Physicians Academy
Established in December 2006 by the Kashmir Academy Of Private Physicians
Table Of Contents
Editorial :
 The Real Paradigm Shift in Management of T2DM
Article 1 :
 Introduction of DMS irrigation to heal Endo–Perio lesions and Cysts
Article 2 :
 Alagille Syndrome in a Neonate
Picture of The Month :
 POTM-April 2018
Drug Update :
 SEGLUROMET (ertugliflozin+metformin)
Abstracts from Other Journals :
 Abstracts from Other Journals-April 2018

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Jan 2018 ( Volume -12 Number -1)

Abstracts from Other Journals
Abstracts from Other Journals-January 2018
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JANUARY 2018

Abstracts from Other Journals

First Live Birth in U.S. with Transplanted Uterus

A woman with a transplanted uterus gave birth to an infant boy at Dallas's Baylor University Medical Center in November, the New York Times reports.

This is the first such birth in the U.S. Eight other infants have been born using this method, but they were all in Sweden. Seven other women at Baylor have undergone transplants. Four of the transplants failed and needed to be removed, two women are trying to conceive, and another woman is pregnant.

The transplants are intended to be temporary. They will be removed after a woman has one or two children, so she can discontinue anti-rejection therapy.

New York Times story (Free)

Monthly Buprenorphine Approved to Treat Opioid Addiction

The FDA has approved a monthly buprenorphine injection, marketed as Sublocade, to treat moderate-to-severe opioid use disorder. Other forms of the drug (e.g., tablet) must be taken daily.

Patients must first begin buprenorphine treatment with a transmucosal formulation and be on a stable dose for at least a week. The injection is indicated for adults and has not been tested in patients younger than 17 years old or older than 65.

Sublocade was approved with a boxed warning about the risks associated with self-administering the drug intravenously. Treatment must be given by a healthcare provider. Common treatment side effects include abnormal liver function tests, constipation, drowsiness, headache, injection-site pruritus and pain, nausea, and vomiting.

It may be available to U.S. patients in early 2018, according to Reuters.

FDA news release (Free)

Reuters story (Free)

Cognitive Decline Charts Could Help Flag Whether Patient Has Dementia

Cognitive charts using percentile curves — similar to pediatric growth charts — could help determine whether a patient has developed dementia, suggests an article in the Canadian Medical Association Journal.

Researchers used a Canadian cohort of over 6000 healthy adults aged 65 and older and 1200 adults with dementia to construct the QuoCo tool. The model considers the patient's age, years of education, and scores on the Mini-Mental State Examination (MMSE) at 0, 5, and 10 years. For identifying patients with dementia in the training sample, the charts had a sensitivity of 80%, a specificity of 87%, and a negative predictive value of 99%, compared with a fixed MMSE cut point for dementia.

A decline in the charts should prompt further clinical evaluation, the authors write.

A commentator cautions: "The widespread benefits derived from cognitive charts for any screening examination [rest] on the assumption that at-risk patients are being screened systematically over time and that results from cognitive tests are communicated to, or can be readily referenced by, physicians. We seem to be some distance away from that reality."

CMAJ article (Free)

CMAJ comment (Free)

QuoCo tool (Free)

Cardiology Experts Offer Guidance on Managing Bleeding Events in Patients on Oral Anticoagulants

The American College of Cardiology has published a guide to managing acute bleeding in patients taking direct oral anticoagulants and vitamin K antagonists.

The decision pathway is based on expert consensus and is published in the Journal of the American College of Cardiology. The document includes:

  • Decision trees on assessing bleeding severity
  • Suggestions for which assays to use for various anticoagulants and clinical objectives
  • Indications for reversal agents for anticoagulants
  • Tips for when to restart anticoagulation

JACC article (Free)

 

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