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By Inessa Yurtsev RN graduated in 2008 from SFSU with Bachelor degree in nursing. I work at Kaiser Santa Clara hospital on medical surgical floor. I plan to go to Grad school
https://www.readbyqxmd.com/read/25645151/what-s-new-in-the-physiopathology-of-acne
#1
REVIEW
D H Suh, H H Kwon
There are four central factors that contribute to acne physiopathology: the inflammatory response, colonization with Propionibacterium acnes, increased sebum production and hypercornification of the pilosebaceous duct. In addition, research in the areas of diet and nutrition, genetics and oxidative stress is also yielding some interesting insights into the development of acne. In this paper we review some of the most recent research and novel concepts revealed in this work, which has been published by researchers from diverse academic disciplines including dermatology, immunology, microbiology and endocrinology...
July 2015: British Journal of Dermatology
https://www.readbyqxmd.com/read/25782453/isolated-transient-aphasia-at-emergency-presentation-is-associated-with-a-high-rate-of-cardioembolic-embolism
#2
Jason K Wasserman, Jeffrey J Perry, Dar Dowlatshahi, Grant Stotts, Marco L A Sivilotti, Andrew Worster, Marcel Emond, Jane Sutherland, Ian G Stiell, Mukul Sharma
OBJECTIVE: A cardiac source is often implicated in strokes where the deficit includes aphasia. However, less is known about the etiology of isolated aphasia during transient ischemic attack (TIA). Our objective was to determine whether patients with isolated aphasia are likely to have a cardioembolic etiology for their TIA. METHODS: We prospectively studied a cohort of TIA patients in eight tertiary-care emergency departments. Patients with isolated aphasia were identified by the treating physician at the time of emergency department presentation...
November 2015: CJEM
https://www.readbyqxmd.com/read/24423249/should-assisted-dying-be-legalised
#3
REVIEW
Thomas D G Frost, Devan Sinha, Barnabas J Gilbert
When an individual facing intractable pain is given an estimate of a few months to live, does hastening death become a viable and legitimate alternative for willing patients? Has the time come for physicians to do away with the traditional notion of healthcare as maintaining or improving physical and mental health, and instead accept their own limitations by facilitating death when requested? The Universities of Oxford and Cambridge held the 2013 Varsity Medical Debate on the motion "This House Would Legalise Assisted Dying"...
January 15, 2014: Philosophy, Ethics, and Humanities in Medicine: PEHM
https://www.readbyqxmd.com/read/19717844/dabigatran-versus-warfarin-in-patients-with-atrial-fibrillation
#4
RANDOMIZED CONTROLLED TRIAL
Stuart J Connolly, Michael D Ezekowitz, Salim Yusuf, John Eikelboom, Jonas Oldgren, Amit Parekh, Janice Pogue, Paul A Reilly, Ellison Themeles, Jeanne Varrone, Susan Wang, Marco Alings, Denis Xavier, Jun Zhu, Rafael Diaz, Basil S Lewis, Harald Darius, Hans-Christoph Diener, Campbell D Joyner, Lars Wallentin
BACKGROUND: Warfarin reduces the risk of stroke in patients with atrial fibrillation but increases the risk of hemorrhage and is difficult to use. Dabigatran is a new oral direct thrombin inhibitor. METHODS: In this noninferiority trial, we randomly assigned 18,113 patients who had atrial fibrillation and a risk of stroke to receive, in a blinded fashion, fixed doses of dabigatran--110 mg or 150 mg twice daily--or, in an unblinded fashion, adjusted-dose warfarin...
September 17, 2009: New England Journal of Medicine
https://www.readbyqxmd.com/read/20200382/comparison-of-dopamine-and-norepinephrine-in-the-treatment-of-shock
#5
RANDOMIZED CONTROLLED TRIAL
Daniel De Backer, Patrick Biston, Jacques Devriendt, Christian Madl, Didier Chochrad, Cesar Aldecoa, Alexandre Brasseur, Pierre Defrance, Philippe Gottignies, Jean-Louis Vincent
BACKGROUND: Both dopamine and norepinephrine are recommended as first-line vasopressor agents in the treatment of shock. There is a continuing controversy about whether one agent is superior to the other. METHODS: In this multicenter, randomized trial, we assigned patients with shock to receive either dopamine or norepinephrine as first-line vasopressor therapy to restore and maintain blood pressure. When blood pressure could not be maintained with a dose of 20 microg per kilogram of body weight per minute for dopamine or a dose of 0...
March 4, 2010: New England Journal of Medicine
https://www.readbyqxmd.com/read/24297193/treatment-of-anemia-in-patients-with-heart-disease-a-clinical-practice-guideline-from-the-american-college-of-physicians
#6
Amir Qaseem, Linda L Humphrey, Nick Fitterman, Melissa Starkey, Paul Shekelle
DESCRIPTION: The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on the treatment of anemia and iron deficiency in adult patients with heart disease. METHODS: This guideline is based on published literature in the English language on anemia and iron deficiency from 1947 to July 2012 that was identified using MEDLINE and the Cochrane Library. Literature was reassessed in April 2013, and additional studies were included...
December 3, 2013: Annals of Internal Medicine
https://www.readbyqxmd.com/read/24008958/rhabdomyolysis
#7
REVIEW
Janice L Zimmerman, Michael C Shen
Rhabdomyolysis is a well-known clinical syndrome of muscle injury associated with myoglobinuria, electrolyte abnormalities, and often acute kidney injury (AKI). The pathophysiology involves injury to the myocyte membrane and/or altered energy production that results in increased intracellular calcium concentrations and initiation of destructive processes. Myoglobin has been identified as the primary muscle constituent contributing to renal damage in rhabdomyolysis. Although rhabdomyolysis was first described with crush injuries and trauma, more common causes in hospitalized patients at present include prescription and over-the-counter medications, alcohol, and illicit drugs...
September 2013: Chest
https://www.readbyqxmd.com/read/23702059/clinical-factors-in-predicting-acute-renal-failure-caused-by-rhabdomyolysis-in-the-ed
#8
Chun-Yu Chen, Yan-Ren Lin, Lu-Lu Zhao, Wen-Chieh Yang, Yu-Jun Chang, Han-Ping Wu
PURPOSE: This study aimed to determine the clinical factors in predicting acute renal failure (ARF) in rhabdomyolysis and investigate the potential risk of renal replacement therapy (RRT). BASIC PROCEDURES: From 2006 to 2011, we retrospectively analyzed 202 patients 65 years or younger with a definite diagnosis of rhabdomyolysis and serum creatinine phosphokinase levels greater than 1000 IU/L. The related clinical factors were analyzed in the patients with ARF caused by rhabdomyolysis...
July 2013: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/24332910/urinalysis-is-an-inadequate-screen-for-rhabdomyolysis
#9
Sameir A Alhadi, Rawnica Ruegner, Brandy Snowden, Gregory W Hendey
STUDY OBJECTIVES: Hematuria by urine dipstick with absent red blood cells (RBCs) on microscopy is indicative of rhabdomyolysis. We determined the sensitivity of this classic urinalysis (UA) finding in the diagnosis of rhabdomyolysis. METHODS: We conducted a retrospective electronic medical record review of patients with a primary or secondary diagnosis of rhabdomyolysis with a creatine phosphokinase (CPK) greater than 1000 IU/L and a UA within the first 24 hours...
March 2014: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/23324509/prevention-of-kidney-injury-following-rhabdomyolysis-a-systematic-review
#10
REVIEW
Elizabeth J Scharman, William G Troutman
OBJECTIVE: To conduct a systematic literature review to evaluate evidence-based recommendations for the prevention of rhabdomyolysis-associated acute renal failure (ARF). DATA SOURCES: PubMed (1966-December 2012), International Pharmaceutical Abstracts, Science Citation Index, and Cochrane databases (1970-December 2012) were searched. There were no language restrictions. STUDY SELECTION AND DATA EXTRACTION: Studies selected dealt with treatment of rhabdomyolysis (crush syndrome) or prevention of ARF in patients with rhabdomyolysis...
January 2013: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/18565859/rhythm-control-versus-rate-control-for-atrial-fibrillation-and-heart-failure
#11
RANDOMIZED CONTROLLED TRIAL
Denis Roy, Mario Talajic, Stanley Nattel, D George Wyse, Paul Dorian, Kerry L Lee, Martial G Bourassa, J Malcolm O Arnold, Alfred E Buxton, A John Camm, Stuart J Connolly, Marc Dubuc, Anique Ducharme, Peter G Guerra, Stefan H Hohnloser, Jean Lambert, Jean-Yves Le Heuzey, Gilles O'Hara, Ole Dyg Pedersen, Jean-Lucien Rouleau, Bramah N Singh, Lynne Warner Stevenson, William G Stevenson, Bernard Thibault, Albert L Waldo
BACKGROUND: It is common practice to restore and maintain sinus rhythm in patients with atrial fibrillation and heart failure. This approach is based in part on data indicating that atrial fibrillation is a predictor of death in patients with heart failure and suggesting that the suppression of atrial fibrillation may favorably affect the outcome. However, the benefits and risks of this approach have not been adequately studied. METHODS: We conducted a multicenter, randomized trial comparing the maintenance of sinus rhythm (rhythm control) with control of the ventricular rate (rate control) in patients with a left ventricular ejection fraction of 35% or less, symptoms of congestive heart failure, and a history of atrial fibrillation...
June 19, 2008: New England Journal of Medicine
https://www.readbyqxmd.com/read/23803136/clopidogrel-with-aspirin-in-acute-minor-stroke-or-transient-ischemic-attack
#12
RANDOMIZED CONTROLLED TRIAL
Yongjun Wang, Yilong Wang, Xingquan Zhao, Liping Liu, David Wang, Chunxue Wang, Chen Wang, Hao Li, Xia Meng, Liying Cui, Jianping Jia, Qiang Dong, Anding Xu, Jinsheng Zeng, Yansheng Li, Zhimin Wang, Haiqin Xia, S Claiborne Johnston
BACKGROUND: Stroke is common during the first few weeks after a transient ischemic attack (TIA) or minor ischemic stroke. Combination therapy with clopidogrel and aspirin may provide greater protection against subsequent stroke than aspirin alone. METHODS: In a randomized, double-blind, placebo-controlled trial conducted at 114 centers in China, we randomly assigned 5170 patients within 24 hours after the onset of minor ischemic stroke or high-risk TIA to combination therapy with clopidogrel and aspirin (clopidogrel at an initial dose of 300 mg, followed by 75 mg per day for 90 days, plus aspirin at a dose of 75 mg per day for the first 21 days) or to placebo plus aspirin (75 mg per day for 90 days)...
July 4, 2013: New England Journal of Medicine
https://www.readbyqxmd.com/read/25226194/management-of-psychosis-and-agitation-in-medical-surgical-patients-who-have-or-are-at-risk-for-prolonged-qt-interval
#13
REVIEW
Rose Ries, Amirali Sayadipour
We review the literature on management of psychosis and agitation in medical-surgical patients who have or are at risk for prolonged QT interval, a risk factor for torsade de pointes (TdP), and we describe our protocols for treating these patients. We searched PubMed and PsycInfo for relevant studies and found few papers describing options for treating psychosis and agitation in these patients. Prolonged QTc interval has been more often associated with low-potency phenothiazines such as thioridazine; however, it may occur with high potency typical antipsychotics such as fluphenazine and haloperidol as well as with atypical antipsychotics such as quetiapine, risperidone, olanzapine, iloperidone, and particularly ziprasidone...
September 2014: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/24352797/2014-evidence-based-guideline-for-the-management-of-high-blood-pressure-in-adults-report-from-the-panel-members-appointed-to-the-eighth-joint-national-committee-jnc-8
#14
Paul A James, Suzanne Oparil, Barry L Carter, William C Cushman, Cheryl Dennison-Himmelfarb, Joel Handler, Daniel T Lackland, Michael L LeFevre, Thomas D MacKenzie, Olugbenga Ogedegbe, Sidney C Smith, Laura P Svetkey, Sandra J Taler, Raymond R Townsend, Jackson T Wright, Andrew S Narva, Eduardo Ortiz
Hypertension is the most common condition seen in primary care and leads to myocardial infarction, stroke, renal failure, and death if not detected early and treated appropriately. Patients want to be assured that blood pressure (BP) treatment will reduce their disease burden, while clinicians want guidance on hypertension management using the best scientific evidence. This report takes a rigorous, evidence-based approach to recommend treatment thresholds, goals, and medications in the management of hypertension in adults...
February 5, 2014: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/24947530/practice-guidelines-for-the-diagnosis-and-management-of-skin-and-soft-tissue-infections-2014-update-by-the-infectious-diseases-society-of-america
#15
Dennis L Stevens, Alan L Bisno, Henry F Chambers, E Patchen Dellinger, Ellie J C Goldstein, Sherwood L Gorbach, Jan V Hirschmann, Sheldon L Kaplan, Jose G Montoya, James C Wade
A panel of national experts was convened by the Infectious Diseases Society of America (IDSA) to update the 2005 guidelines for the treatment of skin and soft tissue infections (SSTIs). The panel's recommendations were developed to be concordant with the recently published IDSA guidelines for the treatment of methicillin-resistant Staphylococcus aureus infections. The focus of this guideline is the diagnosis and appropriate treatment of diverse SSTIs ranging from minor superficial infections to life-threatening infections such as necrotizing fasciitis...
July 15, 2014: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/24569496/clinical-practice-guideline-on-diagnosis-and-treatment-of-hyponatraemia
#16
Goce Spasovski, Raymond Vanholder, Bruno Allolio, Djillali Annane, Steve Ball, Daniel Bichet, Guy Decaux, Wiebke Fenske, Ewout J Hoorn, Carole Ichai, Michael Joannidis, Alain Soupart, Robert Zietse, Maria Haller, Sabine van der Veer, Wim Van Biesen, Evi Nagler
Hyponatraemia, defined as a serum sodium concentration <135 mmol/l, is the most common disorder of body fluid and electrolyte balance encountered in clinical practice. It can lead to a wide spectrum of clinical symptoms, from subtle to severe or even life threatening, and is associated with increased mortality, morbidity and length of hospital stay in patients presenting with a range of conditions. Despite this, the management of patients remains problematic. The prevalence of hyponatraemia in widely different conditions and the fact that hyponatraemia is managed by clinicians with a broad variety of backgrounds have fostered diverse institution- and speciality-based approaches to diagnosis and treatment...
April 2014: Nephrology, Dialysis, Transplantation
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