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https://www.readbyqxmd.com/read/27548766/efficacy-of-folic-acid-therapy-on-the-progression-of-chronic-kidney-disease-the-renal-substudy-of-the-china-stroke-primary-prevention-trial
#1
Xin Xu, Xianhui Qin, Youbao Li, Danhua Sun, Jun Wang, Min Liang, Binyan Wang, Yong Huo, Fan Fan Hou
Importance: The efficacy of folic acid therapy on renal outcomes has not been previously investigated in populations without folic acid fortification. Objective: To test whether treatment with enalapril and folic acid is more effective in slowing renal function decline than enalapril alone across a spectrum of renal function at baseline from normal to moderate chronic kidney disease (CKD) among Chinese adults with hypertension. Design, Setting, and Participants: In this substudy of eligible China Stroke Primary Prevention Trial (CSPPT), 15 104 participants with an estimated glomerular filtration rate (eGFR) 30 mL/min/1...
October 1, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27521393/dual-antiplatelet-therapy-for-secondary-stroke-prevention-use-of-clopidogrel-and-acetylsalicylic-acid-after-noncardioembolic-ischemic-stroke
#2
Karolina Koziol, Vanessa Van der Merwe, Erin Yakiwchuk, Lynette Kosar
No abstract text is available yet for this article.
August 2016: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/27457774/policies-for-replacing-long-term-indwelling-urinary-catheters-in-adults
#3
REVIEW
Fergus P M Cooper, Cameron Edwin Alexander, Sanjay Sinha, Muhammad Imran Omar
BACKGROUND: Long-term indwelling catheters are used commonly in people with lower urinary tract problems in home, hospital and specialised health-care settings. There are many potential complications and adverse effects associated with long-term catheter use. The effect of health-care policies related to the replacement of long-term urinary catheters on patient outcomes is unclear. OBJECTIVES: To determine the effectiveness of different policies for replacing long-term indwelling urinary catheters in adults...
July 26, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27076965/corticosteroids-in-the-adjunctive-therapy-of-community-acquired-pneumonia-an-appraisal-of-recent-meta-analyses-of-clinical-trials
#4
REVIEW
Charles Feldman, Ronald Anderson
Improving the outcome of patients with community-acquired pneumonia (CAP) is an ongoing challenge, even in the setting of significant advances in antimicrobial chemotherapy and critical care. Recognition of the underlying involvement of inflammation-mediated organ dysfunction as a determinant of adverse outcomes in CAP has aroused intense interest in the protective potential of adjunctive anti-inflammatory therapies in CAP, particularly the role of corticosteroids (CS). This is the primary topic of the current review which is focused on an evaluation of the latest meta-analyses encompassing both recent and earlier clinical trials, with particular emphasis on the stringent meta-analysis undertaken by Siemieniuk and colleagues (Ann Intern Med 2015;163:519-528)...
March 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27040132/cholesterol-lowering-in-intermediate-risk-persons-without-cardiovascular-disease
#5
RANDOMIZED CONTROLLED TRIAL
Salim Yusuf, Jackie Bosch, Gilles Dagenais, Jun Zhu, Denis Xavier, Lisheng Liu, Prem Pais, Patricio López-Jaramillo, Lawrence A Leiter, Antonio Dans, Alvaro Avezum, Leopoldo S Piegas, Alexander Parkhomenko, Katalin Keltai, Matyas Keltai, Karen Sliwa, Ron J G Peters, Claes Held, Irina Chazova, Khalid Yusoff, Basil S Lewis, Petr Jansky, Kamlesh Khunti, William D Toff, Christopher M Reid, John Varigos, Gregorio Sanchez-Vallejo, Robert McKelvie, Janice Pogue, Hyejung Jung, Peggy Gao, Rafael Diaz, Eva Lonn
BACKGROUND: Previous trials have shown that the use of statins to lower cholesterol reduces the risk of cardiovascular events among persons without cardiovascular disease. Those trials have involved persons with elevated lipid levels or inflammatory markers and involved mainly white persons. It is unclear whether the benefits of statins can be extended to an intermediate-risk, ethnically diverse population without cardiovascular disease. METHODS: In one comparison from a 2-by-2 factorial trial, we randomly assigned 12,705 participants in 21 countries who did not have cardiovascular disease and were at intermediate risk to receive rosuvastatin at a dose of 10 mg per day or placebo...
May 26, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27007111/diagnostic-workup-for-ards-patients
#6
REVIEW
Laurent Papazian, Carolyn S Calfee, Davide Chiumello, Charles-Edouard Luyt, Nuala J Meyer, Hiroshi Sekiguchi, Michael A Matthay, Gianfranco Umberto Meduri
Acute respiratory distress syndrome (ARDS) is defined by the association of bilateral infiltrates and hypoxaemia following an initial insult. Although a new definition has been recently proposed (Berlin definition), there are various forms of ARDS with potential differences regarding their management (ventilator settings, prone positioning use, corticosteroids). ARDS can be caused by various aetiologies, and the adequate treatment of the responsible cause is crucial to improve the outcome. It is of paramount importance to characterize the mechanisms causing lung injury to optimize both the aetiological treatment and the symptomatic treatment...
May 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/26872323/noninvasive-ventilation-for-neuromuscular-respiratory-failure-when-to-use-and-when-to-avoid
#7
Alejandro A Rabinstein
PURPOSE OF REVIEW: Neuromuscular respiratory failure can occur from a variety of diseases, both acute and chronic with acute exacerbation. There is often a misunderstanding about how the nature of the neuromuscular disease should affect the decision on how to ventilate the patient. This review provides an update on the value and relative contraindications for the use of noninvasive ventilation in patients with various causes of primary neuromuscular respiratory failure. RECENT FINDINGS: Myasthenic crisis represents the paradigmatic example of the neuromuscular condition that can be best treated with noninvasive ventilation...
April 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/26507493/a-rational-approach-to-fluid-therapy-in-sepsis
#8
REVIEW
P Marik, R Bellomo
Aggressive fluid resuscitation to achieve a central venous pressure (CVP) greater than 8 mm Hg has been promoted as the standard of care, in the management of patients with severe sepsis and septic shock. However recent clinical trials have demonstrated that this approach does not improve the outcome of patients with severe sepsis and septic shock. Pathophysiologically, sepsis is characterized by vasoplegia with loss of arterial tone, venodilation with sequestration of blood in the unstressed blood compartment and changes in ventricular function with reduced compliance and reduced preload responsiveness...
March 2016: British Journal of Anaesthesia
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