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https://www.readbyqxmd.com/read/28933519/skin-metastasis-review-with-conceptual-and-practical-guide
#1
Martin R Dittmer, Vincent Liu
Of the outward manifestations of visceral malignancy, cutaneous metastases are of particular interest for their impact on identification, prognosis, and management of the primary tumor. Their diagnosis is often challenging and requires high clinical suspicion. The infrequency and clinicopathologic variability of cutaneous metastases can impede their recognition by physical exam and even histopathology. This review offers a practical approach to judicious utilization of the full repertoire of clinical and pathologic data in precise characterization of metastases to the skin...
September 20, 2017: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
https://www.readbyqxmd.com/read/28932401/practical-approach-to-detection-and-management-of-acute-kidney-injury-in-critically-ill-patient
#2
REVIEW
Vahid Mohsenin
BACKGROUND: Acute kidney injury (AKI) is a common complication in critically ill patients and is associated with high morbidity and mortality. This paper provides a critical review of the etiologies of AKI and a systematic approach toward its diagnosis and management with emphasis on fluid volume assessment and the use of urine biochemical profile and microscopy in identifying the nature and the site of kidney injury. MATERIALS AND METHODS: The search of PubMed and selection of papers had employed observational designs or randomized control trials relevant to AKI...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28929319/a-practical-approach-to-hypertension-management-in-diabetes
#3
REVIEW
Altamash Shaikh
Hypertension is one of the most important comorbidities of diabetes, contributing significantly to death and disability and leads to macrovascular and microvascular complications. When assessing the medical priorities for patients with diabetes, treating hypertension should be a primary consideration. Practical approaches to hypertension in diabetes, including individualized targets are discussed, as per stage and complication of diabetes, according to current studies and guidelines. Angiotensin converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARBs) are the most effective drugs for treating hypertension in diabetes, in the absence of contraindications...
September 19, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28925512/suprafascial-dissection-of-the-pedicled-groin-flap-a-safe-and-practical-approach-to-flap-harvest
#4
Mohamed Abdelrahman, Jonathan Zelken, Ren-Wen Huang, Chung-Chen Hsu, Chih-Hung Lin, Yu-Te Lin, Cheng-Hung Lin
BACKGROUND: The groin flap has been relied upon for more than 4 decades and is well suited for reconstruction of the mutilated hand. Classic groin flap harvest is subfascial and includes the superficial circumflex iliac artery (SCIA). SCIA perforator flaps have shown that one perforator is sufficient to supply a large flap without breaching fascia. Accordingly, we routinely preserve the fascia and rely wholly on the superficial branch of the SCIA, sparing the deep branch. We aim to investigate the safety of suprafascial flap elevation and encourage a paradigm shift in reconstruction with groin flap transfer...
September 19, 2017: Microsurgery
https://www.readbyqxmd.com/read/28918588/a-practical-approach-to-managing-hypoactive-sexual-desire-disorder-in-women-with-diabetes
#5
REVIEW
Charmaine Rochester-Eyeguokan, Lisa Meade
Female sexual dysfunction (FSD) is highly prevalent in women with diabetes mellitus (DM), yet it remains unaddressed, undiagnosed, and untreated. Hypoactive sexual desire disorder (HSDD) is the most common complaint among women with FSD, but there is a paucity of research into its multifactorial etiology. Flibanserin is the only therapy approved by the US Food and Drug Administration for treating acquired, generalized HSDD in premenopausal women. Women with DM diagnosed with HSDD may require a multidisciplinary approach for optimal management...
September 16, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28916998/emergency-neurologic-life-support-meningitis-and-encephalitis
#6
David F Gaieski, Nicole F O'Brien, Ricardo Hernandez
Bacterial meningitis and viral encephalitis, particularly herpes simplex encephalitis, are severe neurological infections that, if not treated promptly and effectively, lead to poor neurological outcome or death. Because of the value of early recognition and treatment, meningitis and encephalitis was chosen as an Emergency Neurological Life Support protocol. This protocol provides a practical approach to recognition and urgent treatment of bacterial meningitis and encephalitis. Appropriate imaging, spinal fluid analysis, and early empiric treatment are discussed...
September 15, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28905272/what-is-a%C3%A2-good-doctor
#7
REVIEW
Verena Steiner-Hofbauer, Beate Schrank, Anita Holzinger
Changes in medical curricula have led to a shift of focus in medical education. The goal was to implement a more practical approach to teaching and thereby create better doctors. However, the question of what makes a good doctor is not easy to answer. This article gives an overview on the literature about this topic. A systematized review and narrative synthesis were conducted including 20 articles about the features of good doctors. Qualitative and quantitative studies as well as questionnaires were included...
September 13, 2017: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28901970/the-2016-who-classification-of-central-nervous-system-tumors-what-neurologists-need-to-know
#8
John C DeWitt, Andreas Mock, David N Louis
PURPOSE OF REVIEW: The 2016 WHO classification of tumors of the central nervous system (2016 CNS WHO) features many changes that are relevant to neurologists treating patients with brain tumors as well as neurologists involved in basic, clinical, and epidemiological research. This review summarizes what neurologists need to know and will need to know in the next years. RECENT FINDINGS: The 2016 CNS WHO introduces diagnostic terms that 'integrate' histological and molecular information and suggests presenting diagnoses in a four-layered reporting format...
September 9, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28893093/practical-approach-to-the-treatment-of-nsaid-hypersensitivity
#9
Natalia Blanca-Lopez, Diana Perez-Alzate, Gabriela Canto, Miguel Blanca
Non-steroidal anti-inflammatory drugs (NSAIDs) are the most frequently involved in drug hypersensitivity reactions (DHR). NSAIDs are prescribed for different processes and some NSAIDs can be obtained over the counter. Areas covered: We analyse the practical approaches for managing and treating NSAID-DHR considering the five major groups of entities recognised, divided into two categories: those responding to strong COX-1 inhibitors and possibly weak COX-1 or selective COX-2 inhibitors named cross-intolerant (CI), and those induced by a single drug or drug group with good tolerance to strong COX-1 inhibitors, known as allergic reactions (SR)...
September 12, 2017: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/28891436/radio-localization-of-non-palpable-breast-lesions-under-ultrasonographic-guidance-current-status-and-future-perspectives
#10
Giulia Anna Follacchio, Francesco Monteleone, Maria Letizia Meggiorini, Maria Paola Nusiner, Carlo De Felice, Giuseppe De Vincentis, Mauro Liberatore
BACKGROUND: Due to the spread of mammographic screening programs, a constant increase of clinically-occult breast cancer diagnosis has been registered. A correct approach to non-palpable breast lesions requires an accurate intra-operative localization in order to achieve a complete surgical resection. Aim of this paper is to describe the state of the art of the US-guided procedures such as Radio-guided Occult Lesion Localization (ROLL) and Radio-guided Seed Localization (RSL) in comparison to the most widely adopted Wire-Guided Localization (WGL)...
September 8, 2017: Current Radiopharmaceuticals
https://www.readbyqxmd.com/read/28885333/rapidly-decreasing-level-of-prostate-specific-antigen-during-initial-androgen-deprivation-therapy-is-a-risk-factor-for-early-progression-to-castration-resistant-prostate-cancer-a-retrospective-study
#11
Guangjie Ji, Gang Song, Cong Huang, Shiming He, Liqun Zhou
To build a practical model for predicting the progression to castration-resistant prostate cancer (CRPC) after androgen deprivation therapy (ADT).In all, 185 patients with prostate cancer who had received ADT as the primary therapy at our institution, from 2003 to 2014, were retrospectively enrolled. The following clinical variables were included in the analysis: age, clinical tumor, node, metastasis stage, Gleason score, risk groups of prostate cancer, prostate-specific antigen (PSA) at the initiation of ADT, PSA nadir after ADT, velocity of PSA decline, and the time to PSA nadir...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28869390/approach-to-interpret-images-produced-by-new-generations-of-multi-detector-computed-tomography-scanners-in-post-operative-spine
#12
Rania Zeitoun, Manar Hussein
OBJECTIVE: To reach a practical approach to interpret MDCT findings in post-opartive spine cases and to change the false belief of CT failure in the setting of instruments secondary to related artifacts. METHODS: We performed observational retrospective analysis of premier, early and late MDCT scans in 68 post-operative spine patients, with emphasis on instruments related complications and osseous fusion status. We used a grading system for assessment of osseous fusion in 35 patients and we further analyzed the findings in failure of fusion, grade (D)...
September 4, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28862994/fc1000-normalized-gene-expression-changes-of-systematically-perturbed-human-cells
#13
Ingrid M Lönnstedt, Sven Nelander
The systematic study of transcriptional responses to genetic and chemical perturbations in human cells is still in its early stages. The largest available dataset to date is the newly released L1000 compendium. With its 1.3 million gene expression profiles of treated human cells it offers many opportunities for biomedical data mining, but also data normalization challenges of new dimensions. We developed a novel and practical approach to obtain accurate estimates of fold change response profiles from L1000, based on the RUV (Remove Unwanted Variation) statistical framework...
September 26, 2017: Statistical Applications in Genetics and Molecular Biology
https://www.readbyqxmd.com/read/28856834/disparities-in-hypertension-and-cardiovascular-disease-in-blacks-the-critical-role-of-medication-adherence
#14
REVIEW
Keith C Ferdinand, Kapil Yadav, Samar A Nasser, Helene D Clayton-Jeter, John Lewin, Dennis R Cryer, Fortunato Fred Senatore
Blacks are two to three times as likely as whites to die of preventable heart disease and stroke. Declines in mortality from heart disease have not eliminated racial disparities. Control and effective treatment of hypertension, a leading cause of cardiovascular disease, among blacks is less than in whites and remains a challenge. One of the driving forces behind this racial/ethnic disparity is medication nonadherence whose cause is embedded in social determinants. Eight practical approaches to addressing medication adherence with the potential to attenuate disparities were identified and include: (1) patient engagement strategies, (2) consumer-directed health care, (3) patient portals, (4) smart apps and text messages, (5) digital pillboxes, (6) pharmacist-led engagement, (7) cardiac rehabilitation, and (8) cognitive-based behavior...
August 30, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28836750/emergency-management-of-renal-and-genitourinary-trauma-best-practices-update-digest
#15
Whitney K Bryant, Sanjay Shewakramani, Milana Zaurova
In up to 10% of patients who experience abdominal trauma, renal and urogenital systems will be involved. In polytrauma patients with other potentially life-threatening injuries, renal and genitourinary trauma may be overlooked initially, but a delayed or missed diagnosis of these injuries may result in preventable complications. This review provides a best-practice approach to the diagnosis and management of renal and genitourinary injuries, with an emphasis on the systematic approach needed to identify subtle injuries and avoid long-term urinary sequelae such as hypertension, incontinence, erectile dysfunction, chronic kidney disease, and nephrectomy...
August 22, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28836177/erratum-to-practical-approach-to-initiating-sglt2-inhibitors-in-type-2-diabetes
#16
Fernando Gomez-Peralta, Cristina Abreu, Albert Lecube, Diego Bellido, Alfonso Soto, Cristóbal Morales, Miguel Brito-Sanfiel, Guillermo Umpierrez
No abstract text is available yet for this article.
August 23, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28829200/pharmacological-treatment-of-trigeminal-neuralgia
#17
Giulia Di Stefano, Andrea Truini
Unique among the different neuropathic pain conditions, trigeminal neuralgia frequently has an excellent response to some selected drugs, which, on the other hand, often entail disabling side effects. Physicians should be therefore acquainted with the management of these drugs and the few alternative options. Areas covered: This article, based on a systematic literature review, describes the pharmacological options, and indicates the future perspectives for treating trigeminal neuralgia. The article therefore provides current, evidence-based knowledge about the pharmacological treatment of trigeminal neuralgia, and suggests a practical approach to the various drugs, including starting dose, titration and side effects...
September 4, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/28825635/assessing-sensory-processing-dysfunction-in-adults-and-adolescents-with-autism-spectrum-disorder-a-scoping-review
#18
REVIEW
Denise DuBois, Erin Lymer, Barbara E Gibson, Pushpal Desarkar, Emily Nalder
Sensory reactivity is a diagnostic criterion for Autism Spectrum Disorder (ASD), and has been associated with poorer functional outcomes, behavioral difficulties, and autism severity across the lifespan. Yet, there is little consensus on best practice approaches to assessing sensory processing dysfunction in adolescents and adults with ASD. Despite growing evidence that sensory symptoms persist into adolescence and adulthood, there is a lack of norms for older age groups, and pediatric assessments may not target appropriate functional outcomes or environments...
August 19, 2017: Brain Sciences
https://www.readbyqxmd.com/read/28820725/understanding-hepatitis-c-virus-drug-resistance-clinical-implications-for-current-and-future-regimens
#19
David L Wyles, Anne F Luetkemeyer
Viral resistance to direct-acting antiviral drugs may impact their effectiveness during treatment of hepatitis C virus (HCV) infection. Most data on HCV drug resistance concern genotypes 1 and 3. The clinical impact of resistance to HCV nonstructural protein 5A (NS5A) inhibitors and a practical approach to indications and methods for resistance testing are discussed.
July 2017: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/28812610/genome-wide-interrogation-advances-resolution-of-recalcitrant-groups-in-the-tree-of-life
#20
Dahiana Arcila, Guillermo Ortí, Richard Vari, Jonathan W Armbruster, Melanie L J Stiassny, Kyung D Ko, Mark H Sabaj, John Lundberg, Liam J Revell, Ricardo Betancur-R
Much progress has been achieved in disentangling evolutionary relationships among species in the tree of life, but some taxonomic groups remain difficult to resolve despite increasing availability of genome-scale data sets. Here we present a practical approach to studying ancient divergences in the face of high levels of conflict, based on explicit gene genealogy interrogation (GGI). We show its efficacy in resolving the controversial relationships within the largest freshwater fish radiation (Otophysi) based on newly generated DNA sequences for 1,051 loci from 225 species...
January 13, 2017: Nature ecology & evolution
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