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Internal Medicine

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53 papers 25 to 100 followers
https://www.readbyqxmd.com/read/29356300/pathophysiology-of-thrombotic-thrombocytopenic-purpura-and-hemolytic-uremic-syndrome
#1
Johanna A Kremer Hovinga, Silvan R Heeb, Magdalena Skowronska, Monica 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 in their clinical presentation often overlapping, have distinctive pathophysiologies. TTP is the consequence of a severe ADAMTS13 deficiency, immune-mediated due to circulating autoantibodies (iTTP), or caused by mutations in the ADAMTS13 gene (cTTP)...
January 22, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29342423/does-bed-rest-or-fluid-supplementation-prevent-post-dural-puncture-headache
#2
EDITORIAL
Michael D April, Brit Long
No abstract text is available yet for this article.
January 13, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28987434/mesenteric-ischemia-a-deadly-miss
#3
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
#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/27637676/stroke
#5
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
#6
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
#7
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
#8
(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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/29303710/vaccinations-in-adults-with-rheumatoid-arthritis-in-an-era-of-new-disease-modifying-anti-rheumatic-drugs
#14
REVIEW
Pier Luigi Meroni, Daniela Zavaglia, Corrado Girmenia
Patients with rheumatoid arthritis are at greater risk of infectious morbidity and mortality due to disease-related abnormalities and use of immunosuppressive medications. Vaccinations are recommended by international guidelines among infection control strategies, but vaccination rates are reported to be still suboptimal in both America and Europe. Furthermore, with the increasing number of immunomodulatory medications used in RA patients, safety and efficacy of vaccinations in RA patients on such therapies have been questioned...
December 15, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28413064/systemic-sclerosis
#15
REVIEW
Christopher P Denton, Dinesh Khanna
Systemic sclerosis, also called scleroderma, is an immune-mediated rheumatic disease that is characterised by fibrosis of the skin and internal organs and vasculopathy. Although systemic sclerosis is uncommon, it has a high morbidity and mortality. Improved understanding of systemic sclerosis has allowed better management of the disease, including improved classification and more systematic assessment and follow-up. Additionally, treatments for specific complications have emerged and a growing evidence base supports the use of immune suppression for the treatment of skin and lung fibrosis...
October 7, 2017: Lancet
https://www.readbyqxmd.com/read/29289687/a-comparison-of-the-quick-sofa-and-systemic-inflammatory-response-syndrome-criteria-for-the-diagnosis-of-sepsis-and-prediction-of-mortality-a-systematic-review-and-meta-analysis
#16
Rodrigo Serafim, José Andrade Gomes, Jorge Salluh, Pedro Póvoa
BACKGROUND: Several studies were published to validate the quick Sepsis-related Organ Failure Assessment (qSOFA), namely in comparison with the systemic inflammatory response syndrome (SIRS) criteria. We performed a systematic review and meta-analysis with the aim of comparing the qSOFA and SIRS in patients outside the ICU. METHODS: We searched MEDLINE, CINAHL, and the Web of Science database from February 23, 2016 until June 30, 2017 to identify full-text English-language studies published after the Sepsis-3 publication comparing the qSOFA and SIRS and their sensitivity or specificity in diagnosing sepsis, as well as hospital and ICU length of stay and hospital mortality...
December 28, 2017: Chest
https://www.readbyqxmd.com/read/29247356/current-and-future-pharmacological-therapies-for-nafld-nash
#17
REVIEW
Yoshio Sumida, Masashi Yoneda
Nonalcoholic fatty liver disease (NAFLD) is the most prevalent liver disease worldwide, and there is no approved pharmacotherapy. The efficacy of vitamin E and pioglitazone has been established in nonalcoholic steatohepatitis (NASH), a progressive form of NAFLD. GLP-1RA and SGLT2 inhibitors, which are currently approved for use in diabetes, have shown early efficacy in NASH, and also have beneficial cardiovascular or renal effects. Innovative NASH therapies include four main pathways. The first approach is targeting hepatic fat accumulation...
December 16, 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/29141174/diuretic-treatment-in-heart-failure
#18
REVIEW
David H Ellison, G Michael Felker
New England Journal of Medicine, Volume 377, Issue 20, Page 1964-1975, November 2017.
November 16, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28286222/2017-acc-aha-hrs-guideline-for-the-evaluation-and-management-of-patients-with-syncope-executive-summary-a-report-of-the-american-college-of-cardiology-american-heart-association-task-force-on-clinical-practice-guidelines-and-the-heart-rhythm-society
#19
Win-Kuang Shen, Robert S Sheldon, David G Benditt, Mitchell I Cohen, Daniel E Forman, Zachary D Goldberger, Blair P Grubb, Mohamed H Hamdan, Andrew D Krahn, Mark S Link, Brian Olshansky, Satish R Raj, Roopinder Kaur Sandhu, Dan Sorajja, Benjamin C Sun, Clyde W Yancy
No abstract text is available yet for this article.
August 1, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28320807/inferior-st-elevation-on-the-ecg-what-is-the-diagnosis
#20
Andrei D Mărgulescu
No abstract text is available yet for this article.
March 21, 2017: Circulation
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