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Outstanding Clinical Review

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44 papers 25 to 100 followers
Jonathan W Waks, Peter Zimetbaum
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and affects over 33 million people worldwide. AF is associated with stroke and systemic thromboembolism, unpleasant symptoms and reduced quality of life, heart failure, and increased mortality, and treatment of AF and its complications are associated with significant cost. Antiarrhythmic drugs (AADs) can suppress AF, allowing long-term maintenance of sinus rhythm, and have the potential to relieve symptoms and reverse or prevent adverse effects associated with AF...
June 2, 2016: Journal of Cardiovascular Pharmacology and Therapeutics
Mathieu van der Jagt
Maintenance fluids in critically ill brain-injured patients are part of routine critical care. Both the amounts of fluid volumes infused and the type and tonicity of maintenance fluids are relevant in understanding the impact of fluids on the pathophysiology of secondary brain injuries in these patients. In this narrative review, current evidence on routine fluid management of critically ill brain-injured patients and use of haemodynamic monitoring is summarized. Pertinent guidelines and consensus statements on fluid management for brain-injured patients are highlighted...
May 31, 2016: Critical Care: the Official Journal of the Critical Care Forum
Anne Kastelianne França da Silva, Marianne Penachini da Costa de Rezende Barbosa, Franciele Marques Vanderlei, Diego Giuliano Destro Christofaro, Luiz Carlos Marques Vanderlei
BACKGROUND: The use of heart rate variability as a tool capable of discriminating individuals with diabetes mellitus is still little explored, as its use has been limited to comparing those with and without the disease. Thus, the purpose of this study was to verify the use of heart rate variability as a tool for diagnostic and prognostic evaluation in person with diabetes and to identify whether there are cutoff points generated from the use of this tool in these individuals. METHODS: A search was conducted in the electronic databases MEDLINE, Cochrane Library, Web of Science, EMBASE, and LILACS starting from the oldest records until January 2015, by means of descriptors related to the target condition, evaluated tool, and evaluation method...
May 2016: Annals of Noninvasive Electrocardiology
Serenella Castelvecchio, Lorenzo Menicanti, Andrea Garatti, Roberto Tramarin, Marianna Volpe, Alessandro Parolari
Patients affected by diabetes usually have extensive coronary artery disease. Coronary revascularization has a prominent role in the treatment of coronary artery disease in the expanding diabetic population. However, diabetic patients undergoing coronary artery bypass grafting or percutaneous coronary intervention experience worse outcomes than nondiabetic patients. Several studies comparing coronary artery bypass grafting vs percutaneous coronary intervention in subgroups of diabetic patients demonstrated a survival advantage and fewer repeat revascularization procedures with an initial surgical strategy...
September 2016: Annals of Thoracic Surgery
Ify Mordi, Natalie Mordi, Christian Delles, Nikolaos Tzemos
Although the endothelium has a number of important functions, the term endothelial dysfunction is commonly used to describe impairment in its vasodilatory capacity. It is increasingly recognized that this is related to hypertension, although whether it predates essential hypertension or is a consequence of it is still unknown. In this review, we explore the mechanisms of endothelial dysfunction in essential hypertension, its prognostic significance and methods of pharmacological reversal.
August 2016: Journal of Hypertension
Ian D Pavord, Paul W Jones, Pierre-Régis Burgel, Klaus F Rabe
Exacerbations of chronic obstructive pulmonary disease (COPD) are defined as sustained worsening of a patient's condition beyond normal day-to-day variations that is acute in onset, and that may also require a change in medication and/or hospitalization. Exacerbations have a significant and prolonged impact on health status and outcomes, and negative effects on pulmonary function. A significant proportion of exacerbations are unreported and therefore left untreated, leading to a poorer prognosis than those treated...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Rob Mac Sweeney, Daniel F McAuley
Acute respiratory distress syndrome presents as hypoxia and bilateral pulmonary infiltrates on chest imaging in the absence of heart failure sufficient to account for this clinical state. Management is largely supportive, and is focused on protective mechanical ventilation and the avoidance of fluid overload. Patients with severe hypoxaemia can be managed with early short-term use of neuromuscular blockade, prone position ventilation, or extracorporeal membrane oxygenation. The use of inhaled nitric oxide is rarely indicated and both β2 agonists and late corticosteroids should be avoided...
April 28, 2016: Lancet
Christiana T Vogkou, Nikolaos I Vlachogiannis, Leonidas Palaiodimos, Antonis A Kousoulis
Infective endocarditis (IE) incidence remains high with considerable fatality rates; guidelines for prophylaxis against IE are currently under review in some settings which highlights the importance of maintaining up-to-date epidemiological estimates about the most common microbial causes. The objective of this systematic review, following PRISMA guidelines, was to identify the most common microbial causes of IE in recent years. Medline was searched from January 1, 2003 to March 31, 2013 for all articles containing the term "infective endocarditis"...
August 2016: European Journal of Clinical Microbiology & Infectious Diseases
François De Guio, Eric Jouvent, Geert Jan Biessels, Sandra E Black, Carol Brayne, Christopher Chen, Charlotte Cordonnier, Frank-Eric De Leeuw, Martin Dichgans, Fergus Doubal, Marco Duering, Carole Dufouil, Emrah Duzel, Franz Fazekas, Vladimir Hachinski, M Arfan Ikram, Jennifer Linn, Paul M Matthews, Bernard Mazoyer, Vincent Mok, Bo Norrving, John T O'Brien, Leonardo Pantoni, Stefan Ropele, Perminder Sachdev, Reinhold Schmidt, Sudha Seshadri, Eric E Smith, Luciano A Sposato, Blossom Stephan, Richard H Swartz, Christophe Tzourio, Mark van Buchem, Aad van der Lugt, Robert van Oostenbrugge, Meike W Vernooij, Anand Viswanathan, David Werring, Frank Wollenweber, Joanna M Wardlaw, Hugues Chabriat
Brain imaging is essential for the diagnosis and characterization of cerebral small vessel disease. Several magnetic resonance imaging markers have therefore emerged, providing new information on the diagnosis, progression, and mechanisms of small vessel disease. Yet, the reproducibility of these small vessel disease markers has received little attention despite being widely used in cross-sectional and longitudinal studies. This review focuses on the main small vessel disease-related markers on magnetic resonance imaging including: white matter hyperintensities, lacunes, dilated perivascular spaces, microbleeds, and brain volume...
August 2016: Journal of Cerebral Blood Flow and Metabolism
Sima L Sharara, Ralph Tayyar, Zeina A Kanafani, Souha S Kanj
INTRODUCTION: The HACEK group, referring to Haemophilus spp., Aggregatibacter actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae, is a rare cause of infective endocarditis (IE). It causes the majority of Gram-negative endocarditis cases and has an excellent prognosis and simple management if properly identified. However, delay in diagnosis and associated complications can render the infection fatal. AREAS COVERED: Over the past few decades, there have been tremendous advancements in understanding the manifestations and progression of HACEK endocarditis (HE)...
June 2016: Expert Review of Anti-infective Therapy
Jiachang Hu, Shaopeng Liu, Ping Jia, Xialian Xu, Nana Song, Ting Zhang, Rongyi Chen, Xiaoqiang Ding
BACKGROUND: Remote ischemic preconditioning (RIPC) is a promising approach to preventing acute kidney injury (AKI), but its efficacy is controversial. METHODS: A systematic review of 30 randomized controlled trials was conducted to investigate the effects of RIPC on the incidence and outcomes of AKI. Random effects model meta-analyses and meta-regressions were used to generate summary estimates and explore sources of heterogeneity. The primary outcome was incidence of AKI and hospital mortality...
April 20, 2016: Critical Care: the Official Journal of the Critical Care Forum
Evelyn P Whitlock, Brittany U Burda, Selvi B Williams, Janelle M Guirguis-Blake, Corinne V Evans
BACKGROUND: The balance between potential aspirin-related risks and benefits is critical in primary prevention. PURPOSE: To evaluate the risk for serious bleeding with regular aspirin use in cardiovascular disease (CVD) primary prevention. DATA SOURCES: PubMed, MEDLINE, Cochrane Central Register of Controlled Trials (2010 through 6 January 2015), and relevant references from other reviews. STUDY SELECTION: Randomized, controlled trials; cohort studies; and meta-analyses comparing aspirin with placebo or no treatment to prevent CVD or cancer in adults...
June 21, 2016: Annals of Internal Medicine
Janelle M Guirguis-Blake, Corinne V Evans, Caitlyn A Senger, Elizabeth A O'Connor, Evelyn P Whitlock
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death in the United States. PURPOSE: To update a systematic review about the benefits of aspirin for the primary prevention of cardiovascular events in adults aged 40 years or older and to evaluate effect modification in subpopulations. DATA SOURCES: MEDLINE, PubMed, Cochrane Central Register of Controlled Trials (January 2008 to January 2015), and Cochrane Database of Systematic Reviews...
June 21, 2016: Annals of Internal Medicine
Hugh J Willison, Bart C Jacobs, Pieter A van Doorn
Guillain-Barré syndrome is the most common and most severe acute paralytic neuropathy, with about 100,000 people developing the disorder every year worldwide. Under the umbrella term of Guillain-Barré syndrome are several recognisable variants with distinct clinical and pathological features. The severe, generalised manifestation of Guillain-Barré syndrome with respiratory failure affects 20-30% of cases. Treatment with intravenous immunoglobulin or plasma exchange is the optimal management approach, alongside supportive care...
August 13, 2016: Lancet
Mohammad G Saklayen, Neeraj V Deshpande
It is surprising that only about 50 years ago hypertension was considered an essential malady and not a treatable condition. Introduction of thiazide diuretics in late 50s made some headway in successful treatment of hypertension and ambitious multicenter VA co-operative study (phase 1 and 2) started in 1964 for diastolic hypertension ranging between 90 and 129 mmHg and completed by 1971 established for the first time that treating diastolic hypertension reduced CV events such as stroke and heart failure and improved mortality...
2016: Frontiers in Cardiovascular Medicine
Mirjana M Platiša, Tijana Bojić, Siniša U Pavlović, Nikola N Radovanović, Aleksandar Kalauzi
Classical Poincaré plot is a standard way to measure nonlinear regulation of cardiovascular control. In our work we propose a generalized form of Poincaré plot where we track correlation between the duration of j preceding and k next RR intervals. The investigation was done in healthy subjects and patients with atrial fibrillation, by varying j,k ≤ 100. In cases where j = k, in healthy subjects the typical pattern was observed by "paths" that were substituting scatterplots and that were initiated and ended by loops of Poincaré plot points...
2016: Frontiers in Neuroscience
K K Adour, D N Bell, R L Hilsinger
Sera from all 41 adult patients with idiopathic facil paralysis (Bell palsy) and 35 (85%) of 41 matched controls who had never had Bell palsy contained antibodies to herpes simplex virus (P smaller than.05). The frequency of antibodies to herpes zoster virus did not differ in patients and controls. A rise in antibody titer, indicating primary herpes simplex virus infection, was not found in these patients. That Bell palsy may be caused by reactivation of herpes simplex virus is suggested by (1) clinical, neurologic, laboratory, and immunologic similarities between idiopathic facial paralysis and known manifestations of reactivated herpes simplex virus infection, and (2) the known neurotropism of herpes simplex virus, including its presence in latent form in the trigeminal ganglia, and parallels with known facial paralysis due to varicella zoster virus, a closely related agent...
August 11, 1975: JAMA: the Journal of the American Medical Association
H M Kang, S Y Jung, J Y Byun, M S Park, S G Yeo
OBJECTIVES: The effectiveness of antiviral agents for the treatment of Bell's palsy is uncertain. We evaluated whether a steroid with an antiviral agent (S + A group) provided better recovery outcomes than a steroid alone (S group) in patients with Bell's palsy. SUBJECTS AND DESIGN: A total of 1342 patients diagnosed with Bell's palsy who visited the Kyung Hee Medical Center in Seoul, Korea, from 2002 to 2012 were included in this study. Patients in the S + A group were treated with prednisolone and antiviral agents (n = 569) and those in the S group with prednisolone alone (n = 773)...
May 2015: Journal of Internal Medicine
John R de Almeida, Gordon H Guyatt, Sachin Sud, Joanne Dorion, Michael D Hill, Michael R Kolber, Jane Lea, Sylvia Loong Reg, Balvinder K Somogyi, Brian D Westerberg, Chris White, Joseph M Chen
No abstract text is available yet for this article.
September 2, 2014: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Kavita Vakharia, Kalpesh Vakharia
Bell's palsy is unilateral, acute onset facial paralysis that is a common condition. One in every 65 people experiences Bell's palsy in the course of their lifetime. The majority of patients afflicted with this idiopathic disorder recover facial function. Initial treatment involves oral corticosteroids, possible antiviral drugs, and protection of the eye from desiccation. A small subset of patients may be left with incomplete recovery, synkinesis, facial contracture, or hemifacial spasm. A combination of medical and surgical treatment options exist to treat the long-term sequelae of Bell's palsy...
February 2016: Facial Plastic Surgery Clinics of North America
2016-02-22 13:53:36
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