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https://www.readbyqxmd.com/read/28203342/optimizing-current-and-emerging-therapies-in-multiple-myeloma-a-guide-for-the-hematologist
#1
REVIEW
Shahzad Raza, Rachael A Safyan, Evan Rosenbaum, Alex S Bowman, Suzanne Lentzsch
Multiple myeloma (MM) is the second most common hematologic malignancy. The diagnosis of MM requires ⩾10% clonal plasma cells in the bone marrow or biopsy-proven plasmacytoma, plus evidence of end-organ damage (hypercalcemia, renal failure, anemia, and lytic bone lesions). The definition of MM has recently been expanded to include a ⩾60% clonal plasma cell burden in the bone marrow, serum involved/uninvolved light chain ratio of ⩾100, or more than one focal lesion on magnetic resonance imaging ⩾5 mm in the absence of end-organ damage...
February 2017: Therapeutic Advances in Hematology
https://www.readbyqxmd.com/read/28190577/dilated-cardiomyopathy
#2
REVIEW
Robert G Weintraub, Christopher Semsarian, Peter Macdonald
Dilated cardiomyopathy is defined by the presence of left ventricular dilatation and contractile dysfunction. Genetic mutations involving genes that encode cytoskeletal, sarcomere, and nuclear envelope proteins, among others, account for up to 35% of cases. Acquired causes include myocarditis and exposure to alcohol, drugs and toxins, and metabolic and endocrine disturbances. The most common presenting symptoms relate to congestive heart failure, but can also include circulatory collapse, arrhythmias, and thromboembolic events...
February 9, 2017: Lancet
https://www.readbyqxmd.com/read/28209335/impact-of-fluid-status-and-inflammation-and-their-interaction-on-survival-a-study-in-an-international-hemodialysis-patient-cohort
#3
Marijke J E Dekker, Daniele Marcelli, Bernard J Canaud, Paola Carioni, Yuedong Wang, Aileen Grassmann, Constantijn J A M Konings, Peter Kotanko, Karel M Leunissen, Nathan W Levin, Frank M van der Sande, Xiaoling Ye, Vaibhav Maheshwari, Len A Usvyat, Jeroen P Kooman
In hemodialysis patients extracellular fluid overload is a predictor of all-cause and cardiovascular mortality, and a relation with inflammation has been reported in previous studies. The magnitude and nature of this interaction and the effects of moderate fluid overload and extracellular fluid depletion on survival are still unclear. We present the results of an international cohort study in 8883 hemodialysis patients from the European MONDO initiative database where, during a three-month baseline period, fluid status was assessed using bioimpedance and inflammation by C-reactive protein...
February 13, 2017: Kidney International
https://www.readbyqxmd.com/read/28184480/dosing-guidance-for-intravenous-colistin-in-critically-ill-patients
#4
Roger L Nation, Samira M Garonzik, Visanu Thamlikitkul, Evangelos J Giamarellos-Bourboulis, Alan Forrest, David L Paterson, Jian Li, Fernanda P Silveira
No abstract text is available yet for this article.
December 23, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28188970/refractory-anemia-with-ring-sideroblasts-rars-and-rars-with-thrombocytosis-rars-t-2017-update-on-diagnosis-risk-stratification-and-management
#5
Mrinal M Patnaik, Ayalew Tefferi
DISEASE OVERVIEW: Ring sideroblasts (RS) are erythroid precursors with abnormal perinuclear mitochondrial iron accumulation. Two myeloid neoplasms defined by the presence of RS, include refractory anemia with ring sideroblasts (RARS), now classified under myelodysplastic syndromes with RS (MDS-RS) and RARS with thrombocytosis (RARS-T); now called myelodysplastic/myeloproliferative neoplasm with RS and thrombocytosis (MDS/MPN-RS-T). DIAGNOSIS: MDS-RS is a lower risk MDS, with single or multilineage dysplasia (SLD/MLD), <5% bone marrow (BM) blasts and ≥15% BM RS (≥5% in the presence of SF3B1 mutations)...
March 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28158982/study-protocol-thyroid-hormone-replacement-for-untreated-older-adults-with-subclinical-hypothyroidism-a-randomised-placebo-controlled-trial-trust
#6
David J Stott, Jacobijn Gussekloo, Patricia M Kearney, Nicolas Rodondi, Rudi G J Westendorp, Simon Mooijaart, Sharon Kean, Terence J Quinn, Naveed Sattar, Kirsty Hendry, Robert Du Puy, Wendy P J Den Elzen, Rosalinde K E Poortvliet, Jan W A Smit, J Wouter Jukema, Olaf M Dekkers, Manuel Blum, Tinh-Hai Collet, Vera McCarthy, Caroline Hurley, Stephen Byrne, John Browne, Torquil Watt, Douglas Bauer, Ian Ford
BACKGROUND: Subclinical hypothyroidism (SCH) is a common condition in elderly people, defined as elevated serum thyroid-stimulating hormone (TSH) with normal circulating free thyroxine (fT4). Evidence is lacking about the effect of thyroid hormone treatment. We describe the protocol of a large randomised controlled trial (RCT) of Levothyroxine treatment for SCH. METHODS: Participants are community-dwelling subjects aged ≥65 years with SCH, diagnosed by elevated TSH levels (≥4...
February 3, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/28098108/the-relationship-between-mean-platelet-volume-and-neutrophil-lymphocyte-ratio-with-inflammation-and-proteinuria-in-chronic-kidney-disease
#7
Gulay Yilmaz, Can Sevinc, Sedat Ustundag, Yasemin Coskun Yavuz, Tuba Hacıbekiroglu, Esra Hatipoglu, Mehmet Baysal
Atherosclerosis, which develops as a result of inflammation, is the most important cause of morbidity and mortality in chronic kidney disease (CKD). In this study, we investigated the relationship of mean platelet volume (MPV) and neutrophil/lymphocyte ratio (NLR) with inflammation and proteinuria in patients with CKD Stage 3-4. Healthy individuals who applied to nephrology clinic for checkup purposes acted as controls. Fifty-three patients and 30 healthy controls were included in the study. Patients with diabetes mellitus, active infection, malignancy, and coronary artery disease were excluded from the study...
January 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27997741/advances-in-pleuroscopy
#8
REVIEW
Stavros Anevlavis, Marios E Froudarakis
OBJECTIVES: To describe the technique of pleuroscopy, its clinical uses such as diagnosis of exudative pleural effusion, treatment of pleural infection, treatment of pneumothorax and diagnosis and pleurodesis of malignant pleural mesothelioma. Also to describe the newer techniques developed such as minothoracoscopy, semirigid thoracoscopy, narrow band imaging pleuroscopy, infrared pleuroscopy, autofluorescence pleuroscopy. DATA SOURCE: We searched the pubmed the last decade for publications with the key words pleuroscopy, medical thoracoscopy, pneumothorax and pleuroscopy, malignant pleural mesothelioma, minothoracoscopy, semirigid thoracoscopy, autofluorescence pleuroscopy...
December 20, 2016: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28105697/association-of-hematocrit-with-blood-pressure-and-hypertension
#9
Marzieh Emamian, Seyed Mahdi Hasanian, Maryam Tayefi, Moniba Bijari, Faeze Movahedian Far, Mojtaba Shafiee, Amir Avan, Alireza Heidari-Bakavoli, Mohsen Moohebati, Mahmoud Ebrahimi, Sousan Darroudi, Parvin Zamani, Mahmoud Reza Azarpazhooh, Mohsen Nematy, Mohammad Safarian, Gordon A Ferns, Habibollah Esmaeili, Mohammad Reza Parizadeh, Majid Ghayour-Mobarhan
BACKGROUND: Hypertension (HTN) is a risk factor for stroke, renal failure, and cardiovascular disease. The association between biochemical and hematological parameters with high blood pressure may provide a more precise approach to risk prediction conferred by HTN in these patients. OBJECTIVE: The aim of current study was to explore whether biochemical and hematological parameters are associated with HTN in a cohort study with a 7-year follow-up. MATERIALS AND METHODS: A total of 9808 individuals were enrolled and recruited as part of the Mashhad Stroke and Heart Atherosclerotic Disorders (MASHAD) cohort study, and biochemical and hematological factors were measured in all subjects...
January 20, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28174217/diagnosis-and-treatment-of-hyponatremia-compilation-of-the-guidelines
#10
Ewout J Hoorn, Robert Zietse
Hyponatremia is a common water balance disorder that often poses a diagnostic or therapeutic challenge. Therefore, guidelines were developed by professional organizations, one from within the United States (2013) and one from within Europe (2014). This review discusses the diagnosis and treatment of hyponatremia, comparing the two guidelines and highlighting recent developments. Diagnostically, the initial step is to differentiate hypotonic from nonhypotonic hyponatremia. Hypotonic hyponatremia is further differentiated on the basis of urine osmolality, urine sodium level, and volume status...
February 7, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/26863353/caplacizumab-for-acquired-thrombotic-thrombocytopenic-purpura
#11
RANDOMIZED CONTROLLED TRIAL
Flora Peyvandi, Marie Scully, Johanna A Kremer Hovinga, Spero Cataland, Paul Knöbl, Haifeng Wu, Andrea Artoni, John-Paul Westwood, Magnus Mansouri Taleghani, Bernd Jilma, Filip Callewaert, Hans Ulrichts, Christian Duby, Dominique Tersago
BACKGROUND: Acquired thrombotic thrombocytopenic purpura (TTP) is caused by aggregation of platelets on ultralarge von Willebrand factor multimers. This microvascular thrombosis causes multiorgan ischemia with potentially life-threatening complications. Daily plasma exchange and immunosuppressive therapies induce remission, but mortality and morbidity due to microthrombosis remain high. METHODS: Caplacizumab, an anti-von Willebrand factor humanized single-variable-domain immunoglobulin (Nanobody), inhibits the interaction between ultralarge von Willebrand factor multimers and platelets...
February 11, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/28178879/prognostic-significance-of-renal-vascular-pathology-in-lupus-nephritis
#12
J M Mejía-Vilet, B M Córdova-Sánchez, N O Uribe-Uribe, R Correa-Rotter, L E Morales-Buenrostro
We performed a retrospective cohort analysis to define the prognostic significance of vascular lesions documented in renal biopsies of lupus nephritis patients. A total of 429 patients were segregated into five groups: (1) no vascular lesions (NVL), (2) arterial sclerosis (AS), (3) non-inflammatory necrotizing vasculitis (NNV), (4) thrombotic microangiopathy (TMA), and (5) true renal vasculitis (TRV). Renal outcomes were analyzed by Cox regression models, and correlations between vascular lesions and activity/chronicity scores were determined by Spearman's coefficients...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28153111/mode-of-death-in-heart-failure-with-preserved-ejection-fraction
#13
REVIEW
Muthiah Vaduganathan, Ravi B Patel, Alexander Michel, Sanjiv J Shah, Michele Senni, Mihai Gheorghiade, Javed Butler
Little is known about specific modes of death in patients with heart failure with preserved ejection fraction (HFpEF). Herein, the authors critically appraise the current state of data and offer potential future directions. They conducted a systematic review of 1,608 published HFpEF papers from January 1, 1985, to December 31, 2015, which yielded 8 randomized clinical trials and 24 epidemiological studies with mode-of-death data. Noncardiovascular modes of death represent an important competing risk in HFpEF...
February 7, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28187292/snapshot-circulating-tumor-cells
#14
Caroline Dive, Ged Brady
Circulating tumor cells in the blood of patients are both signal flares for the existence of a tumor and harbingers of metastasis. With recent technological developments, these cells can be isolated and analyzed to provide insights into the biology of cancer spread and response to therapy and to offer new avenues for blood biomarker development.
February 9, 2017: Cell
https://www.readbyqxmd.com/read/28182327/microangiopathic-hemolytic-anemia-due-to-adamts-13-loss-in-idiopathic-systemic-capillary-leak-syndrome-reply
#15
Daniel C Moreira, Jorge Di Paola
We sincerely appreciate Dr Thachil's letter, which provides further insight into the case we recently published, in which ADAMTS-13 was likely lost in third-space fluid in a patient with idiopathic systemic capillary leak syndrome (SCLS) and that this loss was proposed as a novel mechanism for microangiopathic hemolytic anemia (MAHA) [1]. As mentioned in the original publication, identifying high levels of ADAMTS-13 in the transudate fluid would have proven the proposed mechanism, but unfortunately a sample of the transudate fluid was not available...
February 9, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28146266/how-i-manage-patients-with-hairy-cell-leukaemia
#16
REVIEW
Philip A Thompson, Farhad Ravandi
Patients with hairy cell leukaemia (HCL) have highly favourable outcomes after purine analogue therapy. However, most patients subsequently relapse and require re-treatment. A minority of patients develop purine analogue-refractory disease. Targeted therapies have improved outcomes for such patients. Recently, the BRAF V600E mutation was identified in most patients with classical HCL, resulting in constitutive mitogen-activated protein kinase pathway activation; impressive responses are achieved in heavily pre-treated patients with BRAF inhibition...
February 1, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28122469/dexmedetomidine-for-refractory-intracranial-hypertension
#17
Kendra J Schomer, Christian M Sebat, Jason Y Adams, Jeremiah J Duby, Kiarash Shahlaie, Erin L Louie
Dexmedetomidine (DEX) is a selective α2 adrenergic agonist that is commonly used for sedation in the intensive care unit (ICU). The role of DEX for adjunctive treatment of refractory intracranial hypertension is poorly defined. The primary objective of this study was to determine the effect of DEX on the need for rescue therapy (ie, hyperosmolar boluses, extraventricular drain [EVD] drainages) for refractory intracranial hypertension. Secondary objectives included the number of intracranial pressure (ICP) excursions, bradycardic, hypotensive, and compromised cerebral perfusion pressure episodes...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28159829/iga-nephropathy
#18
Jennifer C Rodrigues, Mark Haas, Heather N Reich
IgA nephropathy (IgAN) is a leading cause of CKD and renal failure. Recent international collaborative efforts have led to important discoveries that have improved our understanding of some of the key steps involved in the immunopathogenesis of IgAN. Furthermore, establishment of multicenter networks has contributed to rigorous design and execution of clinical trials that have provided important insights regarding immunotherapy in IgAN. In this article, we review emerging developments in clinical and translational IgAN research and describe how these novel findings will influence future strategies to improve the outcome of patients with IgAN...
February 3, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28157822/intracranial-pressure-management-in-patients-with-traumatic-brain-injury-an-update
#19
Nino Stocchetti, Tommaso Zoerle, Marco Carbonara
PURPOSE OF REVIEW: Intracranial pressure (ICP) monitoring and treatment is central in the management of traumatic brain injury. Despite 4 decades of clinical use, several aspects remain controversial, including the indications for ICP and treatment options. RECENT FINDINGS: Two major trials tested surgical decompression and mild hypothermia as treatments for high ICP. Both were rigorous, randomized, multicenter studies, with different designs. Decompression was tested for ICP refractory to conventional treatment, whereas hypothermia was offered as an alternative to conventional medical therapy...
February 2, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28169053/management-of-cancer-associated-venous-thromboembolism-in-the-emergency-department
#20
REVIEW
Rahul V Nene, Christopher J Coyne
Patients with cancer are at increased risk of venous thromboembolism, and emergency physicians can play a significant role in addressing one of the leading causes of morbidity and mortality in this patient population. However, there are no comprehensive guidelines addressing the approach to cancer-associated venous thromboembolism in the emergency department. Here, we review the guidelines put forth by various national and international cancer societies and highlight how emergency physicians can help institute appropriate treatment and prevent the recurrence of venous thromboembolism in cancer patients...
February 3, 2017: Annals of Emergency Medicine
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