Rob Zielinski, MBBS, and Christian Kollmannsberger, MD
British Columbia Cancer Agency, Vancouver, BC, CanadaPro-angiogenic factors, such as vascular endothelial growth factor (VEGF) and its receptors, are important regulators of tumor angiogenesis, survival, and metastasis, and are overexpressed in renal cell carcinoma (RCC). There is a plethora of US Food and Drug Administration (FDA)-approved agents for advanced RCC that inhibit circulating VEGF or its targets, the VEGF-receptors (VEGFRs).
Luc Dupuis, PhD1,2,3,4, Albert C Ludolph MD3, and Vincent Meininger MD4,5
1Inserm U692; 2Université de Strasbourg, Faculté de Médecine, UMRS692, Strasbourg, France; 3Department of Neurology, Ulm University, Ulm, Germany; 4Département des Maladies du Système Nerveux, Centre Référent Maladie Rare SLA Hôpital de la Pitié-Salpêtrière (AP-HP); 5Université Pierre et Marie Curie, Paris, FranceAlmost 20 years after the first positive clinical trial, riluzole remains the only drug with proven efficacy in increasing survival in patients with amyotrophic lateral sclerosis (ALS).
Jiwon Oh, MD, FRCPC1,2, and Paul W O’Connor, MD, MSc, FRCPC1
1Department of Neurology, Johns Hopkins University, Baltimore, MD, USA; 2Department of Medicine, Division of Neurology, St Michael’s Hospital, University of Toronto, Toronto, ON, Canada.A number of oral agents are under development and investigation for use in the treatment of multiple sclerosis (MS). Among these experimental agents, teriflunomide is showing promise with respect to safety and clinical efficacy in relapsing MS patients.
Anand Iyer, MD, MRCPCH1; Hui Jeen Tan, MbChB, MRCPCH2; and Rachel Kneen, DCH, MRCPCH1,3
1Littlewoods Neurosciences Unit, Alder Hey Children’s Hospital, Liverpool; 2Neurosciences Department, Royal Manchester Children’s Hospital, Manchester; 3Institute of Infection and Global Health, University of Liverpool, Liverpool, UKZonisamide is a novel antiepileptic drug (AED) that has been used extensively in Japan since 1989. Several open-label studies have shown it to be effective in refractory partial epilepsy.
Joseph M Collaco, MD, MPH1 and Garry R Cutting, MD2
1Eudowood Division of Pediatric Respiratory Sciences, and 2McKusick–Nathans Institute of Genetic Medicine, Johns Hopkins University, Baltimore, MD, USA.Cystic fibrosis (CF) is a genetic autosomal recessive disorder caused by mutations within the CFTR gene. The CFTR gene was first identified in 1989  and over 1900 sequence variants have been reported, although not all of these may be disease-causing.
Robert Taylor Jr, PhD1; Joseph V Pergolizzi Jr, MD2; and Robert B Raffa, PhD3
1NEMA Research, Inc., Naples, FL; 2Johns Hopkins University, Baltimore, MD, Temple University School of Medicine, Philadelphia, PA, and Georgetown University School of Medicine, Washington, DC; and 3Temple University School of Pharmacy, Philadelphia, PA, USAChronic pain is a global and growing medical, economic, and individual burden.
Konstantinos Hatzimouratidis, MD
2nd Department of Urology, Aristotle University of Thessaloniki, Thessaloniki, GreeceAvanafil is a new phosphodiesterase type 5 (PDE5) inhibitor recently approved for the treatment of erectile dysfunction (ED). It is a highly selective PDE5 inhibitor associated with rapid absorption (Tmax 30–45 min) and a short half-life (T1/2 3–5 h) without any significant accumulation of the drug with either once- or twice-daily dosing.
Eelco van Duinkerken, PhD, and Frank J Snoek, PhD
VU Medical Center, Amsterdam, The Netherlands. With over 280 million people suffering from diabetes mellitus, it is globally one of the most common non-communicable diseases [1,2]. The increasing prevalence of both types of diabetes [3,4], especially in low-income countries, poses a challenge to healthcare and to society at large.
Magy Abdelwahab, MD
Cairo University Pediatric Hospital, Cairo, EgyptGaucher disease (GD) is the most common lysosomal storage disorder to be described, and the first to be treated successfully; however, type 3 GD remains a gray area in many aspects, especially with regard to the impact of enzyme-replacement therapy (ERT) on neurological manifestations. The latter is a subject of great debate. In order to properly manage type 3 GD, the treating physician should be mindful of the definition, prevalence, and clinical presentation of this unique group of patients.
John M Henderson, BMBS, BMedSci(Hons), MRCS (Eng)1, and Caroline A Wilson, BMBS, BMedSci(Hons), FRCA, MRCPCH2
1Royal Berkshire Hospital, Reading, and 2Wexham Park Hospital, Slough, UKWith the increasing complexity of modern healthcare, the likelihood of human error is also increasing. The consequences of such errors can be devastating. Checklists as tools to reduce the risk of errors occurring have proven successful in other complex and high-risk industries such as the airline industry. The surgical safety checklist has proven to be an effective tool in reducing human error associated with surgical procedures.
Frank Hoentjen, MD, PhD1 and Nanne K H de Boer, MD, PhD2
1Inflammatory Bowel Disease Center, Radboud University Medical Center, Nijmegen, and 2Department of Gastroenterology and Hepatology, VU University Medical Center, Amsterdam, The NetherlandsConventional thiopurine therapy with azathioprine or 6-mercaptopurine is an important maintenance strategy in IBD. Unfortunately, many patients have to discontinue this therapy owing to adverse events or lack of efficacy.
Elwira Szychot, MD, PhD, MRCPCH1, Andrzej Brodkiewicz, MD, PhD2, and Kathy Pritchard-Jones, BMBCh, PhD, FRCPCH3
1Paediatric Department, Royal Berkshire Hospital, Reading, UK; 2Department of Pediatrics, Hematology and Oncology, Pomeranian Medical University, Szczecin, Poland; 3University College London Institute of Child Health, London, UKWilms’ tumor (nephroblastoma) is a malignant embryonal tumor of the kidney. It represents approximately 90% of all pediatric renal tumors [1–3], and is diagnosed in approximately 80 children in the UK every year . Generally, it is a tumor of young children with most diagnoses made in those aged <5 years .
Efthymia Tasina, MD, Maria Simitsopoulou, PhD, and Emmanuel Roilides, MD, PhD
Infectious Diseases Unit, Third Department of Pediatrics, Aristotle University, Hippokration Hospital, Thessaloniki, GreeceThe airway epithelial cells of patients with cystic fibrosis (CF) are characterized by dysregulation of ion transport channels.
Umile Giuseppe Longo, MD1, Luca Denaro, MD, PhD2, Alessandra Berton, MD1, Nicola Maffulli, MD, MS, PhD, FRCS(Orth)3, and Vincenzo Denaro, MD1
1Campus Biomedico University, Trigoria, Italy; 2Catholic University School of Medicine, Rome, Italy; and 3Barts and The London School of Medicine and Dentistry, London, UKWe performed a comprehensive, quantitative review of the published literature on the sports-related injuries to the cervical region in order to assess the optimal time for athletes to return to play following a non-catastrophic cervical spine injury, to assess the methodology of these studies, and to analyze the reported outcomes.
Veronica A Preda, BSc(Med), MBBS, MPH1,2, Gregory Fulcher, MBBS, MD, FRACP2, Niki Karavitaki, MSc, FRCP, PhD1, and Ashley B Grossman, BA, BSc, MD, FRCP, FMedSci1
1Oxford Centre for Diabetes Endocrinology and Metabolism, Churchill Hospital, Oxford, UK; 2Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia.There are a number of current challenges in the management of Cushing’s disease, including managing the increased morbidity and mortality of cortisol excess, clinical and biochemical relapse, and the need for long-term surveillance.
Quoc-Dien Trinh, MD1,2, Jesse Sammon, DO1, and Kevin C Zorn, MD3
1Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI, USA; 2Cancer Prognostics and Health Outcomes Unit, and 3Department of Surgery, Division of Urology, University of Montreal Health Centre, Montreal, QC, CanadaRenal cell carcinoma (RCC) accounts for 3% of all adult deaths from cancer in the US. Approximately 53 581 new cases were diagnosed in 2010 , and the incidence of RCC is still rising .
Emily Jane Gallagher, MB, BCh, BAO, MRCPI, and Christoph Buettner, MD, PhD
Mount Sinai School of Medicine, New York, NY, USAThe 72nd Scientific Sessions of the American Diabetes Association (ADA) took place this year in Philadelphia, PA, USA, on June 8–12, 2012. The ADA Scientific Sessions is the world’s largest diabetes meeting, covering a broad range of clinical and basic science research in the field of diabetes. The purpose of this meeting report is to highlight and summarize some of the many good clinical, as well as basic and translational science, presentations.
Malcolm Richardson, PhD, FSB, FRCPath1, and Liz McNeil Grist, PhD2
1Manchester Academic Health Science Centre, University Hospital of South Manchester and University of Manchester, Manchester; and 2Medical writer, Crowborough, UK The 5th Advances Against Aspergillosis conference, which was held in Istanbul, Turkey, attracted delegates from the fields of both medicine and the biological sciences. The meeting thus provided a rich environment for extensive cross-fertilization between disciplines, both in the scientific sessions and in conversations during the coffee and lunch breaks.
Ethan V Abel1, Curtis H Kugel III1, and Andrew E Aplin1,2
1Department of Cancer Biology and Kimmel Cancer Center; 2Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA, USA.The development of vemurafenib, a RAF inhibitor, is a notable breakthrough in the treatment of melanoma. With impressive patient response rates in mutant V600 v-raf murine sarcoma viral oncogene homolog B1 (B-RAF) patients, vemurafenib shows undeniable promise in the clinic; however, concerns with its use remain.
Antonio La Cava, MD, PhD
University of California Los Angeles, Los Angeles, CA, USABelimumab is a recombinant, fully human monoclonal antibody that binds to soluble B lymphocyte stimulator (BLyS) and prevents its binding to B cell-activating factor receptors, reducing the survival, activation, and differentiation of mature B lymphocytes.
Otto Metzger Filho1 and Inês Vaz-Luís1,2
1Dana–Farber Cancer Institute, Boston, MA, USA; and 2Instituto de Medicina Molecular-FML, Lisbon, PortugalThe main highlight of the breast cancer session of the 2012 American Society of Clinical Oncology (ASCO) Annual Meeting was the presentation of the Phase III EMILIA (Open-Label Study of Trastuzumab Emtansine [T-DM1] versus Capecitabine + Lapatinib in Patients with HER2-Positive Locally Advanced or Metastatic Breast Cancer) study proving the superiority of TDM-1 over the combination of capecitabine and lapatinib for patients with advanced HER2-positive breast cancer.
Ming Lim, BMBS, PhD1, and Jonathan D Cooper, PhD2
1Children’s Hospital at Guys and St Thomas’ NHS Foundation Trust; 2King’s College London, London, UKLysosomal biogenesis and the subsequent optimal function of this organelle rely upon the complex interplay and integration of multiple processes involving lysosomal substrate derivation (from endocytosis, phagocytosis, or autophagy), synthesis, and subsequent transport to the lysosome .
Sameer Tulpule, FRCPath1, and Bronwen E Shaw, FRCPath, PhD1,2
1Anthony Nolan Research Institute and University College London Cancer Centre, London, and 2Haemato-Oncology Research Unit, Division of Molecular Pathology, The Institute of Cancer Research, Sutton, UKThe use of umbilical cord blood (UCB) as an alternative source of stem cells for transplantation has been increasing over the past few decades. To date, there have been relatively sparse data on immune reconstitution (IR) and the functional characteristics of the reconstituting cord. Morbidity and mortality rates from infection in the first 100 days after cord blood transplantation (CBT) remain high and are partially related to delayed T cell reconstitution.
Talía Sainz MD and María Ángeles Muñoz-Fernández PhD, MD
Hospital General Universitario "Gregorio Marañón", and Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, SpainThe purpose of this review is to explore the role of the integrase inhibitor raltegravir in the treatment of pediatric HIV infection.
Hugh James Freeman, MD
Department of Medicine (Gastroenterology), University of British Columbia, Vancouver, BC, Canada.In 1970, Weinstein et al. detailed a small bowel biopsy lesion in a middle-aged woman who was initially thought to have celiac disease . Although the typical “flattened” biopsy appearance was present, a long-term response to a gluten-free diet failed to occur. Later, biopsies stained with routine hematoxylin–eosin showed a prominent band-like deposit of subepithelial hyaline material in the lamina propria of the small bowel mucosa.
Sarah C Horton, MBChB, MRCP
Division of Musculoskeletal and Rheumatic Diseases, University of Leeds; and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK.Berlin, Germany, June 6–9, 2012The 2012 Annual Congress of the European League Against Rheumatism (EULAR) was held in Berlin, Germany.
Center for Pediatric and Adolescent Medicine, Department of Lysosomal Storage Disorders, University Medical Center Mainz, Mainz, Germany Noordwijkerhout, The Netherlands, June 28–July 1, 2012 The 12th International Symposium on Mucopolysaccharidosis (MPS) and Related Diseases took place from June 28th to July 1st, 2012, in Noordwijkerhout, which is a beautiful small city close to Amsterdam in The Netherlands.
Niamh O’Flaherty, FRCPath, MRCP, James Walsh, MCh, FRCS(Tr&Orth), Lynda Fenelon, FRCPI, FRCPath, and Gary O’Toole, MCh, FRCS(Tr&Orth)
St Vincent’s University Hospital, Dublin, Ireland.Mucormycosis is an uncommon, but frequently fatal, invasive fungal infection mainly seen in immunosuppressed and diabetic patients. The current case report differs from the common descriptions of patients with this infection. Both the site of infection and the absence of a discernible predisposing condition make this an important case to highlight.
Alessandro M. Vannucchi, MD1 and Claire Harrison, DM FRCP FRCPath2
1University of Florence, Italy; and 2Guy’s and St Thomas’ NHS Foundation Trust, London, UK. Chronic myeloproliferative neoplasms (MPNs) represent a heterogeneous group of myeloid neoplasia that include polycythemia vera, essential thrombocythemia, and myelofibrosis (MF).
Giacomo Sgalla MD, Stefania Cerri MD, PhD, Roberto Tonelli, Elisabetta Cocconcelli, Martina Garuti, Margherita Ori, and Luca Richeldi MD, PhD
Center for Rare Lung Diseases, University Hospital of Modena, Modena, Italy. Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, and fatal fibrosing interstitial pneumonia of unknown cause, which is limited to the lungs and occurs primarily in older adults.
Anil Mehta, MBBS, FRCP (Edin), FRCPCH, MSc
Ninewells Hospital and Medical School, Dundee, UK.Dublin, Ireland, June 6–9, 2012.The 35th European Cystic Fibrosis Conference was held in Dublin, Ireland. The next conference to be held in Lisbon will have a greater translational/basic science focus, so this report concentrates on some of the pre-clinical science to provide a flavor of what is to come in 12 months time.
Ulrike Tisch, PhD1, Salem Billan, MD2, Maya Ilouze, PhD3, Michael Phillips, MD4, Nir Peled, MD, PhD3, and Hossam Haick, PhD1
Israel Institute of Technology, Haifa; 2Rambam Health Care Campus, Haifa, Israel; 3Tel-Aviv University, Tel-Aviv, Israel; 4Menssana Research, Inc., Fort Lee, NJ, USA.Lung cancer causes approximately 1.4 million fatal casualties worldwide per year – more than any other cancer in both men and women .
Mark A Wainberg, PhD
McGill University AIDS Centre, Lady Davis Institute, Jewish General Hospital, Montréal, QC, CanadaRilpivirine is a potent new member of the non-nucleoside reverse transcriptase inhibitor family of drugs that has the ability to block HIV replication. This review is focused on the profile of rilpivirine in terms of efficacy and virological suppression, drug resistance, safety, and drug–drug interactions.
Andrea Zanichelli, MD, Giulia Periti, MD, Marta Mansi, MD, and Marco Cicardi, MD
Università degli Studi di Milano, Dipartimento di Scienze Cliniche “Luigi Sacco”, Ospedale Luigi Sacco, Milan, ItalyHereditary angioedema (HAE) associated with C1 inhibitor (C1-INH) deficiency is a rare disease with an estimated prevalence of one in 50 000 in the global population, without racial or gender differences . HAE is caused by mutations in one of the two alleles of the C1INH gene.
Ricard Cervera, MD, PhD, FRCP
Hospital Clínic, Barcelona, Catalonia, Spain The descriptive adjective “catastrophic” was added to the term antiphospholipid syndrome (APS) in 1992 by Ronald A. Asherson in order to highlight an accelerated form of this syndrome that results in multiorgan failure .
Takashi Ueta, MD
University of Tokyo, Tokyo, JapanAge-related macular degeneration (AMD) is a leading cause of legal blindness worldwide. AMD has a complex pathogenesis involving the patient’s ophthalmic and systemic medical history, as well as genetic and environmental factors.
Olga Ciccarelli, PhD
Department of Brain Repair and Rehabilitation, University College London Institute of Neurology, London, UKImaging the spinal cord in vivo in humans is technically challenging, because the spinal cord is a small structure, with a diameter of approximately 1.5 cm at the cervical level. Physiological processes, such as cardiac pulsation and breathing, can cause motion artifacts.
Ana Espinel-Ingroff, PhD
Virginia Commonwealth University, Richmond, VA, USABoth broth microdilution and disk diffusion reference methods are available for testing filamentous fungi (molds). The potential role of high minimal inhibitory concentration (MIC)/minimal effective concentration (MEC) values in clinical practice has begun to be elucidated. In the absence of clinical breakpoints (CBPs), epidemiological cut-off values (ECVs) have been defined in six Aspergillus spp. for triazoles, caspofungin, and amphotericin B.
Hector Chinoy, PhD, MRCP
The University of Manchester, Manchester, UKGlasgow, UK, May 1–3, 2012The British Society for Rheumatology (BSR) 2012 Conference was a 3-day clinical and scientific meeting held in Glasgow, UK. The purpose of this meeting report is to summarize some of the interesting and topical findings.
Robert Crescentini, MD, and Ragini Kudchadkar, MD
Department of Cutaneous Oncology, H Lee Moffitt Cancer Center, Tampa, FL, USAImmunotherapy has long been a treatment for advanced melanoma. Augmentation of the immune response by the disruption of T cell pathways that are responsible for the downregulation of cellular immunity is one mechanism by which promising new therapies for metastatic melanoma are developed.
Roberto Berni Canani, MD, PhD1,2 and Margherita Di Costanzo, MD1
1Department of Pediatrics and 2European Laboratory for the Investigation of Food-Induced Diseases, University of Naples “Federico II”, Naples, ItalyProbiotics are live microorganisms that, when consumed in adequate amounts as part of food or as an oral supplement, confer a health benefit on the host . For more than a century, probiotics have been used as a therapeutic/preventive strategy for a variety of gastrointestinal disorders, restoring the gut microflora.
CD Anthony Herndon, MD, FAAP, FACS
University of Virginia, Charlottesville, VA, USAAtlanta, GA, USA, May 19–23, 2012The American Urological Association (AUA) Annual Meeting was held at the Georgia World Congress Center, Atlanta, GA, USA, on May 19–23, 2012. The current report focuses on the presentations relevant to pediatric urology.
Rita V Patel, MD, and Gary Goldenberg, MD
Mount Sinai School of Medicine, New York, NY, USAActinic keratoses (AKs) are precancerous lesions that are found predominantly in light-skinned individuals on sun-exposed surfaces . After acne vulgaris, AK is the most common diagnosis made by a dermatologist. Of particular dermatological concern, AKs represent the initial manifestation of dysplastic keratinocyte proliferation and have the potential to progress to squamous cell carcinoma (SCC).
Christine Spray, MB ChB, MRCP, FRCPCH
Stockholm, Sweden, April 27–28, 2012Bristol Royal Hospital for Children, Bristol, UKThis was a shortened meeting compared with the usual Annual Meeting of the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN), owing to the World Congress of Pediatric Gastroenterology, Hepatology, and Nutrition, which is due to be held in November 2012 in Taipei, Taiwan. In parallel with the main ESPGHAN scientific meeting, a busy Allied Health Professionals (AHP) meeting was held on Friday 27th April.
Sinéad M Murphy, MB, MD, MRCPI.
The Adelaide and Meath Hospitals, Dublin, incorporating the National Children’s Hospital, Tallaght, Dublin, Ireland.The inherited neuropathies comprise Charcot–Marie–Tooth disease (CMT, also known as hereditary motor and sensory neuropathy), hereditary sensory and autonomic neuropathy (HSAN, also known as hereditary sensory neuropathy [HSN]), and hereditary motor neuropathy (HMN). Although these are often described as distinct entities, there is considerable clinical and genetic overlap between CMT and HSAN, as well as between CMT and HMN.
Riccardo Autorino, MD, PhD1,2, Estevão Lima, MD, PhD3, Ali Khalifeh, MD1, and Jihad H Kaouk, MD1
1Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA; 2Urology Unit, Second University of Naples, Naples, Italy; and 3Life and Health Sciences Research Institute, University of Minho, Braga, PortugalThe development of natural orifice transluminal endoscopic surgery (NOTES) was based on the fascinating concept of performing diagnostic or therapeutic interventions via existing orifices of the human body.
Stephen L Chan, MD
Chinese University of Hong Kong, Hong Kong, People’s Republic of ChinaBreast cancer is the most frequently diagnosed malignancy and the leading cause of cancer death in women globally . In 2008, >1.3 million women were diagnosed with breast cancer and >450 000 women died of the disease . Most breast cancers occur sporadically as a result of combined environmental and polygenic factors [2,3]. Approximately 5% of patients with breast cancer harbor a germline mutation in the BRCA1 or BRCA2 gene [4–6].
Angela C Bien, MD1, and John F Kuemmerle, MD, AGAF1,2,3
1Departments of Medicine and 1,2Physiology and Biophysics, and 3VCU Program for Enteric Neuromuscular Sciences; Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, VA, USACrohn’s disease is complicated by the development of fibrosis and stricture in approximately 30% of patients, and this represents a significant source of morbidity, including the need for surgery, and mortality in these patients.
Emanuela Vesperini, MD, Anna R Maurizi, MD, Paolo Pozzilli, Prof, and Fabrizio Salvinelli, Prof
Campus Bio Medico University, Rome, Italy Hearing impairment is the third most prevalent chronic condition in the US. Based on data from the Health Interview Survey, >2.2 million adults aged >70 years have hearing impairment in the US [1,2]. Hearing is characterized by two pathways: bone and air conduction. In the first, the sounds are transmitted by the bone structure directly to the inner ear, and in the second, the sounds are transmitted through the eardrum and structures of the middle ear and then arrive at the cochlea.
Jeannette E Dankert-Roelse, MD, PhD
Atrium Medisch Centrum Parkstad, Heerlen, The NetherlandsSince the early 1970s, newborn screening for cystic fibrosis (NBSCF) has been possible, but, for a long time, expanding routine NBS programs with screening for CF has led to much debate. Several arguments have been used against adding screening for CF to routine NBS programs. One important reason is that there is currently no approved treatment directed against the harmful effects of the underlying genetic defect in CF.
Robert A Adler, MD
McGuire Veterans Affairs Medical Center and Virginia Commonwealth University, Richmond, VA, USA Screening versus case finding of men at risk of osteoporosis Osteoporosis is an important disorder in men, even though little attention has been paid to it. Approximately 25–33% of hip fractures occur in men, and the likelihood of full recovery is much lower in men than in women . At 50 years of age, a man has a lifetime risk of osteoporotic fracture of between 13% and 25%, and with life expectancy increasing for men the higher value may be more likely.
Luigi Scarpato, MD, Luisa Costa, MD, Maria Maddalena Aquino, MD, and Raffaele Scarpa, MD
Department of Clinical and Experimental Medicine, Rheumatology Research Unit, Early Psoriatic Arthritis Clinic, University Federico II, Naples, ItalyPsoriatic arthritis is a chronic inflammatory arthropathy that is associated with psoriasis and belongs to the group of seronegative spondyloarthropathies. In patients with an uncertain diagnosis of psoriatic arthritis, it is important to look for nail psoriasis to confirm or exclude the diagnosis.
Paola Gaviani, MD, Antonio Silvani, MD, and Andrea Salmaggi, MD
Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, ItalyMalignant gliomas are the most common and malignant brain tumors in adults. The prognosis of patients with malignant glioma is poor, with a median survival time of 12–18 months for patients with glioblastoma multiforme (GBM) receiving a combination of surgery, radiotherapy, and chemotherapy, and a median survival time of 2–3 years for patients with anaplastic astrocytoma.
Alessandro M Vannucchi, MD, Lisa Pieri, MD, Elisabetta Antonioli, MD, PhD, and Paola Guglielmelli, MD, PhD
Section of Hematology, University of Florence, Florence, ItalyThe Philadelphia chromosome (Ph)-negative classic myeloproliferative neoplasms (MPNs) are clonal disorders that originate at the level of a multipotent hematopoietic stem/progenitor cell, and are characterized by exaggerated proliferation of terminally differentiated myeloid cells .
Ali Boden, MBChB, MRCP, and Caroline Harvey, BMedSci, BMBS, MRCP, FRCPath
Department of Haematology, Nottingham University Hospitals NHS TrustGlasgow, UK, April 16–18, 2012This year’s British Society for Haematology’s Annual Scientific Meeting, entitled “Moving from age to biologically directed care”, took place in Glasgow, UK, on April 16–18, 2012. “Recent advances in myelodysplastic syndrome” was one of four education sessions that opened the meeting.
Francesco Dentali, MD, Walter Ageno, MD, and Paolo Prandoni, MD
Department of Clinical Medicine, University of Insubria, Varese and Department of Cardiothoracic and Vascular Sciences, Thromboembolism Unit, University Hospital of Padua, Padua, ItalyUntil recently, venous and arterial thrombosis were considered to be two distinct entities. However, an increasing body of evidence now suggests a link between these conditions. They share a number of risk factors such as increased age, obesity, acute infections, and presence of the metabolic syndrome.
Renaud de Beaurepaire, MD
Groupe Hospitalier Paul Guiraud, Villejuif, FranceTobacco addiction is a major cause of preventable death and health-related economic loss . Despite extensive use of mass media campaigns, warnings, policies, and stop-smoking programs, there remains a high number of smokers in the general population, and studies converge in finding particularly high rates of smoking among people with mental illnesses. One way to understand why so many people smoke despite the well-established dangers of smoking is to investigate the psychobiological basis of tobacco addiction. In patients with mental illnesses, particularly schizophrenia, this is the principal type of investigation that has been conducted.
Susan Alsamarai, MD, Terri Parker, MD, and Hari Deshpande, MD
Yale University Medical School, New Haven, CT, USAIt is a goal of modern medical oncology and translational medicine to develop treatments that are a proof of principal: using basic science to determine meaningful targets and to use medications directed at these to successfully manage disease.
Infectious Diseases Unit, Third Department of Pediatrics, Aristotle University School of Medicine, Hippokration Hospital, Thessaloniki, GreeceThe respiratory tract of patients with cystic fibrosis (CF) can be colonized by filamentous fungi, especially Aspergillus spp. and Scedosporium spp.
Benjamin Koslowsky1‚3, and Dan Turner2‚3
1Digestive Disease Center, Shaare Zedek Medical Center; 2The Pediatric Gastroenterology and Nutrition Unit, Shaare Zedek Medical Center; and 3The Hebrew University of Jerusalem, Jerusalem, IsraelInfliximab is a relatively new therapeutic option in children with ulcerative colitis (UC). In this article, use of this agent to treat UC is reviewed in light of new accumulated data. It has mainly been used to treat children with moderate-to-severe disease that is not responsive to maximal traditional therapy or who are steroid-dependent and to treat patients with steroid-refractory acute severe colitis.
Ted R Mikuls, MD, MSPH1, Geoffrey M Thiele, PhD1, and Jeffrey B Payne, DDS, MDentSc2
1Division of Rheumatology and Immunology, Department of Medicine, University of Nebraska Medical Center and Omaha Veterans Affairs Medical Center, Omaha; 2Department of Surgical Specialties, College of Dentistry, University of Nebraska Medical Center, Lincoln, NE, USAPeriodontitis (PD) has recently emerged as a potential risk factor for rheumatoid arthritis (RA) as well as for other systemic inflammatory diseases.
Sid ahmed Labed, and Nathalie Pujol
Centre d’Immunologie de Marseille-Luminy, Aix-Marseille University; Institut National de la Santé et de la Recherche Médicale, U1104;Centre National de la Recherche Scientifique, UMR7280, Marseille, FranceCaenorhabditis elegans is a popular model in many areas of biology. With fewer than 1000 cells, a simple anatomy, and a life-cycle of 3 days, C elegans is economical to use in the laboratory, ethically acceptable, and its use is supported by a large and growing community of researchers.
Bonnie L Bermas, MD
Division of Rheumatology, Brigham and Women’s Hospital, Boston, MA, USARheumatic disorders are more common in women. Thus, clinicians may be faced with the challenge of managing a rheumatic disease during pregnancy. The physiological and immunological changes that occur in pregnancy can impact disease symptoms and activity.
Floriana Morgillo, MD, PhD, Teresa Troiani, MD, PhD, Erika Martinelli, MD, PhD, Michele Orditura, MD, PhD, Ferdinando De Vita, MD, PhD, and Fortunato Ciardiello, MD, PhD.
Dipartimento Medico-Chirurgico di Internistica Clinica e Sperimentale “F. Magrassi e A. Lanzara”, Seconda Universita degli Studi di Napoli, Napoli, Italy.NSCLC accounts for approximately 80% of all lung cancers. The overall prognosis for patients with NSCLC remains poor, with 15% of patients surviving 5 years. Because most patients have advanced disease at diagnosis, palliative chemotherapy is the mainstay of management, and patients with advanced disease are generally treated with a combination of a platinum-based drug and a non-platinum-based drug, which results in a slight increase in survival of approximately 2 months .
Til Menge, MD, and Bernd C Kieseier, MD
Department of Neurology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, GermanyThe current therapeutic regimen in multiple sclerosis (MS) is based on immunomodulation by interferon-β (IFN-β) or glatiramer acetate (GA). This is termed disease-modifying therapy (DMT). Both IFN-β and GA have been approved for use in MS for >15 years and have an excellent safety profile, but they demonstrate only moderate efficacy [1–3].
Lauren A Henderson, MD1, and Peter A Nigrovic, MD1,2
1Division of Immunology, Children’s Hospital Boston, and 2Division of Rheumatology, Immunology, and Allergy, Brigham and Women’s Hospital, Boston, MA, USAJuvenile idiopathic arthritis (JIA) encompasses all forms of chronic arthritis of unknown origin that begin before the age of 16 years. Although current classification criteria distinguish seven specific subtypes, recent studies defining phenotypic patterns, genetic associations, and peripheral blood RNA signatures provide evidence for the need to redefine these disease categories.
David Wojciechowski, DO, and Flavio Vincenti, MD
Kidney Transplant Service, University of California, San Francisco, California, USAIn June 2011, the US Food and Drug Administration approved belatacept for the prophylaxis of organ rejection in adult kidney transplant recipients. The purpose of this review is to discuss the use of belatacept as part of a maintenance immunosuppression regimen in renal transplant recipients to prevent acute rejection.
Eva M Carmona, MD, PhD, and Andrew H Limper, MD
Thoracic Diseases Research Unit and Division of Pulmonary Critical Care and Internal Medicine, Department of Medicine, Mayo Clinic and Foundation, Rochester, MN, USA.Immunosuppression following transplantation places patients at a higher risk of opportunistic infections such as Pneumocystis pneumonia (PCP). Prior to routine prophylaxis, the incidence of PCP in the transplant patient population ranges from 5–15%.
William L Baker, PharmD, BCPS (AQ Cardiology), and William B White, MD, FACP, FAHA, FASH
University of Connecticut, Schools of Pharmacy and Medicine, Farmington, CT, USAIn this review, the efficacy, safety, and clinical role of azilsartan medoxomil are evaluated. Azilsartan medoxomil is an angiotensin II receptor blocker (ARB) that recently gained approval from the US Food and Drug Administration for the lowering of blood pressure in patients with hypertension.
Meng May Chee, MB ChB, and Duncan Porter, BM BCh
Department of Rheumatology, Gartnavel General Hospital, Glasgow, UKThe management of rheumatoid arthritis (RA) has evolved over the last 20 years. With an ever-increasing number of treatment options including biologics, many studies have been performed to determine the optimal treatment strategy.
Michael J Krowka, MD
Mayo Clinic, Rochester, MN, USAThe era of liver transplantation (LT) has refocused attention on the clinical entity of pulmonary arterial hypertension (PAH) associated with portal hypertension from any cause, also known as portopulmonary hypertension (PPH) .
Elana J Bernstein, MD1, and Jonathan Kay, MD2
1Hospital for Special Surgery, New York, NY, and 2University of Massachusetts Medical School, Worcester, MA, USANephrogenic systemic fibrosis (NSF) is an iatrogenic fibrosing disorder that primarily affects patients with chronic kidney disease in the setting of exposure to gadolinium-based contrast agents. Patients with NSF develop progressive skin hardening, tethering, and hyperpigmentation, predominantly of the extremities, as well as fixed flexion contractures due to periarticular skin tightening.
Emily J Gallagher, MB BCh BAO, MRCPI, and Derek LeRoith, MD, PhD
Mount Sinai Medical Center, New York, NY, USA. Considered by many as the cornerstone of treatment for type 2 diabetes, metformin is also forming a niche as a therapy for cancer. Having type 2 diabetes is associated with an increased risk of developing certain cancers and many of the current diabetes medications are being scrutinized because of reports that they may increase the risk of cancer; however, metformin appears to reduce the risk of developing and dying from cancer.
Hayrunnisa Bolay, MD, PhD1, and Mustafa Ertas, MD2
1Gazi University, Ankara; and 2Anadolu Health Center Hospital, Cayirova, Kocaeli, TurkeyMigraine headache and associated symptoms such as nausea and photophobia are troublesome; in addition, the throbbing headache can be aggravated by motion. The trigeminovascular system plays a fundamental role during the headache phase in terms of peripheral sensitization and neurogenic inflammation, and is also a predominant site of action for pharmaceutical agents such as triptans, ergots, neuropeptide antagonists, and nonsteroidal anti-inflammatory drugs (NSAIDs).
Duk Hwan Kim, Won Ho Kim, and Jae Hee Cheon
Yonsei University College of Medicine, Seoul, KoreaTreatment planning for ulcerative colitis (UC) is based on disease severity and exact diagnosis, the latter of which is currently achieved through assessments of clinical presentation and typical endoscopic appearance coupled with histological confirmation [1–3].
Alon Z Weizer, MD, MS, Christopher Lee, MD, Khaled S Hafez, MD, and Jeffrey S Montgomery, MD, MHSA
University of Michigan, Ann Arbor, MI, USAMore than two-thirds of patients diagnosed with bladder cancer have tumor confined to the mucosa or lamina propria. These patients have non-muscle-invasive bladder cancer (NMIBC) amenable to interventions that preserve the bladder.
Katerina M Antoniou, MD, PhD1, and Demosthenes Bouros, MD, PhD, FCCP2
1Department of Thoracic Medicine, Medical School, University of Crete, Heraklion; and 2Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, GreeceIdiopathic pulmonary fibrosis (IPF) is the most lethal form of diffuse lung fibrosis, with approximately half of those affected dying within 2–3 years of diagnosis.
Shields W Callahan, BA1, and Peter A Lio, MD1,2
1Northwestern University Feinberg School of Medicine; and 2Dermatology and Aesthetics of Wicker Park, Chicago, IL, USAChronic itch is a distressing symptom that is often recalcitrant to standard anti-itch therapies. Distinct from acute itch in its duration and response to common treatments, chronic itch is a frustrating symptom for patients and their physicians alike.
Diane R Hildebrand, MB ChB, MRCS(Ed)1, Natasha P Ross, MB ChB, MRCS(Ed)1, and Angus JM Watson, MB ChB, FRCS(Ed), FRCS(Gen. Surg.)1,2
1Department of General Surgery, Raigmore Hospital, and 2University of Stirling, Inverness, Scotland, UKIBD is a chronic inflammatory condition with a high incidence in Northern Europe. Current biological markers are inadequate for detecting, phenotyping, and monitoring the disease. It is therefore imperative to find novel biomarkers that will not only help with diagnosis but that will also shed further light on the pathogenesis of IBD.
Karl V Clemons, PhD, and David A Stevens, MD
Department of Medicine, Division of Infectious Diseases, Santa Clara Valley Medical Center and California Institute for Medical Research, San Jose, and Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA, USAThere are no commercially available vaccines for the prevention of coccidioidomycosis. This fungal infection, endemic to the Southwestern US and parts of Latin America, is estimated to cause ≥150 000 new infections each year, with exposure possible to approximately 20 million individuals in the US alone.
Laurence Bouillet, MD, PhD
National Reference Centre for Angioedema, Grenoble University Hospital, Grenoble, France.Hereditary angioedema (HAE) that is associated with C1 inhibitor deficiency is a rare disease, the prognosis of which is determined by upper respiratory tract involvement. In the absence of appropriate treatment, 25% of patients with this condition die of fatal asphyxia caused by laryngeal edema.
Tania A Baban, MD1, Roy A Raad, MD2, Dima Dandachi, MD1, Souha S Kanj, MD1, and Zeina A Kanafani, MD1
1Division of Infectious Diseases, Department of Internal Medicine; 2Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, LebanonMucormycosis is a devastating, rapidly progressive, life-threatening disease that necessitates urgent intervention, particularly in immunocompromised patients. So far, data on invasive mold infections from the Middle East and other developing countries are limited.
Sonali Jindal, MD, Virginia F Borges, MD, MMSc
University of Colorado Denver – Anschutz Medical Campus, Aurora, CO, USA Breast cancer is the most common malignancy in US women and remains the leading cause of cancer death in women aged 15–54 years. The current understanding of breast cancer supports the concept of multifactorial causation, involving genomic alteration of epithelial cells coupled with an altered microenvironment supportive of tumor growth.
Dion Stub, MBBS1,2,3, Stephen Bernard, MBBS, MD2,3, Stephen J Duffy, MBBS, PhD1,2,3, James Shaw, MBBS, PhD1,2,3, and David M Kaye, MBBS, PhD1,2,3
1Baker IDI Heart Diabetes Institute; 2Alfred Hospital; and 3Monash University, Melbourne, VIC, AustraliaOut-of-hospital cardiac arrest (OHCA) is a common presentation of cardiovascular disease. Owing to the high incidence of acute coronary ischemia in this clinical scenario, consideration of emergent coronary angiography is currently recommended for all patients whose initial rhythm after OHCA is ventricular fibrillation (VF).
Catherine SM Diefenbach, MD1, and Owen A O’Connor, MD, PhD2
1Division of Hematology and Medical Oncology, New York University (NYU) Cancer Institute, NYU Langone Medical Center; and 2Center for Lymphoid Malignancies, New York Presbyterian Hospital–Columbia University Medical Center, New York, NY, USABrentuximab vedotin is an antibody–drug conjugate (ADC) targeting the CD30 antigen expressed by malignant Hodgkin and Reed–Sternberg cells in Hodgkin lymphoma (HL) and systemic anaplastic large cell lymphoma (sALCL).
Helen Nankervis, BSc (Hons)
University of Nottingham, Nottingham, UK.Many healthcare professionals and researchers who are interested in eczema will at some stage need to search databases for a particular randomized, controlled trial of eczema treatment.
Annalisa Sechi, MD, Andrea Dardis, PhD, and Bruno Bembi, MD
Regional Coordination Centre for Rare Diseases, University Hospital Santa Maria della Misericordia, Udine, ItalyGlycogen storage disease type II (also known as Pompe disease or acid maltase deficiency; Online Mendelian Inheritance in Man [OMIM] 232300), is an autosomal recessive lysosomal storage disease (LSD) caused by a deficiency of acid α-glucosidase (GAA) activity.
Eric M Ruderman, MD
Chicago, IL, USA, November 4–9, 2011Division of Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USAAs usual, this year’s American College of Rheumatology (ACR) annual scientific meeting brought information on new therapies as well as new insights into existing treatments.
Roland Staud, MD
Division of Rheumatology and Clinical Immunology, McKnight Brain Institute, University of Florida, Gainesville, FL, USA Fibromyalgia syndrome (FM) is a chronic pain syndrome that was defined by the American College of Rheumatology (ACR) in 1990 as widespread pain for more than 3 months and the presence of at least 11 out of 18 tender points .
Andreea Ciudin, Cristina Hernández, and Rafael Simó
Diabetes and Metabolism Research Unit, Vall d’Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d’Hebron, Univeristat Autònoma de Barcelona, Barcelona, SpainDiabetic retinopathy (DR) is the most common complication of diabetes, and proliferative DR (PDR) remains the leading cause of blindness among working-age individuals in developed countries. Diabetic macular edema (DME), another important event that occurs in DR, is more frequent in type 2 than in type 1 diabetes .
Simon D Wagner, PhD, FRCP, Matthew J Ahearne, MRCP, and Shaun Willimott, PhD
Department of Cancer Studies and Molecular Medicine and MRC Toxicology Unit, University of Leicester, Leicester, UKOne of the early observations in cancer biology was that avian cells transformed by Rous sarcoma virus lost the ability to adhere and consequently adopted a rounded morphology. This was not an epiphenomenon but a direct effect of the viral Src oncogene causing reduced production of fibronectin, a basement membrane component, and consequent loss of signals inhibiting cell growth [1,2].
Hans Joachim Salize, MD, and Harald Dressing, MD
Central Institute of Mental Health, Mannheim, GermanyThe civil commitment, involuntary placement, and coercive treatment of mentally ill individuals are central issues in mental healthcare. The application of coercive measures in certain circumstances singularly distinguishes psychiatry from most other medical disciplines.
Christoph Mayer, MD and Ulf Ziemann, MD
Clinic for Neurology and Neurosurgery, Goethe University Frankfurt, Frankfurt am Main, GermanyImmunomodulating therapy has proven efficacy in the treatment of patients with multiple sclerosis (MS), which indicates that the disease has an autoimmune genesis.
Ville Saarela, MD, PhD1, Matti Nuutinen, MD, PhD1, and Timo Jahnukainen, MD, PhD2
1Oulu University Hospital, Oulu; and 2Children’s Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandTubulointerstitial nephritis and uveitis (TINU) syndrome is a relatively rare condition affecting both children and adults. There are approximately 250 reported cases in the literature, and >50% of patients are aged <20 years [1,2].
Dirk De Ruysscher, MD, PhD, Bart Reymen, MD, and Angela van Baardwijk, MD, PhD
Maastricht University Medical Centre, Maastricht, The NetherlandsNSCLC is one of the most frequent and lethal cancers worldwide , and local and distant tumor control rates for those with the disease remain disappointingly low.
Alessandra Costanza1, Constantin Bouras1, Eniko Kövari1, and Panteleimon Giannakopoulos1,2
1Department of Psychiatry, University of Geneva School of Medicine, Geneva; and 2Department of Psychiatry, Division of Old Age Psychiatry, Hospices-Centre Hospitalier Universitaire Vaudois, Lausanne, SwitzerlandThe two core pathological hallmarks of Alzheimer’s disease (AD) are insoluble amyloid-β (Aβ) deposits, referred to as senile plaques (SPs), and neurofibrillary tangles (NFTs) composed of abnormally phosphorylated tau protein aggregates [1,2]. The mechanisms of SP and NFT formation and their role in the pathophysiology of AD is an area of great controversy.
Luciana V Armaganijan, MD1,2, and Renato D Lopes, MD, PhD2,3
1Division of Cardiac Arrhythmias and Electrophysiology, Dante Pazzanese Institute of Cardiology; 2Brazilian Clinical Research Institute, Federal University of São Paulo, São Paulo, Brazil; 3Duke Clinical Research Institute, Duke University Medical Center, Durham, USAAtrial fibrillation (AF) is the most commonly encountered cardiac arrhythmia in clinical practice.
Matvey Tsivian, MD, Michael R Abern, MD, and Thomas J Polascik, MD
Duke University Medical Center, Durham, NC, USACigarette smoking remains a prevalent habit among US adults and has been associated with several diseases, including various cancers. Specifically, cigarette smoking is one of the few modifiable risk factors for renal cell carcinoma (RCC), whereby smoking cessation reduces the risk.
Steven E Finkelstein, MD1 and Mayer Fishman, MD, PhD2
121st Century Oncology Translational Research Consortium, Scottsdale, AZ; and 2Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, USAIn April 2010, the US Food and Drug Administration approved sipuleucel-T, an autologous cell infusion for anticancer treatment of minimally symptomatic prostate cancer.
Zeina A Kanafani, MD
Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, LebanonChicago, IL, USA, 17–20 September 2011The abstracts presented during the 51st Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) centered on several themes that encompassed various areas of active research in invasive fungal infections (IFIs).
Luca Di Vito, MD, Giorgio Cautilli, MD, Rocco Vergallo, MD, and Italo Porto, MD, PhD
Catholic University of the Sacred Heart, Rome, ItalyNowadays, blockade of the renin angiotensin aldosterone system (RAAS) can be considered to be a cornerstone of cardiovascular treatment .
Gareth-Rhys Jones, MBChB, BSc (Med Sci) Hons, MRCP
Western General Hospital, Edinburgh, Edinburgh, UKEdinburgh, UK, September 15–16, 2011The inaugural supraregional meeting of the British Society of Gastroenterology was held in the scenic surroundings of Scotland’s capital, in the striking home of the Royal College of Physicians, Edinburgh. The conference boasted a number of domestic and international figures to address current thinking and pioneering research in pathogenesis within the field of IBD.
Dharam J Kumbhani, MD, SM
Brigham and Women’s Hospital, Boston, MA, USAAugust 27–31, 2011, Paris, France The European Society of Cardiology (ESC) held its annual meeting in Paris, France. There were several trials presented that are of interest to physicians who treat patients with cardiovascular (CV) disease.
Agnieszka Ługowska1, PhD, and Anna Tylki-Szymańska2, MD, PhD
1Department of Genetics, Institute of Psychiatry and Neurology; and 2Department of Metabolic Diseases, The Children’s Memorial Health Institute, Warsaw, PolandThe first description of an infant with massive hepatosplenomegaly and adrenal gland calcification was published in 1956 by Abramov, Schorr, and Wolman.
Claire E Wainwright MBBS, MRCP, FRACP, MD
Queensland Children’s Respiratory Centre, Royal Children’s Hospital, Herston and Queensland Children’s Medical Research Institute, University Queensland, Brisbane, QLD, Australia.Cystic fibrosis (CF) is the most common life-shortening autosomal recessive disease in Caucasians, with approximately one in 2500 newborn infants affected .
Ruth LM Cordiner, MBChB, Marcus Vetter, MD, and James Larkin, FRCP, PhD
The Royal Marsden Hospital, London, UKBetween 1975 and 2006, the incidence of renal cell carcinoma (RCC) rose by 2% per year in the USA . Jemal et al. estimated that 58 240 new cases of RCC were diagnosed in the USA in 2010 (35 370 in men, 22 870 in women) .
Dimitrios Chanouzas, MRCP1, and Matthew D Morgan, PhD2
1Nephrology Department, University Hospital North Staffordshire, Stoke-on-Trent, and 2Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UKAntineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV), comprising microscopic polyangiitis, Wegener’s granulomatosis (now renamed as granulomatosis with polyangiitis), and Churg–Strauss syndrome, are life-threatening autoimmune inflammatory diseases commonly associated with renal failure.
Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UKThe 2011 European League Against Rheumatism (EULAR) Annual Congress, held in London, UK, from May 25–28, covered a wealth of original clinical and translational research, as well as topic reviews by experts in specialist fields.
Michael D Parkins1¸2, Christopher D Sibley1, and J Stuart Elborn3,4
1Department of Microbiology, Immunology and Infectious Diseases; 2Department of Medicine, The University of Calgary, Calgary, Canada; 3Northern Ireland Regional Adult Cystic Fibrosis Centre, Belfast City Hospital; and 4Centre for Infection and Immunity, Queen’s University of Belfast, Belfast, UKChronic lower airway infection with Pseudomonas aeruginosa is a hallmark of cystic fibrosis (CF).
Kyle Williams, MD
Yale Child Study Center, Yale School of Medicine, New Haven, CT, USAOver the past 15 years, there has been a tremendous increase in our knowledge of the underpinnings of two prevalent, chronic, and disabling childhood psychiatric disorders – obsessive–compulsive disorder (OCD), and Tourette’s disorder (TD).
Aristotelis Tsiakalos, MD, Dionysios Loukeris, MD, Sarah P Georgiadou, MD,
and Nikolaos V Sipsas, MD
Infectious Disease Unit, Pathophysiology Department, Medical School, National and Kapodistrian University of Athens, and Laikon General Hospital, Athens, GreeceFungemia represents a major cause of increased morbidity and mortality rates among hospitalized patients.
1Department of Microbiology, Immunology and Infectious Diseases; 2Department of Medicine, The University of Calgary, Calgary, Canada; 3Northern Ireland Regional Adult Cystic Fibrosis Centre, Belfast City Hospital; and 4Centre for Infection and Immunity, Queen’s University of Belfast, Belfast, UKCystic fibrosis (CF) lung disease is characterized by thickened secretions that impair mucociliary clearance, thereby reducing the normal removal of inhaled bacteria and other particulates.
Jaimin R Bhatt, MBChB, MMed (Surg), MRCS Ed1,2, Ru MacDonagh, MBChB, MD, FRCS (Urol)1,3, and Neil A Haldar, MBChB, MD, FRCS (Urol)1,2
1UROLINK, British Association of Urological Surgeons, Royal College of Surgeons, London; 2Urology Department, Wycombe Hospital, High Wycombe; 3Musgrove Park Hospital, Taunton, UKThe specialty of urology in the developing world differs significantly from that in the developed world in terms of the pattern, incidence, and presentation of conditions, the availability of technology (diagnostic tools and therapeutic instrumentation), as well as urological services and associated medical and social infrastructures.
Thomas Höchtl and Kurt Huber
Third Medical Department with Cardiology and Emergency Medicine, Wilhelminenhospital Vienna, AustriaDual antiplatelet therapy, usually comprising clopidogrel and aspirin, has come under discussion in recent years because of an increasing incidence of major adverse cardiac events (MACEs) with its use.
Irene M Mulder, MD, and Jefrey Vermeulen, MD, PhD
Department of Surgery, Erasmus University Medical Centre, Rotterdam, The NetherlandsDiverticular disease is one of the most common diseases of the gastrointestinal (GI) tract requiring in-hospital treatment in Western countries. Despite its high incidence, controversies remain about the optimal treatment of the different stages of this disease.
Nicholas G Cost, MD and Vitaly Margulis, MD
Division of Urologic Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USARenal cell carcinoma (RCC) comprises 3% of all adult malignancies and there are approximately 60000 new diagnoses annually in the US. However, the natural history of RCC is extremely variable .
Mohammad Sarraf, MD, and Demetris Yannopoulos, MD
Division of Cardiology, University of Minnesota, Minneapolis, MN, USATherapeutic hypothermia (TH) is an important intervention in the medical and surgical field, and has shown benefits both in animal and human studies. TH can mitigate many detrimental pathways that lead to cell death and, eventually, mortality.
Carlos Ferrándiz, MD, PhD, and José Manuel Carrascosa, MD, PhD
Department of Dermatology, Hospital Universitario Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, SpainErythrodermic psoriasis (EP) is the most severe form of psoriasis. Although it may develop de novo, it is most commonly associated with long-standing, active disease. EP develops acutely or following a subacute or chronic course.
Ram Kela, MBBS, MRCP (Diab/Endo)1 and Melanie J Davies, MB ChB, MD, FRCP1,2
1University Hospitals of Leicester NHS Trust and 2University of Leicester, Leicester, UKCurrently, the management of type 2 diabetes is faced with many challenges. Over recent years, interesting information concerning the goals, targets, and intensity of glycemic management has come to light, instilling the need for individualized care in patients affected by this disease.
Anja K Weidmann, MD, and Helen S Young, MD
The Dermatology Centre, Salford, UKAzathioprine was originally developed >50 years ago for use in solid organ transplantation and for the treatment of hematological malignancies. In clinical practice today, it is used in a variety of specialties and for a host of indications. It is available as a generic preparation at a relatively low cost.
Stefano MM Basso, MD, and Franco Lumachi, MD
University of Padua, Padova, Italy Since the first radical mastectomy proposed by William S Halsted in the 1890s, axillary lymph node dissection (ALND) has been considered the standard procedure for surgical treatment of breast cancer . Although the extent of surgery decreased, ALND was extensively performed for a century.
Zahid Bashir1¸2 and Andrew John Davies3
1Roche Products Limited, Welwyn Garden City, 2Hammersmith Hospital, Imperial College London, London, and 3Southampton Cancer Research UK Centre, University of Southampton Faculty of Medicine, Southampton, UKDiffuse large B cell lymphoma (DLBCL) is a heterogeneous disease with specific subtypes and morphological variants .
Antoine Thiery-Vuillemin, MD1¸2, Elsa Kalbacher, MD1, Laurence Albiges, MD3, and Bernard Escudier, MD4.
1University Hospital Jean Minjoz; 2INSERM U645, Besançon; 3University Hospital Henri Mondor, Créteil; and 4Institut Gustave Roussy, Villejuif, France.Six targeted therapies have been evaluated in randomized, controlled, Phase III clinical trials of patients with metastatic renal cell carcinoma (mRCC) and, subsequently, approved by regulatory authorities. With the availability of several treatment options, each with a slightly different risk-to-benefit profile, there are various options for initial treatment.
Eelco van Duinkerken, MSc1, Augustina MA Brands, PhD2
1VU University Medical Centre, Amsterdam; 2Zuwe Hofpoort Hospital/Regional Psychiatric Centre, Woerden, The NetherlandsThe first report that diabetes negatively influences the brain was published in the early 1920s . Decades later, post mortem research in young adults with type 1 diabetes mellitus (T1DM) demonstrated diffuse cerebral abnormalities, such as demyelination and cortical atrophy [2,3].
Helmut Neumann, MD, PhD1, Raja Atreya, MD, PhD1, Michael Vieth, MD, PhD2,
and Markus F Neurath, MD, PhD1
1Department of Medicine I, University of Erlangen–Nuremberg, Erlangen, and 2Institute of Pathology, Klinikum Bayreuth, Bayreuth, GermanyAdvanced endoscopic imaging with virtual histology has become clinical reality since the introduction of confocal laser endomicroscopy (CLE) in 2004. In the meantime, various studies have shown the explicit potential of CLE for the diagnosis and characterization of different disease entities, including IBD.
Charles B Simone II, MD
Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA, USAWorldwide, a projected 1.6 million people will be diagnosed with lung cancer in 2011 . Approximately 80–85% of these tumors are of the non-small-cell histological type . Lung cancer is the leading cause of death attributed to malignancies, with nearly 1.4 million annual deaths worldwide .
Cindy Flower MBBS, DM, and George D Nicholson, DM, FRCP, FACP
The University of the West Indies, Queen Elizabeth Hospital, Bridgetown, BarbadosThe clinical presentations of lupus nephritis (LN) vary from mild or moderate proteinuria to a rapidly progressive glomerulonephritis that occasionally leads to end-stage renal failure. The histopathological profile of LN encompasses diverse patterns of glomerular, tubulointerstitial, and vascular injury .
Arnold Ceponis, MD, and Arthur Kavanaugh, MD
Division of Rheumatology, Allergy and Immunology, University of California San Diego, La Jolla, CA, USAPsoriatic arthritis (PsA) is an inflammatory arthritis occurring in individuals with psoriasis. It is a multifaceted condition that – in addition to skin and nail psoriasis – presents with peripheral and/or axial arthritis/synovitis, spondylitis, dactylitis, or enthesitis, as well as iritis and various degrees of bowel inflammation.
Jeremy A Falk, MD1 and Ernst R Schwarz, MD, PhD2
1Cedars Sinai Women’s Guild Lung Institute and 2Cedars Sinai Heart Institute, Cedars Sinai Medial Center, Los Angeles, CA, USA.Pulmonary hypertension (PH) is very common, yet only a minority of patients suffer from pulmonary arterial hypertension (PAH). PAH that is idiopathic or associated with other disorders has been associated with poor survival, poor exercise tolerance, progressive symptoms of dyspnea, and reduced quality of life.
Frank Hoentjen, MD, PhD
Inflammatory Bowel Disease Center, University of Chicago, Chicago, IL, USADigestive Disease Week (DDW) 2011 was held from May 7–10, 2011, in Chicago, IL, USA. IBD, in particular biological therapy in IBD, was a popular topic, and these sessions were well attended. This report will summarize the most important clinical findings in IBD research presented at this year’s meeting.
Atsushi Sakuraba, MD
Section of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Chicago, Chicago, IL, USADigestive Disease Week (DDW) 2011 brought together both clinicians and basic scientists to present and discuss novel aspects of gastrointestinal and liver diseases. The current report summarizes the highlights of mostly unpublished basic research in the field of IBD presented at the meeting.
Véronique Houdouin, MD, PhD
Paediatric Gastroenterology, Nutrition and Cystic Fibrosis Department, Robert Debré University Hospital, Paris, FranceHamburg, Germany, June 8–11, 2011The European Cystic Fibrosis (CF) Society held its 2011 annual meeting in Hamburg, Germany. There were presentations on several topics that are of interest to clinicians treating patients with CF.
Jyoti Pillai, MD1 and Michael R Sperling, MD2
1Department of Neurology, Drexel University College of Medicine; 2Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia, PA, USAEpilepsy is a chronic neurological disorder that is associated with significant rates of morbidity and mortality if seizures are uncontrolled. Despite the introduction of many new antiepileptic drugs, >30% of patients remain refractory to medical therapy .
Tiberiu Hershcovici, MD, Tomás Navarro-Rodriguez, MD, PhD, and Ronnie Fass, MD
Southern Arizona VA Health Care System and University of Arizona Health Sciences Center, Tucson, AZ, USANon-cardiac chest pain (NCCP) is defined as recurring, angina-like, retrosternal chest pain of non-cardiac origin. Patient history and characteristics do not reliably distinguish between cardiac and esophageal causes of chest pain [1,2].
Sanjay H Chotirmall, Mbbch, Bao1, Brian J Harvey, PhD2, Noel G McElvaney, Mbbch, Bao1, and Catherine M Greene, PhD1
1Respiratory Research Division, Department of Medicine and; 2Department of Molecular Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Republic of IrelandCystic fibrosis (CF) is a multisystem disease, affecting many organs including the liver, intestines, respiratory and reproductive tracts, bone, heart, spleen, gall bladder, and pancreas (Table 1) .
Martin A Katzman, MD, FRCPC1–4 and Dina Tsirgielis, BSc1
1START Clinic for Mood and Anxiety Disorders, Toronto, ON, Canada; 2Northern Ontario School of Medicine, Thunder Bay, ON, Canada; 3Lakehead University, Thunder Bay, ON, Canada; 4University of Toronto, Toronto, ON, CanadaGeneralized anxiety disorder (GAD) is a highly prevalent and chronic disorder that affects approximately 183 million people worldwide (calculated from International Programs Center, USA data). The 12-month and lifetime prevalence rates of GAD in the US community were estimated to be 5.7% and 8.3%, respectively .
Ramón Rami-Porta, MD1, and Peter Goldstraw, MB, FRCS2
1Thoracic Surgery Service, Hospital Universitari Mutua Terrassa, Terrassa, Barcelona, Spain; 2Department of Thoracic Surgery, Royal Brompton Hospital and Imperial College, London, UK.The publication of the seventh edition of the tumor, node, metastasis (TNM) classification of lung cancer was the culmination of a dozen years of activities carried out by the International Staging Committee of the International Association for the Study of Lung Cancer (IASLC) .
Hakeem James1, Mahmoud Ghannoum1, and Richard Jurevic2
1Center for Medical Mycology, University Hospitals Case Medical Center; 2School of Dentistry, Case Western Reserve University, Cleveland, OH, USAThe current understanding of the fungal biofilm is that it is a complex community of microorganisms capable of surviving and thriving in a multitude of environments. Its ability to adhere and colonize on a number of different substrates including biomaterials and implantable devices can impact healthcare delivery.
Matthew E Wiisanen, MD.
Cardiovascular Disease Fellowship, University of Kentucky, Gill Heart Institute, Lexington, KY, USAThe American College of Cardiology held its annual meeting in New Orleans (LA, USA). There were several trials presented that are of interest to physicians caring for patients with coronary artery disease (CAD).
Sean P Stroup, MD, and Ithaar H Derweesh, MD
Division of Urology/Department of Surgery, University of California San Diego School of Medicine, La Jolla, CA, USAMetastatic renal cell carcinoma (mRCC) has been associated with a poor prognosis. While multimodal treatment with upfront cytoreductive nephrectomy followed by interferon-α (IFN-α) or interleukin-2 (IL-2) was established in the immunotherapy era, the role of cytoreductive nephrectomy in the setting of targeted therapy has been questioned.
Jennifer L Tenor, PhD
Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USAThe many faces of Cryptococcus and CryptococcosisThe 8th International Conference on Cryptococcus and Cryptococcosis (ICCC) was held in downtown Charleston, South Carolina,USA at the Francis Marion Hotel. The meeting’s organizer, Maurizio Del Poeta (Medical University of South Carolina, Charleston, SC, USA), offered a warm welcome and encouraged the continued collaborative efforts and collegiality of the Cryptococcus scientific community.
Julie H Oestreich, PharmD, PhD, and Paul P Dobesh, PharmD
Department of Pharmacy Practice, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, USAHigh on-treatment platelet reactivity is associated with adverse cardiovascular events following percutaneous coronary intervention. In analyses based on areas under receiver operating characteristic curves, platelet reactivity tests have poor-to-fair ability to discriminate between patients who are at risk of ischemic events and those who are not.
Chiara De Cassan, MD1, Gionata Fiorino, MD2, Carmen Correale2, and Silvio Danese, MD, PhD2
1Division of Gastroenterology, Department of Internal Medicine, University of Genoa, Genoa, Italy; 2Inflammatory Bowel Disease Center, Division of Gastroenterology, IRCCS Istituto Clinico Humanitas, Rozzano, Milan, ItalyLeukocyte recruitment is an important step in the pathogenesis of inflammatory bowel diseases, and represents an interesting therapeutic target in the post-anti-tumor necrosis factor-α (TNFα) era.
Darcy A Krueger, MD, PhD
Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USASubependymal giant cell astrocytomas (SEGAs) occur in 10–15% of individuals with tuberous sclerosis complex (TSC). If undiagnosed or untreated, these benign intracranial tumors can cause hydrocephalus and death. Until recently, neurosurgical resection was the only therapeutic option to prevent these complications.
Kim Edhegard, MD, and Russell P Hall, MD
Duke University, Durham, NC, USABullous pemphigoid (BP) is a chronic, autoimmune, blistering disease of the skin in which subepidermal bullae form as a result of autoantibodies targeting BP180 and BP230 (BP antigen gene 1 [BPAG1] and BPAG2, respectively), specific anchoring proteins in basal keratinocytes.
Yvonne Dombrowski, PhD
Department of Dermatology and Allergy, Ludwig-Maximilian University, Munich, GermanyThe 38th annual meeting of the German Society of Experimental Dermatology (Arbeitsgemeinschaft Dermatologische Forschung [ADF]) was held in cooperation with the German Dermatologic Society (Deutsche Dermatologische Gesellschaft) in Tübingen, Germany, from 17–19 February 2011.
Simon A Joosse and Juliane Hannemann
University Medical Center Hamburg–Eppendorf, Hamburg, GermanyPredicting the likelihood that an individual is a BRCA mutation carrier is the first step to genetic counseling, followed by germline mutation testing. Individuals who have been diagnosed as BRCA mutation-positive are offered special medical care; however, clinical management in the case of a negative test result or an unclassified variant (UV) in BRCA1 or BRCA2 can be difficult.
Shoaib Alam, MD, and Gregory J Kato, MD
National Heart, Lung and Blood Institute, National Institutes of Health,Bethesda, MD, USAPulmonary hypertension (PH) or increased pulmonary arterial pressures (PAPs) are commonly encountered in adult patients with sickle cell disease (SCD), with a range of clinical descriptions.
Paul Dieffenbach, MD and Henry Klar Yaggi, MD, MPH
Yale University School of Medicine, New Haven, CT, USAThe prevalence of obesity in the US and other industrialized nations has rapidly increased over the past 40 years, placing an enormous burden on global public health . The combination of an aging population, unhealthy diet, and sedentary lifestyle is largely responsible for this trend.
Paul Henderson, MB ChB, MRCPCH
Department of Child Life and Health, and Gastrointestinal Unit, Centre for Molecular Medicine, University of Edinburgh, Edinburgh, Scotland, UKThis year’s annual meeting was held at the impressive International Convention Centre, Birmingham, UK. The event was attended by over 2500 people, all keen to receive updates on recent advances in both adult and pediatric gastroenterology through symposia, debates, and poster sessions.
Miriam Canavese, MD, and Jürgen Schauber, MD
Department of Dermatology and Allergy, Ludwig Maximilians University, Munich, GermanyPsoriasis is a genetically determined disease of dysregulated inflammation that is driven and maintained by multiple components of the immune system. Although most recent studies point to a process that is predominantly driven by T helper type 17 (Th17) cells, there is evidence that angiogenesis and inflammation are closely linked in the pathogenesis of psoriasis.
Margaret M Hutka, MD, Alicia FC Okines, MBChB, MRCP, and David Cunningham MD, FRCP
Royal Marsden Hospital NHS Foundation Trust, Royal Marsden Hospital, Sutton, Surrey, UKTrastuzumab is a recombinant, fully humanized monoclonal antibodydirected at the human epidermal growth factor receptor-2 (HER-2; alsoknown as ErbB-2), which inhibits HER-2-dependent cell proliferation and survival.
Paul J Kokorowski, MD, MPH, and Jonathan C Routh, MD, MPH
Children’s Hospital Boston, Harvard Medical School, Boston, MA, USAAugmentation cystoplasty is an important treatment option for patients with severe bladder dysfunction. Bladder augmentation is most frequently performed in the context of bladder dysfunction due to neurogenic bladder (e.g. spina bifida) or bladder exstrophy.
Richard K Russell, PhD1, and Dan Turner, MD, PhD2
1Royal Hospital for Sick Children, Glasgow, Scotland, UK, and 2Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Jerusalem, IsraelAcute, severe ulcerative colitis (ASC) is a more common problem in children compared with adults, explained in part by the more frequent occurrence of an extensive disease phenotype in children.
Raimondo Forte, MD, PhD1,2, Giuseppe Querques, MD, PhD1, Gilda Cennamo, MD, PhD2, Paola Bonavolontà, MD2, Arduino Pascotto, MD3, and Eric H Souied, MD, PhD1
1University Paris Est Creteil, Centre Hospitalier Intercommunal de Creteil, Creteil, France; 2University Federico II, Naples; and 3Second University of Naples, Naples, ItalyDiabetic retinopathy is the third major cause of blindness in Western, developed countries after age-related macular degeneration (AMD) and glaucoma . Although proliferative diabetic retinopathy (PDR) is the cause of most severe vision loss, diabetic macular edema (DME) is more prevalent and is the leading cause of moderate vision loss in patients with diabetic retinopathy [2,3].
Donna Polk, MD, MPH, and Diane Tran, MD
Hartford Hospital, Hartford, CT, USA With the expanding and aging population, the prevalence of coronary heart disease (CHD) is escalating. Owing to advances in technological and medical treatment of CHD, more patients are surviving their index events and are, therefore, living longer, shifting the paradigm in the management of CHD to one of chronicity.
Robert S Shibata, MD, and Dinesh S Rao, MD, PhD
Department of Pathology and Laboratory Medicine, University of California at Los Angeles Medical Center, Los Angeles, CA, USA In recent years, the importance of non-coding RNA in cellular biology and disease pathogenesis has become apparent. One of the first fields in which microRNAs (miRNAs) were explored was hemato-poietic development and hematolymphoid malignancies.
Jack D Sobel, MD
Division of Infectious Diseases, Wayne State University School of Medicine, Detroit, MI, USA In spite of the extensive armamentarium of antimycotic agents available to treat vulvovaginal candidiasis (VVC), limitations to successful management still exist. A fundamental step in managing persistent or recurrent symptoms is confirming the diagnosis of VVC, including differentiating between Candida microorganisms that are pathogens versus commensals.
Ivana Hollan, MD, PhD
Hospital for Rheumatic Diseases, Lillehammer; and The Feiring Heart Clinic, Feiring, Norway Systemic rheumatic diseases (SRDs) are associated with a wide range of cardiovascular complications [1,2]. Of these, coronary artery disease (CAD) is particularly important because it is the leading cause of premature mortality in several SRDs, including rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) [3,4].
Josef S Smolen, MD, FRCP, and Daniel Aletaha, MD, MS
Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, and 2nd Department of Medicine, Hietzing Hospital, Vienna, AustriaThe inflammatory disease process in rheumatoid arthritis (RA) elicits all aspects of the disease including the signs and symptoms (e.g. joint pain and swelling), the laboratory abnormalities (e.g. increased acute phase reactant levels), the joint damage in bony and cartilaginous compartments, and all components of disease-related disability.
Subroto Acharjee, MBBS1 and Christopher P Cannon MD2
1Department of Medicine, State University of New York at Buffalo School of Medicine, Buffalo, NY; and 2TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USAThe introduction of ticagrelor would constitute a landmark event in antiplatelet therapy for ACS, showing several benefits over clopidogrel in clinical trials.
Steve Simpson, Jr, MPH, Kate Greenhill, MB, BS, Ingrid Van der Mei, PhD,
Jim Stankovich, PhD, Jac Charlesworth, PhD, and Bruce V Taylor, MD
Menzies Research Institute Tasmania, University of Tasmania, Hobart, TAS, Australia Multiple sclerosis (MS) is a chronic central nervous system (CNS) disorder that is characterized in most cases by relapsing–remitting inflammatory demyelination on a background of slowly progressing neurodegeneration .
Gregory M Pastores, MD1, and Derralynn A Hughes, MA, DPhil, MRCP, FRCPath2
1Departments of Neurology and Pediatrics, New York University School of Medicine, New York, USA, and 2Department of Academic Haematology, Royal Free Campus, University College Medical School, London, UKBone complications associated with Gaucher disease represent major sources of morbidity that can have a significant impact on patients’ physical and functional wellbeing. Problems can range from significant osteopenia and pathological fractures to femoral head osteonecrosis and degenerative osteoarthritis .
Deborah Elstein, PhD, and Ari Zimran, MD
Shaare Zedek Medical Center, Jerusalem, IsraelGaucher disease occurs because of deficiency of the enzyme β-glucocerebrosidase, which results in accumulation of this glycolipid compound in the cells of the macrophage-monocyte system. Of the three types of Gaucher disease, type 1 is the most common with primarily visceral signs and symptoms, which range tremendously in severity. More than 300 mutations have been described in the gene, partially explaining phenotypic heterogeneity.
Christopher Allen, MD
Cardiovascular Disease Fellowship, University of Kentucky, Gill Heart Institute, Lexington, KY, USAThe American Heart Association (AHA) Scientific Sessions 2010 were held in Chicago, IL, USA. Several trials that are of interest to those caring for patients with ACS were presented. Eleven of these trials are discussed in this report.
Barry Iacopetta, PhD
University of Western Australia, Crawley, WA, AustraliaColorectal cancer (CRC) develops following the accumulation of mutations in oncogenes and tumor suppressor genes in a multistep process, with adenomas as precursor lesions . The most common mechanism by which this occurs is referred to as the chromosomal instability (CIN) pathway because of the high frequency of aneuploidy observed in the resultant tumor cells.
Julia Gledhill, MD, MRCPsych, and Matthew Hodes, PhD, FRCPsych
Imperial College London and Central and North West London NHS Foundation Trust, London, UKDuring the transition from childhood to adolescence, depression becomes more prevalent, and affects 3–8% of the population by mid-adolescence; it is more common in females than males [1,2].
Nasim Mavaddat, MBBS, PhD1, Antonis C Antoniou, PhD1, and Montserrat Garcia-Closas, MD, DrPH2
1Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge; and 2Sections of Epidemiology and Genetics at the Institute of Cancer Research and Breakthrough Breast Cancer Research Centre, London, UKSubtypes of breast cancer display distinct ontogeny and biology, and are predictive of clinical outcomes such as tumor recurrence, metastatic potential, and disease-specific survival. A common tumor classification of clinical relevance is that defined by the expression of immunohistochemical (IHC) markers: estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2).
Luiz R Travassos, MD, PhD1, and Carlos P Taborda, PhD2
1Departamento de Microbiologia, Imunologia e Parasitologia, Universidade Federal de São Paulo, and 2Departamento de Microbiologia, Instituto de Ciências Biomédicas and Laboratório de Micologia Médica IMT/SP-LIM-53, Universidade de São Paulo, São Paulo, BrazilParacoccidioidomycosis (PCM) is the predominant systemic mycosis in Latin America, causing half of the total deaths from fungal infectious diseases in Brazil.
Oltita P Jerca, MD, and Cris S Constantinescu, MD, PhD
Division of Clinical Neurology, Queen’s Medical Centre, Nottingham, UK Multiple sclerosis (MS) is an inflammatory, immune-mediated neurodegenerative disease of the central nervous system. It is the most significant cause of non-traumatic neuro-logical disability in young adults and is more common in women and in the Caucasian population .
James C Lee, MD1,2, and Miles Parkes, MD2
1Cambridge Institute for Medical Research, University of Cambridge, and 2Department of Gastroenterology, Addenbrooke’s Hospital, Cambridge, UKThe advent of genome-wide association scanning has revolutionized the search for genetic loci associated with IBD. Recent meta-analyses from the International IBD Genetics Consortium have increased the number of confirmed IBD susceptibility genes and loci to 100.
Ronald M Bukowski, MD1,2
1Cleveland Clinic Taussig Cancer Center; and 2CCF Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USAAngiogenesis is a valid therapeutic target in renal cell carcinoma (RCC), particularly in relation to the vascular endothelial growth factor (VEGF) signaling axis. Clear-cell carcinoma of the kidney is now recognized as a malignancy that is sensitive to inhibitors of the VEGF pathway.
Jason W Busse, DC, PhD1,2
1Institute for Work & Health, Toronto; and 2McMaster University, Hamilton, ON, CanadaOrthopaedic trials can provide important direction for clinical decision-making, but their strength of inference may be weakened by methodological limitations and the extent to which their reported outcomes fail to address patient-important endpoints.
Hitoshi Maruyama, MD1 and Arun J Sanyal, MD2
1Department of Medicine and Clinical Oncology, Chiba University Graduate School of Medicine, Chuou-ku, Japan; 2Division of Gastroenterology and Hepatology, Virginia Commonwealth University, Richmond, VA, USA.Hepatic encephalopathy (HE) is a major complication of liver disease that is characterized by neuropsychiatric and motor abnormalities. Current approaches for the management of HE comprise removal of major precipitants, diet, non-absorbable disaccharides, and antibiotics.
Markus Cybulla, MD, MBA
Department of Nephrology, University Hospital of Freiburg, Freiburg, Germany Fabry disease (FD) is a rare, X-linked, glycosphingolipid storage disorder that is caused by a deficiency of the lysosomal enzyme α-galactosidase A (α-GalA).
Eugene C DePasquale, MD, and Alexandra J Lansky, MD
Yale University School of Medicine, New Haven, CT, USADirect thrombin inhibitors (DTIs) offer several mechanistic advantages over heparin in the management and treatment of ACS, including ST-segment elevation myocardial infarction, and for percutaneous coronary intervention (PCI); these include free and clot-bound thrombin inhibition and consistent dosing.
Tony Mak, MB ChB, MD, FRCS1 and James Hill, MB ChB, FRCS, ChM2
1Department of General Surgery, Prince of Wales Hospital, Shatin, Hong Kong, China and 2Department of Colorectal Surgery, Manchester Royal Infirmary, Manchester, UKColorectal cancer (CRC) has the second highest mortality rate of all cancers and is the third most common cancer in the UK, with over 30 000 cases diagnosed in 2008 . The majority of CRCs are diagnosed at a relatively late stage (63% at Dukes C or more advanced), and almost 50% of patients newly diagnosed are expected to die within 5 years.
Silvia Baiguera, PhD1, Madhuri Kalathur1, and Paolo Macchiarini, MD, PhD1,2
1BIOAIRLab, University Hospital Careggi, Florence, Italy; 2Laboratory of Regenerative Surgery, Karolinska Institutet, Stockholm, SwedenLung cancer is the leading cause of cancer deaths worldwide (16–19% of all deaths that are attributable to cancer) and, unfortunately, one of the most incurable malignancies .
Anne Christine W Vos, MD, and Marjolijn Duijvestein, MD, PhD
Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The NetherlandsMore than 14 000 participants attended the 18th United European Gastroenterology Week (UEGW) in sunny Barcelona, Spain, from October 23–27, 2010. The annual UEGW is a joint congress of four organizations: the United European Gastroenterology Federation, the World Gastroenterology Organization, the World Organization of Digestive Endoscopy (OMED), and the British Society of Gastroenterology.
David Lagares1, Parisa Ghassemi-Kakroodi2, Faezeh Vasheghani2, and Mohit Kapoor2
1Centro de Biología Molecular Severo Ochoa and LaboratorioMixto CSIC-FRIAT, Consejo Superior de Investigaciones Científicas(CSIC), Universidad Autónoma de Madrid (UAM), Madrid, Spain; and 2OsteoarthritisResearch Unit, University of Montreal Hospital Research Centre(CRCHUM), Notre-Dame Hospital, Montreal, QC, CanadaFibrosis is characterized by the excessive production, deposition, and contraction of the extracellular matrix by fibroblasts. The inability to properly terminate the normal tissue repair process is considered to cause a fibrotic response.
Jörg Hofmann, PhD1, Detlev H Krüger, MD1, and Gero Hütter, MD2
1Institute of Medical Virology, Helmut-Ruska-Haus, Charité University Medicine Berlin, Berlin, and 2Institute of Transfusion Medicine and Immunology, Universitätsmedizin Mannheim, Mannheim, GermanyAlmost 25 years have passed since the discovery of HIV and AIDS, and >25 antiviral drugs from various therapeutic classes are available at present. Despite these developments and the numerous educational campaigns that have been initiated worldwide, the numbers of HIV-infected patients in developing and industrialized countries are still increasing. Although the classical AIDS-related conditions have now become less common owing to highly active antiretroviral therapy (HAART), there is a significant risk of “non-AIDS”, early aging complications, including insulin-resistant diabetes mellitus, cardiovascular diseases, liver and kidney failures, and cancer in HIV-infected patients .
Abdulaziz M Althunayan, MD, and Wassim Kassouf, MD, FRCS(C)
Department of Surgery (Urology), McGill University, Montreal, QC, CanadaAsymptomatic microscopic hematuria (AMH) is a common finding, particularly among men aged 50–60 years and postmenopausal women, and has a prevalence rate ranging from 1% to 21% [1–5].
Nicholas J Simmonds, MD(Res), MRCP, BMBS
Department of Cystic Fibrosis, Royal Brompton Hospital, London, UK.Cystic fibrosis (CF) is the most common genetic, life-shortening disease in white populations . It has a predilection for the lungs and gastrointestinal tract, and classically manifests as chronic suppurative lung disease and malabsorption, although significant variability in disease expression is well recognized.
Maged Muhammed, MD, Jeffrey J Coleman, PhD, Themistoklis K Kourkoumpetis, MD, and Eleftherios Mylonakis, MD, PhD
Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA
The use of invertebrate model hosts to study infection has seen considerable growth over the last few years. Invertebrates such as Caenorhabditis elegans, Drosophila melanogaster, and Galleria mellonella hold promise for the detailed study of host–pathogen interactions.
Shilpa S Sawardekar, MD, and Bryan E Anderson, MD
Penn State University, Hershey, PA, USALichen planus (LP) is an inflammatory mucocutaneous condition that character-istically results in violaceous-to-purple, pruritic, polygonal, flat-topped papules or plaques. It can have a variety of clinical manifestations, and can affect any age group.
Jai H Seth, MBBS, BSc, MRCS, Jalesh N Panicker MBBS, MD, DM MRCP(UK), Clare J Fowler MBBS, MSc, FRCP
UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK Multiple sclerosis (MS) is a progressive, chronic inflammatory, demyelinating disease of the central nervous system that can result in a wide range of disabilities. Lower urinary tract dysfunction is a common problem, with a reported incidence rate of approximately 75% .
Guillaume Pineton de Chambrun, MD1, Laurent Peyrin-Biroulet, MD2, Bénédicte De Vroey, MD1, and Jean-Frédéric Colombel, MD1
1Clinique des Maladies de l’Appareil Digestif et de la Nutrition, Hôpital Claude Huriez, CHRU Lille, and2Service d’Hépato-Gastroentérologie, CHU de Nancy, Vandœuvre-lès-Nancy, France
With the increased use of immunosuppressive and biological agents for the treatment of IBD, the risk of serious side effects, especially lymphoma, has become a major concern for clinicians managing patients with Crohn’s disease and ulcerative colitis. When used for organ transplantation, immunosuppressive drugs have been clearly associated with an increased risk of lymphoma.
Laura R McCabe, PhD, and Lindsay M Coe, BS
Departments of Physiology and Radiology, Michigan State University, East Lansing, MI, USA Type 1 diabetes affects >1 million children and adults in the US. It is estimated that one in 300 individuals aged <18 years have type 1 diabetes and its worldwide incidence continues to rise .
Paolo Gionchetti, MD, Carlo Calabrese, MD, Rosy Tambasco, MD, Giulia Straforini, MD, Ramona Brugnera, MD, Giulia Spuri-Fornarini, MD, Giuseppina Liguori, MD, Donatella Riso, MD, Massimo Campieri, MD, and Fernando Rizzello, MD
Department of Clinical Medicine, University of Bologna, Bologna, Italy The rationale for using probiotics in IBD is based on convincing evidence implicating intestinal bacteria in the pathogenesis of these diseases.
Philippa D Darbre, PhD
University of Reading, Reading, UK The human population is now exposed on a daily basis to a multitude of environmental pollutant chemicals that would not have been present a century ago, and many of these chemicals have been detected in the human breast [1,2].
Division of Endocrinology and Metabolism, McGuire Veterans Affairs Medical Center
and Virginia Commonwealth University, Richmond, VA, USA Prostate disorders are common among older men. Therefore, men with benign prostatic hyperplasia (BPH) or prostate cancer may additionally have osteoporosis because age is a major risk factor for osteoporosis and fracture.
Sancy Low, BSc (Hons), MBBS, MRCOphth1,2, and Rizwana Siddiqi, BSc (Hons), MSc, SRO3
1Moorfields Eye Hospital, London; 2University College London Institute of Ophthalmology, London; and 3Birmingham and Midland Eye Centre, Birmingham, UK Glaucoma is a degenerative optic neuropathy, the second most common cause of blindness worldwide . Visual loss from glaucoma occurs as a result of structural and functional damage of the optic nerve .
Marsha Y Morgan, FRCP, and Matthew Stubbs, BSc
Centre for Hepatology, Royal Free Campus, University College London Medical School, London, UK Hepatic encephalopathy comprises a spectrum of neuropsychiatric abnormalities that range from clinically indiscernible changes in cognition, to clinically obvious changes in intellect, behavior, motor function, and consciousness. It impacts detrimentally on the lives of all those affected and on their survival.
Ali Sadoughi, MD1,2, Yinzhong Zhang MD, PhD1, Edmund J Miller, PhD, FRSC1,3,4, and Arunabh Talwar, MD, FCCP1,2,3,4
1Center for Heart and Lung Research, The Feinstein Institute for Medical Research, Manhasset; 2Pulmonary and Critical Care Division, North Shore Long Island Jewish Health System, New Hyde Park; 3Albert Einstein College of Medicine, Bronx; 4Hofstra University School of Medicine, Hempstead, NY, USA Pulmonary hypertension (PH) is characterized by vascular cell growth and proliferation, leading to increased pulmonary vascular resistance, increased pulmonary arterial pressure (PAP), right ventricular (RV) failure, and death.
Cornelius J Clancy, MD
University of Pittsburgh, Pittsburgh, PA, USA Candida spp. are yeasts that are among the most versatile of human pathogens. Under normal circumstances, most Candida spp. are harmless commensal organisms that are found on mucosal surfaces.
Lieselot Brepoels, MD, PhD, and Daan Dierickx, MD
Department of Nuclear Medicine and Department of Clinical Hematology, University Hospital Gasthuisberg, Leuven, Belgium There are many types of lymphoma that differ with regard to initial presentation, histopathology, clinical behavior, response to therapy, and prognosis.
Frances Alba, MD, and Run Wang, MD, FACS
The University of Texas Health Science Center at Houston, Houston, TX, USA
Prostate cancer is the most common newly diagnosed cancer among males in the US, with an incidence of approximately 157 per 100 000 men .
Athanasios G Pallis, MD, MSc, PhD
University Hospital of Heraklion, Heraklion, Crete, Greece.
Although mortality rates due to cancer have decreased during the past decade, lung cancer remains the leading cause of cancerrelated death in both men and women in the Western world. Lung cancer is categorized into two major types: NSCLC, which represents approximately 80–85% of all lung cancer cases, and SCLC, which accounts for the remaining 15–20% of cases.
Maxine Sun, BSc1, Firas Abdollah, MD2, Shahrokh F Shariat, MD3, Rodolphe Thuret, MD4, Claudio Jeldres, MD1,5, Paul Perrotte, MD5, and Pierre I Karakiewicz, MD1,5
1Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada; 2Department of Urology, Vita-Salute San Raffaele University, Milan, Italy; 3Department of Urology, Weill Medical College of Cornell University, New York, NY, USA; 4Department of Urology, University of Montpellier Health Center, Montpellier, France; and 5Department of Urology, University of Montreal Health Center, Montreal, QC, Canada
In the last decade, the disease biology of metastatic renal cell carcinoma (mRCC) has become better understood and this has led to therapeutic advances based on the specific molecular pathways responsible for RCC tumorigenesis.
K Adam Baker, PhD1, Don MacDonald, PhD2,3, P Rahman, MD, FRCPC3,
and Wayne P Gulliver, MD, FRCPC1,3
1NewLab Life Sciences; 2Newfoundland and Labrador Centre for Health Information; 3Faculty of Medicine,
Memorial University of Newfoundland, St John’s, NL, Canada
Psoriasis is a severe, debilitating chronic inflammatory disorder of the skin affecting approximately 2% of the global population. Several comorbid conditions are associated with psoriasis, including dyslipidemia, hypertension, obesity, cardiovascular disease, type 2 diabetes mellitus, depression, and inflammatory arthritis.
Craig S Broberg, MD, FACC
Adult Congenital Heart Disease Program, Oregon Health and Science University, Portland, OR, USA
Adult patients with congenital heart disease (CHD) are growing in both number and complexity. Surgical and interventional advances in pediatric cardiology over the last half century have been enormously successful in increasing survival rates to >90% for the majority of CHD patients .
Laszlo Farkas, MD1,2,3, and Martin R Kolb, MD, PhD1,2
1McMaster University; 2Firestone Institute for Respiratory Health, St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada; and 3Virginia Commonwealth University, Department of Internal Medicine, Richmond, VA, USA .
Pulmonary hypertension (PH) is characterized by elevated pulmonary vascular pressure and resistance, which is associated with increased pressure in the pulmonary arterial and/or venous system . Various conditions can underlie the development of PH, such as connective tissue disease, which leads to pulmonary arterial hypertension (PAH), but also myocardial or heart valve disease, resulting in pulmonary venous hypertension .
Evelien Carrette, MSc, PhDs, Kristl Vonck, MD, PhD, and Paul Boon, MD, PhD.
Reference Center for Refractory Epilepsy, Laboratory for Clinical and Experimental Neurophysiology, Department of Neurology, Ghent University Hospital, Ghent, Belgium
In patients with pharmacologically refractory epilepsy, continued drug trials with newer anti-epilepsy drugs (AEDs) or combinations of drugs are unlikely to achieve complete freedom from seizures.
Nina Raben, MD, PhD, Mary Barden, BS, Amanda Wong, BA, and Paul H Plotz, MD
Arthritis and Rheumatism Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA
Pompe disease, a rare autosomal-recessive myopathy and cardiomyopathy, falls under the classification of several groups of disorders. One such group is the glycogen storage diseases, which are further subdivided into liver or muscle glycogenoses. Pompe disease is a muscle glycogenosis disorder with progressive muscle weakness.
James E Gangwisch, PhD
Division of Cognitive Neuroscience, Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
As healthcare providers, we can typically count on a collaborative partnership with patients in the pursuit of our common goals of improving their health and wellbeing and prolonging their lives.
Joan T Merrill, MD1, and Paul G Brunetta, MD2
1Oklahoma Medical Research Foundation, Oklahoma City, OK, and 2Genentech, Inc., San Francisco, CA, USA In the past two decades, a number of investigational treatments for lupus have entered Phase II/III clinical trials but primary or secondary endpoints have not been met. Recently, successful outcomes were reported for two Phase III trials of belimumab, a human monoclonal antibody that targets the B cell survival factor BLyS (BAFF).
Ahmed S Zayat, MBBCh, MSc, MRCP1, Richard J Wakefield, BM, MD, FRCP1, Philip G Conaghan, MBBS, PhD, FRACP, FRCP1,2, and Paul Emery, MA, MD, FRCP1
1Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, and 2NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK
Musculoskeletal ultrasound (MSUS) is a powerful imaging modality with the potential to revolutionize the way we
practice rheumatology. Advances in rheumatic disease therapeutics have driven a need for tight disease assessment and therapy monitoring.
Catherine Buettner, MD, MPH1,2, Martin A Kriegel, MD1,2,3, Rebecca E Wells, MD, MPH1,2, and Jim S Wu, MD1,2
1Beth Israel Deaconess Medical Center; 2Harvard Medical School; and
3Brigham and Women’s Hospital, Boston, MA, USA
Statins (3-hydroxy-3-methylglutaryl-coenzyme A [HMG-CoA] reductase inhibitors) are the most efficacious medications for lowering cholesterol . They are usually well tolerated, with few serious side-effects .
Zsigmond Tamás Kincses, MD, PhD, Nikoletta Szabó, MD, and Lászlo Vécsei, MD, PhD, DSc.
Department of Neurology, Albert Szent-Györgyi Clinical Center,
University of Szeged, Szeged, Hungary
The first breakthrough in the therapy of Parkinson’s disease (PD) was the introduction of levodopa (L-dopa) in the 1960s. L-dopa has significantly improved the motor symptoms and quality of life of patients with PD, but two major issues are still unresolved: the adverse motor and non-motor complications associated with the disorder, and the lack of potent neuroprotective/neurorestorative therapy.
Alex Gomelsky, MD1, and Roger R Dmochowski, MD, FACS2
1Louisiana State University Health Sciences Center, Shreveport, LA,
and 2Vanderbilt University Medical Center, Nashville, TN, USA
Recent studies estimate that pelvic organ prolapse (POP) and other pelvic floor disorders are increasingly common. A retrospective cohort study of all female
members of the organization Kaiser Permanente Northwest (Portland, OR, USA), who underwent surgical treatment for prolapse and incontinence in 1995, estimated
the lifetime risk of undergoing a single operation for prolapse or incontinence to be 11.1% by the age of 80 years, and that the number of prolapse surgeries in the US will exceed 250 000 annually .
Alexios S Strimpakos MD, MRCP1, Muhammad W Saif MD, MBBS2, and Kostas N Syrigos MD, PhD1,2
1University of Athens, Athens, Greece; and 2Yale University School of Medicine, New Haven, CT, USA
Colorectal cancer (CRC) is the third most common cancer in both men and women, and the third most common cause of cancer related death in the UK and the US .
Rebecca Jane McLean, MSc, and Irene Gottlob, MD
University of Leicester, Leicester, UK
Pathological nystagmus consists of involuntary to and fro oscillations of the eyes. This leads to reduced visual acuity (VA) owing to excessive motion of images on the retina and movement of images away from the fovea . An image must be held steady over the foveal region of the retina to obtain optimal VA. If an image is shifted to the peripheral retina, receptor density decreases and therefore the ability to perceive detail is diminished . VA also declines the faster the target moves across the fovea .
Chandra P Prasad, PhD
Department of Laboratory Medicine, Lund University, Malmö University Hospital, Malmö, Sweden
According to public health figures, the global burden of breast cancer in women, measured by incidence, mortality, and economic costs, is substantial and on the increase . Worldwide, 1 million women are diagnosed with breast cancer every year, and more than 410 000 will die from the disease, representing 14% of female cancer-related deaths [2–4].
Kapil Bhargava, MRCP
University Hospital Lewisham and St John’s Institute of Dermatology, London, UK
Anti-tumor necrosis factor-α (anti-TNF-α) therapy is now an established, evidence-based rung of the therapeutic ladder in psoriasis and has increasing “off-label” utility in dermatological practice. Its increasing utilization within dermatology, and across multiple branches of medicine, has highlighted the associated infectious complications, in particular the risk of tuberculosis (TB) infection.
Michal Olszewski, DVM, PhD, Yanmei Zhang, PhD, and Stuart Zeltzer
Veterans Affairs Ann Arbor Health System and University of Michigan Medical School, Ann Arbor, MI, USA
Fungi are ubiquitously present in the environment and some species can survive on the external and mucosal surfaces of human hosts; however, both the innate and the adaptive arms of the immune response effectively protect a host organism against the development of fungal diseases. The fungal pathogen finds a window of opportunity for uncontrolled growth and tissue invasion when the balance of the immune system is altered by different sets of conditions.
Michael D McCall, MD and AM James Shapiro, MD, PhD
University of Alberta, Edmonton, AB, Canada
There have been many advances in islet transplantation since the initial attempt in 1893, when Watson–Williams and Harsant transplanted minced sheep’s pancreas into the subcutaneous tissues of a young patient with diabetic ketoacidosis.
Thomas T MacDonald, PhD, FRCPath, FMedSci1, Iona Bell, MD1, and Giovanni Monteleone, MD2
1Blizard Institute of Cell and Molecular Science, Barts and the London School of Medicine and Dentistry, London, UK, and 2Dipartimento di Medicina Interna e Centro di Eccellenza per lo Studio delle Malattie Complesse e Multifattoriali, Università Tor Vergata, Rome, Italy
Anti-cytokine therapies, such as the three licensed anti-tumor necrosis factor-α (anti-TNF-α) antibodies, have transformed the management of difficult-to-treat IBD patients. However, only 40–50% of patients respond to these
agents, there are side effects, and efficacy wanes with time.
Nicole Fett, MD, and Victoria P Werth, MD
Philadelphia VA Medical Center; and Department of Dermatology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
Ultraviolet radiation (UVR) exposure is involved in the pathogenesis of systemic
lupus erythematosus (SLE), and is known to affect clinical outcomes in patients with SLE. Educating patients with SLE about the importance of avoiding UVR is an essential therapeutic intervention. In this review, the authors provide background information on the UV spectrum and the important biological effects of UVR, and discuss UVR exposure in the setting of SLE.
Laurent Beaugerie, MD, Harry Sokol, MD, Philippe Seksik, MD, and Jacques Cosnes, MD
Department of Gastroenterology, AP-HP, Hôpital Saint-Antoine, and UPMC–Paris Universitas, Paris, France
Thiopurines are widely used, for prolonged periods, as maintenance treatment in Crohn’s disease and ulcerative colitis. Some safety concerns including blood toxicity, immunoallergic reactions, and teratogenicity have been recognized since the early development of these drugs. These established safety issues are updated in the present review.
Caitlin Kennedy Carney, MD, Wendy Cantrell, CRNP, and Boni E Elewski, MD
Department of Dermatology, University of Alabama at Birmingham, Birmingham, AL, USA.
Psoriasis is a chronic inflammatory skin disorder that affects millions of patients worldwide. Nail psoriasis will affect 80–90% of patients with psoriasis at some point in their lifetime. Nail dystrophies that are commonly associated with psoriasis include subungual hyperkeratosis, nail plate crumbling, splinter hemorrhages, lunula erythema, leukonychia, and paronychia.
Jovina LS See, MBBChir, FRCS, and Paul TK Chew, FRCS, FRCOphth
National University Hospital, Singapore
Glaucoma is the leading cause of irreversible blindness worldwide . Based on several population studies, it has been projected that glaucoma will affect approximately 79.6 million people by 2020 .
Omar Khan, MD, and Laura Harrell, MD, MS
Section of Gastroenterology, Hepatology, and Nutrition, University of Chicago Medical Center, Chicago, IL, USA
The ability to assess disease recurrence in patients with IBD is a complicated task. Endoscopy with mucosal biopsy remains the gold standard for assessing disease activity, while radiology examinations and laboratory tests play supportive roles.
George M Kontakis, MD1, Theodoros Tosounidis, MD2, and Kyriakos Kakavelakis, MD3
1University of Crete, Crete, Greece; 2Leeds General Infirmary, Leeds, UK; and 3University Hospital of Heraklion, Crete, Greece.
During the past few decades, significant advances have been made in the treatment of proximal humeral fractures. Nonetheless, their management remains controversial. This article describes the key points for decision-making and the currents trends in the treatment of complex proximal humeral fractures.
John Witton, BSc, and Kylie D Reed, MA, BM BCh, MRC Psych
National Addiction Centre, Institute of Psychiatry, King’s College London,
South London and Maudsley NHS Foundation Trust, London, UK
Consistent findings from recent epidemiological studies have raised concerns that regular cannabis users may have a heightened risk of mental health problems. While cannabis and its association with later psychosis has been the main focus of this research, there have also been a number of recent studies that have examined the link between cannabis use and mood disorders, as well as how cannabis use may have an impact on the outcomes of those being treated for a mental health problem.
Inas El-Najjar, MBBCh, MRCP, and Silvia Montoto, MD
Institute of Cancer, Centre for Medical Oncology, Barts and The London School of Medicine and Dentistry, London, UK
The term aggressive B cell lymphoma includes mainly Burkitt lymphoma (BL) and diffuse large B cell lymphoma (DLBCL) , the latter being the most common non-Hodgkin lymphoma (NHL), representing around 40% of all NHL cases. New subtypes of DLBCL identified by genetic profiling, with differing characteristics and prognosis, have now been included in the updated World Health Organization (WHO) classification of hematopoietic and lymphoid tumors .
Andreas Lutterotti, MD and Thomas Berger, MD, MSc
Clinical Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
For the past 15 years, standard diseasemodifying
therapies (DMTs) for multiple sclerosis (MS) have been available only as injections, which has limited adherence for many patients. Several new drugs,
including monoclonal antibodies and orally administered agents, are currently being
studied in MS. As well as having a novel mechanism of action, oral drugs hold the
promise of improving patient compliance and adherence to therapy.
Alexander Burashnikov, PhD, and Charles Antzelevitch, PhD, FACC, FAHA, FHRS
Masonic Medical Research Laboratory, Utica, NY, USA
Atrial fibrillation (AF) is a growing clinical problem that is associated with increased
morbidity and mortality rates. There are two principal options for the management
of AF: rate and rhythm control. The rhythm control strategy aims to maintain sinus
rhythm, or to restore rhythm when required, using antiarrhythmic drugs (AADs), catheter ablation, electrical cardioversion, or surgical techniques.
Myung H Park, MD
Pulmonary Vascular Disease Program, University of Maryland School of Medicine, Baltimore, MD, USA
Pulmonary hypertension (PH) was first described by the German physician Ernst von Romberg as “sclerosis of the pulmonary arteries” in 1891, and was considered to be a uniformly fatal disease with an expected survival of <3 years [1,2]. However, an explosion of progress over the past 30 years has resulted in tremendous advances in the understanding of the pathobiology and mechanisms of this disease, through which have developed a systematic approach for diagnosis and eight approved therapies for pulmonary arterial hypertension (PAH).
Nadim G El Chakhtoura, MD, and Zeina A Kanafani, MD
Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon
Shifting epidemiological trends in invasive fungal infections (IFI) have recently surfaced, with an increase in mould infections, which currently constitute the bulk of IFI.
Antonia Ceccarelli, MD, Domenico Caputo, MD, and Marco Rovaris, MD
Multiple Sclerosis Center, Scientific Institute Santa Maria Nascente, Milan, Italy
Magnetic resonance imaging (MRI) is the main tool used in the diagnosis of multiple sclerosis (MS) due to its sensitivity in demonstrating the spatial and temporal dissemination of central nervous system (CNS) lesions , and its value in enabling determination of MS from other neurological diseases.
Harsha H Kariyawasam, MBBS, PhD
Department of Allergy and Medical Rhinology, Royal National Throat, Nose, and Ear Hospital, University College London, London, UK
Currently, 8 million people in the UK (an estimated 13% of the population) have a diagnosis of asthma and approximately 5.1 million are treatment-dependent . The prevalence of asthma has increased four-fold in the last two decades  and is consistent with an epidemic. Despite the estimated therapeutic cost of £850 million per year to the UK National Health Service, 74% of asthmatics still experience symptoms .
Marion L Vetter, MD, RD1,2
1Department of Medicine, Division of Endocrinology, Diabetes and Metabolism; and 2Center for Weight and Eating Disorders, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA , USA
The twin epidemics of obesity and diabetes (“diabesity”) threaten the health and wellbeing of millions of Americans. As the prevalence of these two conditions rise in tandem, bariatric surgery has become an increasingly popular treatment option.
Eva Poveda, PhD, Eduardo Seclén, PhD, and Vincent Soriano, PhD, MD
Department of Infectious Diseases, Hospital Carlos III, Madrid, Spain
The development and approval of the first CCR5 antagonist, maraviroc, which exclusively acts against CCR5-tropic variants of HIV, has necessitated the determination of HIV coreceptor usage in the clinical setting.
Shiv Saidha, MRCPI, Christopher Eckstein, MD, and John N Ratchford, MD
Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
Multiple sclerosis (MS) is a complex immunemediated
disorder of the central nervous system (CNS) and is the most common nontraumatic
cause of neurological disability in early to middle adulthood .
Shari B Goldfarb, MD, Maura N Dickler, MD, and Tiffany A Traina, MD
Memorial Sloan–Kettering Cancer Center, New York, NY, USA
Proangiogenic factors such as vascular endothelial growth factor (VEGF) regulate tumor angiogenesis, which is necessary for breast cancer development, invasion, growth, and metastasis [1–6]. In addition to being one of the central growth factors responsible for neovascularization, VEGF has prognostic significance. Higher levels of VEGF expression are associated with poor clinical outcomes and reduced disease-free survival (DFS) and overall survival (OS) rates in patients with breast cancer [5–8]. Therefore, VEGF is an appropriate target for the pharmacological inhibition of angiogenesis [9–11].
Philip Kasten, MD, PhD, and Jörg Lützner, MD
Division of Shoulder and Elbow Surgery and Sports Medicine, Department of Orthopaedic Surgery, University of Dresden, Dresden, Germany
The reverse shoulder prosthesis is based on a concept introduced by Paul Grammont. It relies on the principles of a semiconstrained ball and socket configuration, medialization of the center of rotation, and tensioning of the deltoid muscle. This can allow flexion of the arm in, for example, rotator cuff tear arthropathies and revision situations. External rotation depends on intact external rotators.
© Remedica 2017. All rights reserved. No part of this publication may be reproduced,
stored in a retrieval system, or transmitted in any form or by any means, electronic,
mechanical, photocopying, recording, or otherwise without the prior permission of
the copyright owners. While every effort is made by the publishers and editorial
board to see that no inaccurate or misleading data, opinions, or statements appear
in this journal, they wish to make it clear that the material contained in the publication
represents a summary of the independent evaluations and opinions of the authors
and contributors. As a consequence, the board, publishers, and any supporting company
accept no responsibility for the consequences of any such inaccurate or misleading
data or statements. Neither do they endorse the content of the publication or the
use of any drug or device in a way that lies outside its current licensed application
in any territory. For detailed information on any drugs or devices discussed in
this publication, readers are advised to consult the manufacturer’s prescribing
Produced and published by Remedica Medical Education and Publishing Limited.