Current medical research and opinion
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Subclinical hypothyroidism (SCH) is diagnosed when serum thyroid stimulation hormone (thyrotropin; TSH) levels are above the reference range, accompanied by levels of free thyroxine within its reference range. The management of SCH remains a diagnostic and therapeutic challenge despite many years of research relating to its epidemiology, aetiology, effectiveness of treatment and safety. ⋯ Clinical evidence emerging during the previous decade generally supports the view that SCH is associated with adverse outcomes to an extent that is intermediate between euthyroidism and overt hypothyroidism although evidence that treatment with thyroid hormone replacement is beneficial is lacking. Accordingly, the rationale for the recommendations for intervention in the ETA guidelines based on the age of the patient, level of serum TSH, symptoms and comorbidities remains valid today.
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Review
Referral criteria to palliative care for patients with Parkinson's disease: a systematic review.
This systematic review aimed to identify the referral criteria for palliative care in patients with Parkinson's disease. ⋯ The 14 themes identified in this systematic review were categorized into disease- and needs-based criteria. These themes show the wide range of referral timing and procedures. Further studies should be conducted to reveal standardized referral criteria.
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Review
Referral criteria to palliative care for patients with Parkinson's disease: a systematic review.
This systematic review aimed to identify the referral criteria for palliative care in patients with Parkinson's disease. ⋯ The 14 themes identified in this systematic review were categorized into disease- and needs-based criteria. These themes show the wide range of referral timing and procedures. Further studies should be conducted to reveal standardized referral criteria.
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Review
Clinical experience of switching patients with severe hemophilia to rVIII-SingleChain or rIX-FP.
Prophylaxis treatment is the current standard of care for patients with severe hemophilia. Factor concentrates with improved pharmacokinetics have offered more options for individualizing treatment. The treatment focus may be on increased protection, aiming for higher trough factor levels or longer dosing intervals to reduce the burden of hemophilia. Both aspects can have long-term effects on joint health. Products, such as rVIII‑SingleChain and rIX-FP have been developed to reduce the treatment burden for patients with hemophilia and optimize prophylactic efficacy. The objective of this report is to provide a summary of the clinical experience of different Hemophilia Treatment Centers in managing the switch to rVIII-SingleChain or rIX-FP in patients with hemophilia. ⋯ The selected patient cases reported here demonstrate that patients may wish to switch factor products for a variety of reasons; therefore, it is critical to understand why patients switch and what they expect from switching.
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Review Meta Analysis
Effectiveness and safety of baricitinib in patients with alopecia areata: a systematic review and meta-analysis of randomized controlled trials.
Since there is now no medication available that has been approved by the US Food and Drug Administration, alopecia areata (AA) is an autoimmune condition that has a detrimental impact on individuals. Recent clinical trials using baricitinib demonstrated that it may be effective in treating AA. This meta-analysis was done to evaluate the effectiveness and safety of baricitinib in comparison to placebo. ⋯ When compared to placebo, baricitinib is an effective and well-tolerated medication for the treatment of AA.