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https://www.readbyqxmd.com/read/29782261/-chronic-kidney-disease-as-basis-of-high-thrombotic-and-bleeding-risk-in-patients-with-atrial-fibrillation-place-of-oral-anticoagulants
#1
A G Obrezan, A Y Zemchenkov
Chronic kidney disease (CKD) aggravates course of practically all diseases by worsening outcomes and hindering adequate treatment. Specificities of renal excretion of various drugs, changes of parameters of their pharmacokinetics and pharmacodynamics, nephrotoxic effects of drugs, tactics of drug therapy in conditions of CKD, terminal stage of kidney failure and dialysis are in the focus of attention of internists. To a greatest degree difficulties of drug therapy in CKD and associated clinical states refer to the group of anticoagulants...
April 2018: Kardiologiia
https://www.readbyqxmd.com/read/29768977/primary-care-physicians-perceptions-of-practice-improvement-as-a-professional-responsibility-a-cross-sectional-study
#2
Christopher R Stephenson, Christopher M Wittich, Joel E Pacyna, Matthew K Wynia, Omar Hasan, Jon C Tilburt
Continuous quality improvement is a component of professionalism. Maintenance of Certification (MOC) is a mechanism in the USA for physicians to keep current with medical knowledge and contribute to practice improvement. Little is known about primary care physicians' perceptions of the practice improvement (Part IV) components of MOC. We aimed to determine primary care physicians' perceptions of their professional responsibility to participate in Part IV MOC. This was a cross-sectional study of primary care physicians using the American Medical Association Masterfile...
December 2018: Medical Education Online
https://www.readbyqxmd.com/read/29761681/milestones-in-the-development-of-fetal-cardiac-interventions
#3
REVIEW
Edward G Abinader
Cardiac patients of all ages were managed in the past by internists who specialized in cardiology. During the past 50 years, the medical field has witnessed great strides in the management of congenital heart disease, and thus pediatric cardiology has become a subspecialty in many countries. This review article focuses on the advances in fetal cardiac interventions (FCI) since its inception by our group in 1975. Three major modes of FCI have evolved during the past 42 years: pharmacologic, closed FCI, and open FCI...
May 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29759117/current-evidence-based-understanding-of-the-epidemiology-prevention-and-treatment-of-atrial-fibrillation
#4
Paul A Rogers, Michael L Bernard, Christopher Madias, Sudarone Thihalolipavan, N A Mark Estes, Daniel P Morin
Atrial fibrillation (AF) is the most common atrial arrhythmia in adults worldwide. As medical advancements continue to contribute to an ever-increasing aging population, the burden of atrial fibrillation on the modern health care system continues to increase. Therapies are also evolving, for treatment of the arrhythmia itself, and stroke risk mitigation. Internists and cardiologists alike are, in most instances, the frontline contact for AF patients, and would benefit from remaining facile in their understanding of care options...
June 2018: Current Problems in Cardiology
https://www.readbyqxmd.com/read/29745441/appropriateness-of-oral-anticoagulant-therapy-prescription-and-its-associated-factors-in-hospitalized-older-people-with-atrial-fibrillation
#5
Carlotta Franchi, Stefania Antoniazzi, Marco Proietti, Alessandro Nobili, Pier Mannuccio Mannucci
BACKGROUND: Oral anticoagulants (OACs) are effective in preventing stroke in older people with atrial fibrillation (AF). Despite this, they are often underused in this at particularly high risk population. OBJECTIVES: To assess the appropriateness of OAC prescription and its associated factors in hospitalized patients aged 65 years or older. METHODS: Data were obtained from the retrospective phase of SIM-AF study, held in 32 Italian internal medicine and geriatric wards...
May 10, 2018: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29728145/transition-to-international-classification-of-disease-version-10-clinical-modification-the-impact-on-internal-medicine-and-internal-medicine-subspecialties
#6
Rachel N Caskey, Angelos Abutahoun, Anne Polick, Michelle Barnes, Pavan Srivastava, Andrew D Boyd
BACKGROUND: The US health care system uses diagnostic codes for billing and reimbursement as well as quality assessment and measuring clinical outcomes. The US transitioned to the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) on October, 2015. Little is known about the impact of ICD-10-CM on internal medicine and medicine subspecialists. METHODS: We used a state-wide data set from Illinois Medicaid specified for Internal Medicine providers and subspecialists...
May 4, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29709455/the-approach-to-peripartum-management-of-anticoagulation-a-multidisciplinary-survey
#7
Sagar Rohailla, Ann Kinga Malinowski, Shital Gandhi, Anne McLeod, Rosane Nisenbaum, Nadine Shehata
OBJECTIVE: This study sought to determine whether there is practice variation in the treatment and prevention of acute venous thromboembolism (VTE) in pregnant patients, potentially to prioritize future studies. BACKGROUND: The risk of VTE during pregnancy is five-fold that of the non-pregnant state. Guidance is often lacking for the treatment and prophylaxis of VTE because there are few RCTs. METHODS: The study used a cross-sectional study design using a self-administered electronic questionnaire consisting of 11 case scenarios that were sent to hematologists, maternal-fetal medicine specialists, obstetricians and gynaecologists, and internal medicine specialists across Canada...
April 27, 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29688570/diffuse-large-b-cell-lymphoma-chemotherapy-reveals-a-combined-immunodeficiency-syndrome-in-cartilage-hair-hypoplasia
#8
Alexandre Nguyen, Nicolas Martin Silva, Hubert de Boysson, Gandhi Damaj, Achille Aouba
Cartilage hair hypoplasia (CHH) is a rare autosomal recessive ribosomopathy characterised by skeletal and integumentary system manifestations. It may also present with varied forms and intensities of haematopoietic and/or immune disorders. We report a 27-year-old female who presented a picture of combined immunodeficiency after receiving an adriamycin-based chemotherapy regimen followed by autologous stem cell transplantation. Her medical history indicated neonatal dwarfism, recurrent ear, nose and throat and respiratory infections, and hypogammaglobulinaemia, which were suggestive of a primary minor B-cell immune deficiency...
April 24, 2018: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29686789/a-case-of-spontaneous-coronary-artery-dissection-presenting-with-acute-anterior-wall-myocardial-infarction-in-a-young-adult-male-an-increasingly-recognized-rare-disease
#9
Mohamed Taha, Htun Latt, Jaafar Al-Khafaji, Mohamed Ali, Richard Seher
Background : Spontaneous coronary artery dissection (SCAD) is increasingly recognized as an important cause of myocardial infarction and sudden death. Although some correlations have been noted in relation to aetiology, no direct causes have been identified in a large number of patients. Most of the patients are women in peripartum period or of childbearing age, with few if any risk factors for coronary heart disease. In men, however, risk factors for atherosclerosis are more prevalent in cases of SCAD Case report : We report a case of a 43-years-old healthy male, with no known risk factors, who presented with ischemic chest pain and elevated troponin levels...
2018: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29686758/feedback-credibility-in-a-formative-postgraduate-objective-structured-clinical-examination-effects-of-examiner-type
#10
Lynfa Stroud, Matthew Sibbald, Denyse Richardson, Heather McDonald-Blumer, Rodrigo B Cavalcanti
Background : Resident perspectives on feedback are key determinants of its acceptance and effectiveness, and provider credibility is a critical element in perspective formation. It is unclear what factors influence a resident's judgment of feedback credibility. Objective : We examined how residents perceive the credibility of feedback providers during a formative objective structured clinical examination (OSCE) in 2 ways: (1) ratings of faculty examiners compared with standardized patient (SP) examiners, and (2) ratings of faculty examiners based on alignment of expertise and station content...
April 2018: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/29683728/healthcare-providers-attitudes-and-behaviours-related-to-paediatric-mild-traumatic-brain-injury-results-from-the-2014-docstyles-survey
#11
Kelly Sarmiento, Zoe Donnell, Rosanne Hoffman, Bethany Tennant
OBJECTIVE: Explore healthcare providers' experiences managing mTBI and better understand their use of mTBI assessment tools and guidelines. Cross-sectional Methods: A random sample of 1,760 healthcare providers responded to the web-based DocStyles survey between June 18 and 30, 2014. The sample included family/general practitioners, internists, pediatricians, and nurse practitioners who reported seeing pediatric patients. We examined their experiences with mTBI to identify opportunities to increase preparedness and improve management of mTBI...
April 23, 2018: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29673918/-day-hospital-in-internal-medicine-a-chance-for-ambulatory-care
#12
A Grasland, E Mortier
INTRODUCTION: Internal medicine is an in-hospital speciality. Along with its expertise in rare diseases, it shares with general medicine the global care of patients but its place in the ambulatory shift has yet to be defined. The objective of our work was to evaluate the benefits of an internal medicine day-hospital devoted to general medicine. METHODS: Named "Centre Vi'TAL" to underline the link between the city and the hospital, this novel activity was implemented in order to respond quickly to general practitioners having difficulties to synthesize their complex patients or facing diagnostic or therapeutic problems...
April 16, 2018: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/29661692/hospital-ambulatory-medicine-a-leading-strategy-for-internal-medicine-in-europe
#13
Xavier Corbella, Vasco Barreto, Stefano Bassetti, Monica Bivol, Pietro Castellino, Evert-Jan de Kruijf, Francesco Dentali, Mine Durusu-Tanriöver, Carmen Fierbinţeanu-Braticevici, Thomas Hanslik, Radovan Hojs, Soňa Kiňová, Leonid Lazebnik, Evija Livčāne, Matthias Raspe, Luis Campos
Addressing the current collision course between growing healthcare demands, rising costs and limited resources is an extremely complex challenge for most healthcare systems worldwide. Given the consensus that this critical reality is unsustainable from staff, consumer, and financial perspectives, our aim was to describe the official position and approach of the Working Group on Professional Issues and Quality of Care of the European Federation of Internal Medicine (EFIM), for encouraging internists to lead a thorough reengineering of hospital operational procedures by the implementation of innovative hospital ambulatory care strategies...
April 13, 2018: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29660234/evaluation-of-chronic-kidney-disease-in-cancer-patients-is-there-a-preferred-estimation-formula
#14
Ghassan Sleilalty, Elie El Rassy, Tarek Assi, Nathalie Al Rassy, Jessica Naseh, Jamale Rizkallah, Serge Finianos, Hiba Azar, Dania Nehme Chelala, Fadi El Karak, Joseph Kattan, Marwan Ghosn
BACKGROUND: The evaluation of chronic kidney disease in cancer patients seems to rely mostly on the Cockcroft-Gault (CG) formula or the creatinine levels to adjust treatment dosages which is a practice refuted by internists. AIMS: We evaluate the overall agreement of the CG, MDRD and CKD-EPI equation with the newly devised Janowitz and Williams' (JW) equation. METHODS: The renal function was estimated in 235 cancer patients according to the CG, MDRD, body surface area (BSA)-adjusted MDRD, CKD-EPI, BSA-adjusted CKD-EPI and JW formulae...
April 16, 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29658209/upper-extremity-deep-vein-thrombosis-symptoms-diagnosis-and-treatment
#15
REVIEW
Jaber Mustafa, Ilan Asher, Zev Sthoeger
Upper extremity deep vein thrombosis (UEDVT) is defined as thrombosis of the deep venous system (subclavian, axillary, brachial, ulnar, and radial veins), which drains the upper extremities. It can be caused by thoracic outlet anatomic obstruction, such as Paget-Schroetter syndrome, (primary) or by central intravenous catheters (secondary). UEDVT may be asymptomatic or present with acute severe pain and arm swelling. Clinical suspicion should be confirmed by diagnostic imaging procedures such as duplex ultrasound, computed tomography scan, or magnetic resonance imaging...
January 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29623173/spontaneous-closure-of-a-secundum-atrial-septal-defect
#16
Stephen Y Wang, Terrence D Welch, Aryé Elfenbein, Aaron V Kaplan
Spontaneous closure of an atrial septal defect (ASD) is well described in pediatric cardiology but may be less familiar to adult internists and cardiologists. We report a moderately sized 6-mm ASD that closed spontaneously without intervention. A literature review found that a smaller defect size and an early age of diagnosis are the most important predictors of closure. Possible mechanisms of a spontaneous ASD closure include adaptive endothelial migration, limited myocardial proliferation, and fibroblast migration with extracellular matrix deposition...
January 2018: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29619767/on-being-an-internist-in-emergency-medicine-a-rare-case-of-epigastric-pain
#17
Annalisa Marchetti, Vincenzo Zaccone, Lorenzo Nobili, Cinzia Nitti, Aldo Salvi
No abstract text is available yet for this article.
April 4, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29614530/-work-and-training-conditions-of-young-german-physicians-in-internal-medicine-results-of-a-second-nationwide-survey-by-young-internists-from-the-german-society-of-internal-medicine-and-the-german-professional-association-of-internists
#18
Matthias Raspe, Anja Vogelgesang, Johannes Fendel, Cornelius Weiß, Kevin Schulte, Thierry Rolling
BACKGROUND:  Medical specialty training is the basis for career development of young internists and it is vital for the delivery of high-quality medical care. In 2014 the young internists of two professional bodies in Germany conducted a survey among their young members and described major factors influencing training and working conditions. We present the results of a follow-up survey to describe changes of these factors over time. An additional focus is set on the difficulties of balancing medical career and family...
April 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29610003/-therapeutic-strategy-for-the-treatment-of-non-infectious-uveitis-proposed-by-an-expert-panel
#19
E Diwo, P Sève, S Trad, P Bielefeld, D Sène, S Abad, A Brézin, P Quartier, I Koné Paut, M Weber, C Chiquet, M H Errera, J Sellam, P Cacoub, G Kaplanski, L Kodjikian, B Bodaghi, D Saadoun
Conventional immunosuppressive drugs, anti-TNF alpha and other biotherapies used in clinical practice are capable of controlling non-infectious anterior uveitis, posterior uveitis and panuveitis. The present work has been led by a multidisciplinary panel of experts, internists, rheumatologists and ophthalmologists and is based on a review of the literature. In case of corticodependency or sight-threatening disease, conventional immunosuppressive drugs (methotrexate, azathioprine and mycophenolate mofetil) and/or anti-TNF alpha (adalimumab, infliximab) are used to achieve and maintain remission...
March 30, 2018: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/29607297/timing-of-anticoagulation-for-portal-vein-thrombosis-in-liver-cirrhosis-an-italian-internist-s-perspective
#20
Nicoletta Riva, Walter Ageno
No abstract text is available yet for this article.
March 2018: Journal of Translational Internal Medicine
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