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https://www.readbyqxmd.com/read/28717918/-syncope-falls-and-vertigo
#1
REVIEW
C Weingart, H-J Schneider, C C Sieber
Dizziness/vertigo, falls and syncope are among the most common reasons for seeking medical care. As clinical entities they share common pathogenetic and clinical features and differences. The diagnostic work-up can often be initiated in a general practitioner's or internist's practice and, if necessary, completed in an interdisciplinary emergency unit. Simple diagnostic tools can be used in an outpatient setting to obtain valuable diagnostic information. First and foremost, it is important to differentiate between prognostically favorable clinical events and potentially serious disease...
July 17, 2017: Der Internist
https://www.readbyqxmd.com/read/28707827/cat-scratch-disease-u-s-clinicians-experience-and-knowledge
#2
C A Nelson, A R Moore, A E Perea, P S Mead
Cat scratch disease (CSD) is a zoonotic infection caused primarily by the bacterium Bartonella henselae. An estimated 12,000 outpatients and 500 inpatients are diagnosed with CSD annually, yet little is known regarding clinician experience with and treatment of CSD in the United States. Questions assessing clinical burden, treatment and prevention of CSD were posed to 3,011 primary care providers (family practitioners, internists, paediatricians and nurse practitioners) during 2014-2015 as part of the annual nationwide DocStyles survey...
July 14, 2017: Zoonoses and Public Health
https://www.readbyqxmd.com/read/28699936/clinician-attitudes-regarding-icd-deactivation-in-dnr-dni-patients
#3
Andrew Bradley, Adam Marks
BACKGROUND: Implantable cardioverter-defibrillators (ICDs) offer lifesaving therapies but can become burdensome at the end of life. Many ICD patients choose to implement a do-not-resuscitate/do-not-intubate (DNR/DNI) order. When hospitalized, patients are seen by a range of clinicians whose beliefs about ICD management in DNR/DNI patients may vary. OBJECTIVE: To assess clinician opinions on managing ICDs in DNR/DNI patients and stratify it by specialty and training level...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28690751/-ocular-beh%C3%A3-et
#4
Ahmed Alami, Mohamed Kriet, Karim Reda, Abdelkader Laktaoui, Abdelbaare Oubaaz
Our study aimed to determine the clinical, therapeutic and prognostic features of ocular involvement in patients with Behçet's disease treated in our Department of ophthalmology. We conducted a retrospective data collection from medical records of 20 patients treated at the military hospital in Laayoune. All patients underwent complete ophthalmological examination and fluorescein angiography if necessary. OCT exam was performed in two patients. Ten patients had anterior uveitis, complicated in one case by ocular hypertonia; two patients had intermediate uveitis; eight patients had posterior segment involvement complicated in one case by intravitreal hemorrhage...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28687265/contextualizing-myocardial-infarction-comorbidities-and-priorities-in-older-adults
#5
REVIEW
Ashok Krishnaswami, Mathew S Maurer, Karen P Alexander
Cardiovascular care for older adults has become increasingly complex due to a rise in the concurrent comorbidity burden that accompanies senescence. Internists, hospitalists, and cardiologists often encounter geriatric patients with multiple chronic conditions needing acute cardiovascular care. Abnormal cardiac biomarker levels in patients with multiple non-cardiac conditions are a common reason for older adults to enter the hospital. This type of acute coronary syndrome, defined as a non-ST segment elevation myocardial infarction or, more precisely, type 2 myocardial infarction, often leads to substantial consternation...
July 4, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28684051/patent-foramen-ovale-closure-to-prevent-secondary-neurologic-events
#6
REVIEW
Rosie Jasper, James C Blankenship
In October of 2016 the United States Food and Drug Administration approved the Amplatzer Patent Foramen Ovale (PFO) occluder device for use in patients with cryptogenic stroke, to reduce the risk of recurrent stroke. This event followed 15years of off-label use of atrial septal occluder devices, 3 randomized trials, and enormous controversy over the efficacy of this procedure. While none of the trials reached the primary endpoint needed to prove the efficacy of PFO closure in preventing recurrent stroke, meta-analyses and 5-year follow-up of 1 trial suggest that PFO closure decreases the risk of recurrent stroke, especially in sub-groups with large shunts and atrial septal aneurysms, and especially when the Amplatzer device (rather than other devices) is used...
July 3, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28672420/-30-year-old-patient-with-suspected-marfan-syndrome-and-progressive-gait-disturbance
#7
Maryam Balke, Helmar C Lehmann, Gereon R Fink, Gilbert Wunderlich
History A 30-year-old man presented with a history of progressive muscle weakness, difficulty in concentrating, and a slender habitus since early childhood. Marfan syndrome was suspected since the age of 14. Examinations 13 years later he was examined by Marfan experts and by genetic testing and Marfan syndrome could not be confirmed. Further neurological examination revealed the suspected diagnosis of myotonic dystrophy type 1, which was confirmed by genetic testing. Treatment and course Similar to Marfan syndrome, myotonic dystrophy is a multisystemic disorder with the risk of cardiac arrythmias...
July 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28661107/-when-ultrasound-meets-the-internist
#8
REVIEW
David Katz, Ziv Dadon, Todd Zalut, Evan Avraham Alpert
Point-of-care ultrasound (POCUS) is an important modality with many advantages. At the Shaare Zedek Medical Centre, we developed a case-based course to teach POCUS to internal medicine residents and attendings. The topics include: "Introduction to Point-of-Care Ultrasound", "Focused Assessment with Sonography of Trauma", "Basic Cardiac, Pulmonary and Vascular Ultrasound", "Rapid Ultrasound in Shock" and "Ultrasound Guided Central Lines". The use of POCUS should aid in rapid diagnosis, decrease complications associated with bed-side procedures, and ultimately improve patient care...
June 2017: Harefuah
https://www.readbyqxmd.com/read/28657233/knowledge-attitude-and-practice-of-iranian-internists-regarding-diabetes-a-cross-sectional-study
#9
Mahtab Niroomand, Seyedeh Najmeh Ghasemi, Hamidreza Karimi-Sari, Mohammad Hossein Khosravi
BACKGROUND: A number of studies investigated the general practitioners' and family physicians' knowledge, attitude, and practice (KAP) on diabetes. However, studies on internists' KAP on diabetes management are limited. This study aimed to investigate the Iranian internists' KAP on diabetes mellitus and its management. METHODS: A cross-sectional study was conducted on a random sample of internists who participated in the 26th annual congress of internists in Tehran, Iran...
June 2017: Diabetes & Metabolism Journal
https://www.readbyqxmd.com/read/28653946/the-truth-on-current-peritoneal-dialysis-state-of-the-art
#10
R T Krediet, A C Abrahams, C W H de Fijter, M G H Betjes, W H Boer, B C van Jaarsveld, C J A M Konings, F W Dekker
The share of peritoneal dialysis (PD) in the spectrum of chronic dialysis has decreased markedly in the Netherlands in the last 15 years. Consequently, the knowledge of nephrologists and nursing staff on PD has declined leading to a negative spiral in which loss of experience resulted in loss of enthusiasm to offer PD to patients and also in less interest in the new PD developments. All these changes took place while the results of PD improved and patient survival was at least similar to that on haemodialysis...
June 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/28652958/lidocaine-induced-systemic-toxicity-a-case-report-and-review-of-literature
#11
Badar Hasan, Talal Asif, Maryam Hasan
For the past 50 years, local anesthetics such as lidocaine have been commonly used in various clinical settings. Its use is not just limited to anesthesia and surgery but is also frequently utilized in internal medicine and in primary care setting for bedside procedures. Despite its widespread use, most physicians are not familiar with the life-threatening manifestations of lidocaine toxicity and its treatment. Our case demonstrates a successful resuscitation after cardiac arrest in a healthy 33-year-old female with systemic lidocaine toxicity after she received lidocaine as a local anesthetic...
May 25, 2017: Curēus
https://www.readbyqxmd.com/read/28642002/development-of-geriatric-mental-health-learning-objectives-for-medical-students-a-response-to-the-institute-of-medicine-2012-report
#12
Susan W Lehmann, William B Brooks, Dennis Popeo, Kirsten M Wilkins, Mary C Blazek
America is aging as the population of older adults increases. The shortage of geriatric mental health specialists means that most geriatric mental healthcare will be provided by physicians who do not have specialty training in geriatrics. The Institute of Medicine Report of 2012 highlighted the urgent need for development of national competencies and curricula in geriatric mental health for all clinicians. Virtually all physicians can expect to treat older patients with mental health symptoms, yet currently there are no widely accepted learning objectives in geriatric mental health specific for medical students...
May 12, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28641809/re-emerging-infectious-diseases-from-the-past-hysteria-or-real-risk
#13
Charlier Philippe, Claverie Jean-Michel, Sansonetti Philippe, Coppens Yves, Augias Anaïs, Jacqueline Sophie, Rengot Fanny, Deo Saudamini
BACKGROUND: Work on human remains and old biological samples is a potential source of contamination by conventional or atypical infectious agents. Similarly, current and future environmental changes are a source of resurgence of ancient epidemic diseases. To what extent are anthropologists sorcerer apprentices (especially those working on ancient samples, i.e. paleo-anthropologists)? Are ancient skeletons, palaeosols and museum objects with a biological component at risk for current populations? Unless there are unfounded fears and undue risk… What can be learned from the recent scientific literature and the common sense of the researchers? METHODS: We have attempted to compile data from the literature and from our personal experience in the fields of anthropology, clinical medicine and epidemiology, in order to grasp the reality of the risk to the human population...
June 19, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28641352/-do-general-surgeons-feel-adequately-prepared-for-the-complex-questions-associated-with-the-handling-of-multi-resistant-pathogens-results-of-the-mr2-survey
#14
Matthias May, Philipp J Spachmann, Steffen Lebentrau, Harald Schumacher, Christian Gilfrich, Hans-Martin Fritsche, Malte Vetterlein, Sabine Brookman-May, Martin Schostak, Florian M Wagenlehner, Maximilian Burger, Alexander Novotny, Robert Obermaier
Background At the present time, there is no evidence available as to the knowledge of general surgeons regarding multi-resistant pathogens (MRP) and the rational use of antibiotic medication (antibiotic stewardship/ABS) compared with physicians from other disciplines. Methods As part of the MR2 survey (Multiinstitutional Reconnaissance of practice with MultiResistant bacteria - a survey focussing on German hospitals), a questionnaire comprising 4 + 35 items was distributed to urologists, internists, gynaecologists and general surgeons in 18 hospitals...
June 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28638567/nephrology-key-information-for-internists
#15
Sohail Abdul Salim, Juan A Medaura, Bharat Malhotra, Vishnu Garla, Shradha Ahuja, Nicki Lawson, Amaleswari Pamarthy, Hardik Sonani, Karthik Kovvuru, Venkataraman Palabindala
Hospitalists and primary care physicians encounter renal disease daily. Although most cases of acute kidney injury (AKI) are secondary to dehydration and resolve by giving fluids, many cases of AKI are due to not uncommon but unfamiliar causes needing nephrology evaluation. Common indications to consult a nephrologist on an emergency basis include hyperkalemia or volume overload in end stage renal disease patients (ESRD). Other causes of immediate consultation are cresenteric glomerulonephritis / rapidly progressive glomerulonephritis in which renal prognosis of the patient depends on timely intervention...
March 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28631068/autoinflammatory-diseases-with-periodic-fevers
#16
REVIEW
Erdal Sag, Yelda Bilginer, Seza Ozen
PURPOSE OF REVIEW: One purpose of this review was to raise awareness for the new autoinflammatory syndromes. These diseases are increasingly recognized and are in the differential diagnosis of many disease states. We also aimed to review the latest recommendations for the diagnosis, management, and treatment of these patients. RECENT FINDINGS: Familial Mediterranean fever (FMF), cryopyrin-associated periodic syndrome (CAPS), tumor necrosis factor receptor-associated periodic fever syndrome (TRAPS), and hyperimmunoglobulinemia D and periodic fever syndrome/mevalonate kinase deficiency (HIDS/MVKD) are the more common autoinflammatory diseases that are characterized by periodic fevers and attacks of inflammation...
July 2017: Current Rheumatology Reports
https://www.readbyqxmd.com/read/28628930/-rational-use-of-antibiotics-data-form-a-survey-from-2014-within-the-mrdo-network-compared-to-nationwide-data-from-2009
#17
Luba Lendowski, Peter Walger, Christoph Hoeser, Martin Exner, Claudia Roesing, Steffen Engelhart
Introduction To combat multi-resistant gram-negative bacteria as the cause of life-threatening infections, antibiotic stewardship activities are of great importance. Objective To detect weaknesses when prescribing antibiotics in hospitals and compare the situation between 2009 and 2014. Methods In 2014, a questionnaire was sent to all 380 physicians employed in 7 hospitals. Primary, secondary and tertiary care hospitals were included. Investigated were: demographic data, position, certified specialization, presence of antibiotic prescription rules and behavior to follow them...
June 19, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28624168/antibiotic-prescription-fills-for-acute-conjunctivitis-among-enrollees-in-a-large-united-states-managed-care-network
#18
Nakul S Shekhawat, Roni M Shtein, Taylor S Blachley, Joshua D Stein
PURPOSE: Antibiotics are seldom necessary to treat acute conjunctivitis. We assessed how frequently patients with newly diagnosed acute conjunctivitis fill prescriptions for topical antibiotics and factors associated with antibiotic prescription fills. DESIGN: Retrospective, observational cohort study. PARTICIPANTS: A total of 340 372 enrollees in a large nationwide United States managed care network with newly diagnosed acute conjunctivitis, from 2001 through 2014...
June 14, 2017: Ophthalmology
https://www.readbyqxmd.com/read/28623995/rationale-design-and-methodology-of-the-observational-insights-svt-study-on-the-current-state-of-care-and-outcomes-of-patients-with-superficial-vein-thrombosis
#19
Rupert Bauersachs, Horst Eberhard Gerlach, Andreas Heinken, Ulrich Hoffmann, Florian Langer, Thomas Noppeney, David Pittrow, Jens Klotsche, Eberhard Rabe
OBJECTIVE: Superficial vein thrombosis (SVT) is a common disease in clinical practice. In terms of pathophysiology and outcomes, the condition is related to venous thromboembolism, bearing a potential for severe thromboembolic complications if it is not treated adequately. A wide range of treatment approaches (including oral and injectable anticoagulants, pain medication, nondrug therapy including compression therapy, and no treatment at all) are applied in clinical practice, but there is sparse information about selection of patients for therapies, current treatment pathways, and drug use as well as outcomes...
July 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28623488/vasculitis-for-the-internist-focus-on-anca-associated-vasculitis
#20
REVIEW
Benjamin Chaigne, Loïc Guillevin
Vasculitides comprise several diseases affecting vessels of different sizes, mainly arteries, but also capillaries and veins. Antineutrophil cytoplasm antibody-associated vasculitides (AAVs) belong to the systemic necrotizing small-vessel vasculitis group that comprises granulomatosis with polyangiitis, microscopic polyangiitis and eosinophilic granulomatosis with polyangiitis. Internists often see AAV patients, and although their outcomes are usually good, the disease can be responsible for morbidity and mortality...
June 16, 2017: Internal and Emergency Medicine
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