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Medicina Interna y eterna

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70 papers 100 to 500 followers Revisiones que vale la pena leer.
https://www.readbyqxmd.com/read/28055049/clinical-outcomes-of-metformin-use-in-populations-with-chronic-kidney-disease-congestive-heart-failure-or-chronic-liver-disease-a-systematic-review
#1
Matthew J Crowley, Clarissa J Diamantidis, Jennifer R McDuffie, C Blake Cameron, John W Stanifer, Clare K Mock, Xianwei Wang, Shuang Tang, Avishek Nagi, Andrzej S Kosinski, John W Williams
Background: Recent changes to the U.S. Food and Drug Administration boxed warning for metformin will increase its use in persons with historical contraindications or precautions. Prescribers must understand the clinical outcomes of metformin use in these populations. Purpose: To synthesize data addressing outcomes of metformin use in populations with type 2 diabetes and moderate to severe chronic kidney disease (CKD), congestive heart failure (CHF), or chronic liver disease (CLD) with hepatic impairment...
February 7, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27567896/severe-community-acquired-pneumonia-timely-management-measures-in-the-first-24-hours
#2
REVIEW
Jason Phua, Nathan C Dean, Qi Guo, Win Sen Kuan, Hui Fang Lim, Tow Keang Lim
Mortality rates for severe community-acquired pneumonia (CAP) range from 17 to 48 % in published studies.In this review, we searched PubMed for relevant papers published between 1981 and June 2016 and relevant files. We explored how early and aggressive management measures, implemented within 24 hours of recognition of severe CAP and carried out both in the emergency department and in the ICU, decrease mortality in severe CAP.These measures begin with the use of severity assessment tools and the application of care bundles via clinical decision support tools...
August 28, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27417010/management-of-patients-with-nste-acs-a-comparison-of-the-recent-aha-acc-and-esc-guidelines
#3
REVIEW
Fatima Rodriguez, Kenneth W Mahaffey
Non-ST-segment elevation acute coronary syndromes (NSTE-ACS) are the leading cause of morbidity and mortality from cardiovascular disease worldwide. The American Heart Association/American College of Cardiology and the European Society of Cardiology periodically release practice guidelines to guide clinicians in the management of NSTE-ACS, most recently in in 2014 and 2015, respectively. The present review compares and contrasts the 2 guidelines, with a focus on the strength of recommendation and level of evidence in the approach to initial presentation and diagnosis of NSTE-ACS, risk assessment, treatments, and systems of care...
July 19, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27660695/update-on-the-treatment-of-type-2-diabetes-mellitus
#4
REVIEW
Juan José Marín-Peñalver, Iciar Martín-Timón, Cristina Sevillano-Collantes, Francisco Javier Del Cañizo-Gómez
To achieve good metabolic control in diabetes and keep long term, a combination of changes in lifestyle and pharmacological treatment is necessary. Achieving near-normal glycated hemoglobin significantly, decreases risk of macrovascular and microvascular complications. At present there are different treatments, both oral and injectable, available for the treatment of type 2 diabetes mellitus (T2DM). Treatment algorithms designed to reduce the development or progression of the complications of diabetes emphasizes the need for good glycaemic control...
September 15, 2016: World Journal of Diabetes
https://www.readbyqxmd.com/read/25689124/reversal-of-the-novel-oral-anticoagulants-dabigatran-rivoraxaban-and-apixaban
#5
REVIEW
Eric M Liotta, Kimberly E Levasseur-Franklin, Andrew M Naidech
PURPOSE OF REVIEW: We summarize the available data related to reversing the anticoagulant effect of the oral direct thrombin and factor Xa inhibitors and provide our opinion on treating patients presenting with severe and life-threatening hemorrhage related to these agents. RECENT FINDINGS: No specific antidotes are currently available for the oral direct thrombin and factor Xa inhibitors but two promising agents are under investigation in phase 3 trials. No data are available on reversing these agents in bleeding patients...
April 2015: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27375038/deep-vein-thrombosis-and-pulmonary-embolism
#6
REVIEW
Marcello Di Nisio, Nick van Es, Harry R Büller
Deep vein thrombosis and pulmonary embolism, collectively referred to as venous thromboembolism, constitute a major global burden of disease. The diagnostic work-up of suspected deep vein thrombosis or pulmonary embolism includes the sequential application of a clinical decision rule and D-dimer testing. Imaging and anticoagulation can be safely withheld in patients who are unlikely to have venous thromboembolism and have a normal D-dimer. All other patients should undergo ultrasonography in case of suspected deep vein thrombosis and CT in case of suspected pulmonary embolism...
17, 2016: Lancet
https://www.readbyqxmd.com/read/27995906/acg-clinical-guideline-evaluation-of-abnormal-liver-chemistries
#7
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/27766049/management-of-venous-thromboembolism-an-update
#8
REVIEW
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
#9
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, Ramachandran S Vasan, Kumudha Ramasubbu, Kismet Rasmusson, Jeffrey A Towbin, Clyde Yancy
No abstract text is available yet for this article.
December 6, 2016: Circulation
https://www.readbyqxmd.com/read/27716262/new-aspects-in-the-management-of-pneumonia
#10
REVIEW
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
#11
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
#12
REVIEW
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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