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Internal medicine

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395 papers 100 to 500 followers
By Elvis Amao Internal Medicine , Cardiology and infectious diseases
https://www.readbyqxmd.com/read/28410648/risk-prediction-models-in-ckd
#1
REVIEW
Blake Lerner, Sean Desrochers, Navdeep Tangri
Chronic kidney disease (CKD) currently affects 20 million Americans and is associated with increased morbidity and mortality. Resource-efficient and appropriate treatment of CKD benefits the patient and provides improved resource allocation for the health care system. Prediction models can be useful in efficiently allocating resources, and currently are being used at the bedside for several important clinical decisions. There is a paucity of prediction models in use in nephrology, but one such model, the Kidney Failure Risk Equation, uses routinely collected laboratory values and can inform clinical decisions related to the following: (1) triage of nephrology referrals, (2) evaluating the need for more intensive interdisciplinary clinic care, (3) determining the timing of modality education, and (4) dialysis access planning...
March 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28412721/are-admission-procalcitonin-levels-universal-mortality-predictors-across-different-medical-emergency-patient-populations-results-from-the-multi-national-prospective-observational-triage-study
#2
Ramon Sager, Yannick Wirz, Devendra Amin, Adina Amin, Pierre Hausfater, Andreas Huber, Sebastian Haubitz, Alexander Kutz, Beat Mueller, Philipp Schuetz
BACKGROUND: Procalcitonin (PCT), an inflammatory blood biomarker, is well studied in infectious diseases. Its prognostic value in unselected emergency department (ED) patients remains yet undefined. Herein, we investigated association of admission PCT levels and mortality in a large, international-multicenter ED patient cohort. METHODS: We prospectively enrolled 6970 unselected, consecutive, adult, medical patients seeking ED care in three tertiary-care hospitals in Switzerland, France and the USA...
April 17, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28405987/cardiorenal-syndrome-clinical-outcome-study
#3
H R Shah, N P Singh, N P Aggarwal, D Singhania, A Kumar
BACKGROUND: Over recent years, the field of medicine has been challenged by the twin epidemic of heart failure and renal insufficiency. The coexistence of the two problems in the same patient, referred to as cardiorenal syndrome (CRS), is defined as 'disorders of the heart and kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other. The mechanisms underlying this interaction are complex and multifactorial in nature. OBJECTIVE OF STUDY: Identify and classify patients admitted with cardiorenal syndrome into various subtypes and assess clinical outcome at discharge and at three months...
December 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28233512/tuberculosis-associated-with-hiv-infection
#4
Jeffrey A Tornheim, Kelly E Dooley
Tuberculosis (TB) has recently surpassed HIV as the primary infectious disease killer worldwide, but the two diseases continue to display lethal synergy. The burden of TB is disproportionately borne by people living with HIV, particularly where HIV and poverty coexist. The impact of these diseases on one another is bidirectional, with HIV increasing risk of TB infection and disease progression and TB slowing CD4 recovery and increasing progression to AIDS and death among the HIV infected. Both antiretroviral therapy (ART) and latent TB infection (LTBI) treatment mitigate the impact of coinfection, and ART is now recommended for HIV-infected patients independent of CD4 count...
January 2017: Microbiology Spectrum
https://www.readbyqxmd.com/read/28366517/risks-of-adverse-events-in-advanced-ckd-the-chronic-renal-insufficiency-cohort-cric-study
#5
Morgan E Grams, Wei Yang, Casey M Rebholz, Xue Wang, Anna C Porter, Lesley A Inker, Edward Horwitz, James H Sondheimer, L Lee Hamm, Jiang He, Matthew R Weir, Bernard G Jaar, Tariq Shafi, Lawrence J Appel, Chi-Yuan Hsu
BACKGROUND: People with advanced chronic kidney disease are at risk for the development of end-stage renal disease (ESRD), but also many other adverse outcomes, including cardiovascular disease (CVD) events and death. Determination of risk factors that explain the variability in prognosis and timing of these adverse outcomes can aid patient counseling and medical decision making. STUDY DESIGN: Prospective research cohort. SETTING & PARTICIPANTS: 1,798 participants with estimated glomerular filtration rates (eGFRs)<30mL/min/1...
March 30, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28366298/clinical-characteristics-and-prognosis-of-pulmonary-embolism-caused-by-economy-class-syndrome
#6
María Abellás, Ana Menéndez, Raquel Morillo, Luis Jara-Palomares, Deisy Barrios, Rosa Nieto, Esther Barbero, Jesús Corres, Pedro Ruiz-Artacho, David Jiménez
OBJECTIVE: Clinical presentation and short-term prognosis of patients with travel-associated acute pulmonary embolism (PE) (i.e., economy class syndrome [ECS]) is not well understood. METHODS: In this retrospective cohort study of patients with acute PE identified from a single center registry, we assessed the clinical presentation and the association between ECS and the outcomes of all-cause mortality, PE-related mortality, nonfatal venous thromboembolism and nonfatal major bleeding rates through 30days after initiation of PE treatment...
March 30, 2017: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/28379023/-cardiovascular-complications-of-cancers-and-anti-cancer-therapy
#7
Jiří Vyskočil, Katarína Petráková, Petr Jelínek, Michal Furdek
In our aging population the incidence of cancer is increasing in the elderly. We are thus facing a new challenge especially considering incidence of cardiovascular diseases (CVD) in this patients population. Overall survival of cancer patients has significantly improved therefore cancer has become in many cases a chronic disease. We are about to be treating patients who either may develop a new CVD or their current CVD may deteriorate. Cancer can cause various cardiovascular conditions locally (pressure in mediastinum, effusions) or systemically (increased risk of pulmonary embolism, arrhythmias, carcinoid heart disease)...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28356037/markers-of-early-vascular-ageing
#8
Vasilios Kotsis, Christina Antza, Ioannis Doundoulakis, Stella Stabouli
BACKGROUND: Cardiovascular damage is clinically manifested as coronary artery disease, heart failure, stroke and peripheral artery disease. The prevalence of these adverse conditions is higher with advancing age. Although many patients present cardiovascular damage late in their life, it is common to see patients with early atherosclerosis in cardiovascular intensive care units at ages lower than 50 years in men and 55 for women. METHODS AND RESULTS: In this review of the literature we identified risk factors of early vascular damage...
March 28, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28283819/neurological-complications-of-beh%C3%A3-et-s-syndrome
#9
D P Kidd
In this review of the neurological complications of Behçet's syndrome, the clinical features and epidemiology of the systemic disease are summarised before a discussion of the neurological syndromes which may develop is made. Neurological involvement occurs in 9% of cases, and is equally prevalent in each geographical area. Vascular complications occur in 14%, in whom thrombosis of the venous sinuses or cerebral veins occurs, and intracranial hypertension, venous infarction and parenchymal haemorrhage may develop...
March 10, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28327462/neurocognitive-dysfunction-in-hiv-infected-youth-investigating-the-relationship-with-immune-activation
#10
Allison Ross Eckard, Julia C Rosebush, Mary Ann O'Riordan, Chanda C Graves, Ashley Alexander, Anita K Grover, S Thera Lee, Jakob G Habib, Joshua H Ruff, Ann Chahroudi, Grace A McComsey
BACKGROUND: HIV-infected individuals are at increased risk of neurocognitive impairment compared to the general population. Studies suggest that, despite combination antiretroviral therapy (cART), HIV infection causes immune activation which results in neural damage; however, few data exist in HIV-infected youth. METHODS: HIV-infected youth 8-26 years old on cART with virologic suppression were prospectively enrolled along with healthy controls. Neurocognitive performance was assessed by age-appropriate Wechsler Intelligence Scales...
March 22, 2017: Antiviral Therapy
https://www.readbyqxmd.com/read/28298956/phosphorus-regulation-in-chronic-kidney-disease
#11
Wadi N Suki, Linda W Moore
Serum phosphorus levels stay relatively constant through the influence of multiple factors-such as parathyroid hormone, fibroblast growth factor 23, and vitamin D-on the kidney, bone, and digestive system. Whereas normal serum phosphorus ranges between 3 mg/dL to 4.5 mg/dL, large cross-sectional studies have shown that even people with normal kidney function are sometimes found to have levels ranging between 1.6 mg/dL and 6.2 mg/dL. While this may partially be due to diet and the factors mentioned above, total understanding of these atypical ranges of serum phosphorus remains uncertain...
October 2016: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28107561/beta-blockers-for-hypertension
#12
REVIEW
Charles S Wiysonge, Hazel A Bradley, Jimmy Volmink, Bongani M Mayosi, Lionel H Opie
BACKGROUND: Beta-blockers refer to a mixed group of drugs with diverse pharmacodynamic and pharmacokinetic properties. They have shown long-term beneficial effects on mortality and cardiovascular disease (CVD) when used in people with heart failure or acute myocardial infarction. Beta-blockers were thought to have similar beneficial effects when used as first-line therapy for hypertension. However, the benefit of beta-blockers as first-line therapy for hypertension without compelling indications is controversial...
January 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28188239/treatment-outcome-in-early-diffuse-cutaneous-systemic-sclerosis-the-european-scleroderma-observational-study-esos
#13
Ariane L Herrick, Xiaoyan Pan, Sébastien Peytrignet, Mark Lunt, Roger Hesselstrand, Luc Mouthon, Alan Silman, Edith Brown, László Czirják, Jörg H W Distler, Oliver Distler, Kim Fligelstone, William J Gregory, Rachel Ochiel, Madelon Vonk, Codrina Ancuţa, Voon H Ong, Dominique Farge, Marie Hudson, Marco Matucci-Cerinic, Alexandra Balbir-Gurman, Øyvind Midtvedt, Alison C Jordan, Paresh Jobanputra, Wendy Stevens, Pia Moinzadeh, Frances C Hall, Christian Agard, Marina E Anderson, Elisabeth Diot, Rajan Madhok, Mohammed Akil, Maya H Buch, Lorinda Chung, Nemanja Damjanov, Harsha Gunawardena, Peter Lanyon, Yasmeen Ahmad, Kuntal Chakravarty, Søren Jacobsen, Alexander J MacGregor, Neil McHugh, Ulf Müller-Ladner, Gabriela Riemekasten, Michael Becker, Janet Roddy, Patricia E Carreira, Anne Laure Fauchais, Eric Hachulla, Jennifer Hamilton, Murat İnanç, John S McLaren, Jacob M van Laar, Sanjay Pathare, Susannah Proudman, Anna Rudin, Joanne Sahhar, Brigitte Coppere, Christine Serratrice, Tom Sheeran, Douglas J Veale, Claire Grange, Georges-Selim Trad, Christopher P Denton
OBJECTIVES: The rarity of early diffuse cutaneous systemic sclerosis (dcSSc) makes randomised controlled trials very difficult. We aimed to use an observational approach to compare effectiveness of currently used treatment approaches. METHODS: This was a prospective, observational cohort study of early dcSSc (within three years of onset of skin thickening). Clinicians selected one of four protocols for each patient: methotrexate, mycophenolate mofetil (MMF), cyclophosphamide or 'no immunosuppressant'...
February 10, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28114143/electrolyte-and-acid-base-disorders-in-chronic-kidney-disease-and-end-stage-kidney-failure
#14
REVIEW
Tsering Dhondup, Qi Qian
The kidneys play a pivotal role in the regulation of electrolyte and acid-base balance. With progressive loss of kidney function, derangements in electrolytes and acid-base inevitably occur and contribute to poor patient outcomes. As chronic kidney disease (CKD) has become a worldwide epidemic, medical providers are increasingly confronted with such problems. Adequate diagnosis and treatment will minimize complications and can potentially be lifesaving. In this review, we discuss the current understanding of the disease process, clinical presentation, diagnosis and treatment strategies, integrating up-to-date knowledge in the field...
2017: Blood Purification
https://www.readbyqxmd.com/read/28288484/pharmacologic-therapy-for-type-2-diabetes-synopsis-of-the-2017-american-diabetes-association-standards-of-medical-care-in-diabetes
#15
James J Chamberlain, William H Herman, Sandra Leal, Andrew S Rhinehart, Jay H Shubrook, Neil Skolnik, Rita Rastogi Kalyani
Description: The American Diabetes Association (ADA) annually updates the Standards of Medical Care in Diabetes to provide clinicians, patients, researchers, payers, and other interested parties with evidence-based recommendations for the diagnosis and management of patients with diabetes. Methods: For the 2017 Standards, the ADA Professional Practice Committee updated previous MEDLINE searches performed from 1 January 2016 to November 2016 to add, clarify, or revise recommendations based on new evidence...
April 18, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28337922/acquired-pulmonary-artery-pseudoaneurysms-a-pictorial-review
#16
Benedicte Guillaume, Anne Vendrell, Xavier Stefanovic, Frederic Thony, Gilbert R Ferretti
Pulmonary artery pseudoaneurysms (PAPs) are uncommon but potentially lethal. They may be incidentally discovered on imaging, or following massive hemoptysis if they rupture, with high risk of mortality. The most frequent causes of PAP are trauma and infectious disease. Vasculitis, in particular Behçet's disease, neoplasm, congenital disease and pulmonary hypertension are rarer causes of PAP. A PAP can be suspected from chest X-Ray and contrast CT, but requires confirmation by CT angiography. Arteriography is no longer performed for diagnostic purposes, but can be useful to prepare endovascular occlusion of the PAP...
March 24, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28338806/influenza-associated-hospitalizations-for-cardiovascular-diseases-in-the-tropics
#17
Li Wei Ang, Jonathan Yap, Vernon Lee, Wei Qiang Chng, Fazlur Rehman Jaufeerally, Carolyn Su Ping Lam, Jeffery Cutter, Khung Keong Yeo, Stefan Ma
Influenza is a major cause of mortality and morbidity. We aimed to examine the influenza-associated hospitalization rates and proportions for cardiovascular disease (CVD) in tropical Singapore. Hospital admissions for ischemic heart disease (IHD), congestive heart failure (CHF), and overall CVD were obtained from the national inpatient database for the period of 2010-2014. We used, as the key indicator of influenza virus activity, the overall proportion of specimens from outpatients with influenza-like illness in the community that tested positive for influenza as part of the national influenza surveillance program...
February 25, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28330545/-treatment-of-chronic-diseases-in-patients-with-dementia
#18
Hanne Pedersen, Kristian Skikkild Klinkby, Frans Borch Waldorff
Comorbidity is common in patients with dementia, and due to the nature of the dementia disease, patients with dementia have special challenges in relation to comorbidity. This article is about dementia and heart failure, chronic obstructive pulmonary disease, urinary incontinence, falls, polypharmacy and chronic pain. Ongoing goal setting is important, and advance care planning is recommended. In general, comorbidity must be carefully and holistic assessed and managed according to each patient's general status of health and stage of dementia...
March 20, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28329380/subclinical-thyroid-dysfunction-and-cardiovascular-diseases-2016-update
#19
Carmen Floriani, Baris Gencer, Tinh-Hai Collet, Nicolas Rodondi
Subclinical thyroid dysfunction comprises subclinical hypothyroidism (SHypo), defined as elevated thyroid-stimulating hormone (TSH) by normal free thyroxine (FT4), and subclinical hyperthyroidism (SHyper) with decreased or undetectable TSH and normal FT4. Up to 10% of the elderly have SHypo, which is usually asymptomatic. Individual participant data (IPD) analyses of prospective cohort studies from the international Thyroid Studies Collaboration show that SHypo is associated with increased coronary heart disease (CHD) mortality [hazard ratio (HR) 1,58 for TSH ≥ 10 mIU/L, 95% CI 1...
February 27, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28306558/monitoring-of-the-physical-exam-in-sepsis
#20
Radu Postelnicu, Laura Evans
PURPOSE OF REVIEW: Monitoring of mental status and peripheral circulatory changes can be accomplished noninvasively in patients in the ICU. Emphasis on physical examination in conditions such as sepsis have gained increased attention as these evaluations can often serve as a surrogate marker for short-term treatment efficacy of therapeutic interventions. Sepsis associated encephalopathy and mental status changes correlate with worse prognosis in patients. Evaluation of peripheral circulation has been shown to be a convenient, easily accessible, and accurate marker for prognosis in patients with septic shock...
March 16, 2017: Current Opinion in Critical Care
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