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West Long Branch, NJ, United States

Mathis A.S.,Monmouth Medical Center
The American journal of managed care | Year: 2012

Infection with hepatitis C virus (HCV) is associated with significant morbidity, mortality, and economic burden. However, HCV infection is challenging to treat, because it is underdiagnosed and undertreated. When patients receive standard therapies, sustained virological response is usually achieved in less than 50% of cases. Newer therapies improve the virological and liverrelated outcomes associated with HCV, but at an increased cost of treatment. Because the economic burden of HCV extends beyond treatment costs, clinicians, patients, and managed care professionals must understand the cost-effectiveness of HCV treatment. Improvements in adherence and the delivery of effective care can promote costeffective management due to reductions in long-term disease-related complications, such as hospitalization, liver transplantation, and death. Source


Kaneko Y.,Discovery Research Alliance | Szallasi A.,Monmouth Medical Center
British Journal of Pharmacology | Year: 2014

Transient receptor potential (TRP) channels are important mediators of sensory signals with marked effects on cellular functions and signalling pathways. Indeed, mutations in genes encoding TRP channels are the cause of several inherited diseases in humans (the so-called 'TRP channelopathies') that affect the cardiovascular, renal, skeletal and nervous systems. TRP channels are also promising targets for drug discovery. The initial focus of research was on TRP channels that are expressed on nociceptive neurons. Indeed, a number of potent, small-molecule TRPV1, TRPV3 and TRPA1 antagonists have already entered clinical trials as novel analgesic agents. There has been a recent upsurge in the amount of work that expands TRP channel drug discovery efforts into new disease areas such as asthma, cancer, anxiety, cardiac hypertrophy, as well as obesity and metabolic disorders. A better understanding of TRP channel functions in health and disease should lead to the discovery of first-in-class drugs for these intractable diseases. With this review, we hope to capture the current state of this rapidly expanding and changing field. Linked Articles This article is part of a themed section on the pharmacology of TRP channels. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171. issue-10 © 2013 The British Pharmacological Society. Source


Van De Beek D.,University of Amsterdam | Drake J.M.,University of Toronto | Tunkel A.R.,Monmouth Medical Center
New England Journal of Medicine | Year: 2010

Nosocomial bacterial meningitis is most often related to either complicated head trauma or invasive procedures, such as craniotomy, placement of ventricular catheters, intrathecal infusion of medications, or spinal anesthesia. In addition, metastatic infection from hospital-acquired bacteremia occasionally leads to meningitis. The conditions are associated with different pathogenetic mechanisms and a different spectrum of microorganisms, and therefore the choice of empirical antimicrobial therapy will vary according to the condition. Copyright © 2010 Massachusetts Medical Society. Source


Kassavin D.S.,North Shore LIJ Health System | Constantinopoulos G.,Monmouth Medical Center
Journal of Endovascular Therapy | Year: 2012

Purpose: To describe the use of in situ fenestration to facilitate management of a disconnected iliac stent-graft limb that could not be repaired by conventional endovascular techniques. Technique: An 85-year-oldman who had a Zenith endovascular graft deployed 3 years earlier for a 10-cm infrarenal abdominal aortic aneurysm presented with separation of the right iliac stent-graft limb from the main body, resulting in type III endoleak and sac enlargement. The disconnected limb occluded the ostiumof themain stent-graft body, blocking all conventional endovascular techniques to traverse the graft limb-main body intersection. To overcome the problem, the cephalad portion of the proximal disconnected limb overlying the main body gate was successfully fenestrated with an endoscopic FNA needle and continuity restored with a Viabahn stent-graft across the balloon-modeled fenestration. Conclusion: In situ fenestration of endovascular stent-grafts may be a useful adjunct in performing rescues of late complications in patients not suitable for open repair. © 2012 by the International Society of Endovascular Specialists. Source


Brouwer M.C.,University of Amsterdam | Thwaites G.E.,Kings College London | Tunkel A.R.,Monmouth Medical Center | Van De Beek D.,University of Amsterdam
The Lancet | Year: 2012

Rapid diagnosis and treatment of acute community-acquired bacterial meningitis reduces mortality and neurological sequelae, but can be delayed by atypical presentation, assessment of lumbar puncture safety, and poor sensitivity of standard diagnostic microbiology. Thus, diagnostic dilemmas are common in patients with suspected acute community-acquired bacterial meningitis. History and physical examination alone are sometimes not suffi cient to confi rm or exclude the diagnosis. Lumbar puncture is an essential investigation, but can be delayed by brain imaging. Results of cerebrospinal fl uid (CSF) examination should be interpreted carefully, because CSF abnormalities vary according to the cause, patient's age and immune status, and previous treatment. Diagnostic prediction models that use a combination of clinical fi ndings, with or without test results, can help to distinguish acute bacterial meningitis from other causes, but these models are not infallible. We review the dilemmas in the diagnosis of acute communityacquired bacterial meningitis, and focus on the roles of clinical assessment and CSF examination. Source

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