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Medicina Interna / internal Medicine

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2866 papers 1000+ followers Medicina Interna / internal Medicine - Request items in this E-Mail: andresflmd@gmail.com
By Andrés López, M.D. Médico/Physician - M.D.
https://www.readbyqxmd.com/read/27995093/new-perspectives-in-the-treatment-of-colorectal-metastases
#1
REVIEW
Dominique Elias, Luca Viganò, Franco Orsi, Marta Scorsetti, Tiziana Comito, Jan Lerut, Davide Cosola, Guido Torzilli
BACKGROUND: In recent years, the management of metastatic colorectal cancer has become more aggressive and more multidisciplinary. New treatment options have been proposed in addition to the standard approach of resection of liver metastases and chemotherapy. SUMMARY: Selected patients with synchronous limited peritoneal and liver disease (peritoneal cancer index <12 and <3 liver metastases) can be scheduled for aggressive treatment, including cytoreductive surgery, hyperthermic intraperitoneal chemotherapy, and liver resection...
November 2016: Liver Cancer
https://www.readbyqxmd.com/read/28188210/management-of-oral-secretions-in-neurological-disease
#2
REVIEW
Alexander J McGeachan, Christopher J Mcdermott
Sialorrhoea is a common and problematic symptom that arises from a range of neurological conditions associated with bulbar or facial muscle dysfunction. Drooling can significantly affect quality of life due to both physical complications such as oral chapping, and psychological complications such as embarrassment and social isolation. Thicker, tenacious oral and pharyngeal secretions may result from the drying management approach to sialorrhoea. The management of sialorrhoea in neurological diseases depends on the underlying pathology and severity of symptoms...
February 10, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28154101/cardioembolic-stroke
#3
Hooman Kamel, Jeff S Healey
Cardiac embolism accounts for an increasing proportion of ischemic strokes and might multiply several-fold during the next decades. However, research points to several potential strategies to stem this expected rise in cardioembolic stroke. First, although one-third of strokes are of unclear cause, it is increasingly accepted that many of these cryptogenic strokes arise from a distant embolism rather than in situ cerebrovascular disease, leading to the recent formulation of embolic stroke of undetermined source as a distinct target for investigation...
February 3, 2017: Circulation Research
https://www.readbyqxmd.com/read/28188055/the-emergency-medicine-management-of-severe-alcohol-withdrawal
#4
Drew Long, Brit Long, Alex Koyfman
INTRODUCTION: Alcohol use is widespread, and withdrawal symptoms are common after decreased alcohol intake. Severe alcohol withdrawal may manifest with delirium tremens, and new therapies may assist in management of this life-threatening condition. OBJECTIVE: To provide an evidence-based review of the emergency medicine management of alcohol withdrawal and delirium tremens. DISCUSSION: The underlying pathophysiology of alcohol withdrawal syndrome (AWS) is central nervous system hyperexcitation...
February 4, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27846456/management-and-outcomes-of-acute-myocardial-infarction-in-patients-with-chronic-kidney-disease
#5
Nathaniel R Smilowitz, Navdeep Gupta, Yu Guo, Rina Mauricio, Sripal Bangalore
BACKGROUND: Chronic kidney disease (CKD) is associated with cardiovascular disease and acute myocardial infarction (AMI). Contemporary management and outcomes of AMI in patients with CKD have not been reported. METHODS: We analyzed United States National Inpatient Sample data for patients admitted with AMI with or without CKD from 2007 to 2012. Propensity score matching was used to identify patients with AMI and CKD with similar baseline characteristics who were managed invasively (cardiac catheterization, percutaneous coronary intervention [PCI], or coronary artery bypass graft surgery [CABG]) or conservatively...
January 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28190580/type-2-diabetes
#6
REVIEW
Sudesna Chatterjee, Kamlesh Khunti, Melanie J Davies
415 million people live with diabetes worldwide, and an estimated 193 million people have undiagnosed diabetes. Type 2 diabetes accounts for more than 90% of patients with diabetes and leads to microvascular and macrovascular complications that cause profound psychological and physical distress to both patients and carers and put a huge burden on health-care systems. Despite increasing knowledge regarding risk factors for type 2 diabetes and evidence for successful prevention programmes, the incidence and prevalence of the disease continues to rise globally...
February 9, 2017: Lancet
https://www.readbyqxmd.com/read/27865194/high-sensitivity-cardiac-troponin-t-levels-in-the-emergency-department-in-patients-with-chest-pain-but-no-myocardial-infarction
#7
Axel C Carlsson, Nadia Bandstein, Andreas Roos, Ola Hammarsten, Martin J Holzmann
BACKGROUND: High-sensitivity cardiac troponin T (hs-cTnT) was recently introduced into clinical practice. The increased sensitivity has decreased the specificity. We aimed to determine the predictors for and prevalence of hs-cTnT levels above the 99th percentile in a stable population of patients without myocardial infarction (MI) who sought medical attention for chest pain in the emergency department. METHODS: We included 11,847 patients with chest pain and at least one hs-cTnT measurement during 2011 and 2012...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28163048/heart-failure-with-preserved-ejection-fraction-diagnosis-and-management
#8
REVIEW
Ohad Oren, Sheldon Goldberg
Heart Failure with Preserved Ejection Fraction (HFpEF) is a prevalent condition with substantial individual and societal burden. Elucidation of the mechanisms of HFpEF is not complete. Recently, intriguing theories about the phenotypic importance of HFpEF (i.e. underlying diabetes mellitus, atrial fibrillation, obesity) have been suggested. However, it has yet to be determined if a targeted approach of that kind would help ameliorate symptoms or slow disease progression. In this article, we review the current status of understanding of HFpEF, focusing on the challenges and uncertainties regarding diagnosis and treatment...
February 2, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28134012/treatment-of-epileptic-encephalopathies
#9
Hiroki Nariai, Susan Duberstein, Shlomo Shinnar
Childhood epileptic encephalopathies are age-dependent disorders of the brain whose hallmarks include loss of neurologic function over time, abnormal electroencephalographic findings, and seizures. Ictal and interictal electrographic activity are conjointly thought to be at the root of the often devastating neuropsychological deterioration, which is specific to the maturing brain. The goals of treatment are not only to control seizures, but also to prevent or reverse neurologic loss of function. In general, time is of the essence in diagnosis, and experienced specialists should promptly design a treatment plan...
January 1, 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28148586/systemic-lupus-erythematosus
#10
Maliha F Shaikh, Natasha Jordan, David P D'Cruz
Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disease that is highly heterogeneous in its presentation. This can pose significant challenges for physicians responsible for the diagnosis and treatment of such patients. SLE arises from a combination of genetic, epigenetic and environmental factors. Pathologically, the disease is primarily driven by loss of immune tolerance and abnormal B- and T-cell function. Major organ involvement may lead to significant morbidity and mortality. Classification criteria for SLE have been developed largely for research purposes; however, these are also widely used in clinical practice...
February 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28013206/systemic-lupus-erythematosus-diagnosis-and-management
#11
REVIEW
Bernard Thong, Nancy J Olsen
SLE presents many challenges for clinicians. The onset of disease may be insidious, with many different symptoms and signs, making early and accurate diagnosis challenging. Tests for SLE in the early stages lack specificity; those that are useful later often appear only after organ damage is manifest. Disease patterns are highly variable; flares are not predictable and not always associated with biomarkers. Children with SLE may have severe disease and present special management issues. Older SLE patients have complicating co-morbid conditions...
December 24, 2016: Rheumatology
https://www.readbyqxmd.com/read/28157814/hypertension-in-dialysis-patients-a-consensus-document-by-the-european-renal-and-cardiovascular-medicine-eureca-m-working-group-of-the-european-renal-association-european-dialysis-and-transplant-association-era-edta-and-the-hypertension-and-the-kidney-working
#12
Pantelis A Sarafidis, Alexandre Persu, Rajiv Agarwal, Michel Burnier, Peter de Leeuw, Charles Ferro, Jean-Michel Halimi, Gunnar Heine, Michel Jadoul, Faical Jarraya, Mehmet Kanbay, Francesca Mallamaci, Patrick B Mark, Alberto Ortiz, Gianfranco Parati, Roberto Pontremoli, Patrick Rossignol, Luis Ruilope, Patricia Van der Niepen, Raymond Vanholder, Marianne C Verharr, Andrzej Wiecek, Gregoire Wuerzner, Gérard M London, Carmine Zoccali
In patients with end-stage renal disease treated with hemodialysis or peritoneal dialysis, hypertension is very common and often poorly controlled. Blood pressure (BP) recordings obtained before or after hemodialysis display a J-shaped or U-shaped association with cardiovascular events and survival, but this most likely reflects the low accuracy of these measurements and the peculiar hemodynamic setting related with dialysis treatment. Elevated BP by home or ambulatory BP monitoring is clearly associated with shorter survival...
February 2, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28159829/iga-nephropathy
#13
Jennifer C Rodrigues, Mark Haas, Heather N Reich
IgA nephropathy (IgAN) is a leading cause of CKD and renal failure. Recent international collaborative efforts have led to important discoveries that have improved our understanding of some of the key steps involved in the immunopathogenesis of IgAN. Furthermore, establishment of multicenter networks has contributed to rigorous design and execution of clinical trials that have provided important insights regarding immunotherapy in IgAN. In this article, we review emerging developments in clinical and translational IgAN research and describe how these novel findings will influence future strategies to improve the outcome of patients with IgAN...
February 3, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28174217/diagnosis-and-treatment-of-hyponatremia-compilation-of-the-guidelines
#14
Ewout J Hoorn, Robert Zietse
Hyponatremia is a common water balance disorder that often poses a diagnostic or therapeutic challenge. Therefore, guidelines were developed by professional organizations, one from within the United States (2013) and one from within Europe (2014). This review discusses the diagnosis and treatment of hyponatremia, comparing the two guidelines and highlighting recent developments. Diagnostically, the initial step is to differentiate hypotonic from nonhypotonic hyponatremia. Hypotonic hyponatremia is further differentiated on the basis of urine osmolality, urine sodium level, and volume status...
February 7, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28119010/diagnosis-and-treatment-of-ascites
#15
Emmanuel A Tsochatzis, Alexander L Gerbes
No abstract text is available yet for this article.
January 21, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28134117/updates-in-tuberculosis-diagnosis-in-the-usa
#16
Ammara Mushtaq
No abstract text is available yet for this article.
February 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28159534/chikungunya-virus-an-update-on-the-biology-and-pathogenesis-of-this-emerging-pathogen
#17
REVIEW
Felicity J Burt, Weiqiang Chen, Jonathan J Miner, Deborah J Lenschow, Andres Merits, Esther Schnettler, Alain Kohl, Penny A Rudd, Adam Taylor, Lara J Herrero, Ali Zaid, Lisa F P Ng, Suresh Mahalingam
Re-emergence of chikungunya virus, a mosquito-transmitted pathogen, is of serious public health concern. In the past 15 years, after decades of infrequent, sporadic outbreaks, the virus has caused major epidemic outbreaks in Africa, Asia, the Indian Ocean, and more recently the Caribbean and the Americas. Chikungunya virus is mainly transmitted by Aedes aegypti mosquitoes in tropical and subtropical regions, but the potential exists for further spread because of genetic adaptation of the virus to Aedes albopictus, a species that thrives in temperate regions...
January 31, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28153383/non-hodgkin-lymphoma
#18
REVIEW
James O Armitage, Randy D Gascoyne, Matthew A Lunning, Franco Cavalli
Lymphomas can affect any organ in the body, present with a wide range of symptoms, and be seen by primary care physicians and physicians from most specialties. They are traditionally divided into Hodgkin's lymphoma (which accounts for about 10% of all lymphomas) and non-Hodgkin lymphoma, which is the topic of this Seminar. Non-Hodgkin lymphoma represents a wide spectrum of illnesses that vary from the most indolent to the most aggressive malignancies. They arise from lymphocytes that are at various stages of development, and the characteristics of the specific lymphoma subtype reflect those of the cell from which they originated...
January 30, 2017: Lancet
https://www.readbyqxmd.com/read/28159390/sickle-cell-disease
#19
REVIEW
Russell E Ware, Mariane de Montalembert, Léon Tshilolo, Miguel R Abboud
Sickle cell disease is a common and life-threatening haematological disorder that affects millions of people worldwide. Abnormal sickle-shaped erythrocytes disrupt blood flow in small vessels, and this vaso-occlusion leads to distal tissue ischaemia and inflammation, with symptoms defining the acute painful sickle-cell crisis. Repeated sickling and ongoing haemolytic anaemia, even when subclinical, lead to parenchymal injury and chronic organ damage, causing substantial morbidity and early mortality. Currently available treatments are limited to transfusions and hydroxycarbamide, although stem cell transplantation might be a potentially curative therapy...
January 31, 2017: Lancet
https://www.readbyqxmd.com/read/28150371/venous-thromboembolism-management-practices-and-knowledge-of-guidelines-a-survey-of-australian-haematologists-and-respiratory-physicians
#20
Rory Wallace, Mary-Ann Anderson, Katharine See, Ms Alexandra Gorelik, A/Prof Louis Irving, Renee Manser
BACKGROUND: Current international clinical practice guidelines do not adequately address all clinical scenarios in the management of venous thromboembolism (VTE) and no comprehensive Australian guidelines exist. We aimed to identify areas of uncertainty in VTE management and whether self-reported practice is consistent with guidelines. METHODS: We conducted an Australian cross-sectional online survey consisting of 53 questions to investigate doctors' VTE management practices...
February 2, 2017: Internal Medicine Journal
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