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Internal Medicine

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60 papers 25 to 100 followers
https://www.readbyqxmd.com/read/29753761/grand-rounds-alcoholic-hepatitis
#1
REVIEW
Ashwani K Singal, Alexandre Louvet, Vijay H Shah, Patrick S Kamath
Alcoholic hepatitis presents with acute on chronic liver failure among patients with chronic and active heavy use of alcohol, with high short-term mortality. These patients suffer from two problems, namely hepatic dysfunction and alcohol use disorder. Short-term outcome is impacted by liver failure and the long-term outcome by alcoholism and relapse to alcohol use. Clearly, these patients need integrated and coordinated management from the beginning by multi-disciplinary team. Herein, we describe a clinical vignette on a 33 year old male patient who survived the first episode of alcoholic hepatitis with this integrated management approach...
May 10, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29791828/diagnosis-and-management-of-the-antiphospholipid-syndrome
#2
REVIEW
David Garcia, Doruk Erkan
New England Journal of Medicine, Volume 378, Issue 21, Page 2010-2021, May 2018.
May 24, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29756596/hepatic-encephalopathy-classification-and-treatment
#3
Jasmohan S Bajaj
No abstract text is available yet for this article.
April 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29625968/2018-update-of-the-eular-recommendations-for-the-management-of-beh%C3%A3-et-s-syndrome
#4
Gulen Hatemi, Robin Christensen, Dongsik Bang, Bahram Bodaghi, Aykut Ferhat Celik, Farida Fortune, Julien Gaudric, Ahmet Gul, Ina Kötter, Pietro Leccese, Alfred Mahr, Robert Moots, Yesim Ozguler, Jutta Richter, David Saadoun, Carlo Salvarani, Francesco Scuderi, Petros P Sfikakis, Aksel Siva, Miles Stanford, Ilknur Tugal-Tutkun, Richard West, Sebahattin Yurdakul, Ignazio Olivieri, Hasan Yazici
Several new treatment modalities with different mechanisms of action have been studied in patients with Behçet's syndrome (BS). The aim of the current effort was to update the recommendations in the light of these new data under the auspices of the European League Against Rheumatism (EULAR) Standing Committee for Clinical Affairs. A task force was formed that included BS experts from different specialties including internal medicine, rheumatology, ophthalmology, dermatology, neurology, gastroenterology, oral health medicine and vascular surgery, along with a methodologist, a health professional, two patients and two fellows in charge of the systematic literature search...
June 2018: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/29667175/first-line-drugs-for-hypertension
#5
REVIEW
James M Wright, Vijaya M Musini, Rupam Gill
BACKGROUND: This is the first update of a review published in 2009. Sustained moderate to severe elevations in resting blood pressure leads to a critically important clinical question: What class of drug to use first-line? This review attempted to answer that question. OBJECTIVES: To quantify the mortality and morbidity effects from different first-line antihypertensive drug classes: thiazides (low-dose and high-dose), beta-blockers, calcium channel blockers, ACE inhibitors, angiotensin II receptor blockers (ARB), and alpha-blockers, compared to placebo or no treatment...
April 18, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29478864/management-of-acute-kidney-injury-core-curriculum-2018
#6
Peter K Moore, Raymond K Hsu, Kathleen D Liu
Acute kidney injury (AKI) is a heterogeneous disorder that is common in hospitalized patients and associated with short- and long-term morbidity and mortality. When AKI is present, prompt workup of the underlying cause should be pursued, with specific attention to reversible causes. Measures to prevent AKI include optimization of volume status and avoidance of nephrotoxic medications. Crystalloids are preferred over colloids for most patients, and hydroxyethyl starches should be avoided. Volume overload in the setting of AKI is associated with adverse outcomes, so attention should be paid to overall fluid balance...
February 22, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29459453/upgoing-thumb-sign-a-sensitive-indicator-of-brain-involvement
#7
(no author information available yet)
No abstract text is available yet for this article.
February 20, 2018: Neurology
https://www.readbyqxmd.com/read/29356300/pathophysiology-of-thrombotic-thrombocytopenic-purpura-and-hemolytic-uremic-syndrome
#8
J A Kremer Hovinga, S R Heeb, M Skowronska, M Schaller
Thrombotic microangiopathies are rare disorders characterized by the concomitant occurrence of severe thrombocytopenia, microangiopathic hemolytic anemia, and a variable degree of ischemic end-organ damage. The latter particularly affects the brain, the heart, and the kidneys. The primary forms, thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS), although their clinical presentations often overlap, have distinctive pathophysiologies. TTP is the consequence of a severe ADAMTS-13 deficiency, either immune-mediated as a result of circulating autoantibodies, or caused by mutations in ADAMTS-13...
April 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29342423/does-bed-rest-or-fluid-supplementation-prevent-post-dural-puncture-headache
#9
EDITORIAL
Michael D April, Brit Long
No abstract text is available yet for this article.
May 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28987434/mesenteric-ischemia-a-deadly-miss
#10
REVIEW
Manpreet Singh, Brit Long, Alex Koyfman
Mesenteric ischemia has 4 etiologies: arterial embolus, arterial thrombosis, venous thrombosis, and nonocclusive. No history or physical examination finding can definitively diagnose the condition. A wide variety of presentations occur. Pain out of proportion and gut emptying may occur early, with minimal tenderness. Once transmural infarction occurs, peritoneal findings and tenderness to palpation may occur. Physicians must be suspicious of pain out of proportion and scrutinize risk factors. Computed tomography angiography is the best imaging modality...
November 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29293475/pharmacokinetics-and-pharmacodynamics-of-antibiotics-in-central-nervous-system-infections
#11
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/27637676/stroke
#12
REVIEW
Graeme J Hankey
In the past decade, the definition of stroke has been revised and major advances have been made for its treatment and prevention. For acute ischaemic stroke, the addition of endovascular thrombectomy of proximal large artery occlusion to intravenous alteplase increases functional independence for a further fifth of patients. The benefits of aspirin in preventing early recurrent ischaemic stroke are greater than previously recognised. Other strategies to prevent recurrent stroke now include direct oral anticoagulants as an alternative to warfarin for atrial fibrillation, and carotid stenting as an alternative to endarterectomy for symptomatic carotid stenosis...
February 11, 2017: Lancet
https://www.readbyqxmd.com/read/27670788/acute-kidney-injury-2016-diagnosis-and-diagnostic-workup
#13
REVIEW
Marlies Ostermann, Michael Joannidis
Acute kidney injury (AKI) is common and is associated with serious short- and long-term complications. Early diagnosis and identification of the underlying aetiology are essential to guide management. In this review, we outline the current definition of AKI and the potential pitfalls, and summarise the existing and future tools to investigate AKI in critically ill patients.
September 27, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27766049/management-of-venous-thromboembolism-an-update
#14
REVIEW
Siavash Piran, Sam Schulman
Venous thromboembolism (VTE), which constitutes pulmonary embolism and deep vein thrombosis, is a common disorder associated with significant morbidity and mortality. Landmark trials have shown that direct oral anticoagulants (DOACs) are as effective as conventional anticoagulation with vitamin K antagonists (VKA) in prevention of VTE recurrence and associated with less bleeding. This has paved the way for the recently published guidelines to change their recommendations in favor of DOACs in acute and long-term treatment of VTE in patients without cancer...
2016: Thrombosis Journal
https://www.readbyqxmd.com/read/28145682/jaundice-in-adults
#15
(no author information available yet)
No abstract text is available yet for this article.
February 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/7576268/the-serotonin-syndrome-implicated-drugs-pathophysiology-and-management
#16
REVIEW
K A Sporer
The serotonin syndrome has increasingly been recognised in patients who have received combined serotonergic drugs. This syndrome is characterised by a constellation of symptoms (confusion, fever, shivering, diaphoresis, ataxia, hyperelflexia, myoclonus or diarrhoea) in the setting of the recent addition of a serotonergic agent. The most common drug combinations causing the serotonin syndrome are monoamine oxidase inhibitors (MAOIs) and serotonin selective reuptake inhibitors (SSRIs), MAOIs and tricyclic antidepressants, MAOIs and tryptophan, and MAOIs and pethidine (meperidine)...
August 1995: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28591533/management-of-septic-shock
#17
Rebecca E Berger, Emanuel Rivers, Mitchell M Levy
New England Journal of Medicine, Volume 376, Issue 23, Page 2282-2285, June 2017.
June 8, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28119010/diagnosis-and-treatment-of-ascites
#18
Emmanuel A Tsochatzis, Alexander L Gerbes
No abstract text is available yet for this article.
January 22, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28240562/guidelines-for-management-of-incidental-pulmonary-nodules-detected-on-ct-images-from-the-fleischner-society-2017
#19
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...
July 2017: Radiology
https://www.readbyqxmd.com/read/25295502/physiological-approach-to-assessment-of-acid-base-disturbances
#20
REVIEW
Kenrick Berend, Aiko P J de Vries, Rijk O B Gans
New England Journal of Medicine, Volume 371, Issue 15, Page 1434-1445, October 2014.
October 9, 2014: New England Journal of Medicine
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