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https://www.readbyqxmd.com/read/29369334/the-incidental-thyroid-nodule
#1
REVIEW
Sarah B Fisher, Nancy D Perrier
Incidental thyroid nodules that are found on an imaging study performed for reasons other than thyroid pathology represent a common scenario encountered by health care providers. The initial workup for these nodules comprises a thorough history and physical examination, thyroid function tests, a dedicated thyroid ultrasound, and fine-needle aspiration of any suspicious lesions. Management ranges from observation and reassurance to surgical resection and depends on the cytologic diagnosis. In cases of cytologically indeterminate or discordant nodules, surgical excision (lobectomy) offers a definitive diagnosis, although molecular testing or a reasonable period of observation may be useful as less invasive adjuncts...
January 25, 2018: CA: a Cancer Journal for Clinicians
https://www.readbyqxmd.com/read/29365240/type-2-diabetes-mellitus-outpatient-insulin-management
#2
Amanda Howard-Thompson, Muneeza Khan, Morgan Jones, Christa M George
In patients with type 2 diabetes mellitus, insulin may be used to augment therapy with oral glycemic medications or as insulin replacement therapy. The American Diabetes Association suggests the use of long-acting (basal) insulin to augment therapy with one or two oral agents or one oral agent plus a glucagon-like peptide 1 receptor agonist when the A1C level is 9% or more, especially if the patient has symptoms of hyperglycemia or catabolism. Insulin regimens should be adjusted every three or four days until targets of self-monitored blood glucose levels are reached...
January 1, 2018: American Family Physician
https://www.readbyqxmd.com/read/29122851/guidelines-on-the-management-of-abnormal-liver-blood-tests
#3
Philip N Newsome, Rob Cramb, Suzanne M Davison, John F Dillon, Mark Foulerton, Edmund M Godfrey, Richard Hall, Ulrike Harrower, Mark Hudson, Andrew Langford, Anne Mackie, Robert Mitchell-Thain, Karen Sennett, Nicholas C Sheron, Julia Verne, Martine Walmsley, Andrew Yeoman
These updated guidelines on the management of abnormal liver blood tests have been commissioned by the Clinical Services and Standards Committee (CSSC) of the British Society of Gastroenterology (BSG) under the auspices of the liver section of the BSG. The original guidelines, which this document supersedes, were written in 2000 and have undergone extensive revision by members of the Guidelines Development Group (GDG). The GDG comprises representatives from patient/carer groups (British Liver Trust, Liver4life, PBC Foundation and PSC Support), elected members of the BSG liver section (including representatives from Scotland and Wales), British Association for the Study of the Liver (BASL), Specialist Advisory Committee in Clinical Biochemistry/Royal College of Pathology and Association for Clinical Biochemistry, British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN), Public Health England (implementation and screening), Royal College of General Practice, British Society of Gastrointestinal and Abdominal Radiologists (BSGAR) and Society of Acute Medicine...
January 2018: Gut
https://www.readbyqxmd.com/read/27852221/non-coronary-chest-pain-does-not-affect-long-term-mortality-a-prospective-observational-study-using-a-matched-population-control
#4
Staffan Nilsson, Petter Järemo
BACKGROUND: Chest pain assumed to be of non-coronary origin (NCCP) may be linked to enhanced mortality due to coronary heart disease (CHD). The aim of this study was to follow NCCP patients, as defined in primary care, with respect to mortality and long-term morbidity of CHD. We further examined if NCCP associates with risk factors for CHD. METHODS: Patients consulting general practitioners (GPs) in 1998-2000 in three primary care centers in the southeast Sweden for chest pain regarded as NCCP were compared with controls matched for age, gender and residential area...
November 16, 2016: BMC Family Practice
https://www.readbyqxmd.com/read/29053792/2017-infectious-diseases-society-of-america-clinical-practice-guidelines-for-the-diagnosis-and-management-of-infectious-diarrhea
#5
Andi L Shane, Rajal K Mody, John A Crump, Phillip I Tarr, Theodore S Steiner, Karen Kotloff, Joanne M Langley, Christine Wanke, Cirle Alcantara Warren, Allen C Cheng, Joseph Cantey, Larry K Pickering
These guidelines are intended for use by healthcare professionals who care for children and adults with suspected or confirmed infectious diarrhea. They are not intended to replace physician judgement regarding specific patients or clinical or public health situations. This document does not provide detailed recommendations on infection prevention and control aspects related to infectious diarrhea.
November 29, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28424149/comparative-safety-of-sulfonylurea-and-metformin-monotherapy-on-the-risk-of-heart-failure-a-cohort-study
#6
COMPARATIVE STUDY
Christianne L Roumie, Jea Young Min, Lucy D'Agostino McGowan, Caroline Presley, Carlos G Grijalva, Amber J Hackstadt, Adriana M Hung, Robert A Greevy, Tom Elasy, Marie R Griffin
BACKGROUND: Medications that impact insulin sensitivity or cause weight gain may increase heart failure risk. Our aim was to compare heart failure and cardiovascular death outcomes among patients initiating sulfonylureas for diabetes mellitus treatment versus metformin. METHODS AND RESULTS: National Veterans Health Administration databases were linked to Medicare, Medicaid, and National Death Index data. Veterans aged ≥18 years who initiated metformin or sulfonylureas between 2001 and 2011 and whose creatinine was <1...
April 19, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28501304/speculations-on-salt-and-the-genesis-of-arterial-hypertension
#7
REVIEW
Jens Titze, Friedrich C Luft
Blood pressure salt sensitivity and salt resistance are mechanistically imperfectly explained. A prescient systems medicine approach by Guyton and colleagues-more than 50 years ago-suggested how salt intake might influence blood pressure. They proposed that a high-salt diet engenders sodium accumulation, volume expansion, cardiac output adjustments, and then autoregulation for flow maintenance. The autoregulation in all vascular beds increases systemic vascular resistance, causing the kidneys to excrete more salt and water, thus reducing systems to normal and minimizing any changes in blood pressure...
June 2017: Kidney International
https://www.readbyqxmd.com/read/28513453/chronic-obstructive-pulmonary-disease
#8
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/28437620/american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-guidelines-for-management-of-dyslipidemia-and-prevention-of-cardiovascular-disease
#9
Paul S Jellinger, Yehuda Handelsman, Paul D Rosenblit, Zachary T Bloomgarden, Vivian A Fonseca, Alan J Garber, George Grunberger, Chris K Guerin, David S H Bell, Jeffrey I Mechanick, Rachel Pessah-Pollack, Kathleen Wyne, Donald Smith, Eliot A Brinton, Sergio Fazio, Michael Davidson
OBJECTIVE: The development of these guidelines is mandated by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs). METHODS: Recommendations are based on diligent reviews of the clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols...
April 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28372866/increased-interarm-blood-pressure-difference-is-associated-with-autonomic-dysfunction-and-atherosclerosis-in-patients-with-chest-pain-and-no-history-of-coronary-artery-disease
#10
Hui-Jeong Hwang, Il Suk Sohn, Dong-Hee Kim, Chang-Bum Park, Jin-Man Cho, Chong-Jin Kim
OBJECTIVES: Interarm blood pressure (BP) difference has been reported to be associated with atherosclerosis and increased cardiovascular death. We were to investigate associations of interarm systolic blood pressure (SBP) difference with heart rate recovery (HRR) after exercise, an index of autonomic function, and carotid atherosclerotic markers, and to evaluate the association of interarm SBP difference with concurrent coronary artery disease (CAD). METHODS: A total of 995 consecutive patients who underwent treadmill stress echocardiography with chest pain but no history of CAD were enrolled...
August 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27248703/-we-are-what-our-bacteria-eat-the-role-of-bacteria-in-personalizing-nutrition-therapy-in-gastrointestinal-conditions
#11
REVIEW
Ruth Harvie, Russell Walmsley, Michael Schultz
The theme for the 2016 World Digestive Health Day is "Your Diet and Gut Health". The World Gastroenterology Organization thereby wishes to raise awareness of the relationship between what we eat and gastrointestinal symptoms. World Digestive Health Day (WDHD) is celebrated each year on May 29. This brief review article on behalf of the New Zealand Society of Gastroenterology will highlight recent developments in this highly active area of research with a special emphasis on gastrointestinal disorders.
February 2017: Journal of Gastroenterology and Hepatology
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
#12
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/28402245/thyroid-hormone-therapy-for-older-adults-with-subclinical-hypothyroidism
#13
RANDOMIZED CONTROLLED TRIAL
David J Stott, Nicolas Rodondi, Patricia M Kearney, Ian Ford, Rudi G J Westendorp, Simon P Mooijaart, Naveed Sattar, Carole E Aubert, Drahomir Aujesky, Douglas C Bauer, Christine Baumgartner, Manuel R Blum, John P Browne, Stephen Byrne, Tinh-Hai Collet, Olaf M Dekkers, Wendy P J den Elzen, Robert S Du Puy, Graham Ellis, Martin Feller, Carmen Floriani, Kirsty Hendry, Caroline Hurley, J Wouter Jukema, Sharon Kean, Maria Kelly, Danielle Krebs, Peter Langhorne, Gemma McCarthy, Vera McCarthy, Alex McConnachie, Mairi McDade, Martina Messow, Annemarie O'Flynn, David O'Riordan, Rosalinde K E Poortvliet, Terence J Quinn, Audrey Russell, Carol Sinnott, Jan W A Smit, H Anette Van Dorland, Kieran A Walsh, Elaine K Walsh, Torquil Watt, Robbie Wilson, Jacobijn Gussekloo
BACKGROUND: The use of levothyroxine to treat subclinical hypothyroidism is controversial. We aimed to determine whether levothyroxine provided clinical benefits in older persons with this condition. METHODS: We conducted a double-blind, randomized, placebo-controlled, parallel-group trial involving 737 adults who were at least 65 years of age and who had persisting subclinical hypothyroidism (thyrotropin level, 4.60 to 19.99 mIU per liter; free thyroxine level within the reference range)...
June 29, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28265411/outcomes-of-an-inpatient-medical-nutritional-rehabilitation-protocol-in-children-and-adolescents-with-eating-disorders
#14
Rebecka Peebles, Andrew Lesser, Courtney Cheek Park, Kerri Heckert, C Alix Timko, Eleni Lantzouni, Ronald Liebman, Laurel Weaver
BACKGROUND: Medical stabilization through inpatient nutritional rehabilitation is often necessary for patients with eating disorders (EDs) but includes the inherent risk of refeeding syndrome. Here we describe our experience of implementing and sustaining an inpatient nutritional rehabilitation protocol designed to strategically prepare patients with EDs and their families for discharge to a home setting in an efficient and effective manner from a general adolescent medicine unit. We report outcomes at admission, discharge, and 4-weeks follow-up...
2017: Journal of Eating Disorders
https://www.readbyqxmd.com/read/28248609/clinical-practice-guideline-benign-paroxysmal-positional-vertigo-update
#15
Neil Bhattacharyya, Samuel P Gubbels, Seth R Schwartz, Jonathan A Edlow, Hussam El-Kashlan, Terry Fife, Janene M Holmberg, Kathryn Mahoney, Deena B Hollingsworth, Richard Roberts, Michael D Seidman, Robert W Prasaad Steiner, Betty Tsai Do, Courtney C J Voelker, Richard W Waguespack, Maureen D Corrigan
Objective This update of a 2008 guideline from the American Academy of Otolaryngology-Head and Neck Surgery Foundation provides evidence-based recommendations to benign paroxysmal positional vertigo (BPPV), defined as a disorder of the inner ear characterized by repeated episodes of positional vertigo. Changes from the prior guideline include a consumer advocate added to the update group; new evidence from 2 clinical practice guidelines, 20 systematic reviews, and 27 randomized controlled trials; enhanced emphasis on patient education and shared decision making; a new algorithm to clarify action statement relationships; and new and expanded recommendations for the diagnosis and management of BPPV...
March 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/26900641/long-term-metformin-use-and-vitamin-b12-deficiency-in-the-diabetes-prevention-program-outcomes-study
#16
RANDOMIZED CONTROLLED TRIAL
Vanita R Aroda, Sharon L Edelstein, Ronald B Goldberg, William C Knowler, Santica M Marcovina, Trevor J Orchard, George A Bray, David S Schade, Marinella G Temprosa, Neil H White, Jill P Crandall
Participants from DPP/DPPOS were assigned to placebo (n=1082) or metformin (n=1073) for 3.2 years, followed by metformin in the metformin group for 9 years. Metformin use was associated with increased risk of vitamin B12 deficiency.
April 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27660695/update-on-the-treatment-of-type-2-diabetes-mellitus
#17
REVIEW
Juan José Marín-Peñalver, Iciar Martín-Timón, Cristina Sevillano-Collantes, Francisco Javier Del Cañizo-Gómez
To achieve good metabolic control in diabetes and keep long term, a combination of changes in lifestyle and pharmacological treatment is necessary. Achieving near-normal glycated hemoglobin significantly, decreases risk of macrovascular and microvascular complications. At present there are different treatments, both oral and injectable, available for the treatment of type 2 diabetes mellitus (T2DM). Treatment algorithms designed to reduce the development or progression of the complications of diabetes emphasizes the need for good glycaemic control...
September 15, 2016: World Journal of Diabetes
https://www.readbyqxmd.com/read/28128970/global-strategy-for-the-diagnosis-management-and-prevention-of-chronic-obstructive-lung-disease-2017-report-gold-executive-summary
#18
Claus F Vogelmeier, Gerard J Criner, Fernando J Martinez, Antonio Anzueto, Peter J Barnes, Jean Bourbeau, Bartolome R Celli, Rongchang Chen, Marc Decramer, Leonardo M Fabbri, Peter Frith, David M G Halpin, M Victorina López Varela, Masaharu Nishimura, Nicolas Roche, Roberto Rodriguez-Roisin, Don D Sin, Dave Singh, Robert Stockley, Jørgen Vestbo, Jadwiga A Wedzicha, Alvar Agustí
This Executive Summary of the Global Strategy for the Diagnosis, Management, and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 report focuses primarily on the revised and novel parts of the document. The most significant changes include: (1) the assessment of chronic obstructive pulmonary disease has been refined to separate the spirometric assessment from symptom evaluation. ABCD groups are now proposed to be derived exclusively from patient symptoms and their history of exacerbations; (2) for each of the groups A to D, escalation strategies for pharmacologic treatments are proposed; (3) the concept of deescalation of therapy is introduced in the treatment assessment scheme; (4) nonpharmacologic therapies are comprehensively presented; and (5) the importance of comorbid conditions in managing chronic obstructive pulmonary disease is reviewed...
March 1, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28135357/hypertension-in-2017-what-is-the-right-target
#19
Aram V Chobanian
No abstract text is available yet for this article.
February 14, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28092694/proton-pump-inhibitors-risks-of-long-term-use
#20
REVIEW
Leonardo Henry Eusebi, Stefano Rabitti, Maria Laura Artesiani, Dania Gelli, Marco Montagnani, Rocco Maurizio Zagari, Franco Bazzoli
Proton pump inhibitors are among the most commonly prescribed classes of drugs, and their use is increasing, in particular for long-term treatment, often being over-prescribed and used for inappropriate conditions. In recent years, considerable attention has been directed towards a wide range of adverse effects, and even when a potential underlying biological mechanism is plausible, the clinical evidence of the adverse effect is often weak. Several long-term side effects have been investigated ranging from interaction with other drugs, increased risk of infection, reduced intestinal absorption of vitamins and minerals, and more recently kidney damage and dementia...
July 2017: Journal of Gastroenterology and Hepatology
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