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Michael J Bradshaw, Siddharama Pawate, Karen C Bloch, Paul Moots, Nishitha M Reddy
No abstract text is available yet for this article.
September 27, 2016: Neurology
Rory Collins, Christina Reith, Jonathan Emberson, Jane Armitage, Colin Baigent, Lisa Blackwell, Roger Blumenthal, John Danesh, George Davey Smith, David DeMets, Stephen Evans, Malcolm Law, Stephen MacMahon, Seth Martin, Bruce Neal, Neil Poulter, David Preiss, Paul Ridker, Ian Roberts, Anthony Rodgers, Peter Sandercock, Kenneth Schulz, Peter Sever, John Simes, Liam Smeeth, Nicholas Wald, Salim Yusuf, Richard Peto
This Review is intended to help clinicians, patients, and the public make informed decisions about statin therapy for the prevention of heart attacks and strokes. It explains how the evidence that is available from randomised controlled trials yields reliable information about both the efficacy and safety of statin therapy. In addition, it discusses how claims that statins commonly cause adverse effects reflect a failure to recognise the limitations of other sources of evidence about the effects of treatment...
September 6, 2016: Lancet
Jean-Louis Vincent, Matteo Bassetti, Bruno François, George Karam, Jean Chastre, Antoni Torres, Jason A Roberts, Fabio S Taccone, Jordi Rello, Thierry Calandra, Daniel De Backer, Tobias Welte, Massimo Antonelli
Infections occur frequently in critically ill patients and their management can be challenging for various reasons, including delayed diagnosis, difficulties identifying causative microorganisms, and the high prevalence of antibiotic-resistant strains. In this review, we briefly discuss the importance of early infection diagnosis, before considering in more detail some of the key issues related to antibiotic management in these patients, including controversies surrounding use of combination or monotherapy, duration of therapy, and de-escalation...
2016: Critical Care: the Official Journal of the Critical Care Forum
Jeffrey A Kraut, Nicolaos E Madias
The kidney has the principal role in the maintenance of acid-base balance. Therefore, a decrease in renal ammonium excretion and a positive acid balance often leading to a reduction in serum bicarbonate concentration are observed in the course of chronic kidney disease (CKD). The decrease in serum bicarbonate concentration is usually absent until glomerular filtration rate decreases to <20 to 25mL/min/1.73 m(2), although it can develop with lesser degrees of decreased kidney function. Non-anion gap acidosis, high-anion gap acidosis, or both can be found at all stages of CKD...
February 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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
Todd A Koch, Jennifer Myers, Lawrence Tim Goodnough
Objective. To provide clinicians with evidence-based guidance for iron therapy dosing in patients with iron deficiency anemia (IDA), we conducted a study examining the benefits of a higher cumulative dose of intravenous (IV) iron than what is typically administered. Methods. We first individually analyzed 5 clinical studies, averaging the total iron deficit across all patients utilizing a modified Ganzoni formula; we then similarly analyzed 2 larger clinical studies. For the second of the larger studies (Study 7), we also compared the efficacy and retreatment requirements of a cumulative dose of 1500 mg ferric carboxymaltose (FCM) to 1000 mg iron sucrose (IS)...
2015: Anemia
Malgorzata J Podolska, Mona Hc Biermann, Christian Maueröder, Jonas Hahn, Martin Herrmann
The immune system struggles every day between responding to foreign antigens and tolerating self-antigens to delicately maintain tissue homeostasis. If self-tolerance is broken, the development of autoimmunity can be the consequence, as it is in the case of the chronic inflammatory autoimmune disease systemic lupus erythematosus (SLE). SLE is considered to be a multifactorial disease comprising various processes and cell types that act abnormally and in a harmful way. Oxidative stress, infections, or, in general, tissue injury are accompanied by massive cellular demise...
2015: Journal of Inflammation Research
Jeffrey A Kraut, Nicolaos E Madias
New England Journal of Medicine, Volume 371, Issue 24, Page 2309-2319, December 2014.
December 11, 2014: New England Journal of Medicine
(no author information available yet)
No abstract text is available yet for this article.
2014: Critical Care: the Official Journal of the Critical Care Forum
Xiaowu Bai, Wenkui Yu, Wu Ji, Zhiliang Lin, Shanjun Tan, Kaipeng Duan, Yi Dong, Lin Xu, Ning Li
INTRODUCTION: This study investigated the incidence of delayed norepinephrine administration following the onset of septic shock and its effect on hospital mortality. METHODS: We conducted a retrospective cohort study using data from 213 adult septic shock patients treated at two general surgical intensive care units of a tertiary care hospital over a two year period. The primary outcome was 28-day mortality. RESULTS: The 28-day mortality was 37...
2014: Critical Care: the Official Journal of the Critical Care Forum
Tommy Cederholm, John E Morley
PURPOSE OF REVIEW: To highlight the new international definitions of sarcopenia. RECENT FINDINGS: New international definitions of sarcopenia have been evaluated and shown to be predictive of poor outcomes in older persons. SUMMARY: There is now international agreement that the definition for sarcopenia should include not only muscle mass, but also some measure of muscle function, such as walking speed or distance or grip strength.
January 2015: Current Opinion in Clinical Nutrition and Metabolic Care
Bram Rochwerg, Waleed Alhazzani, Anees Sindi, Diane Heels-Ansdell, Lehana Thabane, Alison Fox-Robichaud, Lawrence Mbuagbaw, Wojciech Szczeklik, Fayez Alshamsi, Sultan Altayyar, Wang-Chun Ip, Guowei Li, Michael Wang, Anna Wludarczyk, Qi Zhou, Gordon H Guyatt, Deborah J Cook, Roman Jaeschke, Djillali Annane
BACKGROUND: Fluid resuscitation is the cornerstone of sepsis treatment. However, whether balanced or unbalanced crystalloids or natural or synthetic colloids confer a survival advantage is unclear. PURPOSE: To examine the effect of different resuscitative fluids on mortality in patients with sepsis. DATA SOURCES: MEDLINE, EMBASE, ACP Journal Club, CINAHL, HealthSTAR, the Allied and Complementary Medicine Database, and the Cochrane Central Register of Controlled Trials through March 2014...
September 2, 2014: Annals of Internal Medicine
Seung Ha Park, Dong Joon Kim, Young Seok Kim, Hyung Joon Yim, Won Young Tak, Heon Ju Lee, Joo Hyun Sohn, Ki Tae Yoon, In Hee Kim, Hyoung Su Kim, Soon Ho Um, Soon Koo Baik, June Sung Lee, Ki Tae Suk, Sang Gyune Kim, Sang Jun Suh, Soo Young Park, Tae Yeob Kim, Jae Young Jang
BACKGROUND & AIMS: Both corticosteroid and pentoxifylline reduce short-term mortality in severe alcoholic hepatitis. However, few studies have directly compared the efficacy of pentoxifylline and corticosteroid in patients with this condition. METHODS: In this multicentre, open-labelled, randomised non-inferiority trial, we assigned 121 patients with severe alcoholic hepatitis (Maddrey's discriminant function ⩾32) to receive either pentoxifylline (400 mg, 3 times daily, in 62 subjects) or prednisolone (40 mg daily, in 59 subjects)...
October 2014: Journal of Hepatology
Craig T January, L Samuel Wann, Joseph S Alpert, Hugh Calkins, Joaquin E Cigarroa, Joseph C Cleveland, Jamie B Conti, Patrick T Ellinor, Michael D Ezekowitz, Michael E Field, Katherine T Murray, Ralph L Sacco, William G Stevenson, Patrick J Tchou, Cynthia M Tracy, Clyde W Yancy
No abstract text is available yet for this article.
December 2, 2014: Circulation
Paul K Crane, Rod Walker, Rebecca A Hubbard, Ge Li, David M Nathan, Hui Zheng, Sebastien Haneuse, Suzanne Craft, Thomas J Montine, Steven E Kahn, Wayne McCormick, Susan M McCurry, James D Bowen, Eric B Larson
BACKGROUND: Diabetes is a risk factor for dementia. It is unknown whether higher glucose levels increase the risk of dementia in people without diabetes. METHODS: We used 35,264 clinical measurements of glucose levels and 10,208 measurements of glycated hemoglobin levels from 2067 participants without dementia to examine the relationship between glucose levels and the risk of dementia. Participants were from the Adult Changes in Thought study and included 839 men and 1228 women whose mean age at baseline was 76 years; 232 participants had diabetes, and 1835 did not...
August 8, 2013: New England Journal of Medicine
R Parker, M J Armstrong, C Corbett, I A Rowe, D D Houlihan
BACKGROUND: Acute alcoholic hepatitis (AH) is a severe manifestation of alcoholic liver disease with a grave prognosis. Pentoxifylline, an oral antitumour necrosis factor agent, has been reported to reduce mortality and incidence of hepatorenal syndrome (HRS) in severe alcoholic hepatitis (SAH). AIM: To summarise evidence for the use of pentoxifylline in SAH. METHODS: A literature search was undertaken using MeSH terms 'hepatitis, alcoholic' and 'pentoxifylline' using the set operator AND...
May 2013: Alimentary Pharmacology & Therapeutics
Afsaneh Barzi, Mikkael A Sekeres
The myelodysplastic syndromes (MDS) are clonal bone marrow disorders that lead to underproduction of normal blood cells. The consequent cytopenias result in infections and bleeding complications. MDS transform to acute myeloid leukemia in one-third of patients. The number of diagnoses has exploded in the past decade as a result of increased recognition and understanding of the disease and the aging of the population. New therapies can extend life. MDS are now considered the most common form of leukemia, and in some cases deserve immediate intervention...
January 2010: Cleveland Clinic Journal of Medicine
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