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Internal medicine

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244 papers 25 to 100 followers
By Elvis Amao Internal Medicine , Cardiology and infectious diseases
https://www.readbyqxmd.com/read/27896784/ocular-involvement-associated-with-varicella-in-adults
#1
Salma Gargouri, Sana Khochtali, Sourour Zina, Molka Khairallah, Imen Zone-Abid, Imen Kaibi, Salim Ben Yahia, Jamel Feki, Moncef Khairallah
BACKGROUND: Varicella is a common infectious disease primarily of childhood that is usually benign and self-limited. It is, however, increasingly seen in adults who are at a higher risk of severe infection. Ocular complications of varicella are relatively uncommon and have been rarely described in adults. We describe herein five adults who developed ocular involvement in association with primary varicella-zoster virus infection. FINDINGS: Ocular manifestations included acute anterior uveitis in four eyes, with associated stromal keratitis in one of them, epithelial ulcerative keratitis in the two eyes of one patient, and acute retinal necrosis in one eye...
December 2016: Journal of Ophthalmic Inflammation and Infection
https://www.readbyqxmd.com/read/27898714/comparable-effectiveness-of-first-week-treatment-with-anti-staphylococcal-penicillin-versus-cephalosporin-in-methicillin-sensitive-staphylococcus-aureus-bacteremia-a-propensity-score-adjusted-retrospective-study
#2
Erik Forsblom, Eeva Ruotsalainen, Asko Järvinen
: The objective was to compare the prognostic impact of first week treatment with anti-staphylococcal penicillin (ASP) versus cephalosporin in methicillin-sensitive Staphylococcus aureus bacteremia (MS-SAB). Altogether 580 patients were retrospectively followed and categorized according to first week treatment; 84% (488) received ASP (cloxacillin) and 16% (92) cephalosporin (cefuroxime or ceftriaxone). SAB management was optimized with formal bedside infectious disease specialist consultation in 88%, deep infection foci diagnosed in 77% and adjunctive rifampicin therapy given to 61% of patients...
2016: PloS One
https://www.readbyqxmd.com/read/27900225/internal-jugular-vein-thrombosis-in-isolated-tuberculous-cervical-lymphadenopathy
#3
Sanjay Khaladkar, Avadhesh Chauhan, Arijit Ghosh, Kunaal Jain, Surbhi Chauhan
Tuberculosis is a common infectious disease with a high prevalence in developing countries and presents a major public health issue. Internal jugular vein (IJV) thrombosis is a rare complication in tuberculous cervical lymphadenopathy. We report a case of 26-year male patient with a history of low-grade evening rise in fever, dry cough, loss of appetite, and loss of weight with swelling in lower neck on right side. Ultrasonography (USG) neck showed well-defined hypoechoic lymph nodes posterior to right IJV and common carotid artery in the lower neck at level IV and in the right supraclavicular region showing central necrotic areas with adjoining IJV thrombosis...
2016: Case Reports in Radiology
https://www.readbyqxmd.com/read/27900062/pyoderma-gangrenosum-with-spleen-involvement-review-of-the-literature-and-case-report
#4
Rodica Cosgarea, Simona Corina Senilă, Radu Badea, Loredana Ungureanu
BACKGROUND: Pyoderma gangrenosum is a rare, ulcerative, destructive, non-infectious dermatologic disease and it is one clinical entity within the spectrum of neutrophilic dermatoses. Visceral involvement, manifesting as sterile neutrophilic infiltrates in sites other than skin and, is infrequent. Splenic involvement is very rare. MAIN OBSERVATIONS: We present a case of a 58-year-old woman with pyoderma gangrenosum with spleen involvement and review all reports of similar cases...
November 13, 2016: Journal of Dermatological Case Reports
https://www.readbyqxmd.com/read/27913489/platelets-in-infectious-disease
#5
Elizabeth Middleton, Matthew T Rondina
Sepsis is a dynamic, acute, infectious disease syndrome characterized by dysregulated thrombo-inflammatory responses. The high mortality associated with sepsis has been recognized since the earliest clinicians' writings. Despite this, advances in the treatment of sepsis have been more modest. This is limited, in part, by the heterogeneity in the definition, population, presentation, and causal factors of infectious syndromes. Given the persistently high morbidity and mortality associated with sepsis, a better understanding of the dysregulated cellular biology underpinning sepsis is needed...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27798498/hiv-associated-neurocognitive-disorder
#6
David B Clifford
PURPOSE OF REVIEW: HIV-associated neurocognitive disease is the most active topic for neuroAIDS investigations at present. Although impairment is mild in patients successfully treated with modern antiviral regimens, it remains an ongoing problem for HIV patients. It is important to update the emerging research concerning HIV-associated neurocognitive disease. RECENT FINDINGS: The virus enters the brain during acute infection, with evidence for abnormal functioning that may occur early and often persists...
October 27, 2016: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/26600449/maternal-sepsis-and-septic-shock
#7
REVIEW
Ahmad Chebbo, Susanna Tan, Christelle Kassis, Leslie Tamura, Richard W Carlson
The year 2015 marked the 200th anniversary of the birth of Ignaz Semmelweis, the Hungarian physician who identified unhygienic practices of physicians as a major cause of childbed fever or puerperal sepsis. Although such practices have largely disappeared as a factor in the development of chorioamnionitis and postpartum or puerperal endometritis, it is appropriate that this article on sepsis in pregnancy acknowledges his contributions to maternal health. This review describes the incidence and mortality of sepsis in pregnancy, methods to identify and define sepsis in this population, including scoring systems, causes, and sites of infection during pregnancy and parturition and management guidelines...
January 2016: Critical Care Clinics
https://www.readbyqxmd.com/read/27339680/infections-in-liver-disease
#8
REVIEW
Rahul S Nanchal, Shahryar Ahmad
Infectious complications are common occurrences in end-stage liver disease (ESLD). Frequent infections precipitate decompensation of liver disease leading to acute or chronic liver failure, organ dysfunction, de-listing from transplant, and major morbidity and mortality. The spectrum of microorganisms has shifted with the emergence of multidrug-resistant strains, which has major implications for both therapy and prophylaxis. Cirrhosis is often associated with an underlying noninfectious systemic inflammatory state that makes diagnosis of infections particularly challenging...
July 2016: Critical Care Clinics
https://www.readbyqxmd.com/read/27894491/coagulopathy-of-trauma
#9
REVIEW
Mitchell J Cohen, S Ariane Christie
Coagulopathy is common after injury and develops independently from iatrogenic, hypothermic, and dilutional causes. Despite considerable research on the topic over the past decade, trauma-induced coagulopathy (TIC) continues to portend poor outcomes, including decreased survival. We review the current evidence regarding the diagnosis and mechanisms underlying trauma induced coagulopathy and summarize the debates regarding optimal management strategy including product resuscitation, potential pharmacologic adjuncts, and targeted approaches to hemostasis...
January 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/27836915/cardiac-diagnostic-work-up-of-ischaemic-stroke
#10
REVIEW
Hayang Yang, Martina Nassif, Paul Khairy, Joris R de Groot, Yvo B W E M Roos, Robbert J de Winter, Barbara J M Mulder, Berto J Bouma
Cardioembolic sources account for 20-30% of ischaemic strokes and are important to identify considering their prognostic and therapeutic implications. During the past years, new developments have been made in the cardiac diagnostic evaluation and management of patients with ischaemic stroke, especially regarding strokes of unknown aetiology. These recent advances have had a major impact on our understanding of embolic strokes, their diagnostic work-up, and clinical management. Herein, we propose a cardiac diagnostic work-up scheme for patients with ischaemic stroke from definite cardioembolic sources and embolic strokes of undetermined source...
November 10, 2016: European Heart Journal
https://www.readbyqxmd.com/read/27818331/liberation-from-mechanical-ventilation-an-official-american-college-of-chest-physicians-american-thoracic-society-clinical-practice-guideline-inspiratory-pressure-augmentation-during-spontaneous-breathing-trials-protocols-minimizing-sedation-and-non-invasive
#11
Daniel R Ouellette, Sheena Patel, Timothy D Girard, Peter E Morris, Gregory A Schmidt, Jonathon D Truwit, Waleed Al-Hazzani, Suzanne M Burns, Scott K Epstein, Andres Esteban, Eddy Fan, Miguel Ferrer, Gilles L Fraser, Michelle Gong, Catherine L Hough, Sangeeta Mehta, Rahul Nanchal, Amy J Pawlik, William Schweickert, Curtis N Sessler, Thomas Strøm, John P Kress
BACKGROUND: An update of evidence-based guidelines concerning liberation from mechanical ventilation is needed as new evidence has become available. The American College of Chest Physicians (CHEST) and the American Thoracic Society (ATS) have collaborated to provide recommendations to clinicians concerning ventilator liberation. METHODS: Comprehensive evidence syntheses, including meta-analyses, were performed to summarize all available evidence relevant to the guideline panel's questions...
November 3, 2016: Chest
https://www.readbyqxmd.com/read/27818332/accuracy-of-lung-ultrasound-in-the-diagnosis-of-pneumonia-in-adults-systematic-review-and-meta-analysis
#12
Ana M Llamas-Álvarez, Eva M Tenza-Lozano, Jaime Latour-Pérez
BACKGROUND: Some studies suggest that lung ultrasound could be useful for diagnosing pneumonia; moreover, it has a more favorable safety profile and lower cost than chest X-ray (CXR) and computed tomography (CT). The aim of this study is to assess the accuracy of bedside lung ultrasound for diagnosing pneumonia in adults through a systematic review and meta-analysis. METHODS: We searched MEDLINE, Scopus, The Cochrane Library, Web of Science, DARE, HTA Database, Google Scholar, LILACS, ClinicalTrials...
November 3, 2016: Chest
https://www.readbyqxmd.com/read/27865877/cough-in-the-athlete-chest-guideline-and-expert-panel-report
#13
Louis-Philippe Boulet, Julie Turmel, Richard S Irwin
BACKGROUND: Cough is a common symptom experienced by athletes, particularly after exercise. We performed a systematic review to assess in this population: 1) the main etiologies of acute and recurrent cough, either exercise-induced or not; 2) how it is assessed; and 3) how cough is treated in this population. From the systematic review, suggestions for management were developed. METHOD: ology: This review was done according to the CHEST methodological guidelines and GRADE framework up to April 2015...
November 16, 2016: Chest
https://www.readbyqxmd.com/read/27865876/interstitial-lung-disease-in-the-elderly
#14
Karen C Patterson, Rupal J Shah, Mary K Porteous, Jason D Christie, Carly D'Errico, Matthew Chadwick, Matthew Triano, Charuhas Deshpande, Milton D Rossman, Leslie A Litzky, Maryl E Kreider, Wallace T Miller
BACKGROUND: Despite the relationship of idiopathic pulmonary fibrosis (IPF) with advancing age, little is known about the epidemiology of interstitial lung diseases (ILD) in the elderly. Here we describe the diagnoses, clinical characteristics, and outcomes of patients who were elderly at the time of ILD diagnosis. METHODS: Among subjects from a prospective cohort study of ILD, elderly was defined as age > 70. Diagnoses were derived from a multi-disciplinary review...
November 16, 2016: Chest
https://www.readbyqxmd.com/read/27876590/clinical-prognosis-of-non-massive-central-and-non-central-pulmonary-embolism-a-registry-based-cohort-study
#15
Bobby Gouin, Marc Blondon, David Jiménez, Carmen Fernández-Capitán, Henri Bounameaux, Silvia Soler, Rita Duce, Joan Carles Sahuquillo, Nuria Ruiz-Giménez, Manuel Monreal
BACKGROUND: Whether the localization of non-massive pulmonary embolism (PE) is associated with the short and long-term prognosis of patients remains unknown. Our aim is to characterize associations of non-massive PE localization with risks of recurrent venous thromboembolism (VTE), major bleeding and mortality during and after anticoagulation. METHODS: Among participants of the RIETE registry with an incident symptomatic non-massive PE diagnosed by computerized tomography (CT), we compared risks of recurrent VTE, major bleeding and mortality during and after anticoagulation period between central PE (main pulmonary artery) and non-central PE (more peripheral arteries), using Cox proportional hazard adjusted models...
November 19, 2016: Chest
https://www.readbyqxmd.com/read/27876592/sirs-qsofa-and-organ-dysfunction-insights-from-a-prospective-database-of-emergency-department-patients-with-infection
#16
Julian M Williams, Jaimi H Greenslade, Juliet V McKenzie, Kevin Chu, Anthony Ft Brown, Jeffrey Lipman
OBJECTIVE: A proposed revision of sepsis definitions has abandoned SIRS, defined organ dysfunction as an increase in total SOFA score of ≥2, and conceived "qSOFA" as a bedside indicator of organ dysfunction. We aimed to (1) determine the prognostic impact of SIRS, (2) compare diagnostic accuracy of SIRS and qSOFA for organ dysfunction, and (3) compare standard (Sepsis-2) and revised (Sepsis-3) definitions for organ dysfunction in emergency department patients with infection. METHODS: Consecutive ED patients admitted with presumed infection were prospectively enrolled over three years...
November 19, 2016: Chest
https://www.readbyqxmd.com/read/27800178/the-prevalence-of-s-aureus-skin-and-soft-tissue-infections-in-patients-with-pemphigus
#17
Zeinab Fagheei Aghmiyuni, Ahmad Khorshidi, Rezvan Moniri, Tahereh Soori, Seyed Gholam Abbas Musavi
Pemphigus vulgaris are autoimmune blistering diseases that may result in significant morbidity and death. Immunosuppressive therapy of pemphigus vulgaris would predispose the patients to infections. The aim of this study was to assess the prevalence of S. aureus infection and PVL gene in patients with pemphigus admitted to dermatology clinic. Materials and Methods. This descriptive study was conducted on 196 pemphigus vulgaris patients (119 males, 77 females) admitted to dermatology clinic between 2014 and 2015...
2016: Autoimmune Diseases
https://www.readbyqxmd.com/read/27902530/cardiac-troponin-release-is-associated-with-biomarkers-of-inflammation-and-ventricular-dilatation-during-critical-illness
#18
Marlies Ostermann, Salma Ayis, Emma Tuddenham, Jessica Lo, Katie Lei, John Smith, Barnaby Sanderson, Carl Moran, Paul Collinson, Janet Peacock, Andrew Rhodes, David Treacher
INTRODUCTION: Troponin release is common during critical illness. We hypothesized that there was an association between cardiac troponin T (cTnT) and biomarkers of systemic inflammation and ventricular dilatation. METHODS: In an observational prospective cohort study, we enrolled consecutive adult patients admitted for non-cardiac reasons to the Intensive Care Unit (ICU) in 2 tertiary care centers. We measured cTnT, C-reactive protein (CRP), Interleukin-6 (IL-6), procalcitonin (PCT) and N-terminal pro brain natriuretic peptide (NT-proBNP) daily in the first week, and on alternate days in the second week...
November 29, 2016: Shock
https://www.readbyqxmd.com/read/27887762/extracardiac-signs-of-fluid-overload-in-the-critically-ill-cardiac-patient-a-focused-evaluation-using-bedside-ultrasound
#19
REVIEW
William Beaubien-Souligny, Josée Bouchard, Georges Desjardins, Yoan Lamarche, Mark Liszkowski, Pierre Robillard, André Denault
Fluid balance management is of great importance in the critically ill cardiac patient. Although intravenous fluids are a cornerstone therapy in the management of unstable patients, excessive administration coupled with cardiac dysfunction leads to elevation in central venous pressure and end-organ venous congestion. Fluid overload is known to have a detrimental effect on organ function and is responsible for significant morbidity in critically ill patients. Multisystem bedside point of care ultrasound imaging can be used to assess signs of fluid overload and venous congestion in critically ill patients...
August 24, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27892891/atorvastatin-for-high-risk-statin-na%C3%A3-ve-patients-undergoing-noncardiac-surgery-the-lowering-the-risk-of-operative-complications-using-atorvastatin-loading-dose-load-randomized-trial
#20
Otavio Berwanger, Pedro G M de Barros E Silva, Roberto Ramos Barbosa, Dalton Bertolim Precoma, Estêvão Lanna Figueiredo, Ludhmila Abrahão Hajjar, Cleber Dario Pinto Kruel, Carolina Alboim, Adail Paixão Almeida, Marianna Deway Andrade Dracoulakis, Hugo Vargas Filho, Maria José Carvalho Carmona, Lília Nigro Maia, João Bosco de Oliveira Filho, Jose Francisco Kerr Saraiva, Rafael M Soares, Lucas Damiani, Denise Paisani, Alessandra A Kodama, Beatriz Gonzales, Dimas T Ikeoka, Philip J Devereaux, Renato D Lopes
: Preliminary evidence suggests that statins may prevent major perioperative vascular complications. METHODS: We randomized 648 statin-naïve patients who were scheduled for noncardiac surgery and were at risk for a major vascular complication. Patients were randomized to a loading dose of atorvastatin or placebo (80 mg anytime within 18hours before surgery), followed by a maintenance dose of 40 mg (or placebo), started at least 12hours after the surgery, and then 40 mg/d (or placebo) for 7days...
November 9, 2016: American Heart Journal
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