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HericabMedicine

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60 papers 0 to 25 followers Artículos de Medicina interna
https://www.readbyqxmd.com/read/29290508/the-emergency-medicine-evaluation-and-management-of-the-patient-with-cirrhosis
#1
REVIEW
Brit Long, Alex Koyfman
BACKGROUND: Cirrhosis is a significant cause of death in the U.S. and has a variety of causes, most commonly Hepatitis C and alcohol. Liver fibrosis and nodule formation result in significant complications due to portal system hypertension. There are several deadly complications emergency physicians must consider. OBJECTIVE OF THE REVIEW: Provide an evidence-based update for the resuscitation of decompensating cirrhotic patients and an overview of cirrhosis complications...
December 23, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29321547/polycythemia-vera-treatment-algorithm-2018
#2
REVIEW
Ayalew Tefferi, Alessandro M Vannucchi, Tiziano Barbui
Recently reported mature survival data have confirmed the favorable prognosis in polycythemia vera (PV), with an estimated median survival of 24 years, in patients younger than age 60 years old. Currently available drugs for PV have not been shown to prolong survival or alter the natural history of the disease and are instead indicated primarily for prevention of thrombosis. Unfortunately, study endpoints that are being utilized in currently ongoing clinical trials in PV do not necessarily target clinically or biologically relevant outcomes, such as thrombosis, survival, or morphologic remission, and are instead focused on components of disease palliation...
January 10, 2018: Blood Cancer Journal
https://www.readbyqxmd.com/read/29199410/non-alcoholic-fatty-liver-disease-the-emerging-burden-in-cardiometabolic-and-renal-diseases
#3
REVIEW
Eugene Han, Yong Ho Lee
As the number of individuals with non-alcoholic fatty liver disease (NAFLD) has increased, the influence of NAFLD on other metabolic diseases has been highlighted. Accumulating epidemiologic evidence indicates that NAFLD not only affects the liver but also increases the risk of extra-hepatic diseases such as type 2 diabetes mellitus, metabolic syndrome, dyslipidemia, hypertension, cardiovascular or cerebrovascular diseases, and chronic kidney disease. Non-alcoholic steatohepatitis, an advanced type of NAFLD, can aggravate these inter-organ relationships and lead to poorer outcomes...
November 17, 2017: Diabetes & Metabolism Journal
https://www.readbyqxmd.com/read/29293475/pharmacokinetics-and-pharmacodynamics-of-antibiotics-in-central-nervous-system-infections
#4
Roland Nau, Jana Seele, Marija Djukic, Helmut Eiffert
PURPOSE OF REVIEW: The barriers surrounding the central nervous system (CNS) together with the emergence of multiresistant pathogens pose a therapeutic challenge for the effective treatment of CNS infections. RECENT FINDINGS: In addition to vancomycin, colistin and aminoglycosides, classically used for intrathecal injection, drug concentrations in cerebrospinal fluid after intrathecal injection of daptomycin and tigecyclin were recently studied. SUMMARY: The entry of antiinfectives into the CNS compartments is determined by the physicochemical properties of the drug and by conditions in the host...
February 2018: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/29196574/clinical-biomarkers-differentiate-myelitis-from-vascular-and-other-causes-of-myelopathy
#5
Paula Barreras, Kathryn C Fitzgerald, Maureen A Mealy, Jorge A Jimenez, Daniel Becker, Scott D Newsome, Michael Levy, Philippe Gailloud, Carlos A Pardo
OBJECTIVE: To assess the predictive value of the initial clinical and paraclinical features in the differentiation of inflammatory myelopathies from other causes of myelopathy in patients with initial diagnosis of transverse myelitis (TM). METHODS: We analyzed the clinical presentation, spinal cord MRI, and CSF features in a cohort of 457 patients referred to a specialized myelopathy center with the presumptive diagnosis of TM. After evaluation, the myelopathies were classified as inflammatory, ischemic/stroke, arteriovenous malformations/fistulas, spondylotic, or other...
January 2, 2018: Neurology
https://www.readbyqxmd.com/read/29158679/treatment-of-pulmonary-hypertension-with-left-heart-disease-a-concise-review
#6
REVIEW
Anish Desai, Shilpa A Desouza
Pulmonary hypertension (PH) is defined by a mean pulmonary artery pressure ≥ 25 mmHg, as determined by right heart catheterization. Pulmonary arterial hypertension (PAH) can no longer be considered an orphan disease given the increase in awareness and availability of new drugs. PH carries with it a dismal prognosis and leads to significant morbidity and mortality. Symptoms can range from dyspnea, fatigue and chest pain to right ventricular failure and death. PH is divided into five groups by the World Health Organization (WHO), based on etiology...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29304214/biofilms-and-beyond-expanding-echinocandin-utility
#7
Emily L Larkin, Sharvari Dharmaiah, Mahmoud A Ghannoum
Echinocandins have been in use for over 15 years, starting with the first approval in 2001. Current trends, such as increasing resistance to fluconazole and shifts toward non-albicans spp. of Candida, suggest a growing role for echinocandins, as reflected by recent (2016) updates to guidelines that recommend echinocandins as first-line treatment for candidaemia. The efficacy, tolerability, and safety of echinocandins and their target site of action (1,3-β-d-glucan synthesis) have prompted research into potential new uses, such as for treatment of biofilm infections, MDR Candida auris and dermatophytes...
January 1, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29278550/intelligent-use-of-antiepileptic-drugs-is-beneficial-to-patients
#8
Jocelyn Y Cheng, Jacqueline A French
PURPOSE OF REVIEW: To describe the most important issues a clinician must consider whenever selecting and administering antiepileptic drugs (AEDs). There is no available algorithm that identifies how to individualize selection of AEDs. Proper selection and administration can make an enormous difference in both effectiveness and tolerability. RECENT FINDINGS: Many principles of AED selection remain unchanged. Selection of AEDs must be based on understanding of epilepsy syndrome and seizure type, comorbidities, risk of adverse events, as well as on patient characteristics such as age and sex...
December 22, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/29184811/dermatologic-manifestations-of-endocrine-disorders
#9
REVIEW
Michael Lause, Alisha Kamboj, Esteban Fernandez Faith
The skin serves as a window for clinicians to understand, diagnose, and monitor endocrine disease. Dermatologic manifestations of endocrinopathies contribute significantly to an individual's health and quality of life. In this review, we outline various disorders of the hypothalamic-pituitary axis, thyroid gland, pancreas, adrenal gland, and androgen axis as well as hereditary endocrine syndromes. In acromegaly, glycosaminoglycan deposition contributes to a thickening of skin and soft tissue, which manifests as coarsening and enlargement of facial and acral structures...
October 2017: Translational pediatrics
https://www.readbyqxmd.com/read/29272515/update-on-colchicine-2017
#10
Anastasia Slobodnick, Binita Shah, Svetlana Krasnokutsky, Michael H Pillinger
Colchicine is an ancient medication that is currently approved for the treatment of gout and FMF. However, colchicine has a wide range of anti-inflammatory activities, and studies indicate that it may be beneficial in a variety of other conditions. This paper reviews the evidence for the well-established use of colchicine in gout, as well as several other rheumatic diseases. In addition, we highlight the potential benefit of colchicine in cardiac disease, including coronary artery disease in patients both with and without gout...
January 1, 2018: Rheumatology
https://www.readbyqxmd.com/read/29166236/cause-pathogenesis-and-treatment-of-nonalcoholic-steatohepatitis
#11
REVIEW
Anna M Diehl, Christopher Day
New England Journal of Medicine, Volume 377, Issue 21, Page 2063-2072, November 2017.
November 23, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29175086/re-examining-permissive-hypercapnia-in%C3%A2-ards-a-narrative-review
#12
REVIEW
Tavish Barnes, Vasileios Zochios, Ken Parhar
Lung-protective ventilation (LPV) has become the cornerstone of management in patients with ARDS. A subset of patients is unable to tolerate LPV without significant CO2 elevation. In these patients, permissive hypercapnia is used. Although thought to be benign, it is becoming increasingly evident that elevated CO2 levels have significant physiological effects. In this narrative review, we highlight clinically relevant end-organ effects in both animal models and clinical studies. We also explore the association between elevated CO2, acute cor pulmonale, and ICU mortality...
November 22, 2017: Chest
https://www.readbyqxmd.com/read/29229375/the-pathophysiology-of-migraine-implications-for-clinical-management
#13
REVIEW
Andrew Charles
The understanding of migraine pathophysiology is advancing rapidly. Improved characterisation and diagnosis of its clinical features have led to the view of migraine as a complex, variable disorder of nervous system function rather than simply a vascular headache. Recent studies have provided important new insights into its genetic causes, anatomical and physiological features, and pharmacological mechanisms. The identification of new migraine-associated genes, the visualisation of brain regions that are activated at the earliest stages of a migraine attack, a greater appreciation of the potential role of the cervical nerves, and the recognition of the crucial role for neuropeptides are among the advances that have led to novel targets for migraine therapy...
December 8, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/29182749/idsa-position-statement-why-idsa-did-not-endorse-the-surviving-sepsis-campaign-guidelines
#14
David N Gilbert, Andre C Kalil, Michael Klompas, Henry Masur, Dean L Winslow
IDSA did not endorse the 2016 Surviving Sepsis Campaign Guidelines despite being represented in the working group that drafted the guidelines document. Leadership from IDSA, the Surviving Sepsis Campaign Guidelines, and the Society of Critical Care Medicine had numerous amicable discussions primarily regarding the bolded, rated guidelines recommendations. Our societies had different perspectives, however, regarding the interpretation of the major studies that informed the guidelines' recommendations thus leading us to different conclusions and different perspectives on the recommendations...
November 22, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29275977/diagnosis-of-multiple-sclerosis-2017-revisions-of-the-mcdonald-criteria
#15
REVIEW
Alan J Thompson, Brenda L Banwell, Frederik Barkhof, William M Carroll, Timothy Coetzee, Giancarlo Comi, Jorge Correale, Franz Fazekas, Massimo Filippi, Mark S Freedman, Kazuo Fujihara, Steven L Galetta, Hans Peter Hartung, Ludwig Kappos, Fred D Lublin, Ruth Ann Marrie, Aaron E Miller, David H Miller, Xavier Montalban, Ellen M Mowry, Per Soelberg Sorensen, Mar Tintoré, Anthony L Traboulsee, Maria Trojano, Bernard M J Uitdehaag, Sandra Vukusic, Emmanuelle Waubant, Brian G Weinshenker, Stephen C Reingold, Jeffrey A Cohen
The 2010 McDonald criteria for the diagnosis of multiple sclerosis are widely used in research and clinical practice. Scientific advances in the past 7 years suggest that they might no longer provide the most up-to-date guidance for clinicians and researchers. The International Panel on Diagnosis of Multiple Sclerosis reviewed the 2010 McDonald criteria and recommended revisions. The 2017 McDonald criteria continue to apply primarily to patients experiencing a typical clinically isolated syndrome, define what is needed to fulfil dissemination in time and space of lesions in the CNS, and stress the need for no better explanation for the presentation...
December 21, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/29182495/platelet-transfusion-for-patients-with-cancer-american-society-of-clinical-oncology-clinical-practice-guideline-update
#16
Charles A Schiffer, Kari Bohlke, Meghan Delaney, Heather Hume, Anthony J Magdalinski, Jeffrey J McCullough, James L Omel, John M Rainey, Paolo Rebulla, Scott D Rowley, Michael B Troner, Kenneth C Anderson
Purpose To provide evidence-based guidance on the use of platelet transfusion in people with cancer. This guideline updates and replaces the previous ASCO platelet transfusion guideline published initially in 2001. Methods ASCO convened an Expert Panel and conducted a systematic review of the medical literature published from September 1, 2014, through October 26, 2016. This review builds on two 2015 systematic reviews that were conducted by the AABB and the International Collaboration for Transfusion Medicine Guidelines...
November 28, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29167102/coffee-consumption-and-health-umbrella-review-of-meta-analyses-of-multiple-health-outcomes
#17
REVIEW
Robin Poole, Oliver J Kennedy, Paul Roderick, Jonathan A Fallowfield, Peter C Hayes, Julie Parkes
Objectives To evaluate the existing evidence for associations between coffee consumption and multiple health outcomes.Design Umbrella review of the evidence across meta-analyses of observational and interventional studies of coffee consumption and any health outcome.Data sources PubMed, Embase, CINAHL, Cochrane Database of Systematic Reviews, and screening of references.Eligibility criteria for selecting studies Meta-analyses of both observational and interventional studies that examined the associations between coffee consumption and any health outcome in any adult population in all countries and all settings...
November 22, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29253554/heparin-induced-thrombocytopenia-in-the-critically-ill-patient
#18
REVIEW
James M East, Christine Cserti- Gazdewich, John T Granton
Heparin induced thrombocytopenia (HIT) is associated with significant morbidity and mortality. Critically ill patients are commonly thrombocytopenic and exposed to heparin. Although HIT should be considered, it is not usually the cause of thrombocytopenia in the medical-surgical ICU population. A systematic approach to the critically ill patient with thrombocytopenia using clinical features, complemented by appropriate laboratory confirmation should lead to a reduction in inappropriate laboratory testing and reduce the use of more expensive and less reliable anticoagulants...
December 15, 2017: Chest
https://www.readbyqxmd.com/read/29165674/how-to-use-bisphosphonates-safely-and-optimally-using-bisphosphonates
#19
Aprajita Jagpal, Kenneth G Saag
No abstract text is available yet for this article.
November 20, 2017: Rheumatology
https://www.readbyqxmd.com/read/29203195/2017-acc-expert-consensus-decision-pathway-on-management-of-bleeding-in-patients-on-oral-anticoagulants-a-report-of-the-american-college-of-cardiology-task-force-on-expert-consensus-decision-pathways
#20
Gordon F Tomaselli, Kenneth W Mahaffey, Adam Cuker, Paul P Dobesh, John U Doherty, John W Eikelboom, Roberta Florido, William Hucker, Roxana Mehran, Steven R Messé, Charles V Pollack, Fatima Rodriguez, Ravindra Sarode, Deborah Siegal, Barbara S Wiggins
No abstract text is available yet for this article.
December 19, 2017: Journal of the American College of Cardiology
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