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JOURNAL ARTICLE
Xuezhu Li, Shougang Zhuang
Acute kidney injury (AKI) is increasingly recognized in clinical practice, and common in HIV-infection patients, affecting 18% of hospitalized patients. Preexisting hypertension, advanced HIV-infection, tenofovir toxicity, HCV co-infection, sepsis are risk factors of AKI. AKI can lead to prolonged hospitalization and is associated with increased mortality in HIV-infected patients. This review provides the most recent updates in the definition, diagnosis, pathophysiology, risk factors and treatment options for patients with HIV-associated AKI...
April 2013: Journal of Tropical Diseases
#2
Iain C Macdougall, Andreas J Bircher, Kai-Uwe Eckardt, Gregorio T Obrador, Carol A Pollock, Peter Stenvinkel, Dorine W Swinkels, Christoph Wanner, Günter Weiss, Glenn M Chertow
Before the introduction of erythropoiesis-stimulating agents (ESAs) in 1989, repeated transfusions given to patients with end-stage renal disease caused iron overload, and the need for supplemental iron was rare. However, with the widespread introduction of ESAs, it was recognized that supplemental iron was necessary to optimize hemoglobin response and allow reduction of the ESA dose for economic reasons and recent concerns about ESA safety. Iron supplementation was also found to be more efficacious via intravenous compared to oral administration, and the use of intravenous iron has escalated in recent years...
January 2016: Kidney International
#3
REVIEW
Gilles Montalescot, Filippo Crea
No abstract text is available yet for this article.
January 14, 2016: European Heart Journal
#4
RANDOMIZED CONTROLLED TRIAL
Puck S S Fransen, Olvert A Berkhemer, Hester F Lingsma, Debbie Beumer, Lucie A van den Berg, Albert J Yoo, Wouter J Schonewille, Jan Albert Vos, Paul J Nederkoorn, Marieke J H Wermer, Marianne A A van Walderveen, Julie Staals, Jeannette Hofmeijer, Jacques A van Oostayen, Geert J Lycklama À Nijeholt, Jelis Boiten, Patrick A Brouwer, Bart J Emmer, Sebastiaan F de Bruijn, Lukas C van Dijk, L Jaap Kappelle, Rob H Lo, Ewoud J van Dijk, Joost de Vries, Paul L M de Kort, J S Peter van den Berg, Boudewijn A A M van Hasselt, Leo A M Aerden, René J Dallinga, Marieke C Visser, Joseph C J Bot, Patrick C Vroomen, Omid Eshghi, Tobien H C M L Schreuder, Roel J J Heijboer, Koos Keizer, Alexander V Tielbeek, Heleen M den Hertog, Dick G Gerrits, Renske M van den Berg-Vos, Giorgos B Karas, Ewout W Steyerberg, H Zwenneke Flach, Henk A Marquering, Marieke E S Sprengers, Sjoerd F M Jenniskens, Ludo F M Beenen, René van den Berg, Peter J Koudstaal, Wim H van Zwam, Yvo B W E M Roos, Robert J van Oostenbrugge, Charles B L M Majoie, Aad van der Lugt, Diederik W J Dippel
IMPORTANCE: Intra-arterial treatment (IAT) for acute ischemic stroke caused by intracranial arterial occlusion leads to improved functional outcome in patients treated within 6 hours after onset. The influence of treatment delay on treatment effect is not yet known. OBJECTIVE: To evaluate the influence of time from stroke onset to the start of treatment and from stroke onset to reperfusion on the effect of IAT. DESIGN, SETTING, AND PARTICIPANTS: The Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands (MR CLEAN) was a multicenter, randomized clinical open-label trial of IAT vs no IAT in 500 patients...
February 2016: JAMA Neurology
#5
JOURNAL ARTICLE
Bernard Iung, Shahbudin H Rahimtoola, Alec Vahanian
No abstract text is available yet for this article.
February 1, 2016: European Heart Journal
#6
REVIEW
Mitra K Nadim, Francois Durand, John A Kellum, Josh Levitsky, Jacqueline G O'Leary, Constantine J Karvellas, Jasmohan S Bajaj, Andrew Davenport, Rajiv Jalan, Paolo Angeli, Stephen H Caldwell, Javier Fernández, Claire Francoz, Guadalupe Garcia-Tsao, Pere Ginès, Michael G Ison, David J Kramer, Ravindra L Mehta, Richard Moreau, David Mulligan, Jody C Olson, Elizabeth A Pomfret, Marco Senzolo, Randolph H Steadman, Ram M Subramanian, Jean-Louis Vincent, Yuri S Genyk
No abstract text is available yet for this article.
March 2016: Journal of Hepatology
#7
REVIEW
(no author information available yet)
No abstract text is available yet for this article.
January 2016: Diabetes Care
#8
REVIEW
(no author information available yet)
No abstract text is available yet for this article.
January 2016: Diabetes Care
#9
REVIEW
Christian Weimar
PURPOSE OF REVIEW: The purpose of this review is to update the reader on current concepts of workup and secondary prevention in patients with stroke of undetermined cause. RECENT FINDINGS: Clinical research in patients with cryptogenic stroke has been hampered by the lack of standardized, widely accepted diagnostic criteria. The new definition of 'Embolic stroke of undetermined etiology' postulates an embolic mechanism of ischemic stroke. It is based on the exclusion of lacunar infarction by brain imaging, arterial stenosis more than 50% or dissection of the respective brain-supplying artery by computed tomography/magnetic resonance-angiography or ultrasound, atrial fibrillation by at least 24 h EKG monitoring, as well as some rare etiologies such as vasculitis, drug abuse, or coagulopathies...
February 2016: Current Opinion in Neurology
#10
REVIEW
C Robert Horsburgh, Clifton E Barry, Christoph Lange
Tuberculosis, a scourge since prehistoric times, affects more than 9 million people and causes the death of 1.5 million people each year. Effective treatment has been available for 60 years, but such treatment takes at least 6 months, and resistance to the drugs, which is increasing throughout the..
November 26, 2015: New England Journal of Medicine
#11
JOURNAL ARTICLE
Ryotaro Kato, Michael R Pinsky
This review examines the available evidence for targeting a specific mean arterial pressure (MAP) in sepsis resuscitation. The clinical data suggest that targeting an MAP of 65-70 mmHg in patients with septic shock who do not have chronic hypertension is a reasonable first approximation. Whereas in patients with chronic hypertension, targeting a higher MAP of 80-85 mmHg minimizes renal injury, but it comes with increased risk of arrhythmias. Importantly, MAP alone should not be used as a surrogate of organ perfusion pressure, especially under conditions in which intracranial, intra-abdominal or tissue pressures may be elevated...
December 2015: Annals of Intensive Care
#12
COMPARATIVE STUDY
Christian T Ruff, Robert P Giugliano, Eugene Braunwald, Elaine B Hoffman, Naveen Deenadayalu, Michael D Ezekowitz, A John Camm, Jeffrey I Weitz, Basil S Lewis, Alexander Parkhomenko, Takeshi Yamashita, Elliott M Antman
BACKGROUND: Four new oral anticoagulants compare favourably with warfarin for stroke prevention in patients with atrial fibrillation; however, the balance between efficacy and safety in subgroups needs better definition. We aimed to assess the relative benefit of new oral anticoagulants in key subgroups, and the effects on important secondary outcomes. METHODS: We searched Medline from Jan 1, 2009, to Nov 19, 2013, limiting searches to phase 3, randomised trials of patients with atrial fibrillation who were randomised to receive new oral anticoagulants or warfarin, and trials in which both efficacy and safety outcomes were reported...
March 15, 2014: Lancet
#13
REVIEW
Julian L Wichmann, Richard W Katzberg, Sheldon E Litwin, Peter L Zwerner, Carlo N De Cecco, Thomas J Vogl, Philip Costello, U Joseph Schoepf
No abstract text is available yet for this article.
November 17, 2015: Circulation
#14
REVIEW
Shane Nanayakkara, David M Kaye
PURPOSE: The purpose of this article was to review the clinical management of patients with heart failure with preserved ejection fraction (HFPEF). METHODS: For this critical review, electronic databases (MEDLINE, EMBASE, PubMed) were searched for relevant basic research studies and randomized clinical trials recently published or presented at major meetings. Details of in-progress or planned studies were obtained from the ClinicalTrials.gov website. The range of publication dates was the year 2000 to 2015...
October 1, 2015: Clinical Therapeutics
#15
David Sweet , Julian Marsden , Kendall Ho , Christina Krause , James A Russell
Many emergency departments have implemented sepsis protocols since the 2001 publication of results from the early goal-directed therapy trial, which showed early targeted resuscitation lowers mortality. As part of an attempt to improve clinical and operational outcomes for emergency departments across British Columbia, we reviewed sepsis management literature and considered sepsis protocol implementation in the province’s emergency departments. During the literature review we found that many observational studies confirmed an association between implementation of emergency sepsis protocols and decreased mortality...
May 2012: British Columbia Medical Journal
#16
REVIEW
B Rochwerg, W Alhazzani, A Gibson, C M Ribic, A Sindi, D Heels-Ansdell, L Thabane, A Fox-Robichaud, L Mbuagbaw, W Szczeklik, F Alshamsi, S Altayyar, W Ip, G Li, M Wang, A Włudarczyk, Q Zhou, D Annane, D J Cook, R Jaeschke, G H Guyatt
Fluid resuscitation, along with the early administration of antibiotics, is the cornerstone of treatment for patients with sepsis. However, whether differences in resuscitation fluids impact on the requirements for renal replacement therapy (RRT) remains unclear. To examine this issue, we performed a network meta-analysis (NMA), including direct and indirect comparisons, that addressed the effect of different resuscitation fluids on the use of RRT in patients with sepsis. The data sources MEDLINE, EMBASE, ACPJC, CINAHL and Cochrane Central Register were searched up to March 2014...
September 2015: Intensive Care Medicine
#17
RANDOMIZED CONTROLLED TRIAL
Jackson T Wright, Jeff D Williamson, Paul K Whelton, Joni K Snyder, Kaycee M Sink, Michael V Rocco, David M Reboussin, Mahboob Rahman, Suzanne Oparil, Cora E Lewis, Paul L Kimmel, Karen C Johnson, David C Goff, Lawrence J Fine, Jeffrey A Cutler, William C Cushman, Alfred K Cheung, Walter T Ambrosius
BACKGROUND: The most appropriate targets for systolic blood pressure to reduce cardiovascular morbidity and mortality among persons without diabetes remain uncertain. METHODS: We randomly assigned 9361 persons with a systolic blood pressure of 130 mm Hg or higher and an increased cardiovascular risk, but without diabetes, to a systolic blood-pressure target of less than 120 mm Hg (intensive treatment) or a target of less than 140 mm Hg (standard treatment). The primary composite outcome was myocardial infarction, other acute coronary syndromes, stroke, heart failure, or death from cardiovascular causes...
November 26, 2015: New England Journal of Medicine
#18
REVIEW
Joseph A Vassalotti, Robert Centor, Barbara J Turner, Raquel C Greer, Michael Choi, Thomas D Sequist
A panel of internists and nephrologists developed this practical approach for the Kidney Disease Outcomes Quality Initiative to guide assessment and care of chronic kidney disease (CKD) by primary care clinicians. Chronic kidney disease is defined as a glomerular filtration rate (GFR) <60 mL/min/1.73 m(2) and/or markers of kidney damage for at least 3 months. In clinical practice the most common tests for CKD include GFR estimated from the serum creatinine concentration (eGFR) and albuminuria from the urinary albumin-to-creatinine ratio...
February 2016: American Journal of Medicine
#19
REVIEW
J A Myburgh
The administration of intravenous fluids for resuscitation is the most common intervention in acute medicine. There is increasing evidence that the type of fluid may directly affect patient-centred outcomes. There is a lack of evidence that colloids confer clinical benefit over crystalloids and they may be associated with harm. Hydroxyethyl starch preparations are associated with increased mortality and use of renal replacement therapy in critically ill patients, particularly those with sepsis; albumin is associated with increased mortality in patients with severe traumatic brain injury...
January 2015: Journal of Internal Medicine
#20
REVIEW
Isabel S Bazan, Wassim H Fares
Pulmonary hypertension (PH) is a hemodynamic and pathophysiologic state that can be found in multiple conditions with associated symptoms of dyspnea, decreased exercise tolerance, and progression to right heart failure. The World Health Organization has classified PH into five groups. The first group is pulmonary arterial hypertension (PAH), which can be idiopathic, heritable, due to drugs and toxins, or associated with conditions such as connective tissue diseases, congenital heart disease, portal hypertension, and others...
2015: Therapeutics and Clinical Risk Management
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