LONDON — The investigational non-steroidal mineralcorticoid receptor antagonist finerenone worked as well as eplerenone (Inspra) with a possible mortality advantage over the older drug in heart failure, the phase II ARTS-HF trial suggested.
Reductions in NT-proBNP of more than 30% from baseline to day 90, the study’s primary endpoint, occurred in 37.2% of eplerenone-treated patients compared with 30.9% to 38.8% of finerenone-treated patients across doses tested (P not significant), Gerasimos Filippatos, MD, of Athens University Hospital Attikon in Greece, and colleagues found.
The U.S. Food and Drug Administration approved Tesaro Inc’s oral drug rolapitant (Varubi) for treatment for chemotherapy-induced nausea and vomiting in adults, the company said on Wednesday.
Voluven hydroxyl ethyl starch
Glycerin solution – 10 % glycerol plus 5 % fructose mixed in normal saline – indigo carmine
Methyl cellulose – hydroxyl propyl methyl cellulose
You can take solid indigo carmine and make solution
Methylene blue is ok. 5 drops in 250 cc bag
Coaggraaper with soft coag.
Sergey : 6% hetastarch in 0.9% saline with 1-2 cc methylene blue
The recommended workup for an adrenal incidentaloma is
Hormonal evaluation . The evaluation in apparently asymptomatic patients has been debated. Even in asymptomatic patients, the European Network for the Study of Adrenal Tumors (ENSAT) recommends performing the following tests to determine the secretory activity of the tumor: fasting blood glucose, serum potassium, cortisol, corticotropin (ACTH), 24-hour urinary free cortisol, fasting serum cortisol at 8 AM following a 1 mg dose of dexamethasone at bedtime, adrenal androgens (dehydroepiandrosterone-sulfate [DHEA-S], androstenedione, testosterone, 17-OH progesterone), and serum estradiol in men and postmenopausal women .
Adrenal carcinomas are typically inefficient steroid producers, but they secrete excessive amounts of adrenal steroid precursors due to decreased expression of several steroidogenic enzymes (which also results in diminished cortisol production). Even in patients with adrenal carcinomas who presumably did not produce excess steroids, more sensitive methods such as gas chromatography/mass spectrometry identify increased urinary metabolites of several steroids and precursors of androgens (pregnenediol, pregnenetriol, androsterone, etiocholanolone) or glucocorticoids (17-hydroxyproesterone, tetrahydro-11-deoxycortisol, cortisol, 6-hydroxy-cortisol, tetrahydrocortisol, and a-cortol); this is different from cortisol secreting adenomas which produce cortisol, but little androgens . Low serum aldosterone concentrations, but normal or high serum or urinary concentrations of aldosterone precursors (ie, deoxycorticosterone, 18-hydroxydeoxycorticosterone, corticosterone, and 18-hydroxycorticosterone, tetrahydro-11-deoxycorticosterone (THDOC), and 5 alpha-THDOC) are found in most adrenal carcinomas, but not in adrenal adenomas [77,78].
The European Network for the Study of Adrenal Tumors (ENSAT) also recommends that plasma metanephrines or urinary metanephrines and catecholamines be obtained in all patients to exclude pheochromocytoma, and that plasma aldosterone and renin be obtained in patients with hypertension and/or hypokalemia (see “Establishing the cause of Cushing’s syndrome” and “Adrenal hyperandrogenism” and “Pathophysiology and clinical features of primary aldosteronism” and “The adrenal incidentaloma”). Hormonal evaluation may help in establishing the adrenal origin of the tumor and provide tumor markers that can be useful during follow-up to estimate the presence of residual tumor or tumor recurrence after surgery.
Naloxegol – 25 mg
GFR > 60, cyp34a, can cross bbb
Contraindicated with biaxin, ketoconazole
MLH1, MSH2, MSH6, PMS2 testing – 95% sensitive
If MLH1 def, BRAF and MLH1 promoter sequence hypermethylation studies. If either is positive no further studies needed
If PMS2, MSH2, MSH6 def pt or MLH1 def patients with neg BRAF and hypermethylation, germline genetic testing is done.
Make a Super Hidden Folder in Windows Without any Extra Software
Almost anyone knows how to make a “hidden” folder in Windows, but then again almost anyone knows how to make explorer show hidden folders. Let’s take a look at how to make a folder so hidden, only you will know its there. Anyone that has used Windows for a while knows that they can right-click on a file or folder and edit its properties, more so its attributes to make it a so called “hidden” file or folder. The problem is that just as many people know you can show files and folders that have the “hidden” attribute by simply changing a radio button under the folder view options. The easiest way to make a real hidden file or folder is to mark it as an important operating system file, that way Windows wont display it even if explorer is set to display hidden files and folders…
The approval of patiromer for oral suspension (Veltassa, Relypsa) comes after the phase-2
study showed that daily administration of the potassium-binding agent safely controlled hyperkalemia over 1 year in patients with type-2 diabetes and hypertension with or without heart failure (HF). They had entered with mild-to-moderate hyperkalemia secondary to treatment with renin-angiotensin-aldosterone system (RAAS)-inhibiting drugs.
Sarcina ventriculi gastroparesis
Dr Aihara. Boston
IT 2 – 3 or 9 to 6
Dual – 6 to 3
Two types of dual. Smaller one for colon. 1.5 mm
Gastric is 2.0
Bleeding in rectum
Hemostatic sponge for rectum
Forced coag for bleeding
Marking soft coag
Coag- use ef 5 80w for gastric ESD
Ef 5 50w for colon
Gonak 45ml+ saline 50ml
Make room, cholesterol. A new disease marker is entering the medical lexicon: suPAR, or soluble urokinase-type plasminogen activator receptor. A study in the New England Journal of Medicine shows that suPAR, a circulating protein measured by a simple blood test, can reliably predict a person’s chances of developing chronic kidney disease as much as five years before this common killer starts causing damage.
The New England Journal of Medicine article appears in Online First, November 5, 2015 to coincide with the American Society of Nephrology’s Kidney Week meeting. It will also appear in the printed issue of the journal on November 12.
The number needed to treat to prevent a heart attack for patients with a DAPT score of 2 or higher is 34 and the number needed to harm (to cause bleeding) is 272, Yeh said. When the score is less than 2, the number needed to treat to prevent ischemia is 153 and the number needed to harm is 64.
SAN FRANCISCO — Eight weeks of therapy with grazoprevir and elbasvir may be effective in patients with low fibrosis scores, according to findings presented at The Liver Meeting 2015.
Tedizolid phosphate is a second-generation oxazolidinone antibiotic that offers enhanced antimicrobial potency and low rates of bacterial resistance.
Available in both IV and oral forms, tedizolid exhibits bacteriostatic activity by binding the 50S subunit of the bacterial ribosome, resulting in inhibition of bacterial protein synthesis.
The recommended dosage is 200 mg once daily for 6 days,
which may offer increased convenience and compliance when compared to twice daily linezolid.
THE RIGHT WAY OF ADMINISTERING BLOOD PRODUCTS (
[ from “THE CLINICAL — — USE OF BLOOD: HAND BOOK , World Health Organization & Blood Transfusion Safety , GENEVA ]
Prefer a larger cannula: A doubling of the diameter of the cannula increases the flow rate of most fluids by a factor of 16.
In case of Whole blood, red cells, plasma and cryoprecipitate
>Use a new, sterile blood administration set containing an integral 170–200 micron filter
>Change the set at least 12-hourly during blood component infusion
>In a very warm climate, change the set more frequently and usually after every four units of blood, if given within a 12-hour period
In case of Platelet concentrates
>Use a fresh blood administration set or platelet transfusion set, primed with saline.
>There is no evidence that warming blood is beneficial to the patient when infusion is slow.
>At infusion rates greater than 100 ml/minute, cold blood may be a contributing factor in cardiac arrest. However, keeping the patient warm is probably more important than warming the infused blood.
>Warmed blood is most commonly required in: Large volume rapid transfusions:
-Adults: greater than 50 ml/kg/hour -Children: greater than 15 ml/kg/hour
Exchange transfusion in infants Patients with clinically significant cold agglutinins.
>Blood SHOULD ONLY BE WARMED in a blood warmer. Blood warmers should have a visible thermometer and an audible warning alarm and should be properly maintained.
>Blood should never be warmed in a bowl of hot water as this could lead to haemolysis of the red cells which could be life-threatening.
Severe reactions most commonly present during the first 15 minutes of a transfusion. All patients and, in particular, unconscious patients should be monitored during this period and for the first 15 minutes of each subsequent unit.
The transfusion of each unit of the blood or blood component should be completed within four hours of the pack being punctured. If a unit is not completed within four hours, discontinue its use and dispose of the remainder through the clinical waste system.
esophagus patients. There are case reports of proton pump inhibitor induced gastric neuroendocrine tumours and adenocarcinomas as consequences of these effects. In pernicious anemia and chronic gastritis, clinicians should be aware of potential increased risk of gastric neuroendocrine tumour development with chronic proton pump inhibitor use in these patients. Eradication status of Helicobacter pylori prior to commencing long term proton pump inhibitor therapy should be established to reduce the risk of severe atrophic gastritis and development of gastric dysplasia.
Fluoroquinolone labeling currently has warnings about the risks for tendonitis, tendon rupture, central nervous system effects, peripheral neuropathy, myasthenia gravis exacerbation, QT prolongation and Torsades de Pointes, phototoxicity, and hypersensitivity. But panel members called for stronger wording, with some suggesting the risks be called out with a black box warning.
Cardiac resync therapy with Defibrillator helps morbidity mortality in HF ( CRT-D)
Phase 2. Ghrelin agonist drug
VIberzi is contraindicated with SOD spasm, alcoholism or drink more than 3 drinks a day or pancreatitis or cirrhosis Child’s C or severe constipation or mechanical obstruction
It is the first and only mixed opioid receptor modulator. It binds to kappa, mu and delta. It stimulates kappa and mu and blocks delta which is antagonistic.
Overall, it then modifies GI motility and slows down contraction of smooth muscle.It also decreases the activity of afferent neuron of the gut.
This causes decreased visceral hypersensitivity.
It does not get absorbed and only binds to mucosal receptors in the gut. Give with food?
Bristol stool scale : Pain scale was 6.1 and stool consistency was 6.2 (max is 7 diarrhea)
The trial was 52 weeks and more than 1200 patients and the primary end point was improvement in pain, diarrhea at 12 weeks.
Composite responder ( improved pain and diarrhea )
Benefit was 30 and 33% in the 12 and 24 months compared to 16 and 20% in placebo
SOD occurs in patients with s/p chole. SOD occurs in 0.2% of s/p lap chole.
Pancreatitis occurred in 6 out of 3000 patients.
Side effect profile otherwise similar to placebo (except constipation 1-2% had to stop it). 1 % at 75 mg and 2% at 100 mg
It can cause euphoria (0.2%)and feeling drunk (0.1%). Since it can activate mu receptor it is labeled as Schedule IV.
75 mg dose for patients with child’s A or B cirrhosis, s/p chole patients, those unable to tolerate 100 mg bid dose or they are on gemfibrozil or cyclosporine. (Similar to lomotil)
OATP1B1 receptor ((drugs are Rifampicin, Rifamycin SV, Clarithromycin, erythromycin, roxithromycin, telithromycin indinavir, saquinavir, ritonavir, Cyclosporine, gemfibrozil) (organic anion transporting polypeptide)
It increases absorption of Viberzi.
40% increase in Crestor level
Developed by same scientist from J and J that developed loperamide.
10% delta (compared to placebo) of patients who did not respond to loperamide responded to Viberzi.
Agonist for mu, antagonist to delta and unknown to kappa. Passes BBB. Eat it with meal to decrease absorption
Avoid in lap chole : because they may have SOD.
Child’s A and B, use reduced dose and Child’s C contraindicated.
Most of the events of constipation occurred in first 2 weeks (50%)
P value for primary endpoint. Confidence interval for secondary endpoint.
SOD issues occurred in 0.2% at 75 mg dose and 0.8% in 100 mg dose. All resolved after stopping medication.
1 pt with SOD got abnormal LFT, one got pancreatitis. The other 5 pancreatitis had sludge or had alcohol.
Discontinuation rate of Viberzi is 8%
Combination of leucine, meteor in and sildenafil for NAFLD : accelerated trial. Measured with proton-density-fat fraction on MRI. NuSirt pharmaceutical
Use bottled water or teaspoon of apple sauce
Open capsule. Drug is coating beads. So if beads remain it’s ok !
Rifaximin EIR 800 bid for moderately active crohns
KALK German area
Markers at 25 and 15
Inflate balloon with water 5 cc, aspirated to get rid of air, empty air from syringe and then reinflate ballon to fit cap.
Among 10 patients who developed inflammation of the ileoanal anastomosis, or J-pouch, all reported clinical improvements in stool frequency, and symptomatic relief typically was observed within 2 to 3 weeks after treatment with serum-derived bovine immunoglobulin/protein isolate (SBI), according to
, of South Nassau Communities Hospital in Oceanside, N.Y.
The product, also known as
is derived from bovine plasma that has been USDA approved and contains immunoglobulins (primarily IgG), albumin, and other proteins. Pouchitis is not currently included in the labeling for EnteraGam.
Anastrozole/ tamoxifen for HR + which is better ?
Denosumab for post menopausal women breast cancer. Cancer prevention plus osteoporosis prevention
Subset of pbc pt do poorly
Correlated with bilirubin and Alk phos elevation
OCA start at 5 mg and titration at 3 or 6 months to 10 mg. Continue Urso ?
Fibrates help pruritis.
An isolated report from a single center suggested that a purple or crimson discoloration of both anterior tonsillar pillars (crimson crescents) in the absence of pharyngitis is might be a marker in patients with CFS. The cause of crimson crescents is unknown, but they are common in patients with CFS. However, crimson crescents are not specific for CFS,
Fibroblast growth factor 21 suppresses carbohydrate and alcohol craving. It is produced by the liver
Hopkins bandits shark shutdown
Taken together, our findings suggest it is possible that migraine is a neurologic disorder of ‘minor’ sphingolipid dysmetabolism,” they conclude. “Further research, validating the ceramide and sphingomyelin associations with migraine, as well as research examining mechanisms for these associations, may advance our understanding of migraine pathophysiology and open possibilities of the identification of novel migraine biomarkers and targeted drug therapies directed against sphingolipid pathways.”
In analysis of data from a phase 2 study of the effects of glycerol phenylbutyrate in patients with cirrhosis, we found that fasting levels of NH3 in blood can identify patients at risk for HE-related morbidity. Patients with HE might benefit from NH3-lowering therapy.
Either wipes or jelly
OCA MAY NOT EIRK
CDX2. For stage 2. If absent aggressive cancer
Gene marker in future
Right now pro calcitonin level
including exercise, healthy diet, stopping smoking, or moderating alcohol intake if indicated. This little extra time is appreciated by the patients and goes beyond treating patients as if guidelines were a cookbook.
AIMS65 scoring system for survival. Older are rockall and Glasgow blatchford score
Age more than 65, bp less than 90, change in mental status, INR more than 1.5, albumin less than 3.
One point each.
0,3% || 1
1,2% || 2
5,3% || 3
10,3% || 4
16,5% || 5
ESKAPE pathogens – Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species – named for their ability to resist the effects of antibiotics.
Unit is Sv which is seivert 1 Sv is 100 rem.
CT of abd and pelvis is 10-20mSv (this is like 3-7 years of radiation exposure from natural environment)
Approved for 1, 4
Soft coag. 80 watts effect 5. For marking
Forced coag. 50 watts. Effect 2. ( 3-1-1)
Endocut 3-1-1 50 watts effect 3. Or 3-2-1 or 3-3-1
Increase cutting duration for larger duration
Let cautery do the cutting
Dry cut : 50 watts effect 2
Submucosal dissection. : endocut or drycut. Less used is swift coag
Forced coag. 25 watts effect 2. For pedunculated polyp
EMR. Endocut. Q. 3effect duration 1 and 3 interval
Upside down. Take lower part first. Must close in 1 cm. And check mobility Only polyp should move and not wall
Submucosal dissection : Stomach Dual knife Forced coag Effect 2 Watts 40. For esophagus and colon Effect 1 watts 40
Effect is voltage. Higher the number the higher the voltage
IT 2 knife in stomach : Effect 2, watts 50-6 0
Fold convergence, mucosal bleb are sign of fibrosis under polyp. Also when snare is around polyp you should be able to lift it otherwise fibrosis
Endocut effect is the blend. Goes from 1-4. Higher the number more coag. For EMR use effect 2 less coag. You decrease the thermal injury by squeezing tightly before cautery
Forced coag – deep injury. So prefer soft coag.
Soft coag by Doug Rex – effect 5, watts 80 blue pedal
Hot forceps avulsion technique – use endocut i( letter ) effect 3 cut duration 1 interval 3. Advantage over q lowers voltage setting 313
Underwater technique – use pure autocut effect 5 max watt 80
APC for flat lesion – power 30 flow 0.8 to 1 liter flow
Can cause :intracranial calcifications, ventriculomegaly, and neuronal migration disorders (lissencephaly and pachygyria). Other anomalies included congenital contractures and clubfoot, microcephaly
Babies check eyes and hearing 6 months
Testing 3 tests PCR, IgM, PRNT
reverse transcriptase-polymerase chain reaction (RT-PCR) on infant serum. Serology assays can also be used to detect Zika virus-specific IgM and neutralizing antibodies. Plaque-reduction neutralization testing (PRNT) can also be performed to measure virus-specific neutralizing antibodies and differentiate from other flaviviruses.
Like the more well-known
causes symptoms like fever, rash, headache, and neck pain, and as the disease progresses it can cause arthritis. Unlike the original strain, though,
can also cause vomiting and nausea. The initial bacteria was also characterized by a rash that looked like a bull’s eye, but an infection with
can cause a more widespread rash on the body.
— Several medications can delay gastric emptying. These include [
Narcotics (affecting mu opiate receptors alone or combined with inhibition of norepinephrine reuptake [eg,
, respectively]) [
Alpha-2-adrenergic agonists (eg,
Tricyclic antidepressants [
Calcium channel blockers
Muscarinic cholinergic receptor antagonists
Glucagon-like peptide (GLP)-1 agonists and amylin analogues [
, which is derived from macrolide molecule like
, and does not inhibit gastric emptying)
Larger virus. Like a prokaryote
Get infected by virophage ( eg zamilon phage virus)
Have CRISPR immunity that destroys the phage virus. ( areas of DNA that mimic phage DNA and destroy it )
Telmisartan is an angiotensin receptor blocker that could be used as a weapon against NAFLD by increasing insulin sensitivity (and decreasing hepatic fat accumulation), and suppressing hepatic fibrogenesis. It is also reported to be effective in mild to moderate hypertension, and improves insulin sensitivity to type 2 diabetes mellitus, as well as cholesterol and triglyceride levels.
Keytruda and Opdivo
acoustic radiation force impulse was more accurate for detecting hepatitis C virus infection positivity in liver transplant recipients vs. Fibrotest, according to published findings.
Gattex – 0.5 mg /kg
Usual pt is TPN Or frequent dehydration from diarrhea
Polyps or colon cancer or other cancers
Reduce doses of opiates
Increased absorption of fluid so can cause CHF
It is GLP 2 agonist with single ALA with Gly
Colonoscopy 6 months before starting
Respiratory infection, nausea, bloating, hypersensitivity , abd pain
Sleep disturbance, atoms complication
Hydroxy ethyl starch plus methylene blue injection
Right squeeze first
Use Endo cut
Margins use tip of snare with soft coag
SPS use serrated polyposis syndrome
Do annual colonoscopy
If more than 5 lesions or more than 2 cm every 3-6 cm
Use serrated squeeze
Serrated polyp have more fat Some people squeeze, open a little and then squeeze again. This lets muscularis pop up
“We found that the Westernized diet did increase fatty liver, but we saw that the broccoli protected against it,” she said. “Broccoli stopped too much uptake of fat into the liver by decreasing the uptake and increasing the output of lipid from the liver.”
Previous research conducted by Dr Jeffery found that chopping or steaming broccoli was the best way to enhance the availability of sulforaphane, broccoli’s anticancer compound.
The tests measured two proteins nicknamed GFAP and UCH-L1, which are present in brain cells. In a head injury, the proteins can leak into the bloodstream, Papa said.
Do blood test for upto 1 week after concussion
CURB65. Confusion, uremia, respiration, blood pressure and age. Score to admit
“Now the microbiome is another element in this equation—it’s not just diabetes, high blood pressure and obesity,” Iadecola notes. “There are also other factors which we need to know in order to tailor treatment.” The study suggests that such treatment may involve antibiotics, probiotics, dietary changes or other interventions that would change the gut’s microbiota to be supportive of regulatory T cells and reduce delta gamma T cells. For example, patients undergoing heart surgery, many of whom end up suffering a stroke, might go on a special preemptive diet, he says.
In the study of nearly 3,000 patients, researchers from the Intermountain Medical Center Heart Institute in Salt Lake City discovered that the presence of high levels of the biomarker glycoprotein acetylation, or GlycA, was associated with an increased risk of
LOS ANGELES (CBS News) – Drinking coffee may cut your risk of colon cancer by as much as 50 percent, a new study suggests.
The more you drink, the more you may reduce your risk – and it makes no difference whether the coffee is regular or decaf, researchers said.
“The protective effect is not caffeine, per se, but probably a lot of other antioxidant ingredients in the coffee that are released in the roasting process,” said senior researcher Dr. Gad Rennert. He is director of the Clalit National Israeli Cancer Control Center in Haifa, Israel.
n this first stage of research the team developed the blood analysis in 26 patients with NAFLD. The test detects chemical changes on tiny amounts of “cell-free” DNA that are released into the blood when
are injured. Changes in DNA methylation at genes like PPARγ that controls scar formation are then used to stratify patients by fibrosis severity.
Senior author Dr Jelena Mann of Newcastle University’s Institute for Cellular Medicine added: “This is the first time that a DNA methylation ‘signature’ from the blood has been shown to match the severity of a
researchers at the Dana-Farber Cancer Institute and the Broad Institute of MIT and Harvard report on their findings from a new study, which found that colorectal cancers festooned with tumor-related proteins called neoantigens were likely to be saturated with disease-fighting white blood cells, mainly lymphocytes.
. Patients whose tumors had high numbers of neoantigens also survived longer than those with lower neoantigen loads.”
This article has pictures that explains it succinctly
Basically, there are CB ( cannabinoid receptors ) in the brain and gut. Two types. They are very lipophilic. Certain gut bacteria up regulate it and some down regulate it.
When certain gut bacteria bind to it, it decreases mucos production , increase intestinal cell permeability and that leads to translocation of pro inflammatory systemic conditions. Moreover , other things that happen are GLP receptors get stimulated and this affects the glucose metabolism locally and then systematic to lead to T2D. This is at gut level, pancreas, liver and skeletal muscle
At central level, it increases sense of odor and craving of food
There are on the other hand certain gut bacteria that do the exact opposite! This there is a balance that is needed. When people get gastric bypass even the gut microbiota changes
Hope that is not over simplified but it is a primer 101
ECR is performed in the setting of clinically obvious associated high-risk features (polyposis, IBD, synchronous/metachronous cancers) but not in isolated/sporadic CRC. However, attention must be paid to patients with seemingly lower risk characteristics (isolated CRC, no polyposis), as LS can still be present. In addition, the presumed sporadic group requires further study as metachronous CRC risk in early-onset sporadic CRC has not been well-defined, and some may harbor undefined/undiagnosed hereditary conditions. Abnormal MSI (LS risk) is not associated with ECR; abnormal MSI results often return postoperatively after segmental resection has already occurred, which is a contributing factor.
Extended colon resection versus local resection
Heart disease, cancer, liver disease and obesity / metabolic syndrome
When patients with lean-NAFLD and overweight patients were divided according to waist circumference, lean-NAFLD with higher waist circumference had greater prevalence of metabolic syndrome, carotid plaques and significant fibrosis compared with patients who were overweight or had obesity.
Soy is of two types. Fermented and non fermented. Non fermented has phytic acid and lecithin which some people is chelating and toxic. Fermented soy has iso flavin which is beneficial.
So not straightforward.
Reduced total cortical volume and temporal lobe cortical thickness and greater lateral ventricle and inferior lateral ventricle volumes were seen in the AC
participants relative to the AC
Weschler Memory Scale–Revised Logical Memory Immediate Recall
For elderly patients above 70
This was part of Alzheimer’s Disease Neuroimaging Initiative (ADNI) and the Indiana Memory and Aging Study (IMAS). Published in JAMA neurology
Scientists may have found the ultimate sports enhancing drug – dark chocolate.
Cyclists who snacked on the sweet treat were able to go faster and further.
It that thought that epicatechin, a plant chemical particularly abundant in dark chocolate, gives the body a boost by widening the blood vessels.
Is that thought that epicatechin, a plant chemical particularly abundant in dark chocolate, gives the body a boost by widening the blood vessels.
Same with beet root but milder
Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans.” Individuals “who carried Porphyromonas gingivalis had an overall 59 percent greater risk of developing pancreatic cancer, and those who carried Aggregatibacter actinomycetemcomitans were at least 50 percent more likely overall to develop the disease.”
Three or more alcoholic drinks per day every day increases risk of stomach cancer. A standard drink is 12 ounces of beer, 5 ounces of wine or 1.5 ounces of distilled spirits, according to the U.S. National Institutes of Health.
• For every 1.8 ounces of processed meat eaten every day – the equivalent of one hot dog or two slices of bologna – the risk of cancer in the lower stomach rises by 18 percent.
• Every five-unit increase in body mass index – BMI, a ratio of weight to height – causes a 23 percent increased risk of cancer in the upper stomach.
Steatosis predicted C-IMT better than diabetes or dyslipidemia, and steatosis independently predicted C-IMT (P=0.002) and FRS (P <0.001) after adjustment for the metabolic syndrome and cardiovascular risk factors, Pais and colleagues reported.
In the 1,872 patients with a follow-up ultrasound, C-IMT increased in patients with steatosis, from 0.60 ± 0.13 mm to 0.66 ± 0.14 mm (P=0.001), but C-IMT did not change in patients who remained free of steatosis.
(Carotid intima media thickness). Did not do biopsies though. Cannot differentiate between NASH and NAFLD. From France, Journal of Hepatology
“Results of these studies showed that a single, one-time infusion of the antitoxin bezlotoxumab given with standard of care
antibiotic treatment significantly reduced the recurrence of
infection compared to standard of care alone, and demonstrated this benefit over a 12-week period,” said Dr. Mark Wilcox, Leeds Teaching Hospitals and University of Leeds, U.K., and a lead investigator for the studies. “These results were also demonstrated in patient subgroups known to be at high risk for
Relamorelin (RM-131, Motus) is a ghrelin agonist being developed for treating patients with diabetic gastroparesis or GI functional disorders, which works by stimulating GI motility in these patients, according to a press release. The FDA has granted fast track review status to relamorelin for the indication of diabetic gastroparesis, and phase 2a clinical trials in diabetic gastroparesis and
have already been completed.
Hcv drug interactions
Anti mullerian hormone
Ozanimod is a modulator of the sphingosine-1-phosphate subtype 1 (S1P1) and S1P5 receptors. Agonists of S1P1 interfere with the migration of B and T lymphocytes from secondary lymphoid tissues, so the lymphocytes are unable to track to the sites of inflammation. Its mechanism is thus similar to
In addition, clinical responses at that time point were seen in 57% of the 1-mg group and in 54% of the 0.5-mg group, compared with 37% of the placebo group (
=0.06, respectively), the investigators reported in the May 5
*Sea hero quest*. How good are you at it?
Have your patients play it! Poor scores?
*dementia* is a possibility
The antibody, researchers believe, only recognizes the structurally different part of CFH protein that they believe is only found in tumor cells. It then impacts tumor growth by disabling the protective CPH layer and destroying cancer cells. They don’t necessarily want the antibody to kill all the tumor cells, though, Patz noted.
Clostridium difficile infections, according to a case-control study presented at the European Society of Clinical Microbiology and Infectious Diseases annual congress. Tigecycline effected a 76% clinical cure rate, compared with 53% for the combination regimen of intravenous metronidazole and oral vancomycin, Dr. Baltin Gergely Szabo reported.
44% chance of infection after abd or perianal infection
NAFLD and fibrosis will be dosed with either 400 mg of aramchol (Galmed) — a conjugate of cholic acid and arachidic acid — vitamin D, 400 mg of aramchol plus vitamin D or placebo for 24 weeks, followed by a 4-week follow-up period.
*Impella* was approved for *pVAD Tandem* is another one. Both are used for CHF
*Mirca* is a leadless pacing device. A good option for pediatrics
MRI safe pacemakers about to be released
*TAVR*curiously causes renal flow by high urine flow nephritis small study
Researchers found that while the H2 blockers had no effect on vascular aging, chronic use of the PPIs indeed impaired the lysosomes, preventing them from generating acid.
“We also saw the telomeres shortening – they’re on the tips of chromosomes and like our biological clock,” Cooke added. “Those vascular cells couldn’t proliferate or divide as well, and that’s necessary for repairing a wound in the vessel.”