Electroencephalographic Abnormalities in Clozapine-Treated Patients: A Cross-Sectional Study

The objective of our study was to examine the electroencephalogram (EEG) abnormalities associated with clozapine treatment. It was a cross-sectional study on 87 psychiatric patients on clozapine treatment. 32 channel digital EEG was recorded and analysed visually for abnormalities. EEG abnormalities were observed in 63.2% of patients. Both slowing and epileptiform activities were noted in 41.4% of patients. The EEG abnormalities were not associated with dose or duration of clozapine exposure

British Society for Sexual Medicine Guidelines on Adult Testosterone Deficiency, With Statements for UK Practice

BACKGROUND: Testosterone deficiency (TD) is an increasingly common problem with significant health implications, but its diagnosis and management can be challenging. AIM: To review the available literature on TD and provide evidence-based statements for UK clinical practice. METHODS: Evidence was derived from Medline, EMBASE, and Cochrane searches on hypogonadism, testosterone (T) therapy, and cardiovascular safety from May 2005 to May 2015. Further searches continued until May 2017. OUTCOMES: To provide a guideline on diagnosing and managing TD, with levels of evidence and grades of recommendation, based on a critical review of the literature and consensus of the British Society of Sexual Medicine panel. RESULTS: 25 statements are provided, relating to 5 key areas: screening, diagnosis, initiating T therapy, benefits and risks of T therapy, and follow-up. 7 statements are supported by level 1, 8 by level 2, 5 by level 3, and 5 by level 4 evidence. CLINICAL IMPLICATIONS: To help guide UK practitioners on effectively diagnosing and managing primary and age-related TD. STRENGTHS AND LIMITATIONS: A large amount of literature was carefully sourced and reviewed, presenting the best evidence available at the time. However, some statements provided are based on poor-quality evidence. This is a rapidly evolving area of research and recommendations are subject to change. Guidelines can never replace clinical expertise when making treatment decisions for individual patients, but rather help to focus decisions and take personal values and preferences and individual circumstances into account. Many issues remain controversial, but in the meantime, clinicians need to manage patient needs and clinical expectations armed with the best clinical evidence and the multidisciplinary expert opinion available. CONCLUSION: Improving the diagnosis and management of TD in adult men should provide somatic, sexual, and psychological benefits and subsequent improvements in quality of life. Hackett G, Kirby M, Edwards D, et al. British Society for Sexual Medicine Guidelines on Adult Testosterone Deficiency, With Statements for UK Practice. J Sex Med 2017;14:1504-1523

Contemporary management of cancer of the oral cavity

Oral cancer represents a common entity comprising a third of all head and neck malignant tumors. The options for curative treatment of oral cavity cancer have not changed significantly in the last three decades; however, the work up, the approach to surveillance, and the options for reconstruction have evolved significantly. Because of the profound functional and cosmetic importance of the oral cavity, management of oral cavity cancers requires a thorough understanding of disease progression, approaches to management and options for reconstruction. The purpose of this review is to discuss the most current management options for oral cavity cancers

Exercise-induced biochemical changes and their potential influence on cancer: A scientific review

© Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-And-licensing/. Aim To review and discuss the available international literature regarding the indirect and direct biochemical mechanisms that occur after exercise, which could positively, or negatively, influence oncogenic pathways. Methods The PubMed, MEDLINE, Embase and Cochrane libraries were searched for papers up to July 2016 addressing biochemical changes after exercise with a particular reference to cancer. The three authors independently assessed their appropriateness for inclusion in this review based on their scientific quality and relevance. Results 168 papers were selected and categorised into indirect and direct biochemical pathways. The indirect effects included changes in vitamin D, weight reduction, sunlight exposure and improved mood. The direct effects included insulin-like growth factor, epigenetic effects on gene expression and DNA repair, vasoactive intestinal peptide, oxidative stress and antioxidant pathways, heat shock proteins, testosterone, irisin, immunity, chronic inflammation and prostaglandins, energy metabolism and insulin resistance. Summary Exercise is one of several lifestyle factors known to lower the risk of developing cancer and is associated with lower relapse rates and better survival. This review highlights the numerous biochemical processes, which explain these potential anticancer benefits

Efficacy and safety of empagliflozin in combination with other oral hypoglycaemic agents in patients with type 2 diabetes mellitus

Abstract and keywords Objective: To analyse the efficacy and safety of empagliflozin in combination with other oral hypoglycaemic agents in patients with type 2 diabetes mellitus (T2DM). Methods: Pooled analysis of three phase III trials in patients with T2DM (n = 1,801) who received placebo, empagliflozin 10 mg or empagliflozin 25 mg once daily for 24 weeks, in combination with metformin, metformin + sulphonylurea or pioglitazone ± metformin. Results: Empagliflozin significantly reduced HbA1c (adjusted mean reduction vs placebo: with empagliflozin 10 mg, –0.58% [95% CI: –0.66; –0.49]; p < 0.0001 and with empagliflozin 25mg, –0.62% [95% CI: –0.70; –0.53], p < 0.0001), weight (adjusted mean reduction vs placebo: with empagliflozin 10 mg, –1.77 kg [95% CI: –2.05; –1.48]; p < 0.0001 and with empagliflozin 25 mg, –1.96 kg [95% CI: –2.24; –1.67], p < 0.0001), systolic blood pressure (SBP) and diastolic blood pressure (DBP). The frequency of adverse effects (AEs) was 64% with placebo, 63.9% with empagliflozin 10 mg and 60.9% with empagliflozin 25 mg. Confirmed episodes of hypoglycaemia (≤ 70 mg/dl and/or requiring care) occurred in 3.9% of patients with placebo, 6.9% of patients with empagliflozin 10 mg and 5.3% of patients with empagliflozin 25 mg. Urinary tract infections were reported in 9.4% of patients with placebo, 10.2% of patients with empagliflozin 10 mg and 8.3% of patients with empagliflozin 25 mg. Genital infections were reported in 1.0% of patients with placebo, 4.6% of patients with empagliflozin 10 mg and 3.5% of patients with empagliflozin 25 mg. Conclusions: Empagliflozin in combination with other oral treatments versus placebo significantly decreased HbA1c, body weight and SBP/DBP with an overall good safety and tolerability profile

Evolution and comparative analysis of the bat MHC-I region

10.1038/srep21256Scientific Reports62125