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Internal Medicine

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182 papers 100 to 500 followers
https://www.readbyqxmd.com/read/29297057/association-of-cardiovascular-risk-with-inhaled-long-acting-bronchodilators-in-patients-with-chronic-obstructive-pulmonary-disease-a-nested-case-control-study
#1
Meng-Ting Wang, Jun-Ting Liou, Chen Wei Lin, Chen-Liang Tsai, Yun-Han Wang, Yu-Juei Hsu, Jyun-Heng Lai
Importance: The associations between cardiovascular disease (CVD) and inhaled long-acting β2-agonists (LABAs) or long-acting antimuscarinic antagonists (LAMAs) in chronic obstructive pulmonary disease (COPD) are greatly debated. Pivotal and relevant randomized clinical trials included prior LABA or LAMA users and excluded patients with baseline CVD; therefore, cardiovascular events arising from first-time LABA or LAMA use, if any, could not be observed. There is an urgent need to examine whether new use of and duration since initiating LABAs and LAMAs could act as important determinants of cardiovascular events...
January 2, 2018: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29289687/a-comparison-of-the-quick-sofa-and-systemic-inflammatory-response-syndrome-criteria-for-the-diagnosis-of-sepsis-and-prediction-of-mortality-a-systematic-review-and-meta-analysis
#2
Rodrigo Serafim, Jose Andrade Gomes, Jorge Salluh, Pedro Póvoa
BACKGROUND: Several studies were published to validate the quick Sepsis-related Organ Failure Assessment (qSOFA), namely in comparison with the systemic inflammatory response syndrome (SIRS) criteria. We performed a systematic review and meta-analysis with the aim of comparing the qSOFA and SIRS in patients outside the ICU. METHODS: We searched MEDLINE, CINAHL, and the Web of Science database from February 23, 2016 until June 30, 2017 to identify full-text English-language studies published after the Sepsis-3 publication comparing the qSOFA and SIRS and their sensitivity or specificity in diagnosing sepsis, as well as hospital and ICU length of stay and hospital mortality...
December 28, 2017: Chest
https://www.readbyqxmd.com/read/29221664/mechanisms-of-damage-to-the-gastrointestinal-tract-from-non-steroidal-anti-inflammatory-drugs
#3
REVIEW
Ingvar Bjarnason, Carmelo Scarpignato, Erik Holmgren, Michael Olszewski, Kim D Rainsford, Angel Lanas
Non-steroidal anti-inflammatory drugs (NSAIDs) can damage the gastrointestinal tract, causing widespread morbidity and mortality. Although mechanisms of damage involve the activities of prostaglandin-endoperoxide synthase 1 (PTGS1 or COX1) and PTGS1 (COX2), other factors are involved. We review mechanisms of gastrointestinal damage induction by NSAIDs, via COX-mediated and COX-independent processes. NSAIDs interact with phospholipids and uncouple mitochondrial oxidative phosphorylation, which initiates biochemical changes that impair function of the gastrointestinal barrier...
December 5, 2017: Gastroenterology
https://www.readbyqxmd.com/read/29199388/efficacy-and-safety-of-stress-ulcer-prophylaxis-in-critically-ill-patients-a-network-meta-analysis-of-randomized-trials
#4
REVIEW
Waleed Alhazzani, Fayez Alshamsi, Emilie Belley-Cote, Diane Heels-Ansdell, Romina Brignardello-Petersen, Mustafa Alquraini, Anders Perner, Morten Hylander Møller, Mette Krag, Saleh Almenawer, Bram Rochwerg, Joanna Dionne, Roman Jaeschke, Mohammed Alshahrani, Adam Deane, Dan Perri, Lehana Thebane, Awad Al-Omari, Simon Finfer, Deborah Cook, Gordon Guyatt
PURPOSE: Stress ulcer prophylaxis (SUP) is commonly prescribed in the intensive care unit. However, data from systematic reviews and conventional meta-analyses are limited by imprecision and restricted to direct comparisons. We conducted a network meta-analysis of randomized clinical trials (RCTs) to examine the safety and efficacy of drugs available for SUP in critically ill patients. METHODS: We searched MEDLINE, EMBASE, and the Cochrane Library Central Register of Controlled Trials through April 2017 for randomized controlled trials that examined the efficacy and safety of proton pump inhibitors (PPIs), histamine-2 receptor antagonists (H2RAs), and sucralfate for SUP in critically ill patients...
December 4, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/29240784/effects-of-calcium-channel-blockers-comparing-to-angiotensin-converting-enzyme-inhibitors-and-angiotensin-receptor-blockers-in-patients-with-hypertension-and-chronic-kidney-disease-stage-3-to-5-and-dialysis-a-systematic-review-and-meta-analysis
#5
REVIEW
Yen-Chung Lin, Jheng-Wei Lin, Mai-Szu Wu, Kuan-Chou Chen, Chiung-Chi Peng, Yi-No Kang
BACKGROUND: Calcium channel blocker (CCB) or two renin angiotensin aldosterone system blockades (RAAS), angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), are major potent and prevalently used as initial antihypertensive agents for mild to moderate hypertension, but no uniform agreement as to which antihypertensive drugs should be given for initial therapy, especially among chronic kidney disease (CKD) patients. DESIGN: A systematic review and meta-analysis comparing CCBs and the two RAAS blockades for hypertensive patients with CKD stage 3 to 5D...
2017: PloS One
https://www.readbyqxmd.com/read/29094913/secondary-hypertension-discovering-the-underlying-cause
#6
REVIEW
Lesley Charles, Jean Triscott, Bonnie Dobbs
Most patients with hypertension have no clear etiology and are classified as having primary hypertension. However, 5% to 10% of these patients may have secondary hypertension, which indicates an underlying and potentially reversible cause. The prevalence and potential etiologies of secondary hypertension vary by age. The most common causes in children are renal parenchymal disease and coarctation of the aorta. In adults 65 years and older, atherosclerotic renal artery stenosis, renal failure, and hypothyroidism are common causes...
October 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/26030647/chronic-kidney-disease
#7
REVIEW
Paul Drawz, Mahboob Rahman
This issue provides a clinical overview of chronic kidney disease, focusing on prevention, diagnosis, treatment, and patient information. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including ACP Smart Medicine and MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic from these primary sources in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of science writers and physician writers...
June 2, 2015: Annals of Internal Medicine
https://www.readbyqxmd.com/read/26237763/in-the-clinic-hyponatremia
#8
REVIEW
Dan A Henry
No abstract text is available yet for this article.
August 4, 2015: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28586906/irritable-bowel-syndrome
#9
REVIEW
Shahnaz Sultan, Ashish Malhotra
This issue provides a clinical overview of irritable bowel syndrome, 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...
June 6, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29271844/efficacy-and-safety-of-procalcitonin-guidance-in-patients-with-suspected-or-confirmed-sepsis-a-systematic-review-and-meta-analysis
#10
Irena Iankova, Philippe Thompson-Leduc, Noam Y Kirson, Bernie Rice, Juliane Hey, Alexander Krause, Sophie A Schonfeld, Christopher R DeBrase, Samuel Bozzette, Philipp Schuetz
OBJECTIVE: Sepsis is a leading cause of mortality in noncoronary ICUs. Although immediate start of antibiotics reduces sepsis-related mortality, antibiotics are often administered for too long, leading to suboptimal treatment and, importantly, contributes to antimicrobial resistance. Prior literature suggests that procalcitonin correlates with infection and thus may help to guide the decision on when to stop antibiotic treatment. This study was conducted as part of a regulatory submission to the U...
December 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29273246/asthma
#11
REVIEW
Alberto Papi, Christopher Brightling, Søren E Pedersen, Helen K Reddel
Asthma-one of the most common chronic, non-communicable diseases in children and adults-is characterised by variable respiratory symptoms and variable airflow limitation. Asthma is a consequence of complex gene-environment interactions, with heterogeneity in clinical presentation and the type and intensity of airway inflammation and remodelling. The goal of asthma treatment is to achieve good asthma control-ie, to minimise symptom burden and risk of exacerbations. Anti-inflammatory and bronchodilator treatments are the mainstay of asthma therapy and are used in a stepwise approach...
December 19, 2017: Lancet
https://www.readbyqxmd.com/read/29201378/time-to-re-think-the-use-of-dobutamine-in-sepsis
#12
Ryota Sato, Michitaka Nasu
Dobutamine is commonly used worldwide and included in the protocol for early goal-directed therapy (EGDT). Since the use of dobutamine in EGDT was reported, it has been considered to be an important component, especially in the treatment of septic patients with myocardial dysfunction. However, it is questionable whether dobutamine improves the mortality of sepsis and septic shock. In three recent randomized controlled trials (ProCESS, ProMISe, and ARISE trials), the frequency of dobutamine use was significantly higher in the EGDT group than in the standard care group, but there were no significant differences in the mortality between the groups...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/29161385/are-we-close-to-the-ideal-intravenous-fluid
#13
N MacDonald, R M Pearse
The approach to i.v. fluid therapy for hypovolaemia may significantly influence outcomes for patients who experience a systemic inflammatory response after sepsis, trauma, or major surgery. Currently, there is no single i.v. fluid agent that meets all the criteria for the ideal treatment for hypovolaemia. The physician must choose the best available agent(s) for each patient, and then decide when and how much to administer. Findings from large randomized trials suggest that some colloid-based fluids, particularly starch-based colloids, may be harmful in some situations, but it is unclear whether they should be withdrawn from use completely...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29175086/re-examining-permissive-hypercapnia-in%C3%A2-ards-a-narrative-review
#14
REVIEW
Tavish Barnes, Vasileios Zochios, Ken Parhar
Lung-protective ventilation (LPV) has become the cornerstone of management in patients with ARDS. A subset of patients is unable to tolerate LPV without significant CO2 elevation. In these patients, permissive hypercapnia is used. Although thought to be benign, it is becoming increasingly evident that elevated CO2 levels have significant physiological effects. In this narrative review, we highlight clinically relevant end-organ effects in both animal models and clinical studies. We also explore the association between elevated CO2, acute cor pulmonale, and ICU mortality...
November 22, 2017: Chest
https://www.readbyqxmd.com/read/29126250/diabetic-microvascular-disease-an-endocrine-society-scientific-statement
#15
Eugene J Barrett, Zhenqi Liu, Mogher Khamaisi, George L King, Ronald Klein, Barbara E K Klein, Timothy M Hughes, Suzanne Craft, Barry I Freedman, Donald W Bowden, Aaron I Vinik, Carolina M Casellini
Both type 1 and type 2 diabetes adversely affect the microvasculature in multiple organs. Our understanding of the genesis of this injury and of potential interventions to prevent, limit, or reverse injury/dysfunction is continuously evolving. This statement reviews biochemical/cellular pathways involved in facilitating and abrogating microvascular injury. The statement summarizes the types of injury/dysfunction that occur in the three classical diabetes microvascular target tissues, the eye, the kidney, and the peripheral nervous system; the statement also reviews information on the effects of diabetes and insulin resistance on the microvasculature of skin, brain, adipose tissue, and cardiac and skeletal muscle...
November 8, 2017: Journal of Clinical Endocrinology and Metabolism
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
#16
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...
November 7, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29030424/stable-coronary-syndromes-pathophysiology-diagnostic-advances-and-therapeutic-need
#17
REVIEW
Thomas J Ford, David Corcoran, Colin Berry
The diagnostic management of patients with angina pectoris typically centres on the detection of obstructive epicardial CAD, which aligns with evidence-based treatment options that include medical therapy and myocardial revascularisation. This clinical paradigm fails to account for the considerable proportion (approximately one-third) of patients with angina in whom obstructive CAD is excluded. This common scenario presents a diagnostic conundrum whereby angina occurs but there is no obstructive CAD (ischaemia and no obstructive coronary artery disease-INOCA)...
October 13, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29114754/acute-kidney-injury
#18
REVIEW
Andrew S Levey, Matthew T James
Acute kidney injury is a heterogeneous group of conditions characterized by a sudden decrease in glomerular filtration rate, manifested by an increase in serum creatinine concentration or oliguria, and classified by stage and cause. This type of injury occurs in approximately 20% of hospitalized patients, with major complications including volume overload, electrolyte disorders, uremic complications, and drug toxicity. Management includes specific treatments according to the underlying cause and supportive treatment to prevent and manage complications...
November 7, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29110887/managing-peripheral-facial-palsy
#19
REVIEW
Aris Garro, Lise E Nigrovic
No abstract text is available yet for this article.
October 27, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29050566/how-low-to-go-with-glucose-cholesterol-%C3%A2-and-blood-pressure-in-primary%C3%A2-prevention-of-cvd
#20
REVIEW
Kimberly N Hong, Valentin Fuster, Robert S Rosenson, Clive Rosendorff, Deepak L Bhatt
Diabetes, hyperlipidemia, and hypertension are modifiable risk factors that predict cardiovascular disease events. The effect of these risk factors on incident cardiovascular disease increases with progressively higher levels of glucose, low-density lipoprotein cholesterol, and blood pressure. The thresholds for initiating treatment of these modifiable risk factors and the optimal goals of risk factor modification are a focus of primary prevention research. Although an aggressive approach is appealing, adverse events may occur, and potential physiological barriers may exist...
October 24, 2017: Journal of the American College of Cardiology
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