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Medicina interna

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108 papers 25 to 100 followers
https://www.readbyqxmd.com/read/28385354/triple-therapy-for-symptomatic-patients-with-copd
#1
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/28114143/electrolyte-and-acid-base-disorders-in-chronic-kidney-disease-and-end-stage-kidney-failure
#2
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/28298398/management-of-copd-exacerbations-a%C3%A2-european-respiratory-society-american-thoracic-society-guideline
#3
Jadwiga A Wedzicha, Marc Miravitlles, John R Hurst, Peter M A Calverley, Richard K Albert, Antonio Anzueto, Gerard J Criner, Alberto Papi, Klaus F Rabe, David Rigau, Pawel Sliwinski, Thomy Tonia, Jørgen Vestbo, Kevin C Wilson, Jerry A Krishnan
This document provides clinical recommendations for treatment of chronic obstructive pulmonary disease (COPD) exacerbations.Comprehensive evidence syntheses, including meta-analyses, were performed to summarise all available evidence relevant to the Task Force's questions. The evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluation approach and the results were summarised in evidence profiles. The evidence syntheses were discussed and recommendations formulated by a multidisciplinary Task Force of COPD experts...
March 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28282320/alcoholic-hepatitis-current-trends-in-management
#4
Ariel W Aday, Mack C Mitchell, Lisa C Casey
PURPOSE OF REVIEW: Alcohol consumption is increasing globally, as are complications of alcohol-related liver disease, including the most severe manifestation, alcoholic hepatitis. Despite the increased prevalence, many patients hospitalized with alcoholic hepatitis are either not diagnosed or inadequately treated leading to significant morbidity and high mortality rates. The purpose of this review is to discuss current challenges in the diagnosis and management of this frequently fatal condition...
May 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28314211/the-role-of-kupffer-cells-in-hepatic-diseases
#5
REVIEW
Peizhi Li, Kun He, Jinzheng Li, Zuojin Liu, Jianping Gong
Kupffer cells (KCs) constitute 80-90% of the tissue macrophages present in the body. Essential to innate and adaptive immunity, KCs are responsible for the swift containment and clearance of exogenous particulates and immunoreactive materials which are perceived as foreign and harmful to the body. Similar to other macrophages, KCs also sense endogenous molecular signals that may result from perturbed homeostasis of the host. KCs have been implicated in host defense and the pathogenesis of various hepatic diseases, including endotoxin tolerance, liver transplantation, nonalcoholic fatty liver disease, and alcoholic liver disease...
March 14, 2017: Molecular Immunology
https://www.readbyqxmd.com/read/28288484/pharmacologic-therapy-for-type-2-diabetes-synopsis-of-the-2017-american-diabetes-association-standards-of-medical-care-in-diabetes
#6
James J Chamberlain, William H Herman, Sandra Leal, Andrew S Rhinehart, Jay H Shubrook, Neil Skolnik, Rita Rastogi Kalyani
Description: The American Diabetes Association (ADA) annually updates the Standards of Medical Care in Diabetes to provide clinicians, patients, researchers, payers, and other interested parties with evidence-based recommendations for the diagnosis and management of patients with diabetes. Methods: For the 2017 Standards, the ADA Professional Practice Committee updated previous MEDLINE searches performed from 1 January 2016 to November 2016 to add, clarify, or revise recommendations based on new evidence...
April 18, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28286222/2017-acc-aha-hrs-guideline-for-the-evaluation-and-management-of-patients-with-syncope-executive-summary-a-report-of-the-american-college-of-cardiology-american-heart-association-task-force-on-clinical-practice-guidelines-and-the-heart-rhythm-society
#7
Win-Kuang Shen, Robert S Sheldon, David G Benditt, Mitchell I Cohen, Daniel E Forman, Zachary D Goldberger, Blair P Grubb, Mohamed H Hamdan, Andrew D Krahn, Mark S Link, Brian Olshansky, Satish R Raj, Roopinder Kaur Sandhu, Dan Sorajja, Benjamin C Sun, Clyde W Yancy
No abstract text is available yet for this article.
March 9, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28232935/advances-in-understanding-and-management-of-residual-renal-function-in-patients-with-chronic-kidney-disease
#8
REVIEW
Xin Liu, Chunsun Dai
BACKGROUND: Residual renal function (RRF), defined as the ability of native kidneys to eliminate water and uremic toxins, is closely correlated with mortality and morbidity rates among patients receiving either peritoneal dialysis (PD) or hemodialysis (HD) via continuous clearance of middle-sized molecules and protein-bound solutes. Therefore, preserving RRF is considered to be one of the primary goals in managing patients with end-stage renal disease (ESRD). SUMMARY AND KEY MESSAGES: In this article, we provide a review on the understanding and management of RRF in patients on dialysis...
January 2017: Kidney Diseases
https://www.readbyqxmd.com/read/28302313/influenza
#9
REVIEW
Catharine Paules, Kanta Subbarao
Influenza is an acute respiratory illness, caused by influenza A, B, and C viruses, that occurs in local outbreaks or seasonal epidemics. Clinical illness follows a short incubation period and presentation ranges from asymptomatic to fulminant, depending on the characteristics of both the virus and the individual host. Influenza A viruses can also cause sporadic infections or spread worldwide in a pandemic when novel strains emerge in the human population from an animal host. New approaches to influenza prevention and treatment for management of both seasonal influenza epidemics and pandemics are desirable...
March 10, 2017: Lancet
https://www.readbyqxmd.com/read/28249994/duration-of-dual-antiplatelet-therapy-in-acute-coronary-syndrome
#10
REVIEW
Simon John Wilson, David E Newby, Dana Dawson, John Irving, Colin Berry
Despite a large volume of evidence supporting the use of dual antiplatelet therapy in patients with acute coronary syndrome, there remains major uncertainty regarding the optimal duration of therapy. Clinical trials have varied markedly in the duration of therapy, both across and within trials. Recent systematic reviews and meta-analyses suggest that shorter durations of dual antiplatelet therapy are superior because the avoidance of atherothrombotic events is counterbalanced by the greater risks of excess major bleeding with apparent increases in all-cause mortality with longer durations...
April 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28249081/management-of-type-2-diabetes-in-2017-getting-to-goal
#11
Jane E B Reusch, JoAnn E Manson
No abstract text is available yet for this article.
March 14, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28196954/metformin-and-thyroid-disease
#12
REVIEW
Xianghui Meng, Shuhang Xu, Guofang Chen, Michael Derwahl, Chao Liu
An intriguing area of research in thyroidology is the recently discovered association of insulin resistance with thyroid functional and morphological abnormalities. Individuals with hyperinsulinemia have larger thyroid gland and a higher prevalence of thyroid nodules and cancer. Accordingly, patients treated with metformin have a smaller thyroid volume and a lower risk of incident goiter, thyroid nodule and cancer. Multiple studies in vitro and in vivo have demonstrated that metformin can inhibit the growth of thyroid cells and different types of thyroid cancer cells by affecting the insulin/IGF1 and mTOR pathways...
April 2017: Journal of Endocrinology
https://www.readbyqxmd.com/read/15723115/-treatment-of-intracranial-hypertension-of-malign-tumour-origin
#13
REVIEW
A Vázquez, P Portillo, I Zazpe, B Muñoz
Brain tumours are a frequent cause of intracraneal hypertension syndrome, clinically manifested by headache, nausea and vomiting, and a decrease in the level of consciousness. The keypoint sign of intracraneal hypertension is papilloedema. Other manifestations depend on the localization of the tumour, appearing as neurological focality and seizures. The causes of intracranial hypertension of tumoural origin are the mass effect of the tumour, brain edema, the possibility of intratumoural haemorrhage and hydrocephalus caused by obstruction in the circulation of cerebrospinal fluid...
2004: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/27339672/acute-on-chronic-and-decompensated-chronic-liver-failure-definitions-epidemiology-and-prognostication
#14
REVIEW
Jody C Olson
Chronic liver disease is the fifth leading cause of death worldwide and represents a major burden for the health care community. Cirrhosis is a progressive disease resulting in end-stage liver failure, which in the absence of liver transplantation is fatal. Acute-on-chronic liver failure carries high short-term mortality but is potentially reversible. Viral hepatitis, alcohol, and nonalcoholic fatty liver disease remain the principal causes of liver disease. Though treatments exist for hepatitis B and C, they remain unavailable to many with these diseases...
July 2016: Critical Care Clinics
https://www.readbyqxmd.com/read/27339673/hepatic-encephalopathy-the-old-and-the-new
#15
REVIEW
Prem A Kandiah, Gagan Kumar
Hepatic encephalopathy occurs ubiquitously in all causes of advanced liver failure, however, its implications on mortality diverge and vary depending upon acuity and severity of liver failure. This associated mortality has decreased in subsets of liver failure over the last 20 years. Aside from liver transplantation, this improvement is not attributable to a single intervention but likely to a combination of practical advances in critical care management. Misconceptions surrounding many facets of hepatic encephalopathy exists due to heterogeneity in presentation, pathophysiology and outcome...
July 2016: Critical Care Clinics
https://www.readbyqxmd.com/read/27339675/kidney-injury-in-liver-disease
#16
REVIEW
Kevin R Regner, Kai Singbartl
Acute kidney injury (AKI) occurs frequently in patients with liver disease and increases morbidity and mortality. Hepatorenal syndrome is a common cause of AKI in patients with decompensated cirrhosis and is due to alterations in systemic and renal hemodynamics. Serum creatinine-based estimation of kidney function is a key component of the Model for End-stage Liver Disease score in liver transplant candidates. Continuous renal replacement therapy is used in critically ill patients with liver failure and AKI...
July 2016: Critical Care Clinics
https://www.readbyqxmd.com/read/27339678/hematological-issues-in-liver-disease
#17
REVIEW
Michael G Allison, Carl B Shanholtz, Ashutosh Sachdeva
Acute and chronic liver failure are associated with numerous alterations in different features of the coagulation system. Consequently, there is widespread confusion regarding the potential for both bleeding and thrombosis in patients with liver disease. The risk of bleeding is related to the hemodynamic changes in portal pressures and venous congestion whereas the thrombotic risk stems from changes in the coagulation system. Antithrombotic prophylaxis and treatment of patients with hemorrhage and thrombosis requires careful assessment, interpretation of laboratory workup, and attention to coexistent morbidities...
July 2016: Critical Care Clinics
https://www.readbyqxmd.com/read/28159829/iga-nephropathy
#18
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...
April 3, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28170483/diagnosis-and-treatment-of-pituitary-adenomas-a-review
#19
REVIEW
Mark E Molitch
Importance: Pituitary adenomas may hypersecrete hormones or cause mass effects. Therefore, early diagnosis and treatment are important. Observations: Prevalence of pituitary adenomas ranges from 1 in 865 adults to 1 in 2688 adults. Approximately 50% are microadenomas (<10 mm); the remainder are macroadenomas (≥10 mm). Mass effects cause headache, hypopituitarism, and visual field defects. Treatments include transsphenoidal surgery, medical therapies, and radiotherapy...
February 7, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28170086/cancer-screening-in-the-united-states-2017-a-review-of-current-american-cancer-society-guidelines-and-current-issues-in-cancer-screening
#20
Robert A Smith, Kimberly S Andrews, Durado Brooks, Stacey A Fedewa, Deana Manassaram-Baptiste, Debbie Saslow, Otis W Brawley, Richard C Wender
Answer questions and earn CME/CNE Each year, the American Cancer Society publishes a summary of its guidelines for early cancer detection, data and trends in cancer screening rates, and select issues related to cancer screening. In this issue of the journal, the authors summarize current American Cancer Society cancer screening guidelines, describe an update of their guideline for using human papillomavirus vaccination for cancer prevention, describe updates in US Preventive Services Task Force recommendations for breast and colorectal cancer screening, discuss interim findings from the UK Collaborative Trial on Ovarian Cancer Screening, and provide the latest data on utilization of cancer screening from the National Health Interview Survey...
February 7, 2017: CA: a Cancer Journal for Clinicians
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