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By Marcela Catalina Fandino Vargas Residente de 3 año de Medicina Interna. Próxima oncogirl
https://www.readbyqxmd.com/read/28413064/systemic-sclerosis
#1
REVIEW
Christopher P Denton, Dinesh Khanna
Systemic sclerosis, also called scleroderma, is an immune-mediated rheumatic disease that is characterised by fibrosis of the skin and internal organs and vasculopathy. Although systemic sclerosis is uncommon, it has a high morbidity and mortality. Improved understanding of systemic sclerosis has allowed better management of the disease, including improved classification and more systematic assessment and follow-up. Additionally, treatments for specific complications have emerged and a growing evidence base supports the use of immune suppression for the treatment of skin and lung fibrosis...
October 7, 2017: Lancet
https://www.readbyqxmd.com/read/28989565/risk-of-liver-disease-in-methotrexate-treated-patients
#2
REVIEW
Richard Conway, John J Carey
Methotrexate is the first line drug treatment for a number of rheumatic and non-rheumatic diseases. It is effective in controlling disease activity and preventing disease-related damage, and significantly cheaper than many alternatives. Use in rheumatoid arthritis infers a significant morbidity and mortality benefit. Methotrexate is generally well tolerated but can cause symptomatic adverse events. Multiple serious adverse events have been attributed to methotrexate, based largely on older reports using high or daily doses, and subsequent case reports and circumstantial evidence...
September 18, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/29283791/durable-complete-response-after-discontinuation-of-pembrolizumab-in-patients-with-metastatic-melanoma
#3
Caroline Robert, Antoni Ribas, Omid Hamid, Adil Daud, Jedd D Wolchok, Anthony M Joshua, Wen-Jen Hwu, Jeffrey S Weber, Tara C Gangadhar, Richard W Joseph, Roxana Dronca, Amita Patnaik, Hassane Zarour, Richard Kefford, Peter Hersey, Jin Zhang, James Anderson, Scott J Diede, Scot Ebbinghaus, F Stephen Hodi
Purpose Pembrolizumab provides durable antitumor activity in metastatic melanoma, including complete response (CR) in about 15% of patients. Data are limited on potential predictors of CR and patient disposition after pembrolizumab discontinuation after CR. We describe baseline characteristics and long-term follow-up in patients who experienced CR with pembrolizumab in the KEYNOTE-001 study ( ClinicalTrials.gov identifier: NCT01295827). Patients and Methods Patients with ipilimumab-naive or -treated advanced/metastatic melanoma received one of three dose regimens of pembrolizumab...
December 28, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29275334/effect-of-rituximab-on-a-salivary-gland-ultrasound-score-in-primary-sj%C3%A3-gren-s-syndrome-results-of-the-tractiss-randomised-double-blind-multicentre-substudy
#4
Benjamin A Fisher, Colin C Everett, John Rout, John L O'Dwyer, Paul Emery, Costantino Pitzalis, Wan-Fai Ng, Andrew Carr, Colin T Pease, Elizabeth J Price, Nurhan Sutcliffe, Jimmy Makdissi, Anwar R Tappuni, Nagui S T Gendi, Frances C Hall, Sharon P Ruddock, Catherine Fernandez, Claire T Hulme, Kevin A Davies, Christopher John Edwards, Peter C Lanyon, Robert J Moots, Euthalia Roussou, Andrea Richards, Linda D Sharples, Michele Bombardieri, Simon J Bowman
OBJECTIVES: To compare the effects of rituximab versus placebo on salivary gland ultrasound (SGUS) in primary Sjögren's syndrome (PSS) in a multicentre, multiobserver phase III trial substudy. METHODS: Subjects consenting to SGUS were randomised to rituximab or placebo given at weeks 0, 2, 24 and 26, and scanned at baseline and weeks 16 and 48. Sonographers completed a 0-11 total ultrasound score (TUS) comprising domains of echogenicity, homogeneity, glandular definition, glands involved and hypoechoic foci size...
December 23, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/29279102/a-question-of-class-treatment-options-for-patients-with-relapsed-and-or-refractory-multiple-myeloma
#5
REVIEW
Gordon Cook, Sonja Zweegman, María-Victoria Mateos, Florence Suzan, Philippe Moreau
Multiple classes of agent with distinct mechanisms of action are now available for the treatment of patients with relapsed and/or refractory multiple myeloma (RRMM), including immunomodulatory agents, proteasome inhibitors, histone deacetylase inhibitors and monoclonal antibodies. Additionally, several different drugs may be available within each agent class, each with their own specific efficacy and safety profile. This expansion of the treatment landscape has dramatically improved outcomes for patients. However, as the treatment options for RRMM become more complex, choosing the class of agent or combination of agents to use in the relapsed setting becomes increasingly challenging...
January 2018: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/29255070/how-i-treat-disseminated-intravascular-coagulation
#6
Marcel Levi, Marie Scully
Disseminated intravascular coagulation (DIC) is a condition characterised by systemic activation of coagulation, potentially leading to thrombotic obstruction of small and midsize vessels, thereby contributing to organ dysfunction. At the same time, ongoing consumption of platelets and coagulation proteins results in thrombocytopenia and low concentrations of clotting factors, which may cause profuse hemorrhagic complications. DIC is always secondary to an underlying condition, such as severe infections, solid or hematologic malignancies, trauma, or obstetric calamities...
December 18, 2017: Blood
https://www.readbyqxmd.com/read/29260231/tuberculosis-update-2017
#7
M J Friedrich
No abstract text is available yet for this article.
December 19, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29182495/platelet-transfusion-for-patients-with-cancer-american-society-of-clinical-oncology-clinical-practice-guideline-update
#8
Charles A Schiffer, Kari Bohlke, Meghan Delaney, Heather Hume, Anthony J Magdalinski, Jeffrey J McCullough, James L Omel, John M Rainey, Paolo Rebulla, Scott D Rowley, Michael B Troner, Kenneth C Anderson
Purpose To provide evidence-based guidance on the use of platelet transfusion in people with cancer. This guideline updates and replaces the previous ASCO platelet transfusion guideline published initially in 2001. Methods ASCO convened an Expert Panel and conducted a systematic review of the medical literature published from September 1, 2014, through October 26, 2016. This review builds on two 2015 systematic reviews that were conducted by the AABB and the International Collaboration for Transfusion Medicine Guidelines...
November 28, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29224678/atherosclerosis-in-systemic-lupus-erythematosus
#9
REVIEW
Sara Croca, Anisur Rahman
Cardiovascular disease (CVD), comprising coronary heart disease and stroke, is one of the most important causes of death in patients with systemic lupus erythematosus (SLE). The risks of developing both clinical CVD and sub-clinical atherosclerosis are increased in patients with SLE. This increase is not fully explained by traditional cardiovascular risk factors such as smoking, hypertension and elevated cholesterol, and it is believed that immune dysfunction also contributes to CVD risk in SLE. In particular, recent studies have shown that abnormalities in both serum lipid profile and the autoantibody and T lymphocyte response to lipids may play a role in development of atherosclerosis...
June 2017: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/28743899/thrombopoiesis-is-spatially-regulated-by-the-bone-marrow-vasculature
#10
David Stegner, Judith M M vanEeuwijk, Oğuzhan Angay, Maximilian G Gorelashvili, Daniela Semeniak, Jürgen Pinnecker, Patrick Schmithausen, Imke Meyer, Mike Friedrich, Sebastian Dütting, Christian Brede, Andreas Beilhack, Harald Schulze, Bernhard Nieswandt, Katrin G Heinze
In mammals, megakaryocytes (MKs) in the bone marrow (BM) produce blood platelets, required for hemostasis and thrombosis. MKs originate from hematopoietic stem cells and are thought to migrate from an endosteal niche towards the vascular sinusoids during their maturation. Through imaging of MKs in the intact BM, here we show that MKs can be found within the entire BM, without a bias towards bone-distant regions. By combining in vivo two-photon microscopy and in situ light-sheet fluorescence microscopy with computational simulations, we reveal surprisingly slow MK migration, limited intervascular space, and a vessel-biased MK pool...
July 25, 2017: Nature Communications
https://www.readbyqxmd.com/read/29253554/heparin-induced-thrombocytopenia-in-the-critically-ill-patient
#11
REVIEW
James M East, Christine Cserti- Gazdewich, John T Granton
Heparin induced thrombocytopenia (HIT) is associated with significant morbidity and mortality. Critically ill patients are commonly thrombocytopenic and exposed to heparin. Although HIT should be considered, it is not usually the cause of thrombocytopenia in the medical-surgical ICU population. A systematic approach to the critically ill patient with thrombocytopenia using clinical features, complemented by appropriate laboratory confirmation should lead to a reduction in inappropriate laboratory testing and reduce the use of more expensive and less reliable anticoagulants...
December 15, 2017: Chest
https://www.readbyqxmd.com/read/28602048/injected-corticosteroids-for-treating-plantar-heel-pain-in-adults
#12
REVIEW
Judy A David, Venkatesan Sankarapandian, Prince Rh Christopher, Ahana Chatterjee, Ashish S Macaden
BACKGROUND: Plantar heel pain, commonly resulting from plantar fasciitis, often results in significant morbidity. Treatment options include nonsteroidal anti-inflammatory drugs (NSAIDs), orthoses, physical therapy, physical agents (e.g. extracorporeal shock wave therapy (ESWT), laser) and invasive procedures including steroid injections. OBJECTIVES: To assess the effects (benefits and harms) of injected corticosteroids for treating plantar heel pain in adults. SEARCH METHODS: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials (the Cochrane Library), MEDLINE, Embase, CINAHL, clinical trials registries and conference proceedings...
June 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29275977/diagnosis-of-multiple-sclerosis-2017-revisions-of-the-mcdonald-criteria
#13
REVIEW
Alan J Thompson, Brenda L Banwell, Frederik Barkhof, William M Carroll, Timothy Coetzee, Giancarlo Comi, Jorge Correale, Franz Fazekas, Massimo Filippi, Mark S Freedman, Kazuo Fujihara, Steven L Galetta, Hans Peter Hartung, Ludwig Kappos, Fred D Lublin, Ruth Ann Marrie, Aaron E Miller, David H Miller, Xavier Montalban, Ellen M Mowry, Per Soelberg Sorensen, Mar Tintoré, Anthony L Traboulsee, Maria Trojano, Bernard M J Uitdehaag, Sandra Vukusic, Emmanuelle Waubant, Brian G Weinshenker, Stephen C Reingold, Jeffrey A Cohen
The 2010 McDonald criteria for the diagnosis of multiple sclerosis are widely used in research and clinical practice. Scientific advances in the past 7 years suggest that they might no longer provide the most up-to-date guidance for clinicians and researchers. The International Panel on Diagnosis of Multiple Sclerosis reviewed the 2010 McDonald criteria and recommended revisions. The 2017 McDonald criteria continue to apply primarily to patients experiencing a typical clinically isolated syndrome, define what is needed to fulfil dissemination in time and space of lesions in the CNS, and stress the need for no better explanation for the presentation...
December 21, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/29214060/interstitial-lung-disease-the-diagnostic-role-of-bronchoscopy
#14
REVIEW
Jad Kebbe, Tony Abdo
Interstitial lung diseases (ILDs) form one of the most fascinating fields in pulmonary medicine. They also pose one of the greatest challenges for accurate diagnosis and proper treatment. Even within the recommended and warranted multidisciplinary approach, differentiating between one disease and another may lead to frustration, especially when proper lung tissue is not available for adequate pathological review. A surgical lung biopsy (SLB) might render enough tissue for histopathology, but this could come at the expense of high morbidity and even mortality, as in the case of usual interstitial pneumonia (UIP)...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29272515/update-on-colchicine-2017
#15
Anastasia Slobodnick, Binita Shah, Svetlana Krasnokutsky, Michael H Pillinger
Colchicine is an ancient medication that is currently approved for the treatment of gout and FMF. However, colchicine has a wide range of anti-inflammatory activities, and studies indicate that it may be beneficial in a variety of other conditions. This paper reviews the evidence for the well-established use of colchicine in gout, as well as several other rheumatic diseases. In addition, we highlight the potential benefit of colchicine in cardiac disease, including coronary artery disease in patients both with and without gout...
January 1, 2018: Rheumatology
https://www.readbyqxmd.com/read/29254821/is-adenosine-or-an-intravenous-calcium-channel-blocker-more-effective-for-treating-supraventricular-tachycardia
#16
EDITORIAL
Michael Gottlieb, Katarzyna Gore, Stephen R Gore
No abstract text is available yet for this article.
December 15, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29250494/diagnosis-and-treatment-of-inflammatory-joint-disease
#17
REVIEW
Yeesuk Kim, Hyun-Cheol Oh, Jang Won Park, In-Sung Kim, Jun-Young Kim, Ki-Choul Kim, Dong-Sik Chae, Woo-Lam Jo, Joo-Hyoun Song
Arthritis damages the cartilage within joints, resulting in degenerative changes, including loss of function and joint instability. Ankylosing spondylitis (AS) is a chronic inflammatory condition affecting the spine and bone-to-tendon attachment area within the sacroiliac joint leading to back pain and progressive spinal stiffness. In the final stages, AS causes hyperkyphosis-a condition closely tied to the human leukocyte antigen-B27 gene. Rheumatoid arthritis is a chronic, systemic autoimmune disease characterized by the simultaneous inflammation of the synovium of multiple joints, leading to joint damage (e...
December 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/29029294/cardiovascular-events-in-anti-neutrophil-cytoplasmic-antibody-associated-vasculitis-a-meta-analysis-of-observational-studies
#18
Eline Houben, Erik L Penne, Alexandre E Voskuyl, Joost W van der Heijden, René H J Otten, Maarten Boers, Tiny Hoekstra
Objectives: Several chronic inflammatory diseases are associated with cardiovascular disease, but the risk in ANCA-associated vasculitis is poorly quantified. The aim of the present study was to review the evidence for an increased cardiovascular risk, including ischaemic heart disease, cerebrovascular accidents and peripheral arterial disease, in patients with ANCA-associated vasculitis. Methods: A comprehensive systematic review was conducted in accordance with guidelines of preferred reporting items for systematic reviews and meta-analyses...
September 18, 2017: Rheumatology
https://www.readbyqxmd.com/read/29046115/bone-and-the-immune-system
#19
M Neale Weitzmann
Osteoporosis increases fracture risk, a cause of crippling morbidity and mortality. The immunoskeletal interface (ISI) is a centralization of cell and cytokine effectors shared between skeletal and immune systems. Consequently, the immune system mediates powerful effects on bone turnover. Physiologically, B cells secrete osteoprotegerin (OPG), a potent anti-osteoclastogenic factor that preserves bone mass. However, activated T cells and B cells secrete pro-osteoclastogenic factors including receptor activator of Nuclear factor-kappaB (NF-kB) ligand (RANKL), Interleukin (IL)-17A, and tumor necrosis factor (TNF)-α promoting bone loss in inflammatory states such as rheumatoid arthritis...
October 2017: Toxicologic Pathology
https://www.readbyqxmd.com/read/29273246/asthma
#20
REVIEW
Alberto Papi, Christopher Brightling, Søren E Pedersen, Helen K Reddel
Asthma-one of the most common chronic, non-communicable diseases in children and adults-is characterised by variable respiratory symptoms and variable airflow limitation. Asthma is a consequence of complex gene-environment interactions, with heterogeneity in clinical presentation and the type and intensity of airway inflammation and remodelling. The goal of asthma treatment is to achieve good asthma control-ie, to minimise symptom burden and risk of exacerbations. Anti-inflammatory and bronchodilator treatments are the mainstay of asthma therapy and are used in a stepwise approach...
December 19, 2017: Lancet
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