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Lukas Martin, Matthias Derwall, Sura Al Zoubi, Elisabeth Zechendorf, Daniel A Reuter, Chris Thiemermann, Tobias Schuerholz
Septic cardiomyopathy is a key feature of sepsis-associated cardiovascular failure. Despite the lack of consistent diagnostic criteria, patients typically exhibit ventricular dilatation, reduced ventricular contractility and/or both right and left ventricular dysfunction with a reduced response to volume infusion. Although there is solid evidence that the presence of septic cardiomyopathy is a relevant contributor to organ dysfunction and an important factor in the already-complicated therapeutic management of septic patients, there are still several questions to be asked: Which factors/mechanisms cause a cardiac dysfunction associated with sepsis? How do we diagnose septic cardiomyopathy? How do we treat septic cardiomyopathy? How does septic cardiomyopathy influence the long-term outcome of the patient? Each of these questions is interrelated, and the answers require a profound understanding of the underlying pathophysiology that involves a complex mix of systemic factors and molecular, metabolic, and structural changes of the cardiomyocyte...
August 29, 2018: Chest
Beatrice C Lupsa, Silvio E Inzucchi
Sodium-glucose cotransporter 2 (SGLT2) inhibitors belong to a novel class of glucose-lowering medications that reduce plasma glucose concentrations by inhibiting glucose reabsorption by the kidney, inducing glucosuria. Their actions encompass reductions in HbA1c , fasting and postprandial blood glucose levels, body weight and BP. To date, empagliflozin and canagliflozin have additionally been shown to improve cardiovascular outcomes in high-risk individuals and to slow the progression of diabetic kidney disease...
October 2018: Diabetologia
Miguel Sousa-Uva, Franz-Josef Neumann, Anders Ahlsson, Fernando Alfonso, Adrian P Banning, Umberto Benedetto, Robert A Byrne, Jean-Philippe Collet, Volkmar Falk, Stuart J Head, Peter Jüni, Adnan Kastrati, Akos Koller, Steen D Kristensen, Josef Niebauer, Dimitrios J Richter, Petar M Seferovic, Dirk Sibbing, Giulio G Stefanini, Stephan Windecker, Rashmi Yadav, Michael O Zembala
No abstract text is available yet for this article.
August 27, 2018: European Journal of Cardio-thoracic Surgery
Rory Spiegel, Joshua D Farkas, Philippe Rola, Jon-Emile Kenny, Segun Olusanya, Paul E Marik, Scott D Weingart
No abstract text is available yet for this article.
August 30, 2018: Annals of Emergency Medicine
Randy A Taplitz, Erin B Kennedy, Eric J Bow, Jennie Crews, Charise Gleason, Douglas K Hawley, Amelia A Langston, Loretta J Nastoupil, Michelle Rajotte, Kenneth V Rolston, Lynne Strasfeld, Christopher R Flowers
Purpose To provide an updated joint ASCO/Infectious Diseases Society of America (IDSA) guideline on antimicrobial prophylaxis for adult patients with immunosuppression associated with cancer and its treatment. Methods ASCO and IDSA convened an update Expert Panel and conducted a systematic review of relevant studies from May 2011 to November 2016. The guideline recommendations were based on the review of evidence by the Expert Panel. Results Six new or updated meta-analyses and six new primary studies were added to the updated systematic review...
September 4, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
J Michael Miller, Matthew J Binnicker, Sheldon Campbell, Karen C Carroll, Kimberle C Chapin, Peter H Gilligan, Mark D Gonzalez, Robert C Jerris, Sue C Kehl, Robin Patel, Bobbi S Pritt, Sandra S Richter, Barbara Robinson-Dunn, Joseph D Schwartzman, James W Snyder, Sam Telford, Elitza S Theel, Richard B Thomson, Melvin P Weinstein, Joseph D Yao
The critical nature of the microbiology laboratory in infectious disease diagnosis calls for a close, positive working relationship between the physician/advanced practice provider and the microbiologists who provide enormous value to the healthcare team. This document, developed by experts in laboratory and adult and pediatric clinical medicine, provides information on which tests are valuable and in which contexts, and on tests that add little or no value for diagnostic decisions. This document presents a system-based approach rather than specimen-based approach, and includes bloodstream and cardiovascular system infections, central nervous system infections, ocular infections, soft tissue infections of the head and neck, upper and lower respiratory infections, infections of the gastrointestinal tract, intra-abdominal infections, bone and joint infections, urinary tract infections, genital infections, and other skin and soft tissue infections; or into etiologic agent groups, including arthropod-borne infections, viral syndromes, and blood and tissue parasite infections...
August 31, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Jo Caers, Laurent Garderet, K Martin Kortüm, Michael E O'Dwyer, Niels W C J van de Donk, Mascha Binder, Sandra Maria Dold, Francesca Gay, Jill Corre, Yves Beguin, Heinz Ludwig, Alessandra Larocca, Christoph Driessen, Meletios A Dimopoulos, Mario Boccadoro, Martin Gramatzki, Sonja Zweegman, Hermann Einsele, Michele Cavo, Hartmut Goldschmidt, Pieter Sonneveld, Michel Delforge, Holger W Auner, Evangelos Terpos, Monika Engelhardt
The diagnosis of multiple myeloma can be challenging, even for experienced physicians, and requires close collaboration between multiple disciplines (orthopedics, radiology, nuclear medicine, radiation therapy, hematology and oncology) before the final diagnosis of myeloma is made. The definition of multiple myeloma is based on the presence of clinical, biochemical, histo-pathological, and radiological disease markers. At presentation and during follow-up, specific tests are needed for exact disease characterization and correct diagnosis...
August 31, 2018: Haematologica
Carmine Zoccali, Francesca Mallamaci
No abstract text is available yet for this article.
September 3, 2018: American Journal of Nephrology
Muhammad Asif, Iqbal Ahmad Alvi, Shafiq Ur Rehman
Acinetobacter baumannii , once considered a low-category pathogen, has emerged as an obstinate infectious agent. The scientific community is paying more attention to this pathogen due to its stubbornness to last resort antimicrobials, including carbapenems, colistin, and tigecycline, its high prevalence of infections in the hospital setting, and significantly increased rate of community-acquired infections by this organism over the past decade. It has given the fear of pre-antibiotic era to the world. To further enhance our understanding about this pathogen, in this review, we discuss its taxonomy, pathogenesis, current treatment options, global resistance rates, mechanisms of its resistance against various groups of antimicrobials, and future therapeutics...
2018: Infection and Drug Resistance
G Williams, A Williams, P Tozer, R Phillips, A Ahmad, D Jayne, C Maxwell-Armstrong
It is over 10 years since the first ACPGBI Position Statement on the management of anal fistula was published in 2007. This second edition is the result of scrutiny of the literature published during this time; it updates the original Position Statement and reviews the published evidence surrounding treatments for anal fistula that have been developed since the original publication.
July 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Michael Y Mi, Michael A Matthay, Alan H Morris
New England Journal of Medicine, Volume 379, Issue 9, Page 884-887, August 2018.
August 30, 2018: New England Journal of Medicine
(no author information available yet)
No abstract text is available yet for this article.
September 2018: Diabetes Care
Kasper Iversen, Nikolaj Ihlemann, Sabine U Gill, Trine Madsen, Hanne Elming, Kaare T Jensen, Niels E Bruun, Dan E Høfsten, Kurt Fursted, Jens J Christensen, Martin Schultz, Christine F Klein, Emil L Fosbøll, Flemming Rosenvinge, Henrik C Schønheyder, Lars Køber, Christian Torp-Pedersen, Jannik Helweg-Larsen, Niels Tønder, Claus Moser, Henning Bundgaard
Background Patients with infective endocarditis on the left side of the heart are typically treated with intravenous antibiotic agents for up to 6 weeks. Whether a shift from intravenous to oral antibiotics once the patient is in stable condition would result in efficacy and safety similar to those with continued intravenous treatment is unknown. Methods In a randomized, noninferiority, multicenter trial, we assigned 400 adults in stable condition who had endocarditis on the left side of the heart caused by streptococcus, Enterococcus faecalis, Staphylococcus aureus, or coagulase-negative staphylococci and who were being treated with intravenous antibiotics to continue intravenous treatment (199 patients) or to switch to oral antibiotic treatment (201 patients)...
August 28, 2018: New England Journal of Medicine
Kristian Thygesen, Joseph S Alpert, Allan S Jaffe, Bernard R Chaitman, Jeroen J Bax, David A Morrow, Harvey D White
No abstract text is available yet for this article.
August 23, 2018: Journal of the American College of Cardiology
Faiez Zannad, Stefan D Anker, William M Byra, John G F Cleland, Min Fu, Mihai Gheorghiade, Carolyn S P Lam, Mandeep R Mehra, James D Neaton, Christopher C Nessel, Theodore E Spiro, Dirk J van Veldhuisen, Barry Greenberg
Background Heart failure is associated with activation of thrombin-related pathways, which predicts a poor prognosis. We hypothesized that treatment with rivaroxaban, a factor Xa inhibitor, could reduce thrombin generation and improve outcomes for patients with worsening chronic heart failure and underlying coronary artery disease. Methods In this double-blind, randomized trial, 5022 patients who had chronic heart failure, a left ventricular ejection fraction of 40% or less, coronary artery disease, and elevated plasma concentrations of natriuretic peptides and who did not have atrial fibrillation were randomly assigned to receive rivaroxaban at a dose of 2...
August 27, 2018: New England Journal of Medicine
Yale A Fillingham, Dipak B Ramkumar, David S Jevsevar, Adolph J Yates, Stefano A Bini, Henry D Clarke, Emil Schemitsch, Rebecca L Johnson, Stavros G Memtsoudis, Siraj A Sayeed, Alexander P Sah, Craig J Della Valle
No abstract text is available yet for this article.
October 2018: Journal of Arthroplasty
Claudio Sandroni, Paolo De Santis, Sonia D'Arrigo
Successful resuscitation from cardiac arrest depends on provision of adequate blood flow to vital organs generated by cardiopulmonary resuscitation (CPR). Measurement of end-tidal expiratory pressure of carbon dioxide (ETCO2 ) using capnography provides a noninvasive estimate of cardiac output and organ perfusion during cardiac arrest and can therefore be used to monitor the quality of CPR and predict return of spontaneous circulation (ROSC). In clinical observational studies, mean ETCO2 levels in patients with ROSC are higher than those in patients with no ROSC...
August 22, 2018: Resuscitation
Melissa A Hornor, Therese M Duane, Anne P Ehlers, Eric H Jensen, Paul S Brown, Dieter Pohl, Paulo M da Costa, Clifford Y Ko, Christine Laronga
No abstract text is available yet for this article.
August 23, 2018: Journal of the American College of Surgeons
(no author information available yet)
A frequent complication in liver cirrhosis is malnutrition, which is associated with the progression of liver failure, and with a higher rate of complications including infections, hepatic encephalopathy and ascites. In recent years, the rising prevalence of obesity has led to an increase in the number of cirrhosis cases related to non-alcoholic steatohepatitis. Malnutrition, obesity and sarcopenic obesity may worsen the prognosis of patients with liver cirrhosis and lower their survival. Nutritional monitoring and intervention is therefore crucial in chronic liver disease...
August 22, 2018: Journal of Hepatology
Armin Ahmed, Afzal Azim
Background: Endotracheal intubation in critically ill is a high-risk procedure requiring significant expertise in airway handling as well as understanding of pathophysiology of the disease process. Main body: Critically ill patients are prone for hypotension and hypoxemia in the immediate post-intubation phase due to blunting of compensatory sympathetic response. Preoxygenation without NIV is frequently suboptimal, as alveolar flooding cause loss of alveolar capillary interface in many of these patients...
2018: Journal of Intensive Care
2018-09-10 00:24:59
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