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Frailty in Older Adults
Assessing older patients for frailty enables clinicians to tailor clinical care, including decisions about stressful treatments. The authors review the assessment, pathophysiology, and management of frailty.
Journal Article
Harrison's manual of medicine
This full color, portable guide covers all diseases and conditions commonly seen in general medical practice. This edition has been updated to reflect the latest clinical developments in medicine. Designed for quick access and employing an effective blend of concise text, bulleted key points, decision trees, and summary tables, the \"Manual\" makes it easy to find what you need at the point of care. -- From publisher's description.
Book
CD19 CAR T-Cell Therapy in Autoimmune Disease — A Case Series with Follow-up
Treatment for autoimmune diseases such as systemic lupus erythematosus (SLE), idiopathic inflammatory myositis, and systemic sclerosis often involves long-term immune suppression. Resetting aberrant autoimmunity in these diseases through deep depletion of B cells is a potential strategy for achieving sustained drug-free remission.
We evaluated 15 patients with severe SLE (8 patients), idiopathic inflammatory myositis (3 patients), or systemic sclerosis (4 patients) who received a single infusion of CD19 chimeric antigen receptor (CAR) T cells after preconditioning with fludarabine and cyclophosphamide. Efficacy up to 2 years after CAR T-cell infusion was assessed by means of Definition of Remission in SLE (DORIS) remission criteria, American College of Rheumatology-European League against Rheumatism (ACR-EULAR) major clinical response, and the score on the European Scleroderma Trials and Research Group (EUSTAR) activity index (with higher scores indicating greater disease activity), among others. Safety variables, including cytokine release syndrome and infections, were recorded.
The median follow-up was 15 months (range, 4 to 29). The mean (±SD) duration of B-cell aplasia was 112±47 days. All the patients with SLE had DORIS remission, all the patients with idiopathic inflammatory myositis had an ACR-EULAR major clinical response, and all the patients with systemic sclerosis had a decrease in the score on the EUSTAR activity index. Immunosuppressive therapy was completely stopped in all the patients. Grade 1 cytokine release syndrome occurred in 10 patients. One patient each had grade 2 cytokine release syndrome, grade 1 immune effector cell-associated neurotoxicity syndrome, and pneumonia that resulted in hospitalization.
In this case series, CD19 CAR T-cell transfer appeared to be feasible, safe, and efficacious in three different autoimmune diseases, providing rationale for further controlled clinical trials. (Funded by Deutsche Forschungsgemeinschaft and others.).
Journal Article
Long Covid Defined
Long Covid DefinedMembers of the National Academies of Sciences, Engineering, and Medicine describe the process and rationale for the development of the 2024 definition of persistent Covid-19 symptoms (long Covid).
Journal Article
Trial of the MIND Diet for Prevention of Cognitive Decline in Older Persons
A 3-year trial involving persons with a family history of dementia showed no differences in cognitive change or brain MRI outcomes between the MIND diet, designed for neuroprotection, and a control diet.
Journal Article
Bodies of truth : personal narratives on illness, disability, and medicine
\"\"Medicine still contains an oral tradition, passed down in stories: the stories patients tell us, the ones we tell them, and the ones we tell ourselves,\" writes contributor Madaline Harrison. Bodies of Truth continues this tradition through a variety of narrative approaches by writers representing all facets of health care. And, since all of us have been or will be touched by illness or disability--our own or that of a loved one--at some point in our lives, any reader of this anthology can relate to the challenges, frustrations, and pain--both physical and emotional--that the contributors have experienced.
Bodies of Truth offers perspectives on a wide array of issues, from food allergies, cancer, and neurology to mental health, autoimmune disorders, and therapeutic music. These experiences are_recounted by patients, nurses, doctors, parents, children, caregivers, and others who attempt to articulate the intangible human and emotional factors that surround life when it intersects with the medical field\"-- Provided by publisher.
Bodies of Truth offers perspectives on a wide array of issues, from food allergies, cancer, and neurology to mental health, autoimmune disorders, and therapeutic music. These experiences are_recounted by patients, nurses, doctors, parents, children, caregivers, and others who attempt to articulate the intangible human and emotional factors that surround life when it intersects with the medical field\"-- Provided by publisher.
Book
Right Ventricular Failure
The authors discuss the mechanisms, clinical presentation, and evaluation of right ventricular failure, as well as its management.
Journal Article