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By Marcela Catalina Fandino Vargas Residente de 3 año de Medicina Interna. Próxima oncogirl
https://www.readbyqxmd.com/read/29126262/relapsing-polychondritis-a-clinical-review-for-rheumatologists
#1
Jack Kingdon, Joseph Roscamp, Shirish Sangle, David D'Cruz
Relapsing polychondritis (RPC) is a rare autoimmune rheumatic disorder that is traditionally classified as a systemic vasculitis. It is characterized by inflammation of cartilage, and typical presenting features include chondritis of the nasal bridge, auricular chondritis, ocular inflammation and involvement of the bronchial tree. Its rarity often leads to considerable delay in establishing a diagnosis and poses a significant management challenge to clinicians, as no conventional guidelines exist. This review summarizes the clinical features of RPC and provides guidance for rheumatologists on making the diagnosis and assessing organ involvement...
November 6, 2017: Rheumatology
https://www.readbyqxmd.com/read/29057628/apraxia-review-and-update
#2
REVIEW
Jung E Park
Praxis, the ability to perform skilled or learned movements is essential for daily living. Inability to perform such praxis movements is defined as apraxia. Apraxia can be further classified into subtypes such as ideomotor, ideational and limb-kinetic apraxia. Relevant brain regions have been found to include the motor, premotor, temporal and parietal cortices. Apraxia is found in a variety of highly prevalent neurological disorders including dementia, stroke and Parkinsonism. Furthermore, apraxia has been shown to negatively affect quality of life...
October 2017: Journal of Clinical Neurology
https://www.readbyqxmd.com/read/29140875/bone-mineral-density-declines-twice-as-quickly-among-hiv-infected-women-compared-to-men
#3
Kristine M Erlandson, Jordan E Lake, Myung Sim, Julian Falutz, Carla M Prado, Ana Rita Domingues da Silva, Todd T Brown, Giovanni Guaraldi
BACKGROUND: Initial declines in bone mineral density (BMD) following antiretroviral therapy (ART) initiation in HIV are well described, but data on long-term changes and risk factors for decline, particularly among women, are limited. METHODS: HIV-infected men and women in the Modena Metabolic Clinic underwent dual-energy X-ray absorptiometry (DXA) scans every 6-12 months for up to 10 years (median 4.6 years). Mixed effect regression model in combined and sex-stratified models determined annual rates of decline and clinical factors associated with BMD...
November 11, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29044676/world-health-organization-defined-eosinophilic-disorders-2017-update-on-diagnosis-risk-stratification-and-management
#4
REVIEW
Jason Gotlib
DISEASE OVERVIEW: The eosinophilias encompass a broad range of nonhematologic (secondary or reactive) and hematologic (primary, clonal) disorders with potential for end-organ damage. DIAGNOSIS: Hypereosinophilia has generally been defined as a peripheral blood eosinophil count greater than 1500/mm(3) and may be associated with tissue damage. After exclusion of secondary causes of eosinophilia, diagnostic evaluation of primary eosinophilias relies on a combination of morphologic review of the blood and marrow, standard cytogenetics, fluorescent in situ-hybridization, flow immunocytometry, and T-cell clonality assessment to detect histopathologic or clonal evidence for an acute or chronic myeloid or lymphoproliferative disorder...
November 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/29103871/olaparib-in-combination-with-paclitaxel-in-patients-with-advanced-gastric-cancer-who-have-progressed-following-first-line-therapy-gold-a-double-blind-randomised-placebo-controlled-phase-3-trial
#5
Yung-Jue Bang, Rui-Hua Xu, Keisho Chin, Keun-Wook Lee, Se Hoon Park, Sun Young Rha, Lin Shen, Shukui Qin, Nong Xu, Seock-Ah Im, Gershon Locker, Phil Rowe, Xiaojin Shi, Darren Hodgson, Yu-Zhen Liu, Narikazu Boku
BACKGROUND: Olaparib combined with paclitaxel has previously shown a significant improvement in overall survival versus placebo plus paclitaxel as second-line therapy in a phase 2 study in Asian patients with advanced gastric cancer, especially in those with ataxia-telangiectasia mutated protein (ATM)-negative tumours. Here, we report the primary efficacy and safety analyses from a subsequent phase 3 trial. METHODS: This double-blind, randomised, placebo-controlled, phase 3 study (GOLD) recruited Asian patients aged 18 years or older (≥20 years if Japanese) with advanced gastric cancer that had progressed following, or during, first-line chemotherapy...
November 2, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/29114010/2017-international-consensus-on-cardiopulmonary-resuscitation-and-emergency-cardiovascular-care-science-with-treatment-recommendations-summary
#6
REVIEW
Theresa M Olasveengen, Allan R de Caen, Mary E Mancini, Ian K Maconochie, Richard Aickin, Dianne L Atkins, Robert A Berg, Robert M Bingham, Steven C Brooks, Maaret Castrén, Sung Phil Chung, Julie Considine, Thomaz Bittencourt Couto, Raffo Escalante, Raúl J Gazmuri, Anne-Marie Guerguerian, Tetsuo Hatanaka, Rudolph W Koster, Peter J Kudenchuk, Eddy Lang, Swee Han Lim, Bo Løfgren, Peter A Meaney, William H Montgomery, Peter T Morley, Laurie J Morrison, Kevin J Nation, Kee-Chong Ng, Vinay M Nadkarni, Chika Nishiyama, Gabrielle Nuthall, Gene Yong-Kwang Ong, Gavin D Perkins, Amelia G Reis, Giuseppe Ristagno, Tetsuyo Sakamoto, Michael R Sayre, Stephen M Schexnayder, Alfredo F Sierra, Eunice M Singletary, Naoki Shimizu, Michael A Smyth, David Stanton, Janice A Tijssen, Andrew Travers, Christian Vaillancourt, Patrick Van de Voorde, Mary Fran Hazinski, Jerry P Nolan
The International Liaison Committee on Resuscitation has initiated a near-continuous review of cardiopulmonary resuscitation science that replaces the previous 5-year cyclic batch-and-queue approach process. This is the first of an annual series of International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations summary articles that will include the cardiopulmonary resuscitation science reviewed by the International Liaison Committee on Resuscitation in the previous year...
November 6, 2017: Circulation
https://www.readbyqxmd.com/read/29091573/the-2017-bethesda-system-for-reporting-thyroid-cytopathology
#7
Edmund S Cibas, Syed Z Ali
The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) established a standardized, category-based reporting system for thyroid fine-needle aspiration (FNA) specimens. The 2017 revision reaffirms that every thyroid FNA report should begin with one of six diagnostic categories, the names of which remain unchanged since they were first introduced: (i) nondiagnostic or unsatisfactory; (ii) benign; (iii) atypia of undetermined significance (AUS) or follicular lesion of undetermined significance (FLUS); (iv) follicular neoplasm or suspicious for a follicular neoplasm; (v) suspicious for malignancy; and (vi) malignant...
November 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/29137910/tamponade-hemodynamic-and-echocardiographic-diagnosis
#8
REVIEW
Mark J Kearns, Keith R Walley
Cardiac tamponade is a medical emergency that can be readily reversed with timely recognition and appropriate intervention. The clinical diagnosis of cardiac tamponade requires synthesis of a constellation of otherwise non-specific features, based on an understanding of the underlying pathophysiology. Whereas echocardiographic examination is a central component of diagnosis, alone it is insufficient to establish the physiologic diagnosis of hemodynamically significant cardiac tamponade. The hemodynamic diagnosis of cardiac tamponade requires clinical evidence of low cardiac output and stroke volume in the setting of elevated cardiac filling pressures, with evidence of increased sympathetic tone (tachycardia, peripheral vasoconstriction, etc), and exclusion of other causes of shock as the primary problem (particularly cardiogenic shock)...
November 11, 2017: Chest
https://www.readbyqxmd.com/read/29106061/2017-european-league-against-rheumatism-american-college-of-rheumatology-classification-criteria-for-adult-and-juvenile-idiopathic-inflammatory-myopathies-and-their-major-subgroups
#9
Ingrid E Lundberg, Anna Tjärnlund, Matteo Bottai, Victoria P Werth, Clarissa Pilkington, Marianne de Visser, Lars Alfredsson, Anthony A Amato, Richard J Barohn, Matthew H Liang, Jasvinder A Singh, Rohit Aggarwal, Snjolaug Arnardottir, Hector Chinoy, Robert G Cooper, Katalin Dankó, Mazen M Dimachkie, Brian M Feldman, Ignacio Garcia-De La Torre, Patrick Gordon, Taichi Hayashi, James D Katz, Hitoshi Kohsaka, Peter A Lachenbruch, Bianca A Lang, Yuhui Li, Chester V Oddis, Marzena Olesinska, Ann M Reed, Lidia Rutkowska-Sak, Helga Sanner, Albert Selva-O'Callaghan, Yeong-Wook Song, Jiri Vencovsky, Steven R Ytterberg, Frederick W Miller, Lisa G Rider
OBJECTIVE: To develop and validate new classification criteria for adult and juvenile idiopathic inflammatory myopathies (IIM) and their major subgroups. METHODS: Candidate variables were assembled from published criteria and expert opinion using consensus methodology. Data were collected from 47 rheumatology, dermatology, neurology, and pediatric clinics worldwide. Several statistical methods were utilized to derive the classification criteria. RESULTS: Based on data from 976 IIM patients (74% adults; 26% children) and 624 non-IIM patients with mimicking conditions (82% adults; 18% children), new criteria were derived...
October 27, 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/29102957/stepwise-dose-increase-of-febuxostat-is-comparable-with-colchicine-prophylaxis-for-the-prevention-of-gout-flares-during-the-initial-phase-of-urate-lowering-therapy-results-from-fortune-1-a-prospective-multicentre-randomised-study
#10
Hisashi Yamanaka, Shigenori Tamaki, Yumiko Ide, Hyeteko Kim, Kouichi Inoue, Masayuki Sugimoto, Yuji Hidaka, Atsuo Taniguchi, Shin Fujimori, Tetsuya Yamamoto
OBJECTIVES: To determine whether febuxostat with stepwise dose increase is as useful as colchicine prophylaxis in reducing gout flares during the initial introduction of urate-lowering therapy in patients with gout in comparison with febuxostat with no dose titration. METHODS: In this prospective, multicentre, randomised open-label comparative study, patients were randomised to group A (stepwise dose increase of febuxostat from 10 to 40 mg/day), group B (fixed-dose febuxostat 40 mg/day plus colchicine 0...
November 4, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/29122851/guidelines-on-the-management-of-abnormal-liver-blood-tests
#11
Philip N Newsome, Rob Cramb, Suzanne M Davison, John F Dillon, Mark Foulerton, Edmund M Godfrey, Richard Hall, Ulrike Harrower, Mark Hudson, Andrew Langford, Anne Mackie, Robert Mitchell-Thain, Karen Sennett, Nicholas C Sheron, Julia Verne, Martine Walmsley, Andrew Yeoman
These updated guidelines on the management of abnormal liver blood tests have been commissioned by the Clinical Services and Standards Committee (CSSC) of the British Society of Gastroenterology (BSG) under the auspices of the liver section of the BSG. The original guidelines, which this document supersedes, were written in 2000 and have undergone extensive revision by members of the Guidelines Development Group (GDG). The GDG comprises representatives from patient/carer groups (British Liver Trust, Liver4life, PBC Foundation and PSC Support), elected members of the BSG liver section (including representatives from Scotland and Wales), British Association for the Study of the Liver (BASL), Specialist Advisory Committee in Clinical Biochemistry/Royal College of Pathology and Association for Clinical Biochemistry, British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN), Public Health England (implementation and screening), Royal College of General Practice, British Society of Gastrointestinal and Abdominal Radiologists (BSGAR) and Society of Acute Medicine...
November 9, 2017: Gut
https://www.readbyqxmd.com/read/29110361/hairy-cell-leukemia-2018-update-on-diagnosis-risk-stratification-and-treatment
#12
Xavier Troussard, Edouard Cornet
DISEASE OVERVIEW: Hairy cell leukemia (HCL) and HCL-like disorders, including HCL variant (HCL-V) and splenic diffuse red pulp lymphoma (SDRPL), are a very heterogeneous group of mature lymphoid B-cell disorders, characterized by the identification of hairy cells, a specific genetic profile, a different clinical course and the need for appropriate treatment. DIAGNOSIS: Diagnosis of HCL is based on morphological evidence of hairy cells, an HCL immunologic score of 3 or 4 based on the CD11C, CD103, CD123, and CD25 expression, the trephine biopsy which makes it possible to specify the degree of tumoral medullary infiltration and the presence of BRAF V600E somatic mutation...
December 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/29097436/copd-algorithms-and-clinical-management
#13
EDITORIAL
Rosa Faner, Alvar Agustí
No abstract text is available yet for this article.
November 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29042085/advances-in-the-management-of-her2-positive-early-breast-cancer
#14
REVIEW
José Baselga, Robert E Coleman, Javier Cortés, Wolfgang Janni
While trastuzumab is firmly established as the cornerstone of therapy for both early and advanced breast cancer expressing human epidermal growth factor receptor 2 (HER2), many patients either do not respond to trastuzumab treatment or progress following therapy. Improved understanding of breast cancer biology, particularly the complex signaling interactions managed by the HER family of receptors, have resulted in development of several novel HER2-directed therapies and combinations. This article will review the novel approaches to HER2 targeting that have been developed in recent years, with particular focus on results from these approaches in early breast cancer, and will discuss strategies to improve the tolerability of HER2-directed therapies, including prevention of cardiac toxicity and diarrhea...
November 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/29029296/the-british-society-for-rheumatology-guideline-for-the-management-of-systemic-lupus-erythematosus-in-adults-executive-summary
#15
Caroline Gordon, Maame-Boatemaa Amissah-Arthur, Mary Gayed, Sue Brown, Ian N Bruce, David D'Cruz, Benjamin Empson, Bridget Griffiths, David Jayne, Munther Khamashta, Liz Lightstone, Peter Norton, Yvonne Norton, Karen Schreiber, David Isenberg
No abstract text is available yet for this article.
October 6, 2017: Rheumatology
https://www.readbyqxmd.com/read/29059119/early-management-of-acute-cerebrovascular-accident
#16
Jody Manners, Alexis Steinberg, Lori Shutter
PURPOSE OF REVIEW: Stroke is common and often presents as a neurologic emergency that requires rapid evaluation and treatment to minimize debilitation. Recent advances in therapy expanded time windows for intra-arterial thrombectomy in ischemic stroke, and surgical interventions for clot evacuation in large intracranial hemorrhage have recently proven feasible. This review discusses recent data regarding new therapeutic options in both ischemic and hemorrhagic stroke, notably in scenarios in which therapy was previously limited to supportive care...
December 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29020354/the-definition-of-the-brugada-syndrome
#17
Juan Sieira, Pedro Brugada
Brugada syndrome (BS) is an inherited disease characterized by a coved-type ST-segment elevation in the right precordial leads and increased risk of sudden cardiac death (SCD), in the absence of structural abnormalities. The cornerstone of BS diagnosis and definition, is its characteristic ECG pattern that can be present spontaneously or unmasked by drugs. Brugada syndrome was first described 25 years ago; paradoxically, in an era of great technological development, a new syndrome was described with a technology developed almost a century before...
October 21, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28930526/inflammatory-biomarkers-of-coronary-heart-disease
#18
Hongyu Li, Kai Sun, Ruiping Zhao, Jiang Hu, Zhiru Hao, Fei Wang, Yaojun Lu, Fu Liu, Yong Zhang
Coronary heart disease (CHD) is one of the leading causes of death worldwide. CHD is characterized by formation of arterial plaques which are mainly comprised of lipids, calcium and inflammatory cells. These plaques narrow the lumen of coronary arteries leading to episodic or persistent angina. Rupture of these plaques leads to the formation of thrombus, which as a result of cessation of blood flow, causes myocardial infarct and death. CHD is exacerbated by risk factors including obesity, diabetes mellitus, and hypertension...
January 1, 2018: Frontiers in Bioscience (Scholar Edition)
https://www.readbyqxmd.com/read/28423296/eltrombopag-added-to-standard-immunosuppression-for-aplastic-anemia
#19
Danielle M Townsley, Phillip Scheinberg, Thomas Winkler, Ronan Desmond, Bogdan Dumitriu, Olga Rios, Barbara Weinstein, Janet Valdez, Jennifer Lotter, Xingmin Feng, Marie Desierto, Harshraj Leuva, Margaret Bevans, Colin Wu, Andre Larochelle, Katherine R Calvo, Cynthia E Dunbar, Neal S Young
BACKGROUND: Acquired aplastic anemia results from immune-mediated destruction of bone marrow. Immunosuppressive therapies are effective, but reduced numbers of residual stem cells may limit their efficacy. In patients with aplastic anemia that was refractory to immunosuppression, eltrombopag, a synthetic thrombopoietin-receptor agonist, led to clinically significant increases in blood counts in almost half the patients. We combined standard immunosuppressive therapy with eltrombopag in previously untreated patients with severe aplastic anemia...
April 20, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29043071/recent-advances-in-the-management-of-peptic-ulcer-bleeding
#20
REVIEW
Ian Beales
Acute upper gastrointestinal haemorrhage due to peptic ulcer bleeding remains an important cause of emergency presentation and hospital admission. Despite advances in many aspects of management, peptic ulcer bleeding is still associated with significant morbidity, mortality, and healthcare costs. Comprehensive international guidelines have been published, but advances as well as controversies continue to evolve. Important recent advances include the evidence supporting a more restrictive transfusion strategy aiming for a target haemoglobin of 70-90 g/l...
2017: F1000Research
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