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Outstanding Clinical Review

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73 papers 25 to 100 followers
https://www.readbyqxmd.com/read/29108815/noninvasive-bp-monitoring-in-the-critically%C3%A2-ill-time-to-abandon-the-arterial-catheter
#1
REVIEW
Karim Lakhal, Stephan Ehrmann, Thierry Boulain
Although its reliability is often questioned, noninvasive BP (NIBP)-monitoring with an oscillometric arm cuff is widely used, even in critically ill patients in shock. When correctly implemented, modern arm NIBP devices can provide accurate and precise measurements of mean BP, as well as clinically meaningful information such as identification of hypotension and hypertension and monitoring of patient response to therapy. Even in specific circumstances such as arrhythmia, hypotension, vasopressor infusion, and possibly in obese patients, arm NIBP may be useful, contrary to widespread belief...
November 3, 2017: Chest
https://www.readbyqxmd.com/read/29137910/tamponade-hemodynamic-and-echocardiographic-diagnosis
#2
REVIEW
Mark J Kearns, Keith R Walley
Cardiac tamponade is a medical emergency that can be readily reversed with timely recognition and appropriate intervention. The clinical diagnosis of cardiac tamponade requires synthesis of a constellation of otherwise non-specific features, based on an understanding of the underlying pathophysiology. Whereas echocardiographic examination is a central component of diagnosis, alone it is insufficient to establish the physiologic diagnosis of hemodynamically significant cardiac tamponade. The hemodynamic diagnosis of cardiac tamponade requires clinical evidence of low cardiac output and stroke volume in the setting of elevated cardiac filling pressures, with evidence of increased sympathetic tone (tachycardia, peripheral vasoconstriction, etc), and exclusion of other causes of shock as the primary problem (particularly cardiogenic shock)...
November 11, 2017: Chest
https://www.readbyqxmd.com/read/29175361/the-role-of-computed-tomography-for-the-evaluation-of-lung-disease-in-alpha-1-antitrypsin-deficiency
#3
REVIEW
Michael A Campos, Alejandro A Diaz
Alpha-1 antitrypsin deficiency (AATD) is characterized by low serum levels of or dysfunctional alpha-1 proteinase inhibitor (A1-PI). In the lung parenchyma, this results in a loss of protection against the activity of serine proteases, particularly neutrophil elastase. The resultant imbalance in protease and anti-protease activity leads to an increased risk for the development of early-onset emphysema and chronic obstructive pulmonary disease (COPD). As in traditional smoke-related COPD, the assessment of the severity and disease progression of lung disease in AATD is conventionally based on lung function; however, pulmonary function tests are unable to discriminate between emphysema and airway disease, the two hallmark pathologic features of COPD...
November 23, 2017: Chest
https://www.readbyqxmd.com/read/28974541/when-to-start-and-when-to-stop-antifibrotic-therapies
#4
REVIEW
Sebastiano Emanuele Torrisi, Mauro Pavone, Ada Vancheri, Carlo Vancheri
Idiopathic pulmonary fibrosis (IPF) is characterised by progressive changes of the lung architecture causing cough and dyspnoea and ultimately leading to lung failure and death. Today, for the first time, two drugs that may reduce the inexorable progression of the disease are available, suggesting that treatment with specific drugs for IPF should be started as soon as diagnosis is made. This applies to any disease and particularly to IPF, which is marked by a 5-year survival comparable or even worse than many cancers...
September 30, 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/29087399/proton-pump-inhibitor-therapy-for-eosinophilic-esophagitis-a-paradigm-shift
#5
Javier Molina-Infante, Alfredo J Lucendo
No abstract text is available yet for this article.
October 31, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29030424/stable-coronary-syndromes-pathophysiology-diagnostic-advances-and-therapeutic-need
#6
REVIEW
Thomas J Ford, David Corcoran, Colin Berry
The diagnostic management of patients with angina pectoris typically centres on the detection of obstructive epicardial CAD, which aligns with evidence-based treatment options that include medical therapy and myocardial revascularisation. This clinical paradigm fails to account for the considerable proportion (approximately one-third) of patients with angina in whom obstructive CAD is excluded. This common scenario presents a diagnostic conundrum whereby angina occurs but there is no obstructive CAD (ischaemia and no obstructive coronary artery disease-INOCA)...
February 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28953042/critically-ill-patients-with-the-middle-east-respiratory-syndrome-a-multicenter-retrospective-cohort-study
#7
Yaseen M Arabi, Awad Al-Omari, Yasser Mandourah, Fahad Al-Hameed, Anees A Sindi, Basem Alraddadi, Sarah Shalhoub, Abdullah Almotairi, Kasim Al Khatib, Ahmed Abdulmomen, Ismael Qushmaq, Ahmed Mady, Othman Solaiman, Abdulsalam M Al-Aithan, Rajaa Al-Raddadi, Ahmed Ragab, Ghaleb A Al Mekhlafi, Abdulrahman Al Harthy, Ayman Kharaba, Mashael Al Ahmadi, Musharaf Sadat, Hanan Al Mutairi, Eman Al Qasim, Jesna Jose, Maliha Nasim, Abdulaziz Al-Dawood, Laura Merson, Robert Fowler, Frederick G Hayden, Hanan H Balkhy
OBJECTIVES: To describe patient characteristics, clinical manifestations, disease course including viral replication patterns, and outcomes of critically ill patients with severe acute respiratory infection from the Middle East respiratory syndrome and to compare these features with patients with severe acute respiratory infection due to other etiologies. DESIGN: Retrospective cohort study. SETTING: Patients admitted to ICUs in 14 Saudi Arabian hospitals...
August 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28190438/therapeutic-hypothermia-protocols
#8
REVIEW
N Badjatia
The application of targeted temperature management has become common practice in the neurocritical care setting. It is important to recognize the pathophysiologic mechanisms by which temperature control impacts acute neurologic injury, as well as the clinical limitations to its application. Nonetheless, when utilizing temperature modulation, an organized approach is required in order to avoid complications and minimize side-effects. The most common clinically relevant complications are related to the impact of cooling on hemodynamics and electrolytes...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/19535959/development-and-implementation-of-a-therapeutic-hypothermia-protocol
#9
REVIEW
Nicole L Kupchik
Two randomized controlled trials published in 2002 demonstrated that mild hypothermia induced after resuscitation from cardiac arrest decreased mortality and improved neurologic outcomes. Although therapeutic hypothermia is relatively easy to implement, side effects and special nursing considerations are associated with this therapy. This article discusses the process of developing and implementing a therapeutic hypothermia protocol. Patients resuscitated after cardiac arrest are cooled to 32 degrees C-34 degrees C for 12-24 hrs...
July 2009: Critical Care Medicine
https://www.readbyqxmd.com/read/28870355/mechanical-ventilation-state-of-the-art
#10
REVIEW
Tài Pham, Laurent J Brochard, Arthur S Slutsky
Mechanical ventilation is the most used short-term life support technique worldwide and is applied daily for a diverse spectrum of indications, from scheduled surgical procedures to acute organ failure. This state-of-the-art review provides an update on the basic physiology of respiratory mechanics, the working principles, and the main ventilatory settings, as well as the potential complications of mechanical ventilation. Specific ventilatory approaches in particular situations such as acute respiratory distress syndrome and chronic obstructive pulmonary disease are detailed along with protective ventilation in patients with normal lungs...
September 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28938253/guidelines-for-the-diagnosis-and-management-of-critical-illness-related-corticosteroid-insufficiency-circi-in-critically-ill-patients-part-i-society-of-critical-care-medicine-sccm-and-european-society-of-intensive-care-medicine-esicm-2017
#11
Djillali Annane, Stephen M Pastores, Bram Rochwerg, Wiebke Arlt, Robert A Balk, Albertus Beishuizen, Josef Briegel, Joseph Carcillo, Mirjam Christ-Crain, Mark S Cooper, Paul E Marik, Gianfranco Umberto Meduri, Keith M Olsen, Sophia C Rodgers, James A Russell, Greet Van den Berghe
OBJECTIVE: To update the 2008 consensus statements for the diagnosis and management of critical illness-related corticosteroid insufficiency (CIRCI) in adult and pediatric patients. PARTICIPANTS: A multispecialty task force of 16 international experts in critical care medicine, endocrinology, and guideline methods, all of them members of the Society of Critical Care Medicine and/or the European Society of Intensive Care Medicine. DESIGN/METHODS: The recommendations were based on the summarized evidence from the 2008 document in addition to more recent findings from an updated systematic review of relevant studies from 2008 to 2017 and were formulated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology...
December 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28886622/2017-esc-focused-update-on-dual-antiplatelet-therapy-in-coronary-artery-disease-developed-in-collaboration-with-eacts-the-task-force-for-dual-antiplatelet-therapy-in-coronary-artery-disease-of-the-european-society-of-cardiology-esc-and-of-the-european-association
#12
Marco Valgimigli, Héctor Bueno, Robert A Byrne, Jean-Philippe Collet, Francesco Costa, Anders Jeppsson, Peter Jüni, Adnan Kastrati, Philippe Kolh, Laura Mauri, Gilles Montalescot, Franz-Josef Neumann, Mate Petricevic, Marco Roffi, Philippe Gabriel Steg, Stephan Windecker, Jose Luis Zamorano, Glenn N Levine
No abstract text is available yet for this article.
January 14, 2018: European Heart Journal
https://www.readbyqxmd.com/read/28794797/acute-mesenteric-ischemia-guidelines-of-the-world-society-of-emergency-surgery
#13
REVIEW
Miklosh Bala, Jeffry Kashuk, Ernest E Moore, Yoram Kluger, Walter Biffl, Carlos Augusto Gomes, Offir Ben-Ishay, Chen Rubinstein, Zsolt J Balogh, Ian Civil, Federico Coccolini, Ari Leppaniemi, Andrew Peitzman, Luca Ansaloni, Michael Sugrue, Massimo Sartelli, Salomone Di Saverio, Gustavo P Fraga, Fausto Catena
Acute mesenteric ischemia (AMI) is typically defined as a group of diseases characterized by an interruption of the blood supply to varying portions of the small intestine, leading to ischemia and secondary inflammatory changes. If untreated, this process will eventuate in life threatening intestinal necrosis. The incidence is low, estimated at 0.09-0.2% of all acute surgical admissions. Therefore, although the entity is an uncommon cause of abdominal pain, diligence is always required because if untreated, mortality has consistently been reported in the range of 50%...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28886621/2017-esc-guidelines-for-the-management-of-acute-myocardial-infarction-in-patients-presenting-with-st-segment-elevation-the-task-force-for-the-management-of-acute-myocardial-infarction-in-patients-presenting-with-st-segment-elevation-of-the-european-society
#14
Borja Ibanez, Stefan James, Stefan Agewall, Manuel J Antunes, Chiara Bucciarelli-Ducci, Héctor Bueno, Alida L P Caforio, Filippo Crea, John A Goudevenos, Sigrun Halvorsen, Gerhard Hindricks, Adnan Kastrati, Mattie J Lenzen, Eva Prescott, Marco Roffi, Marco Valgimigli, Christoph Varenhorst, Pascal Vranckx, Petr Widimský
No abstract text is available yet for this article.
August 26, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28889110/european-respiratory-society-guidelines-for-the-management-of-adult-bronchiectasis
#15
Eva Polverino, Pieter C Goeminne, Melissa J McDonnell, Stefano Aliberti, Sara E Marshall, Michael R Loebinger, Marlene Murris, Rafael Cantón, Antoni Torres, Katerina Dimakou, Anthony De Soyza, Adam T Hill, Charles S Haworth, Montserrat Vendrell, Felix C Ringshausen, Dragan Subotic, Robert Wilson, Jordi Vilaró, Bjorn Stallberg, Tobias Welte, Gernot Rohde, Francesco Blasi, Stuart Elborn, Marta Almagro, Alan Timothy, Thomas Ruddy, Thomy Tonia, David Rigau, James D Chalmers
Bronchiectasis in adults is a chronic disorder associated with poor quality of life and frequent exacerbations in many patients. There have been no previous international guidelines.The European Respiratory Society guidelines for the management of adult bronchiectasis describe the appropriate investigation and treatment strategies determined by a systematic review of the literature.A multidisciplinary group representing respiratory medicine, microbiology, physiotherapy, thoracic surgery, primary care, methodology and patients considered the most relevant clinical questions (for both clinicians and patients) related to management of bronchiectasis...
September 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28416507/thrombotic-thrombocytopenic-purpura
#16
REVIEW
Bérangère S Joly, Paul Coppo, Agnès Veyradier
Thrombotic thrombocytopenic purpura (TTP) is a rare and life-threatening thrombotic microangiopathy characterized by microangiopathic hemolytic anemia, severe thrombocytopenia, and organ ischemia linked to disseminated microvascular platelet rich-thrombi. TTP is specifically related to a severe deficiency in ADAMTS13 (a disintegrin and metalloprotease with thrombospondin type 1 repeats, member 13), the specific von Willebrand factor-cleaving protease. ADAMTS13 deficiency is most frequently acquired via ADAMTS13 autoantibodies, but rarely, it is inherited via mutations of the ADAMTS13 gene...
May 25, 2017: Blood
https://www.readbyqxmd.com/read/27522622/lactic-acidosis-an-update
#17
REVIEW
Jansen Seheult, Gerard Fitzpatrick, Gerard Boran
Lactate is one of the most crucial intermediates in carbohydrate and nonessential amino acid metabolism. The complexity of cellular interactions and metabolism means that lactate can be considered a waste product for one cell but a useful substrate for another. The presence of elevated lactate levels in critically ill patients has important implications for morbidity and mortality. In this review, we provide a brief outline of the metabolism of lactate, the pathophysiology of lactic acidosis, the clinical significance of D-lactate, the role of lactate measurement in acutely ill patients, the methods used to measure lactate in blood or plasma and some of the methodological issues related to interferences in these assays, especially in the case of ethylene glycol poisoning...
March 1, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/27880878/neurocysticercosis-infection-and-disease-a-review
#18
REVIEW
Lucy B Gripper, Susan C Welburn
Neurocysticercosis (NCC) is the most common parasitic disease of the human central nervous system (CNS), a pleomorphic disease with a diverse array of clinical manifestations. The infection is pleomorphic and dependent on a complex range of interconnecting factors, including number and size of the cysticerci, their stage of development and localisation within the brain with resulting difficulties in accurate diagnosis and staging of the disease. This review examines the factors that contribute to the accurate assessment of NCC distribution and transmission that are critical to achieving robust disease burden calculations...
February 2017: Acta Tropica
https://www.readbyqxmd.com/read/27798738/fluid-management-in-the-icu-has-the-tide-turned
#19
EDITORIAL
Peter Buhl Hjortrup, Anthony Delaney
No abstract text is available yet for this article.
February 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/27840364/25-years-of-proton-pump-inhibitors-a-comprehensive-review
#20
REVIEW
Daniel S Strand, Daejin Kim, David A Peura
Proton pump inhibitors (PPIs) were clinically introduced more than 25 years ago and have since proven to be invaluable, safe, and effective agents for the management of a variety of acid-related disorders. Although all members in this class act in a similar fashion, inhibiting active parietal cell acid secretion, there are slight differences among PPIs relating to their pharmacokinetic properties, metabolism, and Food and Drug Administration (FDA)-approved clinical indications. Nevertheless, each is effective in managing gastroesophageal reflux disease and uncomplicated or complicated peptic ulcer disease...
January 15, 2017: Gut and Liver
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