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Medicina Interna y eterna

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63 papers 25 to 100 followers Revisiones que vale la pena leer.
https://www.readbyqxmd.com/read/27766049/management-of-venous-thromboembolism-an-update
#1
Siavash Piran, Sam Schulman
Venous thromboembolism (VTE), which constitutes pulmonary embolism and deep vein thrombosis, is a common disorder associated with significant morbidity and mortality. Landmark trials have shown that direct oral anticoagulants (DOACs) are as effective as conventional anticoagulation with vitamin K antagonists (VKA) in prevention of VTE recurrence and associated with less bleeding. This has paved the way for the recently published guidelines to change their recommendations in favor of DOACs in acute and long-term treatment of VTE in patients without cancer...
2016: Thrombosis Journal
https://www.readbyqxmd.com/read/27832612/current-diagnostic-and-treatment-strategies-for-specific-dilated-cardiomyopathies-a-scientific-statement-from-the-american-heart-association
#2
Biykem Bozkurt, Monica Colvin, Jennifer Cook, Leslie T Cooper, Anita Deswal, Gregg C Fonarow, Gary S Francis, Daniel Lenihan, Eldrin F Lewis, Dennis M McNamara, Elfriede Pahl, Vasan S Ramachandran, Kumudha Ramasubbu, Kismet Rasmusson, Jeffrey A Towbin, Clyde Yancy
No abstract text is available yet for this article.
November 3, 2016: Circulation
https://www.readbyqxmd.com/read/27716262/new-aspects-in-the-management-of-pneumonia
#3
Elena Prina, Adrian Ceccato, Antoni Torres
Despite improvements in the management of community-acquired pneumonia (CAP), morbidity and mortality are still high, especially in patients with more severe disease. Early and appropriate antibiotics remain the cornerstone in the treatment of CAP. However, two aspects seem to contribute to a worse outcome: an uncontrolled inflammatory reaction and an inadequate immune response. Adjuvant treatments, such as corticosteroids and intravenous immunoglobulins, have been proposed to counterbalance these effects. The use of corticosteroids in patients with severe CAP and a strong inflammatory reaction can reduce the time to clinical stability, the risk of treatment failure, and the risk of progression to acute respiratory distress syndrome...
October 1, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27694263/how-long-should-we-wait-to-start-oral-anticoagulation-after-cardioembolic-stroke
#4
EDITORIAL
Brett Cucchiara
No abstract text is available yet for this article.
November 1, 2016: Neurology
https://www.readbyqxmd.com/read/27670788/acute-kidney-injury-2016-diagnosis-and-diagnostic-workup
#5
Marlies Ostermann, Michael Joannidis
Acute kidney injury (AKI) is common and is associated with serious short- and long-term complications. Early diagnosis and identification of the underlying aetiology are essential to guide management. In this review, we outline the current definition of AKI and the potential pitfalls, and summarise the existing and future tools to investigate AKI in critically ill patients.
September 27, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27579542/metformin-nonglycemic-effects-and-potential-novel-indications
#6
Abeer Anabtawi, John M Miles
OBJECTIVE: Metformin is the most commonly prescribed drug for the treatment of type 2 diabetes because of its apparent robust effects in reducing cardiovascular risk. This review examines the current literature regarding the nonglycemic effects and potential novel indications for metformin. METHODS: Review of the literature, with a focus on metformin use in Stage 3 chronic kidney disease (CKD-3) and heart failure (HF). RESULTS: The United Kingdom Prospective Diabetes Study suggests that metformin reduces the risk of myocardial infarction, and more recent retrospective studies have shown an association between metformin use and a reduction in stroke, atrial fibrillation and all-cause mortality...
August 2016: Endocrine Practice
https://www.readbyqxmd.com/read/27541294/sglt2-inhibitors-benefit-risk-balance
#7
REVIEW
André J Scheen
Inhibitors of sodium-glucose cotransporters type 2 (SGLT2) reduce hyperglycemia by increasing urinary glucose excretion. They have been evaluated in patients with type 2 diabetes treated with diet/exercise, metformin, dual oral therapy or insulin. Three agents are available in Europe and the USA (canagliflozin, dapagliflozin, empagliflozin) and others are commercialized in Japan or in clinical development. SGLT2 inhibitors reduce glycated hemoglobin, with a minimal risk of hypoglycemia. They exert favorable effects beyond glucose control with consistent body weight, blood pressure, and serum uric acid reductions...
October 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27339497/the-diagnosis-and-evaluation-of-dilated-cardiomyopathy
#8
REVIEW
Alan G Japp, Ankur Gulati, Stuart A Cook, Martin R Cowie, Sanjay K Prasad
Dilated cardiomyopathy (DCM) is best understood as the final common response of myocardium to diverse genetic and environmental insults. A rigorous work-up can exclude alternative causes of left ventricular (LV) dilation and dysfunction, identify etiologies that may respond to specific treatments, and guide family screening. A significant proportion of DCM cases have an underlying genetic or inflammatory basis. Measurement of LV size and ejection fraction remain central to diagnosis, risk stratification, and treatment, but other aspects of cardiac remodeling inform prognosis and carry therapeutic implications...
June 28, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27246107/evidence-based-clinical-practice-guidelines-for-liver-cirrhosis-2015
#9
REVIEW
Hiroshi Fukui, Hidetsugu Saito, Yoshiyuki Ueno, Hirofumi Uto, Katsutoshi Obara, Isao Sakaida, Akitaka Shibuya, Masataka Seike, Sumiko Nagoshi, Makoto Segawa, Hirohito Tsubouchi, Hisataka Moriwaki, Akinobu Kato, Etsuko Hashimoto, Kojiro Michitaka, Toshikazu Murawaki, Kentaro Sugano, Mamoru Watanabe, Tooru Shimosegawa
The Japanese Society of Gastroenterology revised the evidence-based clinical practice guidelines for liver cirrhosis in 2015. Eighty-three clinical questions were selected, and a literature search was performed for the clinical questions with use of the MEDLINE, Cochrane, and Igaku Chuo Zasshi databases for the period between 1983 and June 2012. Manual searching of the latest important literature was added until August 2015. The guidelines were developed with use of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system...
July 2016: Journal of Gastroenterology
https://www.readbyqxmd.com/read/27184564/advances-in-antibiotic-therapy-in-the-critically-ill
#10
REVIEW
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...
May 17, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27208050/2016-acc-aha-hfsa-focused-update-on-new-pharmacological-therapy-for-heart-failure-an-update-of-the-2013-accf-aha-guideline-for-the-management-of-heart-failure-a-report-of-the-american-college-of-cardiology-american-heart-association-task-force-on-clinical-practice
#11
Clyde W Yancy, Mariell Jessup, Biykem Bozkurt, Javed Butler, Donald E Casey, Monica M Colvin, Mark H Drazner, Gerasimos Filippatos, Gregg C Fonarow, Michael M Givertz, Steven M Hollenberg, JoAnn Lindenfeld, Frederick A Masoudi, Patrick E McBride, Pamela N Peterson, Lynne Warner Stevenson, Cheryl Westlake
No abstract text is available yet for this article.
September 27, 2016: Circulation
https://www.readbyqxmd.com/read/27323265/the-abc-stroke-risk-score-was-superior-to-the-cha2ds2-vasc-score-for-predicting-stroke-in-atrial-fibrillation
#12
Graeme J Hankey
No abstract text is available yet for this article.
June 21, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/26935782/the-new-antiepileptic-drugs-their-neuropharmacology-and-clinical-indications
#13
Ryosuke Hanaya, Kazunori Arita
The administration of antiepileptic drugs (AEDs) is the first treatment of epilepsy, one of the most common neurological diseases. Therapeutic guidelines include newer AEDs as front-line drugs; monotherapy with new AEDs is delivered in Japan. While about 70% of patients obtain good seizure control by taking one to three AEDs, about 60% experience adverse effects and 33% have to change drugs. Compared to traditional AEDs, the prolonged administration of new AEDs elicits fewer adverse effects and fewer drug interactions and their teratogenicity may be lower...
May 15, 2016: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/27195814/intensive-vs-standard-blood-pressure-control-and-cardiovascular-disease-outcomes-in-adults-aged-%C3%A2-75-years-a-randomized-clinical-trial
#14
RANDOMIZED CONTROLLED TRIAL
Jeff D Williamson, Mark A Supiano, William B Applegate, Dan R Berlowitz, Ruth C Campbell, Glenn M Chertow, Larry J Fine, William E Haley, Amret T Hawfield, Joachim H Ix, Dalane W Kitzman, John B Kostis, Marie A Krousel-Wood, Lenore J Launer, Suzanne Oparil, Carlos J Rodriguez, Christianne L Roumie, Ronald I Shorr, Kaycee M Sink, Virginia G Wadley, Paul K Whelton, Jeffrey Whittle, Nancy F Woolard, Jackson T Wright, Nicholas M Pajewski
IMPORTANCE: The appropriate treatment target for systolic blood pressure (SBP) in older patients with hypertension remains uncertain. OBJECTIVE: To evaluate the effects of intensive (<120 mm Hg) compared with standard (<140 mm Hg) SBP targets in persons aged 75 years or older with hypertension but without diabetes. DESIGN, SETTING, AND PARTICIPANTS: A multicenter, randomized clinical trial of patients aged 75 years or older who participated in the Systolic Blood Pressure Intervention Trial (SPRINT)...
June 28, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27289336/managing-initial-mechanical-ventilation-in-the-emergency-department
#15
Scott D Weingart
No abstract text is available yet for this article.
June 9, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27023283/current-status-and-prospects-of-hiv-treatment
#16
REVIEW
Tomas Cihlar, Marshall Fordyce
Current antiviral treatments can reduce HIV-associated morbidity, prolong survival, and prevent HIV transmission. Combination antiretroviral therapy (cART) containing preferably three active drugs from two or more classes is required for durable virologic suppression. Regimen selection is based on virologic efficacy, potential for adverse effects, pill burden and dosing frequency, drug-drug interaction potential, resistance test results, comorbid conditions, social status, and cost. With prolonged virologic suppression, improved clinical outcomes, and longer survival, patients will be exposed to antiretroviral agents for decades...
June 2016: Current Opinion in Virology
https://www.readbyqxmd.com/read/27100995/rivaroxaban-in-chronic-hemodialysis-patients
#17
Heather Muster, Harry Alcorn
No abstract text is available yet for this article.
2016: American Journal of Nephrology
https://www.readbyqxmd.com/read/27007094/clinical-practice-guideline-management-of-acute-pancreatitis
#18
REVIEW
Joshua A Greenberg, Jonathan Hsu, Mohammad Bawazeer, John Marshall, Jan O Friedrich, Avery Nathens, Natalie Coburn, Gary R May, Emily Pearsall, Robin S McLeod
There has been an increase in the incidence of acute pancreatitis reported worldwide. Despite improvements in access to care, imaging and interventional techniques, acute pancreatitis continues to be associated with significant morbidity and mortality. Despite the availability of clinical practice guidelines for the management of acute pancreatitis, recent studies auditing the clinical management of the condition have shown important areas of noncompliance with evidence-based recommendations. This underscores the importance of creating understandable and implementable recommendations for the diagnosis and management of acute pancreatitis...
April 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/26937187/exacerbations-of-copd
#19
REVIEW
Ian D Pavord, Paul W Jones, Pierre-Régis Burgel, Klaus F Rabe
Exacerbations of chronic obstructive pulmonary disease (COPD) are defined as sustained worsening of a patient's condition beyond normal day-to-day variations that is acute in onset, and that may also require a change in medication and/or hospitalization. Exacerbations have a significant and prolonged impact on health status and outcomes, and negative effects on pulmonary function. A significant proportion of exacerbations are unreported and therefore left untreated, leading to a poorer prognosis than those treated...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27099136/evidence-based-clinical-practice-guidelines-for-nephrotic-syndrome-2014
#20
REVIEW
Shinichi Nishi, Yoshifumi Ubara, Yasunori Utsunomiya, Koichi Okada, Yoko Obata, Hiroyasu Kai, Hideyasu Kiyomoto, Shin Goto, Tsuneo Konta, Yoshie Sasatomi, Yoshinobu Sato, Tomoya Nishino, Kazuhiko Tsuruya, Kengo Furuichi, Junichi Hoshino, Yasuhiro Watanabe, Kenjiro Kimura, Seiichi Matsuo
No abstract text is available yet for this article.
June 2016: Clinical and Experimental Nephrology
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