Comparison of pharmacodynamic effects of ticagrelor vs prasugrel in type 2 diabetes mellitus patients with coronary heart disease

Summary

What is known and objective

Patients with type 2 diabetes mellitus (T2DM) are at higher risk of thrombotic complications. Studies have indicated that patients with T2DM have impaired clopidogrel-induced antiplatelet effect. Ticagrelor and prasugrel are two latest generation P2Y₁₂ inhibitors with advantageous platelet inhibitory profiles. However, the pharmacodynamic differences between the two drugs in patients with T2DM remain poorly explored.

Methods

This study, involving 140 patients with T2DM following percutaneous coronary intervention (PCI), evaluated the efficacy of aspirin upon concomitant use of prasugrel (10 mg/d) or ticagrelor (90 mg/d). Platelet reactivity was assessed by value of ADP-induced light transmittance aggregometry (LTA) and vasodilator-stimulated phosphoprotein phosphorylation-platelet reactivity index (VASP-PRI) at baseline, 7 and 30 days after randomized P2Y₁₂ inhibitor treatment.

Results

The study showed a decreased platelet reactivity after use of P2Y₁₂ inhibitors (both P < .001). On the basis of comparison between regimens, apart from the prasugrel group having a significantly higher LTA value at the 30-day time point (P = .043), there existed no significant differences in platelet reactivity at separate time points (all P > .05). As for intragroup measurements, when compared with 7-day and 30-day time points, similar platelet reactivity was documented in the ticagrelor group (both P > .05), but LTA tests showed a significant increase with time (days 7-30) in the prasugrel group (P = .050).

What is new and conclusion

Although ticagrelor and prasugrel have similar platelet inhibitory effects in patients with T2DM, if a P2Y₁₂ inhibitor is necessitated in patients with T2DM, ticagrelor might exert a more stable antiplatelet effect with 30-day short-term treatment.

Ticagrelor and prasugrel have similar platelet inhibitory effects in patients with T2DM, but if a P2Y12 inhibitor is necessitated in patients with T2DM, ticagrelor might exert a more stable antiplatelet effect with 30-day short-term treatment.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zevvkh
via IFTTT

Liver injury induced by clomiphene citrate: A case report and literature reviews

Summary

What is known and objective

Clomiphene citrate is used to cause ovulation in females and to increase semen production in males. Clomiphene citrate is well tolerated in most patients and rarely induces liver injury. We report a case of liver injury which is associated with administration of clomiphene citrate in a male patient.

Case summary

A 31-year-old man who was treated by clomiphene citrate for 5 days was transferred to our emergency room with reddish-brown urine and upper abdominal pain. The levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were elevated. Based on the subsequent examination, he was diagnosed with liver injury and cholecystitis. The levels of AST and ALT returned to normal range after discontinuation of clomiphene citrate and symptomatic treatment.

What is new and conclusion

The mechanism of liver injury caused by clomiphene citrate is still unclear. Polymorphism of CYP2D6 may have had an effect. Liver function tests should be performed when there is upper abdominal pain after administration of clomiphene citrate.

A case of liver injury induced by clomiphene citrate in a male patient was reported which may caused by polymorphism of CYP2D6. Liver function tests should be performed after adminitration of clomiphene citrate.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2mENVVG
via IFTTT

Four tenants at Devonport

A fully tenanted 1960s retail property, standing beside Devonport's refurbished public library and just a short stroll from its well-used ferry terminal, is for sale through NAI Harcourts. The freehold building at 8 Victoria Rd is scheduled to go to auction on November 30, unless it is sold earlier.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zcdEKX
via IFTTT

Two Scientific Awards for papers published in Sleep Medicine

Under the auspices of the World Association of Sleep Medicine (WASM), Elsevier has established two scientific awards for young basic and clinical sleep specialists in honor of Christian Guilleminault and Elio Lugaresi, respectively. The awards are a tribute to Dr. Guilleminault's and Dr. Lugaresi's contributions to establish the field of Sleep Medicine, its journal and its Society.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2ySoiCr
via IFTTT

Editorial Board

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2AUGT1X
via IFTTT

Effect of laser activated bleaching on the chemical stability and morphology of intracoronal dentin

Publication date: February 2018
Source:Archives of Oral Biology, Volume 86
Author(s): Fabiane Carneiro Lopes, Renato Roperto, Anna Akkus, Ozan Akkus, Regina Guenka Palma-Dibb, Manoel Damião de Sousa-Neto
ObjectivesTo evaluate the effect of the bleaching with 35% hydrogen peroxide either activated or not by a 970nm diode laser on the chemical stability and dentin surface morphology of intracoronary dentin.MethodsTwenty-seven slabs of intracoronary dentin specimens (3×3mm) were distributed into three groups (n=9), according to surface treatment: HP – 35% hydrogen peroxide (1×4'), DL – 970nm diode laser (1×30"/0,8W/10Hz), HP+DL – 35% HP activated with 970nm diode laser (1×30"/0,8W/10Hz leaving the gel in contact to the surface for 4′ after activation). Three Raman spectra from each fragment were obtained to calculate the mean intensity of peaks of inorganic component (a.u.), organic collagen content (a.u.), and the ratio of inorganic/organic content, before and after treatment. Analyses of the samples by confocal laser microscopy were performed to evaluate the surface roughness, percentage of tubules, perimeter and area percentage of tubules, before and after treatment. Data were analyzed by Kruskal-Wallis, Dunn's, and Wilcoxon test (P<0.05).ResultsData analysis showed that HP+DL did not change the inorganic content peaks 8.31 [29.78] or the inorganic/organic ratio 3.37 [14.67] (P>0.05). Similarly, DL did not affect the chemical stability of the dentin surface (P>0.05). However, HP significantly increased inorganic content peaks 10.87 [22.62], as well as the inorganic/organic ratio 6.25 [27.78] (P<0.05). Regarding the morphological alterations, all surface treatments increase tubules exposure; HP treatment significantly increases perimeter and area percentage; and HP+DL increases surface roughness.ConclusionsBleaching HP combined with DL offers an improvement in terms of intracoronal dentin surface protection, yielding better maintenance of dentin chemical stability and morphology.



from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2AZeSqj
via IFTTT

Subadditive responses to extremely short blue and green pulsed light on visual evoked potentials, pupillary constriction and electroretinograms

The simultaneous exposure to blue and green light was reported to result in less melatonin suppression than monochromatic exposure to blue or green light. Here, we conducted an experiment using extremely short...

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2j4XCHT
via IFTTT

Life, Positively 2017

Published: November 17, 2017 in A&E / Life&Style , Cover Stories , Featured Stories Updated: November 16, 2017 at 8:02 pm ENGAGE: Write a letter to the editor qnotes is pleased to partner with Affinity Health Center, RAIN, Rosedale Medical, Ballantyne Family Medicine and PowerHouse Project in presenting this special section, "Life, Positively," in recognition of World AIDS Day. Affinity Health Center is a Federally Qualified Community Health Center located in Rock Hill, S.C. Our staff of almost 50 employees is growing to serve the needs of your community with compassion, dignity and respect.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2j5qIqv
via IFTTT

Letter to the Editor regarding “Robotic or non-robotic transoral laryngectomy”

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2yTkKzQ
via IFTTT

Reply to Letter to the Editor regarding “Robotic or non-robotic transoral laryngectomy”

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2AZmQzt
via IFTTT

Pneumoparotitis as a complication of long-term oronasal positive airway pressure for sleep apnea

Abstract

Background

Parotid swelling is rarely caused by pneumoparotitis from retrograde insufflation of air into Stensen's duct. Previous reports have identified occupational exposures, self-induced habits, exercise, spirometry, and short-term positive pressure airway ventilation as causes of salivary duct insufflation.

Methods

We present 2 cases of pneumoparotitis in patients on long-term oronasal continuous positive airway pressure (CPAP) for obstructive sleep apnea.

Results

A diagnosis of pneumoparotitis was made by CT scan in case 1 and sialography in case 2. Patients were advised to transition from oronasal to nasal-only CPAP. One patient was successfully transferred and had good symptomatic improvement, whereas the second patient did not tolerate nasal CPAP and had persistent symptoms on oronasal CPAP.

Conclusion

Long-term use of oronasal CPAP is a potential cause of pneumoparotitis.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2yTkRvg
via IFTTT

Top 10 research priorities in head and neck cancer: Results of an Alberta priority setting partnership of patients, caregivers, family members, and clinicians

Abstract

Background

The epidemiology, etiology, and management of head and neck cancer are evolving. Understanding the perspectives and priorities of nonresearchers regarding treatment uncertainties is important to inform future research.

Methods

Using the James Lind Alliance approach, patients, caregivers, and clinicians responded to a survey regarding their unanswered questions about treating and managing head and neck cancer. Distinct uncertainties were extracted from responses and sorted into themes. Uncertainties already answered in the literature were removed. Those remaining were ranked by patients and clinicians to develop a short list of priorities, which were discussed at a workshop and reduced to the top 10.

Results

One hundred sixty-one respondents posed 818 uncertainties, culminating in 77 for interim ranking and 27 for discussion at a workshop. Participants reached consensus on the top 10, which included questions on prevention, screening, treatment, and quality of life.

Conclusion

Nonresearchers can effectively collaborate to establish priorities for future research in head and neck cancer.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2AZmNnh
via IFTTT

Predictive factors for osteoradionecrosis of the jaws: A retrospective study

Abstract

Background

Osteoradionecrosis of the jaw (ORNJ) is a well-recognized complication of radiotherapy. The purpose of this study was to assess predictive factors for the development of ORNJ.

Methods

A retrospective study of 325 patients with head and neck squamous cell carcinoma (HNSCC) treated at one institution between January 1, 1999, and December 31, 2008, was conducted. Outcome measure was the presence/absence of ORNJ. Time to event was recorded and Cox proportional hazard regression analysis was used to determine statistically significant predictive factors.

Results

Fifty-nine patients had ORNJ. Statistical analysis using Cox regression analysis identified several statistically significant variables: dentoalveolar surgery; peri-resective surgery of the jaw; continued tobacco usage after radiotherapy, diabetes mellitus type 2 (DM2); and total radiation dose.

Conclusion

Patients at greater risk of developing ORNJ can be identified and measures can be instituted to reduce its incidence and expedite management when it does occur.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2yTrKwz
via IFTTT

Prevalence of antibiotic prescription in pediatric outpatients in Italy: the role of local health districts and primary care physicians in determining variation. A multilevel design for healthcare decision support

According to scientific literature, antibacterials are prescribed for common pediatric conditions that do not benefit from antibiotic therapy. The link between antibiotic use and bacterial resistance is well k...

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zRexFI
via IFTTT

Risk management of emergency service vehicle crashes in the United States fire service: process, outputs, and recommendations

Emergency service vehicle crashes (ESVCs) are a leading cause of death in the United States fire service. Risk management (RM) is a proactive process for identifying occupational risks and reducing hazards and...

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2j4GiTo
via IFTTT

Assessing the delivery of alcohol screening and brief intervention in sexual health clinics in the north east of England

Risky drinking is associated with risky sexual experiences, however the relationship between alcohol and sex is complex. The aim of the study was to assess the feasibility of delivering alcohol screening and b...

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zR8jWs
via IFTTT

Observation and assessment of the nutritional quality of ‘out of school’ foods popular with secondary school pupils at lunchtime

The contemporary Scottish diet is unhealthy and a risk factor for poor health outcomes including obesity. Over a third of Scottish children are at risk of being overweight or obese, and there have been calls t...

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2j2G4vW
via IFTTT

Dentist teaches basics of oral care for police dogs

Roughly 30 area officers learned the basics of oral care for their working police dogs Thursday morning from veterinary dentist Dr. Stephen Juriga, who spoke to the group at the Aurora police headquarters. Juriga said police dogs - typically German shepherds, Belgian malinois or bloodhounds - have a high pain tolerance and won't show signs when their teeth are broken, discolored or otherwise causing pain.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2AWmDwR
via IFTTT

FLASHBACK: Maxine tries out the DIY dental kit from Barnitts, January 1998

It was a busy newsroom, with two banks of reporters filling the editorial floor and a row of features writers and subs. I had been working as a features writer in London and a sub-editor in Cambridge before my move north and had not been a reporter for a couple of years, having cut my teeth on the Oxford Mail.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2yT7fQE
via IFTTT

Plant eater

Seymore Krelborn, portrayed by Peyton Smith, talks to his plant for the first time. Plant eater By Chris Strunk Last Updated: November 16, 2017 Valley Center to perform 'Little Shop of Horrors' If 'Little Shop of Horrors" is so gory and gross, why can't audiences stop laughing? The musical, which features a blood-thirsty talking plant and a self-medicating and sadistic dentist, is, at its core, a comedy.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2AXVz0k
via IFTTT