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By Marcela Catalina Fandino Vargas Residente de 3 año de Medicina Interna. Próxima oncogirl
https://www.readbyqxmd.com/read/29653941/guidelines-for-the-investigation-of-chronic-diarrhoea-in-adults-british-society-of-gastroenterology-3rd-edition
#1
Ramesh P Arasaradnam, Steven Brown, Alastair Forbes, Mark R Fox, Pali Hungin, Lawrence Kelman, Giles Major, Michelle O'Connor, Dave S Sanders, Rakesh Sinha, Stephen Charles Smith, Paul Thomas, Julian R F Walters
Chronic diarrhoea is a common problem, hence clear guidance on investigations is required. This is an updated guideline from 2003 for the investigations of chronic diarrhoea commissioned by the Clinical Services and Standards Committee of the British Society of Gastroenterology (BSG). This document has undergone significant revision in content through input by 13 members of the Guideline Development Group (GDG) representing various institutions. The GRADE system was used to appraise the quality of evidence and grading of recommendations...
April 13, 2018: Gut
https://www.readbyqxmd.com/read/29628280/easl-clinical-practice-guidelines-management-of-alcohol-related-liver-disease
#2
(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/29622670/pharmacology-behind-common-drug-nephrotoxicities
#3
Mark A Perazella
Patients are exposed to numerous prescribed and over-the-counter medications. Unfortunately, drugs remain a relatively common cause of acute and chronic kidney injury. A combination of factors including the innate nephrotoxicity of drugs, underlying patient characteristics that increase their risk for kidney injury, and the metabolism and pathway of excretion by the kidneys of the various agents administered enhance risk for drug-induced nephrotoxicity. This paper will review these clinically relevant aspects of drug-induced nephrotoxicity for the clinical nephrologist...
April 5, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29625968/2018-update-of-the-eular-recommendations-for-the-management-of-beh%C3%A3-et-s-syndrome
#4
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/29146534/systematic-review-for-the-2017-acc-aha-aapa-abc-acpm-ags-apha-ash-aspc-nma-pcna-guideline-for-the-prevention-detection-evaluation-and-management-of-high-blood-pressure-in-adults-a-report-of-the-american-college-of-cardiology-american-heart-association-task
#5
David M Reboussin, Norrina B Allen, Michael E Griswold, Eliseo Guallar, Yuling Hong, Daniel T Lackland, Edgar Pete R Miller, Tamar Polonsky, Angela M Thompson-Paul, Suma Vupputuri
OBJECTIVE: To review the literature systematically and perform meta-analyses to address these questions: 1) Is there evidence that self-measured blood pressure (BP) without other augmentation is superior to office-based measurement of BP for achieving better BP control or for preventing adverse clinical outcomes that are related to elevated BP? 2) What is the optimal target for BP lowering during antihypertensive therapy in adults? 3) In adults with hypertension, how do various antihypertensive drug classes differ in their benefits and harms compared with each other as first-line therapy? METHODS: Electronic literature searches were performed by Doctor Evidence, a global medical evidence software and services company, across PubMed and EMBASE from 1966 to 2015 using key words and relevant subject headings for randomized controlled trials that met eligibility criteria defined for each question...
May 15, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29438523/reconsidering-cap-treatment-are-macrolides-beta-lactams-essential
#6
Harold Horowitz
No abstract text is available yet for this article.
February 9, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29447109/sepsis-2018-definitions-and-guideline-changes
#7
Lena M Napolitano
BACKGROUND: Sepsis is a global healthcare issue and continues to be the leading cause of death from infection. Early recognition and diagnosis of sepsis is required to prevent the transition into septic shock, which is associated with a mortality rate of 40% or more. DISCUSSION: New definitions for sepsis and septic shock (Third International Consensus Definitions for Sepsis and Septic Shock [Sepsis-3]) have been developed. A new screening tool for sepsis (quick Sequential Organ Failure Assessment [qSOFA]) has been proposed to predict the likelihood of poor outcome in out-of-intensive care unit (ICU) patients with clinical suspicion of sepsis...
February 2018: Surgical Infections
https://www.readbyqxmd.com/read/27182688/haemostatic-balance-in-cirrhosis
#8
Héla Baccouche, Asma Labidi, Monia Fekih, Sonia Mahjoub, Houda Kaabi, Slama Hmida, Azza Filali, Neila B Romdhane
Despite the prolongation of coagulation tests, recent studies reported an increased frequency of thromboembolic events in patients with cirrhosis. The aim of this study was to evaluate the haemostatic balance in cirrhotic patients through assessing the variation of pro- and anticoagulant factors and evaluating the in-vitro thrombin generation in patients with cirrhosis and in healthy patients. Fifty-one cirrhotic patients with or without thromboembolic events and 50 controls matched by age and sex were enrolled...
March 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28416506/clinical-updates-in-adult-immune-thrombocytopenia
#9
REVIEW
Michele P Lambert, Terry B Gernsheimer
Immune thrombocytopenia (ITP) occurs in 2 to 4/100 000 adults and results in variable bleeding symptoms and thrombocytopenia. In the last decade, changes in our understanding of the pathophysiology of the disorder have led to the publication of new guidelines for the diagnosis and management of ITP and standards for terminology. Current evidence supports alternatives to splenectomy for second-line management of patients with persistently low platelet counts and bleeding. Long-term follow-up data suggest both efficacy and safety, in particular, for the thrombopoietin receptor agonists and the occurrence of late remissions...
May 25, 2017: Blood
https://www.readbyqxmd.com/read/28784423/diagnosis-and-management-of-the-antiphospholipid-syndrome
#10
REVIEW
Shruti Chaturvedi, Keith R McCrae
Antiphospholipid syndrome (APS) is characterized by thrombosis and/or pregnancy complications in the presence of persistent antiphospholipid antibodies (APLA). Laboratory diagnosis of APLA depends upon the detection of a lupus anticoagulant, which prolongs phospholipid-dependent anticoagulation tests, and/or anticardiolipin (aCL) and anti-β2-glycoprotein-1 (β2GPI) antibodies. APLA are primarily directed toward phospholipid binding proteins. Pathophysiologic mechanisms underlying thrombosis and pregnancy loss in APS include APLA induced cellular activation, inhibition of natural anticoagulant and fibrinolytic systems, and complement activation, among others...
November 2017: Blood Reviews
https://www.readbyqxmd.com/read/29512199/chronic-neutrophilic-leukemia-2018-update-on-diagnosis-molecular-genetics-and-management
#11
Michelle A Elliott, Ayalew Tefferi
DISEASE OVERVIEW AND DIAGNOSIS: Chronic neutrophilic leukemia (CNL) is a potentially aggressive myeloproliferative neoplasm, for which current WHO diagnostic criteria include leukocytosis of ≥ 25 x 109 /L of which ≥ 80% are neutrophils, with < 10% circulating neutrophil precursors with blasts rarely observed. In addition, there is no dysplasia, nor clinical or molecular criteria for other myeloproliferative neoplasms. UPDATE ON DIAGNOSIS: Previously the diagnosis of CNL was often as one of exclusion based on no identifiable cause for physiologic neutrophilia in patients fulfilling the aforementioned criteria...
August 2018: American Journal of Hematology
https://www.readbyqxmd.com/read/28321258/the-evolution-of-prognostic-factors-in-multiple-myeloma
#12
REVIEW
Amr Hanbali, Mona Hassanein, Walid Rasheed, Mahmoud Aljurf, Fahad Alsharif
Multiple myeloma (MM) is a heterogeneous hematologic malignancy involving the proliferation of plasma cells derived by different genetic events contributing to the development, progression, and prognosis of this disease. Despite improvement in treatment strategies of MM over the last decade, the disease remains incurable. All efforts are currently focused on understanding the prognostic markers of the disease hoping to incorporate the new therapeutic modalities to convert the disease into curable one. We present this comprehensive review to summarize the current standard prognostic markers used in MM along with novel techniques that are still in development and highlight their implications in current clinical practice...
2017: Advances in Hematology
https://www.readbyqxmd.com/read/29461260/hemolysis-and-immune-regulation
#13
Hui Zhong, Karina Yazdanbakhsh
PURPOSE OF REVIEW: Hemolytic anemias caused by premature destruction of red blood cells occur in many disorders including hemoglobinopathies, autoimmune conditions, during infection or following reaction to drugs or transfusions. Recent studies which will be reviewed here have uncovered several novel mechanisms by which hemolysis can alter immunological functions and increase the risk of severe complications in hemolytic disorders. RECENT FINDINGS: Plasma-free heme can induce the formation of neutrophil extracellular traps (NETs) through reactive oxygen species signaling...
May 2018: Current Opinion in Hematology
https://www.readbyqxmd.com/read/29574922/transitioning-patients-with-immune-thrombocytopenia-to-second-line-therapy-challenges-and-best-practices
#14
REVIEW
Adam Cuker
In patients with immune thrombocytopenia who do not adequately respond to first-line therapy, there is no clear consensus on which second-line therapy to initiate and when. This situation leads to suboptimal approaches, including prolonged exposure to treatments that are not intended for long-term use (e.g. corticosteroids) and overuse of off-label therapies (e.g. rituximab) while approved, more efficacious options exist. These approaches may not only fail to address symptoms and burden of disease, but may also worsen health-related quality of life...
March 25, 2018: American Journal of Hematology
https://www.readbyqxmd.com/read/28605525/infectious-diseases-team-for-the-early-management-of-severe-sepsis-and-septic-shock-in-the-emergency-department
#15
Pierluigi Viale, Sara Tedeschi, Luigia Scudeller, Luciano Attard, Lorenzo Badia, Michele Bartoletti, Alessandra Cascavilla, Francesco Cristini, Nicola Dentale, Giovanni Fasulo, Giorgio Legnani, Filippo Trapani, Fabio Tumietto, Gabriella Verucchi, Giulio Virgili, Andrea Berlingeri, Simone Ambretti, Chiara De Molo, Mara Brizi, Mario Cavazza, Maddalena Giannella
Background: The impact on patient survival of an infectious disease (ID) team dedicated to the early management of severe sepsis/septic shock (SS/SS) in Emergency Department (ED) has yet to be assessed. Methods: A quasiexperimental pre-post study was performed at the general ED of our hospital. During the pre phase (June 2013-July 2014), all consecutive adult patients with SS/SS were managed according to the standard of care, data were prospectively collected. During the post phase (August 2014-October 2015), patients were managed in collaboration with a dedicated ID team performing a bedside patient evaluation within 1 hour of ED arrival...
October 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28598790/croi-2017-advances-in-antiretroviral-therapy
#16
Joyce Jones, Barbara S Taylor, Hong-Van Tieu, Timothy J Wilkin
The 2017 Conference on Retroviruses and Opportunistic Infections (CROI) featured exciting preclinical data on investigational antiretroviral agents with good in vitro efficacy and long half-lives. Investigational medications, including bictegravir, demonstrated excellent efficacy and tolerability, as did dual-agent therapy with dolutegravir paired with rilpivirine or with lamivudine. Dolutegravir monotherapy proved inadvisable due to virologic failure and resistance. The gap between high- and low-income settings along the HIV care continuum is narrowing, with Zimbabwe, Malawi, and Zambia approaching the 90-90-90 targets established by the joint United Nations Programme on HIV/AIDS (UNAIDS), whereas communities in the Southern United States are falling behind...
May 2017: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/29562331/the-2018-european-heart-rhythm-association-practical-guide-on-the-use-of-non-vitamin-k-antagonist-oral-anticoagulants-in-patients-with-atrial-fibrillation-executive-summary
#17
Jan Steffel, Peter Verhamme, Tatjana S Potpara, Pierre Albaladejo, Matthias Antz, Lien Desteghe, Karl Georg Haeusler, Jonas Oldgren, Holger Reinecke, Vanessa Roldan-Schilling, Nigel Rowell, Peter Sinnaeve, Ronan Collins, A John Camm, Hein Heidbüchel
The current manuscript is the Executive Summary of the second update to the original Practical Guide, published in 2013. Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in patients with atrial fibrillation (AF), and have emerged as the preferred choice, particularly in patients newly started on anticoagulation. Both physicians and patients are becoming more accustomed to the use of these drugs in clinical practice. However, many unresolved questions on how to optimally use these agents in specific clinical situations remain...
March 19, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29617787/diagnosis-and-treatment-of-neurocysticercosis-2017-clinical-practice-guidelines-by-the-infectious-diseases-society-of-america-idsa-and-the-american-society-of-tropical-medicine-and-hygiene-astmh
#18
A Clinton White, Christina M Coyle, Vedantam Rajshekhar, Gagandeep Singh, W Allen Hauser, Aaron Mohanty, Hector H Garcia, Theodore E Nash
No abstract text is available yet for this article.
April 3, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29589205/hyperchloraemia-in-sepsis
#19
REVIEW
Christos Filis, Ioannis Vasileiadis, Antonia Koutsoukou
Chloride represents-quantitatively-the most prevalent, negatively charged, strong plasma electrolyte. Control of chloride concentration is a probable major mechanism for regulating the body's acid-base balance and for maintaining homeostasis of the entire internal environment. The difference between the concentrations of chloride and sodium constitutes the major contributor to the strong ion difference (SID); SID is the key pH regulator in the body, according to the physicochemical approach. Hyperchloraemia resulting from either underlying diseases or medical interventions is common in intensive care units...
March 27, 2018: Annals of Intensive Care
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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