To contact us Click HERE
From NHS Choices YouTube channel: Patrick, 54, was diagnosed with gout (a form of arthritis) 22 years ago. He describes the symptoms, treatment options and how he learned to live with the condition:
Here is a list of some of the new drugs for an old disease (gout):
Febuxostat is a non-purine-analogue inhibitor of xanthine oxidase that opened a new era in the treatment of gout.
Modified uricases
The use of modified uricases to rapidly reduce serum urate concentrations in patients with otherwise untreatable gout is progressing. Pegloticase, a pegylated uricase, is in development.
JAMA update, 08/2011: New Treatment Offers Hope for Patients With Severe Gout: pegloticase (Krystexxa) costs $2,500 per dose (http://goo.gl/gz9sO).
Drugs in development
Transport of uric acid in the renal proximal tubule and the inflammatory response to monosodium urate crystals (shown above) are targets for potential new treatments.
Several pipeline drugs for gout related to the targets above include:
- selective uricosuric drug RDEA594
- various interleukin-1 inhibitors. Canakinumab (trade name Ilaris) is a human monoclonal antibody targeted at interleukin-1 beta. It was rejected by the FDA panel in June 2011.
References:
Gout therapeutics: new drugs for an old disease. The Lancet, Volume 377, Issue 9760, Pages 165 - 177, 8 January 2011.
Diuretics, beta-blockers, ACEi, non-losartan ARBs associated with increased risk of gout vs. CCB lower risk. BMJ, 2012.
With FDA Approval, a Gout Drug Now Costs $5 Instead of Pennies - WSJ, 2011.
FDA Panel Rejects Gout Drug Canakinumab on Safety Concerns http://goo.gl/lO9uy
The strange story that links gout with the birth of the cocktail drinks. Lancet, 2012.
Comments from Twitter:
francis berenbaum @Larhumato: Gout explained by a patient. Very informative for medical students.
8 Aralık 2012 Cumartesi
Bell's palsy - NHS video
To contact us Click HERE
Bell’s palsy is the abrupt paralysis of the facial nerve (cranial nerve 7, CN7), resulting in an inability to control facial muscles on the affected side. A common condition, Bell’s palsy has an annual incidence of 11-40 cases per 100 ,000 population. Many patients recover without intervention; however, up to 30% have poor recovery of facial muscle control and experience facial disfigurement, psychological trauma, and facial pain.
From the NHS Choices YouTube channel: Bell's palsy is the temporary weakness or paralysis of the muscles in one side of the face. In this video, a speech therapist explains who is most at risk and describes common causes and treatment options available. Helen explains how she dealt with the condition and recovered from it:
Remember:
U MN damage
U pper face is OK (the patient is able to wrinkle his forehead)
LMN damage = patient is unable to wrinkle his forehead (our patient)
The examination of CN 7 palsy can be remembered by the mnemonic COWS:
C lose your eyes
O pen (the examining physician tries to open the patient's eyes)
W rinkle your forehead
S mile
Two main types of pharmacological treatment have been used to improve outcomes from Bell’s palsy:
- steroids
- antivirals.
The rationale for these treatments is based on the presumed pathophysiology of Bell’s palsy, namely inflammation and viral infection.
In a 2009 study published in the BMJ antivirals did not provide an added benefit in achieving at least partial facial muscle recovery compared with steroids alone in patients with Bell’s palsy.
References:
The benefits of steroids versus steroids plus antivirals for treatment of Bell’s palsy: a meta-analysis | BMJ http://bit.ly/YD3iLG
From the NHS Choices YouTube channel: Bell's palsy is the temporary weakness or paralysis of the muscles in one side of the face. In this video, a speech therapist explains who is most at risk and describes common causes and treatment options available. Helen explains how she dealt with the condition and recovered from it:
Remember:
U MN damage
U pper face is OK (the patient is able to wrinkle his forehead)
LMN damage = patient is unable to wrinkle his forehead (our patient)
The examination of CN 7 palsy can be remembered by the mnemonic COWS:
C lose your eyes
O pen (the examining physician tries to open the patient's eyes)
W rinkle your forehead
S mile
Two main types of pharmacological treatment have been used to improve outcomes from Bell’s palsy:
- steroids
- antivirals.
The rationale for these treatments is based on the presumed pathophysiology of Bell’s palsy, namely inflammation and viral infection.
In a 2009 study published in the BMJ antivirals did not provide an added benefit in achieving at least partial facial muscle recovery compared with steroids alone in patients with Bell’s palsy.
References:
The benefits of steroids versus steroids plus antivirals for treatment of Bell’s palsy: a meta-analysis | BMJ http://bit.ly/YD3iLG
7 Aralık 2012 Cuma
Gout - Patrick's story - NHS video
To contact us Click HERE
From NHS Choices YouTube channel: Patrick, 54, was diagnosed with gout (a form of arthritis) 22 years ago. He describes the symptoms, treatment options and how he learned to live with the condition:
Here is a list of some of the new drugs for an old disease (gout):
Febuxostat is a non-purine-analogue inhibitor of xanthine oxidase that opened a new era in the treatment of gout.
Modified uricases
The use of modified uricases to rapidly reduce serum urate concentrations in patients with otherwise untreatable gout is progressing. Pegloticase, a pegylated uricase, is in development.
JAMA update, 08/2011: New Treatment Offers Hope for Patients With Severe Gout: pegloticase (Krystexxa) costs $2,500 per dose (http://goo.gl/gz9sO).
Drugs in development
Transport of uric acid in the renal proximal tubule and the inflammatory response to monosodium urate crystals (shown above) are targets for potential new treatments.
Several pipeline drugs for gout related to the targets above include:
- selective uricosuric drug RDEA594
- various interleukin-1 inhibitors. Canakinumab (trade name Ilaris) is a human monoclonal antibody targeted at interleukin-1 beta. It was rejected by the FDA panel in June 2011.
References:
Gout therapeutics: new drugs for an old disease. The Lancet, Volume 377, Issue 9760, Pages 165 - 177, 8 January 2011.
Diuretics, beta-blockers, ACEi, non-losartan ARBs associated with increased risk of gout vs. CCB lower risk. BMJ, 2012.
With FDA Approval, a Gout Drug Now Costs $5 Instead of Pennies - WSJ, 2011.
FDA Panel Rejects Gout Drug Canakinumab on Safety Concerns http://goo.gl/lO9uy
The strange story that links gout with the birth of the cocktail drinks. Lancet, 2012.
Comments from Twitter:
francis berenbaum @Larhumato: Gout explained by a patient. Very informative for medical students.
Here is a list of some of the new drugs for an old disease (gout):
Febuxostat is a non-purine-analogue inhibitor of xanthine oxidase that opened a new era in the treatment of gout.
Modified uricases
The use of modified uricases to rapidly reduce serum urate concentrations in patients with otherwise untreatable gout is progressing. Pegloticase, a pegylated uricase, is in development.
JAMA update, 08/2011: New Treatment Offers Hope for Patients With Severe Gout: pegloticase (Krystexxa) costs $2,500 per dose (http://goo.gl/gz9sO).
Drugs in development
Transport of uric acid in the renal proximal tubule and the inflammatory response to monosodium urate crystals (shown above) are targets for potential new treatments.
Several pipeline drugs for gout related to the targets above include:
- selective uricosuric drug RDEA594
- various interleukin-1 inhibitors. Canakinumab (trade name Ilaris) is a human monoclonal antibody targeted at interleukin-1 beta. It was rejected by the FDA panel in June 2011.
References:
Gout therapeutics: new drugs for an old disease. The Lancet, Volume 377, Issue 9760, Pages 165 - 177, 8 January 2011.
Diuretics, beta-blockers, ACEi, non-losartan ARBs associated with increased risk of gout vs. CCB lower risk. BMJ, 2012.
With FDA Approval, a Gout Drug Now Costs $5 Instead of Pennies - WSJ, 2011.
FDA Panel Rejects Gout Drug Canakinumab on Safety Concerns http://goo.gl/lO9uy
The strange story that links gout with the birth of the cocktail drinks. Lancet, 2012.
Comments from Twitter:
francis berenbaum @Larhumato: Gout explained by a patient. Very informative for medical students.
The longevity of a rock singer
To contact us Click HERE
Here is Ian Gillan (age 67) from Deep Purple in a recent interview:
You have been screaming rock music for over 40 years. How do you do it?
I think it’s quite natural, I do a lot of it, and so I keep myself fairly fit. My mates who were singers they quit to enjoy their success or raise families and they didn’t continue. Then they tried to come back years later but it was very difficult because vocal cords, unlike guitar strings, are unforgiving, you can’t change them. So I think I’ve been singing all my life, and therefore I’m pretty much fit, so to speak. Most things are within my scope, I sing pretty naturally so it’s not a strain, never has been.
Here is Deep Purple with Maybe I'm a Leo, Mainz, Germany, July 2011:
This is the same band 40 years ago, in 1972:
I have been to two concerts of Deep Purple, the last one was in June 2011 and it was quite impressive. The audience age ranged from 5 to 75 and everyone rose to their feet to the sound of Smoke on the Water.
Here is Mick Jagger on staying fit: "You watch what you eat, you exercise, you have a bit of fun. You keep on going forward. Don’t stop. Do what makes you happy. Don’t look at the clouds of tomorrow through the sunshine of today. That’s it."
References:
Deep Purple but no blues: US legends top Dubai jazz festival line-up | Al Bawaba http://buff.ly/V520RZ
Mick Jagger's new supergroup with Joss Stone and Dave Stewart. DailyMail.
Redefining age 65 - when your job description is "rockstar"
You have been screaming rock music for over 40 years. How do you do it?
I think it’s quite natural, I do a lot of it, and so I keep myself fairly fit. My mates who were singers they quit to enjoy their success or raise families and they didn’t continue. Then they tried to come back years later but it was very difficult because vocal cords, unlike guitar strings, are unforgiving, you can’t change them. So I think I’ve been singing all my life, and therefore I’m pretty much fit, so to speak. Most things are within my scope, I sing pretty naturally so it’s not a strain, never has been.
Here is Deep Purple with Maybe I'm a Leo, Mainz, Germany, July 2011:
This is the same band 40 years ago, in 1972:
I have been to two concerts of Deep Purple, the last one was in June 2011 and it was quite impressive. The audience age ranged from 5 to 75 and everyone rose to their feet to the sound of Smoke on the Water.
Here is Mick Jagger on staying fit: "You watch what you eat, you exercise, you have a bit of fun. You keep on going forward. Don’t stop. Do what makes you happy. Don’t look at the clouds of tomorrow through the sunshine of today. That’s it."
References:
Deep Purple but no blues: US legends top Dubai jazz festival line-up | Al Bawaba http://buff.ly/V520RZ
Mick Jagger's new supergroup with Joss Stone and Dave Stewart. DailyMail.
Redefining age 65 - when your job description is "rockstar"
Top medicine articles for November/December 2012
To contact us Click HERE
Here are my suggestions for some of the top articles in medicine for November/December 2012:
The Smartphone in Medicine: A Review of Current and Potential Use Among Physicians and Students http://buff.ly/THrvOA
Shocking News: Intraaortic Balloon Pumps May Not Help in Myocardial Infarction with Cardiogenic Shock http://buff.ly/QVzggF
What Your Breath Reveals: Each Patient Has a Unique Breath 'Fingerprint' That Doctors Could Use to Diagnose http://buff.ly/Ravmkd
Rilonacept for Colchicine-Resistant or -Intolerant Familial Mediterranean Fever http://buff.ly/QWJV76
Lowering LDL levels with statin reduces major vascular events regardless of baseline risk http://buff.ly/QWKuxU
Radical prostatectomy and observation did not differ for mortality in localized prostate cancer http://buff.ly/QWLbqM
The Mini-Cog had sensitivity similar to the longer 3MS for detecting cognitive impairment or dementia http://buff.ly/PQkDwL
Risk stratification schemes predict ischemic stroke and bleeding in AF - CHA2DS2-VASc score had 100% sensitivity but only 6% specificty http://buff.ly/QWLu4Z
Deep-Brain Stimulation for Parkinson’s Disease - NEJM summary http://buff.ly/QWNIkR
Update on the management of chronic kidney disease - AFP 2012 http://buff.ly/PQlEol
Chronic fatigue syndrome: diagnosis and treatment - 2012 update from AFP http://buff.ly/QWOePV
Diagnosis and treatment of acne - 2012 AFP update http://buff.ly/QWOmit
Why Some Physician Practices Are Wildly Successful - Medscape http://buff.ly/RFD3Nc
"End-run" lawsuits can blindside physicians. Administrative claims against doctors are likely to rise under the Affordable Care Act - amednews http://buff.ly/S6KU9a
Patients who read doctor notes feel more in control of their health http://buff.ly/RgGPPg
Older patients join crowd consulting "Dr. Internet" http://buff.ly/PNeD7Y
Doctors follow own advice for healthy living http://buff.ly/QYHPDY
The articles were selected from my Twitter and Google Reader streams. Please feel free to send suggestions for articles to clinicalcases@gmail.com and you will receive acknowledgement in the next edition of this publication.
Here are my suggestions for some of the top articles in medicine for November/December 2012:The Smartphone in Medicine: A Review of Current and Potential Use Among Physicians and Students http://buff.ly/THrvOA
Shocking News: Intraaortic Balloon Pumps May Not Help in Myocardial Infarction with Cardiogenic Shock http://buff.ly/QVzggF
What Your Breath Reveals: Each Patient Has a Unique Breath 'Fingerprint' That Doctors Could Use to Diagnose http://buff.ly/Ravmkd
Rilonacept for Colchicine-Resistant or -Intolerant Familial Mediterranean Fever http://buff.ly/QWJV76
Lowering LDL levels with statin reduces major vascular events regardless of baseline risk http://buff.ly/QWKuxU
Radical prostatectomy and observation did not differ for mortality in localized prostate cancer http://buff.ly/QWLbqM
The Mini-Cog had sensitivity similar to the longer 3MS for detecting cognitive impairment or dementia http://buff.ly/PQkDwL
Risk stratification schemes predict ischemic stroke and bleeding in AF - CHA2DS2-VASc score had 100% sensitivity but only 6% specificty http://buff.ly/QWLu4Z
Deep-Brain Stimulation for Parkinson’s Disease - NEJM summary http://buff.ly/QWNIkR
Update on the management of chronic kidney disease - AFP 2012 http://buff.ly/PQlEol
Chronic fatigue syndrome: diagnosis and treatment - 2012 update from AFP http://buff.ly/QWOePV
Diagnosis and treatment of acne - 2012 AFP update http://buff.ly/QWOmit
Why Some Physician Practices Are Wildly Successful - Medscape http://buff.ly/RFD3Nc
"End-run" lawsuits can blindside physicians. Administrative claims against doctors are likely to rise under the Affordable Care Act - amednews http://buff.ly/S6KU9a
Patients who read doctor notes feel more in control of their health http://buff.ly/RgGPPg
Older patients join crowd consulting "Dr. Internet" http://buff.ly/PNeD7Y
Doctors follow own advice for healthy living http://buff.ly/QYHPDY
The articles were selected from my Twitter and Google Reader streams. Please feel free to send suggestions for articles to clinicalcases@gmail.com and you will receive acknowledgement in the next edition of this publication.
Bell's palsy - NHS video
To contact us Click HERE
Bell’s palsy is the abrupt paralysis of the facial nerve (cranial nerve 7, CN7), resulting in an inability to control facial muscles on the affected side. A common condition, Bell’s palsy has an annual incidence of 11-40 cases per 100 ,000 population. Many patients recover without intervention; however, up to 30% have poor recovery of facial muscle control and experience facial disfigurement, psychological trauma, and facial pain.
From the NHS Choices YouTube channel: Bell's palsy is the temporary weakness or paralysis of the muscles in one side of the face. In this video, a speech therapist explains who is most at risk and describes common causes and treatment options available. Helen explains how she dealt with the condition and recovered from it:
Remember:
U MN damage
U pper face is OK (the patient is able to wrinkle his forehead)
LMN damage = patient is unable to wrinkle his forehead (our patient)
The examination of CN 7 palsy can be remembered by the mnemonic COWS:
C lose your eyes
O pen (the examining physician tries to open the patient's eyes)
W rinkle your forehead
S mile
Two main types of pharmacological treatment have been used to improve outcomes from Bell’s palsy:
- steroids
- antivirals.
The rationale for these treatments is based on the presumed pathophysiology of Bell’s palsy, namely inflammation and viral infection.
In a 2009 study published in the BMJ antivirals did not provide an added benefit in achieving at least partial facial muscle recovery compared with steroids alone in patients with Bell’s palsy.
References:
The benefits of steroids versus steroids plus antivirals for treatment of Bell’s palsy: a meta-analysis | BMJ http://bit.ly/YD3iLG
From the NHS Choices YouTube channel: Bell's palsy is the temporary weakness or paralysis of the muscles in one side of the face. In this video, a speech therapist explains who is most at risk and describes common causes and treatment options available. Helen explains how she dealt with the condition and recovered from it:
Remember:
U MN damage
U pper face is OK (the patient is able to wrinkle his forehead)
LMN damage = patient is unable to wrinkle his forehead (our patient)
The examination of CN 7 palsy can be remembered by the mnemonic COWS:
C lose your eyes
O pen (the examining physician tries to open the patient's eyes)
W rinkle your forehead
S mile
Two main types of pharmacological treatment have been used to improve outcomes from Bell’s palsy:
- steroids
- antivirals.
The rationale for these treatments is based on the presumed pathophysiology of Bell’s palsy, namely inflammation and viral infection.
In a 2009 study published in the BMJ antivirals did not provide an added benefit in achieving at least partial facial muscle recovery compared with steroids alone in patients with Bell’s palsy.
References:
The benefits of steroids versus steroids plus antivirals for treatment of Bell’s palsy: a meta-analysis | BMJ http://bit.ly/YD3iLG
30 Kasım 2012 Cuma
Gout - Patrick's story - NHS video
To contact us Click HERE
From NHS Choices YouTube channel: Patrick, 54, was diagnosed with gout (a form of arthritis) 22 years ago. He describes the symptoms, treatment options and how he learned to live with the condition:
Here is a list of some of the new drugs for an old disease (gout):
Febuxostat is a non-purine-analogue inhibitor of xanthine oxidase that opened a new era in the treatment of gout.
Modified uricases
The use of modified uricases to rapidly reduce serum urate concentrations in patients with otherwise untreatable gout is progressing. Pegloticase, a pegylated uricase, is in development.
JAMA update, 08/2011: New Treatment Offers Hope for Patients With Severe Gout: pegloticase (Krystexxa) costs $2,500 per dose (http://goo.gl/gz9sO).
Drugs in development
Transport of uric acid in the renal proximal tubule and the inflammatory response to monosodium urate crystals (shown above) are targets for potential new treatments.
Several pipeline drugs for gout related to the targets above include:
- selective uricosuric drug RDEA594
- various interleukin-1 inhibitors. Canakinumab (trade name Ilaris) is a human monoclonal antibody targeted at interleukin-1 beta. It was rejected by the FDA panel in June 2011.
References:
Gout therapeutics: new drugs for an old disease. The Lancet, Volume 377, Issue 9760, Pages 165 - 177, 8 January 2011.
Diuretics, beta-blockers, ACEi, non-losartan ARBs associated with increased risk of gout vs. CCB lower risk. BMJ, 2012.
With FDA Approval, a Gout Drug Now Costs $5 Instead of Pennies - WSJ, 2011.
FDA Panel Rejects Gout Drug Canakinumab on Safety Concerns http://goo.gl/lO9uy
The strange story that links gout with the birth of the cocktail drinks. Lancet, 2012.
Comments from Twitter:
francis berenbaum @Larhumato: Gout explained by a patient. Very informative for medical students.
Here is a list of some of the new drugs for an old disease (gout):
Febuxostat is a non-purine-analogue inhibitor of xanthine oxidase that opened a new era in the treatment of gout.
Modified uricases
The use of modified uricases to rapidly reduce serum urate concentrations in patients with otherwise untreatable gout is progressing. Pegloticase, a pegylated uricase, is in development.
JAMA update, 08/2011: New Treatment Offers Hope for Patients With Severe Gout: pegloticase (Krystexxa) costs $2,500 per dose (http://goo.gl/gz9sO).
Drugs in development
Transport of uric acid in the renal proximal tubule and the inflammatory response to monosodium urate crystals (shown above) are targets for potential new treatments.
Several pipeline drugs for gout related to the targets above include:
- selective uricosuric drug RDEA594
- various interleukin-1 inhibitors. Canakinumab (trade name Ilaris) is a human monoclonal antibody targeted at interleukin-1 beta. It was rejected by the FDA panel in June 2011.
References:
Gout therapeutics: new drugs for an old disease. The Lancet, Volume 377, Issue 9760, Pages 165 - 177, 8 January 2011.
Diuretics, beta-blockers, ACEi, non-losartan ARBs associated with increased risk of gout vs. CCB lower risk. BMJ, 2012.
With FDA Approval, a Gout Drug Now Costs $5 Instead of Pennies - WSJ, 2011.
FDA Panel Rejects Gout Drug Canakinumab on Safety Concerns http://goo.gl/lO9uy
The strange story that links gout with the birth of the cocktail drinks. Lancet, 2012.
Comments from Twitter:
francis berenbaum @Larhumato: Gout explained by a patient. Very informative for medical students.
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