Sharon Smith

UUI co-exists with numerous health conditions, having a substantial negative impact on health-related quality of life and mental health. Cognitive-behavioral therapy (CBT) could help patients manage these problems by changing the way they think and behave. We carried out a systematic review of the literature assessing the modalities and effects of CBT as a stand-alone strategy, without adding PFMT, on symptoms and clinical signs, in women with UUI. Our secondary objective was to report modalities and effects of CBT on health-related quality of life, psychological symptoms and patient-reported satisfaction. The PRISMA methodology was used to carry out this systematic review. A literature search was conducted in PubMed, PEDro, Web of Science and Cochrane Library databases from inception to December 2020. The PICO approach was used to determine the eligibility criteria. Twelve papers were included in the present review which showed beneficial effects on both symptom severity (p < 0.0

The purpose is to report the United Kingdom’s largest single-centre experience of robotically assisted laparoscopic radical prostatectomies (RALP), using the neurovascular structure-adjacent frozen-section (NeuroSAFE) technique. We describe the utilisation and outcomes of this technique. This is a retrospective study from 2012 to 2019 on 520 patients undergoing NeuroSAFE RALP at our Institution. Our Institution’s database was analysed for false-positive frozen-section (FS) margins as confirmed on paraffin histopathological analysis: functional outcomes of potency, continence, and biochemical recurrence (BCR). The median (range) of console time was 145 (90-300) min. In our cohort, positive FS was seen in 30.7% (160/520) of patients, with a confirmatory paraffin analysis in 91.8% of our patients’ cohort (147/160). The neurovascular bundles (NVBs) that underwent secondary resection contained tumour in 26.8% (43/160) of the cases. Biochemical recurrence (BCR) was 6.7% (35/520), of which FS

Haze problem is an important factor threatening human health. PM2.5 is the main culprit haze. 1-Nitropyrene (1-NP) is the main nitrated polycyclic aromatic hydrocarbon, the toxic component of PM2.5 particles. The effects of 1-NP on various organs and reproductive health have been extensively and deeply studied, but the effects of 1-NP on embryo implantation and endometrial receptivity remain to be determined. The purpose of this study was to investigate the adverse effects of 1-NP on mouse embryo implantation and human endometrial receptivity. In early pregnancy, CD1 mice were given 2 mg/kg 1-NP by oral gavage, which resulted in a decreased embryo implantation number on day 5, inhibited leukemic inhibitory factor (LIF)/STAT3 pathway, decreased expression of estrogen receptor and progesterone receptor, and disrupted regulation of uterine cell proliferation. In addition, in a human in vitro implantation model, 1-NP was found to significantly inhibit the adhesion rate between trophoblast

We investigated the efficacy and safety of further bevacizumab therapy in platinum-resistant ovarian cancer patients whose disease had progressed after bevacizumab plus chemotherapy. In this multi-center, open-label, phase II trial (JGOG3023), patients were randomized 1:1 to a single-agent chemotherapy alone (either pegylated liposomal doxorubicin [40 or 50 mg/m administered intravenously], topotecan [1.25 mg/m intravenously], paclitaxel [80 mg/m intravenously], or gemcitabine [1000 mg/m intravenously]) or single-agent chemotherapy + bevacizumab (15 mg/m intravenously). The primary endpoint was investigator-assessed progression-free survival (PFS) according to RECIST version 1.1. Secondary endpoints were overall survival (OS), objective response rate (ORR), and response rate according to Gynecological Cancer Intergroup cancer antigen 125 criteria. In total, 103 patients were allocated to chemotherapy (n=51) or chemotherapy + bevacizumab (n=52). Median investigator-assessed PFS was 3.1

DOG1 (Discovered on GIST1) is a voltage-gated calcium-activated chloride and bicarbonate channel that is highly expressed in interstitial cells of Cajal and in gastrointestinal stromal tumors (GIST) derived from Cajal cells. To systematically determine in what tumor entities and normal tissue types DOG1 may be further expressed, a tissue microarray (TMA) containing 15,965 samples from 121 different tumor types and subtypes as well as 608 samples of 76 different normal tissue types was analyzed by immunohistochemistry. DOG1 immunostaining was found in 67 tumor types including GIST (95.7%), esophageal squamous cell carcinoma (31.9%), pancreatic ductal adenocarcinoma (33.6%), adenocarcinoma of the Papilla Vateri (20%), squamous cell carcinoma of the vulva (15.8%) and the oral cavity (15.3%), mucinous ovarian cancer (15.3%), esophageal adenocarcinoma (12.5%), endometrioid endometrial cancer (12.1%), neuroendocrine carcinoma of the colon (11.1%) and diffuse gastric adenocarcinoma (11%). Low

Results of numerous studies gave contradictory conclusions when analysing associations between copy number variants (CNVs) within the azoospermia factor (AZF) locus of the Y chromosome and idiopathic male infertility. The aim of this study was to identify the presence and possible association of CNVs in the AZF region of Y chromosome with idiopathic male infertility in the Serbian population. Using the multiplex ligation-dependent probe amplification technique, we were able to detect CNVs in 24 of 105 (22.86%) infertile men and in 11 of 112 (9.82%) fertile controls. The results of Fisher’s exact test showed a statistically significant difference between cases and controls after merging g(reen)-r(ed)/g(reen)-r(ed) and b(lue)2/b(lue)3 partial deletions identified in the AZFc region (p = 0.024). At the same time, we observed a trend towards statistical significance for a deletion among gr/gr amplicons (p = 0.053). In addition to these, we identified a novel complex CNV involving inversion

Histone deacetylase 3 (HDAC3) is one of the most promising targets to develop anticancer therapeutics. In continuation of our quest for selective HDAC3 inhibitors, a series of small molecules having o-hydroxy benzamide as the novel zinc binding group (ZBG) has been introduced for the first time that can be able to produce good HDAC3-selectivity over other HDACs. The most promising HDAC3 inhibitors, 11a and 12b, displayed promising in vitro anticancer activities with less toxicity to normal kidney cells. These compounds significantly upregulate histone acetylation and induce apoptosis with a G2/M phase arrest in B16F10 cells. Compound 11a exhibited potent antitumor efficacy in 4T1-Luc breast cancer xenograft mouse model in female Balb/c mice. It also showed significant tumor growth suppression with no general toxicity and extended survival rates post-tumor resection. It significantly induced higher ROS generation, leading to apoptosis. No considerable toxicity was noticed in major organ

This study aims to explore the clinical implications and potential mechanistic functions of CCR5 in triple negative breast cancer. Briefly, we demonstrated that CCR5 is overexpressed in TNBC and is associated with better prognosis of TNBC. CCR5 expression is positively correlated with tumor immune cell infiltration and tumor immune response related pathways. Multi-omics data analyses identified CCR5 associated genomic and proteomic changes. CCR5 overexpression was associated with better overall survival in TNBC patients with TP53 mutation. We also summarized the latest findings on ICB efficacy related genes and explored the association between CCR5 and those genes. These results indicated that CCR5 is a potential tumor suppressor gene and individualized therapeutic strategy could be established based on multi-omics background and expression pattern of ICB related genes. In conclusion, CCR5 is associated with better survival of TNBC patients with TP53 mutation, which may exert its roles

Subcortical vascular cognitive impairment (SVCI) is characterized by the presence of cerebral small vessel disease (CSVD) markers. Some SVCI patients also show Alzheimer’s disease and cerebral amyloid angiopathy (CAA) markers. However, the effects of these imaging markers on long-term clinical outcomes have not yet been established. The present study, therefore, aimed to determine how these imaging markers influence functional disability and/or mortality. We recruited 194 participants with SVCI from the memory clinic and followed them up. All participants underwent brain MRI at baseline, and 177 (91.2%) participants underwent beta-amyloid (Aβ) PET. We examined the occurrence of ischemic or hemorrhagic strokes. We also evaluated functional disability and mortality using the modified Rankin scale. To determine the effects of imaging markers on functional disability or mortality, we used the Fine and Gray competing regression or the Cox regression analysis. During a 8.6-year follow-up p

Ovarian cancer is the leading cause of gynaecological cancer deaths and the seventh most commonly diagnosed cancer among women worldwide, so that, as it is related to substantial and increasing disease burden, the management of ovarian cancer survivors should be a priority. Such issues involve prevention and management of emotional distress, anxiety/depressive symptoms, and maintenance of quality of life from initial diagnosis to post-treatment. Within this framework, sleep disturbances, in particular insomnia, are emerging as modifiable determinants of mental health, also contributing to substantial morbidity among cancer, including ovarian cancer. To this aim we conducted a systematic review according to PRISMA guidelines on prevalence and management of insomnia and circadian sleep disorders in ovarian cancer, while selecting 22 papers. Insomnia was evaluated in ovarian cancer and, while circadian sleep disturbances were poorly assessed in ovarian cancer, insomnia increased from 14%

THURSDAY, Oct. 28, 2021 (HealthDay News) — From 2015 to 2019, all-cause mortality rates for recently pregnant women increased 4.4 percent annually, according to a research letter published in the Oct. 26 issue of the Journal of the American Medical Association . Jeffrey T. Howard, Ph.D., from the University of Texas at San Antonio, and colleagues reported the rates and annual percentage changes (APCs) for pregnancy-related and other causes of mortality among pregnant and recently pregnant women from 2015 to 2019 using data from the National Center for Health Statistics. The researchers found that 9,532 pregnant women died from 2015 to 2019. In 2019, the pregnancy-related mortality rate was 27.5 per 100,000 live births, which was not significantly different from the rate in 2015. Between 2015 and 2019, mortality rates among recently pregnant women increased per 100,000 live births, from 44.4 to 53.9 for all causes, from 4.3 to 8.8 for drug/alcohol poisoning, and from 2.0 to 3.9 for ho

THURSDAY, Oct. 28, 2021 (HealthDay News) — The incidence of small fiber neuropathy (SFN) is increasing and is associated with multiple comorbidities and increased mortality, according to a study published online Oct. 27 in Neurology . Stephen A. Johnson, M.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues examined SFN incidence, prevalence, comorbidities, longitudinal impairments, and disabilities in a cohort of test-confirmed patients with SFN matched 3:1 with controls from Jan. 1, 1998, to Dec. 31, 2017. Data were included for 94 patients with SFN. The researchers found that the incidence of SFN was 1.3/100,000 per year and increased during the study period, while prevalence was 13.3/100,000. Patients with SFN were more likely to be female (67 percent) and obese (mean body mass index, 30.4 versus 28.5 kg/m 2 ) and to have insomnia (86 versus 54 percent), analgesic-opioid prescriptions (72 versus 46 percent), hypertriglyceridemia (180 versus 147 mg/dL), and diabetes m

THURSDAY, Oct. 28, 2021 (HealthDay News) — Many patients with appendicitis who initially receive antibiotic treatment will subsequently undergo an appendectomy, according to a correspondence published online Oct. 25 in the New England Journal of Medicine to coincide with the annual meeting of the American College of Surgeons, held virtually from Oct. 23 to 27. Giana H. Davidson, M.D., M.P.H., from the University of Washington Medical Center in Seattle, and colleagues reported longer-term outcomes from a trial involving 1,552 patients with appendicitis, in which antibiotic treatment was found to be noninferior to appendectomy at 30 days. The researchers found that the percentage of patients in the antibiotics group who underwent subsequent appendectomy was 40 and 46 percent at one and two years, respectively, and 49 percent at both three and four years. The risk for appendectomy was 27 percent at 30 days after randomization through one year. Patients who had an appendicolith more oft

THURSDAY, Oct. 28, 2021 (HealthDay News) — For adults with moderate-to-severe asthma, itepekimab monotherapy is associated with a reduction in events indicating loss of asthma control, according to a study published in the Oct. 28 issue of the New England Journal of Medicine . Michael E. Wechsler, M.D., from National Jewish Health in Denver, and colleagues conducted a phase 2 trial involving adults with moderate-to-severe asthma receiving inhaled glucocorticoids plus long-acting beta-agonists. A total of 296 participants were randomly assigned in a 1:1:1:1 ratio to receive subcutaneous itepekimab, itepekimab plus dupilumab, dupilumab, or placebo every two weeks for 12 weeks. The researchers found that an event indicating loss of asthma control occurred in 22, 27, 19, and 41 percent of those in the itepekimab, itepekimab plus dupilumab, dupilumab, and placebo groups, respectively, by 12 weeks; the corresponding odds ratios were 0.42 (95 percent confidence interval, 0.20 to 0.88; P = 0

THURSDAY, Oct. 28, 2021 (HealthDay News) — From 1999 to 2019, mortality from Parkinson disease (PD) increased in the United States, according to a study published online Oct. 27 in Neurology . Shuang Rong, M.D., Ph.D., from the Wuhan University of Science and Technology in China, and colleagues describe trends in PD mortality in the United States from 1999 to 2019 using data from the National Vital Statistics System. The analyses focused on data from 479,059 PD deaths; temporal trends in age-standardized death rates were examined. The researchers observed an increase in age-adjusted mortality from PD from 5.4 to 8.8 per 100,000 population in 1999 and 2019, respectively, with an average annual percent change of 2.4 percent. Across all age groups, both sexes, various racial/ethnic groups, and different urban/rural classifications, PD mortality increased significantly from 1999 to 2019. An increase in PD mortality was seen in U.S. states with reported death rates and the District of Col

THURSDAY, Oct. 28, 2021 (HealthDay News) — Sotrovimab reduces the risk for disease progression in high-risk patients with mild-to-moderate COVID-19, according to a study published online Oct. 27 in the New England Journal of Medicine . Anil Gupta, M.D., from the William Osler Health Center in Toronto, and colleagues randomly assigned nonhospitalized patients with symptomatic COVID-19 and at least one risk factor for disease progression to receive a single infusion of sotrovimab or placebo in an ongoing, multicenter, double-blind, phase 3 trial. The researchers found that in the prespecified interim analysis in an intention-to-treat population of 583 patients (291 in the sotrovimab group and 292 in the placebo group), 1 and 7 percent of patients in the sotrovimab and placebo groups, respectively, had disease progression leading to hospitalization or death (relative risk reduction, 85 percent). Five patients in the placebo group were admitted to the intensive care unit, including one w

THURSDAY, Oct. 28, 2021 (HealthDay News) — For high-risk outpatients with COVID-19, fluvoxamine reduces the need for hospitalization, according to a study published online Oct. 27 in The Lancet Global Health . Gilmar Reis, Ph.D., from the Pontificia Universidade Católica de Minas Gerais in Belo Horizonte, Brazil, and colleagues recruited from 11 clinical sites high-risk symptomatic Brazilian adults who were confirmed positive for severe acute respiratory syndrome coronavirus-2 and had a known risk factor for progression to severe disease. Participants were randomly assigned to fluvoxamine (100 mg twice daily for 10 days) or placebo (741 and 756 patients, respectively). The trial arms were stopped for superiority with randomization to fluvoxamine reported from Jan. 20 to Aug. 5, 2021. The researchers found that compared with the placebo group, the fluvoxamine group had a lower proportion of patients in a COVID-19 emergency setting for more than six hours or transferred to a tertiary h

THURSDAY, Oct. 28, 2021 (HealthDay News) — COVID-19 vaccination is not associated with an increased risk for first-trimester miscarriage, according to a research letter published online Oct. 20 in the New England Journal of Medicine . Maria C. Magnus, Ph.D., from the Norwegian Institute of Public Health in Oslo, and colleagues performed a case-control study using data from Norwegian registries on first-trimester pregnancies, COVID-19 vaccination, background characteristics, and underlying health conditions. All women who were registered as having had a miscarriage before 14 weeks of gestation (case patients) and those with a primary care-based confirmation of ongoing pregnancy (controls) were identified between Feb. 15 and Aug. 15, 2021. Data were included for 13,956 women with ongoing pregnancies (5.5 percent vaccinated) and 4,521 women with miscarriages (5.1 percent vaccinated). There was a median of 19 days between vaccination and miscarriage or confirmation of ongoing pregnancy.

THURSDAY, Oct. 28, 2021 (HealthDay News) — The number of U.S. meatpacking workers who were infected during the COVID-19 pandemic is nearly three times higher than previously thought, a U.S. House report shows. The report said that at least 59,000 workers caught the disease and 269 died as the pandemic raged through the industry last year, and the report authors added that companies could have done more to protect their employees, the Associated Press reported. Because workers stand shoulder-to-shoulder in production lines, the meatpacking industry was one of the early epicenters of the COVID-19 pandemic. During the height of the outbreaks in the spring of 2020, U.S. meatpacking production fell to about 60 percent of normal as several major plants were forced to close for deep cleaning and safety upgrades or operated at slower speeds because of worker shortages. Previously, the United Food and Commercial Workers Union said 22,400 meatpacking workers were infected or exposed. The new

THURSDAY, Oct. 28, 2021 (HealthDay News) — A boxed warning and a checklist of risks that must be shared with patients are among the new breast implant safety measures announced by the U.S. Food and Drug Administration on Wednesday. As the FDA “continues to evaluate the overall effects of breast implants in patients, today’s actions help ensure that all patients receive the information they need to make well-informed decisions affecting their long-term, personal health,” Binita Ashar, M.D., director of the FDA’s Office of Surgical and Infection Control Devices, said in an agency news release. “Protecting patients’ health when they are treated with a medical device is our most important priority.” Only health care providers and facilities that provide the checklist will be allowed to sell and distribute breast implants, the agency noted. The checklist “must be reviewed with the prospective patient by the health care provider to help ensure the patient understands the risks, benefits, a

THURSDAY, Oct. 28, 2021 (HealthDay News) — From 2019 to 2020, there were decreases in global estimates of childhood vaccinations, according to research published in the Oct. 29 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report . Pierre Muhoza, Ph.D., from the CDC in Atlanta, and colleagues investigated global, regional, and national vaccination coverage estimates and trends in 2020 compared with 2019. The researchers found that from 2019 to 2020, there was a decrease in global estimates of coverage with the third dose of the diphtheria, tetanus, and pertussis-containing vaccine (DTP3) and a polio vaccine (Pol3) from 86 to 83 percent. Coverage with the first dose of measles-containing vaccine (MCV1) also decreased, from 86 to 84 percent. The last year that coverage estimates were at 2020 levels for DTP3, MCV1, and Pol3 was 2009, 2014, and 2014, respectively. Worldwide, 17 percent of the target population was not vaccinated with DTP3 in

THURSDAY, Oct. 28, 2021 (HealthDay News) — The blood lead reference value (BLRV) in children has been updated to 3.5 µg/dL, according to research published in the Oct. 29 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report . Perri Zeitz Ruckart, M.P.H., from the CDC in Atlanta, and colleagues updated the population-based BLRV, introduced in 2012 to identify children exposed to more lead than most other children in the United States. The BLRV is based on the 97.5th percentile of blood lead distribution in U.S. children aged 1 to 5 years. The researchers note that the initial BLRV was 5 µg/dL and was based on data from the 2007 to 2008 and 2009 to 2010 National Health and Nutrition Examination Survey (NHANES) cycles. Consistent with recommendations from a former advisory committee, the BLRV was updated to 3.5 µg/dL using NHANES data from the 2015 to 2016 and 2017 to 2018 cycles. Public health and clinical professionals should focus screeni

FRIDAY, Oct. 29, 2021 (HealthDay News) — Psychosocial and psychological interventions are effective for relapse prevention in schizophrenia, according to a review published online Oct. 12 in The Lancet Psychiatry . Irene Bighelli, Ph.D., from the Technical University of Munich in Germany, and colleagues conducted a systematic literature review to identify studies evaluating the efficacy, acceptability, and tolerability of psychosocial and psychological interventions for relapse prevention in schizophrenia. Based on 72 included studies (10,364 participants), the researchers found that at one year, family interventions (odds ratio, 0.35), relapse prevention programs (odds ratio, 0.33), cognitive behavioral therapy (odds ratio, 0.45), family psychoeducation (odds ratio, 0.56), integrated interventions (odds ratio, 0.62), and patient psychoeducation (odds ratio, 0.63) reduced relapse more than treatment as usual. “We found robust benefits in reducing the risk of relapse for family inter

FRIDAY, Oct. 29, 2021 (HealthDay News) — Clinically active inflammatory bowel disease (IBD) is associated with adverse COVID-19 outcomes, especially in younger and middle-aged adults, according to a study published online Sept. 27 in the Journal of Crohn’s and Colitis . Amanda Ricciuto, M.D., Ph.D., from The Hospital for Sick Children in Toronto, and colleagues measured clinical IBD activity by physician global assessment (PGA) among IBD patients diagnosed with COVID-19 between March 13, 2020, and Aug. 3, 2021. COVID-19 outcomes of intensive care unit (ICU) admission, ventilation, death, and hospitalization were examined. The researchers found that adverse COVID-19 outcomes were more common with active IBD among the 6,078 patients: ICU/ventilation/death occurred in 3.6, 4.9, and 8.8 percent of those with remission/mild, moderate, and severe IBD, respectively; hospitalization occurred in 13, 19, and 38 percent, respectively. Effect sizes were larger for younger patients on stratificat

FRIDAY, Oct. 29, 2021 (HealthDay News) — The number of days alive without life support at day 28 did not differ among adults with COVID-19 and severe hypoxemia receiving dexamethasone 12 mg/day versus dexamethasone 6 mg/day administered intravenously for up to 10 days, according to a study published online Oct. 21 in the Journal of the American Medical Association . Marie W. Munch, M.D., and colleagues from the COVID STEROID 2 Trial Group, compared the effects of 12 mg/day versus 6 mg/day of dexamethasone in patients with COVID-19 and severe hypoxemia. The analysis included patients (491 at 12 mg of dexamethasone and 480 at 6 mg) with confirmed COVID-19 requiring at least 10 L/min of oxygen or mechanical ventilation being treated at 26 hospitals in Europe and India from August 2020 to May 2021. The researchers found that the median number of days alive without life support was 22.0 days in the group receiving 12 mg of dexamethasone versus 20.5 days in the group receiving 6 mg of dexa

FRIDAY, Oct. 29, 2021 (HealthDay News) — At five years, symptom severity does not differ, but rates of subsequent surgical treatment are lower in patients with idiopathic carpal tunnel syndrome receiving local methylprednisolone injection versus saline placebo injection, according to a study published online Oct. 22 in JAMA Network Open . Manfred Hofer, from Kristianstad Hospital in Sweden, and colleagues assessed the long-term treatment effects of local steroid injection for carpal tunnel syndrome. The analysis included extended follow-up for 111 patients (aged 22 to 69 years) with primary idiopathic carpal tunnel syndrome and no prior treatment with local steroid injections. Patients were randomly assigned to injection into the carpal tunnel with 80 mg methylprednisolone (37 patients), 40 mg methylprednisolone (37 patients), or a saline placebo (37 patients). The researchers found that compared with placebo, there was no significant difference in mean change in symptom severity sco

FRIDAY, Oct. 29, 2021 (HealthDay News) — A substantial proportion of relatively young COVID-19 survivors exhibit cognitive dysfunction several months after recovering from COVID-19, according to a research letter published online Oct. 22 in JAMA Network Open . Jacqueline H. Becker, Ph.D., from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues investigated rates of cognitive impairment in 740 adult survivors of COVID-19 (mean age, 49 years) who were treated in outpatient, emergency department, or inpatient hospital settings (April 2020 to May 2021). The mean time of assessment from COVID-19 diagnosis was 7.6 months. The researchers found that in adjusted analyses, hospitalized patients were more likely than outpatients to have impairments in attention (odds ratio [OR], 2.8; 95 percent confidence interval [CI], 1.3 to 5.9), executive functioning (OR, 1.8; 95 percent CI, 1.0 to 3.4), category fluency (OR, 3.0; 95 percent CI, 1.7 to 5.2), memory encoding (OR, 2

FRIDAY, Oct. 29, 2021 (HealthDay News) — Among infants and children with the skull deformity known as craniosynostosis, 4 percent were conceived by in vitro fertilization (IVF), according to a study published online Sept. 20 in The Journal of Craniofacial Surgery . Abdoljalil Kalantar-Hormozi, M.D., from the Medical College of Shahid Beheshti University of Medical Science in Tehran, Iran, and colleagues reviewed records of 200 patients (ages 1 month to 7 years) with nonsyndromic craniosynostosis who underwent surgery in a tertiary children’s hospital between 2010 and 2019 to evaluate the prevalence of IVF use related to infants born with craniosynostosis. The researchers report that 43 percent of patients were plagiocephalic, 39 percent trigonocephalic, 8.5 percent scaphocephalic, 8 percent brachiocephalic, and 1.5 percent were mixed. Clomiphene citrate was received by nine patients, and eight mothers had become pregnant under IVF, with all using clomiphene citrate for ovulation stim

Cabenuva, the first long-acting injectable drug for HIV treatment, was approved in January and is slowly rolling out to clinics and patients nationwide. Medscape Medical News source https://www.medscape.com/viewarticle/961921?src=rss

Social media sites, like Facebook, Instagram, Twitter, and LinkedIn, get billions of daily users from all over the world. With such a crush of visitors, it’s no wonder that these online destinations are go-to places for patients seeking health-related information. As a physician, you’re in a unique position to build a social media following by leveraging your expertise and providing much-needed medical information. With a large enough following, you can not only educate the public, but support and advocate for policies that you believe in as well as increase your reputation and standing, leading to additional opportunities to advance your professional career. A recent article on Influencer Marketing Hub lists seven steps to becoming a social media influencer: Select your niche —Successful influencers have interest and expertise in a particular niche. Physicians have a leg up in this area because few individuals have this type of professional background to leverage. Optimize your s

Lower barriers to HIV pre-exposure prophylaxis may capture people who are missed through screening but could benefit from the prevention pill. Medscape Medical News source https://www.medscape.com/viewarticle/961920?src=rss

The stock market can be categorized into different sectors, which are industries that have similarities. According to the Motley Fool , differentiating these various sectors can help physician investors better evaluate certain stocks when compared with their sector siblings. For example, when you are trying to determine the value of Pfizer’s stock, you wouldn’t compare it to Exxon Mobile, but you could compare it to Astra Zeneca. Two pharmaceutical companies have far more in common than an energy company. The most commonly used classification of the U.S. Stock Market sectors is based on Global Industry Classification Standards (GICS). It includes the following 11 categories: Energy (eg, Exxon Mobile, ConocoPhillps) Materials (eg, Celanese Corp, DuPont de Nemours) Industrials (eg, General Electric, Honeywell) Utilities (eg, Eversource Energy, American Water Works Company, Inc.) Healthcare (eg, Sage Therapeutics, Inc., Regeneron Pharmaceuticals Inc.) Financials (eg, American Expr

Physicians must tread lightly on social media, as it is a fast and dangerous way to expose their vulnerabilities and put their careers at risk. Everything from disseminating perfectly accurate medical information to upholding patient privacy must be considered before posting any content. One critical error that can quickly break a physician’s career is not acknowledging the viral nature of social media. Once something is posted, it has the potential to reach tens of thousands of people in a matter of seconds. What may be an innocent comment can be taken out of context and turned into an unerasable mistake. By the time a physician realizes their mistake and removes the post, it may be too late, resulting in a violation of the Health Insurance Portability and Accountability Act (HIPAA), state medical-board action, and potential job loss. There is an inherent risk of violating privacy when referring to a particular patient on social media in situations like crowdsourcing a diagnosis with

After routine surgery, a “virtual” follow-up visit might be just as good as a traditional offi ce appointment, according to a study published in the Journal of the American College of Surgeons. Researchers found that surgery patients who had video follow-up appointments were just as satisfi ed with their care as those who made a trip to the offi ce.They also appreciated the convenience of skipping the commute and the doctor’s waiting room. Overall, patients in both groups were equally satisfi ed with their care, but the virtual group was more likely to opt for the same route again: About 79% said they’d choose virtual for future follow-ups; fewer than half of offi ce patients said they’d choose in-person visits. Not surprisingly, the virtual group liked the convenience: They avoided the biggest hassles reported by the in-person group—the commute, fi nding parking and sitting in the waiting room. Virtual visits were not always smooth, however. Around 27% of patients faced technical issu

A new DNA sensor can detect viruses and tell if they are infectious or not in minutes, according to a report published in Science Advances.The sensor was developed by using DNA technology and does not require the need to pretreat test samples. Researchers demonstrated this technique with the human adenovirus and SARS-CoV-2. e new sensor method can produce results in 30 minutes to 2 hours. Because it requires no treatment of the sample, it can be used on viruses that will not grow in the lab.The sensing technique could be applied to other viruses, the researchers said, by tweaking the DNA to target diff erent pathogens. source https://www.physiciansweekly.com/dna-sensor-can-spot-when-covid-is-contagious/

“Glucose and A1C are among the most important biomarkers for diabetes management, with A1C generally believed to reflect a patient’s average glucose in the past 3 months,” explains Yongjin Xu, PhD. “However, differences between A1C and mean glucose are frequently observed in clinical practice. Recent research indicates that clinicians need be to be aware that A1C may not as accurately reflect mean glucose as previously thought. Therefore, the need exists to understand the factors involved to help align these measures, since they are so central to diabetes management decisions.” To address this issue, Dr. Xu and colleagues analyzed continuous glucose monitoring (CGM) data from two previous clinical studies in 120 individuals with diabetes and published their findings in the Journal of Diabetes Science and Technology. The researchers derived a novel kinetic model that considers red blood cell (RBC) turnover, cross-membrane glucose transport, and hemoglobin glycation processes to indivi

Patients with HF receiving blended care for both HF and depression reported significantly better mental health-related quality of life, or QOL, and mood at 12 months versus those receiving usual care, according to a study published in JAMA Internal Medicine. At 12 months, among 756 participants with HF with reduced left ventricular ejection fraction (<45%), blended care participants reported improvement on the Mental Component Summary of the 12-item Short Form Health Survey versus usual care, but similar scores to the collaborative care for HF only group. Significant improvements in mood for blended care participants were seen versus usual care and collaborative care for the HF-only groups. However, physical function, HF pharmacotherapy use, rehospitalization, and mortality were similar by both baseline depression and randomization status. source https://www.physiciansweekly.com/blended-care-for-hf-depression-may-improve-qol/

Elderly patients with HF gain quality of life (QOL) benefits with left ventricular assist devices (LVAD), according to a study published in the Journal of the American College of Cardiology. Researchers evaluated survival, functional outcomes, and QOL after LVAD among adult patients receiving durable LVADs. Mortality rates of 34% for patients younger than 65, 54% for patients aged 65-75, and 66% for patients older than 75 were observed. Newer-generation devices were associated with reduced late mortality (HR, 0.35). Stroke, device malfunction or thrombosis, and rehospitalizations decreased with increasing age. In all ages, median 6-minute walk distance increased from 0 feet to 1,065 feet, and QOL improved after LVAD. source https://www.physiciansweekly.com/lvad-benefits-elderly/

During a recent PW Podcast episode, we spoke with ESC 2021 plenary talk presenter Stefan Anker, MD, PhD, about the full results of the EMPEROR Preserved trial, which affirm that empagliflozin lowers the risk of CVD in patients with heart failure (HF) and HF with preserved ejection fraction (HFpEF), leading one expert to say this is “a big day for patients living with HFpEF, a big day for heart failure clinicians.” What makes the results from the EMPEROR-Preserved trial significant? EMPEROR-Preserved is the first positive clinical trial with meaningful results for patients with HFpEF. SGLT2 inhibitors work in HF with reduced EF, which has been reported in several trials during the last couple years. Now, we are focusing on HFpEF, for which guidelines do not recommend any specific therapy, because the trials in this field narrowly missed their target of achieving significance. With EMPEROR-Preserved, recruiting 6,000 patients over the last 3.5 years and following them for 26 months o

New research was presented at HFSA 2021, the Heart Failure Society of America Annual Scientific Meeting 2021, held September 10-13 in Denver and virtually. The features below highlight some of the studies that HFSA2021emerged from the conference. Similar Benefits in Black & White Patients With HF Agent With limited data on the impact of HF medications in non-White patients, researchers conducted an analysis of the GALACTIC-HF trial to assess active therapy with omecamtiv mecarbil among Black and White patients with HF with reduced ejection fraction (HFrEF). Eligible participants had a New York Heart Association classification of 2-4, with a left ventricular EF no higher than 35% on such therapy and prior hospitalization for HF or an HF event—defined as an HF hospitalization or emergency room/ urgent care visit for escalation of therapy—in the preceding year. The researchers randomly assigned 562 Black patients to omecamtiv mecarbil or placebo. Active therapy correlated with an H

COVID-19 vaccines are eff ective against SARSCoV-2 infection requiring hospitalization, ICU admission, and emergency department (ED) or urgent care clinic visits, even in populations disproportionately aff ected by SARS-CoV-2 infection, according to a study published in the New England Journal of Medicine. Data from 41,552 admissions to 187 hospitals and 21,522 visits to 221 EDs or urgent care clinics from January 1 through June 22, 2021 showed that the eff ectiveness rates of full mRNA vaccination were 89%, 90%, and 91% against confi rmed SARS-CoV-2 infection leading to hospitalization, ICU admission, or an ED or urgent care clinic visit, respectively. Full vaccination was similarly eff ective for the BNT162b2 and mRNA-1273 vaccines. source https://www.physiciansweekly.com/covid-19-vaccines-prevent-critical-care-visits-in-high-risk-populations/

Adults with hyperuricemia and gout are most likely to develop liver dysfunctions and suffer associated morbidities, according to a study published in Diseases. Researchers examined the association between uric acid levels and liver enzyme functions among adults with hyperuricemia and gout in the United States, using National Health and Nutrition Examination Survey (NHANES) data from 2007 to 2016. Data were analyzed for descriptive statistics and for differences using the t test, Chi-square test, and ANOVA. A regression analysis was performed to determine association between demographics and liver enzymes. A total of 14,946 adults were included; sample mean age was 49 ± 0.15, and 54% were female. Overall, 15% of adults had elevated uric acid levels (≥6.8 mg/dL), men had significantly higher uric acid levels than women (6 mg/dL vs 4.8 mg/dL). High uric acid levels were associated with more than two times higher odds of elevated ALT, AST and GGT. Similarly, gender-based target uric acid v

The incidence and prevalence of gout across indigenous groups from places like Europe, Asia, and Africa are different from what is seen in people from the United States, according to research. Studies suggest that genetics can significantly modulate risks for gout and for hyperuricemia—which usually precedes gout—after exposure to specific environmental or dietary factors. “Worldwide, there are significant health disparities in the prevalence of gout,” explains Youssef Roman, PharmD, PhD. “In addition, some people will develop gout rapidly and others can have more severe form of the disease. By gaining a better understanding of genetic and epigenetic risk factors for gout across ethnic groups, clinicians may be able to improve how specific populations are managed and can potentially reduce disparities in gout care.” Comparing Patterns in Different Racial Groups Dr. Roman and his group had a study published in the Journal of Personalized Medicine that estimated the frequency of risk