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https://www.readbyqxmd.com/read/29526952/lambert-eaton-myasthenic-syndrome-associated-with-synchronous-double-cancer-a-combination-of-small-cell-carcinoma-of-the-cervix-and-breast-carcinoma
#1
Hiroyuki Fukuda, Akira Tanaka, Yasuyuki Hirashima, Ichiro Ito
Lambert-Eaton myasthenic syndrome (LEMS) is most commonly associated with small cell lung carcinoma, while it is rarely associated with gynecological and breast carcinoma. We herein report a case of LEMS associated with synchronous double cancer, which was a combination of small cell carcinoma of the cervix and breast carcinoma. The early diagnosis and treatment of LEMS are important for achieving a good outcome. The possibility of accompanying paraneoplastic neurological syndrome must be sufficiently considered in gynecology and breast cancer patients...
August 15, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29522710/vitamin-c-pharmacokinetics-in-critically-ill-patients-a-randomized-trial-of-four-iv-regimens
#2
Harm-Jan de Grooth, Wai-Ping Manubulu-Choo, Anthe S Zandvliet, Angélique M E Spoelstra-de Man, Armand R Girbes, Eleonora L Swart, Heleen M Oudemans-van Straaten
BACKGROUND: Early high-dose IV vitamin C is being investigated as adjuvant therapy in patients who are critically ill, but the optimal dose and infusion method are unclear. The primary aim of this study was to describe the dose-plasma concentration relationship and safety of four different dosing regimens. METHODS: This was a four-group randomized pharmacokinetic trial. Patients who were critically ill with multiple organ dysfunction were randomized to receive 2 or 10 g/d vitamin C as a twice daily bolus infusion or continuous infusion for 48 h...
June 2018: Chest
https://www.readbyqxmd.com/read/29534630/antibiotic-use-in-the-intensive-care-unit-optimization-and-de-escalation
#3
Maureen Campion, Gail Scully
Appropriate antimicrobial therapy is essential to ensuring positive patient outcomes. Inappropriate or suboptimal utilization of antibiotics can lead to increased length of stay, multidrug-resistant infections, and mortality. Critically ill intensive care patients, particularly those with severe sepsis and septic shock, are at risk of antibiotic failure and secondary infections associated with incorrect antibiotic use. Through the initiation of active empiric antibiotic therapy based upon local susceptibilities, daily evaluation of signs and symptoms of infection and narrowing of antibiotic therapy when feasible, providers can streamline the treatment of common intensive care unit (ICU) infections...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29020354/the-definition-of-the-brugada-syndrome
#4
REVIEW
Juan Sieira, Pedro Brugada
Brugada syndrome (BS) is an inherited disease characterized by a coved-type ST-segment elevation in the right precordial leads and increased risk of sudden cardiac death (SCD), in the absence of structural abnormalities. The cornerstone of BS diagnosis and definition, is its characteristic ECG pattern that can be present spontaneously or unmasked by drugs. Brugada syndrome was first described 25 years ago; paradoxically, in an era of great technological development, a new syndrome was described with a technology developed almost a century before...
October 21, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28757818/procalcitonin-assisted-antibiotic-strategy-in-sepsis
#5
Domonkos Trásy, Zsolt Molnár
Sepsis is one of the biggest challenges in critical care nowadays. Defining sepsis is a difficult task on its own and its diagnosis and treatment requires well trained, devoted personnel with interdisciplinary collaboration in order to provide the patients the best chance for survival. Immediate resuscitation, early adequate antimicrobial therapy, source control and highly sophisticated organ support on the intensive care units are all inevitable necessities for successful recovery. To help fast and accurate diagnosis biomarkers have been measured for decades...
May 2017: EJIFCC
https://www.readbyqxmd.com/read/28941558/emergency-medicine-evaluation-of-community-acquired-pneumonia-history-examination-imaging-and-laboratory-assessment-and-risk-scores
#6
REVIEW
Brit Long, Drew Long, Alex Koyfman
BACKGROUND: Pneumonia is a common infection, accounting for approximately one million hospitalizations in the United States annually. This potentially life-threatening disease is commonly diagnosed based on history, physical examination, and chest radiograph. OBJECTIVE: To investigate emergency medicine evaluation of community-acquired pneumonia including history, physical examination, imaging, and the use of risk scores in patient assessment. DISCUSSION: Pneumonia is the number one cause of death from infectious disease...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28455343/2017-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
#7
REVIEW
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.
August 8, 2017: Circulation
https://www.readbyqxmd.com/read/28114143/electrolyte-and-acid-base-disorders-in-chronic-kidney-disease-and-end-stage-kidney-failure
#8
REVIEW
Tsering Dhondup, Qi Qian
The kidneys play a pivotal role in the regulation of electrolyte and acid-base balance. With progressive loss of kidney function, derangements in electrolytes and acid-base inevitably occur and contribute to poor patient outcomes. As chronic kidney disease (CKD) has become a worldwide epidemic, medical providers are increasingly confronted with such problems. Adequate diagnosis and treatment will minimize complications and can potentially be lifesaving. In this review, we discuss the current understanding of the disease process, clinical presentation, diagnosis and treatment strategies, integrating up-to-date knowledge in the field...
2017: Blood Purification
https://www.readbyqxmd.com/read/28208757/pathogenesis-and-therapeutic-mechanisms-in-immune-thrombocytopenia-itp
#9
REVIEW
Anne Zufferey, Rick Kapur, John W Semple
Immune thrombocytopenia (ITP) is a complex autoimmune disease characterized by low  platelet counts. The pathogenesis of ITP remains unclear although both antibody-mediated and/or  T cell-mediated platelet destruction are key processes. In addition, impairment of T cells, cytokine  imbalances, and the contribution of the bone marrow niche have now been recognized to be  important. Treatment strategies are aimed at the restoration of platelet counts compatible with  adequate hemostasis rather than achieving physiological platelet counts...
February 9, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/27590096/assessing-acid-base-status-physiologic-versus-physicochemical-approach
#10
Horacio J Adrogué, Nicolaos E Madias
The physiologic approach has long been used in assessing acid-base status. This approach considers acids as hydrogen ion donors and bases as hydrogen ion acceptors and the acid-base status of the organism as reflecting the interaction of net hydrogen ion balance with body buffers. In the physiologic approach, the carbonic acid/bicarbonate buffer pair is used for assessing acid-base status and blood pH is determined by carbonic acid (ie, Paco2 ) and serum bicarbonate levels. More recently, the physicochemical approach was introduced, which has gained popularity, particularly among intensivists and anesthesiologists...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27532622/evidence-for-transmission-of-zika-virus-by-platelet-transfusion
#11
LETTER
Iara J F Motta, Bryan R Spencer, Suely G Cordeiro da Silva, Monica B Arruda, Jane A Dobbin, Yung B M Gonzaga, Ingrid P Arcuri, Rita C B S Tavares, Elias H Atta, Regina F M Fernandes, Deise A Costa, Liane J Ribeiro, Fabio Limonte, Luiza M Higa, Carolina M Voloch, Rodrigo M Brindeiro, Amilcar Tanuri, Orlando C Ferreira
To the Editor: Zika virus (ZIKV) is a mosquito-borne virus that has important secondary means of transmission that include perinatal and sexual modes. The potential for transmission in transfused donated blood components has been a concern owing to the detection of ZIKV viremia in healthy blood..
September 15, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27322982/nomogram-for-predicting-pulmonary-hypertension-in-patients-without-pulmonary-embolism
#12
COMMENT
Yanqi Huang, Changhong Liang, Zaiyi Liu
No abstract text is available yet for this article.
July 2016: Radiology
https://www.readbyqxmd.com/read/27338855/the-benefit-of-exercise-training-in-pulmonary-hypertension-a-clinical-review
#13
REVIEW
Karen S W Chia, Peter K K Wong, Steven G Faux, Craig S McLachlan, Eugene Kotlyar
Pulmonary hypertension (PH) is a clinical condition characterised by raised pulmonary artery pressure, which results in increased right ventricular afterload and dyspnoea. This is accompanied by reduced exercise capacity, quality of life and, eventually, death. An increasing range of targeted medications has transformed the treatment of pulmonary arterial hypertension, a specific type of PH. Supervised exercise training is recommended as part of a multifaceted management plan for PH. However, many questions remain regarding how exercise training improves exercise capacity and quality of life...
April 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/25732200/low-c-reactive-protein-values-at-admission-predict-mortality-in-patients-with-severe-community-acquired-pneumonia-caused-by-streptococcus-pneumoniae-that-require-intensive-care-management
#14
Yok-Ai Que, Virginie Virgini, Elise Dupuis Lozeron, Géraldine Paratte, Guy Prod'hom, Jean-Pierre Revelly, Jean-Luc Pagani, Emmanuel Charbonney, Philippe Eggimann
PURPOSE: To identify risk factors associated with mortality in patients with severe community-acquired pneumonia (CAP) caused by S. pneumoniae who require intensive care unit (ICU) management, and to assess the prognostic values of these risk factors at the time of admission. METHODS: Retrospective analysis of all consecutive patients with CAP caused by S. pneumoniae who were admitted to the 32-bed medico-surgical ICU of a community and referral university hospital between 2002 and 2011...
April 2015: Infection
https://www.readbyqxmd.com/read/25599328/association-of-amiodarone-use-with-acute-pancreatitis-in-patients-with-atrial-fibrillation-a-nested-case-control-study
#15
Alvaro Alonso, Richard F MacLehose, Pamela L Lutsey, Suma Konety, Lin Y Chen
No abstract text is available yet for this article.
March 2015: JAMA Internal Medicine
https://www.readbyqxmd.com/read/25633465/serum-derived-bovine-immunoglobulin-protein-isolate-should-be-considered-in-patients-with-hiv-gut-barrier-dysfunction
#16
LETTER
M S Gelfand, B P Burnett
No abstract text is available yet for this article.
April 2015: Infection
https://www.readbyqxmd.com/read/25616312/acute-pancreatitis
#17
REVIEW
Paul Georg Lankisch, Minoti Apte, Peter A Banks
Acute pancreatitis, an inflammatory disorder of the pancreas, is the leading cause of admission to hospital for gastrointestinal disorders in the USA and many other countries. Gallstones and alcohol misuse are long-established risk factors, but several new causes have emerged that, together with new aspects of pathophysiology, improve understanding of the disorder. As incidence (and admission rates) of acute pancreatitis increase, so does the demand for effective management. We review how to manage patients with acute pancreatitis, paying attention to diagnosis, differential diagnosis, complications, prognostic factors, treatment, and prevention of second attacks, and the possible transition from acute to chronic pancreatitis...
July 4, 2015: Lancet
https://www.readbyqxmd.com/read/25552355/what-the-dead-can-teach-the-living-systemic-nature-of-heart-failure-with-preserved-ejection-fraction
#18
EDITORIAL
Dalane W Kitzman, Bharathi Upadhya, Sujethra Vasu
No abstract text is available yet for this article.
February 10, 2015: Circulation
https://www.readbyqxmd.com/read/25540889/multiple-myeloma
#19
REVIEW
Christoph Röllig, Stefan Knop, Martin Bornhäuser
Multiple myeloma is a malignant disease characterised by proliferation of clonal plasma cells in the bone marrow and typically accompanied by the secretion of monoclonal immunoglobulins that are detectable in the serum or urine. Increased understanding of the microenvironmental interactions between malignant plasma cells and the bone marrow niche, and their role in disease progression and acquisition of therapy resistance, has helped the development of novel therapeutic drugs for use in combination with cytostatic therapy...
May 30, 2015: Lancet
https://www.readbyqxmd.com/read/25536258/metformin-in-patients-with-type-2-diabetes-and-kidney-disease-a-systematic-review
#20
REVIEW
Silvio E Inzucchi, Kasia J Lipska, Helen Mayo, Clifford J Bailey, Darren K McGuire
IMPORTANCE: Metformin is widely viewed as the best initial pharmacological option to lower glucose concentrations in patients with type 2 diabetes mellitus. However, the drug is contraindicated in many individuals with impaired kidney function because of concerns of lactic acidosis. OBJECTIVE: To assess the risk of lactic acidosis associated with metformin use in individuals with impaired kidney function. EVIDENCE ACQUISITION: In July 2014, we searched the MEDLINE and Cochrane databases for English-language articles pertaining to metformin, kidney disease, and lactic acidosis in humans between 1950 and June 2014...
December 24, 2014: JAMA: the Journal of the American Medical Association
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