American medical journal最新文献

{"title":"Platelets, Coagulation and Cancer: Multifaceted Interactions","authors":"H. Goubran, T. Burnouf","doi":"10.3844/AMJSP.2012.130.140","DOIUrl":"https://doi.org/10.3844/AMJSP.2012.130.140","url":null,"abstract":"Approach: Literature review of the multifaceted interactions between platelets, coagulation and cancer. Results: Over the years, the links existing between cancer development, progression and occurrence of metastasis on one side and coagulation on the other have become obvious. Tumors seems to activate platelets whereas, platelets, on the other hand, through their capacity to activate and release soluble factors and microparticles, interact with tumor cells and influence immune regulation. They appear to be key regulators of many cancer events. Furthermore, coagulation with its different facets also interplays and significantly crosstalks with malignancy. The objectives of this article are to review the mechanisms through which cancer interacts with platelets and the coagulation, triggering thrombosis and the role played by platelets and coagulation factors in the regulation of cancer and to underline the perspectives that are now open in the development of novel diagnostic tools and new cancer treatment strategies. Conclusion/Recommendations: Challenging issues and unresolved questions still need to be addressed to understand the complexity existing between coagulation factors and platelet components and the different stages of cancer progression. Recent discoveries are leading clinicians to consider new therapeutic applications of anticoagulant therapies or new drugs targeting specific platelet functions in cancer patients’ management. Furthermore, markers of coagulation and platelet activity may prove to serve as biomarkers for dormant tumors.","PeriodicalId":89887,"journal":{"name":"American medical journal","volume":"3 1","pages":"130-140"},"PeriodicalIF":0.0,"publicationDate":"2012-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3844/AMJSP.2012.130.140","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70191355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rivaroxaban and its Effect on International Normalised Ratio-A Prospective Study of 28 Hip and Knee Arthroplasty Patients","authors":"C. Yeo, V. Eranki, A. Pillai, G. Morrison","doi":"10.3844/AMJSP.2012.126.129","DOIUrl":"https://doi.org/10.3844/AMJSP.2012.126.129","url":null,"abstract":"Problem statement: Rivaroxaban is an orally active, competitively reversible antagonist of activated factor Xa. The purpose of this study is to comment on Riveroxaban’s effect on INR. Approach: At the Queen Elizabeth Hospital, all patients undergoing elective anthroplasty were anticoagulated with 10mg of Rivaroxaban. All patients had INR measurements for 3 days post operatively. Further 16 patients had weekly INR follow follow up for the reminder of their therapy. Measurements between 0.2-1.2 were classified normal, 1.3-1.4 elevated and INR>1.4 high. Results: On day 1 after Rivaroxaban was commenced, 67.9% of patients recorded high INR value of >1.4 while 7.1% of patients had normal value of INR value (0.8-1.2). However, the number of patient with normal value of INR increased over next 2 days. On the third day after Rivaroxaban was commenced, 35.7% of the patients recorded a normal INR value while 32.1% of the studied patients had recorded mild elevated INR value. 32.1% of the studied patients had high INR value. All patients had an INR greater than 1.1. In the first 3 days, the maximum INR reached was 3.1. In patients who. All patients with a normal INR on day 1 remined normal throughout their course. 4 patients with an elevated INR on day 1 normalised by day 3. 8 patients had an INR trend upwards from day 1-2. 3 patients had a higher INR at day 3 compared to day 1. Of the 16 pateints followed up till the end of their therapy, 68.8% patients had a normal, 18.8% elevated and 12.5% patients had a high INR. Conclusion: Rivaroxaban has been proven as an effective alternate to existing anticoagulats in tehrms of patient compliance, rates of thrombus and bleeding risks. This study successfully demonstrates that Rivaroxaban leads to a trancient increase in INR in the majority of pateints in the first 72 h. Nil litrature exists on the effect of Rivaroxaban on prothrombin time and appropriate reversal and mangemetn of pateints who require further surgical intervention. Further research is required into invistigating the cause and effect of this increase.","PeriodicalId":89887,"journal":{"name":"American medical journal","volume":"3 1","pages":"126-129"},"PeriodicalIF":0.0,"publicationDate":"2012-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3844/AMJSP.2012.126.129","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70191307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trauma Induced AppendicitisA Real Entity","authors":"J. Torres-Grau, S. Monkhouse","doi":"10.3844/AMJSP.2012.124.125","DOIUrl":"https://doi.org/10.3844/AMJSP.2012.124.125","url":null,"abstract":"Problem statement: Appendicitis is a very common surgical problem. Sometimes, appendicitis and trauma coexist. There has been evidence that trauma may be an aetiology for acute appendicitis. We present the case history of one of our patients in which trauma was the only aetiological factor causing acute appendicitis. To highlight the importance of considering the diagnosis of appendicitis when a case of an acute abdomen with RIF presents, following trauma. Conclusion: Albeit a rare origin, trauma can be a cause for appendicitis as we show in our case study. In order to make this diagnosis, there are certain criteria that must be met. This is an important diagnosis to consider when presented with such cases. This will lead to prompt diagnosis and treatment, avoiding, delays which may lead to complications.","PeriodicalId":89887,"journal":{"name":"American medical journal","volume":"3 1","pages":"124-125"},"PeriodicalIF":0.0,"publicationDate":"2012-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3844/AMJSP.2012.124.125","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70191297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Is The “Safest” Non-Steroidal Anti-Inflammatory Drugs?","authors":"P. Ungprasert, W. Kittanamongkolchai, Chrystal D. Price, Supawat Ratanapo, Napat Leeaphorn, Daych Chongnarungsin, W. Cheungpasitporn","doi":"10.3844/AMJSP.2012.115.123","DOIUrl":"https://doi.org/10.3844/AMJSP.2012.115.123","url":null,"abstract":"Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) which are widely used in clinical practice are also very well-known for their various adverse reactions. Each NSAID has its own unique safety profile and selecting an appropriate NSAID m ust be individualized for each patient based on his or her medical needs and risk factors. We reviewed literatures on NSAIDs, focusing on their adverse reaction profile. We reviewed and compared the inci dence of adverse reaction from individual NSAIDs according to organ systems. This review includes both selective COX-2 inhibitors and non- selective NSAIDs. Based on the most up-to-date evidence, ibuprofen appears to be the preferred NSAIDs based on its favorable GI and nephrotoxicity profiles. Naproxen might be considered in patients who have greater cardiac risk. Celecoxib, at the do se of less than or equal to 200 mg day -1 , might be an option in the patients who are at high risk for GI bleeding. Key word: Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), COX-2 inhibitor, adverse drug reaction, adverse reactions, safety profile, clinic al practice, organ systems","PeriodicalId":89887,"journal":{"name":"American medical journal","volume":"3 1","pages":"115-123"},"PeriodicalIF":0.0,"publicationDate":"2012-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3844/AMJSP.2012.115.123","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70191244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Differences in Quality of Life in Prostate Cancer Project: Methods and Design of a Multidisciplinary Population-Based Follow-up Study","authors":"C. Brennan, E. Oral, E. Fontham, J. Mohler, J. Bensen, M. Mishel, Neal Simonsen","doi":"10.3844/AMJSP.2012.104.114","DOIUrl":"https://doi.org/10.3844/AMJSP.2012.104.114","url":null,"abstract":"Problem statement: Numerous studies have examined the Health Related Quality of Life (HRQoL) in Prostate Cancer (PCa) survivors but few have examined potential differences between races. The causes for alterations in HRQoL in PCa survivors have not been thoroughly explored either, limiting insight regarding potential means to improve their quality of life. Using a large sample of approximately equal numbers of Caucasian-American (CA) and African-American (AA) PCa survivors, the Quality of Life in Prostate Cancer Project (Q-PCaP) is designed to determine if there is a disparity in HRQoL between these groups. Furthermore, QPCaP will determine to what extent certain factors, specifically Healthy Life Behaviors (HLBs), socioeconomic determinants and cultural characteristics of AA and CA PCa survivors affect HRQoL and provide an explanation for any potential disparities observed. Approach: Q-PCaP is a follow-up study built upon a population-based study, the North Carolina-Louisiana Prostate Cancer Project (PCaP). PCaP enrolled men with newly-diagnosed PCa from specific regions of these two states from September 2004 through August 2009. Q-PCaP is designed to collect follow up HRQoL data from the Louisiana cohort of PCaP 3-6 years after their initial baseline interview. Subjects’ current HLBs, social, economical, physical and emotional status, including prostate-related symptoms and other comorbidities, as well as their self-reported experience regarding PCa treatment and health care, will be collected via telephone interviews. The presence and degree of any disparity in the HRQoL between AA and CA PCa survivors will be evaluated. Results: The study will generate a rich archive of follow-up data for a well-characterized population-based cohort of men with PCa to improve understanding of the determinants and disparities in HRQoL. Primary data collection activities are expected to continue through January 2013, yielding approximately 900 enrolled PCa survivors. Conclusion: HLBs are potentially modifiable factors affecting the HRQoL of PCa survivorship. Identifying those that contribute the most to HRQoL and instituting interventions to alter “unhealthy” behaviors may make it possible to not only improve overall HRQoL of PCa survivors, but to reduce racial disparities.","PeriodicalId":89887,"journal":{"name":"American medical journal","volume":"63 1","pages":"104-114"},"PeriodicalIF":0.0,"publicationDate":"2012-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3844/AMJSP.2012.104.114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70191235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-Depth Review of Stroke Prevention in Patients with Non-Valvular Atrial Fibrillation","authors":"Daych Chongnarungsin, Supawat Ratanapo, N. Srivali, P. Ungprasert, P. Suksaranjit, Saeed Ahmed, W. Cheungpasitporn","doi":"10.3844/AMJSP.2012.100.103","DOIUrl":"https://doi.org/10.3844/AMJSP.2012.100.103","url":null,"abstract":"Stroke is a common complication of atrial fibrillation that leads to high morbidity. Anticoagulation therapy significantly reduces the risk of stroke in a selected group of patients. The decision to start anticoagulation needs to be balanced with bleeding risk. During the past years, multiple oral anticoagulation agents were proven to be as effective as warfarin in multiple randomized clinical trials. The superior benefits of these agents over warfarin are lower risk of intracranial bleeding, stable blood level and no need for frequent blood monitoring. The non-pharmacological approach for stroke prevention is undergoing development and only use in the clinical trials. If proven to be beneficial, it will have great impact for the patient who is contraindicated for anticoagulation therapy. The objective of this article is to review the most current options for stroke prevention in patients with non-valvular atrial fibrillation.","PeriodicalId":89887,"journal":{"name":"American medical journal","volume":"3 1","pages":"100-103"},"PeriodicalIF":0.0,"publicationDate":"2012-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3844/AMJSP.2012.100.103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70191679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insulin Pump Therapy in Type 1 Diabetes-Merging Technology with Diabetes Care","authors":"H. Thabit","doi":"10.3844/AMJSP.2012.93.99","DOIUrl":"https://doi.org/10.3844/AMJSP.2012.93.99","url":null,"abstract":"The use of insulin pump therapy has been increasing over the past number of years in many countries. The Diabetes Control and Complications Trial (DCCT) have proven that better glycaemic control with fewer hypoglycemic events is achievable with insulin pump therapy. The delivery of subcutaneous insulin through an insulin pump mimics physiological insulin delivery better than Multiple Daily Injection of insulin (MDI). Insulin pump therapy is an attractive therapeutic option for many patients with T1DM with the potential to improve glycaemic control and quality of life. Technological developments over the past few years have enhanced the functional capabilities and appearance of modern insulin pumps. Careful patient selection for insulin pump therapy by health care professionals is still important, to optimize its benefit and to lessen the associated risk. In this review article, the clinical evidence for insulin pumps, its advantages and disadvantages, as well as patient selection criteria for insulin pumps are outlined. Examples of insulin pump devices that are currently available, including the advent of newer devices and technology in this field are also reviewed.","PeriodicalId":89887,"journal":{"name":"American medical journal","volume":"3 1","pages":"93-99"},"PeriodicalIF":0.0,"publicationDate":"2012-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3844/AMJSP.2012.93.99","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70192390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary Endothelial Dysfunction after Drug-Eluting Stent Implantation","authors":"S. Ito","doi":"10.3844/AMJSP.2012.75.81","DOIUrl":"https://doi.org/10.3844/AMJSP.2012.75.81","url":null,"abstract":"Problem statement: Stent thrombosis, which may occur even one year after stent implantation, is a drawback of Drug-Eluting Stents (DES). Among the variety of causes of stent thrombosis after DES implantation, coronary endothelial dysfunction manifested or exaggerated by DES implantation should not be overlooked. This review article summarizes previous reports on coronary endothelial dysfunction after DES implantation and/or coronary spasm and discusses the mechanism, clinical implications and prognosis. Although novel stents that do not impair endothelial function will most likely be developed in the near future, millions of patients have already undergone implantation of a first or second generation DES. Conclusion/Recommendations: Some studies have reported that a drug improves the impairment of endothelial function. On the other hand, no direct relationships between spasm and stent thrombosis after DES implantation have been reported. A larger study is warranted to clarify the clinical significance of this important clinical issue.","PeriodicalId":89887,"journal":{"name":"American medical journal","volume":"3 1","pages":"75-81"},"PeriodicalIF":0.0,"publicationDate":"2012-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70192267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intubation using the Video Laryngoscope","authors":"B. Boedeker, W. Murray, T. Nicholas","doi":"10.3844/AMJSP.2012.67.74","DOIUrl":"https://doi.org/10.3844/AMJSP.2012.67.74","url":null,"abstract":"Problem statement: Inadequate airway management is a major contributor to morbidity and mortality in the prehospital and out-of-operating room hospital settings. Difficulties that occur during airway management are usually related to the intubator not being able to achieve an adequate view of the glottic opening to allow insertion of an endotracheal tube. Approach: Obtaining an adequate glottic view is technically challenging for the experiened practioner but it is exponentially more difficult for the novice intubator. Needless to say, it is a challenge to teach the actual process of intubation using traditional direct laryngoscopy. Results: Subsequently, numerous intubation devices like the video laryngoscope have been developed that incorporate an optical fiber image transmitter integrated with a modified laryngoscope blade to facilitate visualization of the glottic opening. Conclusion: With the addition of these devices, which have a short, more beneficial learning curve, the video laryngoscope has emerged as a leading method of obtaining an improved view of the glottis opening during intubation.","PeriodicalId":89887,"journal":{"name":"American medical journal","volume":"3 1","pages":"67-74"},"PeriodicalIF":0.0,"publicationDate":"2012-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3844/AMJSP.2012.67.74","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70192258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Order Interactions in Rheumatoid Arthritis Detected by Bayesian Method using Genome-Wide Association Studies Data","authors":"Jing Zhang, Zheyang Wu, Chao Gao, Michael Q. Zhang","doi":"10.3844/AMJSP.2012.56.66","DOIUrl":"https://doi.org/10.3844/AMJSP.2012.56.66","url":null,"abstract":"Problem statement: In order to reveal the missing genetic component of Rheumatoid Arthritis (RA) susceptibility, we carried out a genome-wide high-order epistatic interaction study for RA. Approach: A powerful Bayesian strategy was applied to analyze the data of Genome-Wide Association Studies (GWAS) from the Welcome Trust Case Control Consortium (WTCCC), where 319 high-order interactions were found across the whole genome and many of which were validated by the GWAS data from the North American Rheumatoid Arthritis Consortium (NARAC). Results: This is the first study intensively searching for high-order epistatic interactions genome-widely for RA. Conclusion: Our results suggest that high-order interactions might explain a big proportion of missing genetic component of RA. In the meanwhile, synapse, calcium ion binding and membrane part likely have interactive associations with RA. This finding implies that not only autoimmune system but also nervous system can play an important role in RA.","PeriodicalId":89887,"journal":{"name":"American medical journal","volume":"3 1","pages":"56-66"},"PeriodicalIF":0.0,"publicationDate":"2012-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3844/AMJSP.2012.56.66","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70192197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}