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Internal Medicine Collection

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252 papers 100 to 500 followers
By Juan David Plata Internist - Infectious Disease Fellowship
https://www.readbyqxmd.com/read/28742529/risk-factors-for-early-mortality-on-antiretroviral-therapy-in-advanced-hiv-infected-adults
#1
Gregory P Bisson, Ritesh Ramchandani, Sachiko Miyahara, Rosie Mngqibisa, Mitch Matoga, McNeil Ngongondo, Wadzanai Samaneka, Lucy Koech, Kogieleum Naidoo, Mohammed Rassool, Fredrick Kirui, Peter Banda, Vidya Mave, Dileep Kadam, Paul Leger, German Henestroza, Yukari C Manabe, Jing Bao, Johnstone Kumwenda, Amita Gupta, Mina C Hosseinipour
BACKGROUND: Many HIV-infected individuals present with advanced HIV disease. These patients are at high risk of death after antiretroviral therapy (ART) initiation, but risk factors for death in these patients are unclear. METHODS: We used data from a multisite randomized trial comparing empiric vs. preventive tuberculosis therapy in HIV-infected adults initiating ART with CD4 T-cell counts less than 50 cells/μl to evaluate risk factors for death within 48 weeks after ART initiation...
October 23, 2017: AIDS
https://www.readbyqxmd.com/read/28531241/effect-of-statin-treatment-vs-usual-care-on-primary-cardiovascular-prevention-among-older-adults-the-allhat-llt-randomized-clinical-trial
#2
RANDOMIZED CONTROLLED TRIAL
Benjamin H Han, David Sutin, Jeff D Williamson, Barry R Davis, Linda B Piller, Hannah Pervin, Sara L Pressel, Caroline S Blaum
Importance: While statin therapy for primary cardiovascular prevention has been associated with reductions in cardiovascular morbidity, the effect on all-cause mortality has been variable. There is little evidence to guide the use of statins for primary prevention in adults 75 years and older. Objectives: To examine statin treatment among adults aged 65 to 74 years and 75 years and older when used for primary prevention in the Lipid-Lowering Trial (LLT) component of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT-LLT)...
July 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28616210/acute-kidney-injury-an-overview-of-diagnostic-methods-and-clinical-management
#3
Daniel Hertzberg, Linda Rydén, John W Pickering, Ulrik Sartipy, Martin J Holzmann
Acute kidney injury (AKI) is a common condition in multiple clinical settings. Patients with AKI are at an increased risk of death, over both the short and long term, and of accelerated renal impairment. As the condition has become more recognized and definitions more unified, there has been a rapid increase in studies examining AKI across many different clinical settings. This review focuses on the classification, diagnostic methods and clinical management that are available, or promising, for patients with AKI...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28702763/pharmacokinetics-of-antifungal-drugs-practical-implications-for-optimized-treatment-of-patients
#4
REVIEW
Romuald Bellmann, Piotr Smuszkiewicz
INTRODUCTION: Because of the high mortality of invasive fungal infections (IFIs), appropriate exposure to antifungals appears to be crucial for therapeutic efficacy and safety. MATERIALS AND METHODS: This review summarises published pharmacokinetic data on systemically administered antifungals focusing on co-morbidities, target-site penetration, and combination antifungal therapy. CONCLUSIONS AND DISCUSSION: Amphotericin B is eliminated unchanged via urine and faeces...
July 12, 2017: Infection
https://www.readbyqxmd.com/read/28598790/croi-2017-advances-in-antiretroviral-therapy
#5
Joyce Jones, Barbara S Taylor, Hong-Van Tieu, Timothy J Wilkin
The 2017 Conference on Retroviruses and Opportunistic Infections (CROI) featured exciting preclinical data on investigational antiretroviral agents with good in vitro efficacy and long half-lives. Investigational medications, including bictegravir, demonstrated excellent efficacy and tolerability, as did dual-agent therapy with dolutegravir paired with rilpivirine or with lamivudine. Dolutegravir monotherapy proved inadvisable due to virologic failure and resistance. The gap between high- and low-income settings along the HIV care continuum is narrowing, with Zimbabwe, Malawi, and Zambia approaching the 90-90-90 targets established by the joint United Nations Programme on HIV/AIDS (UNAIDS), whereas communities in the Southern United States are falling behind...
May 2017: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/28591533/management-of-septic-shock
#6
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/28598792/croi-2017-complications-and-comorbidities-of-hiv-disease-and-its-treatment
#7
Judith S Currier, Diane V Havlir
Complications of HIV disease remained a major focus at the 2017 Conference on Retroviruses and Opportunistic Infections (CROI), and included studies focused on noncommunicable chronic diseases (eg, cardiovascular disease, obesity, bone disease, and malignancies) and opportunistic infections (Mycobacterium tuberculosis and cryptococcosis). Progress in identifying predictors of specific complications as well as interventions for the prevention and treatment of these comorbidities are summarized below.
May 2017: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/28355466/invasive-mould-infections-in-the-icu-setting-complexities-and-solutions
#8
REVIEW
Matteo Bassetti, Emilio Bouza
Infections caused by filamentous fungi represent a major burden in the ICU. Invasive aspergillosis is emerging in non-neutropenic individuals with predisposing conditions, e.g. corticosteroid treatment, chronic obstructive pulmonary disease, liver cirrhosis, solid organ cancer, HIV infection and transplantation. Diagnosis is challenging because the signs and symptoms are non-specific, and initiation of additional diagnostic examinations is often delayed because clinical suspicion is low. Isolation of an Aspergillus species from the respiratory tract in critically ill patients, and tests such as serum galactomannan, bronchoalveolar lavage 1-3-β-d-glucan and specific PCR should be interpreted with caution...
March 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28483766/how-i-treat-recurrent-venous-thromboembolism-in-patients-receiving-anticoagulant-therapy
#9
REVIEW
Sam Schulman
Oral anticoagulant therapy for venous thromboembolism is very effective. When oral anticoagulants are managed well, the risk of recurrence is approximately 2 per 100 patient-years. The main reasons for a breakthrough event are underlying disease and subtherapeutic drug levels. The most common underlying disease that results in recurrence on treatment is cancer. Subtherapeutic drug levels can be caused by poor adherence to the drug regimen, interactions with other drugs or food, or inappropriate dosing. It is important to investigate and understand the cause whenever such an event occurs and to improve management of anticoagulants thereby avoiding further recurrences...
June 22, 2017: Blood
https://www.readbyqxmd.com/read/28233632/helminths-in-organ-transplantation
#10
REVIEW
Andrew J R Cooper, Shamik Dholakia, Celia V Holland, Peter J Friend
With transplantation becoming an increasingly routine form of treatment for diverse populations, and with international travel becoming ever more accessible and affordable, the danger of transplantation-mediated helminth infections, exacerbated by coincident immunosuppression, must be considered. In this Review, we attempt to catalogue all clinically-relevant helminthiases that have been reported to coincide with transplantation, whether by transplantation-mediated transmission, reactivation of latent infections in an immunosuppressed context, or possible de-novo infection during the immunosuppressed peritransplant period...
June 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28605525/infectious-diseases-team-for-the-early-management-of-severe-sepsis-and-septic-shock-in-the-emergency-department
#11
Pierluigi Viale, Sara Tedeschi, Luigia Scudeller, Luciano Attard, Lorenzo Badia, Michele Bartoletti, Alessandra Cascavilla, Francesco Cristini, Nicola Dentale, Giovanni Fasulo, Giorgio Legnani, Filippo Trapani, Fabio Tumietto, Gabriella Verucchi, Giulio Virgili, Andrea Berlingeri, Simone Ambretti, Chiara De Molo, Mara Brizi, Mario Cavazza, Maddalena Giannella
Background: The impact on patient survival of an infectious disease (ID) team dedicated to the early management of severe sepsis/septic shock (SS/SS) in Emergency Department (ED) has yet to be assessed. Methods: A quasiexperimental pre-post study was performed at the general ED of our hospital. During the pre phase (June 2013-July 2014), all consecutive adult patients with SS/SS were managed according to the standard of care, data were prospectively collected. During the post phase (August 2014-October 2015), patients were managed in collaboration with a dedicated ID team performing a bedside patient evaluation within 1 hour of ED arrival...
October 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28513453/chronic-obstructive-pulmonary-disease
#12
REVIEW
Klaus F Rabe, Henrik Watz
Chronic obstructive pulmonary disease (COPD) kills more than 3 million people worldwide every year. Despite progress in the treatment of symptoms and prevention of acute exacerbations, few advances have been made to ameliorate disease progression or affect mortality. A better understanding of the complex disease mechanisms resulting in COPD is needed. Smoking cessation programmes, increasing physical activity, and early detection and treatment of comorbidities are further key components to reduce the burden of the disease...
May 13, 2017: Lancet
https://www.readbyqxmd.com/read/28364357/treatment-of-diabetic-ketoacidosis-dka-hyperglycemic-hyperosmolar-state-hhs-novel-advances-in-the-management-of-hyperglycemic-crises-uk-versus-usa
#13
REVIEW
Ketan K Dhatariya, Priyathama Vellanki
PURPOSE OF REVIEW: Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are diabetic emergencies that cause high morbidity and mortality. Their treatment differs in the UK and USA. This review delineates the differences in diagnosis and treatment between the two countries. RECENT FINDINGS: Large-scale studies to determine optimal management of DKA and HHS are lacking. The diagnosis of DKA is based on disease severity in the USA, which differs from the UK...
May 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28369197/risk-of-acute-coronary-heart-disease-after-sepsis-hospitalization-in-the-reasons-for-geographic-and-racial-differences-in-stroke-regards-cohort
#14
Henry E Wang, Justin X Moore, John P Donnelly, Emily B Levitan, Monika M Safford
Background: Sepsis is associated with long-term health consequences. We sought to determine the long-term risks of acute and fatal coronary heart disease (CHD) events after sepsis hospitalizations among community-dwelling adults. Methods: We analyzed data from 30329 participants in the population-based REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort. Sepsis events included hospitalizations for a serious infection with ≥2 systemic inflammatory response syndrome criteria...
July 1, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28426440/the-impact-of-couple-hiv-testing-and-counseling-on-consistent-condom-use-among-pregnant-women-and-their-male-partners-an-observational-study
#15
Nora E Rosenberg, Lauren A Graybill, Austin Wesevich, Nuala McGrath, Carol E Golin, Suzanne Maman, Nivedita Bhushan, Mercy Tsidya, Limbikani Chimndozi, Irving F Hoffman, Mina C Hosseinipour, William C Miller
BACKGROUND: In sub-Saharan Africa couple HIV testing and counseling (CHTC) has been associated with substantial increases in safe sex, especially when at least one partner is HIV infected. However, this relationship has not been characterized in an Option B+ context. SETTING: The study was conducted at the antenatal clinic at Bwaila District Hospital in Lilongwe, Malawi in 2016 under an Option B+ program. METHODS: Ninety heterosexual couples with an HIV-infected pregnant woman (female-positive couples) and 47 couples with an HIV-uninfected pregnant woman (female-negative couples) were enrolled in an observational study...
August 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28413064/systemic-sclerosis
#16
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...
April 13, 2017: Lancet
https://www.readbyqxmd.com/read/27159126/association-of-environmental-contamination-in-the-home-with-the-risk-for-recurrent-community-associated-methicillin-resistant-staphylococcus-aureus-infection
#17
COMPARATIVE STUDY
Justin Knox, Sean B Sullivan, Julia Urena, Maureen Miller, Peter Vavagiakis, Qiuhu Shi, Anne-Catrin Uhlemann, Franklin D Lowy
IMPORTANCE: The role of environmental contamination in recurrent Staphylococcus aureus infections within households and its potential effect on intervention strategies has been debated recently. OBJECTIVE: To assess whether household environmental contamination increases the risk for recurrent infection among individuals with a community-associated methicillin-resistant S aureus (MRSA) infection. DESIGN, SETTING, AND PARTICIPANTS: This cohort study was conducted from November 1, 2011, to June 30, 2014, in the Columbia University Medical Center catchment area...
June 1, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28366227/fast-renal-decline-to-end-stage-renal-disease-an-unrecognized-feature-of-nephropathy-in-diabetes
#18
REVIEW
Andrzej S Krolewski, Jan Skupien, Peter Rossing, James H Warram
A new model of diabetic nephropathy in type 1 diabetes emerged from our studies of Joslin Clinic patients. The dominant feature is progressive renal decline, not albuminuria. This decline is a unidirectional process commencing while patients have normal renal function and, in the majority, progressing steadily (linearly) to end-stage renal disease (ESRD). While an individual's rate of renal decline is constant, the estimated glomerular filtration rate (eGFR) slope varies widely among individuals from -72 to -3...
June 2017: Kidney International
https://www.readbyqxmd.com/read/28298398/management-of-copd-exacerbations-a%C3%A2-european-respiratory-society-american-thoracic-society-guideline
#19
Jadwiga A Wedzicha, Marc Miravitlles, John R Hurst, Peter M A Calverley, Richard K Albert, Antonio Anzueto, Gerard J Criner, Alberto Papi, Klaus F Rabe, David Rigau, Pawel Sliwinski, Thomy Tonia, Jørgen Vestbo, Kevin C Wilson, Jerry A Krishnan
This document provides clinical recommendations for treatment of chronic obstructive pulmonary disease (COPD) exacerbations.Comprehensive evidence syntheses, including meta-analyses, were performed to summarise all available evidence relevant to the Task Force's questions. The evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluation approach and the results were summarised in evidence profiles. The evidence syntheses were discussed and recommendations formulated by a multidisciplinary Task Force of COPD experts...
March 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
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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