General Medicine and Primary Care

Infliximab Trough Levels at Induction to Predict Treatment Failure During Maintenance.

Liefferinckx C1, Minsart C, Toubeau JF, Cremer A, Amininejad L, Quertinmont E, Devière J, Gils A, van Gossum A, Franchimont D. BACKGROUND:

Infliximab (IFX) is indicated for the treatment of inflammatory bowel diseases (IBD). Nevertheless, loss of response (LOR) to IFX is reported in up to 10% to 30% of patients within the first year of treatment. Our objective was to evaluate the impact of the pharmacokinetics of IFX at induction on treatment failure.

METHODS:

This is a longitudinal cohort study on 269 patients with IBD treated with IFX in a single center. A total of 2331 blood samples were prospectively collected from 2007 until March 2015 with a retrospective analysis of clinical data. IFX trough levels (TLs) were measured by enzyme-linked immunosorbent assay. Antibodies to IFX were measured by drug-sensitive bridging assay.

RESULTS:

During follow-up, patients were defined according to treatment outcome. At week 6, median IFX TL in patients requiring a switch to another treatment due to LOR (LOR switched group) (2.32 μg/mL [0.12-19.93 μg/mL]) was lower than in patients with long-term response (long-term responders) (8.66 μg/mL [0.12-12.09 μg/mL], P = …

Host: Matt Rosenberg, MD

Guest: Zil Garner Golstein, FNP-BC

The medical knowledge needed to treat trangender patients is not as equipped as it should be, which leads to trouble in finding adequate doctors to meet their specifc needs. This conversation includes tips on how to offer transgender patients adequate healthcare and how medical practioners can make their offices more welcoming.

Joining Dr. Matt Rosenberg in this discussion is Ms. Zil Gardner Goldstein, Family Nurse Practioner, Assistant Professor of Medical Education at the Icahn School of Medicine, and Program Director at the Center for Transgender Medicine and Surgery at Mount Sinai.

Host: Andrea J. Singer, MD, FACP, CCD

Guest: Lisa Larkin, MD, FACP, NCMP, IF

Direct Primary Care, or DPC, is a new healthcare model that focuses on affordability, accessibility and personalization. Health insurance is an obstacle that many patients face and one of DCP's goals is to create an affordable way for patients to get the healthcare they need at a reasonable price with a physician who has the time to see them.

Joining Dr. Andrea Singer in this emerging discussion of Direct Primary Care is Dr. Lisa Larkin, President and CEO of Lisa Larkin M.D. & Associates, Internal Medicine and Women's Health Group Practice, Medical Director of Women's Health Services for TriHealth Corporate Health, and Founder of the Cinncinati Sexual Health Consortium in Cinncinati, Ohio. The two discuss both the benefits and challenges of Direct Primary Care as well as the similiarities and differences between DCP and traditional primary care.

Host: Thomas C. Wright, Jr., MD

Guest: Andrew M. Kaunitz, MD, FACOG

Recorded live at a recent Women’s Health Annual Visit symposium, host Dr. Thomas Wright Jr. welcomed Dr Andrew Kaunitz to discuss the misconceptions of hormonal therapy of menopausal patients, current guidelines and recommendations, and patient safety.

Dr. Andrew Kaunitz is Professor and Associate Chair of Obstetrics and Gynecology at the University of Florida College of Medicine. He also serves as Director of Menopause and Gynecologic Ultrasound Services at Southside Women's Health.

Host: Andrea J. Singer, MD, FACP, CCD

Guest: Stephen M. Cohen, MD, FACOG

Over 6 million women in the United States are impacted by infertility. Luckily, there are many treatment options available for couples dealing with infertility, and there are many things physicians can do to help infertile couples in their office.

At a recent live event in Pasadena, CA, program moderator, Dr. Andrea Singer, was joined by Dr. Stephen M. Cohen, Faculty at SUNY Upstate Medical School in Syracuse, New York to discuss infertility testing and treatments.

Host: Michael Greenberg, MD

"Medical improv" is an emerging subset of comedic performance art using improvisational theater principles and training techniques to improve communication, cognition, and teamwork among health care professionals.

Joining Host Dr. Michael Greenberg is Valeri Lantz-Gefroh, Improvisation Program Director at the Alan Alda Center for Communicating Science at Stony Brook University. They talk about how the fundamentals of improv can be applied to medical practices.

Host: Matt Rosenberg, MD

Guest: Aiden Harrington, ANP, CNM

Current CDC Treatment Guidelines include transgender men and women as special populations. These guidelines recommend risk assessment based on current anatomy and sexual behaviors and screening for asymptomatic STIs based on the patient's history and sexual practices.

At a recent live event recorded in Chicago, moderator Dr. Matt T. Rosenberg welcomes Aiden Harrington, ANP, CNM from Howard Brown Health in Chicago, Illinois. Topics covered include health risks in the LGBTQ community, STI screening and treatment, and how to discuss sexuality with your patients.

Host: Andrew Wilner, MD, FACP, FAAN

There is still a great deal to learn about the long term effects of blast injuries on military personnel. Emerging evidence suggests that exposure to a blast can produce both overt and subtle neurological consequences in the brain, but much remains unknown.

Host Dr. Andrew Wilner is joined by Dr. Jack Tsao, Director of Traumatic Brain Injury Programs for the US Navy Bureau of Medicine and Surgery, and Professor of Neurology at the University of Tennessee Health Science Center. He is a Captain in the United States Navy, and an expert in detection and prevention of traumatic brain injury in active duty military personnel.

Host: David Weisman, MD

It is estimated that approximately 30% of epilepsy patients are drug-resistant, meaning their seizures do not successfully respond to anti-seizure medications. What other treatment options are available to patients who aren’t responding to medication?

Host Dr. David Weisman chats with Dr. Lara Marcuse, Co-Director of Mount Sinai Epilepsy Center, about new and emerging treatment options for epilepsy.

Host: Brian P. McDonough, MD, FAAFP

Several studies have shown that therapy dogs help to reduce people’s pain levels and anxiety. Therapy dogs have also been found to increase patients’ physical, mental, emotional and social states and improve their quality of life.

Host Dr. Brian McDonough talks with David Frei, co-creator of Angel on a Leash, a charity supporting therapy dog programs that serve health care facilities, about how therapy dogs bring comfort, affection and happiness to people in confined living situations. Frei is the former host of The Westminster Kennel Club Dog Show and expert analyst for The National Dog Show on NBC Thanksgiving Day.