The American journal of medicine
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Meta Analysis Comparative Study
The comparative safety of tumor necrosis factor inhibitors in rheumatoid arthritis: a meta-analysis update of 44 trials.
The study objective was to evaluate and update the safety data from randomized controlled trials of tumor necrosis factor inhibitors in patients treated for rheumatoid arthritis. ⋯ These meta-analysis updates of the comparative safety of tumor necrosis factor inhibitors suggest a higher risk of serious infection associated with adalimumab, certolizumab pegol, and infliximab, which seems to contribute to higher rates of discontinuation. In contrast, etanercept use showed a lower rate of discontinuation. These data may help guide clinical comparative decision making in the management of rheumatoid arthritis.
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The International Psoriasis Council, a global nonprofit organization dedicated to advancing psoriasis research and treatment, led an initiative to better define the association of various cardiometabolic comorbidities with psoriasis. In November 2013, a workshop was held in Boston, Mass. ⋯ The International Psoriasis Council has played a historical role in associating psoriasis with various comorbidities by integrating multidisciplinary expertise to advance the scientific and clinical knowledge through publications and clinical trials. This report synthesizes the current understanding of psoriasis with various cardiometabolic risk factors by exploring the potential shared pathogenic mechanisms and genetic connectivity.
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Observational Study
Acute porphyrias in the USA: features of 108 subjects from porphyrias consortium.
Recent descriptions of the clinical and laboratory features of subjects with acute porphyrias in the US are lacking. Our aim was to describe clinical, biochemical, and genetic features of 108 subjects. ⋯ Acute porphyrias often remain undiagnosed for more than a decade after first symptoms develop. Intravenous hematin is the treatment of choice, both for treatment of acute attacks and for prevention of recurrent attacks.
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Adherence to medical management of vascular risk is vital for stroke prevention in patients with asymptomatic carotid stenosis. Because carotid disease is a risk factor for cognitive impairment, we sought to determine whether undiagnosed cognitive impairment affects medication adherence in this setting. ⋯ Medication adherence in patients with asymptomatic carotid stenosis is significantly reduced among those with undiagnosed cognitive impairment. Cognitive screening of asymptomatic patients with carotid stenosis identifies those who may benefit from increased supervision to improve medication adherence.