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Internal medicine

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570 papers 100 to 500 followers
By Elvis Amao Internal Medicine , Cardiology and infectious diseases
https://www.readbyqxmd.com/read/29196066/cough-due-to-tb-and-other-chronic-infections-chest-guideline-and-expert-panel-report
#1
Stephen K Field, Patricio Escalante, Dina A Fisher, Belinda Ireland, Richard S Irwin
BACKGROUND: Cough is common in pulmonary TB and other chronic respiratory infections. Identifying features that predict whether pulmonary TB is the cause would help target appropriate individuals for rapid and cost-effective screening, potentially limiting disease progression and preventing transmission to others. METHODS: A systematic literature search for individual studies to answer eight key questions (KQs) was conducted according to established Chest Organization methods by using the following databases: MEDLINE via PubMed, Embase, Scopus, and the Cochrane Database of Systematic Reviews from January 1, 1984, to April 2014...
November 28, 2017: Chest
https://www.readbyqxmd.com/read/29222007/current-concepts-in-pathogenesis-diagnosis-and-management-of-smoking-related-interstitial-lung-diseases
#2
REVIEW
Anupam Kumar, Sujith V Cherian, Robert Vassallo, Eunhee S Yi, Jay H Ryu
Tobacco exposure results in various changes to the airways and lung parenchyma. While emphysema represents the more common injury pattern, in some individuals, cigarette smoke injures alveolar epithelial and other lung cells resulting in diffuse infiltrates and parenchymal fibrosis. Smoking can trigger interstitial injury patterns mediated via recruitment and inappropriate persistence of myeloid and other immune cells including eosinophils. As our understanding of the role of cigarette smoke constituents in triggering lung injury continues to evolve, so does our recognition of the spectrum of smoking-related interstitial lung changes...
December 5, 2017: Chest
https://www.readbyqxmd.com/read/29253553/the-risk-of-tuberculosis-disease-in-type-2-diabetes-patients-initiating-metformin-versus-sulfonylureas
#3
Sheng-Wei Pan, Yung-Feng Yen, Yu Ru Kou, Pei-Hung Chuang, Vincent Yi-Fong Su, Jia-Yih Feng, Yu-Jiun Chan, Wei-Juin Su
BACKGROUND: Metformin and sulfonylureas are common initial antidiabetic agents; the former has demonstrated anti-tuberculosis action in in vitro and animal studies. The comparative effect of metformin versus sulfonylureas on tuberculosis risk in type 2 diabetes mellitus (T2DM) patients remains unclear. METHODS: In this retrospective cohort study, patients with T2DM diagnosis during 2003-2013, without chronic kidney disease, were identified from the Taiwan National Health Insurance Research Database...
December 15, 2017: Chest
https://www.readbyqxmd.com/read/29289687/a-comparison-of-the-quick-sofa-and-systemic-inflammatory-response-syndrome-criteria-for-the-diagnosis-of-sepsis-and-prediction-of-mortality-a-systematic-review-and-meta-analysis
#4
Rodrigo Serafim, Jose Andrade Gomes, Jorge Salluh, Pedro Póvoa
BACKGROUND: Several studies were published to validate the quick Sepsis-related Organ Failure Assessment (qSOFA), namely in comparison with the systemic inflammatory response syndrome (SIRS) criteria. We performed a systematic review and meta-analysis with the aim of comparing the qSOFA and SIRS in patients outside the ICU. METHODS: We searched MEDLINE, CINAHL, and the Web of Science database from February 23, 2016 until June 30, 2017 to identify full-text English-language studies published after the Sepsis-3 publication comparing the qSOFA and SIRS and their sensitivity or specificity in diagnosing sepsis, as well as hospital and ICU length of stay and hospital mortality...
December 28, 2017: Chest
https://www.readbyqxmd.com/read/29325986/the-challenge-of-rare-diseases
#5
James K Stoller
Rare diseases pose particular challenges to patients who are affected, to the clinicians who care for them, and to the investigators who study their conditions. Though individually uncommon, rare diseases are common in the aggregate, with the ∼7000 described rare diseases affecting 25-30 million Americans. Challenges posed to affected individuals and their families largely regard being diagnosed; receiving optimal care; and affording disease-specific medications. Challenges facing clinicians who care for affected individuals include gaining knowledge and experience in caring for such patients, and the availability of local experts and of expert guidelines...
January 8, 2018: Chest
https://www.readbyqxmd.com/read/29329694/management-of-refractory-vasodilatory-shock
#6
REVIEW
Jacob C Jentzer, Saraschandra Vallabhajosyula, Ashish K Khanna, Lakhmir S Chawla, Laurence W Busse, Kianoush B Kashani
Refractory shock is a lethal manifestation of cardiovascular failure defined by an inadequate hemodynamic response to high doses of vasopressor medications. Approximately 7% of critically ill patients will develop refractory shock, with short-term mortality exceeding 50%. Refractory vasodilatory shock develops from uncontrolled vasodilation and vascular hyporesponsiveness to endogenous vasoconstrictors, causing failure of physiologic vasoregulatory mechanisms. Standard approaches to initial management of shock include fluid resuscitation and initiation of norepinephrine...
January 9, 2018: Chest
https://www.readbyqxmd.com/read/29305560/heart-failure-with-preserved-ejection-fraction-controversies-challenges-and-future-directions
#7
REVIEW
Rosita Zakeri, Martin R Cowie
Heart failure with preserved ejection fraction (HFpEF) comprises almost half of the population burden of HF. Because HFpEF likely includes a range of cardiac and non-cardiac abnormalities, typically in elderly patients, obtaining an accurate diagnosis may be challenging, not least due to the existence of multiple HFpEF mimics and a newly identified subset of patients with HFpEF and normal plasma natriuretic peptide concentrations. The lack of effective treatment for these patients represents a major unmet clinical need...
January 5, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29262435/neuroprognostication-of-cardiac-arrest-patients-outcomes-of-importance
#8
Tobias Cronberg
During the last two decades, survival rates after cardiac arrest have increased while the fraction of patients surviving with a severe neurological disability or vegetative state has decreased in many countries. While improved survival is due to improvements in the whole "chain of survival," improved methods for prognostication of neurological outcome may be of major importance for the lower disability rates. Patients who are resuscitated and treated in intensive care will die mainly from the withdrawal of life-sustaining (WLST) therapy due to presumed poor chances of meaningful neurological recovery...
December 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29274919/use-of-lung-ultrasound-for-the-assessment-of-volume-status-in-ckd
#9
REVIEW
Adrian Covic, Dimitrie Siriopol, Luminita Voroneanu
Adequate assessment of fluid status is an imperative objective in the management of all types of patients in cardiology, intensive care, and especially nephrology. Fluid overload is one of the most common modifiable risk factors directly associated with hypertension, heart failure, left ventricular hypertrophy, and eventually, higher morbidity and mortality risk in these categories of patients. Different methods are commonly used to determine fluid status (eg, clinical assessment, natriuretic peptide concentrations, echocardiography, inferior vena cava measurements, or bioimpedance analysis)...
December 20, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29287124/impact-of-delirium-on-postoperative-frailty-and-long-term-cardiovascular-events-after-cardiac-surgery
#10
Masato Ogawa, Kazuhiro P Izawa, Seimi Satomi-Kobayashi, Yasunori Tsuboi, Kodai Komaki, Yasuko Gotake, Yoshitada Sakai, Hiroshi Tanaka, Yutaka Okita
BACKGROUND: Postoperative delirium (POD) is a common and critical complication after cardiac surgery. However, the relationship between POD and postoperative physical frailty and the effect of both on long-term clinical outcomes have not been fully explored. OBJECTIVE: We aimed to examine the associations among POD, postoperative frailty, and major adverse cardiac events (MACE). DESIGN: This was a prospective cohort study. METHODS: We studied 329 consecutive patients undergoing elective cardiac surgery...
2017: PloS One
https://www.readbyqxmd.com/read/29247259/effect-of-sarcopenia-on-clinical-and-surgical-outcome-in-elderly-patients-with-proximal-femur-fractures
#11
Ching-Di Chang, Jim S Wu, Jennifer Ni Mhuircheartaigh, Marry G Hochman, Edward K Rodriguez, Paul T Appleton, Colm J Mcmahon
PURPOSE: To investigate the relationship between sarcopenia with short-term surgical outcome in elderly patients with proximal femur fractures. METHODS AND MATERIALS: Following Institutional Review Board approval, a database of patients receiving a pelvis CT scan for acute trauma between January 2000-August 2016 was screened for an isolated proximal femur fracture. Patients were excluded if they were: < 50 years old, had conditions predisposing to sarcopenia (renal failure, congestive heart failure, muscular dystrophies), had undergone no surgical treatment, had other major traumatic injuries, or had a pathologic femur fracture...
December 15, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/29250494/diagnosis-and-treatment-of-inflammatory-joint-disease
#12
REVIEW
Yeesuk Kim, Hyun-Cheol Oh, Jang Won Park, In-Sung Kim, Jun-Young Kim, Ki-Choul Kim, Dong-Sik Chae, Woo-Lam Jo, Joo-Hyoun Song
Arthritis damages the cartilage within joints, resulting in degenerative changes, including loss of function and joint instability. Ankylosing spondylitis (AS) is a chronic inflammatory condition affecting the spine and bone-to-tendon attachment area within the sacroiliac joint leading to back pain and progressive spinal stiffness. In the final stages, AS causes hyperkyphosis-a condition closely tied to the human leukocyte antigen-B27 gene. Rheumatoid arthritis is a chronic, systemic autoimmune disease characterized by the simultaneous inflammation of the synovium of multiple joints, leading to joint damage (e...
December 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/29224832/the-pathogenesis-of-pulmonary-sarcoidosis-and-implications-for-treatment
#13
REVIEW
Karen C Patterson, Edward S Chen
Thoracic sarcoidosis is the most common form of sarcoidosis, encompassing a heterogeneous group of patients with a wide range of clinical features and associated outcomes. The distinction between isolated thoracic lymphadenopathy and pulmonary involvement matters. Morbidity is often higher, and long-term outcomes are worse for the latter. While inflammatory infiltrates in pulmonary sarcoidosis may resolve, persistent disease activity is common and can result in lung fibrosis. Given the distinct clinical features and natural history of pulmonary sarcoidosis, its pathogenesis may differ in important ways from other sarcoidosis manifestations...
December 7, 2017: Chest
https://www.readbyqxmd.com/read/29214060/interstitial-lung-disease-the-diagnostic-role-of-bronchoscopy
#14
REVIEW
Jad Kebbe, Tony Abdo
Interstitial lung diseases (ILDs) form one of the most fascinating fields in pulmonary medicine. They also pose one of the greatest challenges for accurate diagnosis and proper treatment. Even within the recommended and warranted multidisciplinary approach, differentiating between one disease and another may lead to frustration, especially when proper lung tissue is not available for adequate pathological review. A surgical lung biopsy (SLB) might render enough tissue for histopathology, but this could come at the expense of high morbidity and even mortality, as in the case of usual interstitial pneumonia (UIP)...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29253554/heparin-induced-thrombocytopenia-in-the-critically-ill-patient
#15
REVIEW
James M East, Christine Cserti- Gazdewich, John T Granton
Heparin induced thrombocytopenia (HIT) is associated with significant morbidity and mortality. Critically ill patients are commonly thrombocytopenic and exposed to heparin. Although HIT should be considered, it is not usually the cause of thrombocytopenia in the medical-surgical ICU population. A systematic approach to the critically ill patient with thrombocytopenia using clinical features, complemented by appropriate laboratory confirmation should lead to a reduction in inappropriate laboratory testing and reduce the use of more expensive and less reliable anticoagulants...
December 15, 2017: Chest
https://www.readbyqxmd.com/read/29230392/non-invasive-monitoring-of-cardiac-output-in-critical-care-medicine
#16
REVIEW
Lee S Nguyen, Pierre Squara
Critically ill patients require close hemodynamic monitoring to titrate treatment on a regular basis. It allows administering fluid with parsimony and adjusting inotropes and vasoactive drugs when necessary. Although invasive monitoring is considered as the reference method, non-invasive monitoring presents the obvious advantage of being associated with fewer complications, at the expanse of accuracy, precision, and step-response change. A great many methods and devices are now used over the world, and this article focuses on several of them, providing with a brief review of related underlying physical principles and validation articles analysis...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/29254862/ceftazidime-avibactam-versus-meropenem-in-nosocomial-pneumonia-including-ventilator-associated-pneumonia-reprove-a-randomised-double-blind-phase-3-non-inferiority-trial
#17
Antoni Torres, Nanshan Zhong, Jan Pachl, Jean-François Timsit, Marin Kollef, Zhangjing Chen, Jie Song, Dianna Taylor, Peter J Laud, Gregory G Stone, Joseph W Chow
BACKGROUND: Nosocomial pneumonia is commonly associated with antimicrobial-resistant Gram-negative pathogens. We aimed to assess the efficacy and safety of ceftazidime-avibactam in patients with nosocomial pneumonia, including ventilator-associated pneumonia, compared with meropenem in a multinational, phase 3, double-blind, non-inferiority trial (REPROVE). METHODS: Adults with nosocomial pneumonia (including ventilator-associated pneumonia), enrolled at 136 centres in 23 countries, were randomly assigned (1:1) to 2000 mg ceftazidime and 500 mg avibactam (by 2 h intravenous infusion every 8 h) or 1000 mg meropenem (by 30-min intravenous infusion every 8 h) for 7-14 days; regimens were adjusted for renal function...
December 15, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29094875/heart-failure-with-preserved-ejection-fraction-diagnosis-and-management
#18
REVIEW
John D Gazewood, Patrick L Turner
Heart failure with preserved ejection fraction, also referred to as diastolic heart failure, causes almost one-half of the 5 million cases of heart failure in the United States. It is more common among older patients and women, and results from abnormalities of active ventricular relaxation and passive ventricular compliance, leading to a decline in stroke volume and cardiac output. Heart failure with preserved ejection fraction should be suspected in patients with typical symptoms (e.g., fatigue, weakness, dyspnea, orthopnea, paroxysmal nocturnal dyspnea, edema) and signs (S3 heart sound, displaced apical pulse, and jugular venous distension) of chronic heart failure...
November 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/29178033/a-review-of-neuropathic-pain-from-guidelines-to-clinical-practice
#19
REVIEW
Giorgio Cruccu, Andrea Truini
Neuropathic pain is a chronic condition representing a significant burden for patients, society, and healthcare systems. The prevalence of neuropathic pain in the general population has been estimated at 7-8% and is expected to increase in the future. Neuropathic pain differs from nociceptive pain and requires a different therapeutic approach; and the management of neuropathic pain is complicated and challenging. This chapter discusses clinical practice guidelines for neuropathic pain and their usefulness in clinical practice...
December 2017: Pain and Therapy
https://www.readbyqxmd.com/read/29253280/guidelines-for-the-management-of-systemic-lupus-erythematosus-great-synthesis-of-evidence-and-eminence-with-limited-focus-on-patient-s-needs
#20
Matthias Schneider
No abstract text is available yet for this article.
January 1, 2018: Rheumatology
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