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Internal Medicine

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67 papers 100 to 500 followers
https://www.readbyqxmd.com/read/27583432/weight-loss-practical-tips
#1
(no author information available yet)
No abstract text is available yet for this article.
September 1, 2016: American Family Physician
https://www.readbyqxmd.com/read/19318384/intensive-versus-conventional-glucose-control-in-critically-ill-patients
#2
RANDOMIZED CONTROLLED TRIAL
Simon Finfer, Dean R Chittock, Steve Yu-Shuo Su, Deborah Blair, Denise Foster, Vinay Dhingra, Rinaldo Bellomo, Deborah Cook, Peter Dodek, William R Henderson, Paul C Hébert, Stephane Heritier, Daren K Heyland, Colin McArthur, Ellen McDonald, Imogen Mitchell, John A Myburgh, Robyn Norton, Julie Potter, Bruce G Robinson, Juan J Ronco
BACKGROUND: The optimal target range for blood glucose in critically ill patients remains unclear. METHODS: Within 24 hours after admission to an intensive care unit (ICU), adults who were expected to require treatment in the ICU on 3 or more consecutive days were randomly assigned to undergo either intensive glucose control, with a target blood glucose range of 81 to 108 mg per deciliter (4.5 to 6.0 mmol per liter), or conventional glucose control, with a target of 180 mg or less per deciliter (10...
March 26, 2009: New England Journal of Medicine
https://www.readbyqxmd.com/read/27566810/new-antiplatelet-drugs-and-new-oral-anticoagulants
#3
V Koenig-Oberhuber, M Filipovic
In our daily anaesthetic practice, we are confronted with an increasing number of patients treated with either antiplatelet or anticoagulant agents. During the last decade, changes have occurred that make the handling of antithrombotic medication a challenging part of anaesthetic perioperative management. In this review, the authors discuss the most important antiplatelet and anticoagulant drugs, the perioperative management, the handling of bleeding complications, and the interpretation of some laboratory analyses related to these agents...
September 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27567896/severe-community-acquired-pneumonia-timely-management-measures-in-the-first-24-hours
#4
REVIEW
Jason Phua, Nathan C Dean, Qi Guo, Win Sen Kuan, Hui Fang Lim, Tow Keang Lim
Mortality rates for severe community-acquired pneumonia (CAP) range from 17 to 48 % in published studies.In this review, we searched PubMed for relevant papers published between 1981 and June 2016 and relevant files. We explored how early and aggressive management measures, implemented within 24 hours of recognition of severe CAP and carried out both in the emergency department and in the ICU, decrease mortality in severe CAP.These measures begin with the use of severity assessment tools and the application of care bundles via clinical decision support tools...
August 28, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27716262/new-aspects-in-the-management-of-pneumonia
#5
Elena Prina, Adrian Ceccato, Antoni Torres
Despite improvements in the management of community-acquired pneumonia (CAP), morbidity and mortality are still high, especially in patients with more severe disease. Early and appropriate antibiotics remain the cornerstone in the treatment of CAP. However, two aspects seem to contribute to a worse outcome: an uncontrolled inflammatory reaction and an inadequate immune response. Adjuvant treatments, such as corticosteroids and intravenous immunoglobulins, have been proposed to counterbalance these effects. The use of corticosteroids in patients with severe CAP and a strong inflammatory reaction can reduce the time to clinical stability, the risk of treatment failure, and the risk of progression to acute respiratory distress syndrome...
October 1, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27530907/what-doctors-say-and-what-patients-hear
#6
Andrew McDonald
No abstract text is available yet for this article.
2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27478966/assessment-of-adequacy-of-volume-resuscitation
#7
John H Boyd, Demetrios Sirounis
PURPOSE OF REVIEW: It has recently become evident that administration of intravenous fluids following initial resuscitation has a greater probability of producing tissue edema and hypoxemia than of increasing oxygen delivery. Therefore, it is essential to have a rational approach to assess the adequacy of volume resuscitation. Here we review passive leg raising (PLR) and respiratory variation in hemodynamics to assess fluid responsiveness. RECENT FINDINGS: The use of ultrasound enhances the clinician's ability to detect and predict fluid responsiveness, whereas enthusiasm for this modality must be tempered by recent evidence that it is only reliable in apneic patients...
October 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27510349/managing-thyroid-disease-in-general-practice
#8
John P Walsh
Serum thyroid-stimulating hormone (TSH) testing is the best screening tool for thyroid dysfunction. When TSH levels are in the reference range, additional tests such as free thyroxine, free triiodothyronine or thyroid antibodies rarely add value, except in patients with pituitary disease, when TSH is unreliable. Overt hypothyroidism and subclinical hypothyroidism with TSH levels > 10 mU/L can be treated without further investigation. The health impact of subclinical hypothyroidism with mildly elevated levels of TSH (4-10 mU/L) remains uncertain, particularly in older people; treatment or observation are reasonable options...
August 15, 2016: Medical Journal of Australia
https://www.readbyqxmd.com/read/27291485/lactic-acidosis-current-treatments-and-future-directions
#9
Jeffrey A Kraut, Nicolaos E Madias
Mortality rates associated with severe lactic acidosis (blood pH<7.2) due to sepsis or low-flow states are high. Eliminating the triggering conditions remains the most effective therapy. Although recommended by some, administration of sodium bicarbonate does not improve cardiovascular function or reduce mortality. This failure has been attributed to both reduction in serum calcium concentration and generation of excess carbon dioxide with intracellular acidification. In animal studies, hyperventilation and infusion of calcium during sodium bicarbonate administration improves cardiovascular function, suggesting that this approach could allow expression of the positive aspects of sodium bicarbonate...
September 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/26314490/iron-deficiency-anaemia
#10
REVIEW
Anthony Lopez, Patrice Cacoub, Iain C Macdougall, Laurent Peyrin-Biroulet
Anaemia affects roughly a third of the world's population; half the cases are due to iron deficiency. It is a major and global public health problem that affects maternal and child mortality, physical performance, and referral to health-care professionals. Children aged 0-5 years, women of childbearing age, and pregnant women are particularly at risk. Several chronic diseases are frequently associated with iron deficiency anaemia--notably chronic kidney disease, chronic heart failure, cancer, and inflammatory bowel disease...
February 27, 2016: Lancet
https://www.readbyqxmd.com/read/27195814/intensive-vs-standard-blood-pressure-control-and-cardiovascular-disease-outcomes-in-adults-aged-%C3%A2-75-years-a-randomized-clinical-trial
#11
RANDOMIZED CONTROLLED TRIAL
Jeff D Williamson, Mark A Supiano, William B Applegate, Dan R Berlowitz, Ruth C Campbell, Glenn M Chertow, Larry J Fine, William E Haley, Amret T Hawfield, Joachim H Ix, Dalane W Kitzman, John B Kostis, Marie A Krousel-Wood, Lenore J Launer, Suzanne Oparil, Carlos J Rodriguez, Christianne L Roumie, Ronald I Shorr, Kaycee M Sink, Virginia G Wadley, Paul K Whelton, Jeffrey Whittle, Nancy F Woolard, Jackson T Wright, Nicholas M Pajewski
IMPORTANCE: The appropriate treatment target for systolic blood pressure (SBP) in older patients with hypertension remains uncertain. OBJECTIVE: To evaluate the effects of intensive (<120 mm Hg) compared with standard (<140 mm Hg) SBP targets in persons aged 75 years or older with hypertension but without diabetes. DESIGN, SETTING, AND PARTICIPANTS: A multicenter, randomized clinical trial of patients aged 75 years or older who participated in the Systolic Blood Pressure Intervention Trial (SPRINT)...
June 28, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/26880451/treatment-of-hyperkalemia-something-old-something-new
#12
REVIEW
Richard H Sterns, Marvin Grieff, Paul L Bernstein
Treatment options for hyperkalemia have not changed much since the introduction of the cation exchange resin, sodium polystyrene sulfonate (Kayexalate, Covis Pharmaceuticals, Cary, NC), over 50 years ago. Although clinicians of that era did not have ready access to hemodialysis or loop diuretics, the other tools that we use today-calcium, insulin, and bicarbonate-were well known to them. Currently recommended insulin regimens provide too little insulin to achieve blood levels with a maximal kalemic effect and too little glucose to avoid hypoglycemia...
March 2016: Kidney International
https://www.readbyqxmd.com/read/27068718/acg-clinical-guideline-diagnosis-treatment-and-prevention-of-acute-diarrheal-infections-in-adults
#13
Mark S Riddle, Herbert L DuPont, Bradley A Connor
Acute diarrheal infections are a common health problem globally and among both individuals in the United States and traveling to developing world countries. Multiple modalities including antibiotic and non-antibiotic therapies have been used to address these common infections. Information on treatment, prevention, diagnostics, and the consequences of acute diarrhea infection has emerged and helps to inform clinical management. In this ACG Clinical Guideline, the authors present an evidence-based approach to diagnosis, prevention, and treatment of acute diarrhea infection in both US-based and travel settings...
May 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/26426314/treatment-of-unexplained-chronic-cough-chest-guideline-and-expert-panel-report
#14
REVIEW
Peter Gibson, Gang Wang, Lorcan McGarvey, Anne E Vertigan, Kenneth W Altman, Surinder S Birring
BACKGROUND: Unexplained chronic cough (UCC) causes significant impairments in quality of life. Effective assessment and treatment approaches are needed for UCC. METHODS: This systematic review of randomized controlled trials (RCTs) asked: What is the efficacy of treatment compared with usual care for cough severity, cough frequency, and cough-related quality of life in patients with UCC? Studies of adults and adolescents aged > 12 years with a chronic cough of > 8 weeks' duration that was unexplained after systematic investigation and treatment were included and assessed for relevance and quality...
January 2016: Chest
https://www.readbyqxmd.com/read/26408108/how-we-diagnose-and-treat-iron-deficiency-anemia
#15
REVIEW
Michael Auerbach, John W Adamson
It is estimated that one-third of the world's population is anemic, the majority being due to iron deficiency (ID). In adults, ID is associated with fatigue in the absence of anemia, restless legs syndrome, pica and, in neonates, delayed growth and development. In adolescents, ID is associated with decrements in learning and behavioral abnormalities. In the absence of a clear cause, search for a source of bleeding is indicated. No single test is diagnostic of ID unless the serum ferritin is low or the percent transferrin saturation is low with an elevated total iron binding capacity...
January 2016: American Journal of Hematology
https://www.readbyqxmd.com/read/27074377/zika-virus-and-birth-defects-reviewing-the-evidence-for-causality
#16
Sonja A Rasmussen, Denise J Jamieson, Margaret A Honein, Lyle R Petersen
Summary. The Zika virus has spread rapidly in the Americas since its first identification in Brazil in early 2015. Prenatal Zika virus infection has been linked to adverse pregnancy and birth outcomes, most notably microcephaly and other serious brain anomalies. To determine whether Zika virus..
May 19, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/26294976/clinical-use-of-diuretics-in-heart-failure-cirrhosis-and-nephrotic-syndrome
#17
REVIEW
Ahmed Hassaan Qavi, Rida Kamal, Robert W Schrier
Diuretics play significant role in pharmacology and treatment options in medicine. This paper aims to review and evaluate the clinical use of diuretics in conditions that lead to fluid overload in the body such as cardiac failure, cirrhosis, and nephrotic syndrome. To know the principles of treatment it is essential to understand the underlying pathophysiological mechanisms that cause the need of diuresis in the human body. Various classes of diuretics exist, each having a unique mode of action. A systemic approach for management is recommended based on the current guidelines, starting from thiazides and proceeding to loop diuretics...
2015: International Journal of Nephrology
https://www.readbyqxmd.com/read/26545940/2015-american-college-of-rheumatology-guideline-for-the-treatment-of-rheumatoid-arthritis
#18
REVIEW
Jasvinder A Singh, Kenneth G Saag, S Louis Bridges, Elie A Akl, Raveendhara R Bannuru, Matthew C Sullivan, Elizaveta Vaysbrot, Christine McNaughton, Mikala Osani, Robert H Shmerling, Jeffrey R Curtis, Daniel E Furst, Deborah Parks, Arthur Kavanaugh, James O'Dell, Charles King, Amye Leong, Eric L Matteson, John T Schousboe, Barbara Drevlow, Seth Ginsberg, James Grober, E William St Clair, Elizabeth Tindall, Amy S Miller, Timothy McAlindon
OBJECTIVE: To develop a new evidence-based, pharmacologic treatment guideline for rheumatoid arthritis (RA). METHODS: We conducted systematic reviews to synthesize the evidence for the benefits and harms of various treatment options. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to rate the quality of evidence. We employed a group consensus process to grade the strength of recommendations (either strong or conditional)...
January 2016: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/26472995/part-7-adult-advanced-cardiovascular-life-support-2015-american-heart-association-guidelines-update-for-cardiopulmonary-resuscitation-and-emergency-cardiovascular-care
#19
REVIEW
Mark S Link, Lauren C Berkow, Peter J Kudenchuk, Henry R Halperin, Erik P Hess, Vivek K Moitra, Robert W Neumar, Brian J O'Neil, James H Paxton, Scott M Silvers, Roger D White, Demetris Yannopoulos, Michael W Donnino
No abstract text is available yet for this article.
November 3, 2015: Circulation
https://www.readbyqxmd.com/read/18343857/2002-acc-aha-guideline-versus-clinician-judgment-as-diagnostic-tests-for-chest-pain
#20
COMPARATIVE STUDY
Stephen M Hagberg, Finbar Woitalla, Paul Crawford
PURPOSE: Hospital admissions for chest pain are frequent and costly. The use of objective criteria to determine the need for hospitalization may save money. Here we compare the 2002 American College of Cardiology/American Heart Association (ACC/AHA) guidelines for the management of patients with unstable angina and nonST-segment elevation myocardial infarction to clinical judgment as diagnostic tests to predict which patients with chest pain will develop positive cardiac troponin-I. METHODS: Researchers conducted a retrospective chart review of patients admitted to a military community hospital for chest pain over a 2-year period...
March 2008: Journal of the American Board of Family Medicine: JABFM
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