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https://www.readbyqxmd.com/read/28784609/understanding-cardiac-troponin-part-1-avoiding-troponinitis
#1
REVIEW
Richard Body, Edward Carlton
Cardiac troponin (cTn) is a highly specific biomarker of myocardial injury and is central to the diagnosis of acute myocardial infarction (AMI). By itself, however, cTn cannot identify the cause of myocardial injury. 'Troponinitis' is the condition that leads clinicians to falsely assign a diagnosis of AMI based only on the fact that a patient has an elevated cTn concentration. There are many causes of myocardial injury other than AMI. Clinicians are required to differentiate myocardial injury caused by AMI from other causes...
August 7, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28704915/treatment-of-diabetic-kidney-disease-current-and-future-targets
#2
REVIEW
Mi-Kyung Kim
Diabetic kidney disease (DKD) is a leading cause of end-stage renal disease in Korea and worldwide, and is a risk factor for the development of cardiovascular complications. The conventional treatments for DKD are control of blood glucose and blood pressure levels by inhibiting the renin-angiotensin system. However, the prevalence of DKD continues to increase and additional therapies are required to prevent or ameliorate the condition. Many drugs have been, or are being, developed to target the molecular mechanisms in play in DKD...
July 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28792883/left-middle-lobe-pneumonia
#3
Ling Yuan Kong, Yves Longtin
A 34-year-old man presented to the emergency department with a 5-day history of fever, cough, and dyspnea. He had received a diagnosis of situs inversus when he was 2 years of age, after a chest radiograph had been obtained in order to evaluate a cough. Physical examination was notable for heart..
August 10, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28782884/chronic-lymphocytic-leukemia-2017-update-on-diagnosis-risk-stratification-and-treatment
#4
REVIEW
Michael Hallek
DISEASE OVERVIEW: Chronic lymphocytic leukemia (CLL) is the commonest leukemia in western countries. The disease typically occurs in elderly patients and has a highly variable clinical course. Leukemic transformation is initiated by specific genomic alterations that impair apoptosis of clonal B cells. DIAGNOSIS: The diagnosis is established by blood counts, blood smears, and immunophenotyping of circulating B lymphocytes, which identify a clonal B-cell population carrying the CD5 antigen and B-cell markers...
September 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28723321/subarachnoid-hemorrhage
#5
REVIEW
Michael T Lawton, G Edward Vates
New England Journal of Medicine, Volume 377, Issue 3, Page 257-266, July 2017.
July 20, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28699668/poems-syndrome-2017-update-on-diagnosis-risk-stratification-and-management
#6
REVIEW
Angela Dispenzieri
DISEASE OVERVIEW: POEMS syndrome is a paraneoplastic syndrome due to an underlying plasma cell neoplasm. The major criteria for the syndrome are polyradiculoneuropathy, clonal plasma cell disorder (PCD), sclerotic bone lesions, elevated vascular endothelial growth factor, and the presence of Castleman disease. Minor features include organomegaly, endocrinopathy, characteristic skin changes, papilledema, extravascular volume overload, and thrombocytosis. Diagnoses are often delayed because the syndrome is rare and can be mistaken for other neurologic disorders, most commonly chronic inflammatory demyelinating polyradiculoneuropathy...
August 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28720644/effects-of-non-vitamin-k-antagonist-oral-anticoagulants-versus-warfarin-in-patients-with-atrial-fibrillation-and-valvular-heart-disease-a-systematic-review-and-meta-analysis
#7
REVIEW
Kuo-Li Pan, Daniel E Singer, Bruce Ovbiagele, Yi-Ling Wu, Mohamed A Ahmed, Meng Lee
BACKGROUND: The original non-vitamin K antagonist oral anticoagulant (NOAC) trials in nonvalvular atrial fibrillation (AF) enrolled patients with native valve pathologies. The object of this study was to quantify the benefit-risk profiles of NOACs versus warfarin in AF patients with native valvular heart disease (VHD). METHODS AND RESULTS: Trials were identified by exhaustive literature search. Trial data were combined using inverse variance weighting to produce a meta-analytic summary hazard ratio (HR) and 95% confidence interval (CI) of efficacy and safety of NOACs versus warfarin...
July 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28707967/mechanical-ventilation
#8
(no author information available yet)
No abstract text is available yet for this article.
July 15, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28760445/coeliac-disease
#9
REVIEW
Benjamin Lebwohl, David S Sanders, Peter H R Green
Coeliac disease occurs in about 1% of people in most populations. Diagnosis rates are increasing, and this seems to be due to a true rise in incidence rather than increased awareness and detection. Coeliac disease develops in genetically susceptible individuals who, in response to unknown environmental factors, develop an immune response that is subsequently triggered by the ingestion of gluten. The disease has many clinical manifestations, ranging from severe malabsorption to minimally symptomatic or non-symptomatic presentations...
July 28, 2017: Lancet
https://www.readbyqxmd.com/read/28402245/thyroid-hormone-therapy-for-older-adults-with-subclinical-hypothyroidism
#10
RANDOMIZED CONTROLLED TRIAL
David J Stott, Nicolas Rodondi, Patricia M Kearney, Ian Ford, Rudi G J Westendorp, Simon P Mooijaart, Naveed Sattar, Carole E Aubert, Drahomir Aujesky, Douglas C Bauer, Christine Baumgartner, Manuel R Blum, John P Browne, Stephen Byrne, Tinh-Hai Collet, Olaf M Dekkers, Wendy P J den Elzen, Robert S Du Puy, Graham Ellis, Martin Feller, Carmen Floriani, Kirsty Hendry, Caroline Hurley, J Wouter Jukema, Sharon Kean, Maria Kelly, Danielle Krebs, Peter Langhorne, Gemma McCarthy, Vera McCarthy, Alex McConnachie, Mairi McDade, Martina Messow, Annemarie O'Flynn, David O'Riordan, Rosalinde K E Poortvliet, Terence J Quinn, Audrey Russell, Carol Sinnott, Jan W A Smit, H Anette Van Dorland, Kieran A Walsh, Elaine K Walsh, Torquil Watt, Robbie Wilson, Jacobijn Gussekloo
BACKGROUND: The use of levothyroxine to treat subclinical hypothyroidism is controversial. We aimed to determine whether levothyroxine provided clinical benefits in older persons with this condition. METHODS: We conducted a double-blind, randomized, placebo-controlled, parallel-group trial involving 737 adults who were at least 65 years of age and who had persisting subclinical hypothyroidism (thyrotropin level, 4.60 to 19.99 mIU per liter; free thyroxine level within the reference range)...
June 29, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28747306/how-i-treat-new-agents-in-myeloma
#11
Philippe Moreau
At present, multiple classes of agents with distinct mechanisms of action are available for the treatment of patients with multiple myeloma (MM), including alkylators, steroids, immunomodulatory agents (IMiDs), proteasome inhibitors (PIs), histone deacetylase inhibitors (DACIs) and monoclonal antibodies (mAbs). Over the last 5 years, several new agents, such as the third-generation IMiD pomalidomide, the second generation PIs carfilzomib and ixazomib, the DACI panobinostat and two monoclonal antibodies, elotuzumab and daratumumab, have been approved, incorporated into clinical guidelines and have transformed our approach to the treatment of patients...
July 26, 2017: Blood
https://www.readbyqxmd.com/read/28669352/impact-of-comorbidities-on-gout-and-hyperuricaemia-an-update-on-prevalence-and-treatment-options
#12
REVIEW
Thomas Bardin, Pascal Richette
Gout, the most prevalent inflammatory arthritis worldwide, is associated with cardiovascular and renal diseases, and is an independent predictor of premature death. The frequencies of obesity, chronic kidney disease (CKD), hypertension, type 2 diabetes, dyslipidaemias, cardiac diseases (including coronary heart disease, heart failure and atrial fibrillation), stroke and peripheral arterial disease have been repeatedly shown to be increased in gout. Therefore, the screening and care of these comorbidities as well as of cardiovascular risk factors are of outmost importance in patients with gout...
July 3, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28662310/thrombotic-thrombocytopenic-purpura-pathogenesis-diagnosis-and-potential-novel-therapeutics
#13
REVIEW
M Saha, J K McDaniel, X L Zheng
Thrombotic thrombocytopenic purpura (TTP), a potentially fatal clinical syndrome, is primarily caused by autoantibodies against the von Willebrand factor (VWF)-cleaving metalloprotease ADAMTS-13. In general, severe deficiency of plasma ADAMTS-13 activity (< 10 IU dL(-1) ) with or without detectable inhibitory autoantibodies against ADAMTS-13 supports the diagnosis of TTP. A patient usually presents with thrombocytopenia and microangiopathic hemolytic anemia (i.e. schistocytes, elevated serum lactate dehydrogenase, decreased hemoglobin and haptoglobin) without other known etiologies that cause thrombotic microangiopathy (TMA)...
June 29, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28655976/iron-deficiency-anemia-in-chronic-liver-disease-etiopathogenesis-diagnosis-and-treatment
#14
REVIEW
Eleana Gkamprela, Melanie Deutsch, Dimitrios Pectasides
Chronic liver disease is accompanied by multiple hematological abnormalities. Iron deficiency anemia is a frequent complication of advanced liver disease. The etiology is multifactorial, mostly due to chronic hemorrhage into the gastrointestinal tract. The diagnosis of iron deficiency anemia is very challenging, as simple laboratory methods, including serum iron, ferritin, transferrin saturation (Tsat), and mean corpuscular volume are affected by the liver disease itself or the cause of the disease, resulting in difficulty in the interpretation of the results...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28702076/the-management-of-intra-abdominal-infections-from-a-global-perspective-2017-wses-guidelines-for-management-of-intra-abdominal-infections
#15
REVIEW
Massimo Sartelli, Alain Chichom-Mefire, Francesco M Labricciosa, Timothy Hardcastle, Fikri M Abu-Zidan, Abdulrashid K Adesunkanmi, Luca Ansaloni, Miklosh Bala, Zsolt J Balogh, Marcelo A Beltrán, Offir Ben-Ishay, Walter L Biffl, Arianna Birindelli, Miguel A Cainzos, Gianbattista Catalini, Marco Ceresoli, Asri Che Jusoh, Osvaldo Chiara, Federico Coccolini, Raul Coimbra, Francesco Cortese, Zaza Demetrashvili, Salomone Di Saverio, Jose J Diaz, Valery N Egiev, Paula Ferrada, Gustavo P Fraga, Wagih M Ghnnam, Jae Gil Lee, Carlos A Gomes, Andreas Hecker, Torsten Herzog, Jae Il Kim, Kenji Inaba, Arda Isik, Aleksandar Karamarkovic, Jeffry Kashuk, Vladimir Khokha, Andrew W Kirkpatrick, Yoram Kluger, Kaoru Koike, Victor Y Kong, Ari Leppaniemi, Gustavo M Machain, Ronald V Maier, Sanjay Marwah, Michael E McFarlane, Giulia Montori, Ernest E Moore, Ionut Negoi, Iyiade Olaoye, Abdelkarim H Omari, Carlos A Ordonez, Bruno M Pereira, Gerson A Pereira Júnior, Guntars Pupelis, Tarcisio Reis, Boris Sakakhushev, Norio Sato, Helmut A Segovia Lohse, Vishal G Shelat, Kjetil Søreide, Waldemar Uhl, Jan Ulrych, Harry Van Goor, George C Velmahos, Kuo-Ching Yuan, Imtiaz Wani, Dieter G Weber, Sanoop K Zachariah, Fausto Catena
Intra-abdominal infections (IAIs) are common surgical emergencies and have been reported as major contributors to non-trauma deaths in the emergency departments worldwide. The cornerstones of effective treatment of IAIs are early recognition, adequate source control, and appropriate antimicrobial therapy. Prompt resuscitation of patients with ongoing sepsis is of utmost important. In hospitals worldwide, non-acceptance of, or lack of access to, accessible evidence-based practices and guidelines result in overall poorer outcome of patients suffering IAIs...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28716645/update-in-management-of-severe-hypoxemic-respiratory-failure
#16
REVIEW
Dharani Kumari Narendra, Dean R Hess, Curtis N Sessler, Habtamu M Belete, Kalpalatha K Guntupalli, Felix Khusid, Charles Mark Carpati, Mark Elton Astiz, Suhail Raoof
Mortality related to severe-moderate and severe ARDS remains high. We searched the literature to update this topic. We defined severe hypoxemic respiratory failure as Pao2/Fio2 < 150 mm Hg (ie, severe-moderate and severe ARDS). For these patients, we support setting the ventilator to a tidal volume of 4 to 8 mL/kg predicted body weight (PBW), with plateau pressure (Pplat) ≤ 30 cm H2O, and initial positive end-expiratory pressure (PEEP) of 10 to 12 cm H2O. To promote alveolar recruitment, we propose increasing PEEP in increments of 2 to 3 cm provided that Pplat remains ≤ 30 cm H2O and driving pressure does not increase...
July 14, 2017: Chest
https://www.readbyqxmd.com/read/28665419/acute-lymphoblastic-leukemia-a-comprehensive-review-and-2017-update
#17
REVIEW
T Terwilliger, M Abdul-Hay
Acute lymphoblastic leukemia (ALL) is the second most common acute leukemia in adults, with an incidence of over 6500 cases per year in the United States alone. The hallmark of ALL is chromosomal abnormalities and genetic alterations involved in differentiation and proliferation of lymphoid precursor cells. In adults, 75% of cases develop from precursors of the B-cell lineage, with the remainder of cases consisting of malignant T-cell precursors. Traditionally, risk stratification has been based on clinical factors such age, white blood cell count and response to chemotherapy; however, the identification of recurrent genetic alterations has helped refine individual prognosis and guide management...
June 30, 2017: Blood Cancer Journal
https://www.readbyqxmd.com/read/28701730/the-mll-recombinome-of-acute-leukemias-in-2017
#18
C Meyer, T Burmeister, D Gröger, G Tsaur, L Fechina, S Renneville, R Sutton, N C Venn, M Emerenciano, M S Pombo-de-Oliveira, C Barbieri Blunck, B Almeida Lopes, J Zuna, J Trka, P Ballerini, H Lapillonne, M De Braekeleer, G Cazzaniga, L Corral Abascal, V H J van der Velden, E Delabesse, T S Park, S H Oh, M L M Silva, T Lund-Aho, V Juvonen, A S Moore, O Heidenreich, J Vormoor, E Zerkalenkova, Y Olshanskaya, C Bueno, P Menendez, S Teigler-Schlegel, U Zur Stadt, J Lentes, G Göhring, S Kustanovich, O Aleinikova, B W Schäfer, S Kubetzko, H O Madsen, B Gruhn, X Duarte, P Gameiro, E Lippert, S Bidet, J M Cayuela, E Clappier, C N Alonso, C M Zwaan, M M van den Heuvel-Eibrink, S Izraeli, L Trakhtenbrot, P Archer, J Hancock, A Möricke, J Alten, M Schrappe, M Stanulla, S Strehl, A Attarbaschi, M Dworzak, O A Haas, R Panzer-Grümayer, L Sedék, T Szczepański, S Caye, L Suarez, H Cavé, R Marschalek
Chromosomal rearrangements of the human MLL/KMT2A gene are associated with infant, pediatric, adult and therapy-induced acute leukemias. Here, we present the data obtained from 2345 acute leukemia patients. Genomic breakpoints within the MLL gene and the involved translocation partner genes (TPGs) were determined and 11 novel TPGs were identified. Thus, a total of 135 different MLL rearrangements habe been identified so far, of which 94 TPGs are now characterized at the molecular level. Thirty-five out of these 94 TPGs occur recurrently, but only 9 specific gene fusions account for more than 90% of all illegitimate recombinations of the MLL gene...
July 13, 2017: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
https://www.readbyqxmd.com/read/28699667/mantle-cell-lymphoma-2017-update-on-diagnosis-risk-stratification-and-clinical-management
#19
REVIEW
Julie M Vose
DISEASE OVERVIEW: Mantle cell lymphoma (MCL) is a non-Hodgkin lymphoma characterized by involvement of the lymph nodes, spleen, blood and bone marrow with a short remission duration to standard therapies and a median overall survival (OS) of 4-5 years. DIAGNOSIS: Diagnosis is based on lymph node, bone marrow, or tissue morphology of centrocytic lymphocytes, small cell type, or blastoid variant cells. A chromosomal translocation t (11:14) is the molecular hallmark of MCL, resulting in the overexpression of cyclin D1...
August 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28677333/review-article-new-treatments-in-non-alcoholic-fatty-liver-disease
#20
REVIEW
S A Townsend, P N Newsome
BACKGROUND: Non-alcoholic fatty liver disease is the fastest growing cause of liver disease in the Western world, yet there is no approved pharmacotherapy. While lifestyle modifications remain the mainstay of treatment, only a proportion of individuals are able to make or sustain them, and so more treatment options are required. AIM: To review the potential benefit of drugs used in clinical practice, those entering phase II trials, and compounds being investigated in pre-clinical studies...
July 4, 2017: Alimentary Pharmacology & Therapeutics
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