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Internal medicine

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461 papers 100 to 500 followers
By Elvis Amao Internal Medicine , Cardiology and infectious diseases
https://www.readbyqxmd.com/read/28606649/accuracy-of-lung-ultrasound-in-patients-with-acute-dyspnea-the-influence-of-age-multimorbidity-and-cognitive-and-motor-impairment
#1
Luca Vizioli, Paola Forti, Elena Bartoli, Marco Giovagnoli, Guerino Recinella, Davide Bernucci, Marco Masetti, Elena Martino, Gian Luca Pirazzoli, Marco Zoli, Giampaolo Bianchi
Discriminating between causes of dyspnea may be difficult, particularly in the elderly. The aim of this retrospective study of 83 inpatients with acute dyspnea was to assess the influence of age, multimorbidity and cognitive or motor impairment on the diagnostic accuracy of lung ultrasound (LUS) in discriminating acute heart failure (AHF) from noncardiogenic dyspnea (NCD). Univariate analysis indicates that LUS misdiagnosis was associated with the following parameters: history of stroke (p = 0.037), lower activity of daily living (p = 0...
June 9, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28556585/a-practical-approach-to-diagnosing-endocrine-hypertension
#2
REVIEW
Jun Yang, Jimmy Shen, Peter J Fuller
Hypertension is a leading cardiovascular risk factor that remains difficult to manage in a large segment of the population. Secondary causes of hypertension, which are amenable to targeted treatment or even cure, may contribute to poor blood pressure control. The most common endocrine cause, primary aldosteronism, requires biochemical screening as there are often no symptoms or signs other than hypertension. Screening tests should be done after adequate preparation to optimise the results and minimise the confounding effects of diet and medications...
May 27, 2017: Nephrology
https://www.readbyqxmd.com/read/27857121/guillain-barr%C3%A3-syndrome-a-century-of-progress
#3
REVIEW
John A Goodfellow, Hugh J Willison
In 1916, Guillain, Barré and Strohl reported on two cases of acute flaccid paralysis with high cerebrospinal fluid protein levels and normal cell counts - novel findings that identified the disease we now know as Guillain-Barré syndrome (GBS). 100 years on, we have made great progress with the clinical and pathological characterization of GBS. Early clinicopathological and animal studies indicated that GBS was an immune-mediated demyelinating disorder, and that severe GBS could result in secondary axonal injury; the current treatments of plasma exchange and intravenous immunoglobulin, which were developed in the 1980s, are based on this premise...
December 2016: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/28573445/cardiac-arrhythmias-in-patients-with-exacerbation-of-copd
#4
Tomasz Rusinowicz, Tadeusz M Zielonka, Katarzyna Zycinska
Supraventricular and ventricular arrhythmias are common among patients with chronic obstructive pulmonary disease (COPD). Multiple factors can contribute to the development of arrhythmias in patients with exacerbation of the disease, including: respiratory or heart failure, hypertension, coronary disease and also medications. In the present study we seek to determine the prevalence of cardiac arrhythmias and risk factors among patients with exacerbation of COPD. The study was a retrospective evaluation of 2753 24-h Holter recordings of patients hospitalized in 2004-2016...
June 2, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28576397/the-contribution-of-clinical-and-pathological-predisposing-factors-to-severe-gastro-duodenal-lesions-in-patients-with-long-term-low-dose-aspirin-and-proton-pump-inhibitor-therapy
#5
Anca Negovan, Mihaela Iancu, Valeriu Moldovan, Kinga Sàrkàny, Simona Bataga, Simona Mocan, Ioan Țilea, Claudia Banescu
BACKGROUND: Preventive strategies developed to avoid the complications of antiplatelet therapies recommend the evaluation of risk factors for gastrointestinal events and indicated gastroprotective strategies. AIM: We aimed to assess the impact of predisposing factors - histological findings, concomitant drug consumption, comorbidities, symptoms, social habits, Helicobacter pylori infection - on severe gastro-duodenal lesions in patients with low-dose aspirin and concomitant protective therapy with proton pump inhibitors (PPI)...
May 30, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28528705/complications-of-proton-pump-inhibitor-therapy
#6
REVIEW
Michael F Vaezi, Yu-Xiao Yang, Colin W Howden
Safety issues associated with proton pump inhibitors (PPIs) have recently attracted widespread media and lay attention. Gastroenterologists are frequently asked about the appropriateness of PPI therapy for specific patients. Furthermore, some patients may have had PPI therapy discontinued abruptly or inappropriately due to safety concerns. Faced with such a wide variety of potentially serious adverse consequences, prescribers need to evaluate the evidence objectively to discern the likelihood that any reported association might actually be causal...
May 19, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28510730/trimethoprim-sulfamethoxazole-versus-vancomycin-in-the-treatment-of-healthcare-ventilator-associated-mrsa-pneumonia-a-case-control-study
#7
Noa Eliakim-Raz, Moran Hellerman, Dafna Yahav, Jonathan Cohen, Ili Margalit, Sharon Fisher, Oren Zusman, Hila Shaked, Jihad Bishara
No abstract text is available yet for this article.
May 16, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28412919/neurological-disorders-in-medical-use-of-cannabis-an-update
#8
Renata Solimini, Maria Concetta Rotolo, Simona Pichini, Roberta Pacifici
Medical cannabis is increasingly used as a treatment or adjunct treatment with different levels of efficacy in several neurological disorders or related symptoms (such as multiple sclerosis, autism, Parkinson and Alzheimer disease, Tourette's syndrome, Huntington's disease, neuropathic pain, epilepsy, headache), as well as in other medical conditions (e.g. nausea and vomiting, glaucoma, appetite stimulation, cancer, inflammatory conditions, asthma). Nevertheless, a number of neurological adverse effects from use of medical cannabis on the short- and on the long- term have been reported, in addition to other adverse health events...
April 13, 2017: CNS & Neurological Disorders Drug Targets
https://www.readbyqxmd.com/read/28513453/chronic-obstructive-pulmonary-disease
#9
REVIEW
Klaus F Rabe, Henrik Watz
Chronic obstructive pulmonary disease (COPD) kills more than 3 million people worldwide every year. Despite progress in the treatment of symptoms and prevention of acute exacerbations, few advances have been made to ameliorate disease progression or affect mortality. A better understanding of the complex disease mechanisms resulting in COPD is needed. Smoking cessation programmes, increasing physical activity, and early detection and treatment of comorbidities are further key components to reduce the burden of the disease...
May 13, 2017: Lancet
https://www.readbyqxmd.com/read/28338486/congenital-cytomegalovirus-infection-management-update
#10
Asma Khalil, Chrissie Jones, Yves Ville
PURPOSE OF REVIEW: Until recently, management options in congenital cytomegalovirus (cCMV) infection have been either conservative or termination of pregnancy. However, medical therapies aimed at reducing the risk of infection and/or its severity have recently been investigated. RECENT FINDINGS: In a phase 2 open label, nonrandomized trial, valaciclovir (ValACV) was given to women carrying a CMV-infected fetus. ValACV was associated with a greater proportion of asymptomatic neonates when compared with a historical cohort (82 vs...
June 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28505028/cytomegalovirus-disease-in-hematopoietic-stem-cell-transplant-patients-current-and-future-therapeutic-options
#11
Shigeo Fuji, Hermann Einsele, Markus Kapp
PURPOSE OF REVIEW: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) has become one of the standard treatment for hematological diseases. Although the clinical outcome has improved significantly during the last decades, the morbidity and mortality after allo-HSCT are still obstacles to cure. Out of major morbidities, opportunistic virus infections such as cytomegalovirus (CMV) infection are important complications, in particular in patients who received human leukocyte antigen-mismatched HSCT...
May 12, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28509673/immune-responses-to-invasive-aspergillosis-new-understanding-and-therapeutic-opportunities
#12
Tobias M Hohl
PURPOSE OF REVIEW: Invasive aspergillosis is a worldwide disease that primarily affects immune-compromised patients, agricultural workers with corneal abrasions, individuals with structural lung disease, and patients with primary immune deficiency. The critical function of the immune system is to prevent the germination of airborne conidia into tissue-invasive hyphae. This review covers recent advances that shape our understanding of anti-Aspergillus immunity at the molecular and cellular level...
May 13, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28511929/clinical-characteristics-of-pertussis-associated-cough-in-adults-and-children-a-diagnostic-systematic-review-and-meta-analysis
#13
Abigail Moore, Helen F Ashdown, Bethany Shinkins, Nia W Roberts, Cameron C Grant, Daniel S Lasserson, Anthony Harnden
BACKGROUND: Pertussis (whooping cough) is a highly infective cause of cough that causes significant morbidity and mortality. Existing case definitions include paroxysmal cough, whooping and post-tussive vomiting but diagnosis can be difficult. We determined the diagnostic accuracy of clinical characteristics of pertussis-associated cough. METHODS: We systematically searched CINAHL, Embase, Medline and SCI-EXPANDED/CPCI-S up to June 2016. Eligible studies compared clinical characteristics in those positive and negative for Bordetella pertussis infection, confirmed by laboratory investigations...
May 13, 2017: Chest
https://www.readbyqxmd.com/read/28512114/associations-of-acid-suppressive-therapy-with-cardiac-mortality-in-heart-failure-patients
#14
Akiomi Yoshihisa, Mai Takiguchi, Yuki Kanno, Akihiko Sato, Tetsuro Yokokawa, Shunsuke Miura, Satoshi Abe, Tomofumi Misaka, Takamasa Sato, Satoshi Suzuki, Masayoshi Oikawa, Atsushi Kobayashi, Takayoshi Yamaki, Hiroyuki Kunii, Kazuhiko Nakazato, Hitoshi Suzuki, Shu-Ichi Saitoh, Yasuchika Takeishi
BACKGROUND: It has been recently reported that histamine H2 receptor antagonists (H2RAs) are associated with impairment of ventricular remodeling and incident heart failure. In addition, favorable pleiotropic effects and adverse effects of proton pump inhibitors (PPIs) on cardiovascular disease have also been reported. We examined the associations of acid suppressive therapy using H2RAs or PPIs with cardiac mortality in patients with heart failure. METHODS AND RESULTS: In total, 1191 consecutive heart failure patients were divided into 3 groups: a non-acid suppressive therapy group (n=363), an H2RA group (n=164), and a PPI group (n=664)...
May 16, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28514322/relationship-between-a-sepsis-intervention-bundle-and-in-hospital-mortality-among-hospitalized-patients-a-retrospective-analysis-of-real-world-data
#15
Priya A Prasad, Erica R Shea, Stephen Shiboski, Mary C Sullivan, Ralph Gonzales, David Shimabukuro
BACKGROUND: Sepsis is a systemic response to infection that can lead to tissue damage, organ failure, and death. Efforts have been made to develop evidence-based intervention bundles to identify and manage sepsis early in the course of the disease to decrease sepsis-related morbidity and mortality. We evaluated the relationship between a minimally invasive sepsis intervention bundle and in-hospital mortality using robust methods for observational data. METHODS: We performed a retrospective cohort study at the University of California, San Francisco, Medical Center among adult patients discharged between January 1, 2012, and December 31, 2014, and who received a diagnosis of severe sepsis/septic shock (SS/SS)...
May 12, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28511923/igg4-aortopathy-an-underappreciated-cause-of-non-infectious-thoracic-aortitis
#16
Victor Aguirre, Catherine Connolly, Robert Stuklis
IgG4 related thoracic aortitis is a recent addition to the differential diagnosis for inflammatory aortic disease - a condition which is often underappreciated until complications arise such as aneurysmal formation or aortic dissection. Currently, IgG4 aortitis remains a post-surgical diagnosis reliant on positive immunohistochemistry findings. Management is guided by the extent of disease involvement, which can be gauged by serum IgG4 levels and radiological findings. Options include surgical resection, corticosteroid therapy and steroid-sparing agents to prevent relapses...
April 19, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28514703/bacterial-infections-and-hepatic-encephalopathy-in-liver-cirrhosis-prophylaxis-and-treatment
#17
REVIEW
Damian Piotrowski, Anna Boroń-Kaczmarska
Infections are common among patients with liver cirrhosis. They occur more often in cirrhotic patient groups than in the general population and result in higher mortality. One reason for this phenomenon is bacterial translocation from the intestinal lumen that occurs as a consequence of intestinal bacterial overgrowth, increased permeability and decreased motility. The most common infections in cirrhotic patients are spontaneous bacterial peritonitis and urinary tract infections, followed by pneumonia, skin and soft tissue infections...
May 14, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28512184/effect-of-intensive-blood-pressure-lowering-on-left-ventricular-hypertrophy-in-patients-with-hypertension-the-systolic-blood-pressure-intervention-sprint-trial
#18
Elsayed Z Soliman, Walter T Ambrosius, William C Cushman, Zhu-Ming Zhang, Jeffrey T Bates, Javier A Neyra, Thaddeus Y Carson, Leonardo Tamariz, Lama Ghazi, Monique E Cho, Brian P Shapiro, Jiang He, Lawrence J Fine, Cora E Lewis
Background -It is currently unknown whether intensive blood pressure (BP) lowering beyond that recommended would lead to more lowering of the risk of Left ventricular hypertrophy (LVH) in patients with hypertension, and whether reducing the risk of LVH explains the reported cardiovascular disease (CVD) benefits of intensive BP lowering in this population. Methods -This analysis included 8,164 participants (mean age 67.9 years, 35.3% women, 31.2% blacks) with hypertension but no diabetes from the Systolic Blood Pressure Intervention (SPRINT) Trial; 4,086 randomly assigned to intensive BP lowering (target systolic BP<120mmHg) and 4,078 assigned to standard BP lowering (target systolic BP <140mmHg)...
May 16, 2017: Circulation
https://www.readbyqxmd.com/read/28514822/-cardiovascular-effects-of-antidiabetic-therapies
#19
Katharina Laubner, Jochen Seufert
Type 2- diabetes mellitus (T2DM) represents a major risk factor for cardiovascular complications and mortality. Strict glucose control in the early course of the disease prevents cardiovascular complications only in the long run. Non-medical therapies (diet, exercise, body weight reduction) bear little evidence for positive cardiovascular effects.Bariatric surgery is not number one choice in therapy of T2DM. Metformin seems to provide positive cardiovascular effects. Insulin seems to be cardiovascular neutral, as well as the DPP4-inhibitors Saxagliptin, Sitagliptin and Alogliptin...
May 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27007094/clinical-practice-guideline-management-of-acute-pancreatitis
#20
REVIEW
Joshua A Greenberg, Jonathan Hsu, Mohammad Bawazeer, John Marshall, Jan O Friedrich, Avery Nathens, Natalie Coburn, Gary R May, Emily Pearsall, Robin S McLeod
There has been an increase in the incidence of acute pancreatitis reported worldwide. Despite improvements in access to care, imaging and interventional techniques, acute pancreatitis continues to be associated with significant morbidity and mortality. Despite the availability of clinical practice guidelines for the management of acute pancreatitis, recent studies auditing the clinical management of the condition have shown important areas of noncompliance with evidence-based recommendations. This underscores the importance of creating understandable and implementable recommendations for the diagnosis and management of acute pancreatitis...
April 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
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