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management and treatment

Heitor S P de Souza, Claudio Fiocchi
Despite unquestionable progress in the management of inflammatory bowel disease (IBD) and the much improved clinical results achievable today in Crohn's disease (CD) and ulcerative colitis (UC) patients, the overall therapeutic outcome remains far from optimal. The main reason of this partial success is that all current medications only block individual components of a highly complex disease process that results from the integration of multiple and incompletely identified pathogenic components. Thus, if further progress is to be achieved in IBD therapeutics and we want to move from the current success rate to nearly 100%, bold new ideas must be entertained and new approaches put into practice...
March 19, 2018: Inflammatory Bowel Diseases
L Clifford McDonald, Dale N Gerding, Stuart Johnson, Johan S Bakken, Karen C Carroll, Susan E Coffin, Erik R Dubberke, Kevin W Garey, Carolyn V Gould, Ciaran Kelly, Vivian Loo, Julia Shaklee Sammons, Thomas J Sandora, Mark H Wilcox
A panel of experts was convened by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) to update the 2010 clinical practice guideline on Clostridium difficile infection (CDI) in adults. The update, which has incorporated recommendations for children (following the adult recommendations for epidemiology, diagnosis, and treatment), includes significant changes in the management of this infection and reflects the evolving controversy over best methods for diagnosis...
March 19, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Claire M Keene, Arjen Dondorp, Jane Crawley, Eric O Ohuma, Mavuto Mukaka
Background: Malaria burdens global health systems, and management with limited resources requires robust treatment guidelines and comprehensive planning. Expected length of stay (LOS) is useful in health-system planning, and factors influencing it can be targeted to reduce admission time and optimise service delivery. Methods: A secondary survival analysis of 1217 adult severe malaria patients from the South-East Asia Quinine Artesunate Malaria Trial, using a competing-risk approach...
March 19, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Bhavik N Modi, Kalpa De Silva, Ronak Rajani, Nick Curzen, Divaka Perera
Importance: Ischemia-guided revascularization is the cornerstone of contemporary management of coronary artery disease and has evolved from noninvasive functional evaluation to real-time assessment with invasive physiological indices during diagnostic catheterization. However, serial/diffuse disease is common, and revascularization decisions often need to be made about individual lesions within the same vessel. It is unclear whether current physiological techniques, such as fractional flow reserve, can be reliably used to discern the individual contribution of lesions within a serially diseased vessel with erroneous measurements, potentially leading to suboptimal revascularization decisions...
March 21, 2018: JAMA Cardiology
Zhao Dehua, Chu Mingming, Wang Jisheng
OBJECTIVE: To evaluate the efficacy and safety of gemcitabine (GEM) at 30 min standard-dose infusion (30 min-SDI) compared with prolonged low-dose infusion (P-LDI) in patients with advanced non-small-cell lung cancer (NSCLC). METHODS: Electronic databases including Pubmed, EMbase, Cochrane Library, CNKI, CBM, and VIP were searched using keywords "GEM", "P-LDI", and "NSCLC". Review Manager 5.3 was used to perform the meta-analysis. Primary endpoints were overall response rate (ORR) and 1-year survival rate (1-year SR)...
2018: PloS One
Stan Benjamens, Robert A Pol, Lioe-Fee de Geus-Oei, Aiko P J de Vries, Andor W J M Glaudemans, Stefan P Berger, Riemer H J A Slart
INTRODUCTION: This study focused on the value of quantitatively analyzed and qualitatively graded renal scintigraphy in relation to the expected duration of delayed graft function after kidney transplantation. A more reliable prediction of delayed graft function duration may result in a more tailored and patient-specific treatment regimen post-transplantation. METHODS: From 2000 to 2014, patients with early transplant dysfunction and a Tc-99m MAG3 renal scintigraphy, within 3 days post-transplantation, were included in a dual center retrospective study...
2018: PloS One
Christiana Leimena, Hongyu Qiu
Hypertension is a complex, multifactorial disease that involves the coexistence of multiple risk factors, environmental factors and physiological systems. The complexities extend to the treatment and management of hypertension, which are still the pursuit of many researchers. In the last two decades, various genes have emerged as possible biomarkers and have become the target for investigations of specialized drug design based on its risk factors and the primary cause. Owing to the growing technology of microarrays and next-generation sequencing, the non-protein-coding RNAs (ncRNAs) have increasingly gained attention, and their status of redundancy has flipped to importance in normal cellular processes, as well as in disease progression...
March 21, 2018: International Journal of Molecular Sciences
Pradeep Phadnis, Purnima Dey Sarkar, Mithun Singh Rajput
BACKGROUND: Initial evidences have shown that diabetes mellitus occurs concomitantly with obsessive-compulsive disorder (OCD) symptomatology. Serotonergic psychiatric therapy posits that serotonin is a central character in the management of OCD. Hence, it is worth investigating novel chemical entities affecting the serotonergic system for targeting OCD. An isoflavonoid phytoestrogen, genistein, has been recognized as of great pharmacological value especially for protecting neurodegeneration, depression (serotonin regulation), and diabetes...
March 21, 2018: Journal of Basic and Clinical Physiology and Pharmacology
Matilde Inglese, Maria Petracca
PURPOSE OF REVIEW: Clinical MRI is of paramount importance for multiple sclerosis diagnosis but lacks the specificity to investigate the pathogenic mechanisms underlying disease onset and progression. The application of advanced magnetic resonance (MR) sequences allows the characterization of diverse and complex pathological mechanisms, granting insights into multiple sclerosis natural history and response to treatment. RECENT FINDINGS: This review provides an update on the most recent international guidelines for optimal standard imaging of multiple sclerosis and discusses advantages and limitations of advanced imaging approaches for investigating inflammation, demyelination and neurodegeneration...
March 19, 2018: Current Opinion in Neurology
Wei An, Aisaiti Ainiwaer, Patiguli Wusiman, Gulibusitan Ali, Adili Moming
PURPOSE: The study proposed to determine the superiority between different fixation methods in the mandibular angle fractures (MAFs) and to evaluate best option for surgeon and patient. METHODS: A systematic review was conducted according to PRISMA guidelines, examining Medline-Ovid, Embase, and Pubmed databases. The quality of studies was assessed, and the odds risk (OR) with its corresponding 95% confidence interval (CI) was assessed to measure the effect size...
March 20, 2018: Journal of Craniofacial Surgery
Yoshiaki Sakamoto, Tomoru Miwa, Kazunari Yoshida, Kazuo Kishi
BACKGROUND: The management of fronto-orbital fibrous dysplasia involves total excision of the dysplastic bone and bone reconstruction using implants. Custom-made implants are used to achieve good contouring. However, the remnant defect after excising the lesion often does not match the implant. METHODS: To design the craniotomy line, a template was prepared by preoperative computed surgical simulation. The template was overlaid on the preoperative cranium, such that its inner surface fits exactly with the cranial surface...
March 20, 2018: Journal of Craniofacial Surgery
Wei Wang, Dong Xing, Yingjian Song, Feiyu Liu
BACKGROUND: Esophageal cancer is one of the worst malignant digestive neoplasms with poor treatment outcomes. Definitive concurrent chemoradiotherapy (CRT) has become the standard nonsurgical treatment option for locally advanced esophageal cancer. The chemotherapeutic drugs 5-fluorouracil and cisplatin have been most commonly used in CRT of esophageal cancer. However, radiotherapy combined with 5-FU/cisplatin often delivers severe toxicity to patients. S-1 as an oral chemotherapeutic drug exhibits higher anti-tumor activity, less adverse effects, and better biological availability...
March 2018: Medicine (Baltimore)
Bo Ma, Yingjun Zhu, Yixin Liu
Atypical polypoid adenomyoma (APA) is a rare uterine lesion, which has a high rate of recurrence and malignant transformation. How to treat this disease is crucial for the prognosis, but there are few reports on it.We retrospectively reviewed the clinical records of all the patients diagnosed with APA after surgical therapy in our hospital. All the clinical information, pathological results, treatment, and outcome were retrieved from the clinical records.A total of 43 patients were diagnosed with APA. The median age was 56...
March 2018: Medicine (Baltimore)
Batool Tirgari, Leili Mirshekari, Mansooreh Azzizadeh Forouzi
BACKGROUND: Pressure injuries are the third most expensive condition after cancer and cardiovascular disease. Nurses are responsible for the direct and continuous care, treatment, and prevention of pressure injuries. To achieve optimal quality care, nursing knowledge and attitudes must be based on the best scientific evidence. This study aimed to examine the knowledge and attitudes of nurses working in intensive care units of hospitals affiliated with Zahedan Medical Sciences University regarding the prevention of pressure injuries...
April 2018: Advances in Skin & Wound Care
Robert Strohal, Martina Mittlböck, Gilbert Hämmerle
OBJECTIVE: Critical colonization or local infection is very common in chronic wounds, but clinically problematic. Because therapeutic options for these conditions are limited in number and efficacy, the study authors tested a new acid-oxidizing solution (AOS [Nexodyn]; APR Applied Pharma Research S.A., Balerna, Switzerland) to determine its ancillary antimicrobial properties and potential support for wound healing. DESIGN AND SETTING: This open-label clinical case series was conducted with a prospective, single-arm design at the Federal County Hospital in Bregenz, Austria...
April 2018: Advances in Skin & Wound Care
Jennifer J Mueller, Henrik Lajer, Berit Jul Mosgaard, Slim Bach Hamba, Philippe Morice, Sebastien Gouy, Yaser Hussein, Robert A Soslow, Brooke A Schlappe, Qin C Zhou, Alexia Iasonos, Claus Høgdall, Alexandra Leary, Roisin E OʼCearbhaill, Nadeem R Abu-Rustum
OBJECTIVE: We sought to describe a large, international cohort of patients diagnosed with primary mucinous ovarian carcinoma (PMOC) across 3 tertiary medical centers to evaluate differences in patient characteristics, surgical/adjuvant treatment strategies, and oncologic outcomes. METHODS: This was a retrospective review spanning 1976-2014. All tumors were centrally reviewed by an expert gynecologic pathologist. Each center used a combination of clinical and histologic criteria to confirm a PMOC diagnosis...
March 21, 2018: International Journal of Gynecological Cancer
Jason Chesney, Yoannis Imbert-Fernandez, Sucheta Telang, Mary Baum, Smita Ranjan, Mostafa Fraig, Nicolas Batty
Talimogene laherparepvec is a genetically modified herpes simplex virus type 1-based oncolytic immunotherapy for the local treatment of unresectable subcutaneous and nodal tumors in patients with melanoma recurrent after initial surgery. We report on two patients with melanoma who, after progression on numerous systemic therapies, derived clinical benefit from talimogene laherparepvec in an expanded-access protocol (, NCT02147951). Intralesional talimogene laherparepvec (day 1, ≤4 ml 10 PFU/ml; after 3 weeks, ≤4 ml 10 PFU/ml every 2 weeks) was administered until complete response, no injectable tumors, progressive disease, or intolerance occurred...
March 20, 2018: Melanoma Research
Michael F Orr, Crystal Lederhos Smith, Myles Finlay, Samantha C Martin, Olivia Brooks, Oladunni A Oluwoye, Emily Leickly, Michael McDonell, Ekaterina Burduli, Celestina Barbosa-Leiker, Matt Layton, John M Roll, Sterling M McPherson
Contingency management (CM) is associated with decreases in off-target drug and alcohol use during primary target treatment. The primary hypothesis for this trial was that targeting alcohol use or tobacco smoking would yield increased abstinence in the opposite, nontargeted drug. We used a 2 [CM vs. noncontingent control (NC) for alcohol]×2 (CM vs. NC for smoking tobacco) factorial design, with alcohol intake (through urinary ethyl glucuronide) and tobacco smoking (through urinary cotinine) as the primary outcomes...
March 20, 2018: Behavioural Pharmacology
Darius M Moshfeghi
PURPOSE OF REVIEW: This review highlights the common areas of medicolegal risk during retinopathy of prematurity (ROP) screening. RECENT FINDINGS: Most malpractice risk in ROP comes from systemic errors that ultimately result in failure to screen the patient in a timely fashion, resulting in failures to intervene and/or refer in a timely fashion. Currently, the emphasis is engaging the family members, the hospital staff, and clinic staff to pro-actively manage ROP patients and ensure that they are screened in a timely fashion...
March 20, 2018: Current Opinion in Ophthalmology
Walid Ben-Nafa, Wendy Munro
INTRODUCTION: Lateral epicondylitis is a common musculoskeletal disorder of the upper limb. Corticosteroid injection has been widely used as a major mode of treatment. However, better understanding of the pathophysiology of the disease led to a major change in treating the disease, with new options including platelet-rich plasma (PRP) are currently used. Objectives/research aim: To systematically evaluate the effect of corticosteroid versus PRP injections for the treatment of LE. HYPOTHESIS: PRP injections provide longer-term therapeutic effect and less rate of complications compared to corticosteroid injection...
2018: SICOT-J
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