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Clinical medicine

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https://www.readbyqxmd.com/read/28476644/autoantibody-mediated-diseases-of-the-cns-structure-dysfunction-and-therapy
#1
REVIEW
James Varley, Jennifer Taylor, Sarosh R Irani
The field of neuronal autoantibody associated diseases of the central nervous system has expanded dramatically in the last few years. The range of identified neuronal and glial antibody targets has led to the accurate classification of a number of syndromes which each associate with characteristic clinical features. These diseases are especially important due to their frequent response to immunotherapies. Antibodies against the N-methyl, d-aspartate receptor (NMDAR) and leucine-rich glioma inactivated 1 (LGI1) are the commonest autoantibodies known in patients with autoimmune forms of encephalitis...
May 3, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/28505667/early-versus-delayed-feeding-in-patients-with-acute-pancreatitis-a-systematic-review
#2
REVIEW
Valerie M Vaughn, Dmitry Shuster, Mary A M Rogers, Jason Mann, Marisa L Conte, Sanjay Saint, Vineet Chopra
Background: Acute pancreatitis is among the most common and costly reasons for hospitalization in the United States. Bowel rest, pain control, and intravenous fluids are the cornerstones of treatment, but early feeding might also be beneficial. Purpose: To compare length of hospital stay, mortality, and readmission in adults hospitalized with pancreatitis who received early versus delayed feeding. Data Sources: MEDLINE via Ovid, EMBASE, the Cochrane Library, CINAHL, and Web of Science through January 2017...
June 20, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28446982/management-of-chest-trauma
#3
REVIEW
Corinna Ludwig, Aris Koryllos
Trauma is the leading cause of death worldwide. Approximately 2/3 of the patients have a chest trauma with varying severity from a simple rib fracture to penetrating injury of the heart or tracheobronchial disruption. Blunt chest trauma is most common with 90% incidence, of which less than 10% require surgical intervention of any kind. Mortality is second highest after head injury, which underlines the importance of initial management. Many of these deaths can be prevented by prompt diagnosis and treatment...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28286222/2017-acc-aha-hrs-guideline-for%C3%A2-the%C3%A2-evaluation-and-management-of%C3%A2-patients-with-syncope-executive%C3%A2-summary-a-report-of-the-american-college-of-cardiology-american-heart-association-task-force-on-clinical-practice-guidelines-and-the-heart-rhythm-society
#4
Win-Kuang Shen, Robert S Sheldon, David G Benditt, Mitchell I Cohen, Daniel E Forman, Zachary D Goldberger, Blair P Grubb, Mohamed H Hamdan, Andrew D Krahn, Mark S Link, Brian Olshansky, Satish R Raj, Roopinder Kaur Sandhu, Dan Sorajja, Benjamin C Sun, Clyde W Yancy
No abstract text is available yet for this article.
August 1, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28242845/focal-segmental-glomerulosclerosis
#5
Avi Z Rosenberg, Jeffrey B Kopp
Focal segmental glomerulosclerosis (FSGS) is a leading cause of kidney disease worldwide. The presumed etiology of primary FSGS is a plasma factor with responsiveness to immunosuppressive therapy and a risk of recurrence after kidney transplant-important disease characteristics. In contrast, adaptive FSGS is associated with excessive nephron workload due to increased body size, reduced nephron capacity, or single glomerular hyperfiltration associated with certain diseases. Additional etiologies are now recognized as drivers of FSGS: high-penetrance genetic FSGS due to mutations in one of nearly 40 genes, virus-associated FSGS, and medication-associated FSGS...
March 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28097313/association-of-weekend-warrior-and-other-leisure-time-physical-activity-patterns-with-risks-for-all-cause-cardiovascular-disease-and-cancer-mortality
#6
Gary O'Donovan, I-Min Lee, Mark Hamer, Emmanuel Stamatakis
Importance: More research is required to clarify the association between physical activity and health in "weekend warriors" who perform all their exercise in 1 or 2 sessions per week. Objective: To investigate associations between the weekend warrior and other physical activity patterns and the risks for all-cause, cardiovascular disease (CVD), and cancer mortality. Design, Setting, and Participants: This pooled analysis of household-based surveillance studies included 11 cohorts of respondents to the Health Survey for England and Scottish Health Survey with prospective linkage to mortality records...
March 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28451853/management-of-hypertension-in-patients-with-chronic-kidney-disease
#7
REVIEW
Seyed Mehrdad Hamrahian
Hypertension is the leading factor in the global burden of disease. It is the predominant modifiable risk factor for stroke, heart disease, and kidney failure. Chronic kidney disease (CKD) is both a common cause and sequel of uncontrolled hypertension. The pathophysiology of CKD-associated hypertension is complex and multi-factorial. This paper reviews the key pathogenic mechanisms of CKD-associated hypertension, the importance of standardized blood pressure (BP) measurement in establishing the diagnosis and management plus the significance of ambulatory BP monitoring for assessment of diurnal BP variation commonly seen in CKD...
May 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28462125/helicobacter-pylori-and-cardiovascular-complications-a-mechanism-based-review-on-role-of-helicobacter-pylori-in-cardiovascular-diseases
#8
REVIEW
Prasad G Jamkhande, Surendra G Gattani, Shaikh Ayesha Farhat
Heart disease comprises a wide class of cardiovascular abnormalities, including ischemic heart disease, myocardial infarction, atherosclerosis, and coronary artery disease. It is the leading cause of death all over the world. Several traditional and novel risk factors, such as infectious and noninfectious agents, have been associated with heart disease. Out of these, Helicobacter pylori has been recently introduced as an important etiological factor for heart disease. Numerous seroepidemiological findings observed H...
December 2016: Integrative medicine research
https://www.readbyqxmd.com/read/28461007/2017-acc-aha-hfsa-focused-update-of-the-2013-accf-aha-guideline-for-the-management-of-heart-failure-a-report-of-the-american-college-of-cardiology-american-heart-association-task-force-on-clinical-practice-guidelines-and-the-heart-failure-society-of-america
#9
Clyde W Yancy, Mariell Jessup, Biykem Bozkurt, Javed Butler, Donald E Casey, Monica M Colvin, Mark H Drazner, Gerasimos S Filippatos, Gregg C Fonarow, Michael M Givertz, Steven M Hollenberg, JoAnn Lindenfeld, Frederick A Masoudi, Patrick E McBride, Pamela N Peterson, Lynne Warner Stevenson, Cheryl Westlake
No abstract text is available yet for this article.
April 21, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28439398/a-practical-approach-to-the-pharmacological-management-of-hypertension-in-older-people
#10
REVIEW
Nikesh Parekh, Amy Page, Khalid Ali, Kevin Davies, Chakravarthi Rajkumar
Hypertension is the leading cause of cardiovascular (CV) morbidity and mortality in adults over the age of 65. The first part of this paper is an overview, summarizing the current guidelines on the pharmacological management of hypertension in older adults in Europe and the USA, and evidence from key trials that contributed to the guidelines. In the second part of the paper, we will discuss the major challenges of managing hypertension in the context of multimorbidity, including frailty, orthostatic hypotension (OH), falls and cognitive impairment that are associated with ageing...
April 2017: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/28450367/atrial-fibrillation-epidemiology-pathophysiology-and-clinical-outcomes
#11
REVIEW
Laila Staerk, Jason A Sherer, Darae Ko, Emelia J Benjamin, Robert H Helm
The past 3 decades have been characterized by an exponential growth in knowledge and advances in the clinical treatment of atrial fibrillation (AF). It is now known that AF genesis requires a vulnerable atrial substrate and that the formation and composition of this substrate may vary depending on comorbid conditions, genetics, sex, and other factors. Population-based studies have identified numerous factors that modify the atrial substrate and increase AF susceptibility. To date, genetic studies have reported 17 independent signals for AF at 14 genomic regions...
April 28, 2017: Circulation Research
https://www.readbyqxmd.com/read/24275173/toxicologic-acid-base-disorders
#12
REVIEW
Sage W Wiener
Acid-base disorders may complicate the presentation of patients with poisoning. This article summarizes an approach to acid-base disorders from a toxicologic perspective. It aims to assist the reader in identifying underlying acid-base processes, generating a differential diagnosis for each, and approaching that differential diagnosis in a systematic fashion. Understanding these processes will help to guide management and interventional strategies.
February 2014: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/21814173/critical-care-nephrology-management-of-acid-base-disorders-with-crrt
#13
REVIEW
Jorge Cerdá, Ashita J Tolwani, David G Warnock
Normal acid-base homeostasis is severely challenged in the intensive care setting. In this review, we address acid-base disturbances, with a special focus on the use of continuous (rather than intermittent) extracorporeal technologies in critical ill patients with acute kidney injury. We consider hypercapnic acidosis and lactic acidosis as examples in which continuous modalities may have different roles and indications than the traditional intermittent approaches to renal replacement therapy. Hypercapnic acidosis develops as a consequence of alveolar hypoventilation...
July 2012: Kidney International
https://www.readbyqxmd.com/read/26011230/acid-base-disturbance-in-patients-with-cirrhosis-relation-to-hemodynamic-dysfunction
#14
Jens H Henriksen, Flemming Bendtsen, Søren Møller
PURPOSE: Acid-base disturbances were investigated in patients with cirrhosis in relation to hemodynamic derangement to analyze the hyperventilatory effects and the metabolic compensation. METHODS: A total of 66 patients with cirrhosis and 44 controls were investigated during a hemodynamic study. RESULTS: Hyperventilatory hypocapnia was present in all patients with cirrhosis and progressed from Child class A to C (P<0.01). Arterial pH increased significantly from class A to C (P<0...
August 2015: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/23884137/whole-body-acid-base-and-fluid-electrolyte-balance-a-mathematical-model
#15
Matthew B Wolf
A cellular compartment was added to our previous mathematical model of steady-state acid-base and fluid-electrolyte chemistry to gain further understanding and aid diagnosis of complex disorders involving cellular involvement in critically ill patients. An important hypothesis to be validated was that the thermodynamic, standard free-energy of cellular H(+) and Na(+) pumps remained constant under all conditions. In addition, a hydrostatic-osmotic pressure balance was assumed to describe fluid exchange between plasma and interstitial fluid, including incorporation of compliance curves of vascular and interstitial spaces...
October 15, 2013: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/17656477/use-of-the-deltaag-deltahco3-ratio-in-the-diagnosis-of-mixed-acid-base-disorders
#16
REVIEW
Asghar Rastegar
When a strong acid is added to plasma, one expects a quantitative relationship between excess anion gap (DeltaAG) and bicarbonate deficit (DeltaHCO(3)(-)) with the DeltaAG/DeltaHCO(3)(-) ratio close to unity. If true, then this ratio could be used to diagnose mixed acid-base disorders in patients with metabolic acidosis. Although the mean ratio in selected patients is close to unity, this ratio also has a wide range, making its use in individual patients problematic. The ratio should therefore be used cautiously in making a diagnosis of mixed acid-base disorders...
September 2007: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/25370778/drug-induced-acid-base-disorders
#17
REVIEW
Daniel Kitterer, Matthias Schwab, M Dominik Alscher, Niko Braun, Joerg Latus
The incidence of acid-base disorders (ABDs) is high, especially in hospitalized patients. ABDs are often indicators for severe systemic disorders. In everyday clinical practice, analysis of ABDs must be performed in a standardized manner. Highly sensitive diagnostic tools to distinguish the various ABDs include the anion gap and the serum osmolar gap. Drug-induced ABDs can be classified into five different categories in terms of their pathophysiology: (1) metabolic acidosis caused by acid overload, which may occur through accumulation of acids by endogenous (e...
September 2015: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/26410149/understanding-acid-base-disorders
#18
REVIEW
Hernando Gomez, John A Kellum
The concentration of hydrogen ions is regulated in biologic solutions. There are currently 3 recognized approaches to assess changes in acid base status. First is the traditional Henderson-Hasselbalch approach, also called the physiologic approach, which uses the relationship between HCO3(-) and Pco2; the second is the standard base excess approach based on the Van Slyke equation. The third approach is the quantitative or Stewart approach, which uses the strong ion difference and the total weak acids. This article explores the origins of the current concepts framing the existing methods to analyze acid base balance...
October 2015: Critical Care Clinics
https://www.readbyqxmd.com/read/22874469/acid-base-status-and-progression-of-chronic-kidney-disease
#19
REVIEW
Nimrit Goraya, Donald E Wesson
PURPOSE OF REVIEW: Most patients with reduced glomerular filtration rate (GFR) have progressive GFR decline despite currently recommended kidney-protective interventions. Recent studies support that dietary acid reduction with Na(+)-based alkali or food types that yield base when metabolized provides kidney protection that is additive to currently recommended interventions. We review these recent studies in light of current kidney-protective recommendations for chronic kidney disease (CKD)...
September 2012: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/23833313/the-serum-anion-gap-in-the-evaluation-of-acid-base-disorders-what-are-its-limitations-and-can-its-effectiveness-be-improved
#20
REVIEW
Jeffrey A Kraut, Glenn T Nagami
The serum anion gap has been utilized to identify errors in the measurement of electrolytes, to detect paraproteins, and, most relevant to the nephrologist, to evaluate patients with suspected acid-base disorders. In regard to the latter purpose, traditionally an increased anion gap is identified when it exceeds the upper limit of normal for a particular clinical laboratory measurement. However, because there is a wide range of normal values (often 8-10 mEq/L), an increase in anion concentration can be present in the absence of an increased anion gap...
November 2013: Clinical Journal of the American Society of Nephrology: CJASN
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