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Early Initiation

Stéphane Gaudry, Jean-Pierre Quenot, Alexandre Hertig, Saber Davide Barbar, David Hajage, Jean-Damien Ricard, Didier Dreyfuss
Acute kidney injury (AKI) affects many intensive care unit patients and is responsible for increased morbidity and mortality. Although life-saving in many situations, renal replacement therapy (RRT) may be associated with complications and the appropriate timing of its initiation is still the subject of intense debate. An early initiation strategy can prevent some metabolic complications whereas a delayed one may allow for renal function recovery in some patients without need for this costly and potentially dangerous technique...
February 20, 2019: American Journal of Respiratory and Critical Care Medicine
Lenka Radonova, Tereza Svobodova, Martin Anger
Early embryonic development is characterized by a plethora of very complex and simultaneously operating processes, which are constantly changing cellular morphology and behaviour. After fertilization, blastomeres of the newly created embryo undergo global epigenetic changes and simultaneously initiate transcription from the zygotic genome and differentiation forming separate cell lineages. Some of these mechanisms were extensively studied during the last several decades and valuable insight was gained into how these processes are regulated at the molecular level...
February 6, 2019: International Journal of Developmental Biology
Abdelbasset Brahim, Rachid Jennane, Rabia Riad, Thomas Janvier, Laila Khedher, Hechmi Toumi, Eric Lespessailles
This paper presents a fully developed computer aided diagnosis (CAD) system for early knee OsteoArthritis (OA) detection using knee X-ray imaging and machine learning algorithms. The X-ray images are first preprocessed in the Fourier domain using a circular Fourier filter. Then, a novel normalization method based on predictive modeling using multivariate linear regression (MLR) is applied to the data in order to reduce the variability between OA and healthy subjects. At the feature selection/extraction stage, an independent component analysis (ICA) approach is used in order to reduce the dimensionality...
January 29, 2019: Computerized Medical Imaging and Graphics: the Official Journal of the Computerized Medical Imaging Society
Jocelyn F Hafer, Jane A Kent, Katherine A Boyer
BACKGROUND: Knee osteoarthritis (OA) is a highly prevalent disease leading to mobility disability in the aged that could, in part, be initiated by age-related alterations in knee mechanics. However, if and how knee mechanics change with age remains unclear. RESEARCH QUESTION: What are the impacts of age and physical activity (PA) on biomechanical characteristics that can affect the loading environment in the knee during gait? METHODS: Three groups (n = 20 each, 10 male and 10 female) of healthy adults were recruited: young (Y, 21-35 years), mid-life highly active (MHi, 55-70 years, runners), and mid-life less active (MLo, 55-70 years, low PA)...
February 13, 2019: Gait & Posture
Fanchao Feng, Zhichao Wang, Ruofei Li, Qi Wu, Cheng Gu, Yong Xu, Wenpan Peng, Di Han, Xianmei Zhou, Jing Wu, Hailang He
Idiopathic pulmonary fibrosis (IPF) is a progressive and ultimately fatal lung disease with a poor prognosis and limited treatment options. The incidence of IPF increases with age, and the mechanisms related to aging such as cellular senescence have been strongly implicated in disease pathology. Therefore, a better understanding of fibroblasts senescence might provide a new therapeutic strategy to prevent and treat pulmonary fibrosis. In this study, we aimed to explore the effects of citrus alkaline extracts (CAE) on the fibroblasts senescence, and elucidate the underlying mechanism to ameliorate pulmonary fibrosis...
February 19, 2019: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Ryun Ha, Byeoung Woo Lim, Dong Hyun Kim, Jung Woo Park, Chang Hyun Cho, Ju Hyoung Lee
BACKGROUND AND OBJECTIVES: No consensus has been reached regarding the optimum treatment or factors affecting prognosis in pediatric idiopathic sudden sensorineural hearing loss (ISSNHL) due to its rarity. In the present study, treatment outcomes and prognostic factors of ISSNHL were investigated in pediatric patients who underwent steroid therapy. SUBJECTS: and Methods: Forty-two patients diagnosed with ISSNHL were enrolled in this retrospective study and compared with 39 normal healthy controls with respect to demography and complete blood cell count test results...
February 11, 2019: International Journal of Pediatric Otorhinolaryngology
Shira Maguen, Yongmei Li, Erin Madden, Karen H Seal, Thomas C Neylan, Olga V Patterson, Scott L DuVall, Callan Lujan, Brian Shiner
Little is known about predictors of initiation and completion of evidence-based psychotherapy (EBP) for posttraumatic stress disorder (PTSD), with most data coming from small cohort studies and post-hoc analyses of clinical trials. We examined patient and treatment factors associated with initiation and completion of EBP for PTSD in a large longitudinal cohort. We conducted a national, retrospective cohort study of all Iraq and Afghanistan War veterans who had a post-deployment PTSD diagnosis from 10/01-9/15 at a Veterans Health Administration facility and had at least one coded post-deployment psychotherapy visit...
February 11, 2019: Psychiatry Research
Carlos Galán-Arriola, Manuel Lobo, Jean Paul Vílchez-Tschischke, Gonzalo J López, Antonio de Molina-Iracheta, Claudia Pérez-Martínez, Jaume Agüero, Rodrigo Fernández-Jiménez, Ana Martín-García, Eduardo Oliver, Rocío Villena-Gutierrez, Gonzalo Pizarro, Pedro L Sánchez, Valentin Fuster, Javier Sánchez-González, Borja Ibanez
BACKGROUND: Anthracycline-induced cardiotoxicity is a major clinical problem, and early cardiotoxicity markers are needed. OBJECTIVES: The purpose of this study was to identify early doxorubicin-induced cardiotoxicity by serial multiparametric cardiac magnetic resonance (CMR) and its pathological correlates in a large animal model. METHODS: Twenty pigs were included. Of these, 5 received 5 biweekly intracoronary doxorubicin doses (0.45 mg/kg/injection) and were followed until sacrifice at 16 weeks...
February 26, 2019: Journal of the American College of Cardiology
M Fakhimi Bonab, A Mojra, M Shirazi
The most desired target of orthodontic treatment is tooth movement as a result of application of efficient force system. In this study, effect of tooth loading is studied on temperature profile around the tooth at early stages of treatment. The basis of temperature variation is increase of cell number and activities in periodontium as a result of compression and tension of this layer. Highest cellular activities occur in the beginning of loading procedure and aim to reduce mechanical stress in the periodontium which finally ends up with orthodontic tooth movement during couple of years...
February 2019: Journal of Thermal Biology
Catherine E Mercado, William F Hartsell, Charles B Simone, Henry K Tsai, Carlos E Vargas, He J Zhu, Randal H Henderson, Jing Zeng, Gary L Larson, Bradford S Hoppe
OBJECTIVE: Thymic malignancies (TM) are rare tumors with long-term survivorship, causing concerns for radiotherapy-related late side effects. Proton therapy (PT) reduces the radiation dose to organs at risk, potentially decreasing long-term toxicities while preserving disease control. We report patterns-of-care and early clinical outcomes after PT for thymoma and thymic carcinoma. METHODS: Between January 2008 and March 2017, 30 patients with TMs enrolled on one of two IRB-approved prospective protocols and received postoperative or definitive PT...
February 20, 2019: Acta Oncologica
Alon Abraham, Beatrice Nefussy, Yaara Fainmesser, Yoram Ebrahimi, Arnon Karni, Vivian E Drory
INTRODUCTION: Treatment with edaravone has shown efficacy in a subgroup of patients with amyotrophic lateral sclerosis (ALS). However, it has been estimated that <7% of ALS patients fulfill the stringent inclusion criteria of the trial. In the current study, we aimed to explore retrospectively the efficacy of edaravone in unselected ALS patients. METHODS: Demographic and clinical data were retrospectively collected for 22 patients who opted for treatment with edaravone and 71 untreated ALS patients attending the ALS clinic at Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, between May 2017 and January 2018...
February 20, 2019: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
Alexander E St John, Jason C Newton, Erika J Martin, Bassem M Mohammed, Daniel Contaifer, Jessica L Saunders, Gretchen M Brophy, Bruce D Spiess, Kevin R Ward, Donald F Brophy, José A López, Nathan J White
BACKGROUND: Trauma-induced coagulopathy (TIC) is a common and deadly bleeding disorder. Platelet dysfunction is present during TIC, but its mechanisms remain unclear. Platelets are currently thought to become "exhausted", a state in which they have released their granule contents and can no longer aggregate or contract. METHODS: This prospective observational cohort study tested the hypothesis that platelet exhaustion is present during TIC and characterized the early time course of platelet dysfunction...
February 19, 2019: Journal of Thrombosis and Haemostasis: JTH
F V Estévez, Mª D L Alarcón, V Mayoral, M de Madariaga, C Margarit, J A Duran, J M T Martín-Arroyo, A Carregal
PURPOSE: Current evidence suggests the need to improve the management of breakthrough cancer pain (BTcP). For this reason, we aimed to assess the opinion of a panel of experts composed exclusively of physicians from pain units, who play a major role in BTcP diagnosis and treatment, regarding the key aspects of BTcP management. METHODS: An ad hoc questionnaire was developed to collect real-world data on the management of BTcP. The questionnaire had 5 parts: (a) organizational aspects of pain units (n = 12), (b) definition and diagnosis (n = 3), (c) screening (n = 3), (d) treatment (n = 8), and (e) follow-up (n = 7)...
February 19, 2019: Clinical & Translational Oncology
Catherine McDermott, Kaitlyn Shank, Caleb Shervinskie, Jed D Gonzalo
As health systems are adapting to increased accountability for quality outcomes, population health, and collaborative care, medical schools are adapting curricula to better prepare physicians to function in health systems. Two components of this educational transformation are (1) increasing physician competence in Health Systems Science, including quality, population health, social determinants of health, and interprofessional collaboration, and (2) providing roles for students to act as change agents while adding value to the health system...
February 19, 2019: Journal of General Internal Medicine
Amaury De Barros, Justine Attal, Margaux Roques, Julien Nicolau, Jean-Christophe Sol, Elizabeth Cohen-Jonathan-Moyal, Franck-Emmanuel Roux
PURPOSE: Systematic pre-radiotherapy MRI in patients with newly resected glioblastoma (OMS 2016) sometimes reveals tumor growth in the period between surgery and radiotherapy. We evaluated the relation between early tumor growth and overall survival (OS) with the aim of finding predictors of regrowth. METHODS: Seventy-five patients from 25 to 84 years old (Median age 62 years) with preoperative, immediate postoperative, and preradiotherapy MRI were included. Volumetric measurements were made on each of the three MRI scans and clinical and molecular parameters were collected for each case...
February 19, 2019: Journal of Neuro-oncology
M K Nisar
INTRODUCTION: Early arthritis clinics (EACs) have been well established since 1980s. Most of the data for their effectiveness comes from rheumatoid arthritis (RA) management and is largely limited to process outcomes. There is little evidence that such clinics improve clinical outcomes particularly for psoriatic arthritis (PsA). We examined whether EACs provide better outcomes irrespective of final arthritis diagnosis. METHODS: A 52-week prospective observational study of all inflammatory arthritis patients presenting to early arthritis service at our secondary care hospital in 2016 was undertaken...
February 19, 2019: Rheumatology International
Bryan S Benn, Mihir Parikh, Pei H Tsau, Eric Seeley, Ganesh Krishna
PURPOSE: While there is significant mortality and morbidity with lung cancer, early stage diagnoses carry a better prognosis. As lung cancer screening programs increase with more pulmonary nodules detected, expediting definitive treatment initiation for newly diagnosed patients is imperative. The objective of our analysis was to determine if the use of a dedicated interventional pulmonology practice decreases time delay from new diagnosis of lung cancer or metastatic disease to the chest to treatment initiation...
February 19, 2019: Lung
Nitish Virmani, Jyoti Dabholkar
Introduction: Involvement of the salivary glands in tuberculosis is rare, even in countries where tuberculosis is endemic. It can occur by systemic dissemination from a distant focus or, less commonly, as primary involvement. This article focuses on its myriad clinical presentations that pose a diagnostic challenge to the clinician. We discuss the schema of investigations required to confirm the diagnosis and the limitations faced in the low-cost setting of a developing country. Materials and Methods: Medical records, including history, physical examination and imaging findings, and the results of cytological, microbiological and histopathological studies of patients diagnosed with primary tubercular sialadenitis were retrieved and analyzed...
January 2019: Iranian Journal of Otorhinolaryngology
Necati Ucler
Periosteal enchondromas located in the spine are rare. We reported an even more infrequent occurrence of a periosteal enchondroma in the cervical spine of a 19-year-old girl. During the operation, a giant (>8 cm × 5.5 cm × 5 cm) ossified periosteal enchondroma with involvement of posterior structures and muscles of the axis was resected. The pathological examination revealed that the tumor consisted of enchondroid tissue with typical chondrocytes, confirming the diagnosis of periosteal enchondroma. Early identification of the initial lesion should be coupled with total surgical resection, as a definitive treatment, to prevent malignant transformation...
October 2018: Journal of Craniovertebral Junction and Spine
Harshini Manohar, Preeti Kandasamy, Venkatesh Chandrasekaran, Ravi Philip Rajkumar
Background: Early interventions in children with autism spectrum disorder (ASD) reduce progressive symptom development. Delay in diagnosis and initiation of ASD-specific interventions is observed across settings. This study aimed to assess the trends in time to diagnosis and treatment initiation in a tertiary care pediatric setting. Methodology: Families of children with ASD ( n = 50) were assessed, and details regarding age at first symptom recognition, medical consultation, receiving the diagnosis, and initiation of treatment were collected, in addition to detailed clinical assessment...
January 2019: Indian Journal of Psychological Medicine
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