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acid-base disorders guidelines

John M Weiler, John D Brannan, Christopher C Randolph, Teal S Hallstrand, Jonathan Parsons, William Silvers, William Storms, Joanna Zeiger, David I Bernstein, Joann Blessing-Moore, Matthew Greenhawt, David Khan, David Lang, Richard A Nicklas, John Oppenheimer, Jay M Portnoy, Diane E Schuller, Stephen A Tilles, Dana Wallace
The first practice parameter on exercise-induced bronchoconstriction (EIB) was published in 2010. This updated practice parameter was prepared 5 years later. In the ensuing years, there has been increased understanding of the pathogenesis of EIB and improved diagnosis of this disorder by using objective testing. At the time of this publication, observations included the following: dry powder mannitol for inhalation as a bronchial provocation test is FDA approved however not currently available in the United States; if baseline pulmonary function test results are normal to near normal (before and after bronchodilator) in a person with suspected EIB, then further testing should be performed by using standardized exercise challenge or eucapnic voluntary hyperpnea (EVH); and the efficacy of nonpharmaceutical interventions (omega-3 fatty acids) has been challenged...
September 15, 2016: Journal of Allergy and Clinical Immunology
Mary A Fristad
Treatment guidelines recommend that psychotherapy be used in conjunction with pharmacotherapy in children with bipolar disorder. A well-established category of psychotherapy is family skill-building plus psychoeducation; 3 examples of this are family-focused treatment, psychoeducational psychotherapy, and child- and family-focused cognitive-behavioral therapy. These treatments share several common elements that are important in pediatric populations, including being family-based, providing psychoeducation on symptoms and their management, and training patients and families in emotion regulation, communication, and problem-solving skills...
2016: Journal of Clinical Psychiatry
Masamitsu Morishita, Nanae Matsuo, Yukio Maruyama, Masatsugu Nakao, Izumi Yamamoto, Yudo Tanno, Ichiro Ohkido, Masato Ikeda, Keitaro Yokoyama, Takashi Yokoo
BACKGROUND: Several guidelines have set the target levels of serum Ca, phosphorus, and parathyroid hormone (PTH) for better management of chronic kidney disease-mineral and bone disorders (CKDMBD) in dialysis patients. Although serum ionized Ca (iCa) is a biologically active component, corrected Ca (cCa) is used in clinical settings. However, the association between iCa and cCa is affected by acid-base status. We investigated the difference in acid-base and the calcium-parathyroid status between hemodialysis (HD) and peritoneal dialysis (PD)...
August 2016: Clinical Nephrology
Michael Vincent, Mark Whidden, Santiago Schnell
Intrinsically disordered proteins fail to adopt a stable three-dimensional structure under physiological conditions. It is now understood that many disordered proteins are not dysfunctional, but instead engage in numerous cellular processes, including signaling and regulation. Disorder characterization from amino acid sequence relies on computational disorder prediction algorithms. While numerous large-scale investigations of disorder have been performed using these algorithms, and have offered valuable insight regarding the prevalence of protein disorder in many organisms, critical proteome-based descriptive statistical guidelines that would enable the objective assessment of intrinsic disorder in a protein of interest remain to be established...
June 2016: Biophysical Chemistry
Mark Tarnopolsky, Hans Katzberg, Basil J Petrof, Sandra Sirrs, Harvey B Sarnat, Kimberley Myers, Nicolas Dupré, Dubravka Dodig, Angela Genge, Shannon L Venance, Lawrence Korngut, Julian Raiman, Aneal Khan
Pompe disease is a lysosomal storage disorder caused by a deficiency of the enzyme acid alpha-glucosidase. Patients have skeletal muscle and respiratory weakness with or without cardiomyopathy. The objective of our review was to systematically evaluate the quality of evidence from the literature to formulate evidence-based guidelines for the diagnosis and management of patients with Pompe disease. The literature review was conducted using published literature, clinical trials, cohort studies and systematic reviews...
July 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Philip S Mehler, Kristine Walsh
OBJECTIVE: Eating disorders that are associated with purging behaviors are complicated by frequent blood electrolyte and acid-base abnormalities. Herein, we review the major electrolyte and acid-base abnormalities and their treatment methods. The body of rigorous, eating disorder-specific literature on this topical area is not robust enough to perform a systematic review as defined by PRISMA guidelines. Therefore, a qualitative review of mostly medical literature was conducted. RESULTS: Hypokalemia, hyponatremia, and sodium chloride-responsive metabolic alkalosis are the most common serum changes that occur as a result of purging behaviors...
March 2016: International Journal of Eating Disorders
Ossama Abbas, Alfred Ammoury, Mohammad Abbadi, Medhat Abdel Malek, Laith Akkash, Kamal Al-Chakharah, Khalil Al-Hamdi, Firas Al-Qarqaz, Abduljabbar Al-Soudani, Nameer Al-Soudani, Anwar Dandashle, Fouad El-Sayed, Yasser Ghafir, Nazek Gargour, Said Kabalan, Abdul-Ghani Kibbi, Isam Oumeish, Zeina Tannous, Roland Tomb
Psoriasis vulgaris is a common chronic, inflammatory, multisystem disorder that affects approximately 1.5% to 3.4% of the population in the Middle East. The disease has an impact on the quality of life in a significant number of affected patients. The majority of patients (approximately 70%) have mild to moderate psoriasis that is manageable with topical agents, which generally show a high efficacy to safety ratio. Topical agents can be used alone when treating patients with limited disease or may be used as adjunctive therapy for patients with more extensive psoriasis undergoing systemic treatment...
2015: Skinmed
Amir Qaseem, Michael J Barry, Devan Kansagara
DESCRIPTION: The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on the comparative effectiveness of treatment with second-generation antidepressants versus nonpharmacologic treatments for major depressive disorder in adults. METHODS: This guideline is based on a systematic review of published, English-language, randomized, controlled trials from 1990 through September 2015 identified using several databases and through hand searches of references of relevant studies...
March 1, 2016: Annals of Internal Medicine
Sébastien Lévesque, Christiane Auray-Blais, Elaine Gravel, Michel Boutin, Laura Dempsey-Nunez, Pierre-Etienne Jacques, Sébastien Chenier, Sandrine Larue, Marie-France Rioux, Walla Al-Hertani, Amelie Nadeau, Jean Mathieu, Bruno Maranda, Valérie Désilets, Paula J Waters, Joan Keutzer, Stephanie Austin, Priya Kishnani
BACKGROUND: Late-onset Pompe disease (LOPD) is a rare treatable lysosomal storage disorder characterized by progressive lysosomal glycogen accumulation and muscle weakness, with often a limb-girdle pattern. Despite published guidelines, testing for LOPD is often overlooked or delayed in adults, owing to its low frequency compared to other muscle disorders with similar muscle patterns. Next-generation sequencing has the capability to test concurrently for several muscle disorders. This could potentially lead to increased diagnosis of LOPD, disorders with non-specific muscle weakness or atypical patients...
2016: Orphanet Journal of Rare Diseases
Todd J Swick
Cataplexy is defined as episodes of sudden loss of voluntary muscle tone triggered by emotions generally lasting <2 minutes. Cataplexy is most commonly associated with and considered pathognomonic for narcolepsy, a sleep disorder affecting ~0.05% of the general population. Knowledge of the pathophysiology of cataplexy has advanced through study of canine, murine, and human models. It is now generally considered that loss of signaling by hypothalamic hypocretin/orexin-producing neurons plays a key role in the development of cataplexy...
2015: Nature and Science of Sleep
Peter G Gibson, Anne E Vertigan
Chronic refractory cough (CRC) is defined as a cough that persists despite guideline based treatment. It is seen in 20-46% of patients presenting to specialist cough clinics and it has a substantial impact on quality of life and healthcare utilization. Several terms have been used to describe this condition, including the recently introduced term cough hypersensitivity syndrome. Key symptoms include a dry irritated cough localized around the laryngeal region. Symptoms are not restricted to cough and can include globus, dyspnea, and dysphonia...
2015: BMJ: British Medical Journal
Andreas E Kremer, Barbara Namer, Ruth Bolier, Michael J Fischer, Ronald P Oude Elferink, Ulrich Beuers
Pruritus is a preeminent symptom in patients with chronic cholestatic liver disorders such as primary biliary cirrhosis and primary sclerosing cholangitis. More than two-thirds of these patients experience itching during the course of their disease. This symptom is also frequently observed in patients with other causes of cholestasis such as cholangiocarcinoma, inherited forms of cholestasis and intrahepatic cholestasis of pregnancy, but may accompany almost any other liver disease. The pathogenesis of pruritus of cholestasis remains largely elusive...
2015: Digestive Diseases
U Bonnet, A Ossowski, M Schubert, H Gall, I Steinkamp, L E Richter, Y Khalil-Boutros, A Nefedev, R Kuhlmann
We present the case of a 76 year old female inpatient who suffered from a chronic intractable cough which arose simultaneously to a severe major depression and was secondary to an exorbitant psychological distress. Chronic cough had never been experienced before and was initially considered to have a mere psychogenic origin since a comprehensive and guideline-based diagnostic screening did not reveal any underlying somatic cause. However, several factors cast doubt on the solitary psychic genesis of the chronic cough: i) occurrence immediately after a penetrant cold, ii) embedding in other complaints of laryngeal hyperreagibility (larynx irritable), such as persistent globus pharyngeus sensation, throat clearing and episodic dysphonia, iii) first occurrence on old life, iv) erupting from sleep as well, v) persistence despite remission of the major depression, and v) no sustaining benefit from specific psychotherapy and speech therapy...
October 2015: Fortschritte der Neurologie-Psychiatrie
Yanli He, Ping Wang, Kaiwei Liang, Xiangjun Chen, Wen Du, Juan Li, Yanjie Hu, Yan Bai, Wei Liu, Xiaoqing Li, Runming Jin, Min Zhang, Jine Zheng
Acute promyelocytic leukemia (APL) is a specific malignant hematological disorder with a diagnostic hallmark of chromosome translocation t(15;17)(q22;q21). As a very rare secondary cytogenetic aberration in pediatric APL, ider(17q) (q10)t(15;17) was suggested to be a poor prognostic factor based on previous case reports.Here, we report a pediatric APL case with a rare karyotype of ider(17)(q10)t(15;17). Bone marrow aspiration, immunophenotyping, molecular biology, cytogenetic, and fluorescence in situ hybridization (FISH) analyses were performed at initial diagnosis and during the treatment...
October 2015: Medicine (Baltimore)
Luisa De Risio, Sofie Bhatti, Karen Muñana, Jacques Penderis, Veronika Stein, Andrea Tipold, Mette Berendt, Robyn Farqhuar, Andrea Fischer, Sam Long, Paul J J Mandigers, Kaspar Matiasek, Rowena M A Packer, Akos Pakozdy, Ned Patterson, Simon Platt, Michael Podell, Heidrun Potschka, Martí Pumarola Batlle, Clare Rusbridge, Holger A Volk
This article outlines the consensus proposal on diagnosis of epilepsy in dogs by the International Veterinary Epilepsy Task Force. The aim of this consensus proposal is to improve consistency in the diagnosis of epilepsy in the clinical and research settings. The diagnostic approach to the patient presenting with a history of suspected epileptic seizures incorporates two fundamental steps: to establish if the events the animal is demonstrating truly represent epileptic seizures and if so, to identify their underlying cause...
2015: BMC Veterinary Research
Goele Jans, Christophe Matthys, Annick Bogaerts, Matthias Lannoo, Johan Verhaeghe, Bart Van der Schueren, Roland Devlieger
Pregnant and postpartum women with a history of bariatric surgery are at risk of micronutrient deficiencies as a result of the combination of physiologic changes related to pregnancy and iatrogenic postoperative alterations in the absorption and metabolism of crucial nutrients. This systematic review investigates micronutrient deficiencies and related adverse clinical outcomes in pregnant and postpartum women after bariatric surgery. A systematic approach involving critical appraisal was conducted independently by 2 researchers to examine deficiencies of phylloquinone, folate, iron, calcium, zinc, magnesium, iodide, copper, and vitamins A, D, and B-12 in pregnant and postpartum women after bariatric surgery, together with subsequent outcomes in the neonates...
July 2015: Advances in Nutrition
Jong-Hyun Jeong, Jeong Goo Lee, Moon-Doo Kim, Inki Sohn, Se-Hoon Shim, Hee Ryung Wang, Young Sup Woo, Duk-In Jon, Jeong Seok Seo, Young-Chul Shin, Kyung Joon Min, Bo-Hyun Yoon, Won-Myong Bahk
Our goal was to compare the recommendations of the Korean Medication Algorithm Project for Bipolar Disorder 2014 (KMAP-BP 2014) with other recently published guidelines for the treatment of bipolar disorder. We reviewed a total of four recently published global treatment guidelines and compared each treatment recommendation of the KMAP-BP 2014 with those in other guidelines. For the initial treatment of mania, there were no significant differences across treatment guidelines. All recommended mood stabilizer (MS) or atypical antipsychotic (AAP) monotherapy or the combination of an MS with an AAP as a first-line treatment strategy for mania...
2015: Neuropsychiatric Disease and Treatment
Saad Khalid Niaz, Muhammed Saeed Quraishy, Muhammad Ali Taj, Shahab Abid, Altaf Alam, Arif Amir Nawaz, Syed Hasnain Ali Shah, Ijaz Muhammed Khan, Abdul Rauf Memon, Bader Fiaz Zuberi, Ghayasun Nabi Tayyab, Kashif Malik, Shakeel Mirza, Zaigham Abbas
Gastroesophageal reflux disease (GERD) is the most common acid-related disorder encountered during clinical practice in Pakistan and is associated with significant impairment of health-related quality of life. A number of guidelines and recommendations for the diagnosis and management of GERD have been published in different countries, but a Pakistani accepted directive by the standards of evidence-based medicine is still lacking. Our aim was to create an understanding of the natural history and presentations of reflux disease; evaluating possible treatment options available for the patients with complex and uncomplicated reflux ailments with the development of current and up to date evidence based endorsement, relevant to the needs of Pakistani health care providers in order to treat oesophageal manifestations of GERD...
May 2015: JPMA. the Journal of the Pakistan Medical Association
K M A Rogers, K McCutcheon
This article examines acid-base balance and the interpretation of arterial blood gases (ABG). The article begins with a brief revision of related physiology, followed by a description of the primary disorders associated with acid-base imbalance. The normal ranges and the significance of abnormal ABG results are explored. The article concludes by providing an easy to follow four-step guide to ABG interpretation with practice examples presented in the CPD task section.
March 2015: Journal of Perioperative Practice
Antonio Coppola, Jerzy Windyga, Antonella Tufano, Cindy Yeung, Matteo Nicola Dario Di Minno
BACKGROUND: In people with haemophilia or other congenital bleeding disorders undergoing surgical interventions, haemostatic treatment is needed in order to correct the underlying coagulation abnormalities and minimise the bleeding risk. This treatment varies according to the specific haemostatic defect, its severity and the type of surgical procedure. The aim of treatment is to ensure adequate haemostatic coverage for as long as the bleeding risk persists and until wound healing is complete...
2015: Cochrane Database of Systematic Reviews
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