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https://www.readbyqxmd.com/read/28434406/efavirenz-based-simplification-after-successful-early-lopinavir-boosted-ritonavir-based-therapy-in-hiv-infected-children-in-burkina-faso-and-c%C3%A3-te-d-ivoire-the-monod-anrs-12206-non-inferiority-randomised-trial
#1
Désiré Lucien Dahourou, Madeleine Amorissani-Folquet, Karen Malateste, Clarisse Amani-Bosse, Malik Coulibaly, Carole Seguin-Devaux, Thomas Toni, Rasmata Ouédraogo, Stéphane Blanche, Caroline Yonaba, François Eboua, Philippe Lepage, Divine Avit, Sylvie Ouédraogo, Philippe Van de Perre, Sylvie N'Gbeche, Angèle Kalmogho, Roger Salamon, Nicolas Meda, Marguerite Timité-Konan, Valériane Leroy
BACKGROUND: The 2016 World Health Organization guidelines recommend all children <3 years start antiretroviral therapy (ART) on protease inhibitor-based regimens. But lopinavir/ritonavir (LPV/r) syrup has many challenges in low-income countries, including limited availability, requires refrigeration, interactions with anti-tuberculous drugs, twice-daily dosing, poor palatability in young children, and higher cost than non-nucleoside reverse transcriptase inhibitor (NNRTI) drugs. Successfully initiating LPV/r-based ART in HIV-infected children aged <2 years raises operational challenges that could be simplified by switching to a protease inhibitor-sparing therapy based on efavirenz (EFV), although, to date, EFV is not recommended in children <3 years...
April 24, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28427336/protocol-for-the-home-hazards-removal-program-harp-study-a-pragmatic-randomized-clinical-trial-and-implementation-study
#2
Susan Stark, Emily Somerville, Marian Keglovits, Jane Conte, Melody Li, Yi-Ling Hu, Yan Yan
BACKGROUND: Falls remain the leading cause of injury, long-term disability, premature institutionalization, and injury-related mortality in the older adult population. Home modifications, when delivered by occupational therapists, can reduce falls among high-risk community-dwelling older adults by 39%. However, home-modification implementation is not standard practice in the United States. The goal of the Home Hazard Removal Program (HARP) study is to implement an evidence-based home modification intervention for older adults designed to reduce the incidence of falls through an aging services network...
April 20, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28426835/outcomes-from-a-cohort-of-patients-with-acute-kidney-injury-subjected-to-continuous-venovenous-hemodiafiltration-the-role-of-negative-fluid-balance
#3
Thais Oliveira Claizoni Dos Santos, Marisa Aparecida de Souza Oliveira, Julio Cesar Martins Monte, Marcelo Costa Batista, Virgilio Gonçalves Pereira Junior, Bento Fortunato Cardoso Dos Santos, Oscar Fernando Pavão Santos, Marcelino de Souza Durão Junior
BACKGROUND: Several factors influence the outcomes in acute kidney injury (AKI), especially in intensive care unit (ICU) patients. In this scenario, continuous renal replacement therapies (CRRT) are used to control metabolic derangements and blood volume. Knowing this fact, it may be possible to change the course of the disease and decrease the high mortality rate observed. Thus, we aimed to evaluate the main risk factors for death in AKI patients needing CRRT. RESULTS: This was a prospective, observational cohort study of ICU patients (N = 183) with AKI who underwent continuous venovenous hemodiafiltration (CVVHDF) as their initial dialysis modality choice...
2017: PloS One
https://www.readbyqxmd.com/read/28422521/different-approaches-to-the-assessment-of-adherence-and-persistence-with-cardiovascular-disease-preventive-medications
#4
Sara Malo, Isabel Aguilar-Palacio, Cristina Feja, María Jesús Lallana, María José Rabanaque, Javier Armesto, Enrica Menditto
OBJECTIVE: To assess suitability and comparability of the most common methods of treatment adherence and persistence assessment, as applied to the same pharmacy dataset. METHODS: Data on drugs prescribed for cardiovascular primary prevention to participants in the Aragon Workers' Health Study (AWHS) were collected from a regional electronic drug prescription database. Several different approaches were used to measure treatment adherence (with the Medication Possession Ratio [MPR]) and Proportion of Days Covered [PDC]) and persistence in new users by therapeutic subgroup...
April 19, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28421991/patterns-in-use-and-costs-of-conventional-and-biologic-disease-modifying-anti-rheumatic-drugs-in-australia
#5
Ellen Donges, Christine Staatz, Helen Benham, Paul Kubler, Samantha A Hollingworth
OBJECTIVES: The aim of this study was to characterise the use and costs of subsidising conventional disease-modifying anti-rheumatic drugs (DMARDs) and biologic DMARDs in Australia from 2004-2014 through pharmaceutical benefits schemes. METHODS: Dispensing and expenditure data on conventional and biologic DMARDs were extracted from Medicare Australia and temporal trends were analysed. Medicine use was standardised in terms of the defined daily dose (DDD) per 1,000 population per day (DDD/1,000 population/day)...
April 18, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28417624/cow-s-milk-desensitization-in-anaphylactic-patients-a-new-personalized-dose-method
#6
Delara Babaie, Mohammad Nabavi, Saba Arshi, Mehrnaz Mesdaghi, Zahra Chavoshzadeh, Mohammad Hasan Bemanian, Mitra Tafakori, Mehrdad Amirmoini, Hosein Esmailzadeh, Rasoul Molatefi, Mahsa Rekabi, Nadieh Akbarpour, Farimah Masoumi, Morteza Fallahpour
Cow's milk allergy (CMA) is the most frequent food allergy in children and oral immunotherapy (OIT) is a promising approach for treatment of patients. The most challenging cases are anaphylactic with coexisting asthma and proposing safe protocols is crucial especially in high risk groups. Considering that CMA varies among patients, an individualized OIT protocol would be beneficial to achieve a safer and more efficient method of desensitization. 18 children more than 3 years of age with IgE-mediated CMA were enrolled...
February 2017: Iranian Journal of Allergy, Asthma, and Immunology
https://www.readbyqxmd.com/read/28417544/urine-biomarkers-of-acute-kidney-injury-in-noncritically-ill-hospitalized-children-treated-with-chemotherapy
#7
Maya Sterling, Zubaida Al-Ismaili, Kelly R McMahon, Melissa Piccioni, Michael Pizzi, Theresa Mottes, Larry C Lands, Sharon Abish, Adam J Fleming, Michael R Bennett, Ana Palijan, Prasad Devarajan, Stuart L Goldstein, Maureen M O'Brien, Michael Zappitelli
BACKGROUND: Cisplatin (Cis), carboplatin (Carb), and ifosfamide (Ifos) are common nephrotoxic chemotherapies. Biomarkers of tubular injury may allow for early acute kidney injury (AKI) diagnosis. PROCEDURE: We performed a two-center (Canada, United States) pilot study to prospectively measure serum creatinine (SCr), urine neutrophil gelatinase-associated lipocalin (NGAL), and interleukin-18 (IL-18) in children receiving Cis/Carb (27 episodes), Ifos (30 episodes), and in 15 hospitalized, nonchemotherapy patients...
April 18, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28411959/implementation-and-outcomes-of-an-antimicrobial-stewardship-program-effectiveness-of-education
#8
Yea-Yuan Chang, Hsin-Pai Chen, Chia-Wei Lin, Jen-Jen Tang, Ti-Ying Hsu, Yueh-Chun Weng, Yuan-Ming Lee, Wei-Shu Wang, Su-Shun Lo
BACKGROUND: Unnecessary use of antibiotics is a common occurrence in hospitals. Implementation of antibiotic stewardship programs (ASPs) has been shown to reduce both unnecessary antibiotic use and drug-resistant bacteria. Education is a fundamental component of an ASP. However, the effectiveness of proper uses of antibiotics education has not been clearly analyzed. METHODS: In a 520-bed university hospital located in northeastern Taiwan, a significantly increasing prescription of carbapenems, specifically imipenem and meropenem, was observed...
April 12, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28410338/multiple-sources-of-prescription-payment-and-risky-opioid-therapy-among-veterans
#9
William C Becker, Brenda T Fenton, Cynthia A Brandt, Erin L Doyle, Joseph Francis, Joseph L Goulet, Brent A Moore, Virginia Torrise, Robert D Kerns, Peter W Kreiner
BACKGROUND: Opioid overdose and other related harms are a major source of morbidity and mortality among US Veterans, in part due to high-risk opioid prescribing. OBJECTIVES: We sought to determine whether having multiple sources of payment for opioids-as a marker for out-of-system access-is associated with risky opioid therapy among veterans. RESEARCH DESIGN: Cross-sectional study examining the association between multiple sources of payment and risky opioid therapy among all individuals with Veterans Health Administration (VHA) payment for opioid analgesic prescriptions in Kentucky during fiscal year 2014-2015...
April 13, 2017: Medical Care
https://www.readbyqxmd.com/read/28409830/magnesium-for-treating-sickle-cell-disease
#10
REVIEW
Nan Nitra Than, Htoo Htoo Kyaw Soe, Senthil K Palaniappan, Adinegara Bl Abas, Lucia De Franceschi
BACKGROUND: Sickle cell disease is an autosomal recessive inherited haemoglobinopathy which causes painful vaso-occlusive crises due to sickle red blood cell dehydration. Vaso-occlusive crises are common painful events responsible for a variety of clinical complications; overall mortality is increased and life expectancy decreased compared to the general population. Experimental studies suggest that intravenous magnesium has proven to be well-tolerated in individuals hospitalised for the immediate relief of acute (sudden onset) painful crisis and has the potential to decrease the length of hospital stay...
April 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28409477/ethnic-differences-in-persistence-with-copd-medications-a-register-based-study
#11
Yusun Hu, Lourdes Cantarero-Arévalo, Anne Frølich, Ramune Jacobsen
BACKGROUND: Long-acting bronchodilators (LABDs) are recommended as a first-line maintenance therapy in patients with moderate or severe chronic obstructive pulmonary disease (COPD). The aim of the study was to explore potential ethnic differences in persistence with LABD in COPD patients. METHODS: A cohort of COPD patients diagnosed in 2003-2007 in Copenhagen, Denmark, was followed for 2 years in the Danish national registers. According to the number of the LABD medications dispensed, individuals were categorized into three therapy groups: monotherapy, drug combination therapy, and multiple drug therapy...
April 13, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28408193/imipramine-versus-placebo-for-multiple-functional-somatic-syndromes-stress-3-a-double-blind-randomised-study
#12
Johanne L Agger, Andreas Schröder, Lise K Gormsen, Jens S Jensen, Troels S Jensen, Per K Fink
BACKGROUND: Functional somatic syndromes, including chronic fatigue syndrome or irritable bowel syndrome, often co-exist. Treatment guidelines supported by high quality evidence exist for most functional somatic syndromes, but are lacking for multiple comorbid functional somatic syndromes. We aimed to assess the effect of the tricyclic antidepressant, imipramine, in patients with multiple functional somatic syndromes defined by the criteria for multiorgan bodily distress syndrome, a unifying diagnosis that encompasses most functional somatic syndromes and somatoform disorders...
April 10, 2017: Lancet Psychiatry
https://www.readbyqxmd.com/read/28400118/pre-clinical-therapeutic-development-of-a-series-of-metalloporphyrins-for-parkinson-s-disease
#13
Li-Ping Liang, Jie Huang, Ruth Fulton, Jennifer N Pearson-Smith, Brian J Day, Manisha Patel
Reactive oxygen species are a well-defined therapeutic target for Parkinson's disease (PD) and pharmacological agents that catalytically scavenge reactive species are promising neuroprotective strategies for treatment. Metalloporphyrins are synthetic catalytic antioxidants that mimic the body's own antioxidant enzymes i.e. superoxide dismutases and catalase. The goal of this study was to determine if newly designed metalloporphyrins have enhanced pharmacodynamics including oral bioavailability, longer plasma elimination half-lives, penetrate the blood brain barrier, and show promise for PD treatment...
April 8, 2017: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/28399946/impact-of-a-multifaceted-antimicrobial-stewardship-program-a-front-line-ownership-driven-quality-improvement-project-in-a-large-urban-emergency-department
#14
Adam Jonathan Kaufman, Janine McCready, Jeff Powis
BACKGROUND: Antibiotic overuse has promoted growing rates of antimicrobial resistance and secondary antibiotic-associated infections such as Clostridium difficile (C. difficile). Antimicrobial stewardship programs (ASPs) are effective in reducing antimicrobial use in the inpatient setting; however, the unique environment of the emergency department (ED) lends itself to challenges for successful implementation. Front-line ownership (FLO) methodology has been shown to be a potentially effective strategy for the implementation of inpatient ASPs through an iterative multi-pronged approach driven by front-line providers...
April 12, 2017: CJEM
https://www.readbyqxmd.com/read/28399008/use-of-intrapleural-tissue-plasminogen-activator-and-deoxyribonuclease-in-pleural-space-infections-an-update-on-alternative-regimens
#15
Christopher R Gilbert, Jed A Gorden
PURPOSE OF REVIEW: Pleural infection remains a common problem with significant associated morbidity and mortality. The current treatment paradigm for pleural infection appears to be shifting as more recent data have suggested that the use of intrapleural fibrinolytic therapy (IPFT) may be adequate for treatment, potentially avoiding the need for surgical intervention in a significant number of patients. RECENT FINDINGS: The previous Multicenter Intrapleural Sepsis Trial demonstrated improved outcomes when utilizing combined IPFT, however, more recently alterations in this dosing regimen have been explored...
April 8, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28394975/-risk-factors-for-acute-kidney-injury-in-patients-treated-with-polymyxin-b-experience-from-139-cases-at-a-tertiary-university-hospital-in-colombia
#16
Johanna Osorio, Jackeline Barreto, Claudia F Samboni, Lina A Cándelo, Luis C Álvarez, Susana Benavidez, Roso P Téllez, Dagoberto Santofimio, Jorge A Ramos, Carlos A Gómez
BACKGROUND: The rise of infections caused by multidrug-resistant Gram negative bacilli (MDR-GNB), added to paucity of newer therapy, have led to increase polymyxin B use, despite adverse renal toxicity profile. AIM: To determine the incidence and risk factors associated to acute kidney injury (AKI) and polymyxin B use, in patients with infections caused by MDR-GNB. METHODS: A retrospective cohort, with a nested case-control study of adults who received polymyxin B for more than 48 hours at a tertiary university hospital in Colombia (2011-2015) was performed...
February 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/28394903/5-alpha-reductase-inhibitor-therapy-postpones-urine-retention-and-prostate-surgery-in-patients-with-prostate-enlargement-and-a-maximum-uroflow-rate-of-less-than-15-ml-sec
#17
Wenhsu Lin, Shangsen Lee, Jengyuan Wu, Yuhung Kuo, Tengfu Hsieh
BACKGROUND: This study investigated the risk of transurethral resection of prostate (TURP) and acute urine retention (AUR) in relation to 5-alpha-reductase inhibitor (5ARI) therapy. METHODS: We identified 22,687 patients who were newly diagnosed with PE and low urinary tract symptoms (LUTS) between January 1, 2002 and December 31, 2011. We further classified study subjects who had moderate to severe LUTS and a maximum uroflow rate of less than 15ml/sec into three groups by their defined daily dose (DDD) of 5ARI used...
2017: PloS One
https://www.readbyqxmd.com/read/28392676/differential-clinical-pharmacology-of-rolapitant-in-delayed-chemotherapy-induced-nausea-and-vomiting-cinv
#18
REVIEW
Noha Rashad, Omar Abdel-Rahman
Rolapitant is a highly selective neurokinin-1 receptor antagonist, orally administered for a single dose of 180 mg before chemotherapy with granisetron D1, dexamethasone 8 mg BID on day 2-4. It has a unique pharmacological characteristic of a long plasma half-life (between 163 and 183 hours); this long half-life makes a single use sufficient to cover the delayed emesis risk period. No major drug-drug interactions between rolapitant and dexamethasone or other cytochrome P450 inducers or inhibitors were observed...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28390715/effects-of-feeding-extruded-linseed-on-production-performance-and-milk-fatty-acid-profile-in-dairy-cows-a-meta-analysis
#19
T Meignan, C Lechartier, G Chesneau, N Bareille
The objectives of this study were to quantify the effects on production performance and milk fatty acid (FA) profile of feeding dairy cows extruded linseed (EL), a feed rich in α-linolenic acid, and to assess the variability of the responses related to the dose of EL and the basal diet composition. This meta-analysis was carried out using only data from trials including a control diet without fat supplementation. The dependent variables were defined by the mean differences between values from EL-supplemented groups and values from control groups...
April 5, 2017: Journal of Dairy Science
https://www.readbyqxmd.com/read/28384235/risk-analysis-of-use-of-different-classes-of-antidepressants-on-subsequent-dementia-a-nationwide-cohort-study-in-taiwan
#20
Chee-Kin Then, Nai-Fang Chi, Kuo-Hsuan Chung, Lynn Kuo, Kao-Hui Liu, Chaur-Jong Hu, Shing-Chuan Shen, Yen-Kuang Lin
Depression and dementia are common mental health problems and are associated in several ways. Early-life depression is associated with increased risk of later life dementia, and depression can present as a preclinical symptom or consequence of dementia. Despite the plausible relationship between these two clinical entities, the potential association between antidepressant medication and dementia has rarely been investigated. We conducted a 9-year retrospective analysis of Taiwan's National Health Insurance Research Database (NHIRD), enrolling 5819 cases who had received prescriptions of antidepressants between 2003 and 2006, and 23,276 (with ratio of 1:4) age, sex, and index date-matched controls...
2017: PloS One
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