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Internal Medicine

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347 papers 500 to 1000 followers General Internal Medicine
By Jeff Bank Internal Medicine R2 at the University of Utah
https://www.readbyqxmd.com/read/29063908/adherence-to-mediterranean-diet-and-non-alcoholic-fatty-liver-disease-effect-on-insulin-resistance
#1
Francesco Baratta, Daniele Pastori, Licia Polimeni, Tommaso Bucci, Fabrizio Ceci, Cinzia Calabrese, Ilaria Ernesti, Gaetano Pannitteri, Francesco Violi, Francesco Angelico, Maria Del Ben
OBJECTIVES: The prevalence of cardiometabolic disorders, including non-alcoholic fatty liver disease (NAFLD), is increasing in western countries, because of changes in lifestyle and dietary habits. Mediterranean Diet (Med-Diet) is effective for cardiovascular prevention, but its relationship with NAFLD has been scarcely investigated. METHODS: We included 584 consecutive outpatients presenting with one or more cardiovascular risk factor such as type 2 diabetes mellitus (T2DM), arterial hypertension, overweight/obesity, and dyslipidemia...
October 24, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28757818/procalcitonin-assisted-antibiotic-strategy-in-sepsis
#2
Domonkos Trásy, Zsolt Molnár
Sepsis is one of the biggest challenges in critical care nowadays. Defining sepsis is a difficult task on its own and its diagnosis and treatment requires well trained, devoted personnel with interdisciplinary collaboration in order to provide the patients the best chance for survival. Immediate resuscitation, early adequate antimicrobial therapy, source control and highly sophisticated organ support on the intensive care units are all inevitable necessities for successful recovery. To help fast and accurate diagnosis biomarkers have been measured for decades...
May 2017: EJIFCC
https://www.readbyqxmd.com/read/28869989/reconciling-the-effects-of-screening-on-prostate-cancer-mortality-in-the-erspc-and-plco-trials
#3
Alex Tsodikov, Roman Gulati, Eveline A M Heijnsdijk, Paul F Pinsky, Sue M Moss, Sheng Qiu, Tiago M de Carvalho, Jonas Hugosson, Christine D Berg, Anssi Auvinen, Gerald L Andriole, Monique J Roobol, E David Crawford, Vera Nelen, Maciej Kwiatkowski, Marco Zappa, Marcos Luján, Arnauld Villers, Eric J Feuer, Harry J de Koning, Angela B Mariotto, Ruth Etzioni
Background: The ERSPC (European Randomized Study of Screening for Prostate Cancer) found that screening reduced prostate cancer mortality, but the PLCO (Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial) found no reduction. Objective: To evaluate whether effects of screening on prostate cancer mortality relative to no screening differed between the ERSPC and PLCO. Design: Cox regression of prostate cancer death in each trial group, adjusted for age and trial...
October 3, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28776086/the-mechanisms-of-action-of-metformin
#4
REVIEW
Graham Rena, D Grahame Hardie, Ewan R Pearson
Metformin is a widely-used drug that results in clear benefits in relation to glucose metabolism and diabetes-related complications. The mechanisms underlying these benefits are complex and still not fully understood. Physiologically, metformin has been shown to reduce hepatic glucose production, yet not all of its effects can be explained by this mechanism and there is increasing evidence of a key role for the gut. At the molecular level the findings vary depending on the doses of metformin used and duration of treatment, with clear differences between acute and chronic administration...
August 3, 2017: Diabetologia
https://www.readbyqxmd.com/read/28806817/the-effects-of-cannabis-among-adults-with-chronic-pain-and-an-overview-of-general-harms-a-systematic-review
#5
REVIEW
Shannon M Nugent, Benjamin J Morasco, Maya E O'Neil, Michele Freeman, Allison Low, Karli Kondo, Camille Elven, Bernadette Zakher, Makalapua Motu'apuaka, Robin Paynter, Devan Kansagara
Background: Cannabis is increasingly available for the treatment of chronic pain, yet its efficacy remains uncertain. Purpose: To review the benefits of plant-based cannabis preparations for treating chronic pain in adults and the harms of cannabis use in chronic pain and general adult populations. Data Sources: MEDLINE, Cochrane Database of Systematic Reviews, and several other sources from database inception to March 2017. Study Selection: Intervention trials and observational studies, published in English, involving adults using plant-based cannabis preparations that reported pain, quality of life, or adverse effect outcomes...
September 5, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28738130/treatment-of-cholesterol-in-2017
#6
Harlan M Krumholz
No abstract text is available yet for this article.
August 1, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28720644/effects-of-non-vitamin-k-antagonist-oral-anticoagulants-versus-warfarin-in-patients-with-atrial-fibrillation-and-valvular-heart-disease-a-systematic-review-and-meta-analysis
#7
REVIEW
Kuo-Li Pan, Daniel E Singer, Bruce Ovbiagele, Yi-Ling Wu, Mohamed A Ahmed, Meng Lee
BACKGROUND: The original non-vitamin K antagonist oral anticoagulant (NOAC) trials in nonvalvular atrial fibrillation (AF) enrolled patients with native valve pathologies. The object of this study was to quantify the benefit-risk profiles of NOACs versus warfarin in AF patients with native valvular heart disease (VHD). METHODS AND RESULTS: Trials were identified by exhaustive literature search. Trial data were combined using inverse variance weighting to produce a meta-analytic summary hazard ratio (HR) and 95% confidence interval (CI) of efficacy and safety of NOACs versus warfarin...
July 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28720208/treatment-of-uremic-pruritus-a-systematic-review
#8
REVIEW
Elizabeth Simonsen, Paul Komenda, Blake Lerner, Nicole Askin, Clara Bohm, James Shaw, Navdeep Tangri, Claudio Rigatto
BACKGROUND: Uremic pruritus is a common and burdensome symptom afflicting patients with advanced chronic kidney disease (CKD) and has been declared a priority for CKD research by patients. The optimal treatments for uremic pruritus are not well defined. STUDY DESIGN: Systematic review. SETTING & POPULATION: Adult patients with advanced CKD (stage ≥ 3) or receiving any form of dialysis. SELECTION CRITERIA FOR STUDIES: PubMed, CINAHL, Embase, International Pharmaceutical Abstracts, Scopus, Cochrane Library, and ClinicalTrials...
November 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28679009/treating-anxiety-in-2017-optimizing-care-to-improve-outcomes
#9
Murray B Stein, Michelle G Craske
No abstract text is available yet for this article.
July 18, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28598792/croi-2017-complications-and-comorbidities-of-hiv-disease-and-its-treatment
#10
Judith S Currier, Diane V Havlir
Complications of HIV disease remained a major focus at the 2017 Conference on Retroviruses and Opportunistic Infections (CROI), and included studies focused on noncommunicable chronic diseases (eg, cardiovascular disease, obesity, bone disease, and malignancies) and opportunistic infections (Mycobacterium tuberculosis and cryptococcosis). Progress in identifying predictors of specific complications as well as interventions for the prevention and treatment of these comorbidities are summarized below.
May 2017: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/28585373/2017-american-college-of-rheumatology-guideline-for-the-prevention-and-treatment-of-glucocorticoid-induced-osteoporosis
#11
REVIEW
Lenore Buckley, Gordon Guyatt, Howard A Fink, Michael Cannon, Jennifer Grossman, Karen E Hansen, Mary Beth Humphrey, Nancy E Lane, Marina Magrey, Marc Miller, Lake Morrison, Madhumathi Rao, Angela Byun Robinson, Sumona Saha, Susan Wolver, Raveendhara R Bannuru, Elizaveta Vaysbrot, Mikala Osani, Marat Turgunbaev, Amy S Miller, Timothy McAlindon
OBJECTIVE: To develop recommendations for prevention and treatment of glucocorticoid-induced osteoporosis (GIOP). METHODS: We conducted a systematic review to synthesize the evidence for the benefits and harms of GIOP prevention and treatment options. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to rate the quality of evidence. We used a group consensus process to determine the final recommendations and grade their strength...
August 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/28605603/efficacy-and-safety-of-degludec-versus-glargine-in-type-2-diabetes
#12
RANDOMIZED CONTROLLED TRIAL
Steven P Marso, Darren K McGuire, Bernard Zinman, Neil R Poulter, Scott S Emerson, Thomas R Pieber, Richard E Pratley, Poul-Martin Haahr, Martin Lange, Kirstine Brown-Frandsen, Alan Moses, Simon Skibsted, Kajsa Kvist, John B Buse
BACKGROUND: Degludec is an ultralong-acting, once-daily basal insulin that is approved for use in adults, adolescents, and children with diabetes. Previous open-label studies have shown lower day-to-day variability in the glucose-lowering effect and lower rates of hypoglycemia among patients who received degludec than among those who received basal insulin glargine. However, data are lacking on the cardiovascular safety of degludec. METHODS: We randomly assigned 7637 patients with type 2 diabetes to receive either insulin degludec (3818 patients) or insulin glargine U100 (3819 patients) once daily between dinner and bedtime in a double-blind, treat-to-target, event-driven cardiovascular outcomes trial...
August 24, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28461307/diagnosis-of-asthma-copd-overlap-the-five-commandments
#13
EDITORIAL
Marc Miravitlles
No abstract text is available yet for this article.
May 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28585410/2017-american-college-of-rheumatology-guideline-for-the-prevention-and-treatment-of-glucocorticoid-induced-osteoporosis
#14
REVIEW
Lenore Buckley, Gordon Guyatt, Howard A Fink, Michael Cannon, Jennifer Grossman, Karen E Hansen, Mary Beth Humphrey, Nancy E Lane, Marina Magrey, Marc Miller, Lake Morrison, Madhumathi Rao, Angela Byun Robinson, Sumona Saha, Susan Wolver, Raveendhara R Bannuru, Elizaveta Vaysbrot, Mikala Osani, Marat Turgunbaev, Amy S Miller, Timothy McAlindon
OBJECTIVE: To develop recommendations for prevention and treatment of glucocorticoid-induced osteoporosis (GIOP). METHODS: We conducted a systematic review to synthesize the evidence for the benefits and harms of GIOP prevention and treatment options. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to rate the quality of evidence. We used a group consensus process to determine the final recommendations and grade their strength...
August 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28549662/simplified-diagnostic-management-of-suspected-pulmonary-embolism-the-years-study-a-prospective-multicentre-cohort-study
#15
Tom van der Hulle, Whitney Y Cheung, Stephanie Kooij, Ludo F M Beenen, Thomas van Bemmel, Josien van Es, Laura M Faber, Germa M Hazelaar, Christian Heringhaus, Herman Hofstee, Marcel M C Hovens, Karin A H Kaasjager, Rick C J van Klink, Marieke J H A Kruip, Rinske F Loeffen, Albert T A Mairuhu, Saskia Middeldorp, Mathilde Nijkeuter, Liselotte M van der Pol, Suzanne Schol-Gelok, Marije Ten Wolde, Frederikus A Klok, Menno V Huisman
BACKGROUND: Validated diagnostic algorithms in patients with suspected pulmonary embolism are often not used correctly or only benefit subgroups of patients, leading to overuse of computed tomography pulmonary angiography (CTPA). The YEARS clinical decision rule that incorporates differential D-dimer cutoff values at presentation, has been developed to be fast, to be compatible with clinical practice, and to reduce the number of CTPA investigations in all age groups. We aimed to prospectively evaluate this novel and simplified diagnostic algorithm for suspected acute pulmonary embolism...
July 15, 2017: Lancet
https://www.readbyqxmd.com/read/28509668/norepinephrine-in-septic-shock-when-and-how-much
#16
Olfa Hamzaoui, Thomas W L Scheeren, Jean-Louis Teboul
PURPOSE OF REVIEW: Norepinephrine is the first-line agent recommended during resuscitation of septic shock to correct hypotension due to depressed vascular tone. Important clinical issues are the best timing to start norepinephrine, the optimal blood pressure target, and the best therapeutic options to face refractory hypotension when high doses of norepinephrine are required to reach the target. RECENT FINDINGS: Recent literature has reported benefits of early administration of norepinephrine because of the following reasons: profound and durable hypotension is an independent factor of increased mortality, early administration of norepinephrine increases cardiac output, improves microcirculation and avoids fluid overload...
August 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28439398/a-practical-approach-to-the-pharmacological-management-of-hypertension-in-older-people
#17
REVIEW
Nikesh Parekh, Amy Page, Khalid Ali, Kevin Davies, Chakravarthi Rajkumar
Hypertension is the leading cause of cardiovascular (CV) morbidity and mortality in adults over the age of 65. The first part of this paper is an overview, summarizing the current guidelines on the pharmacological management of hypertension in older adults in Europe and the USA, and evidence from key trials that contributed to the guidelines. In the second part of the paper, we will discuss the major challenges of managing hypertension in the context of multimorbidity, including frailty, orthostatic hypotension (OH), falls and cognitive impairment that are associated with ageing...
April 2017: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/28461007/2017-acc-aha-hfsa-focused-update-of-the-2013-accf-aha-guideline-for-the%C3%A2-management-of-heart-failure-a-report-of-the-american-college-of-cardiology-american-heart-association-task-force-on-clinical-practice-guidelines-and-the-heart-failure-society-of-america
#18
Clyde W Yancy, Mariell Jessup, Biykem Bozkurt, Javed Butler, Donald E Casey, Monica M Colvin, Mark H Drazner, Gerasimos S 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.
August 8, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28451853/management-of-hypertension-in-patients-with-chronic-kidney-disease
#19
REVIEW
Seyed Mehrdad Hamrahian
Hypertension is the leading factor in the global burden of disease. It is the predominant modifiable risk factor for stroke, heart disease, and kidney failure. Chronic kidney disease (CKD) is both a common cause and sequel of uncontrolled hypertension. The pathophysiology of CKD-associated hypertension is complex and multi-factorial. This paper reviews the key pathogenic mechanisms of CKD-associated hypertension, the importance of standardized blood pressure (BP) measurement in establishing the diagnosis and management plus the significance of ambulatory BP monitoring for assessment of diurnal BP variation commonly seen in CKD...
May 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28455343/2017-acc-aha-hfsa-focused-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-guidelines-and-the-heart-failure-society-of-america
#20
REVIEW
Clyde W Yancy, Mariell Jessup, Biykem Bozkurt, Javed Butler, Donald E Casey, Monica M Colvin, Mark H Drazner, Gerasimos S 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.
August 8, 2017: Circulation
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