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Outstanding Clinical Review

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217 papers 100 to 500 followers
https://www.readbyqxmd.com/read/21989247/clinical-diagnosis-and-management-of-amyotrophic-lateral-sclerosis
#1
REVIEW
Orla Hardiman, Leonard H van den Berg, Matthew C Kiernan
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that results in progressive loss of bulbar and limb function. Patients typically die from respiratory failure within 3 years of symptom onset. The incidence of ALS in Europe is 2-3 cases per 100,000 individuals in the general population, and the overall lifetime risk of developing the disease is 1:400. ALS is familial in 5% of cases, and shows a Mendelian pattern of inheritance. ALS is recognized to overlap with frontotemporal dementia. Diagnosis is made on clinical grounds, using internationally recognized consensus criteria, after exclusion of conditions that can mimic ALS...
October 11, 2011: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/20603280/multiple-sclerosis-a-practical-overview-for-clinicians
#2
REVIEW
Konrad Rejdak, Samuel Jackson, Gavin Giovannoni
Multiple sclerosis (MS) is the commonest disabling neurological condition to afflict young adults and therefore has a high social burden. Over several decades, there has been a considerable progress in the understanding of the disease pathogenesis as well as in the clinical management of MS patients. The emphasis in managing MS patients has shifted to multidisciplinary teams working in specialist groups. A review of the literature was conducted using MedLine to identify recent advances in MS. The current consensus is that MS is an autoimmune disease triggered by environmental agents acting in genetically susceptible people...
2010: British Medical Bulletin
https://www.readbyqxmd.com/read/25405824/outcome-measures-for-takayasu-s-arteritis
#3
REVIEW
Sibel Z Aydin, Peter A Merkel, Haner Direskeneli
PURPOSE OF REVIEW: Takayasu's arteritis (TAK) is a large-vessel vasculitis with a chronic, indolent course affecting the aorta and its main branches. This review will describe the recent studies to develop validated outcome measures to assess TAK. RECENT FINDINGS: TAK is traditionally assessed with a physician's global assessment including symptoms and signs of inflammation and vascular insufficiency, acute-phase reactants (APRs), and imaging including conventional digital subtraction angiography, computerized tomographic, and magnetic resonance angiography, and recently 18-FDG-PET...
January 2015: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/28723321/subarachnoid-hemorrhage
#4
REVIEW
Michael T Lawton, G Edward Vates
New England Journal of Medicine, Volume 377, Issue 3, Page 257-266, July 2017.
July 20, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28578555/infections-due-to-acinetobacter-baumannii-in-the-icu-treatment-options
#5
Joseph P Lynch, George G Zhanel, Nina M Clark
Bacteria within the genus Acinetobacter (principally A. baumannii-calcoaceticus complex [ABC]) are gram-negative coccobacilli that may cause nosocomial infections in critically ill or debilitated patients (particularly ventilator-associated pneumonia and infections of the bloodstream, urinary tract, and wounds). Treatment of Acinetobacter infections is difficult, as Acinetobacter spp. are intrinsically resistant to multiple antimicrobial agents, and have a remarkable ability to acquire new resistance determinants via mechanisms that include plasmids, transposons, integrons, and resistance islands...
June 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28681941/the-respiratory-threat-posed-by-multidrug-resistant-gram-negative-bacteria
#6
REVIEW
Ana Rodrigo-Troyano, Oriol Sibila
Respiratory infections are a major cause of global mortality and morbidity. In recent years, an increased incidence of multidrug-resistant (MDR) Gram-negative bacteria (GNB) has been described. Microorganisms such as Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae or Acinetobacter baumannii have been identified as causative pathogens of different respiratory tract infections. Several studies have detected MDR-GNB in patients with community-acquired and nosocomial pneumonia. Furthermore, MDR-GNB have also been isolated in patients with chronic obstructive pulmonary disease and bronchiectasis having acute or chronic bronchial infection...
July 6, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28729329/fluids-in-sepsis-and-septic-shock-fissh-protocol-for-a-pilot-randomised-controlled-trial
#7
Bram Rochwerg, Tina Millen, Peggy Austin, Michelle Zeller, Frédérick D'Aragon, Roman Jaeschke, Marie-Hélène Masse, Sangeeta Mehta, Francois Lamontagne, Maureen Meade, Gordon Guyatt, Deborah J Cook
INTRODUCTION: Observational evidence suggests physiological benefits and lower mortality with lower chloride solutions; however, 0.9% saline remains the most widely used fluid worldwide. Given uncertainty regarding the association of lower chloride on mortality, it is unlikely that practice will change without direct randomised clinical trial (RCT) evidence. This pilot RCT will investigate the feasibility of a large-scale trial directly comparing low chloride with high chloride fluids in patients with septic shock...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28750875/chronic-kidney-disease-in-hypertensive-subjects-%C3%A2-60-years-treated-in-primary-care
#8
Betlem Salvador-González, Jordi Mestre-Ferrer, Maria Soler-Vila, Luisa Pascual-Benito, Eva Alonso-Bes, Oriol Cunillera-Puértolas
BACKGROUND: Hypertension (HT) is the second leading cause of kidney failure. In hypertensive patients with chronic kidney disease (CKD), blood pressure (BP) control is the most important intervention to minimise progression. For CKD diagnosis, standardised creatinine and estimated glomerular filtration rate (eGFR) testing by CKD-EPI is recommended. OBJECTIVES: To describe the prevalence and factors associated with a moderate decrease in eGFR (by CKD-EPI) and BP control in subjects with HT...
July 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28665811/small-fibre-neuropathy
#9
Daniele Cazzato, Giuseppe Lauria
PURPOSE OF REVIEW: To provide a review on the state-of-art of clinical features, diagnostics, genetics and treatments of small fibre neuropathy (SFN). RECENT FINDINGS: The spectrum of clinical features has been widened from the classical presentation of burning feet as length-dependent SFN to that of small fibre dysfunction and/or degeneration associated with focal, diffuse and episodic neuropathic pain syndromes. The involvement of small nerve fibres in neurodegenerative diseases has been further defined, challenging the relationship between neuropathic pain symptoms and small fibre loss...
June 29, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/26304282/clinical-reasoning-and-risk-in-the-intensive-care-unit
#10
REVIEW
Geoffrey R Connors, Jonathan M Siner
Clinical reasoning in medicine describes the process whereby a clinician gathers, assimilates, and assesses information about a person and their illness to assign a diagnosis and institute therapy. Care of patients in the intensive care unit involves managing a substantial quantity of incomplete, novel, and rapidly changing data. A modified nine-step bayesian approach to clinical reasoning comports well with this complex environment and is useful for assisting and educating novice learners to apply clinical reasoning accurately and consistently...
September 2015: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/22219235/skin-and-soft-tissue-infections-classifying-and-treating-a-spectrum
#11
REVIEW
Sabitha Rajan
Skin and soft-tissue infections (SSTIs) are a common presenting problem in both inpatients and outpatients. SSTIs have been broadly classified as complicated or uncomplicated, but specific disease processes and patient characteristics are important in guiding clinical management. Early recognition of the extent of infection, close follow-up, and familiarity with local antibiotic susceptibility data are critical to successful treatment.
January 2012: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/28611879/pitfalls-in-electrocardiographic-diagnosis-of-acute-coronary-syndrome-in-low-risk-chest-pain
#12
REVIEW
Semhar Z Tewelde, Amal Mattu, William J Brady
Less than half of patients with a chest pain history indicative of acute coronary syndrome have a diagnostic electrocardiogram (ECG) on initial presentation to the emergency department. The physician must dissect the ECG for elusive, but perilous, characteristics that are often missed by machine analysis. ST depression is interpreted and often suggestive of ischemia; however, when exclusive to leads V1-V3 with concomitant tall R waves and upright T waves, a posterior infarction should first and foremost be suspected...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28598792/croi-2017-complications-and-comorbidities-of-hiv-disease-and-its-treatment
#13
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/27242089/predicting-coronary-heart-disease-and-stroke-the-finrisk-calculator
#14
REVIEW
Erkki Vartiainen, Tiina Laatikainen, Markku Peltonen, Pekka Puska
The FINRISK risk calculator predicts 10-year risk for coronary heart disease, stroke incidence, and their combination. The model is based on 10-year cohort follow-up from 3 different cohorts in 1982, 1987, and 1992 from a random population sample in 3 areas in Finland. Coronary heart disease, stroke, and their combination are predicted by smoking, systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, diabetes, and family history. The Internet-based calculator is commonly used in Finland in health services to assess the need for hypertension and hypercholesterolemia treatment and is used also in patients' counseling...
June 2016: Global Heart
https://www.readbyqxmd.com/read/27543137/echocardiography-in-shock-management
#15
REVIEW
Anthony S McLean
Echocardiography is pivotal in the diagnosis and management of the shocked patient. Important characteristics in the setting of shock are that it is non-invasive and can be rapidly applied.In the acute situation a basic study often yields immediate results allowing for the initiation of therapy, while a follow-up advanced study brings the advantage of further refining the diagnosis and providing an in-depth hemodynamic assessment. Competency in basic critical care echocardiography is now regarded as a mandatory part of critical care training with clear guidelines available...
August 20, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28057253/hiv-and-ischemic-heart-disease
#16
REVIEW
Ahmed Vachiat, Keir McCutcheon, Nqoba Tsabedze, Don Zachariah, Pravin Manga
The association of coronary heart disease (CHD) and human immunodeficiency virus (HIV) infection has been well recognized for many years. The etiology of the increased prevalence of CHD in HIV-infected populations is the result of complex interactions among the viral infection, host factors, traditional risk factors, and therapies for HIV. As the HIV population is living longer, largely attributable to combination antiretroviral therapy, there is concern about the effect of the rising prevalence of CHD on morbidity and mortality, as well its effect on health systems around the world...
January 3, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/23237230/recognizing-and-managing-the-expanded-risk-of-tumor-lysis-syndrome-in-hematologic-and-solid-malignancies
#17
REVIEW
Ali McBride, Peter Westervelt
Tumor lysis syndrome (TLS) is widely recognized as a serious adverse event associated with the cytotoxic therapies primarily used in hematologic cancers, such as Burkitt lymphoma and acute lymphoblastic leukemia. In recent years, TLS has been more widely observed, due at least in part to the availability of more effective cancer treatments. Moreover, TLS is seen with greater frequency in solid tumors, and particularly in bulky tumors with extensive metastases and tumors with organ or bone marrow involvement...
December 13, 2012: Journal of Hematology & Oncology
https://www.readbyqxmd.com/read/27351679/stress-dose-steroids-myths-and-perioperative-medicine
#18
REVIEW
C Ronald MacKenzie, Susan M Goodman
Perioperative medication management for patients with systemic autoimmune inflammatory diseases has focused on strategies to improve outcomes and mitigate risks. The emphasis has been to minimize the risk of infection associated with most antirheumatic medications, while attempting to avoid flares of disease precipitated by medication withdrawal. Management of glucocorticoids in the perioperative period has been based on an assumption that supraphysiologic increases in dose were always necessary to avoid hypotension and shock in glucocorticoid treated patients, and alternative strategies were rarely considered despite the known infectious, metabolic, and wound healing risks associated with glucocorticoid administration...
July 2016: Current Rheumatology Reports
https://www.readbyqxmd.com/read/27457509/diabetic-nephropathy-in-type-1-diabetes-a-review-of-early-natural-history-pathogenesis-and-diagnosis
#19
REVIEW
Nektaria Papadopoulou-Marketou, George P Chrousos, Christina Kanaka-Gantenbein
Diabetic nephropathy constitutes a devastating complication in patients with type 1 diabetes mellitus, and its diagnosis is traditionally based on microalbuminuria. The aim of this review is to update through the medical literature the suggested early natural course of diabetic nephropathy, the theories behind the pathways of its pathogenesis, and its diagnosis. Poor glycemic control, dyslipidemia, smoking, advanced glycation end products, and environmental and genetic clues play an important role in the development of diabetic nephropathy...
February 2017: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/27618509/cardiovascular-risk-assessment-a-systematic-review-of-guidelines
#20
REVIEW
Mohammed Y Khanji, Vinícius V S Bicalho, Claudia N van Waardhuizen, Bart S Ferket, Steffen E Petersen, M G Myriam Hunink
Background: Many guidelines exist for screening and risk assessment for the primary prevention of cardiovascular disease in apparently healthy persons. Purpose: To systematically review current primary prevention guidelines on adult cardiovascular risk assessment and highlight the similarities and differences to aid clinician decision making. Data Sources: Publications in MEDLINE and CINAHL between 3 May 2009 and 30 June 2016 were identified...
November 15, 2016: Annals of Internal Medicine
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