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Medicina Interna / internal Medicine

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2771 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/27522622/lactic-acidosis-an-update
#1
Jansen Seheult, Gerard Fitzpatrick, Gerard Boran
Lactate is one of the most crucial intermediates in carbohydrate and nonessential amino acid metabolism. The complexity of cellular interactions and metabolism means that lactate can be considered a waste product for one cell but a useful substrate for another. The presence of elevated lactate levels in critically ill patients has important implications for morbidity and mortality. In this review, we provide a brief outline of the metabolism of lactate, the pathophysiology of lactic acidosis, the clinical significance of D-lactate, the role of lactate measurement in acutely ill patients, the methods used to measure lactate in blood or plasma and some of the methodological issues related to interferences in these assays, especially in the case of ethylene glycol poisoning...
August 15, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28000593/chronic-obstructive-pulmonary-disease-copd
#2
Laura Feetham, Aaron van Dorn
No abstract text is available yet for this article.
January 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/27980278/severe-fever-with-thrombocytopenia-syndrome
#3
Tomohiro Taniguchi, Yuki Miyasako, Hideyasu Hirosawa
No abstract text is available yet for this article.
2016: Internal Medicine
https://www.readbyqxmd.com/read/27784575/the-appropriate-use-of-proton-pump-inhibitors-ppis-need-for-a-reappraisal
#4
REVIEW
Vincenzo Savarino, Pietro Dulbecco, Nicola de Bortoli, Andrea Ottonello, Edoardo Savarino
The advent of powerful acid-suppressive drugs, such as proton pump inhibitors (PPIs), has revolutionized the management of acid-related diseases and has minimized the role of surgery. The major and universally recognized indications for their use are represented by treatment of gastro-esophageal reflux disease, eradication of Helicobacter pylori infection in combination with antibiotics, therapy of H. pylori-negative peptic ulcers, healing and prophylaxis of non-steroidal anti-inflammatory drug-associated gastric ulcers and control of several acid hypersecretory conditions...
October 23, 2016: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28039338/thrombosis-and-platelets-an-update
#5
REVIEW
Milka Koupenova, Beate E Kehrel, Heather A Corkrey, Jane E Freedman
Haemostasis and thrombosis are complex, multifactorial processes. There is an evolving understanding of the mechanisms influencing vascular occlusion and the role of inflammation and immunity. Despite major advances in elucidating the mechanistic pathways mediating platelet function and thrombosis, challenges in the treatment of vascular occlusive diseases persist. Pharmacological advances have greatly affected thrombotic outcomes, but this has led to the unwanted side effect of bleeding. Detailed assessment of the impact of non-thrombotic diseases on haemostasis and thrombosis is necessary to better evaluate thrombotic risk and establish optimal treatment...
December 30, 2016: European Heart Journal
https://www.readbyqxmd.com/read/27999003/diabetic-neuropathy-a-position-statement-by-the-american-diabetes-association
#6
REVIEW
Rodica Pop-Busui, Andrew J M Boulton, Eva L Feldman, Vera Bril, Roy Freeman, Rayaz A Malik, Jay M Sosenko, Dan Ziegler
No abstract text is available yet for this article.
January 2017: Diabetes Care
https://www.readbyqxmd.com/read/27842745/managing-acute-lung-injury
#7
REVIEW
Gregory A Schmidt
The foundation of mechanical ventilation for acute respiratory distress syndrome involves limiting lung overdistention by using small tidal volumes or transpulmonary pressures. Potential for additional lung recruitment with higher positive end-expiratory pressure (PEEP) should be assessed. When stress index indicates tidal recruitment-derecruitment, PEEP is increased to higher values. Alternatively, a high PEEP table is used in all patients. When these conventional approaches are insufficient to sustain acceptable gas exchange, rescue is attempted using extracorporeal therapies, airway pressure-release ventilation, inhaled vasodilators, or high-frequency oscillatory ventilation...
December 2016: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/27938518/taurine-energy-drinks-and-neuroendocrine-effects
#8
REVIEW
Jonathan J Caine, Thomas D Geracioti
Taurine is an amino acid found abundantly in brain, retina, heart, and reproductive organ cells, as well as in meat and seafood. But it is also a major ingredient in popular "energy drinks," which thus constitute a major source of taurine supplementation. Unfortunately, little is known about taurine's neuroendocrine effects. The authors review the sparse data and provide a basic background on the structure, synthesis, distribution, metabolism, mechanisms, effects, safety, and currently proposed therapeutic targets of taurine...
December 2016: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/28024548/canadian-cardiovascular-society-canadian-cardiovascular-critical-care-society-canadian-association-of-interventional-cardiology-position-statement-on-the-optimal-care-of-the-postarrest-patient
#9
Graham C Wong, Sean van Diepen, Craig Ainsworth, Rakesh C Arora, Jean G Diodati, Mark Liszkowski, Michael Love, Chris Overgaard, Greg Schnell, Jean-Francois Tanguay, George Wells, Michel Le May
Out of hospital cardiac arrest (OHCA) is associated with a low rate of survival to hospital discharge and high rates of neurological morbidity among survivors. Programmatic efforts to institute and integrate OHCA best care practices from the bystander response through to the in-hospital phase have been associated with improved patient outcomes. This Canadian Cardiovascular Society position statement was developed to provide comprehensive yet practical recommendations to guide the in-hospital care of OHCA patients...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28024554/moving-beyond-shock-new-paradigms-in-the-management-of-acute-myocardial-infarction-complicated-by-cardiogenic-shock
#10
REVIEW
Dimitri Kalavrouziotis, Josep Rodés-Cabau, Siamak Mohammadi
The current management of patients with acute myocardial infarction complicated by cardiogenic shock (AMI-CS) is associated with a high rate of mortality, despite widespread regional implementation of rapid transfer to percutaneous coronary intervention-capable centres for prompt infarct-related artery reperfusion. The limited clinical effectiveness of early revascularization in patients with AMI-CS might be secondary to the extent of coronary artery disease in these patients and the risk of incomplete revascularization, as well as the lower probability of achieving successful reperfusion compared with acute myocardial infarction without hemodynamic instability...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28024557/acute-right-ventricle-failure-in-the-intensive-care-unit-assessment-and-management
#11
REVIEW
Carmen Hrymak, Johann Strumpher, Eric Jacobsohn
Caring for the critically ill patient with acute right ventricle (RV) failure is a diagnostic and management challenge. A thorough understanding of normal RV anatomy and physiology is essential to manage RV failure. Despite the fact that the RV is essentially a volume chamber that ejects into a low-pressure system, the left ventricle contributes significantly to RV function through maintenance of the transseptal gradient (TSG). Preserving systemic mean arterial pressure maintains the TSG and RV perfusion. Various pathological states cause acute RV failure by decreasing the TSG and RV perfusion and/or increasing pulmonary vascular resistance...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28034582/an-evidence-based-guide-to-cholesterol-lowering-guidelines
#12
REVIEW
David D Waters, S Matthijs Boekholdt
Since 2014, guidelines for the management of lipid disorders to reduce cardiovascular (CV) events have been updated in the United States, the United Kingdom, Europe, and Canada. Some of these guidelines are almost entirely evidence-based whereas others are a mix of evidence and expert opinion. Guidelines differ on such simple questions as to whether blood samples should be fasting or nonfasting, and whether low-density lipoprotein cholesterol (LDL-C) or another lipid parameter should be the primary focus of treatment...
October 24, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28042719/insulins-nph-glargine-and-detemir-and-risk-of-severe-hypoglycaemia-among-working-age-adults
#13
Arto Y Strandberg, Houssem Khanfir, Sari Mäkimattila, Tero Saukkonen, Timo E Strandberg, Fabian Hoti
INTRODUCTION: The longer acting basal insulin analogues glargine and detemir have shown a lower incidence of hypoglycaemia compared to insulin NPH in clinical studies. We evaluated the real-life risk of severe hypoglycaemia among new users of insulins in the working-age population in Finland. METHODS: All persons aged 18-65 years with diabetes mellitus who were newly prescribed with insulins NPH, glargine, or detemir during 2006-2009, were identified from national registers...
December 31, 2016: Annals of Medicine
https://www.readbyqxmd.com/read/27992909/management-of-chronic-insomnia-disorder-in-adults
#14
Thomas E Finucane
No abstract text is available yet for this article.
December 20, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28055047/oral-pharmacologic-treatment-of-type-2-diabetes
#15
(no author information available yet)
No abstract text is available yet for this article.
January 3, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28030676/aortic-stenosis
#16
Faisal G Bakaeen, Todd K Rosengart, Blase A Carabello
This issue provides a clinical overview of aortic stenosis, focusing on screening, diagnosis, treatment, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers...
January 3, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28055075/oral-pharmacologic-treatment-of-type-2-diabetes-mellitus-a-clinical-practice-guideline-update-from-the-american-college-of-physicians
#17
Amir Qaseem, Michael J Barry, Linda L Humphrey, Mary Ann Forciea
Description: The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on oral pharmacologic treatment of type 2 diabetes in adults. This guideline serves as an update to the 2012 ACP guideline on the same topic. This guideline is endorsed by the American Academy of Family Physicians. Methods: This guideline is based on a systematic review of randomized, controlled trials and observational studies published through December 2015 on the comparative effectiveness of oral medications for type 2 diabetes...
January 3, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27897155/diagnosis-and-management-of-microscopic-colitis
#18
REVIEW
Darrell S Pardi
Microscopic colitis (MC) is a relatively common cause of chronic watery diarrhea, especially in older persons. Associated symptoms, including abdominal pain and arthralgias, are common. The diagnosis is based upon characteristic histological findings in the presence of diarrhea. The two types of MC, collagenous and lymphocytic colitis, share similar clinical features, with the main difference being the presence or absence of a thickened subepithelial collagen band. There are several treatment options for patients with MC, although only budesonide has been well studied in multiple controlled clinical trials...
November 29, 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27995906/acg-clinical-guideline-evaluation-of-abnormal-liver-chemistries
#19
Paul Y Kwo, Stanley M Cohen, Joseph K Lim
Clinicians are required to assess abnormal liver chemistries on a daily basis. The most common liver chemistries ordered are serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase and bilirubin. These tests should be termed liver chemistries or liver tests. Hepatocellular injury is defined as disproportionate elevation of AST and ALT levels compared with alkaline phosphatase levels. Cholestatic injury is defined as disproportionate elevation of alkaline phosphatase level as compared with AST and ALT levels...
January 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28045663/caustic-ingestion
#20
REVIEW
Mircea Chirica, Luigi Bonavina, Michael D Kelly, Emile Sarfati, Pierre Cattan
Corrosive ingestion is a rare but potentially devastating event and, despite the availability of effective preventive public health strategies, injuries continue to occur. Most clinicians have limited personal experience and rely on guidelines; however, uncertainty persists about best clinical practice. Ingestions range from mild cases with no injury to severe cases with full thickness necrosis of the oesophagus and stomach. CT scan is superior to traditional endoscopy for stratification of patients to emergency resection or observation...
October 26, 2016: Lancet
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