Psoriasis is treated with several classes of treatments that may be used in combination, but the ways combination therapies are used are not well characterized.<BR> To determine the frequency of prescribing calcipotriene and other psoriasis drugs in combination.<BR> Visits with a sole diagnosis of psoriasis were selected from 1990-2010 data ...

The question of how to optimally manage coronary artery disease (CAD) has been a challenge for the cardiology community. The results of early, large randomized clinical trials (RCTs) comparing strategies of medical therapy alone versus revascularization plus medical therapy in patients with stable CAD suggested a survival advantage for a ...

A major limitation in the development of mechanical circulatory support (MCS) devices has been the lack of a clinically relevant, stable, and reproducible large animal chronic heart failure (HF) model. High mortality rates have been reported with large animal chronic HF models. In this study, methods of medical management to ...

In order for a new therapy to qualify for the accelerated approval pathway, it must treat a serious disease for which there is "unmet medical need"-- defined as providing a therapy where none exists or providing a therapy which may be potentially superior to existing therapy. The increasing number of ...

Revascularisation strategies involving coronary artery bypass grafting or percutaneous interventions are the main treatments for stable coronary artery disease, particularly for patients with ongoing symptoms despite medical therapy and/or extensive ischaemia as demonstrated by either non-invasive or invasive means. Irrespective of whether revascularisation is being undertaken, all patients with stable ...

RATIONALE: Carotid endarterectomy and medical therapy (aspirin) were shown superior to medical therapy alone for asymptomatic (≥60%) carotid stenosis. The role of modern medical therapy (statins, antihypertensive treatment, and aspirin) in the treatment of such patients is undefined. Establishing the safety, efficacy, and durability of optimal medical therapy and lifestyle ...

BACKGROUND: Stricturing is the most common complicated phenotype in paediatric Crohn's disease, but only few studies have described its course, while data on the outcome of medical treatment are scanty. AIM: To retrospectively describes the course of paediatric stricturing Crohn's disease and assess clinical and imaging response to medical therapy. ...

Chronic rhinosinusitis (CRS) is a prevalent disease with many potential interventions including medical and surgical treatments. Because CRS is a chronic condition it is essential that therapy limits exacerbations. The purpose of this article is to show that literature supports the implementation of aggressive medical management as the mainstay of ...

Percutaneous coronary intervention (PCI) for stable coronary artery disease (CAD) is not superior to optimal medical therapy. It remains unclear if patients who receive PCI for stable CAD are receiving appropriate medical therapy. We evaluated the medical management of 60,386 patients who underwent PCI for stable CAD between 2004 and ...

OBJECTIVES: This study sought to quantify the incremental cost-effectiveness ratios (ICER) of angiotensin-converting enzyme inhibitor (ACEI), beta-blocker (BB), and aldosterone antagonist (AldA) therapies for patients with heart failure with reduced ejection fraction (HFrEF). BACKGROUND: There are evidence-based, guideline-directed medical therapies for patients with HFrEF, but the incremental cost-effectiveness of these ...

BACKGROUND AND OBJECTIVE: Measuring adherence to inhaled asthma treatment is a key priority for asthma care. The aim of this study was to determine the relationship between self-report and actual medication use as measured by electronic monitoring for single and combination inhaled corticosteroid (ICS) and long acting beta-agonist (LABA) metered-dose ...

Parkinson's disease (PD) is a progressive neurologic disorder primarily characterized by altered motor function. Lower-extremity forced exercise (FE) has been shown to reduce motor symptoms in patients with PD. Recent functional magnetic resonance imaging (fMRI) studies have shown that FE and medication produce similar changes in brain activation patterns. Functional ...

Background:  Acid suppression therapy (AST) is commonly overprescribed in hospitalised patients. This indiscriminate use increases cost and drug-related side effects. Minimal data is available on interventions aimed at reducing the burden of overprescription. The aim of our study was to evaluate the impact of education and medication reconciliation forms use ...

To the Editor: In reporting the results of the Fractional Flow Reserve versus Angiography for Multivessel Evaluation 2 (FAME 2) study, De Bruyne et al. (Sept. 13 issue)(1) conclude that fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) plus medical therapy in patients with stable coronary artery disease was superior ...

To the Editor: In reporting the results of the Fractional Flow Reserve versus Angiography for Multivessel Evaluation 2 (FAME 2) study, De Bruyne et al. (Sept. 13 issue)(1) conclude that fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) plus medical therapy in patients with stable coronary artery disease was superior ...

We report the case of a 13-year-old prepubertal boy who presented with a left-sided proptosis, bilateral papilloedema and hydrocephalus who was subsequently diagnosed with a giant prolactinoma invading the left orbit. He was commenced on dopamine receptor agonists in the form of quinagolide and cabergoline, and made an excellent response ...

BACKGROUND:: Untreated substance use disorders (SUD) among HIV patients contribute to worse HIV care outcomes and increased HIV transmission. Although there are clinical and policy recommendations for integrated SUD and HIV treatment, payment issues including complex funding streams are a barrier. OBJECTIVES:: We assessed the availability of guideline-concordant medication-assisted therapies ...

Introduction Many neonatal centers offer surgical ligation of patent ductus arteriosus (PDA) after two failed courses of pharmacologic therapy. This study compares health status of extremely premature (< 28 weeks gestation) neonates who failed medical therapy at the time of their second course of medical treatment versus operation.Materials and Methods A retrospective ...

OBJECTIVES/HYPOTHESIS: Septoplasty is a frequently performed surgical procedure with the most common indication being nasal airway obstruction. Almost universally, health insurance companies mandate a trial of medical therapy consisting of intranasal corticosteroids prior to performance of septoplasty regardless of clinical assessment. Evidence for this requirement is lacking. We sought to ...

We investigated the hypothesis that variation in endogenous dopamine (DA) across brain regions explains dissimilar effects of dopaminergic therapy on aspects of cognition in early Parkinson's disease (PD). Extensive degeneration of DA-producing cells in the substantia nigra cause dorsal striatum (DS) DA deficiency and movement abnormalities. Particularly in early PD, ...

: The appropriate use of medications can influence quality performance measures and costs. Drug-related morbidity and mortality represents a public health challenge due to the ineffective and unsafe consequences of medication use. This article addresses the impact of team-based care that incorporates comprehensive medication therapy management on per capita expenditures, ...

Objectives: This study was designed to assess the effect of tyrosine kinase inhibitor (TKI) use on nonpharmaceutical medical spending for patients with chronic myeloid leukemia (CML), and estimate the association between cost-sharing and the TKI medication possession ratio (MPR). Study Design: The retrospective study covered the 13 years from 1997 ...

BACKGROUND: The management of chronic rhinosinusitis is based on a trial of "maximal medical therapy" before surgery is considered. Ear-Nose-Throat (ENT) UK consultant members were surveyed to determine the role and variability of UK-wide practices. METHODS: A survey was posted to all ENT UK consultant members (n = 603). This ...

Frontotemporal lobar degeneration is an umbrella term for several different disorders. In behavioral variant frontotemporal dementia (bvFTD), patients show deterioration in cognition and social behavior. New diagnostic criteria proposed by the International Behavioral Variant FTD Consortium provide greater sensitivity in diagnosing bvFTD. Current pharmacological management of symptoms relies on medications ...

OBJECTIVES: To describe our experience and clinical outcomes with the management of pediatric tympanostomy tube otorrhea secondary to methicillin-resistant Staphylococcus aureus (MRSA). METHODS: Retrospective review of pediatric patients (age <18) diagnosed with culture-positive MRSA tympanostomy tube otorrhea. RESULTS: MRSA positive ear cultures in the presence of tympanostomy tubes were identified ...

Patients with velopharyngeal insufficiency who require inhalation therapy should be advised to hold their noses when inhaling medication to ensure that they receive the dosage prescribed.

Mixed urinary incontinence accounts for 33% of all incontinence and is the involuntary loss of urine associated with the sensation of urgency; it is also associated with exertion, sneezing or coughing. Risk factors include vaginal delivery, obesity, age and possible genetic factors. Treatment includes lifestyle changes, behavioral therapies, medication and ...

Objectives: Several stimulant and nonstimulant medications are used alone or in combination to treat attention-deficit/hyperactivity disorder (ADHD). Little is known about the current prevalence and predictors of combination therapy. This analysis describes ADHD medication use focusing on combination versus monotherapy. Methods: Health insurance claims from the Truven Health MarketScan® Commercial ...

The preferred initial treatment for patients with stable coronary artery disease is the best available medical therapy. We hypothesized that in patients with functionally significant stenoses, as determined by measurement of fractional flow reserve (FFR), percutaneous coronary intervention (PCI) plus the best available medical therapy would be superior to the ...

BACKGROUND: Dopaminergic medications and subthalamic nucleus deep brain stimulation (STN-DBS) alleviate motor symptoms in Parkinson disease, but balance and gait are more variably affected. Balance reports are particularly inconsistent. Further, despite their prevalence in daily life, complex gait situations including backward and dual task gait are rarely studied. We aimed ...

Ultrasound transducers have many important applications in medical, industrial, and environmental settings. Large-active-area piezoelectric fibers are presented here, which can be woven into extended and flexible ultrasound transducing fabrics. This work opens significant opportunities for large-area, flexible and adjustable acoustic emission and sensing for a variety of emerging applications.

OBJECTIVE: Clinical pathway analysis, as a pivotal issue in ensuring specialized, standardized, normalized and sophisticated therapy procedures, is receiving increasing attention in the field of medical informatics. Clinical pathway pattern mining is one of the most important components of clinical pathway analysis and aims to discover which medical behaviors are ...

Infantile hemangiomas (IHs) are the most common tumors of infancy and are usually characterized by a pattern of rapid proliferation, followed by a slower period of involution. In most cases, IHs do not require any treatment because they spontaneously regress over the years. However, in a minority of patients, a ...

It is a long held maxim by neurologists and non-neurologists alike that if you want a lumbar puncture performed, call in the neurologist. In a training institution, when a board-certified neurologist is not available, call the neurology resident. With 10, 50, maybe even 100 spinal taps under his or her ...

Multiple sclerosis (MS) is an autoimmune disorder of the central nervous system that results in inflammation, demyelination, and axonal and neuronal loss. The typical course of MS is one of symptom exacerbations followed by periods of remission; however, patients will eventually accrue disability from the exacerbations. Several drugs, including interferon ...

Cerebral palsy (CP) is a term that has been applied over the years to a group of children with motor disability and related service requirements. The first conceptions of cerebral palsy and our knowledge about aetiology and pathogeny allow us to assume that cerebral palsy existed in the Ancient World. ...

Neurally-mediated syncope (also known as fainting and vasovagal syncope) is by far the most common cause of transient loss of consciousness. Fainting is almost always benign and most people who faint have non-traumatic syncope episodes occasionally throughout their lives, with minimal adverse consequences. Most episodes of fainting occur in the ...

Patients with chronic migraine developing medication-overuse headache (MOH) show dependency-like behaviors such as loss of control over analgesics despite adverse consequences on headaches, high rates of relapse after withdrawal from symptomatic medications, and compromised social functioning. Neuroimaging research suggests a common pathophysiology between substance-use disorders and MOH, which involves functional ...

Osteoarthritis is one of the most frequent and chronic conditions that affect the U.S. population. Use of intra-articular injections is one of the established treatment options available in the nonoperative care for the management of symptomatic osteoarthritis. Common injectable medications include corticosteroids, hyaluronic acid, and other less traditional compounds (for ...

Tremor is a common clinical problem in middle-aged and older patients, and Parkinson disease (PD) is one of the commonest causes. Careful history-taking and physical examination is usually sufficient for diagnosis of PD; extensive investigation is generally not required. Treatment of PD should be individualised, taking into account the patient's ...

We examined hippocampal activation in schizophrenia (SZ) with fMRI BOLD in response to the presentation of novel and familiar scenes. Voxel-wise analysis showed no group differences. However, anatomical region-of-interest analyses contrasting normal (NL), SZ-on-medication (SZ-ON), SZ-off-medication (SZ-OFF) showed substantial differences in MTL-based novelty responding, accounted for by the reduction in ...

Thomas Willis made numerous contributions to the neurosciences that were broad in scope. In an age of scientific breakthroughs and intellectual revolutions, Willis bestowed upon medical research the clinical rigor that set the stage for subsequent medical breakthroughs. In Cerebri Anatome, Willis introduced a measure of empiricism hitherto unknown in ...

Aedes aegypti is one of the demonstrated vector-borne diseases worldwide particularly in the Sub-Sahara of Africa. Its re-emergence in the Egyptian southern border (Aswan) and now in Toshka is an integration mark. Ae. aegypti medical importance, epidemiological implications, ecological behaviors and control measures were discussed.

Numerous diffusion tensor imaging (DTI) studies have implicated white matter brain tissue abnormalities in schizophrenia. However, the vast majority of these studies included patient populations that use antipsychotic medication. Previous research showed that medication intake can affect brain morphology and the question therefore arises to what extent the reported white ...

Gait and balance impairments in people with Parkinson disease (PD) may lead to falls and serious injuries. Therefore, it is critical to improve our understanding of the nature of these impairments, including how they respond to prescribed anti-Parkinson medication. This is particularly important for complex balance and gait tasks that ...

BACKGROUND: Based on combined analysis of clinical assessment of parkinsonian rigidity (constant resistance force generated during passive movement in a joint), electromyography and/or dynamometry many studies showed objectively that anti-parkinsonian medication decreases the rigidity in Parkinson's disease (PD). Rigidity-related changes in resting muscle stiffness (changed muscle's mechanical property related to ...

BACKGROUND: Global brain abnormalities such as brain volume loss and grey- and white-matter deficits are consistently reported in first-episode schizophrenia patients and may already be detectable in the very early stages of the illness. Whether these changes are dependent on medication use or related to intelligence quotient (IQ) is still ...

To examine behavioral risk factors in relation to fatigue after spinal cord injury (SCI), specifically cardiovascular-related behaviors, prescription medication use, and alcohol and cigarette use. Cross-sectional. A medical university in the southeastern United States. Adults (N=2245) at least 1 year post-SCI from a large specialty hospital in the Southeast responded ...

Much effort has been devoted to research focused on pharmacotherapies for cocaine dependence yet there are no FDA-approved medications for this brain disease. Preclinical models have been essential to defining the central and peripheral effects produced by cocaine. Recent evidence suggests that cocaine exerts its reinforcing effects by acting on ...

The aim of this paper is to introduce a great physician of the late Ottoman period and his writings on spinal anatomy. The paper presents chapters related to the anatomy of vertebra and the vertebral column in the book of Şanizade Ataullah Mehmed, Mir'ā t al-Abdān fı Tashrīḥ-i A'ḍ ąi'l-Insān ...