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Internal Medicine

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311 papers 100 to 500 followers General Internal Medicine
By Jeff Bank Internal Medicine R2 at the University of Utah
https://www.readbyqxmd.com/read/28286222/2017-acc-aha-hrs-guideline-for-the-evaluation-and-management-of-patients-with-syncope-executive-summary-a-report-of-the-american-college-of-cardiology-american-heart-association-task-force-on-clinical-practice-guidelines-and-the-heart-rhythm-society
#1
Win-Kuang Shen, Robert S Sheldon, David G Benditt, Mitchell I Cohen, Daniel E Forman, Zachary D Goldberger, Blair P Grubb, Mohamed H Hamdan, Andrew D Krahn, Mark S Link, Brian Olshansky, Satish R Raj, Roopinder Kaur Sandhu, Dan Sorajja, Benjamin C Sun, Clyde W Yancy
No abstract text is available yet for this article.
March 9, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28279964/serum-creatinine-elevation-after-renin-angiotensin-system-blockade-and-long-term-cardiorenal-risks-cohort-study
#2
Morten Schmidt, Kathryn E Mansfield, Krishnan Bhaskaran, Dorothea Nitsch, Henrik Toft Sørensen, Liam Smeeth, Laurie A Tomlinson
Objective To examine long term cardiorenal outcomes associated with increased concentrations of creatinine after the start of angiotensin converting enzyme inhibitor/angiotensin receptor blocker treatment.Design Population based cohort study using electronic health records from the Clinical Practice Research Datalink and Hospital Episode Statistics.Setting UK primary care, 1997-2014.Participants Patients starting treatment with angiotensin converting enzyme inhibitors or angiotensin receptor blockers (n=122 363)...
March 9, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28235886/the-pearl-score-predicts-90-day-readmission-or-death-after-hospitalisation-for-acute-exacerbation-of-copd
#3
C Echevarria, J Steer, K Heslop-Marshall, S C Stenton, P M Hickey, R Hughes, M Wijesinghe, R N Harrison, N Steen, A J Simpson, G J Gibson, S C Bourke
BACKGROUND: One in three patients hospitalised due to acute exacerbation of COPD (AECOPD) is readmitted within 90 days. No tool has been developed specifically in this population to predict readmission or death. Clinicians are unable to identify patients at particular risk, yet resources to prevent readmission are allocated based on clinical judgement. METHODS: In participating hospitals, consecutive admissions of patients with AECOPD were identified by screening wards and reviewing coding records...
February 24, 2017: Thorax
https://www.readbyqxmd.com/read/28240562/guidelines-for-management-of-incidental-pulmonary-nodules-detected-on-ct-images-from-the-fleischner-society-2017
#4
Heber MacMahon, David P Naidich, Jin Mo Goo, Kyung Soo Lee, Ann N C Leung, John R Mayo, Atul C Mehta, Yoshiharu Ohno, Charles A Powell, Mathias Prokop, Geoffrey D Rubin, Cornelia M Schaefer-Prokop, William D Travis, Paul E Van Schil, Alexander A Bankier
The Fleischner Society Guidelines for management of solid nodules were published in 2005, and separate guidelines for subsolid nodules were issued in 2013. Since then, new information has become available; therefore, the guidelines have been revised to reflect current thinking on nodule management. The revised guidelines incorporate several substantive changes that reflect current thinking on the management of small nodules. The minimum threshold size for routine follow-up has been increased, and recommended follow-up intervals are now given as a range rather than as a precise time period to give radiologists, clinicians, and patients greater discretion to accommodate individual risk factors and preferences...
February 23, 2017: Radiology
https://www.readbyqxmd.com/read/28288484/pharmacologic-therapy-for-type-2-diabetes-synopsis-of-the-2017-american-diabetes-association-standards-of-medical-care-in-diabetes
#5
James J Chamberlain, William H Herman, Sandra Leal, Andrew S Rhinehart, Jay H Shubrook, Neil Skolnik, Rita Rastogi Kalyani
Description: The American Diabetes Association (ADA) annually updates the Standards of Medical Care in Diabetes to provide clinicians, patients, researchers, payers, and other interested parties with evidence-based recommendations for the diagnosis and management of patients with diabetes. Methods: For the 2017 Standards, the ADA Professional Practice Committee updated previous MEDLINE searches performed from 1 January 2016 to November 2016 to add, clarify, or revise recommendations based on new evidence...
March 14, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28233565/prophylactic-hydration-to-protect-renal-function-from-intravascular-iodinated-contrast-material-in-patients-at-high-risk-of-contrast-induced-nephropathy-amacing-a-prospective-randomised-phase-3-controlled-open-label-non-inferiority-trial
#6
Estelle C Nijssen, Roger J Rennenberg, Patty J Nelemans, Brigitte A Essers, Marga M Janssen, Marja A Vermeeren, Vincent van Ommen, Joachim E Wildberger
BACKGROUND: Intravenous saline is recommended in clinical practice guidelines as the cornerstone for preventing contrast-induced nephropathy in patients with compromised renal function. However, clinical-effectiveness and cost-effectiveness of this prophylactic hydration treatment in protecting renal function has not been adequately studied in the population targeted by the guidelines, against a group receiving no prophylaxis. This was the aim of the AMACING trial. METHODS: AMACING is a prospective, randomised, phase 3, parallel-group, open-label, non-inferiority trial of patients at risk of contrast-induced nephropathy according to current guidelines...
February 20, 2017: Lancet
https://www.readbyqxmd.com/read/28222250/long-term-treatment-of-cancer-associated-thrombosis-the-choice-of-the-optimal-anticoagulant
#7
REVIEW
I Elalamy, I Mahé, W Ageno, G Meyer
Patients with cancer associated thrombosis (CAT) carry a higher risk of recurrence, bleeding and mortality as compared to non-cancer patients. The specific profile of cancer patients combining frequent co-morbidities, the use of anti-tumoral therapies and the cancer progression itself represent a major therapeutic challenge for choosing a long-term anticoagulant treatment. This review discusses the practical basis of that choice among available drugs for the long-term antithrombotic strategy linked to their pharmacology, mechanism of action, evidence of clinical benefits, advantages and limitations in such a complex clinical context...
February 21, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28153111/mode-of-death-in-heart-failure-with-preserved-ejection-fraction
#8
REVIEW
Muthiah Vaduganathan, Ravi B Patel, Alexander Michel, Sanjiv J Shah, Michele Senni, Mihai Gheorghiade, Javed Butler
Little is known about specific modes of death in patients with heart failure with preserved ejection fraction (HFpEF). Herein, the authors critically appraise the current state of data and offer potential future directions. They conducted a systematic review of 1,608 published HFpEF papers from January 1, 1985, to December 31, 2015, which yielded 8 randomized clinical trials and 24 epidemiological studies with mode-of-death data. Noncardiovascular modes of death represent an important competing risk in HFpEF...
February 7, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28192790/systemic-pharmacologic-therapies-for-low-back-pain-a-systematic-review-for-an-american-college-of-physicians-clinical-practice-guideline
#9
Roger Chou, Richard Deyo, Janna Friedly, Andrea Skelly, Melissa Weimer, Rochelle Fu, Tracy Dana, Paul Kraegel, Jessica Griffin, Sara Grusing
Background: A 2007 American College of Physicians guideline addressed pharmacologic options for low back pain. New evidence and medications have now become available. Purpose: To review the current evidence on systemic pharmacologic therapies for acute or chronic nonradicular or radicular low back pain. Data Sources: Ovid MEDLINE (January 2008 through November 2016), Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and reference lists...
February 14, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28174217/diagnosis-and-treatment-of-hyponatremia-compilation-of-the-guidelines
#10
Ewout J Hoorn, Robert Zietse
Hyponatremia is a common water balance disorder that often poses a diagnostic or therapeutic challenge. Therefore, guidelines were developed by professional organizations, one from within the United States (2013) and one from within Europe (2014). This review discusses the diagnosis and treatment of hyponatremia, comparing the two guidelines and highlighting recent developments. Diagnostically, the initial step is to differentiate hypotonic from nonhypotonic hyponatremia. Hypotonic hyponatremia is further differentiated on the basis of urine osmolality, urine sodium level, and volume status...
February 7, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27662240/american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-clinical-practice-guidelines-for-the-diagnosis-and-treatment-of-postmenopausal-osteoporosis-2016
#11
Pauline M Camacho, Steven M Petak, Neil Binkley, Bart L Clarke, Steven T Harris, Daniel L Hurley, Michael Kleerekoper, E Michael Lewiecki, Paul D Miller, Harmeet S Narula, Rachel Pessah-Pollack, Vin Tangpricha, Sunil J Wimalawansa, Nelson B Watts
AACE = American Association of Clinical Endocrinologists AFF = atypical femur fracture ASBMR = American Society for Bone and Mineral Research BEL = best evidence level BMD = bone mineral density BTM = bone turnover marker CBC = complete blood count CI = confidence interval DXA = dual-energy X-ray absorptiometry EL = evidence level FDA = U.S. Food and Drug Administration FLEX = Fracture Intervention Trial (FIT) Long-term Extension FRAX(®) = Fracture Risk Assessment Tool GFR = glomerular filtration rate GI = gastrointestinal HORIZON = Health Outcomes and Reduced Incidence with Zoledronic Acid Once Yearly IOF = International Osteoporosis Foundation ISCD = International Society for Clinical Densitometry IU = international units IV = intravenous LSC = least significant change NBHA = National Bone Health Alliance NOF = National Osteoporosis Foundation 25(OH)D = 25-hydroxy vitamin D ONJ = osteonecrosis of the jaw PINP = serum carboxy-terminal propeptide of type I collagen PTH = parathyroid hormone R = recommendation RANK = receptor activator of nuclear factor kappa-B RANKL = receptor activator of nuclear factor kappa-B ligand RCT = randomized controlled trial RR = relative risk S-CTX = serum C-terminal telopeptide SQ = subcutaneous VFA = vertebral fracture assessment WHO = World Health Organization...
September 2, 2016: Endocrine Practice
https://www.readbyqxmd.com/read/28114931/procalcitonin-guided-diagnosis-and-antibiotic-stewardship-revisited
#12
REVIEW
Ramon Sager, Alexander Kutz, Beat Mueller, Philipp Schuetz
Several controlled clinical studies have evaluated the potential of the infection biomarker procalcitonin (PCT) to improve the diagnostic work-up of patients with bacterial infections and its influence on decisions regarding antibiotic therapy. Most research has focused on lower respiratory tract infections and critically ill sepsis patients. A clinical utility for PCT has also been found for patients with urinary tract infections, postoperative infections, meningitis, and patients with acute heart failure with possible superinfection (i...
January 24, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28128970/global-strategy-for-the-diagnosis-management-and-prevention-of-chronic-obstructive-lung-disease-2017-report-gold-executive-summary
#13
Claus F Vogelmeier, Gerard J Criner, Fernando J Martinez, Antonio Anzueto, Peter J Barnes, Jean Bourbeau, Bartolome R Celli, Rongchang Chen, Marc Decramer, Leonardo M Fabbri, Peter Frith, David M G Halpin, M Victorina López Varela, Masaharu Nishimura, Nicolas Roche, Roberto Rodriguez-Roisin, Don D Sin, Dave Singh, Robert Stockley, Jørgen Vestbo, Jadwiga A Wedzicha, Alvar Agusti
This Executive Summary of the Global Strategy for the Diagnosis, Management, and Prevention of COPD (GOLD) 2017 Report focuses primarily on the revised and novel parts of the document. The most significant changes include: i) the assessment of COPD has been refined to separate the spirometric assessment from symptom evaluation. ABCD groups are now proposed to be derived exclusively from patient symptoms and their history of exacerbations; ii) for each of the groups A to D, escalation strategies for pharmacological treatments are proposed; iii) the concept of de-escalation of therapy is introduced in the treatment assessment scheme; iv) nonpharmacologic therapies are comprehensively presented and; v) the importance of comorbid conditions in managing COPD is reviewed...
January 27, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28135357/hypertension-in-2017-what-is-the-right-target
#14
Aram V Chobanian
No abstract text is available yet for this article.
February 14, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28099222/a-users-guide-to-the-2016-surviving-sepsis-guidelines
#15
R Phillip Dellinger, Christa A Schorr, Mitchell M Levy
No abstract text is available yet for this article.
March 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28032484/treatment-of-methicillin-resistant-staphylococcus-aureus-bacteremia
#16
REVIEW
Eun Ju Choo, Henry F Chambers
Methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of health care-associated infections. Vancomycin remains an acceptable treatment option. There has been a welcome increase in the number of agents available for the treatment of MRSA infection. These drugs have certain differentiating attributes and may offer some advantages over vancomycin, but they also have significant limitations. These agents provide some alternative when no other options are available.
December 2016: Infection & Chemotherapy
https://www.readbyqxmd.com/read/27849359/basal-insulin-4-0-updating-your-clinical-practice-with-ultralong-acting-insulins-and-insulin-combination-therapy
#17
(no author information available yet)
No abstract text is available yet for this article.
November 2016: Endocrine Practice
https://www.readbyqxmd.com/read/28073314/safety-of-the-peripheral-administration-of-vasopressor-agents
#18
Tyler Lewis, Cristian Merchan, Diana Altshuler, John Papadopoulos
Vasopressors are an integral component of the management of septic shock and are traditionally given via a central venous catheter (CVC) due to the risk of tissue injury and necrosis if extravasated. However, the need for a CVC for the management of septic shock has been questioned, and the risk of extravasation and incidence of severe injury when vasopressors are given via a peripheral venous line (PVL) remains poorly defined. We performed a retrospective chart review of 202 patients who received vasopressors through a PVL...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28054130/posterior-reversible-encephalopathy-syndrome
#19
REVIEW
Marlene Fischer, Erich Schmutzhard
The posterior reversible encephalopathy syndrome (PRES) is a neurological disorder of (sub)acute onset characterized by varied neurological symptoms, which may include headache, impaired visual acuity or visual field deficits, disorders of consciousness, confusion, seizures, and focal neurological deficits. In a majority of patients the clinical presentation includes elevated arterial blood pressure up to hypertensive emergencies. Neuroimaging, in particular magnetic resonance imaging, frequently shows a distinctive parieto-occipital pattern with a symmetric distribution of changes reflecting vasogenic edema...
January 4, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28029394/non-anion-gap-metabolic-acidosis-a-clinical-approach%C3%A2-to%C3%A2-evaluation
#20
Mandana Rastegar, Glenn T Nagami
Acid-base disturbances can result from kidney or nonkidney disorders. We present a case of high-volume ileostomy output causing large bicarbonate losses and resulting in a non-anion gap metabolic acidosis. Non-anion gap metabolic acidosis can present as a form of either acute or chronic metabolic acidosis. A complete clinical history and physical examination are critical initial steps to begin the evaluation process, followed by measuring serum electrolytes with a focus on potassium level, blood gas, urine pH, and either direct or indirect urine ammonium concentration...
October 28, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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