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https://www.readbyqxmd.com/read/28428095/sjogren-s-syndrome-clinical-aspects
#1
Frederick B Vivino
Sjogren's syndrome (SS) is the 2nd most common chronic autoimmune rheumatic disease and associated with a high burden of illness. Morbidity arises not only from untreated xerostomia and keratoconjunctivitis sicca but also from extra-glandular manifestations and the development of non-Hodgkin's B cell lymphomas. Proper diagnosis of SS requires objective evidence of dry eyes and/or objective evidence of dry mouth and proof of autoimmunity. The recent development of new international classification criteria and clinical practice guidelines for SS should not only enhance the existing standards of care but also facilitate further studies to improve future diagnosis and management...
April 17, 2017: Clinical Immunology: the Official Journal of the Clinical Immunology Society
https://www.readbyqxmd.com/read/28427453/the-italian-society-for-pediatric-nephrology-sinepe-consensus-document-on-the-management-of-nephrotic-syndrome-in-children-part-i-diagnosis-and-treatment-of-the-first-episode-and-the-first-relapse
#2
REVIEW
Andrea Pasini, Elisa Benetti, Giovanni Conti, Luciana Ghio, Marta Lepore, Laura Massella, Daniela Molino, Licia Peruzzi, Francesco Emma, Carmelo Fede, Antonella Trivelli, Silvio Maringhini, Marco Materassi, Giovanni Messina, Giovanni Montini, Luisa Murer, Carmine Pecoraro, Marco Pennesi
This consensus document is aimed at providing an updated, multidisciplinary overview on the diagnosis and treatment of pediatric nephrotic syndrome (NS) at first presentation. It is the first consensus document of its kind to be produced by all the pediatric nephrology centres in Italy, in line with what is already present in other countries such as France, Germany and the USA. It is based on the current knowledge surrounding the symptomatic and steroid treatment of NS, with a view to providing the basis for a separate consensus document on the treatment of relapses...
April 21, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28424823/-coma-in-the-emergency-room
#3
M Braun, C J Ploner, T Lindner, M Möckel, W U Schmidt
Coma of unknown origin (CUO) is a frequent unspecific emergency symptom associated with a high mortality. A fast diagnostic work-up is essential given the wide spectrum of underlying diagnoses that are made up of approximately 50% primary central nervous system (CNS) pathologies and approximately 50% extracerebral, almost exclusively internal medical causes. Despite the high mortality associated with this symptom, there are currently no generally accepted management guidelines for adult patients presenting with CUO...
April 19, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28424144/expertise-and-infrastructure-capacity-impacts-acute-coronary-syndrome-outcomes
#4
Carolyn M Astley, Isuru Ranasinghe, David Brieger, Chris J Ellis, Julie Redfern, Tom Briffa, Bernadette Aliprandi-Costa, Tegwen Howell, Stephen G Bloomer, Greg Gamble, Andrea Driscoll, Karice K Hyun, Chris J Hammett, Derek P Chew
Objective Effective translation of evidence to practice may depend on systems of care characteristics within the health service. The present study evaluated associations between hospital expertise and infrastructure capacity and acute coronary syndrome (ACS) care as part of the SNAPSHOT ACS registry.Methods A survey collected hospital systems and process data and our analysis developed a score to assess hospital infrastructure and expertise capacity. Patient-level data from a registry of 4387 suspected ACS patients enrolled over a 2-week period were used and associations with guideline care and in-hospital and 6-, 12- and 18-month outcomes were measured...
April 20, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28421980/guidelines-for-the-recognition-and-management-of-mixed-depression
#5
Stephen M Stahl, Debbi A Morrissette, Gianni Faedda, Maurizio Fava, Joseph F Goldberg, Paul E Keck, Yena Lee, Gin Malhi, Ciro Marangoni, Susan L McElroy, Michael Ostacher, Joshua D Rosenblat, Eva Solé, Trisha Suppes, Minoru Takeshima, Michael E Thase, Eduard Vieta, Allan Young, Mark Zimmerman, Roger S McIntyre
A significant minority of people presenting with a major depressive episode (MDE) experience co-occurring subsyndromal hypo/manic symptoms. As this presentation may have important prognostic and treatment implications, the DSM-5 codified a new nosological entity, the "mixed features specifier," referring to individuals meeting threshold criteria for an MDE and subthreshold symptoms of (hypo)mania or to individuals with syndromal mania and subthreshold depressive symptoms. The mixed features specifier adds to a growing list of monikers that have been put forward to describe phenotypes characterized by the admixture of depressive and hypomanic symptoms (e...
February 28, 2017: CNS Spectrums
https://www.readbyqxmd.com/read/28421958/acute-limb-compartment-syndrome-in-the-lower-leg-following-trauma-assessment-in-the-intensive-care-unit
#6
Emma Limbert, Julie Santy-Tomlinson
Acute limb compartment syndrome (ALCS) is a serious complication of traumatic injury. Although ALCS can occur in any limb, it most commonly occurs following injury to the lower leg, particularly in fractures of the tibia. Practitioners should recognise and treat ALCS as early as possible to prevent the development of further, potentially serious, complications. Most of the literature recommends that patients at risk of ALCS should be carefully monitored, with a focus on pain as the main symptom. However, patients in the intensive care unit (ICU) who are unconscious or sedated may be unable to report pain or are unreliable in doing so, therefore it is necessary to consider alternative assessments for ALCS...
April 19, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28421273/-definition-classification-clinical-diagnosis-and-prognosis-of-fibromyalgia-syndrome-updated-guidelines-2017-and-overview-of-systematic-review-articles
#7
W Eich, K-J Bär, M Bernateck, M Burgmer, C Dexl, F Petzke, C Sommer, A Winkelmann, W Häuser
BACKGROUND: The regular update of the guidelines on fibromyalgia syndrome, AWMF number 145/004, was scheduled for April 2017. METHODS: The guidelines were developed by 13 scientific societies and 2 patient self-help organizations coordinated by the German Pain Society. Working groups (n =8) with a total of 42 members were formed balanced with respect to gender, medical expertise, position in the medical or scientific hierarchy and potential conflicts of interest...
April 18, 2017: Der Schmerz
https://www.readbyqxmd.com/read/28420281/long-term-follow-up-of-antithrombotic-management-patterns-in-patients-with-acute-coronary-syndrome-in-russia-an-observational-study-epicor-rus-study
#8
Mikhail Ya Ruda, Oleg V Averkov, Yunona V Khomitskaya
OBJECTIVE: This study sought to describe the short- and long-term (up to 2 years) antithrombotic management patterns in a real-life setting for patients hospitalized for an acute coronary syndrome (ACS) event, and to document clinical outcomes. RESEARCH DESIGN AND METHODS: EPICOR-RUS was a multicenter (34 centers), prospective, observational, longitudinal cohort study conducted across Russia on antithrombotic management in hospitalized (within 24 hours of symptom onset) ACS patients with 2 year follow-up...
April 19, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28419083/pneumococcal-vaccination-and-efficacy-in-patients-with-heterotaxy-syndrome
#9
Pei-Lan Shao, Mei-Hwan Wu, Jou-Kou Wang, Hui-Wen Hsu, Li-Min Huang, Shuenn-Nan Chiu
BACKGROUND: Pneumococcal vaccines, including pneumococcal polysaccharide vaccine (PPV) and pneumococcal conjugated vaccine (PCV), are important in preventing invasive pneumococcal disease. We analyzed the pneumococcal vaccination rate, efficacy and durability in patients with heterotaxy. METHODS: All patients with heterotaxy and CCHD who were followed at our institution between 2010 and 2015 were included. Pneumococcal vaccine status and geometric mean concentration (GMC) of serotypes 6B, 14, 19F, and 23F were analyzed...
April 18, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28417882/easl-clinical-practical-guidelines-on-the-management-of-acute-fulminant-liver-failure
#10
(no author information available yet)
The term acute liver failure (ALF) is frequently applied as a generic expression to describe patients presenting with or developing an acute episode of liver dysfunction. In the context of hepatological practice, however, ALF refers to a highly specific and rare syndrome, characterised by an acute abnormality of liver blood tests in an individual without underlying chronic liver disease. The disease process is associated with development of a coagulopathy of liver aetiology, and clinically apparent altered level of consciousness due to hepatic encephalopathy...
May 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28417024/new-classification-for-heart-failure-with-mildly-reduced-ejection-fraction-greater-clarity-or-more-confusion
#11
Sunil Nadar
The latest European Society of Cardiology (ESC) guidelines for the diagnosis and management of heart failure include a new patient group for those with heart failure with mildly reduced ejection fraction (HFmrEF). By defining this group of patients as a separate entity, the ESC hope to encourage more research focusing on patients with HFmrEF. Previously, patients with this condition were caught between two classifications-heart failure with reduced ejection fraction and heart failure with preserved ejection fraction...
February 2017: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/28416323/review-of-coronary-subclavian-steal-syndrome
#12
REVIEW
Bennett Cua, Natasha Mamdani, David Halpin, Sunny Jhamnani, Sasanka Jayasuriya, Carlos Mena-Hurtado
The clinical benefits of using the left internal mammary artery (LIMA) to bypass the left anterior descending artery are well established making it the most frequently used conduit for coronary artery bypass surgery (CABG). Coronary subclavian steal syndrome (CSSS) occurs during left arm exertion when (1) the LIMA is used during bypass surgery and (2) there is a high grade (≥75%) left subclavian artery stenosis or occlusion proximal to the ostia of the LIMA resulting in "stealing" of the myocardial blood supply via retrograde flow up the LIMA graft to maintain left upper extremity perfusion...
April 14, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28416298/-epicutaneous-patch-testing-in-delayed-drug-hypersensitivity-reactions-induced-by-antiepileptic-drugs
#13
Lobna Ben Mahmoud, Najla Bahloul, Hanen Ghozzi, Brahim Kammoun, Ahmed Hakim, Zouheir Sahnoun, Sami Kammoun, Khaled Zeghal
INTRODUCTION: Antiepileptic drugs are widely used and are associated with numerous side effects including skin eruptions. Epicutaneous tests have been used with variable success in skin drug reactions. The purpose of this study was to evaluate the profitability of epicutaneous tests in delayed hypersensitivity reactions induced by antiepileptic drugs. METHODS: We analyzed all cases of allergic skin reactions to antiepileptic drugs notified in regional pharmacovigilance center of Sfax (Tunisia) between June 1, 2014 and April 30, 2016...
March 25, 2017: Thérapie
https://www.readbyqxmd.com/read/28414398/tuberous-sclerosis-complex-a-review
#14
Stephanie Carapetian Randle
Tuberous sclerosis complex (TSC) is a neurocutaneous syndrome that can present at any age and can affect multiple organ systems. This disorder is usually identified in infants and children based on characteristic skin lesions, seizures, and cellular overgrowth or hamartomas in the heart, brain, and kidneys. Tuberous sclerosis complex is a genetic disorder caused by a mutation in either the TSC1 or TSC2 gene leading to dysfunction of hamartin or tuberin, respectively. Hamartin and tuberin form a protein complex that helps regulate cellular hyperplasia...
April 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28410332/sepsis-3-on-the-block-what-does-it-mean-for-preclinical-sepsis-modeling
#15
Marcin F Osuchowski, Christoph Thiemermann, Daniel G Remick
To effectively improve outcomes of septic patients, we first need to elucidate the multifaceted pathogenesis of sepsis syndromes and related inflammatory conditions. In fulfillment of such needs, in February 2016, new definitions for sepsis and septic shock were published under the acronym Sepsis-3. Although aimed at the clinical area, Sepsis-3 will have an inevitable influence upon the field of translational research as well. Sepsis-3 brings a considerable shift regarding the experimental focal point: from inflammatory states (SIRS/CARS) to organ failure (single and multiple) as the decisive factor...
May 2017: Shock
https://www.readbyqxmd.com/read/28409378/percutaneous-cholecystostomy-prognostic-factors-and-comparison-to-cholecystectomy
#16
Tyler J Loftus, Elisha M Collins, Camille G Dessaigne, Amber N Himmler, Alicia M Mohr, Ryan M Thomas, Charles E Hobson, George A Sarosi, William J Zingarelli
BACKGROUND: Data regarding long-term outcomes following percutaneous cholecystostomy (PC) are limited, and comparisons to cholecystectomy (CCY) are lacking. We hypothesized that chronic disease burden would predict 1-year mortality following PC, and that outcomes following PC and CCY would be similar when controlling for preprocedural risk factors. METHODS: We performed a 10-year retrospective cohort analysis of patients with acute cholecystitis managed by PC (n = 114) or CCY (n = 234)...
April 13, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28408631/asymmetric-meckel-cave-enlargement-a-potential-marker-of-phaces-syndrome
#17
J N Wright, V Wycoco
BACKGROUND AND PURPOSE: PHACES syndrome is a complex of morphologic abnormalities of unknown cause and includes posterior fossa abnormalities; head and neck infantile hemangiomas; arterial, cardiac, and eye anomalies; and sternal or abdominal wall defects. Accurate identification of the syndrome is important for optimal treatment. The purpose of this study was to investigate the incidence of asymmetric Meckel cave enlargement, a potential novel imaging marker, in a population of patients referred for evaluation of possible PHACES syndrome...
April 13, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28408193/imipramine-versus-placebo-for-multiple-functional-somatic-syndromes-stress-3-a-double-blind-randomised-study
#18
Johanne L Agger, Andreas Schröder, Lise K Gormsen, Jens S Jensen, Troels S Jensen, Per K Fink
BACKGROUND: Functional somatic syndromes, including chronic fatigue syndrome or irritable bowel syndrome, often co-exist. Treatment guidelines supported by high quality evidence exist for most functional somatic syndromes, but are lacking for multiple comorbid functional somatic syndromes. We aimed to assess the effect of the tricyclic antidepressant, imipramine, in patients with multiple functional somatic syndromes defined by the criteria for multiorgan bodily distress syndrome, a unifying diagnosis that encompasses most functional somatic syndromes and somatoform disorders...
April 10, 2017: Lancet Psychiatry
https://www.readbyqxmd.com/read/28407153/premenstrual-exacerbations-achieving-stability-all-month-every-month
#19
Laura G Leahy
Premenstrual syndrome, premenstrual dysphoric disorder, or premenstrual exacerbation of a psychiatric condition may disrupt 10 years of a woman's life over the course of her reproductive lifespan. As health care practitioners, nurses see women who experience these premenstrual symptom exacerbations in all treatment settings. Premenstrual exacerbation of psychiatric illness is a common phenomenon, and it is treatable; however, research is limited and evidence-based guidelines for treatment are sparse. The current article offers insights and an algorithm, extrapolated from the existing literature, into a lesser-known treatment strategy, semi-intermittent dosing, which will provide symptom stability all month, every month...
April 1, 2017: Journal of Psychosocial Nursing and Mental Health Services
https://www.readbyqxmd.com/read/28406856/treating-women-who-are-pregnant-and-parenting-for-opioid-use-disorder-and-the-concurrent-care-of-their-infants-and-children-literature-review-to-support-national-guidance
#20
Stacey L Klaman, Krystyna Isaacs, Anne Leopold, Joseph Perpich, Susan Hayashi, Jeff Vender, Melinda Campopiano, Hendrée E Jones
OBJECTIVES: The prevalence of opioid use disorder (OUD) during pregnancy is increasing. Practical recommendations will help providers treat pregnant women with OUD and reduce potentially negative health consequences for mother, fetus, and child. This article summarizes the literature review conducted using the RAND/University of California, Los Angeles Appropriateness Method project completed by the US Department of Health and Human Services Substance Abuse and Mental Health Services Administration to obtain current evidence on treatment approaches for pregnant and parenting women with OUD and their infants and children...
April 13, 2017: Journal of Addiction Medicine
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