN, a blood pressure greater than 140/90 mmHg despite three medications including a diuretic. It appears that the prevalence of HTN and resistant HTN is increasing over time...
May 12, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28503676/learning-optimal-individualized-treatment-rules-from-electronic-health-record-data
#18
Yuanjia Wang, Peng Wu, Ying Liu, Chunhua Weng, Donglin Zeng
Medical research is experiencing a paradigm shift from "one-size-fits-all" strategy to a precision medicine approach where the right therapy, for the right patient, and at the right time, will be prescribed. We propose a statistical method to estimate the optimal individualized treatment rules (ITRs) that are tailored according to subject-specific features using electronic health records (EHR) data. Our approach merges statistical modeling and medical domain knowledge with machine learning algorithms to assist personalized medical decision making using EHR...
October 2016: IEEE International Conference on Healthcare Informatics IEEE International Conference on Healthcare Informatics
https://www.readbyqxmd.com/read/28503097/asthma-management-among-allergists-in-italy-results-from-a-survey
#19
M S Magnoni, M Caminati, G W Canonica, F Arpinelli, A Rizzi, G Senna
BACKGROUND: In Europe more than 50% of asthmatic treated patients have not well-controlled asthma. Asthma affects about 2.5 million of patients in Italy. AIMS AND OBJECTIVES: The present survey aims at investigating how Italian allergists approach asthmatic patients, in order to highlight pitfalls and unmet needs concerning real-life asthma management. METHODS: An anonymous 16 item web questionnaire was available (April-October 2015) to all allergists who visited the web site of SIAAIC (Società Italiana di Allergologia, Asma Immunologia Clinica)...
2017: Clinical and Molecular Allergy: CMA
https://www.readbyqxmd.com/read/28502589/a-case-of-a-novel-mutation-in-hnf1%C3%AE-related-maturity-onset-diabetes-of-the-young-type-5-with-diabetic-kidney-disease-complication-in-a-chinese-family
#20
Yiting Wang, Yingwang Zhao, Junlin Zhang, Yuxiang Yang, Fang Liu
AIMS: Precise diagnosis of maturity-onset diabetes of the young (MODY) has proven valuable for understanding mechanism of diabetes and selecting optimal therapy. A proband and her mother with diabetic kidney disease (DKD) were studied to investigate potential genes responsible for diabetes and different severity of DKD between the parent and offspring. METHODS: The family with suspected MODY underwent mutational analyses by the whole exome sequencing (WES). Candidate pathogenic variants were validated by Sanger sequencing and tested for co-segregation...
November 15, 2016: Journal of Diabetes and its Complications
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