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Suzanne Lareau, Erika Moseson, Christopher G Slatore
No abstract text is available yet for this article.
December 1, 2018: American Journal of Respiratory and Critical Care Medicine
Marc Carrier, Karim Abou-Nassar, Ranjeeta Mallick, Vicky Tagalakis, Sudeep Shivakumar, Ariah Schattner, Philip Kuruvilla, Danny Hill, Silvana Spadafora, Katerine Marquis, Mateya Trinkaus, Anna Tomiak, Agnes Y Y Lee, Peter L Gross, Alejandro Lazo-Langner, Robert El-Maraghi, Glenwood Goss, Gregoire Le Gal, David Stewart, Timothy Ramsay, Marc Rodger, Debra Witham, Philip S Wells
BACKGROUND: Patients with active cancer have an increased risk of venous thromboembolism, which results in substantial morbidity, mortality, and health care expenditures. The Khorana score (range, 0 to 6, with higher scores indicating a higher risk of venous thromboembolism) has been validated to identify patients with cancer at elevated risk for this complication and may help select those who could benefit from thromboprophylaxis. METHODS: We conducted a randomized, placebo-controlled, double-blind clinical trial assessing the efficacy and safety of apixaban (2...
December 4, 2018: New England Journal of Medicine
Erwan Treillet, Sophie Laurent, Yacine Hadjiat
Purpose: To review the recent literature on opioid rotation (ie, switching from one opioid drug to another or changing an opioid's administration route) in cancer patients experiencing severe pain and to develop a novel equianalgesia table for use in routine clinical practice. Methods: The MEDLINE database was searched with terms "cancer pain," "opioid rotation," "opioid switching," "opioid ratio," "opioid conversion ratio," and "opioid equianalgesia" for the major opioids (morphine, oxycodone, fentanyl, and hydromorphone) and the intravenous, subcutaneous, oral, and transdermal administration routes...
2018: Journal of Pain Research
Jasmeet Soar, Gavin D Perkins, Ian Maconochie, Bernd W Böttiger, Charles D Deakin, Claudio Sandroni, Theresa M Olasveengen, Jonathan Wyllie, Robert Greif, Andrew Lockey, Federico Semeraro, Patrick Van de Voorde, Carsten Lott, Leo Bossaert, Koenraad G Monsieurs, Jerry P Nolan
This European Resuscitation Council (ERC) Guidelines for Resuscitation 2018 update is focused on the role of antiarrhythmic drugs during advanced life support for cardiac arrest with shock refractory ventricular fibrillation/pulseless ventricular tachycardia in adults, children and infants. This update follows the publication of the International Liaison Committee on Resuscitation (ILCOR) 2018 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations (CoSTR)...
November 26, 2018: Resuscitation
Or Kalchiem-Dekel, Jeffrey R Galvin, Allen P Burke, Sergei P Atamas, Nevins W Todd
Interstitial lung disease (ILD) and pulmonary fibrosis comprise a wide array of inflammatory and fibrotic lung diseases which are often confusing to general medicine and pulmonary physicians alike. In addition to the myriad of clinical and radiologic nomenclature used in ILD, histopathologic descriptors may be particularly confusing, and are often extrapolated to radiologic imaging patterns which may further add to the confusion. We propose that rather than focusing on precise histologic findings, focus should be on identifying an accurate etiology of ILD through a comprehensive and detailed medical history...
November 24, 2018: Journal of Clinical Medicine
Mark W Elliott
Audits and case reviews of the acute delivery of non-invasive ventilation (NIV) have shown that the results achieved in real life often fall short of those achieved in research trials. Factors include inappropriate selection of patients for NIV and failure to apply NIV correctly. This highlights the need for proper training of all involved individuals. This article addresses the different skills needed in a team to provide an effective NIV service. Some detail is given in each of the key areas but it is not comprehensive and should stimulate further learning (reading, attendance on courses, e-learning, etc...
November 23, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
Rachel Brown, Lionel Ginsberg
POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes) is a rare paraneoplastic syndrome, caused by a plasma cell proliferative disorder, which is most commonly lambda restricted. The neurological hallmark, which forms one of the mandatory criteria for diagnosis, is a subacute onset demyelinating neuropathy, which can be rapidly disabling and painful. A number of multi-system features are also characteristic of this disorder, and certainly not restricted to those included in its acronym, which though limited, remains a useful and memorable name, helping distinguish POEMS syndrome from other paraproteinaemic neuropathies...
November 29, 2018: Journal of Neurology
Sri Lekha Tummalapalli
No abstract text is available yet for this article.
October 25, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Jan F Scheitz, Christian H Nolte, Wolfram Doehner, Vladimir Hachinski, Matthias Endres
Cardiac complications are a frequent medical problem during the first few days after an ischaemic stroke, and patients present with a broad range of symptoms including myocardial injury, cardiac dysfunction, and arrhythmia, with varying overlap between these three conditions. Evidence from clinical and neuroimaging studies and animal research suggests that these cardiac disturbances share the same underlying mechanisms. Although the exact cascade of events has yet to be elucidated, stroke-induced functional and structural alterations in the central autonomic network, with subsequent dysregulation of normal neural cardiac control, are the assumed pathophysiology...
December 2018: Lancet Neurology
Bertrand Guidet, Helene Vallet, Jacques Boddaert, Dylan W de Lange, Alessandro Morandi, Guillaume Leblanc, Antonio Artigas, Hans Flaatten
BACKGROUND: There is currently no international recommendation for the admission or treatment of the critically ill older patients over 80 years of age in the intensive care unit (ICU), and there is no valid prognostic severity score that includes specific geriatric assessments. MAIN BODY: In this review, we report recent literature focusing on older critically ill patients in order to help physicians in the multiple-step decision-making process. It is unclear under what conditions older patients may benefit from ICU admission...
November 26, 2018: Annals of Intensive Care
Noémie Kraaijpoel, Marc Carrier
Venous thromboembolism, which includes deep vein thrombosis and pulmonary embolism, is a common complication of cancer and is associated with significant morbidity and mortality. Several cancer-related risk factors contribute to the development of venous thromboembolism including cancer type/stage, chemotherapy, surgery, and patient-related factors such as advanced age and immobilization. Patients with cancer frequently undergo diagnostic imaging scans for cancer staging and treatment response evaluation, which is increasing the underlying risk of venous thromboembolism detection...
November 26, 2018: Blood
Leonard G Feld, Daniel R Neuspiel, Byron A Foster, Michael G Leu, Matthew D Garber, Kelly Austin, Rajit K Basu, Edward E Conway, James J Fehr, Clare Hawkins, Ron L Kaplan, Echo V Rowe, Muhammad Waseem, Michael L Moritz
Maintenance intravenous fluids (IVFs) are used to provide critical supportive care for children who are acutely ill. IVFs are required if sufficient fluids cannot be provided by using enteral administration for reasons such as gastrointestinal illness, respiratory compromise, neurologic impairment, a perioperative state, or being moribund from an acute or chronic illness. Despite the common use of maintenance IVFs, there is high variability in fluid prescribing practices and a lack of guidelines for fluid composition administration and electrolyte monitoring...
November 26, 2018: Pediatrics
Corey Heitz, Justin Morgenstern, Christopher Bond, William K Milne
Ketamine has been studied as an alternative to opioids for acute pain in the emergency department setting. This review compares the effectives of intravenous ketamine at a dose of <0.5mg/kg to opioids for acute pain in adult patients. Measurements were taken within 60 minutes of administration. Ketamine was found to have similar effectiveness to opioids. Increased, but short-lived, side effects were seen with ketamine.
November 27, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Matthew James Reed
Syncope is a common reason for ED attendance and it presents a major management challenge with regard to the appropriate workup and disposition. Nearly 50% of patients are admitted, and for many this is unnecessary; clinical decision rules have not proven to decrease unnecessary admissions. The European Society of Cardiology has recently developed guidance for managing syncope in the ED. This article highlights the key steps in evaluating syncope in the ED, factors involved in determining risk of a cardiac cause, and considerations for admission, observation or discharge...
November 23, 2018: Emergency Medicine Journal: EMJ
Sandeep R Das, Brendan M Everett, Kim K Birtcher, Jenifer M Brown, William T Cefalu, James L Januzzi, Rita Rastogi Kalyani, Mikhail Kosiborod, Melissa L Magwire, Pamela B Morris, Laurence S Sperling
No abstract text is available yet for this article.
November 24, 2018: Journal of the American College of Cardiology
Yu Jie Chen, Liang Jin Li, Wen Lu Tang, Jia Yang Song, Ru Qiu, Qian Li, Hao Xue, James M Wright
BACKGROUND: This is the first update of a Cochrane Review first published in 2015. Renin angiotensin system (RAS) inhibitors include angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs) and renin inhibitors. They are widely prescribed for treatment of hypertension, especially for people with diabetes because of postulated advantages for reducing diabetic nephropathy and cardiovascular morbidity and mortality. Despite widespread use for hypertension, the efficacy and safety of RAS inhibitors compared to other antihypertensive drug classes remains unclear...
November 14, 2018: Cochrane Database of Systematic Reviews
Jordan D Bohnen, Keith D Lillemoe, Elizabeth A Mort, Haytham M A Kaafarani
No abstract text is available yet for this article.
November 22, 2018: Annals of Surgery
Maria Vargas, Giuseppe Servillo
No abstract text is available yet for this article.
December 2018: Critical Care Medicine
C Michael Valentine, James E Tcheng, Thad Waites
No abstract text is available yet for this article.
November 27, 2018: Journal of the American College of Cardiology
W J Fawcett, M Thomas
It is widely recognised that prolonged fasting for elective surgery in both children and adults serves no purpose, adversely affects patient well-being and can be detrimental. Although advised fasting times for solids remain unchanged, there is good evidence to support a 1-h fast for children, with no increase in risk of pulmonary aspiration. In adults, a major focus has been the introduction of carbohydrate loading before anaesthesia, so that patients arrive for surgery not only hydrated but also in a more normal metabolic state...
November 30, 2018: Anaesthesia
2018-12-10 00:24:58
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