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Internal Medicine

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283 papers 100 to 500 followers General Internal Medicine
By Jeff Bank Internal Medicine R2 at the University of Utah
https://www.readbyqxmd.com/read/27919104/dual-health-care-system-use-and-high-risk-prescribing-in-patients-with-dementia-a-national-cohort-study
#1
Joshua M Thorpe, Carolyn T Thorpe, Walid F Gellad, Chester B Good, Joseph T Hanlon, Maria K Mor, John R Pleis, Loren J Schleiden, Courtney Harold Van Houtven
Background: Recent federal policy changes attempt to expand veterans' access to providers outside the Department of Veterans Affairs (VA). Receipt of prescription medications across unconnected systems of care may increase the risk for unsafe prescribing, particularly in persons with dementia. Objective: To investigate the association between dual health care system use and potentially unsafe medication (PUM) prescribing. Design: Retrospective cohort study...
December 6, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27858374/prediction-of-fluid-responsiveness-an-update
#2
REVIEW
Xavier Monnet, Paul E Marik, Jean-Louis Teboul
In patients with acute circulatory failure, the decision to give fluids or not should not be taken lightly. The risk of overzealous fluid administration has been clearly established. Moreover, volume expansion does not always increase cardiac output as one expects. Thus, after the very initial phase and/or if fluid losses are not obvious, predicting fluid responsiveness should be the first step of fluid strategy. For this purpose, the central venous pressure as well as other "static" markers of preload has been used for decades, but they are not reliable...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27826957/development-of-new-therapies-for-severe-asthma
#3
REVIEW
Merritt L Fajt, Sally E Wenzel
Persistent asthma has long been treated with inhaled corticosteroids (CSs), as the mainstay of therapy. However, their efficacy in patients with more severe disease is limited, which led to the incorporation of poor response to ICSs (and thereby use of high doses of ICS) into recent definitions of severe asthma. Several studies have suggested that severe asthma might consist of several different phenotypes, each with ongoing symptoms and health care utilization, despite the use of high doses of ICS, usually in combination with a second or third controller...
January 2017: Allergy, Asthma & Immunology Research
https://www.readbyqxmd.com/read/27664247/management-of-febrile-neutropaenia-esmo-clinical-practice-guidelines
#4
J Klastersky, J de Naurois, K Rolston, B Rapoport, G Maschmeyer, M Aapro, J Herrstedt
No abstract text is available yet for this article.
September 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/27790273/clinical-practice-guideline-of-acute-respiratory-distress-syndrome
#5
REVIEW
Young-Jae Cho, Jae Young Moon, Ein-Soon Shin, Je Hyeong Kim, Hoon Jung, So Young Park, Ho Cheol Kim, Yun Su Sim, Chin Kook Rhee, Jaemin Lim, Seok Jeong Lee, Won-Yeon Lee, Hyun Jeong Lee, Sang Hyun Kwak, Eun Kyeong Kang, Kyung Soo Chung, Won-Il Choi
There is no well-stated practical guideline for mechanically ventilated patients with or without acute respiratory distress syndrome (ARDS). We generate strong (1) and weak (2) grade of recommendations based on high (A), moderate (B) and low (C) grade in the quality of evidence. In patients with ARDS, we recommend low tidal volume ventilation (1A) and prone position if it is not contraindicated (1B) to reduce their mortality. However, we did not support high-frequency oscillatory ventilation (1B) and inhaled nitric oxide (1A) as a standard treatment...
October 2016: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/27807144/clinical-practice-guideline-on-management-of-older-patients-with-chronic-kidney-disease-stage-3b-or-higher-egfr-45-ml-min-1-73-m2
#6
Ken Farrington, Adrian Covic, Fillipo Aucella, Naomi Clyne, Leen de Vos, Andrew Findlay, Denis Fouque, Tomasz Grodzicki, Osasuyi Iyasere, Kitty J Jager, Hanneke Joosten, Juan Florencio Macias, Andrew Mooney, Dorothea Nitsch, Marijke Stryckers, Maarten Taal, James Tattersall, Dieneke Van Asselt, Nele Van den Noortgate, Ionut Nistor, Wim Van Biesen
No abstract text is available yet for this article.
November 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27773805/pathophysiology-evaluation-and-management-of-chronic-watery-diarrhea
#7
Michael Camilleri, Joseph H Sellin, Kim E Barrett
Chronic watery diarrhea poses a diagnostic and therapeutic challenge and is often a disabling condition for patients. Although acute diarrhea is likely to be caused by infection, the causes of chronic diarrhea (more than 4 weeks in duration) are more elusive. We review on the pathophysiology, diagnosis, and treatment of chronic diarrhea. Drawing on recent insights into the molecular mechanisms of intestinal epithelial transport and barrier function, we discuss how diarrhea can result from a decrease in luminal solute absorption, an increase in secretion, or both, as well as derangements in barrier properties...
October 20, 2016: Gastroenterology
https://www.readbyqxmd.com/read/27746163/diagnostic-value-of-imaging-in-infective-endocarditis-a-systematic-review
#8
Anna Gomes, Andor W J M Glaudemans, Daan J Touw, Joost P van Melle, Tineke P Willems, Alexander H Maass, Ehsan Natour, Niek H J Prakken, Ronald J H Borra, Peter Paul van Geel, Riemer H J A Slart, Sander van Assen, Bhanu Sinha
Sensitivity and specificity of the modified Duke criteria for native valve endocarditis are both suboptimal, at approximately 80%. Diagnostic accuracy for intracardiac prosthetic material-related infection is even lower. Non-invasive imaging modalities could potentially improve diagnosis of infective endocarditis; however, their diagnostic value is unclear. We did a systematic literature review to critically appraise the evidence for the diagnostic performance of these imaging modalities, according to PRISMA and GRADE criteria...
October 13, 2016: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/27741949/hydrocortisone-treatment-in-early-sepsis-associated-acute-respiratory-distress-syndrome-results-of-a-randomized-controlled-trial
#9
Surat Tongyoo, Chairat Permpikul, Wasineenart Mongkolpun, Veerapong Vattanavanit, Suthipol Udompanturak, Mehmet Kocak, G Umberto Meduri
BACKGROUND: Authors of recent meta-analyses have reported that prolonged glucocorticoid treatment is associated with significant improvements in patients with severe pneumonia or acute respiratory distress syndrome (ARDS) of multifactorial etiology. A prospective randomized trial limited to patients with sepsis-associated ARDS is lacking. The objective of our study was to evaluate the efficacy of hydrocortisone treatment in sepsis-associated ARDS. METHODS: In this double-blind, single-center (Siriraj Hospital, Bangkok), randomized, placebo-controlled trial, we recruited adult patients with severe sepsis within 12 h of their meeting ARDS criteria...
October 15, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27802507/to-treat-or-not-to-treat-to-target-in-gout
#10
Tuhina Neogi, Ted R Mikuls
No abstract text is available yet for this article.
November 1, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/26408108/how-we-diagnose-and-treat-iron-deficiency-anemia
#11
REVIEW
Michael Auerbach, John W Adamson
It is estimated that one-third of the world's population is anemic, the majority being due to iron deficiency (ID). In adults, ID is associated with fatigue in the absence of anemia, restless legs syndrome, pica and, in neonates, delayed growth and development. In adolescents, ID is associated with decrements in learning and behavioral abnormalities. In the absence of a clear cause, search for a source of bleeding is indicated. No single test is diagnostic of ID unless the serum ferritin is low or the percent transferrin saturation is low with an elevated total iron binding capacity...
January 2016: American Journal of Hematology
https://www.readbyqxmd.com/read/27742825/atrial-fibrillation-and-chronic-kidney-disease-struggling-through-thick-and-thin
#12
Simardeep Gill, Min Jun, Pietro Ravani
The prevalence of atrial fibrillation and the risk of stroke display an age-related increase in the chronic kidney disease (CKD) population. Evidence from large randomized controlled trials conducted in the general population supports the use of anticoagulation to reduce the risk of stroke in the setting of non-valvular atrial fibrillation. However, data in the non-dialysis-dependent and dialysis-dependent CKD populations are limited largely to observational studies, which demonstrate conflicting results regarding the risk-benefit profile of anticoagulation...
October 14, 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27716262/new-aspects-in-the-management-of-pneumonia
#13
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/27750329/the-consult-guys-is-a-bridge-needed-along-this-road
#14
Geno J Merli, Howard H Weitz
No abstract text is available yet for this article.
October 18, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27670788/acute-kidney-injury-2016-diagnosis-and-diagnostic-workup
#15
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/27723893/copay-assistance-for-expensive-drugs-a-helping-hand-that-raises-costs
#16
Peter A Ubel, Peter B Bach
No abstract text is available yet for this article.
October 11, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27567896/severe-community-acquired-pneumonia-timely-management-measures-in-the-first-24-hours
#17
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/27623476/diverticulosis-and-diverticulitis
#18
Amy E Thompson
No abstract text is available yet for this article.
September 13, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27623461/implementation-of-a-value-driven-outcomes-program-to-identify-high-variability-in-clinical-costs-and-outcomes-and-association-with-reduced-cost-and-improved-quality
#19
Vivian S Lee, Kensaku Kawamoto, Rachel Hess, Charlton Park, Jeffrey Young, Cheri Hunter, Steven Johnson, Sandi Gulbransen, Christopher E Pelt, Devin J Horton, Kencee K Graves, Tom H Greene, Yoshimi Anzai, Robert C Pendleton
IMPORTANCE: Transformation of US health care from volume to value requires meaningful quantification of costs and outcomes at the level of individual patients. OBJECTIVE: To measure the association of a value-driven outcomes tool that allocates costs of care and quality measures to individual patient encounters with cost reduction and health outcome optimization. DESIGN, SETTING, AND PARTICIPANTS: Uncontrolled, pre-post, longitudinal, observational study measuring quality and outcomes relative to cost from 2012 to 2016 at University of Utah Health Care...
September 13, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27567407/2016-esc-eas-guidelines-for-the-management-of-dyslipidaemias-the-task-force-for-the-management-of-dyslipidaemias-of-the-european-society-of-cardiology-esc-and-european-atherosclerosis-society-eas-developed-with-the-special-contribution-of-the-european-assocciation
#20
Alberico L Catapano, Ian Graham, Guy De Backer, Olov Wiklund, M John Chapman, Heinz Drexel, Arno W Hoes, Catriona S Jennings, Ulf Landmesser, Terje R Pedersen, Željko Reiner, Gabriele Riccardi, Marja-Riita Taskinen, Lale Tokgozoglu, W M Monique Verschuren, Charalambos Vlachopoulos, David A Wood, Jose Luis Zamorano
No abstract text is available yet for this article.
August 27, 2016: European Heart Journal
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