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HericabMedicine

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30 papers 0 to 25 followers Artículos de Medicina interna
https://www.readbyqxmd.com/read/28887767/management-of-spontaneous-intracerebral-hemorrhage
#1
REVIEW
Roland Veltkamp, Jan Purrucker
PURPOSE OF REVIEW: We review the current evidence for medical and surgical treatments of spontaneous intracerebral hemorrhage (ICH). RECENT FINDINGS: Therapy with hemostatic agents (e.g. factor VIIa and tranexamic acid) if started early after bleeding onset may reduce hematoma expansion, but their clinical effectiveness has not been shown. Rapid anticoagulation reversal with prothrombin concentrates (PCC) plus vitamin K is the first choice in vitamin K antagonist-related ICH...
September 8, 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28844205/ultrasound-guided-central-venous-catheter-placement-a-structured-review-and-recommendations-for-clinical-practice
#2
REVIEW
Bernd Saugel, Thomas W L Scheeren, Jean-Louis Teboul
The use of ultrasound (US) has been proposed to reduce the number of complications and to increase the safety and quality of central venous catheter (CVC) placement. In this review, we describe the rationale for the use of US during CVC placement, the basic principles of this technique, and the current evidence and existing guidelines for its use. In addition, we recommend a structured approach for US-guided central venous access for clinical practice. Static and real-time US can be used to visualize the anatomy and patency of the target vein in a short-axis and a long-axis view...
August 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28847619/pharmacologic-therapy-for-heart-failure-with-reduced-ejection-fraction-closing-the-gap-between-clinical-guidelines-and-practice
#3
REVIEW
J Barr Biglane, Miriam F Becnel, Hector O Ventura, Selim R Krim
Despite the great progress made in the management of heart failure (HF) with reduced ejection fraction (HFrEF), its prevalence continues to rise owing to an aging population and an epidemic of hypertension, obesity and coronary artery disease. For decades, angiotensin converting enzyme inhibitors and beta blockers have been the mainstay of HFrEF therapy. The recent addition of sacubitril/valsartan and ivabradine to the HF armamentarium has the potential to transform our therapeutic approach to HFrEF, while simultaneously raising some questions and uncertainties on their applicability...
September 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28822777/managing-the-course-of-diabetic-kidney-disease-from-the-old-to-the-new
#4
REVIEW
Ronald M Goldenberg, Murray Berall, Christopher T M Chan, David Z I Cherney, Julie A Lovshin, Philip A McFarlane, Peter A Senior, Subodh Verma, Jordan J Weinstein
Diabetic kidney disease (DKD) is a group of chronic kidney diseases that is associated with significant cardiovascular as well as all-cause morbidity and mortality. Although DKD is often progressive in nature, its evolution can be modified by intensive management of glycemia and blood pressure and inhibition of the renin-angiotensin-aldosterone system. This review provides an overview of how multifactorial interventions can provide renal protection and includes a discussion of the nonglycemic effects of incretin-based diabetes therapies (glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase 4 inhibitors) and sodium-glucose cotransporter-2 inhibitors within the kidney in patients with type 2 diabetes...
August 16, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28851126/occult-cancer-screening-in-patients-with-venous-thromboembolism-guidance-from-the-ssc-of-the-isth
#5
A Delluc, D Antic, R Lecumberri, C Ay, G Meyer, M Carrier
No abstract text is available yet for this article.
October 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28958335/the-clinical-use-of-ivabradine
#6
REVIEW
Jacob S Koruth, Anuradha Lala, Sean Pinney, Vivek Y Reddy, Srinivas R Dukkipati
The clinical use of ivabradine has and continues to evolve along channels that are predicated on its mechanism of action. It selectively inhibits the funny current (If) in sinoatrial nodal tissue, resulting in a decrease in the rate of diastolic depolarization and, consequently, the heart rate, a mechanism that is distinct from those of other negative chronotropic agents. Thus, it has been evaluated and is used in select patients with systolic heart failure and chronic stable angina without clinically significant adverse effects...
October 3, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28924481/euglycemic-diabetic-ketoacidosis-a-diagnostic-and-therapeutic-dilemma
#7
Prashanth Rawla, Anantha R Vellipuram, Sathyajit S Bandaru, Jeffrey Pradeep Raj
Euglycemic diabetic ketoacidosis (EDKA) is a clinical triad comprising increased anion gap metabolic acidosis, ketonemia or ketonuria and normal blood glucose levels <200 mg/dL. This condition is a diagnostic challenge as euglycemia masquerades the underlying diabetic ketoacidosis. Thus, a high clinical suspicion is warranted, and other diagnosis ruled out. Here, we present two patients on regular insulin treatment who were admitted with a diagnosis of EDKA. The first patient had insulin pump failure and the second patient had urinary tract infection and nausea, thereby resulting in starvation...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28669995/redefining-lupus-nephritis-clinical-implications-of-pathophysiologic-subtypes
#8
REVIEW
Feng Yu, Mark Haas, Richard Glassock, Ming-Hui Zhao
Systemic lupus erythematosus (SLE) is associated with a broad spectrum of clinical and immunologic manifestations, of which lupus nephritis is the most common cause of morbidity and mortality. The development of nephritis in patients with SLE involves multiple pathogenic pathways including aberrant apoptosis, autoantibody production, immune complex deposition and complement activation. The 2003 International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification system for lupus nephritis was widely accepted with high intraobserver and interobserver concordance to guide therapeutic strategy and provide prognostic information...
August 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28672393/management-of-newly-diagnosed-hiv-infection
#9
REVIEW
Judith Feinberg, Susana Keeshin
No field in medicine has moved as swiftly as HIV/AIDS over the past 35 years. Because of the rapid turnover of key information, this In the Clinic focuses on essential principles of care for newly diagnosed adults with HIV-1 infection and how to prevent infection in persons at risk. To ensure continued usefulness, future directions in therapy and how to access updated information on a continuous basis are emphasized.
July 4, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28791529/effects-of-raas-inhibitors-in-patients-with-kidney-disease
#10
REVIEW
Fan Zhang, Hong Liu, Di Liu, Yexin Liu, Huiqiong Li, Xia Tan, Fuyou Liu, Youming Peng, Hongqing Zhang
Proteinuria and decline of renal function are associated with progression of kidney disease. The Renin Angiotensin Aldosterone System (RAAS) plays an important role in blood pressure regulation, fluid volume, and sodium balance. Overactivity of RAAS contributes to the pathogenesis of a variety of clinical conditions including progress of chronic kidney disease (CKD). This review summarizes the use of RAAS inhibitors as dual therapy or monotherapy in different stages of kidney disease. Experimental and clinical studies have demonstrated RAAS inhibitors prevent proteinuria, kidney fibrosis and slow decline of renal function and thus play a protective role in both early and end stages of kidney disease...
August 8, 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28787716/two-liters-a-day-keep-the-doctor-away-considerations-on-the-pathophysiology-of-suboptimal-fluid-intake-in-the-common-population
#11
Florian Lang, Isabelle Guelinckx, Guillaume Lemetais, Olle Melander
Suboptimal fluid intake may require enhanced release of antidiuretic hormone (ADH) or vasopressin for the maintenance of adequate hydration. Enhanced copeptin levels (reflecting enhanced vasopressin levels) in 25% of the common population are associated with enhanced risk of metabolic syndrome with abdominal obesity, type 2 diabetes, hypertension, coronary artery disease, heart failure, vascular dementia, cognitive impairment, microalbuminuria, chronic kidney disease, inflammatory bowel disease, cancer, and premature mortality...
2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/28646995/executive-summary-of-the-2017-kdigo-chronic-kidney%C3%A2-disease-mineral-and-bone-disorder-ckd-mbd-guideline-update-what-s-changed-and-why-it-matters
#12
Markus Ketteler, Geoffrey A Block, Pieter Evenepoel, Masafumi Fukagawa, Charles A Herzog, Linda McCann, Sharon M Moe, Rukshana Shroff, Marcello A Tonelli, Nigel D Toussaint, Marc G Vervloet, Mary B Leonard
The KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of CKD-MBD represents a selective update of the prior CKD-MBD Guideline published in 2009. This update, along with the 2009 publication, is intended to assist the practitioner caring for adults and children with chronic kidney disease (CKD), those on chronic dialysis therapy, or individuals with a kidney transplant. This review highlights key aspects of the 2017 CKD-MBD Guideline Update, with an emphasis on the rationale for the changes made to the original guideline document...
July 2017: Kidney International
https://www.readbyqxmd.com/read/28610806/heart-failure-in-patients-with-kidney-disease-and-iron-deficiency-the-role-of-iron-therapy
#13
Aleix Cases Amenós, Raquel Ojeda López, José María Portolés Pérez
Chronic kidney disease and anaemia are common in heart failure (HF) and are associated with a worse prognosis in these patients. Iron deficiency is also common in patients with HF and increases the risk of morbidity and mortality, regardless of the presence or absence of anaemia. While the treatment of anaemia with erythropoiesis-stimulating agents in patients with HF have failed to show a benefit in terms of morbidity and mortality, treatment with IV iron in patients with HF and reduced ejection fraction and iron deficiency is associated with clinical improvement...
June 10, 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28666993/digoxin-use-and-subsequent-clinical-outcomes-in-patients-with-atrial-fibrillation-with-or-without-heart-failure-in-the-engage-af-timi-48-trial
#14
Alon Eisen, Christian T Ruff, Eugene Braunwald, Rose A Hamershock, Basil S Lewis, Christian Hassager, Tze-Fan Chao, Jean Yves Le Heuzey, Michele Mercuri, Howard Rutman, Elliott M Antman, Robert P Giugliano
BACKGROUND: Digoxin is widely used in patients with atrial fibrillation despite the lack of randomized controlled trials. Observational studies report conflicting results regarding its association with mortality, perhaps because of residual confounding by the presence of heart failure (HF). METHODS AND RESULTS: In the ENGAGE AF-TIMI 48 (Effective Anticoagulation With Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis in Myocardial Infarction 48) trial, clinical outcomes of patients with atrial fibrillation with and without HF were examined by baseline digoxin use during a median follow-up of 2...
June 30, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28605608/canagliflozin-and-cardiovascular-and-renal-events-in-type-2-diabetes
#15
RANDOMIZED CONTROLLED TRIAL
Bruce Neal, Vlado Perkovic, Kenneth W Mahaffey, Dick de Zeeuw, Greg Fulcher, Ngozi Erondu, Wayne Shaw, Gordon Law, Mehul Desai, David R Matthews
Background Canagliflozin is a sodium-glucose cotransporter 2 inhibitor that reduces glycemia as well as blood pressure, body weight, and albuminuria in people with diabetes. We report the effects of treatment with canagliflozin on cardiovascular, renal, and safety outcomes. Methods The CANVAS Program integrated data from two trials involving a total of 10,142 participants with type 2 diabetes and high cardiovascular risk. Participants in each trial were randomly assigned to receive canagliflozin or placebo and were followed for a mean of 188...
August 17, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28612425/iron-deficiency-across-chronic-inflammatory-conditions-international-expert-opinion-on-definition-diagnosis-and-management
#16
REVIEW
Maria Domenica Cappellini, Josep Comin-Colet, Angel de Francisco, Axel Dignass, Wolfram Doehner, Carolyn S P Lam, Iain C Macdougall, Gerhard Rogler, Clara Camaschella, Rezan Kadir, Nicholas J Kassebaum, Donat R Spahn, Ali T Taher, Khaled M Musallam
Iron deficiency, even in the absence of anemia, can be debilitating, and exacerbate any underlying chronic disease, leading to increased morbidity and mortality. Iron deficiency is frequently concomitant with chronic inflammatory disease; however, iron deficiency treatment is often overlooked, partially due to the heterogeneity among clinical practice guidelines. In the absence of consistent guidance across chronic heart failure, chronic kidney disease and inflammatory bowel disease, we provide practical recommendations for iron deficiency to treating physicians: definition, diagnosis, and disease-specific diagnostic algorithms...
October 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28712645/comparison-of-qsofa-score-and-sirs-criteria-as-screening-mechanisms-for-emergency-department-sepsis
#17
COMPARATIVE STUDY
Samir Haydar, Matthew Spanier, Patricia Weems, Samantha Wood, Tania Strout
OBJECTIVES: The Quick Sequential [Sepsis-related] Organ Failure Assessment (qSOFA) score has been shown to accurately predict mortality in septic patients and is part of recently proposed diagnostic criteria for sepsis. We sought to ascertain the sensitive of the score in diagnosing sepsis, as well as the diagnostic timeliness of the score when compared to traditional systemic inflammatory response syndrome (SIRS) criteria in a population of emergency department (ED) patients treated in the ED, admitted, and subsequently discharged with a diagnosis of sepsis...
November 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28598792/croi-2017-complications-and-comorbidities-of-hiv-disease-and-its-treatment
#18
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/28700476/peripheral-monocytosis-as-a-predictive-factor-for-adverse-outcome-in-the-emergency-department-survey-based-on-a-register-study
#19
Mathias Hensel, Lena Grädel, Alexander Kutz, Sebastian Haubitz, Andreas Huber, Beat Mueller, Philipp Schuetz, Thomas Hügle
Monocytosis is associated with chronic infections such as tuberculosis or endocarditis as well as rheumatic and myeloproliferative disorders. Monocytes are also involved in the pathogenesis of atherosclerosis, coronary artery disease, and stroke. The value of monocytosis as a prognostic marker in different diagnostic groups in the emergency setting, however, has not been investigated so far.The aim of the article is to study monocytosis as an outcome factor in the emergency setting.In a Swiss register study, we analyzed monocyte counts in 4238 patients aged >18 years who were admitted to the emergency department of a regional tertiary care hospital...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28633665/optimizing-bronchodilation-in-the-prevention-of-copd-exacerbations
#20
REVIEW
Marc Miravitlles, Antonio Anzueto, José R Jardim
The natural disease course of chronic obstructive pulmonary disease (COPD) is often punctuated by exacerbations: acute events of symptom worsening associated with significant morbidity and healthcare resource utilization; reduced quality of life; and increased risk of hospitalization and death. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommend that patients at risk of exacerbations (GOLD Groups C and D) receive a long-acting muscarinic antagonist (LAMA) or a long-acting β2-agonist (LABA)/LAMA combination, respectively, as preferred initial treatments...
June 20, 2017: Respiratory Research
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