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Intrauterine Devices: An Update
Three intrauterine devices (IUDs) are available in the United States: the copper T 380A and two levonorgestrel-releasing IUDs, one that releases 20 mcg of levonorgestrel per 24 hours, and one that releases 14 mcg per 24 hours. All are safe and effective methods of contraception that work predominantly by prefertilization mechanisms. The copper T 380A IUD may be placed in nonpregnant women at an…
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Menopausal hormone therapy 2019
As women transition through the menopause, the decreased production of estrogens can manifest itself in three different ways: - Immediate vasomotor, sleep and emotional impacts - Later local genital tract and urinary symptoms - Long-term cardiovascular, skeletal and other ‘chronic’ consequences
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Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obst…
Precision medicine is a patient specific approach that integrates all relevant clinical, genetic and biological information in order to optimise the therapeutic benefit relative to the possibility of side effects for each individual. Recent clinical trials have shown that higher blood eosinophil counts are associated with a greater efficacy of inhaled corticosteroids (ICS) in COPD patients
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HLA antigens in individuals with down syndrome and alopecia areata
Seventy per cent of evaluated individuals in the DS and AA group were male; presented mean age of 18.6 (SD ± 7.2) years and 70% were Caucasian. We observed involvement of the scalp, with a single lesion in 10% and multiple in 90% of subjects. It was observed that there is no significant difference in the frequency distributions of the alleles HLA loci A, B, C, DRB1 and DQB1 of subjects studie…
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Clinical Characteristics of Alopecia Areata in Down Syndrome
This study was undertaken to better understand clinical characteristics, environmental and physical events in Down syndrome (DS) and alopecia areata (AA). This cross-sectional study included 18 DS patients who were currently presenting or had presented AA. We evaluated gender, age, location and type of AA, presence of autoimmune disease or atopy, AA in first-degree relatives, and environmental,…
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Radiation Enteritis
Radiation enteritis continues to be a major health concern in recipients of radiation therapy. The incidence of radiation enteritis is expected to continue to rise during the coming years paralleling the unprecedented use of radiotherapy in pelvic cancers. Radiation enteritis can present as either an acute or chronic syndrome. The acute form presents within hours to days of radiation exposure a…
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Stent Thrombosis
The most dreaded complication with percutaneous coronary intervention with stents, either bare-metal or drug-eluting stents is stent thrombosis (ST) and it has a significant detrimental effect on the outcome for the patient. The initial attempts at intervention with bare-metal stents had much higher rates of ST compared with what is currently prevailing in the modern interventional world. Signi…
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Fluid management in the critically ill
Fluid therapy, which is provided to restore and maintain tissue perfusion, is part of routine management for almost all critically ill patients. However, because either too much or too little fluid can have a negative impact on patient outcomes, fluid administration must be titrated carefully for each patient.
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Reversal of Direct Oral Anticoagulants: Guidance from the Anticoagulation Forum
The direct oral anticoagulants (DOACs) comprise the direct thrombin inhibitor, dabigatran, and the direct factor Xa inhibitors, apixaban, betrixaban, edoxaban, and rivaroxaban. Collectively, these agents have been approved by the United States Food and Drug Administration (US FDA) for prevention of stroke and systemic embolism in non-valvular atrial fibrillation, prevention and treatment of ven…
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Current Knowledge of Occult Hepatitis B Infection and Clinical Implications
Occult hepatitis B infection (OBI) is a status of undetectable serum hepatitis B surface antigen (HBsAg) yet detectable serum and/or intrahepatic hepatitis B virus (HBV) DNA. Mutations in the preS1, preS2, and S regions of the HBsAg gene may result in undetectable HBsAg. OBI may either result froma self-limiting acute hepatitis, or in patients with chronic hepatitis B who achieved HBsAg serocle…
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