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Outstanding Clinical Review

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136 papers 25 to 100 followers
https://www.readbyqxmd.com/read/20965437/aetiological-diagnosis-of-ischaemic-stroke-in-young-adults
#1
REVIEW
José M Ferro, Ayrton R Massaro, Jean-Louis Mas
Despite improvements in diagnosis and treatment, ischaemic stroke in young adults remains a catastrophic event from the patients' perspective. Stroke can cause death, disability, and hamper quality of life. For the neurologist treating a young adult with suspected ischaemic stroke, the diagnostic challenge is to identify its cause. Contemporary neuroimaging of the brain and its vessels, and a comprehensive cardiac assessment, will enable identification of the most frequent causes of stroke in this age group: cardioembolism and arterial dissection...
November 2010: Lancet Neurology
https://www.readbyqxmd.com/read/27832978/current-practice-of-hypoglycemia-management-in-the-ed
#2
Matthew H Bilhimer, Cierra N Treu, Nicole M Acquisto
PURPOSE: To characterize hypoglycemia management and identify characteristics associated with refractory (need for additional treatment following initial management) and recurrent (adequate initial treatment followed by blood glucose [BG] ≤50 mg/dL) hypoglycemia. METHODS: Retrospective review of adult emergency department (ED) patients who presented to a large academic medical center with hypoglycemia (BG ≤ 50 mg/dL) between January 2011 and July 2015. Data collection focused on BG measurements and treatment practices...
October 8, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/24919684/furosemide-and-albumin-for-diuresis-of-edema-fade-a-study-protocol-for-a-randomized-controlled-trial
#3
RANDOMIZED CONTROLLED TRIAL
Simon J W Oczkowski, Ian Mazzetti, Maureen O Meade, Cindy Hamielec
BACKGROUND: Fluid retention is a common complication of critical illness. It typically results from large-volume fluid infusions during acute resuscitation and is worsened by hypoalbuminemia. Recognized as edema, fluid retention is important for its association with delayed weaning and increased mortality. The standard treatment is the administration of diuretics, with or without albumin. We hypothesize that intravenous 25% albumin plus furosemide, by comparison with furosemide alone, improves diuresis, oxygenation, and hemodynamic stability in the deresuscitation of critically ill, hypoalbuminemic patients...
June 12, 2014: Trials
https://www.readbyqxmd.com/read/12708949/combined-furosemide-and-human-albumin-treatment-for-diuretic-resistant-edema
#4
REVIEW
Rowland J Elwell, Ann P Spencer, George Eisele
OBJECTIVE: To evaluate the clinical usefulness of combined furosemide and human albumin for the treatment of diuretic-resistant edema in patients with nephrotic syndrome and cirrhosis. DATA SOURCES: Clinical literature was accessed through MEDLINE (1966-May 2002). Key search terms included furosemide, albumin, human albumin solution, nephrotic syndrome, and cirrhosis. DATA SYNTHESIS: Hypoalbuminemia, edema, and ascites are often manifestations of nephrotic syndrome and cirrhosis of the liver...
May 2003: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/27852691/medical-management-of-intracerebral-haemorrhage
#5
REVIEW
Floris H B M Schreuder, Shoichiro Sato, Catharina J M Klijn, Craig S Anderson
The global burden of intracerebral haemorrhage (ICH) is enormous. Developing evidence-based management strategies for ICH has been hampered by its diverse aetiology, high case fatality and variable cooperative organisation of medical and surgical care. Progress is being made through the conduct of collaborative multicentre studies with the large sample sizes necessary to evaluate therapies with realistically modest treatment effects. This narrative review describes the major consequences of ICH and provides evidence-based recommendations to support decision-making in medical management...
November 16, 2016: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/27853529/current-concepts-and-dilemmas-in-idiopathic-interstitial-pneumonias
#6
REVIEW
Jay H Ryu, Teng Moua, Natalya Azadeh, Misbah Baqir, Eunhee S Yi
Idiopathic interstitial pneumonias comprise approximately one-third of interstitial lung diseases (also called diffuse parenchymal infiltrative lung diseases). The classification of idiopathic interstitial pneumonias has undergone several revisions since the initial description of 40 years ago, and the most recent version was published in 2013. Although some aspects have been clarified, this group of heterogeneous disorders continues to be a source of confusion and misunderstanding in clinical applications...
2016: F1000Research
https://www.readbyqxmd.com/read/27664247/management-of-febrile-neutropaenia-esmo-clinical-practice-guidelines
#7
J Klastersky, J de Naurois, K Rolston, B Rapoport, G Maschmeyer, M Aapro, J Herrstedt
No abstract text is available yet for this article.
September 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/27815588/the-new-sepsis-consensus-definitions-the-good-the-bad-and-the-ugly
#8
EDITORIAL
Charles L Sprung, Roland M H Schein, Robert A Balk
No abstract text is available yet for this article.
December 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27712137/an-update-on-the-management-of-urinary-tract-infections-in-the-era-of-antimicrobial-resistance
#9
Mazen S Bader, Mark Loeb, Annie A Brooks
Urinary tract infections (UTIs) caused by antibiotic-resistant Gram-negative bacteria are a growing concern due to limited therapeutic options. Gram-negative bacteria, specifically Enterobacteriaceae, are common causes of both community-acquired and hospital acquired UTIs. These organisms can acquire genes that encode for multiple antibiotic resistance mechanisms, including extended-spectrum-lactamases (ESBLs), AmpC- β -lactamase, and carbapenemases. The assessment of suspected UTI includes identification of characteristic symptoms or signs, urinalysis, dipstick or microscopic tests, and urine culture if indicated...
October 7, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27802474/copd
#10
Terri Kirby Erickson
No abstract text is available yet for this article.
November 1, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27618274/evaluating-pulmonary-function-an-assessment-of-pao2-fio2
#11
John R Feiner, Richard B Weiskopf
OBJECTIVES: PaO2/FIO2 is used commonly for diagnosis of lung injury (acute respiratory distress syndrome and transfusion-related acute lung injury), for assessment of pulmonary disease course and therapy, and in pulmonary transplantation for evaluation of donor lungs and clinical outcome. It was developed for convenience, without formal mathematical and graphic assessment to validate its suitability for these purposes. DESIGN: We examined, mathematically and graphically, the relationship of PaO2/FIO2 to FIO2 at constant normal and several degrees of increased intrapulmonary shunting (QS/QT), assessing the impact of intra- and extrapulmonary factors on the relationship and thus the reliability of PaO2/FIO2...
September 9, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27653706/diagnosis-of-latent-tuberculous-infection
#12
Colin L Crawford
No abstract text is available yet for this article.
September 20, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27659877/physiological-mechanisms-of-pulmonary-hypertension
#13
REVIEW
David H MacIver, Ismail Adeniran, Iain R MacIver, Alistair Revell, Henggui Zhang
Pulmonary hypertension is usually related to obstruction of pulmonary blood flow at the level of the pulmonary arteries (eg, pulmonary embolus), pulmonary arterioles (idiopathic pulmonary hypertension), pulmonary veins (pulmonary venoocclusive disease) or mitral valve (mitral stenosis and regurgitation). Pulmonary hypertension is also observed in heart failure due to left ventricle myocardial diseases regardless of the ejection fraction. Pulmonary hypertension is often regarded as a passive response to the obstruction to pulmonary flow...
October 2016: American Heart Journal
https://www.readbyqxmd.com/read/27538060/toxic-alcohol-ingestion-prompt-recognition-and-management-in-the-emergency-department
#14
Gillian A Beauchamp, Matthew Valento
Identifying patients with potential toxic alcohol exposure and initiating appropriate management is critical to avoid significant patient morbidity. Sources of toxic alcohol exposure include ethylene glycol, methanol, diethylene glycol, propylene glycol, and isopropanol. Treatment considerations include the antidotes fomepizole and ethanol, and hemodialysis for removal of the parent compound and its toxic metabolites. Additional interventions include adjunctive therapies that may improve acidosis and enhance clearance of the toxic alcohol or metabolites...
September 2016: Emergency Medicine Practice
https://www.readbyqxmd.com/read/27638544/acute-decompensated-heart-failure
#15
Drayton A Hammond, Melanie N Smith, Kristen C Lee, Danielle Honein, April Miller Quidley
Heart failure (HF) is a societal burden due to its high prevalence, frequent admissions for acute decompensated heart failure (ADHF), and the economic impact of direct and indirect costs associated with HF and ADHF. Common etiologies of ADHF include medication and diet noncompliance, arrhythmias, deterioration in renal function, poorly controlled hypertension, myocardial infarction, and infections. Appropriate medical management of ADHF in patients is guided by the identification of signs and symptoms of fluid overload or low cardiac output and utilization of evidence-based practices...
September 16, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27373891/acute-kidney-injury-short-term-and-long-term-effects
#16
REVIEW
James F Doyle, Lui G Forni
Acute kidney injury (AKI) is the most common cause of organ dysfunction in critically ill adults, with a single episode of AKI, regardless of stage, carrying a significant morbidity and mortality risk. Since the consensus on AKI nomenclature has been reached, data reflecting outcomes have become more apparent allowing investigation of both short- and long-term outcomes.Classically the short-term effects of AKI can be thought of as those reflecting an acute deterioration in renal function per se. However, the effects of AKI, especially with regard to distant organ function ("organ cross-talk"), are being elucidated as is the increased susceptibility to other conditions...
July 4, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27382285/the-causes-of-new-onset-epilepsy-and-seizures-in-the-elderly
#17
REVIEW
Shasha Liu, Weihua Yu, Yang Lü
With increasing age, the prevalence and incidence of epilepsy and seizures increases correspondingly. New-onset epilepsy in elderly people often has underlying etiology, including cerebrovascular diseases, primary neuron degenerative disorders, intracerebral tumors, and traumatic head injury. In addition, an acute symptomatic seizure cannot be called epilepsy, which manifests usually as a common symptom secondary to metabolic or toxicity factors in older people. In this review, we have mainly focused on the causes of new-onset epilepsy and seizures in elderly people...
2016: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/27637676/stroke
#18
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...
September 13, 2016: Lancet
https://www.readbyqxmd.com/read/27560278/rhythm-control-in-atrial-fibrillation
#19
REVIEW
Jonathan P Piccini, Laurent Fauchier
Many patients with atrial fibrillation have substantial symptoms despite ventricular rate control and require restoration of sinus rhythm to improve their quality of life. Acute restoration (ie, cardioversion) and maintenance of sinus rhythm in patients with atrial fibrillation are referred to as rhythm control. The decision to pursue rhythm control is based on symptoms, the type of atrial fibrillation (paroxysmal, persistent, or long-standing persistent), patient comorbidities, general health status, and anticoagulation status...
August 20, 2016: Lancet
https://www.readbyqxmd.com/read/27502078/acute-myocardial-infarction
#20
Grant W Reed, Jeffrey E Rossi, Christopher P Cannon
Acute myocardial infarction has traditionally been divided into ST elevation or non-ST elevation myocardial infarction; however, therapies are similar between the two, and the overall management of acute myocardial infarction can be reviewed for simplicity. Acute myocardial infarction remains a leading cause of morbidity and mortality worldwide, despite substantial improvements in prognosis over the past decade. The progress is a result of several major trends, including improvements in risk stratification, more widespread use of an invasive strategy, implementation of care delivery systems prioritising immediate revascularisation through percutaneous coronary intervention (or fibrinolysis), advances in antiplatelet agents and anticoagulants, and greater use of secondary prevention strategies such as statins...
August 5, 2016: Lancet
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