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Internal Medicine

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63 papers 25 to 100 followers
https://www.readbyqxmd.com/read/27825384/inhibiting-the-proton-pump-mechanisms-benefits-harms-and-questions
#1
Jeffrey K Aronson
Inhibition of the H(+)/K(+)-adenosine triphosphatase (the proton pump) is the final common mechanistic pathway in reducing gastric acid secretion pharmacologically. Proton pump inhibitors are widely used in upper gastrointestinal diseases, including gastric and duodenal ulcers, eradication of Helicobacter pylori in combination with antibiotics, gastroesophageal reflux disease, Zollinger-Ellison syndrome, eosinophilic esophagitis, and prevention of non-steroidal anti-inflammatory drug-induced peptic ulceration...
November 9, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27884254/troponin-testing-for-clinicians
#2
REVIEW
John E Brush, Sanjay Kaul, Harlan M Krumholz
The analytical performance of troponin assays has improved markedly in the last 2 decades. The variety of assays, their evolution over time, and their critical importance in influencing care, mandates the need for skills in their use. There are 3 critical elements necessary for optimal use of troponin testing in clinical care, as follows: 1) the analytical performance of the assay; 2) the clinical sensitivity and specificity of the test result; and 3) the clinical reasoning for ordering and the proper clinical context for interpreting the test result...
November 29, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27729952/cirrhosis-and-autoimmune-liver-disease-current-understanding
#3
Rodrigo Liberal, Charlotte R Grant
Primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC) and autoimmune hepatitis (AIH) constitute the classic autoimmune liver diseases (AILDs). While AIH target the hepatocytes, in PBC and PSC the targets of the autoimmune attack are the biliary epithelial cells. Persistent liver injury, associated with chronic AILD, leads to un-resolving inflammation, cell proliferation and the deposition of extracellular matrix proteins by hepatic stellate cells and portal myofibroblasts. Liver cirrhosis, and the resultant loss of normal liver function, inevitably ensues...
October 8, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27881565/low-dose-aspirin-for-primary-prevention-of-cardiovascular-events-in-patients-with-type-2-diabetes-10-year-follow-up-of-a-randomized-controlled-trial
#4
Yoshihiko Saito, Sadanori Okada, Hisao Ogawa, Hirofumi Soejima, Mio Sakuma, Masafumi Nakayama, Naofumi Doi, Hideaki Jinnouchi, Masako Waki, Izuru Masuda, Takeshi Morimoto
BACKGROUND: -The long-term efficacy and safety of low-dose aspirin for primary prevention of cardiovascular events in patients with type 2 diabetes are still inconclusive. METHODS: -The Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes (JPAD) trial was a randomized, open-label, standard-care controlled trial examining whether low-dose aspirin affected cardiovascular events in 2539 Japanese patients with type 2 diabetes and without pre-existing cardiovascular disease...
November 15, 2016: Circulation
https://www.readbyqxmd.com/read/27825511/severe-respiratory-failure
#5
REVIEW
Rupert Williams, Gavin Salt, Tom Jackson, Leianora Mazur, Natalia Briceno, Brian Clapp, Simon Redwood, Nick Barrett, Ronak Rajani, Amedeo Chiribiri
No abstract text is available yet for this article.
November 5, 2016: Lancet
https://www.readbyqxmd.com/read/27889190/diagnosis-of-multiple-sclerosis-progress-and-challenges
#6
REVIEW
Wallace J Brownlee, Todd A Hardy, Franz Fazekas, David H Miller
The diagnosis of multiple sclerosis is based on neurological symptoms and signs, alongside evidence of dissemination of CNS lesions in space and time. MRI is often sufficient to confirm the diagnosis when characteristic lesions accompany a typical clinical syndrome, but in some patients, further supportive information is obtained from cerebrospinal fluid examination and neurophysiological testing. Differentiation is important from other diseases in which demyelination is a feature (eg, neuromyelitis optica spectrum disorder and acute disseminated encephalomyelitis) and from non-demyelinating disorders such as chronic small vessel disease and other inflammatory, granulomatous, infective, metabolic, and genetic causes that can mimic multiple sclerosis...
November 23, 2016: Lancet
https://www.readbyqxmd.com/read/27838723/statin-use-for-the-primary-prevention-of-cardiovascular-disease-in-adults-us-preventive-services-task-force-recommendation-statement
#7
Kirsten Bibbins-Domingo, David C Grossman, Susan J Curry, Karina W Davidson, John W Epling, Francisco A R García, Matthew W Gillman, Alex R Kemper, Alex H Krist, Ann E Kurth, C Seth Landefeld, Michael L LeFevre, Carol M Mangione, William R Phillips, Douglas K Owens, Maureen G Phipps, Michael P Pignone
Importance: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the United States, accounting for 1 of every 3 deaths among adults. Objective: To update the 2008 US Preventive Services Task Force (USPSTF) recommendation on screening for lipid disorders in adults. Evidence Review: The USPSTF reviewed the evidence on the benefits and harms of screening for and treatment of dyslipidemia in adults 21 years and older; the benefits and harms of statin use in reducing CVD events and mortality in adults without a history of CVD events; whether the benefits of statin use vary by subgroup, clinical characteristics, or dosage; and the benefits of various treatment strategies in adults 40 years and older without a history of CVD events...
November 15, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27908918/alpha-blockers-for-treatment-of-ureteric-stones-systematic-review-and-meta-analysis
#8
John M Hollingsworth, Benjamin K Canales, Mary A M Rogers, Shyam Sukumar, Phyllis Yan, Gretchen M Kuntz, Philipp Dahm
OBJECTIVE:  To investigate the efficacy and safety of alpha blockers in the treatment of patients with ureteric stones. DESIGN:  Systematic review and meta-analysis. DATA SOURCES:  Cochrane Central Register of Controlled Trials, Web of Science, Embase, LILACS, and Medline databases and scientific meeting abstracts to July 2016. REVIEW METHODS:  Randomized controlled trials of alpha blockers compared with placebo or control for treatment of ureteric stones were eligible...
December 1, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27864004/beta-adrenergic-blockade-and-decompensated-cirrhosis
#9
REVIEW
Thomas Reiberger, Mattias Mandorfer
Non-selective betablockers (NSBBs) remain the cornerstone of medical treatment of portal hypertension. The evidence for their efficacy to prevent variceal bleeding is derived from prospective trials, which largely excluded patients with refractory ascites and renal failure. In parallel to the increasing knowledge on portal hypertension-induced changes in systemic hemodynamics, cardiac function, and renal perfusion, emerging studies have raised concerns about harmful effects of NSBBs. Clinicians are facing an ongoing controversy on the use of NSBBs in patients with advanced cirrhosis...
November 15, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27887750/chronic-kidney-disease
#10
REVIEW
Angela C Webster, Evi V Nagler, Rachael L Morton, Philip Masson
The definition and classification of chronic kidney disease (CKD) have evolved over time, but current international guidelines define this condition as decreased kidney function shown by glomerular filtration rate (GFR) of less than 60 mL/min per 1·73 m(2), or markers of kidney damage, or both, of at least 3 months duration, regardless of the underlying cause. Diabetes and hypertension are the main causes of CKD in all high-income and middle-income countries, and also in many low-income countries. Incidence, prevalence, and progression of CKD also vary within countries by ethnicity and social determinants of health, possibly through epigenetic influence...
November 22, 2016: Lancet
https://www.readbyqxmd.com/read/27815588/the-new-sepsis-consensus-definitions-the-good-the-bad-and-the-ugly
#11
EDITORIAL
Charles L Sprung, Roland M H Schein, Robert A Balk
No abstract text is available yet for this article.
December 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27865536/breast-cancer
#12
REVIEW
Nadia Harbeck, Michael Gnant
Breast cancer is one of the three most common cancers worldwide. Early breast cancer is considered potentially curable. Therapy has progressed substantially over the past years with a reduction in therapy intensity, both for locoregional and systemic therapy; avoiding overtreatment but also undertreatment has become a major focus. Therapy concepts follow a curative intent and need to be decided in a multidisciplinary setting, taking molecular subtype and locoregional tumour load into account. Primary conventional surgery is not the optimal choice for all patients any more...
November 16, 2016: Lancet
https://www.readbyqxmd.com/read/27664247/management-of-febrile-neutropaenia-esmo-clinical-practice-guidelines
#13
J Klastersky, J de Naurois, K Rolston, B Rapoport, G Maschmeyer, M Aapro, J Herrstedt
No abstract text is available yet for this article.
September 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/27787564/effect-of-cranberry-capsules-on-bacteriuria-plus-pyuria-among-older-women-in-nursing-homes-a-randomized-clinical-trial
#14
Manisha Juthani-Mehta, Peter H Van Ness, Luann Bianco, Andrea Rink, Sabina Rubeck, Sandra Ginter, Stephanie Argraves, Peter Charpentier, Denise Acampora, Mark Trentalange, Vincent Quagliarello, Peter Peduzzi
Importance: Bacteriuria plus pyuria is highly prevalent among older women living in nursing homes. Cranberry capsules are an understudied, nonantimicrobial prevention strategy used in this population. Objective: To test the effect of 2 oral cranberry capsules once a day on presence of bacteriuria plus pyuria among women residing in nursing homes. Design, Setting, and Participants: Double-blind, randomized, placebo-controlled efficacy trial with stratification by nursing home and involving 185 English-speaking women aged 65 years or older, with or without bacteriuria plus pyuria at baseline, residing in 21 nursing homes located within 50 miles (80 km) of New Haven, Connecticut (August 24, 2012-October 26, 2015)...
November 8, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27802475/giant-cell-arteritis
#15
Gary S Hoffman
This issue provides a clinical overview of giant cell arteritis, focusing on diagnosis, treatment, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers...
November 1, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27741995/diagnosis-and-treatment-of-central-nervous-system-infections-in-the-emergency-department
#16
REVIEW
Maia Dorsett, Stephen Y Liang
Central nervous system (CNS) infections, including meningitis, encephalitis, and brain abscess, are rare but time-sensitive emergency department (ED) diagnoses. Patients with CNS infection can present to the ED with nonspecific signs and symptoms, including headache, fever, altered mental status, and behavioral changes. Neuroimaging and CSF fluid analysis can appear benign early in the course of disease. Delaying therapy negatively impacts outcomes, particularly with bacterial meningitis and herpes simplex virus encephalitis...
November 2016: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27749314/early-liberal-fluid-therapy-for-sepsis-patients-is-not-harmful-hydrophobia-is-unwarranted-but-drink-responsibly
#17
Anja K Jaehne, Emanuel P Rivers
No abstract text is available yet for this article.
October 4, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27733536/aortic-dissection-medical-interventional-and-surgical-management
#18
Miriam Silaschi, Jonathan Byrne, Olaf Wendler
No abstract text is available yet for this article.
October 12, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27770514/what-is-shared-decision-making-and-what-it-is-not
#19
Marleen Kunneman, Victor M Montori, Ana Castaneda-Guarderas, Erik P Hess
No abstract text is available yet for this article.
October 21, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27378464/development-of-the-canadian-syncope-risk-score-to-predict-serious-adverse-events-after-emergency-department-assessment-of-syncope
#20
Venkatesh Thiruganasambandamoorthy, Kenneth Kwong, George A Wells, Marco L A Sivilotti, Muhammad Mukarram, Brian H Rowe, Eddy Lang, Jeffrey J Perry, Robert Sheldon, Ian G Stiell, Monica Taljaard
BACKGROUND: Syncope can be caused by serious conditions not evident during initial evaluation, which can lead to serious adverse events, including death, after disposition from the emergency department. We sought to develop a clinical decision tool to identify adult patients with syncope who are at risk of a serious adverse event within 30 days after disposition from the emergency department. METHODS: We prospectively enrolled adults (age ≥ 16 yr) with syncope who presented within 24 hours after the event to 1 of 6 large emergency departments from Sept...
September 6, 2016: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
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