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Internal medicine

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625 papers 100 to 500 followers
By Elvis Amao Internal Medicine , Cardiology and infectious diseases
https://www.readbyqxmd.com/read/29754804/diabetes-mellitus-and-cardiovascular-risk-update-of-the-recommendations-of-the-diabetes-and-cardiovascular-disease-working-group-of-the-spanish-diabetes-society-sed-2018
#1
Francisco Arrieta, Pedro Iglesias, Juan Pedro-Botet, Antonio Becerra, Emilio Ortega, Juan Carlos Obaya, Andreu Nubiola, Gonzalo Fernando Maldonado, Maria Del Mar Campos, Romina Petrecca, José Luis Pardo, Víctor Sánchez-Margalet, José Juan Alemán, Jorge Navarro, Santiago Duran, Francisco Javier Tébar, Manuel Aguilar, Fernando Escobar
This document is an update to the clinical practice recommendations for the management of cardiovascular risk factors in diabetes mellitus. The consensus is made by members of the Cardiovascular Risk Group of the Spanish Diabetes Society. We have proposed and updated interventions on lifestyle, pharmacological treatment indicated to achieve therapeutic objectives according to the levels of HbA1c, degree of obesity, hypertension, hyperlipidemia, heart failure, platelet antiagregation, renal insufficiency, and diabetes in the elderly, as well as new biomarkers of interest in the evaluation of cardiovascular risk in individuals with diabetes mellitus...
May 10, 2018: Clínica e Investigación en Arteriosclerosis
https://www.readbyqxmd.com/read/29511284/the-importance-of-cohort-studies-in-the-post-gwas-era
#2
REVIEW
Cisca Wijmenga, Alexandra Zhernakova
The past decade has seen enormous success of wide-scale genetic studies in identifying genetic variants that modify individuals' predisposition to common diseases. However, the interpretation and functional understanding of these variants lag far behind. In this Perspective, we discuss opportunities for using large-scale cohort studies to investigate the downstream molecular effects of SNPs at different 'omics' data levels. We point to the pivotal role of population cohorts in establishing causality and advancing drug discovery...
March 2018: Nature Genetics
https://www.readbyqxmd.com/read/29641969/diagnostic-use-of-base-excess-in-acid-base-disorders
#3
REVIEW
Kenrick Berend
New England Journal of Medicine, Volume 378, Issue 15, Page 1419-1428, April 2018.
April 12, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29679597/management-of-dyspnea-in-the-terminally-ill
#4
REVIEW
Lara Pisani, Nicholas S Hill, Angela Maria Grazia Pacilli, Massimiliano Polastri, Stefano Nava
The genesis of dyspnea involves the activation of several mechanisms that are mediated and perceived depending on previous experiences, values, emotions and beliefs. Breathlessness may become unbearable, especially in terminally ill patients, whether afflicted by respiratory, cardiac or cancer-related disorders, due to a final stage of a chronic process, an acute event or both. Compared to pain, palliation of dyspnea has received relatively little attention in clinical practice and the medical literature. This is particularly true when the breathlessness is associated with acute respiratory failure since most of the studies on pharmacological and non-pharmacological treatments of respiratory distress have excluded such patients...
April 18, 2018: Chest
https://www.readbyqxmd.com/read/29628280/easl-clinical-practice-guidelines-management-of-alcohol-related-liver-disease
#5
(no author information available yet)
No abstract text is available yet for this article.
April 5, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29539274/antifungal-combinations-for-treatment-of-cryptococcal-meningitis-in-africa
#6
RANDOMIZED CONTROLLED TRIAL
Síle F Molloy, Cecilia Kanyama, Robert S Heyderman, Angela Loyse, Charles Kouanfack, Duncan Chanda, Sayoki Mfinanga, Elvis Temfack, Shabir Lakhi, Sokoine Lesikari, Adrienne K Chan, Neil Stone, Newton Kalata, Natasha Karunaharan, Kate Gaskell, Mary Peirse, Jayne Ellis, Chimwemwe Chawinga, Sandrine Lontsi, Jean-Gilbert Ndong, Philip Bright, Duncan Lupiya, Tao Chen, John Bradley, Jack Adams, Charles van der Horst, Joep J van Oosterhout, Victor Sini, Yacouba N Mapoure, Peter Mwaba, Tihana Bicanic, David G Lalloo, Duolao Wang, Mina C Hosseinipour, Olivier Lortholary, Shabbar Jaffar, Thomas S Harrison
BACKGROUND: Cryptococcal meningitis accounts for more than 100,000 human immunodeficiency virus (HIV)-related deaths per year. We tested two treatment strategies that could be more sustainable in Africa than the standard of 2 weeks of amphotericin B plus flucytosine and more effective than the widely used fluconazole monotherapy. METHODS: We randomly assigned HIV-infected adults with cryptococcal meningitis to receive an oral regimen (fluconazole [1200 mg per day] plus flucytosine [100 mg per kilogram of body weight per day] for 2 weeks), 1 week of amphotericin B (1 mg per kilogram per day), or 2 weeks of amphotericin B (1 mg per kilogram per day)...
March 15, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29634848/early-readmission-risk-identification-for-hospitalized-older-adults-with-decompensated-heart-failure
#7
Yousef Ayatollahi, Xibei Liu, Ali Namazi, Mohammad Jaradat, Takashi Yamashita, Jay J Shen, Yong-Jae Lee, Soumya Upadhyay, Sun Jung Kim, Ji Won Yoo
The current study evaluated risk factors of early hospital readmission in geriatric patients with acute heart failure (HF) and analyzed 2,279 consecutively hospitalized older adults with decompensated HF from November 2013 to October 2014 across 15 U.S. hospitals. The eTracker-HF was designed to make risk factors known to treating clinicians in electronic health records. Multilevel multivariate logistic regression was applied to examine the association between risk factors and all-cause and HF 30-day readmission rates...
April 9, 2018: Research in Gerontological Nursing
https://www.readbyqxmd.com/read/29452669/optimal-management-of-the-young-patient-cll-patient
#8
REVIEW
John N Allan, Richard R Furman
The emergence of targeted therapy for patients with chronic lymphocytic leukemia (CLL) has permanently altered the therapeutic landscape. In both upfront and relapsed settings, safe and effective oral kinase inhibitors are available which rival the responses and durability seen with standard chemo immunotherapy regimens. In 2016, ibrutinib was granted Federal Drug Administration approval for first-line therapy in patients with CLL. While its role as initial therapy for older, unfit or deleted 17p CLL patients is less controversial, its role as first-line treatment for younger fit patients is less clear, begging the question, what is the optimal treatment for these patients, novel agents or standard CIT strategies? In this review, we aim to provide guidance for what we believe is the optimal management of young fit patients with CLL...
March 2018: Best Practice & Research. Clinical Haematology
https://www.readbyqxmd.com/read/29502236/a-review-of-recent-advances-using-tocilizumab-in-the-treatment-of-rheumatic-diseases
#9
REVIEW
Andrea Rubbert-Roth, Daniel E Furst, Jan Michael Nebesky, Angela Jin, Erhan Berber
Tocilizumab (TCZ) is the first humanized anti-interleukin-6 (IL-6) receptor monoclonal antibody approved for the treatment of patients with rheumatoid arthritis (RA), Castleman's disease, polyarticular and systemic juvenile idiopathic arthritis, and, most recently, giant cell arteritis as well as for the treatment of chimeric antigen receptor T cell therapy-induced cytokine release syndrome. The global clinical development program for TCZ provides a wealth of clinical data on intravenous TCZ, and more recent studies in patients with RA have provided evidence characterizing the role of intravenous TCZ as monotherapy in early disease and led to the introduction of a subcutaneous formulation of TCZ...
June 2018: Rheumatology and Therapy
https://www.readbyqxmd.com/read/29635941/the-prevalence-and-predictors-of-elevated-c-reactive-protein-after-a-coronary-heart-disease-event
#10
John Munkhaugen, Jan Erik Otterstad, Toril Dammen, Erik Gjertsen, Torbjørn Moum, Einar Husebye, Lars Gullestad
Objective An interleukin-beta antagonist reduces the risk of subsequent cardiovascular events in coronary patients with high-sensitivity C-reactive protein (hs-CRP) ≥2 mg/L. It remains to be defined how large the coronary population at inflammatory risk is, and what the predictors of elevated risk are. Methods A cross-sectional study investigated the proportion of patients with elevated hs-CRP (i.e. ≥2 mg/L) and the respective demographic and clinical predictors in 971 patients without concomitant inflammatory diseases who had been hospitalized with myocardial infarction (80%) and/or a revascularization procedure...
January 1, 2018: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/29527974/cardiovascular-safety-of-febuxostat-or-allopurinol-in-patients-with-gout
#11
William B White, Kenneth G Saag, Michael A Becker, Jeffrey S Borer, Philip B Gorelick, Andrew Whelton, Barbara Hunt, Majin Castillo, Lhanoo Gunawardhana
Background Cardiovascular risk is increased in patients with gout. We compared cardiovascular outcomes associated with febuxostat, a nonpurine xanthine oxidase inhibitor, with those associated with allopurinol, a purine base analogue xanthine oxidase inhibitor, in patients with gout and cardiovascular disease. Methods We conducted a multicenter, double-blind, noninferiority trial involving patients with gout and cardiovascular disease; patients were randomly assigned to receive febuxostat or allopurinol and were stratified according to kidney function...
March 12, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29630894/better-with-ultrasound-paracentesis
#12
REVIEW
Scott J Millington, Seth Koenig
Paracentesis is a commonly performed procedure, and generally considered to be low risk. Despite its overall favorable safety profile, use of ultrasound has been demonstrated to reduce the incidence of complications, especially in higher risk patients. Many individual ultrasound techniques have been described in the literature, each with the goal of making paracentesis safer. This article presents a systematic approach for incorporating many of these tools into bedside practice, and includes a series of illustrative figures and narrated video presentations to demonstrate the techniques described...
April 6, 2018: Chest
https://www.readbyqxmd.com/read/29624847/use-of-direct-oral-anticoagulants-in-antiphospholipid-syndrome
#13
REVIEW
Hannah Cohen, Maria Efthymiou, David Isenberg
The direct oral anticoagulants (DOACs) are therapeutic alternatives to warfarin and other vitamin K antagonists (VKAs), and the standard of care for many indications. VKAs are conventional therapy for the treatment and secondary thromboprophylaxis of thrombotic antiphospholipid syndrome (APS), but are often problematic due to the variable sensitivity of thromboplastins to lupus anticoagulant. Thus, the International Normalised Ratio may not accurately reflect anticoagulation intensity, or be clinically effective...
April 6, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29628281/easl-clinical-practice-guidelines-management-of-hepatocellular-carcinoma
#14
(no author information available yet)
No abstract text is available yet for this article.
April 5, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29650297/n-terminal-pro-b-type-natriuretic-peptide-is-inversely-correlated-with-low-density-lipoprotein-cholesterol-in-the-very-elderly
#15
F Spannella, F Giulietti, G Cocci, L Landi, E Borioni, F E Lombardi, G Rosettani, B Bernardi, V Bordoni, P Giordano, M Bordicchia, R Sarzani
BACKGROUND AND AIMS: Laboratory studies on human adipose tissue and differentiated adipocytes indicate that natriuretic peptides (NPs) affect lipid metabolism and plasma cholesterol. Few previous clinical studies in non-elderly populations found associations between NPs in the physiological range and cholesterol. AIM: evaluate the association between NT-proBNP and lipid profile in very elderly hospitalized patients characterized by a wide range of NT-proBNP levels...
June 2018: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
https://www.readbyqxmd.com/read/29603142/optimal-pain-management-for-patients-with-cancer-in-the-modern-era
#16
REVIEW
Bethann M Scarborough, Cardinale B Smith
Pain is a common symptom among patients with cancer. Adequate pain assessment and management are critical to improve the quality of life and health outcomes in this population. In this review, the authors provide a framework for safely and effectively managing cancer-related pain by summarizing the evidence for the importance of controlling pain, the barriers to adequate pain management, strategies to assess and manage cancer-related pain, how to manage pain in patients at risk of substance use disorder, and considerations when managing pain in a survivorship population...
March 30, 2018: CA: a Cancer Journal for Clinicians
https://www.readbyqxmd.com/read/29625968/2018-update-of-the-eular-recommendations-for-the-management-of-beh%C3%A3-et-s-syndrome
#17
Gulen Hatemi, Robin Christensen, Dongsik Bang, Bahram Bodaghi, Aykut Ferhat Celik, Farida Fortune, Julien Gaudric, Ahmet Gul, Ina Kötter, Pietro Leccese, Alfred Mahr, Robert Moots, Yesim Ozguler, Jutta Richter, David Saadoun, Carlo Salvarani, Francesco Scuderi, Petros P Sfikakis, Aksel Siva, Miles Stanford, Ilknur Tugal-Tutkun, Richard West, Sebahattin Yurdakul, Ignazio Olivieri, Hasan Yazici
Several new treatment modalities with different mechanisms of action have been studied in patients with Behçet's syndrome (BS). The aim of the current effort was to update the recommendations in the light of these new data under the auspices of the European League Against Rheumatism (EULAR) Standing Committee for Clinical Affairs. A task force was formed that included BS experts from different specialties including internal medicine, rheumatology, ophthalmology, dermatology, neurology, gastroenterology, oral health medicine and vascular surgery, along with a methodologist, a health professional, two patients and two fellows in charge of the systematic literature search...
June 2018: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/29478868/management-of-heart-failure-in-advancing-ckd-core-curriculum-2018
#18
Andrew A House
Heart failure and chronic kidney disease have increasing incidence and prevalence owing in part to the aging population and increasing rates of hypertension, diabetes, and other cardiovascular and kidney disease risk factors. The presence of one condition also has a strong influence on the other, leading to greater risks for hospitalization, morbidity, and death, as well as very high health care costs. Despite the frequent coexistence of heart failure and chronic kidney disease, many of the pivotal randomized trials that guide the management of heart failure have excluded patients with more advanced stages of chronic kidney disease...
February 23, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29531957/an-algorithmic-approach-for-the-treatment-of-severe-uncontrolled-asthma
#19
REVIEW
Eleftherios Zervas, Konstantinos Samitas, Andriana I Papaioannou, Petros Bakakos, Stelios Loukides, Mina Gaga
A small subgroup of patients with asthma suffers from severe disease that is either partially controlled or uncontrolled despite intensive, guideline-based treatment. These patients have significantly impaired quality of life and although they constitute <5% of all asthma patients, they are responsible for more than half of asthma-related healthcare costs. Here, we review a definition for severe asthma and present all therapeutic options currently available for these severe asthma patients. Moreover, we suggest a specific algorithmic treatment approach for the management of severe, difficult-to-treat asthma based on specific phenotype characteristics and biomarkers...
January 2018: ERJ Open Research
https://www.readbyqxmd.com/read/29548485/incidence-of-venous-thromboembolism-and-use-of-anticoagulation-in-hematological-malignancies-critical-review-of-the-literature
#20
REVIEW
Ombretta Annibali, Mariasanta Napolitano, Giuseppe Avvisati, Sergio Siragusa
Venous Thromboembolism (VTE) frequently complicates the course of hematologic malignancies (HM) and its incidence is similar to that observed in high-risk solid tumors. Despite that, pharmacologic prophylaxis and treatment of VTE in patients with HM is challenging, mainly because a severe thrombocytopenia frequently complicates the course of treatments or may be present since diagnosis, thus increasing the risk of bleeding. Therefore, in this setting, safe and effective methods of VTE prophylaxis and treatment have not been well defined and hematologists generally refer to guidelines produced for cancer patients that give indications on anticoagulation in patients with thrombocytopenia...
April 2018: Critical Reviews in Oncology/hematology
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