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https://www.readbyqxmd.com/read/28087156/french-national-consensus-clinical-guidelines-for-the-management-of-crohn-s-disease
#1
Laurent Peyrin-Biroulet, Yoram Bouhnik, Xavier Roblin, Guillaume Bonnaud, Hervé Hagège, Xavier Hébuterne
BACKGROUND: Crohn's disease (CD) is a chronic and disabling condition. There is no curative medical treatment but current treatments provide increasingly sustainable control of the disease and allow patients a better quality of life. There is limited evidence supporting CD management in specific clinical situations, thus precluding an evidence-based approach. AIMS: To help clinicians in making informed treatment decisions, a group of 59 French gastroenterologists with experience in the management of CD met to develop straightforward and practical algorithms based on the European Crohn's and Colitis Organisation (ECCO) recommendations...
December 22, 2016: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28087074/quantifying-loading-toxic-concentrations-and-systemic-persistence-of-chloride-in-a-contemporary-mixed-land-use-watershed-using-an-experimental-watershed-approach
#2
J A Hubbart, E Kellner, L W Hooper, S Zeiger
A nested-scale experimental watershed study was implemented to quantify loading and persistence of chloride in an urbanizing, mixed-land-use watershed. A Midwest USA (Missouri) watershed was partitioned into five sub-basins with contrasting dominant land use. Streamwater was tested for chloride concentration four days per week from October 2009 through May 2014 at each site. Monitoring sites included co-located gauging and climate stations recording variables at 30-minute intervals. Results indicate significant (p<0...
January 10, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28077135/comorbidity-study-of-borderline-personality-disorder-applying-association-rule-mining-to-the-taiwan-national-health-insurance-research-database
#3
Cheng-Che Shen, Li-Yu Hu, Ya-Han Hu
BACKGROUND: Borderline personality disorder (BPD) is a complex clinical state with highly polymorphic symptoms and signs. Studies have demonstrated that people with a BPD diagnosis are likely to have numerous co-occurring psychiatric disorders and physical comorbidities. The aim of our study was to obtain further insight about the associations among comorbidities of BPD and to demonstrate the practicality of using association rule mining (ARM) technique in clinical databases. METHODS: A retrospective case-control study was conducted on information of 1460 patients (292 BPD patients and 1168 control patients) selected from the Taiwan National Health Insurance Research Database...
January 11, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28075307/chronic-heart-failure-part-2-treatment-and-management
#4
Rebecca Brake, Ian David Jones
Chronic heart failure is a common and complex clinical syndrome that results from impaired cardiac relaxation or contraction. There have been considerable advances in the management of chronic heart failure; however, the mortality rate remains high. Patients with chronic heart failure may experience multiple debilitating symptoms, such as fatigue, pain, and peripheral oedema. However, breathlessness may be considered the most debilitating symptom. The management of chronic heart failure aims to improve the patient's quality of life by reducing symptoms and supporting the patient to manage their condition...
January 11, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28075056/m1-aminopeptidases-as-drug-targets-broad-applications-or-therapeutic-niche
#5
REVIEW
Nyssa Drinkwater, Jisook Lee, Wei Yang, Tess R Malcolm, Sheena McGowan
M1 aminopeptidase enzymes are a diverse family of metalloenzymes characterized by conserved structure and reaction specificity. Excluding viruses, M1 aminopeptidases are distributed throughout all phyla, and have been implicated in a wide range of functions including cell maintenance, growth and development, and defense. The structure and catalytic mechanism of M1 aminopeptidases are well understood, and make them ideal candidates for the design of small molecule inhibitors. As a result, many research groups have assessed their utility as therapeutic targets for both infectious and chronic diseases of humans, and many inhibitors with a range of target specificities and potential therapeutic applications have been developed...
January 11, 2017: FEBS Journal
https://www.readbyqxmd.com/read/28074831/rgs9-2-modulates-responses-to-oxycodone-in-pain-free-and-chronic-pain-states
#6
Sevasti Gaspari, Valeria Cogliani, Lefteris Manouras, Ethan M Anderson, Vasiliki Mitsi, Kleopatra Avrampou, Fiona B Carr, Venetia Zachariou
Regulator of G protein signalling 9-2 (RGS9-2) is a striatal enriched signal transduction modulator, known to play a critical role in the development of addiction-related behaviours following exposure to psychostimulants or opioids. RGS9-2 controls the function of several GPCRs, including dopamine and mu opioid (MOR) receptors. We previously showed that RGS9-2 complexes negatively control morphine analgesia, and promote the development of morphine tolerance. In contrast, RGS9-2 positively modulates the actions of other opioid analgesics, such as fentanyl and methadone...
January 11, 2017: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28073875/unexpected-complication-after-radical-inguinal-orchidectomy-trans-sphincteric-anoscrotal-fistula
#7
Amit Patel, Chris Gillespie, Anthony J Kiosoglous
Anoscrotal fistula is an extremely rare condition involving an epithelialised tract between the anal canal and scrotal wall. It is more commonly seen as a congenital phenomenon in the paediatric population, and has not previously been described in the literature in adults. We present the case of a man aged 52 years who developed a complex anoscrotal fistula after a radical inguinal orchidectomy for an intratesticular seminoma. A postsurgical wound-site infection developed into a chronically discharging wound refractory to antibiotic treatment prompting further investigation...
January 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28073146/value-based-care-in-hepatology
#8
REVIEW
Mario Strazzabosco, John I Allen, Elizabeth O Teisberg
The migration from legacy fee-for-service reimbursement to payments linked to high value health care is accelerating in the United States because of new legislation and re-design of payments from the Centers for Medicare and Medicaid Services (CMS). Since patients with chronic diseases account for substantial use of health care resources, payers and health systems are focusing on maximizing the value of care for these patients. Since chronic liver diseases impose a major health burden worldwide affecting the health and lives of many individuals and families as well as substantial costs for individuals and payers, hepatologists must understand how they can improve their practices ...
January 10, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28072930/left-ventricular-outflow-tract-obstruction-be-prepared
#9
J S Evans, S J Huang, A S McLean, M Nalos
The current trend to treat hypotension in critically ill patients is to place a greater emphasis on inotropic support and less on fluid resuscitation in order to limit the potential harm from fluid overload. This combination may trigger left ventricular outflow tract obstruction (LVOTO) in susceptible patients. Although LVOTO is classically described in patients with hypertrophic cardiomyopathy it has been reported in other conditions including septic shock, apical ballooning syndrome, myocardial infarction, respiratory failure, and post valvular surgery...
January 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28072813/a-case-report-on-red-ear-syndrome-with-tinnitus-successfully-treated-with-transcranial-random-noise-stimulation
#10
Peter M Kreuzer, Veronika Vielsmeier, Timm B Poeppl, Berthold Langguth
BACKGROUND: The red ear syndrome represents a rare symptom complex consisting of auricular erythema associated with painful and burning sensations. It has been described in combination with tinnitus rarely. It has been hypothesized to be etiologically related to altered trigeminal afferent input, temporomandibular disorders, and thalamic dysfunction. OBJECTIVES: The initial objective of applying transcranial random noise stimulation (tRNS) in a case of red ear syndrome in combination with tinnitus was the alleviation of the phantom sounds...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28072810/high-frequency-spinal-cord-stimulation-for-complex-regional-pain-syndrome-a-case-report
#11
Joseph T Crapanzano, Lisa M Harrison-Bernard, Mark R Jones, Alan D Kaye, Erich O Richter, Mordeci N Potash
Complex regional pain syndrome (CRPS) is a chronic, debilitating, neuropathic pain condition which is often misdiagnosed, difficult to manage, and lacks proven methods for remission. Most available methods provide some relief to a small percentage of patients. Recent FDA approval and superiority of the Nevro Senza 10-kHz high frequency (HF10) spinal cord stimulation (SCS) therapy over traditional low-frequency spinal cord stimulation for treatment of chronic back and leg pain may provide a new interventional therapeutic option for patients suffering from CRPS...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28070671/place-of-death-of-children-with-complex-chronic-conditions-cross-national-study-of-11-countries
#12
Cecilia Håkanson, Joakim Öhlén, Ulrika Kreicbergs, Marylou Cardenas-Turanzas, Donna M Wilson, Martin Loucka, Sandra Frache, Lucia Giovannetti, Wayne Naylor, YongJoo Rhee, Miguel Ruiz Ramos, Joan Teno, Kim Beernaert, Luc Deliens, Dirk Houttekier, Joachim Cohen
: Cross-national understanding of place of death is crucial for health service systems for their provision of efficient and equal access to paediatric palliative care. The objectives of this population-level study were to examine where children with complex chronic conditions (CCC) die and to investigate associations between places of death and sex, cause of death and country. The study used death certificate data of all deceased 1- to 17-year-old children (n = 40,624) who died in 2008, in 11 European and non-European countries...
January 9, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28068790/temporomandibular-disorders-old-ideas-and-new-concepts
#13
Thomas List, Rigmor Højland Jensen
Background Temporomandibular disorders (TMD) is an umbrella term for pain and dysfunction involving the masticatory muscles and the temporomandibular joints (TMJs). TMD is the most common orofacial pain condition. Its prominent features include regional pain in the face and preauricular area, limitations in jaw movement, and noise from the TMJs during jaw movements. TMD affects up to 15% of adults and 7% of adolescents. Chronic pain is the overwhelming reason that patients with TMD seek treatment. TMD can associate with impaired general health, depression, and other psychological disabilities, and may affect the quality of life of the patient...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/28063266/antibiotics-may-trigger-mitochondrial-dysfunction-inducing-psychiatric-disorders
#14
George B Stefano, Joshua Samuel, Richard M Kream
Clinical usage of several classes of antibiotics is associated with moderate to severe side effects due to the promotion of mitochondrial dysfunction. We contend that this may be due to perturbation of unique evolutionary relationships that link selective biochemical and molecular aspects of mitochondrial biology to conserved enzymatic processes derived from bacterial progenitors. Operationally, stereo-selective conformational matching between mitochondrial respiratory complexes, cytosolic and nuclear signaling complexes appears to support the conservation of a critically important set of chemical messengers required for existential regulation of homeostatic cellular processes...
January 7, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28056958/about-the-complexity-of-adult-onset-still-s-disease%C3%A2-and-advances-still-required-for-its-management
#15
EDITORIAL
Philippe Guilpain, Alain Le Quellec
Adult onset Still's disease (AOSD) is a rare inflammatory disorder that remains poorly understood. Its pathophysiology is yet to be completely elucidated, but is known to consist mainly on a cytokine cascade, responsible for the systemic manifestations. AOSD diagnosis is usually difficult and delayed, with physicians having to rule out several other conditions, including cancer or infectious diseases. Prognosis is heterogeneous and difficult to establish, ranging from benign outcome to chronic destructive polyarthritis and/or life-threatening events...
January 6, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28056852/non-dialysis-dependent-chronic-kidney-disease-is-associated-with-high-total-and-out-of-pocket-healthcare-expenditures
#16
Christina Small, Holly J Kramer, Karen A Griffin, Kavitha Vellanki, David J Leehey, Vinod K Bansal, Talar W Markossian
BACKGROUND: Previous studies have documented the high costs of non-dialysis dependent chronic kidney disease (CKD) but out-of-pocket healthcare expenditures remain poorly explored. This study described total direct and out-of-pocket expenditures for adults with non-dialysis dependent CKD and compared expenditures with those for cancer or stroke. METHODS: This study used data from the 2011-2013 Medical Expenditure Panel Survey, a national survey of healthcare expenditures in the U...
January 5, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28056185/a-trial-of-concurrent-care-shedding-light-on-the-gray-zone
#17
Annemarie Hargadon, Quy Tran, Karen Stephen, Howard Homler
BACKGROUND: Patients are hospice eligible when they have an estimated prognosis of 6 months and the readiness to forgo attempts at disease-modifying treatments related to their terminal illness. The decision to enroll in hospice is relatively clear when the prognosis is based on an incurable illness for which there are no further life-prolonging therapies. However, when the prognosis is based on a serious chronic illness for which possible interventions remain but must be forgone to access hospice support, the decision process is more complex...
February 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28056050/a-latent-class-analysis-of-multimorbidity-and-the-relationship-to-socio-demographic-factors-and-health-related-quality-of-life-a-national-population-based-study-of-162-283-danish-adults
#18
Finn Breinholt Larsen, Marie Hauge Pedersen, Karina Friis, Charlotte Glümer, Mathias Lasgaard
OBJECTIVES: To identify patterns of multimorbidity in the general population and examine how these patterns are related to socio-demographic factors and health-related quality of life. STUDY DESIGN AND SETTING: We used latent class analysis to identify subgroups with statistically distinct and clinically meaningful disease patterns in a nationally representative sample of Danish adults (N = 162,283) aged 16+ years. The analysis was based on 15 chronic diseases. RESULTS: Seven classes with different disease patterns were identified: a class with no or only a single chronic condition (59% of the population) labeled "1) Relatively Healthy" and six classes with a very high prevalence of multimorbidity labeled; "2) Hypertension" (14%); "3) Musculoskeletal Disorders" (10%); "4) Headache-Mental Disorders" (7%); "5) Asthma-Allergy" (6%); "6) Complex Cardiometabolic Disorders" (3%); and "7) Complex Respiratory Disorders" (2%)...
2017: PloS One
https://www.readbyqxmd.com/read/28054496/tailoring-exercise-interventions-to-comorbidities-and-treatment-induced-adverse-effects-in-patients-with-early-stage-breast-cancer-undergoing-chemotherapy-a-framework-to-support-clinical-decisions
#19
Marike van der Leeden, Rosalie J Huijsmans, Edwin Geleijn, Mariëtte de Rooij, Inge R Konings, Laurien M Buffart, Joost Dekker, Martijn M Stuiver
PURPOSE: Delivery of exercise interventions to patients with early-stage breast cancer undergoing chemotherapy requires complex clinical decisions. The purpose of this study was to develop a framework to support clinical decisions for tailoring exercise interventions to common comorbidities and cancer treatment-induced adverse effects. METHOD: Tailored exercise prescriptions were developed in four steps, following the i3-S strategy. All steps were based on current best available evidence, complemented with expert opinions...
January 5, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28054430/the-complex-patient-a-concept-clarification
#20
REVIEW
Eli Manning, Marilou Gagnon
Over the last decade, the concept of the "complex patient" has not only been more widely used in multidisciplinary healthcare teams and across various healthcare disciplines, but it has also become more vacuous in meaning. The uptake of the concept of the "complex patient" spans across disciplines, such as medicine, nursing, and social work, with no consistent definition. We review the chronological evolution of this concept and its surrogate terms, namely "comorbidity," "multimorbidity," "polypathology," "dual diagnosis," and "multiple chronic conditions...
January 5, 2017: Nursing & Health Sciences
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