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Medicina Interna / internal Medicine

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2992 papers 1000+ followers Medicina Interna / Internal Medicine - E-Mail: andresflmd@gmail.com
By Andrés López, M.D. Médico/Physician - M.D.
https://www.readbyqxmd.com/read/24169317/-the-treament-of-hyponatremia-secundary-to-the-syndrome-of-inappropriate-antidiuretic-hormone-secretion
#1
Isabelle Runkle, Carles Villabona, Andrés Navarro, Antonio Pose, Francesc Formiga, Alberto Tejedor, Esteban Poch
The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the most frequent cause of hyponatremia in a hospital setting. However, detailed protocols and algorithms for its management are lacking. Our objective was to develop 2 consensus algorithms for the therapy of hyponatremia due to SIADH in hospitalized patients. A multidisciplinary group made up of 2 endocrinologists, 2 nephrologists, 2 internists, and one hospital pharmacist held meetings over the period of a year. The group worked under the auspices of the European Hyponatremia Network and the corresponding Spanish medical societies...
December 7, 2013: Medicina Clínica
https://www.readbyqxmd.com/read/27305194/clinical-practice-upper-gastrointestinal-bleeding-due-to-a-peptic-ulcer
#2
REVIEW
Loren Laine
No abstract text is available yet for this article.
June 16, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/22901631/a-physiologic-based-approach-to-the-treatment-of-a-patient-with-hypokalemia
#3
Abdo Asmar, Rajesh Mohandas, Charles S Wingo
Hypokalemia is common and can be associated with serious adverse consequences, including paralysis, ileus, cardiac arrhythmias, and death. As a result, the body maintains serum potassium concentration within very narrow limits by tightly regulated feedback and feed-forward systems. Whereas the consequences of symptomatic hypokalemia and severe potassium depletion are well appreciated, chronic mild hypokalemia can accelerate the progression of chronic kidney disease, exacerbate systemic hypertension, and increase mortality...
September 2012: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/21278718/pathophysiology-and-management-of-hypokalemia-a-clinical-perspective
#4
REVIEW
Robert J Unwin, Friedrich C Luft, David G Shirley
Potassium (K(+)) ions are the predominant intracellular cations. K(+) homeostasis depends on external balance (dietary intake [typically 100 mmol per day] versus excretion [95% via the kidney; 5% via the colon]) and internal balance (the distribution of K(+) between intracellular and extracellular fluid compartments). The uneven distribution of K(+) across cell membranes means that a mere 1% shift in its distribution can cause a 50% change in plasma K(+) concentration. Hormonal mechanisms (involving insulin, β-adrenergic agonists and aldosterone) modulate K(+) distribution by promoting rapid transfer of K(+) across the plasma membrane...
February 2011: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/19414841/narrative-review-evolving-concepts-in-potassium-homeostasis-and-hypokalemia
#5
REVIEW
Megan Greenlee, Charles S Wingo, Alicia A McDonough, Jang-Hyun Youn, Bruce C Kone
Humans are intermittently exposed to large variations in potassium intake, which range from periods of fasting to ingestion of potassium-rich meals. These fluctuations would abruptly alter plasma potassium concentration if not for rapid mechanisms, primarily in skeletal muscle and the liver, that buffer the changes in plasma potassium concentration by means of transcellular potassium redistribution and feedback control of renal potassium excretion. However, buffers have capacity limits, and even robust feedback control mechanisms require that the perturbation occur before feedback can initiate corrective action...
May 5, 2009: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28411293/safe-and-effective-bedside-thoracentesis-a-review-of-the-evidence-for-practicing-clinicians
#6
REVIEW
Richard Schildhouse, Andrew Lai, Jeffrey H Barsuk, Michelle Mourad, Vineet Chopra
BACKGROUND: Physicians often care for patients with pleural effusion, a condition that requires thoracentesis for evaluation and treatment. We aim to identify the most recent advances related to safe and effective performance of thoracentesis. METHODS: We performed a narrative review with a systematic search of the literature. Two authors independently reviewed search results and selected studies based on relevance to thoracentesis; disagreements were resolved by consensus...
April 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28410663/frontotemporal-dementia
#7
REVIEW
Nicholas T Olney, Salvatore Spina, Bruce L Miller
Frontotemporal dementia (FTD) is a heterogeneous disorder with distinct clinical phenotypes associated with multiple neuropathologic entities. Presently, the term FTD encompasses clinical disorders that include changes in behavior, language, executive control, and often motor symptoms. The core FTD spectrum disorders include behavioral variant FTD, nonfluent/agrammatic variant primary progressive aphasia, and semantic variant PPA. Related FTD disorders include frontotemporal dementia with motor neuron disease, progressive supranuclear palsy syndrome, and corticobasal syndrome...
May 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/28410654/update-on-alzheimer-s-and-the-dementias-introduction
#8
John M Ringman
Though the numbers of dementia cases are rising worldwide, there is evidence that incidence rates are decreasing. We now know that the neuropathological changes of Alzheimer's disease (AD) precede overt clinical signs by 15 to 20 years and we have biochemical and imaging markers that enable us to identify them. The genetic complexity of AD suggests it is not a single entity but rather represents a group of related diseases. The amyloid cascade hypothesis has led to the development of putative disease-modifying interventions but these have not yet been demonstrated to be substantively effective and additional approaches are warranted...
May 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/28372707/hypertensive-emergency
#9
REVIEW
Manish Suneja, M Lee Sanders
A rapid and severe increase in blood pressure resulting in new or progressive end-organ damage is defined as hypertensive emergency. Clinicians should effectively use the patient interview, physical examination, and additional testing to differentiate hypertensive emergency from nonemergent hypertension. Patients with evidence or high suspicion for end-organ damage should be expediently referred from the outpatient setting to a higher level of care. Knowledge of appropriate hypertensive emergency management and the ability to initiate this care in the clinic could help reduce patient morbidity in certain situations...
May 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/28372711/outpatient-emergencies-anaphylaxis
#10
REVIEW
Scott P Commins
Anaphylactic fatalities are rare; however, mild reactions can rapidly progress to cardiovascular and respiratory arrest. The clinical course of anaphylaxis can be unpredictable. Prompt and early use of epinephrine should be considered. Most anaphylaxis episodes have an immunologic mechanism involving immunoglobulin E (IgE). Foods are the most common cause in children; medications and insect stings are more common in adults. When the cause is not completely avoidable or cannot be determined, a patient should be supplied with autoinjectable epinephrine and be instructed its use...
May 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/28372716/monoarticular-arthritis
#11
REVIEW
Namrata Singh, Scott A Vogelgesang
Monoarticular arthritis is inflammation characterized by joint pain, swelling, and sometimes periarticular erythema. Although chronic causes are seen, the onset is often acute. An infected joint can quickly lead to permanent damage, making it a medical emergency. However, acute gout presenting as monoarticular arthritis is often so uncomfortable it requires urgent attention. Monoarticular crystalline arthritis is common and a septic joint is a medical emergency so it is no surprise that these diagnoses come to mind with complaint of inflammation in 1 joint...
May 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/28292540/reactive-arthritis
#12
REVIEW
Steven K Schmitt
Reactive arthritis is classified as a spondyloarthropathy. Current concepts of disease suggest an infectious trigger, followed by inflammatory arthritis. Several mechanisms have been proposed to explain the interaction of host susceptibility and microorganism. Diagnosis relies on a compatible clinical syndrome and microbiologic confirmation of the pathogen. Antibiotic therapy seems useful in Chlamydia-triggered arthritis. The role of antibiotics in arthritis triggered by enteric pathogens is less clear. The role of tumor necrosis factor alpha inhibitors in therapy is evolving...
March 11, 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28366221/septic-arthritis-of-native-joints
#13
REVIEW
John J Ross
Septic arthritis is a rheumatologic emergency that may lead to disability or death. Prompt evacuation of the joint, either by arthrocentesis at the bedside, open or arthroscopic drainage in the operating room, or imaging-guided drainage in the radiology suite, is mandatory. Methicillin-resistant Staphylococcus aureus (MRSA) has become a major cause of septic arthritis in the United States. MRSA joint infection seems to be associated with worse outcomes. Antibiotic courses of 3 to 4 weeks in duration are usually adequate for uncomplicated bacterial arthritis...
March 30, 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28366223/radiologic-approach-to-musculoskeletal-infections
#14
REVIEW
Claus S Simpfendorfer
Imaging is often used to establish a diagnosis of musculoskeletal infections and evaluate the full extent and severity of disease. Imaging should always start with radiographs, which provide an important anatomic overview. MRI is the test of choice in most musculoskeletal infections because of its superior soft tissue contrast resolution and high sensitivity for pathologic edema. However, MRI is not always possible. Alternative imaging modalities including ultrasound scan, computed tomography, and radionuclide imaging may be used...
March 30, 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28409203/the-role-of-infection-models-and-pk-pd-modelling-for-optimising-care-of-critically-ill-patients-with-severe-infections
#15
REVIEW
T Tängdén, V Ramos Martín, T W Felton, E I Nielsen, S Marchand, R J Brüggemann, J B Bulitta, M Bassetti, U Theuretzbacher, B T Tsuji, D W Wareham, L E Friberg, J J De Waele, V H Tam, Jason A Roberts
Critically ill patients with severe infections are at high risk of suboptimal antimicrobial dosing. The pharmacokinetics (PK) and pharmacodynamics (PD) of antimicrobials in these patients differ significantly from the patient groups from whose data the conventional dosing regimens were developed. Use of such regimens often results in inadequate antimicrobial concentrations at the site of infection and is associated with poor patient outcomes. In this article, we describe the potential of in vitro and in vivo infection models, clinical pharmacokinetic data and pharmacokinetic/pharmacodynamic models to guide the design of more effective antimicrobial dosing regimens...
April 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28396083/ecg-patterns-indicate-severity-of-acute-pulmonary-embolism-insights-from-serial-ecg-changes-in-a-patient-treated-with-thrombolysis
#16
Fu-Qiang Sheng, Rong Xu, Jin-Dong Xia, Mao-Rong He
No abstract text is available yet for this article.
April 7, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28403441/clinical-and-laboratory-diagnosis-of-dengue-virus-infection
#17
REVIEW
David A Muller, Alexandra C I Depelsenaire, Paul R Young
Infection with any of the 4 dengue virus serotypes results in a diverse range of symptoms, from mild undifferentiated fever to life-threatening hemorrhagic fever and shock. Given that dengue virus infection elicits such a broad range of clinical symptoms, early and accurate laboratory diagnosis is essential for appropriate patient management. Virus detection and serological conversion have been the main targets of diagnostic assessment for many years, however cross-reactivity of antibody responses among the flaviviruses has been a confounding issue in providing a differential diagnosis...
March 1, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28385354/triple-therapy-for-symptomatic-patients-with-copd
#18
Leonardo M Fabbri, Sara Roversi, Bianca Beghé
No abstract text is available yet for this article.
April 3, 2017: Lancet
https://www.readbyqxmd.com/read/28372975/guidelines-for-management-of-diabetic-ketoacidosis-time-to-revise
#19
Ketan K Dhatariya, Guillermo E Umpierrez
No abstract text is available yet for this article.
March 31, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28385658/glycaemic-control-and-weight-loss-with-semaglutide-in-type-2-diabetes
#20
Sten Madsbad, Jens J Holst
No abstract text is available yet for this article.
April 3, 2017: Lancet Diabetes & Endocrinology
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