Schacktemple0804

Dual antiplatelet therapy (DAPT, aspirin, and a P2Y12 inhibitor) reduces thrombotic events in patients with coronary artery disease (CAD). The T-TAS PL assay uses arterial shear flow over collagen surface, better mimicking in vivo conditions compared to conventional agonist-based platelet function assays, to evaluate platelet function. Here, the platelet function in patients taking DAPT is evaluated with the T-TAS PL assay. In 57 patients with CAD, taking DAPT ≥7 days (n = 22 for clopidogrel, n = 15 for prasugrel, n = 20 for ticagrelor), T-TAS PL assessments were performed in duplicate, and expressed as area under the flow pressure curve within a 10-minute period (AUC10). The duplicate measurements were strongly correlated (r = 0.90, p less then .001), with an intra-assay coefficient of variation (CV) of 11,5%. For clopidogrel, the median AUC10 was 11.5 (IQR5.9-41.8), for prasugrel 28.8 (IQR10.3-37.6), and for ticagrelor 8.9 (IQR 6.4-10.9). All measurements were below the AUC10 cutoff of 260 measured in healthy volunteers, suggesting excellent discrimination of DAPT-treated and untreated persons. Nigericin sodium The new T-TAS PL assay demonstrated complete discrimination of platelet function in patients on DAPT based on an established cutoff. Ticagrelor showed lower levels of platelet function and a more uniform response compared to prasugrel and clopidogrel.

To compare the efficacy and safety of topical nonsteroidal anti-inflammatory drugs (NSAIDs) against placebo and active controls for improving pain and physical function of patients with knee osteoarthritis (OA). We hypothesize that topical NSAIDs will be safe and effective for relieving symptoms in patients with knee OA.

The authors performed a systematic review according to the PRISMA guidelines, searching PubMed, EMBASE, and Cochrane databases. Randomized control trials that investigated topical NSAIDs that are widely available in many countries against both placebo and active controls in primary knee osteoarthritis were included. Studies that investigated other treatment modalities or treated nonspecific OA were excluded. A meta-analysis was performed to quantify the effect sizes and heterogeneity of the NSAIDs used.

Upon initial search, 259 records were identified with 18 studies remaining after duplicate removal, abstract, and full-text screening. All NSAIDs demonstrated statistically significant rable internationally and is the only topical NSAID approved for over-the-counter use in the US. It should be recommended to patients as a first-line conservative management for OA of the knee.

Cohabitation and social conditions predict prognosis in several cancers; recent data suggest this might also be the case in penile cancer.

To assess the prognostic significance of cohabitation, living arrangements and socio-economic conditions for cancer-specific survival (CSS) in patients with penile squamous cell carcinoma (pSCC).

We retrospectively evaluated CSS in 429 pSCC patients from a 10-year period. We assessed cohabitation, living arrangements and socio-economic conditions(SEC) as prognostic predictors. Kaplan-Meier estimates and Cox hazard rates (HR) with 95% confidence intervals were used for analysis.

Out of 429 pSCC patients, 137 (32%) were living alone and 292 (68%) were cohabiting. With a Cox HR at 1.91 (95% CI 1.3-2.98) patients living alone had a significantly lower median five-year survival rate at 69% (95% CI 60-77%) compared to cohabiting patients at 83% (95% CI 78-87%),

 = 0.002. Comparing 60 (14%) from higher to 202 (47%) from medium and 95 (22%) patients from lower socio-economic groups we found Cox HRs at 1, 2.4 (95% CI 1.0-5.7,

 = 0.04) and 3.4 (95% CI 1.4-8.1,

 < 0.01) respectively. When comparing living arrangements, the trend that patients living in apartments and institutions had poorer outcomes than patients living in a house did not reach statistical significance.

Living alone and in poor socio-economic conditions predict poor prognosis in penile cancer in this national study. We make the case for further research in efforts to minimize cancer inequality pSCC patients.

Living alone and in poor socio-economic conditions predict poor prognosis in penile cancer in this national study. We make the case for further research in efforts to minimize cancer inequality pSCC patients.Introduction Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA), remains a significant pathogen in children. Despite evidence of decreasing prevalence, MRSA bacteremia has been closely associated with complications, including certain infections (i.e. musculoskeletal and endovascular) linked to increased treatment failures.Areas covered This expert review summarized recent published literature on the role of treatment, dosing and administration of antibiotics used to combat serious S. aureus infections in children. The pertinent antibiotics presented were vancomycin, oxazolidinones, semi-synthetic glycopeptides, daptomycin, tigecycline, novel cephalosporins, fosfomycin and lefamulin. Vancomycin has been the most commonly used antibiotic in empiric therapy for serious MRSA infection, with new key recommendations emphasizing a different approach to dosing and therapeutic monitoring. For other antibiotics, data remain limited or clinical trials are underway.Expert opinion MRSA remains a significant pathogen in the pediatric population. As numerous therapeutic agents are available, many agents have limited data on usage in pediatric patients. Future studies require pharmacokinetic, safety and efficacy studies in pediatric patients to ensure appropriate therapeutic treatment and outcomes. Phage therapy has been used to treat deep-seated MRSA infections and is an emerging investigational treatment option.Objective Little is known about muscle wasting in elderly patients with rheumatoid arthritis (RA). We examined muscle characteristics and their clinical significance in this group.Method Consecutive RA patients were recruited and clinical data were collected. Muscle mass and distribution were assessed using bioelectric impedance analysis. Myopenia was defined as an appendicular skeletal muscle mass index (ASMI) ≤ 7.0 kg/m2 (men) and ≤ 5.7 kg/m2 (women).Results Among the 643 RA patients recruited, 165 (25.7%) were elderly patients (age ≥ 60 years) with a mean age of 65.1 ± 4.5 years. Compared with young patients (age less then 60 years), elderly RA patients had significantly higher Disease Activity Score based on 28-joint count-C-reactive protein (DAS28-CRP) (median 3.4 vs 3.2), Health Assessment Questionnaire Disability Index (HAQ-DI) (0.38 vs 0.13), and modified total Sharp score (mTSS) (16 vs 9), and a higher proportion of myopenia (54.5% vs 41.4%; all p less then 0.01). Elderly RA patients with myopenia (n = 90, 14.