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Internal Medicine

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49 papers 25 to 100 followers
By P N University of Florida College of Pharmacy - PharmD Candidate - Class of 2017
https://www.readbyqxmd.com/read/28087742/heartbeat-warfarin-therapy-for-mechanical-heart-valves
#1
EDITORIAL
Catherine M Otto
No abstract text is available yet for this article.
February 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27957711/the-role-of-beta-blockers-in-the-treatment-of-hypertension
#2
John M Cruickshank
IMPORTANCE: Two major guide-line committees (JNC-8 and NICE UK) have dropped beta-blockers as first-line therapy in the treatment of hypertension. Also, recent meta-analyses (that do not take age into account) have concluded that beta-blockers are inappropriate first-line agents in the treatment of hypertension. This review seeks to shed some light on the "rights and wrongs" of such actions and conclusions. OBJECTIVES: Because the pathophysiology of primary/essential hypertension differs in elderly and younger subjects, the latter being closely linked to obesity and increased sympathetic nerve activity, the author sought to clarify the efficacy of beta-blockers in the younger/middle-aged group in reducing the risk of death, and cardiovascular end-points...
December 13, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/26976916/combined-angiotensin-receptor-antagonism-and-neprilysin-inhibition
#3
REVIEW
Scott A Hubers, Nancy J Brown
Heart failure affects ≈5.7 million people in the United States alone. Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, β-blockers, and aldosterone antagonists have improved mortality in patients with heart failure and reduced ejection fraction, but mortality remains high. In July 2015, the US Food and Drug Administration approved the first of a new class of drugs for the treatment of heart failure: Valsartan/sacubitril (formerly known as LCZ696 and currently marketed by Novartis as Entresto) combines the angiotensin receptor blocker valsartan and the neprilysin inhibitor prodrug sacubitril in a 1:1 ratio in a sodium supramolecular complex...
March 15, 2016: Circulation
https://www.readbyqxmd.com/read/27840364/25-years-of-proton-pump-inhibitors-a-comprehensive-review
#4
REVIEW
Daniel S Strand, Daejin Kim, David A Peura
Proton pump inhibitors (PPIs) were clinically introduced more than 25 years ago and have since proven to be invaluable, safe, and effective agents for the management of a variety of acid-related disorders. Although all members in this class act in a similar fashion, inhibiting active parietal cell acid secretion, there are slight differences among PPIs relating to their pharmacokinetic properties, metabolism, and Food and Drug Administration (FDA)-approved clinical indications. Nevertheless, each is effective in managing gastroesophageal reflux disease and uncomplicated or complicated peptic ulcer disease...
January 15, 2017: Gut and Liver
https://www.readbyqxmd.com/read/27875032/management-of-renal-failure-in-end-stage-liver-disease-a-critical-appraisal
#5
REVIEW
Xingxing S Cheng, Jane C Tan, W Ray Kim
Renal failure is a late consequence of end-stage liver disease (ESLD). Even with liver transplantation, pretransplant renal impairment remains a strong predictor of posttransplant mortality. This review seeks to summarize and critically appraise common therapies used in this setting, including pharmacologic agents, procedures (transjugular intrahepatic portosystemic shunt, renal replacement therapy), and simultaneous liver-kidney transplantation. More experimental extracorporal modalities, eg, albumin dialysis or bioartificial livers, will not be discussed...
December 2016: Liver Transplantation
https://www.readbyqxmd.com/read/25700585/appropriate-prescribing-and-important-drug-interactions-in-older-adults
#6
REVIEW
Jeffrey Wallace, Douglas S Paauw
Polypharmacy, specifically the overuse and misuse of medications, is associated with adverse health events, increased disability, hospitalizations, and mortality. Mechanisms through which polypharmacy may increase adverse health outcomes include decreased adherence, increased drug side effects, higher use of potentially inappropriate medications, and more frequent drug-drug interactions. This article reviews clinical problems associated with polypharmacy and presents a framework to optimize prescribing for older adults...
March 2015: Medical Clinics of North America
https://www.readbyqxmd.com/read/25621434/cumulative-use-of-strong-anticholinergics-and-incident-dementia-a-prospective-cohort-study
#7
Shelly L Gray, Melissa L Anderson, Sascha Dublin, Joseph T Hanlon, Rebecca Hubbard, Rod Walker, Onchee Yu, Paul K Crane, Eric B Larson
IMPORTANCE: Many medications have anticholinergic effects. In general, anticholinergic-induced cognitive impairment is considered reversible on discontinuation of anticholinergic therapy. However, a few studies suggest that anticholinergics may be associated with an increased risk for dementia. OBJECTIVE: To examine whether cumulative anticholinergic use is associated with a higher risk for incident dementia. DESIGN, SETTING, AND PARTICIPANTS: Prospective population-based cohort study using data from the Adult Changes in Thought study in Group Health, an integrated health care delivery system in Seattle, Washington...
March 2015: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27978952/prosthetic-heart-valve-thrombosis
#8
REVIEW
George D Dangas, Jeffrey I Weitz, Gennaro Giustino, Raj Makkar, Roxana Mehran
Although surgery was the mainstay of treatment for valvular heart disease, transcatheter valve therapies have grown exponentially over the past decade. Two types of artificial heart valve exist: mechanical heart valves (MHV), which are implanted surgically, and bioprosthetic heart valves (BHV), which can be implanted via a surgical or transcatheter approach. Whereas long-term anticoagulation is required to prevent thromboembolism after MHV replacement, its value in patients receiving BHVs is uncertain. Patients undergoing transcatheter BHV replacement are at risk for thromboembolism in the first few months, and recent data suggest that the risk continues thereafter...
December 20, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27581830/the-management-of-benign-non-infective-pleural-effusions
#9
Oliver J Bintcliffe, Gary Y C Lee, Najib M Rahman, Nick A Maskell
The evidence base concerning the management of benign pleural effusions has lagged behind that of malignant pleural effusions in which recent randomised trials are now informing current clinical practice and international guidelines.The causes of benign pleural effusions are broad, heterogenous and patients may benefit from individualised management targeted at both treating the underlying disease process and direct management of the fluid. Pleural effusions are very common in a number of non-malignant pathologies, such as decompensated heart failure, and following coronary artery bypass grafting...
September 2016: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/27995597/acute-heart-failure-in-patients-admitted-to-the-emergency-department-with-acute-myocardial-infarction
#10
Justyna Maria Krzysztofik, Mateusz Sokolski, Michał Kosowski, Wojciech Zimoch, Adrian Lis, Maciej Klepuszewski, Michał Kasperczak, Marcin Proniak, Krzysztof Reczuch, Waldemar Banasiak, Ewa Anita Jankowska, Piotr Ponikowski
BACKGROUD: Acute heart failure (AHF), occurring as a complication of ongoing acute myocardial infarction (AMI), is a common predictor of worse clinical outcomes. Much less is known about a very unique subpopulation of patients, who already in the emergency department (ED) present these two life-threatening conditions. AIM: The aim of the study was to establish the prevalence of coexistence of AHF with AMI in the ED, identify clinical factors associated with the higher prevalence of AHF at the very early onset of AMI and to assess prognostic impact of the presence of AHF with AMI...
December 20, 2016: Kardiologia Polska
https://www.readbyqxmd.com/read/27855640/long-term-secondary-prevention-of-acute-myocardial-infarction-sepat-guidelines-adherence-and-outcome
#11
Constantinos Ergatoudes, Erik Thunström, Annika Rosengren, Lena Björck, Kristina Bengtsson Boström, Kristin Falk, Michael Fu
BACKGROUND: A number of registry studies have reported suboptimal adherence to guidelines for cardiovascular prevention during the first year after acute myocardial infarction (AMI). However, only a few studies have addressed long-term secondary prevention after AMI. This study evaluates prevention guideline adherence and outcome of guideline-directed secondary prevention in patients surviving 2 years after AMI. METHODS: Patients aged 18-85 years at the time of their index AMI were consecutively identified from hospital discharge records between July 2010 and December 2011 in Gothenburg, Sweden...
November 17, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27179902/ace-inhibitors-versus-angiotensin-receptor-blockers-for-prevention-of-events-in-cardiovascular-patients-without-heart-failure-a-network-meta-analysis
#12
Fabrizio Ricci, Augusto Di Castelnuovo, Gianluigi Savarese, Pasquale Perrone Filardi, Raffaele De Caterina
BACKGROUND: Angiotensin receptor blockers (ARBs) are a valuable option to reduce cardiovascular (CV) mortality and morbidity in cardiac patients in whom ACE-inhibitors (ACE-Is) cannot be used. However, clinical outcome data from direct comparisons between ACE-Is and ARBs are scarce, and some data have recently suggested superiority of ACE-Is over ARBs. METHODS: We performed a Bayesian network-meta-analysis, with data from both direct and indirect comparisons, from 27 randomized controlled trials (RCTs), including a total population of 125,330 patients, to assess the effects of ACE-Is and ARBs on the composite endpoint of CV death, myocardial infarction (MI) and stroke, and on all-cause death, new-onset heart failure (HF) and new-onset diabetes mellitus (DM) in high CV risk patients without HF...
August 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27858191/focus-on-the-novel-cardiovascular-drug-lzc696-from-evidence-to-clinical-consideration
#13
L M Lin, Y Wu, M F Wu, J X Lin
LCZ696, a first-in-class angiotensin receptor neprilysin inhibitor (ARNI), is comprised of the angiotensin receptor blocker valsartan and the neprilysin inhibitor pro-drug sacubitril (AHU377). After oral administration, AHU377 is rapidly metabolized to the active neprilysin inhibitor LBQ657. LCZ696 exerts its effects of diuresis, natriuresis, vasodilation and aldosterone secretion inhibition through simultaneous renin-angiotensin-aldosterone system (RAAS) blockade and natriuretic peptides system (NPS) enhancement...
December 2016: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/27230644/heart-failure-considerations-of-antihyperglycemic-medications-for-type-2-diabetes
#14
Eberhard Standl, Oliver Schnell, Darren K McGuire
Prevalent and incident heart failure (HF) is increased in people with type 2 diabetes mellitus, with risk directly associated with the severity of hyperglycemia. Furthermore, in patients with type 2 diabetes mellitus, mortality is increased ≈10-fold in patients with versus without HF. Reducing HF with antihyperglycemic therapies, however, has been unsuccessful until recently. In fact, HF as an important outcome in patients with type 2 diabetes mellitus seems to be heterogeneously modulated by antihyperglycemic medications, as evidenced by results from cardiovascular outcome trials (CVOTs) and large observational cohort studies...
May 27, 2016: Circulation Research
https://www.readbyqxmd.com/read/27766049/management-of-venous-thromboembolism-an-update
#15
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/27887750/chronic-kidney-disease
#16
REVIEW
Angela C Webster, Evi V Nagler, Rachael L Morton, Philip Masson
The definition and classification of chronic kidney disease (CKD) have evolved over time, but current international guidelines define this condition as decreased kidney function shown by glomerular filtration rate (GFR) of less than 60 mL/min per 1·73 m(2), or markers of kidney damage, or both, of at least 3 months duration, regardless of the underlying cause. Diabetes and hypertension are the main causes of CKD in all high-income and middle-income countries, and also in many low-income countries. Incidence, prevalence, and progression of CKD also vary within countries by ethnicity and social determinants of health, possibly through epigenetic influence...
November 22, 2016: Lancet
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/27755944/natriuretic-peptides-and-their-therapeutic-potential-in-heart-failure-treatment-an-updated-review
#18
M Namdari, A Eatemadi, B Negahdari
Brain natriuretic peptide (BNP), also known as a B-type natriuretic peptide, is one of the important biomarkers with a proven role in the diagnosis of congestive heart failure (CHF). Researchers from the different clinical field have researched into the performance features of BNP testing in the acute care set-up to assist and improve in diagnosing CHF and in predicting future morbidity and mortality rates. The potency of BNP has also been researched into in cases like myocardial ischemia and infarction, cor pulmonale, and acute pulmonary embolism (PE)...
September 30, 2016: Cellular and Molecular Biology
https://www.readbyqxmd.com/read/27687200/hyperkalemia-in-heart-failure
#19
REVIEW
Chaudhry M S Sarwar, Lampros Papadimitriou, Bertram Pitt, Ileana Piña, Faiez Zannad, Stefan D Anker, Mihai Gheorghiade, Javed Butler
Disorders of potassium homeostasis can potentiate the already elevated risk of arrhythmia in heart failure. Heart failure patients have a high prevalence of chronic kidney disease, which further heightens the risk of hyperkalemia, especially when renin-angiotensin-aldosterone system inhibitors are used. Acute treatment for hyperkalemia may not be tolerated in the long term. Recent data for patiromer and sodium zirconium cyclosilicate, used to treat and prevent high serum potassium levels on a more chronic basis, have sparked interest in the treatment of hyperkalemia, as well as the potential use of renin-angiotensin-aldosterone system inhibitors in patients who were previously unable to take these drugs or tolerated only low doses...
October 4, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27826957/development-of-new-therapies-for-severe-asthma
#20
REVIEW
Merritt L Fajt, Sally E Wenzel
Persistent asthma has long been treated with inhaled corticosteroids (CSs), as the mainstay of therapy. However, their efficacy in patients with more severe disease is limited, which led to the incorporation of poor response to ICSs (and thereby use of high doses of ICS) into recent definitions of severe asthma. Several studies have suggested that severe asthma might consist of several different phenotypes, each with ongoing symptoms and health care utilization, despite the use of high doses of ICS, usually in combination with a second or third controller...
January 2017: Allergy, Asthma & Immunology Research
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