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Internal Medicine

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106 papers 25 to 100 followers
https://www.readbyqxmd.com/read/28141683/fever-in-the-emergency-department-predicts-survival-of-patients-with-severe-sepsis-and-septic-shock-admitted-to-the-icu
#1
Jonas Sundén-Cullberg, Rebecca Rylance, Jesper Svefors, Anna Norrby-Teglund, Jonas Björk, Malin Inghammar
OBJECTIVES: To study the prognostic value of fever in the emergency department in septic patients subsequently admitted to the ICU. DESIGN: Observational cohort study from the Swedish national quality register for sepsis. SETTING: Thirty ICU's in Sweden. PATIENTS: Two thousand two hundred twenty-five adults who were admitted to an ICU within 24 hours of hospital arrival with a diagnosis of severe sepsis or septic shock were included...
January 30, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28114673/benefits-and-harms-of-intensive-blood-pressure-treatment-in-adults-aged-60-years-or-older-a-systematic-review-and-meta-analysis
#2
Jessica Weiss, Michele Freeman, Allison Low, Rochelle Fu, Amy Kerfoot, Robin Paynter, Makalapua Motu'apuaka, Karli Kondo, Devan Kansagara
Background: Recent guidelines recommend a systolic blood pressure (SBP) goal of less than 150 mm Hg for adults aged 60 years or older, but the balance of benefits and harms is unclear in light of newer evidence. Purpose: To systematically review the effects of more versus less intensive BP control in older adults. Data Sources: Multiple databases through January 2015 and MEDLINE to September 2016. Study Selection: 21 randomized, controlled trials comparing BP targets or treatment intensity, and 3 observational studies that assessed harms...
January 17, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28135725/pharmacologic-treatment-of-hypertension-in-adults-aged-60-years-or-older-to-higher-versus-lower-blood-pressure-targets-a-clinical-practice-guideline-from-the-american-college-of-physicians-and-the-american-academy-of-family-physicians
#3
Amir Qaseem, Timothy J Wilt, Robert Rich, Linda L Humphrey, Jennifer Frost, Mary Ann Forciea
Description: The American College of Physicians (ACP) and the American Academy of Family Physicians (AAFP) jointly developed this guideline to present the evidence and provide clinical recommendations based on the benefits and harms of higher versus lower blood pressure targets for the treatment of hypertension in adults aged 60 years or older. Methods: This guideline is based on a systematic review of published randomized, controlled trials for primary outcomes and observational studies for harms only (identified through EMBASE, the Cochrane Database of Systematic Reviews, MEDLINE, and ClinicalTrials...
January 17, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28118658/whether-to-intubate-during-cardiopulmonary-resuscitation-conventional-wisdom-vs-big-data
#4
EDITORIAL
Derek C Angus
No abstract text is available yet for this article.
7, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28092694/proton-pump-inhibitors-risks-of-long-term-use
#5
REVIEW
Leonardo Henry Eusebi, Stefano Rabitti, Maria Laura Artesiani, Dania Gelli, Marco Montagnani, Rocco Maurizio Zagari, Franco Bazzoli
Proton pump inhibitors are among the most commonly prescribed classes of drugs and their use is increasing, in particular for long term treatment, often being over-prescribed and used for inappropriate conditions. In recent years, considerable attention has been directed towards a wide range of adverse effects, and even when a potential underlying biological mechanism is plausible, the clinical evidence of the adverse effect is often weak. Several long term side effects have been investigated ranging from interaction with other drugs, increased risk of infection, reduced intestinal absorption of vitamins and minerals, and more recently kidney damage and dementia...
January 16, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28114553/prognostic-accuracy-of-the-sofa-score-sirs-criteria-and-qsofa-score-for-in-hospital-mortality-among-adults-with-suspected-infection-admitted-to-the-intensive-care-unit
#6
Eamon P Raith, Andrew A Udy, Michael Bailey, Steven McGloughlin, Christopher MacIsaac, Rinaldo Bellomo, David V Pilcher
Importance: The Sepsis-3 Criteria emphasized the value of a change of 2 or more points in the Sequential [Sepsis-related] Organ Failure Assessment (SOFA) score, introduced quick SOFA (qSOFA), and removed the systemic inflammatory response syndrome (SIRS) criteria from the sepsis definition. Objective: Externally validate and assess the discriminatory capacities of an increase in SOFA score by 2 or more points, 2 or more SIRS criteria, or a qSOFA score of 2 or more points for outcomes among patients who are critically ill with suspected infection...
17, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28107561/beta-blockers-for-hypertension
#7
REVIEW
Charles S Wiysonge, Hazel A Bradley, Jimmy Volmink, Bongani M Mayosi, Lionel H Opie
BACKGROUND: Beta-blockers refer to a mixed group of drugs with diverse pharmacodynamic and pharmacokinetic properties. They have shown long-term beneficial effects on mortality and cardiovascular disease (CVD) when used in people with heart failure or acute myocardial infarction. Beta-blockers were thought to have similar beneficial effects when used as first-line therapy for hypertension. However, the benefit of beta-blockers as first-line therapy for hypertension without compelling indications is controversial...
January 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28116595/early-risk-factors-and-the-role-of-fluid-administration-in-developing-acute-respiratory-distress-syndrome-in-septic-patients
#8
Raghu R Seethala, Peter C Hou, Imoigele P Aisiku, Gyorgy Frendl, Pauline K Park, Mark E Mikkelsen, Steven Y Chang, Ognjen Gajic, Jonathan Sevransky
BACKGROUND: Sepsis is a major risk factor for acute respiratory distress syndrome (ARDS). However, there remains a paucity of literature examining risk factors for ARDS in septic patients early in their course. This study examined the role of early fluid administration and identified other risk factors within the first 6 h of hospital presentation associated with developing ARDS in septic patients. METHODS: This was a secondary analysis of septic adult patients presenting to the Emergency Department or being admitted for high-risk elective surgery from the multicenter observational cohort study, US Critical Injury and Illness trial Group-Lung Injury Prevention Study 1 (USCIITG-LIPS 1, NCT00889772)...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28088580/grand-round-anticoagulation-in-chronic-liver-disease
#9
REVIEW
Ameet Dhar, Benjamin H Mullish, Mark R Thursz
In this Grand Round, we first present a case of a man with decompensated liver disease who subsequently developed a fatal pulmonary embolism, having not been prescribed prophylactic anticoagulation to prevent venous thromboembolic disease. We go on to discuss the burden of thrombotic disease in those with chronic liver disease, before a more detailed discussion regarding the current evidence, safety data, and clinical dilemmas regarding the use of anticoagulation in patients with chronic liver disease, as well as discussing potential future directions within this field...
January 11, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28101605/surviving-sepsis-campaign-international-guidelines-for-management-of-sepsis-and-septic-shock-2016
#10
Andrew Rhodes, Laura E Evans, Waleed Alhazzani, Mitchell M Levy, Massimo Antonelli, Ricard Ferrer, Anand Kumar, Jonathan E Sevransky, Charles L Sprung, Mark E Nunnally, Bram Rochwerg, Gordon D Rubenfeld, Derek C Angus, Djillali Annane, Richard J Beale, Geoffrey J Bellinghan, Gordon R Bernard, Jean-Daniel Chiche, Craig Coopersmith, Daniel P De Backer, Craig J French, Seitaro Fujishima, Herwig Gerlach, Jorge Luis Hidalgo, Steven M Hollenberg, Alan E Jones, Dilip R Karnad, Ruth M Kleinpell, Younsuk Koh, Thiago Costa Lisboa, Flavia R Machado, John J Marini, John C Marshall, John E Mazuski, Lauralyn A McIntyre, Anthony S McLean, Sangeeta Mehta, Rui P Moreno, John Myburgh, Paolo Navalesi, Osamu Nishida, Tiffany M Osborn, Anders Perner, Colleen M Plunkett, Marco Ranieri, Christa A Schorr, Maureen A Seckel, Christopher W Seymour, Lisa Shieh, Khalid A Shukri, Steven Q Simpson, Mervyn Singer, B Taylor Thompson, Sean R Townsend, Thomas Van der Poll, Jean-Louis Vincent, W Joost Wiersinga, Janice L Zimmerman, R Phillip Dellinger
OBJECTIVE: To provide an update to "Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012". DESIGN: A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings (for those committee members attending the conference). A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. A stand-alone meeting was held for all panel members in December 2015...
January 18, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28065909/assumption-versus-evidence-the-case-of-digoxin-in-atrial-fibrillation-and-heart-failure
#11
REVIEW
Udo Bavendiek, Lukas Aguirre Davila, Armin Koch, Johann Bauersachs
No abstract text is available yet for this article.
January 8, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28084079/fast-assessment-and-management-of-chest-pain-patients-without-st-elevation-in-the-pre-hospital-gateway-famous-triage-ruling-out-a-myocardial-infarction-at-home-with-the-modified-heart-score
#12
Maycel Ishak, Danish Ali, Marion J Fokkert, Robbert J Slingerland, Rudolf T Tolsma, Erik Badings, Aize van der Sluis, Fred van Eenennaam, Arend Mosterd, Jurriën M Ten Berg, Arnoud Wj van 't Hof
BACKGROUND: The first study of the FamouS Triage project investigates the feasibility of ruling out a myocardial infarction in pre-hospital chest pain patients without electrocardiographic ST-segment elevation by using the modified HEART score at the patient's home, incorporating only a single highly sensitive troponin T measurement. METHODS: A venous blood sample was drawn in the ambulance from 1127 consecutive chest pain patients for measurement of the pre-hospital highly sensitive troponin T levels, in order to establish a pre-hospital HEART score (i...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28098591/surviving-sepsis-campaign-international-guidelines-for-management-of-sepsis-and-septic-shock-2016
#13
Andrew Rhodes, Laura E Evans, Waleed Alhazzani, Mitchell M Levy, Massimo Antonelli, Ricard Ferrer, Anand Kumar, Jonathan E Sevransky, Charles L Sprung, Mark E Nunnally, Bram Rochwerg, Gordon D Rubenfeld, Derek C Angus, Djillali Annane, Richard J Beale, Geoffrey J Bellinghan, Gordon R Bernard, Jean-Daniel Chiche, Craig Coopersmith, Daniel P De Backer, Craig J French, Seitaro Fujishima, Herwig Gerlach, Jorge Luis Hidalgo, Steven M Hollenberg, Alan E Jones, Dilip R Karnad, Ruth M Kleinpell, Younsuck Koh, Thiago Costa Lisboa, Flavia R Machado, John J Marini, John C Marshall, John E Mazuski, Lauralyn A McIntyre, Anthony S McLean, Sangeeta Mehta, Rui P Moreno, John Myburgh, Paolo Navalesi, Osamu Nishida, Tiffany M Osborn, Anders Perner, Colleen M Plunkett, Marco Ranieri, Christa A Schorr, Maureen A Seckel, Christopher W Seymour, Lisa Shieh, Khalid A Shukri, Steven Q Simpson, Mervyn Singer, B Taylor Thompson, Sean R Townsend, Thomas Van der Poll, Jean-Louis Vincent, W Joost Wiersinga, Janice L Zimmerman, R Phillip Dellinger
OBJECTIVE: To provide an update to "Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012." DESIGN: A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings (for those committee members attending the conference). A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. A stand-alone meeting was held for all panel members in December 2015...
March 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28039870/outcomes-of-treated-hypertension-at-age-80-and-older-cohort-analysis-of-79-376-individuals
#14
João Delgado, Jane A H Masoli, Kirsty Bowman, W David Strain, George A Kuchel, Kate Walters, Louise Lafortune, Carol Brayne, David Melzer, Alessandro Ble
OBJECTIVES: To estimate outcomes according to attained blood pressure (BP) in the oldest adults treated for hypertension in routine family practice. DESIGN: Cohort analysis of primary care inpatient and death certificate data for individuals with hypertension. SETTING: Primary care practices in England (Clinical Practice Research Datalink). PARTICIPANTS: Individuals aged 80 and older taking antihypertensive medication and free of dementia, cancer, coronary heart disease, stroke, heart failure, and end-stage renal failure at baseline...
December 30, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28073314/safety-of-the-peripheral-administration-of-vasopressor-agents
#15
Tyler Lewis, Cristian Merchan, Diana Altshuler, John Papadopoulos
Vasopressors are an integral component of the management of septic shock and are traditionally given via a central venous catheter (CVC) due to the risk of tissue injury and necrosis if extravasated. However, the need for a CVC for the management of septic shock has been questioned, and the risk of extravasation and incidence of severe injury when vasopressors are given via a peripheral venous line (PVL) remains poorly defined. We performed a retrospective chart review of 202 patients who received vasopressors through a PVL...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28034871/how-i-evaluate-and-treat-thrombocytopenia-in-the-intensive-care-unit-patient
#16
REVIEW
Andreas Greinacher, Sixten Selleng
Multiple causes (pseudothrombocytopenia, hemodilution, increased consumption, decreased production, increased sequestration, and immune-mediated destruction of platelets) alone or in combination make thrombocytopenia very common in intensive care unit (ICU) patients. Persisting thrombocytopenia in critically ill patients is associated with, but not causative of, increased mortality. Identification of the underlying cause is key for management decisions in individual patients. While platelet transfusion might be indicated in patients with impaired platelet production or increased platelet destruction, it could be deleterious in patients with increased intravascular platelet activation...
December 29, 2016: Blood
https://www.readbyqxmd.com/read/27991651/oxygen-therapy-for-acute-myocardial-infarction
#17
REVIEW
Juan B Cabello, Amanda Burls, José I Emparanza, Susan E Bayliss, Tom Quinn
BACKGROUND: Oxygen (O2) is widely used in people with acute myocardial infarction (AMI). Previous systematic reviews concluded that there was insufficient evidence to know whether oxygen reduced, increased or had no effect on heart ischaemia or infarct size. Our first Cochrane review in 2010 also concluded there was insufficient evidence to know whether oxygen should be used. Since 2010, the lack of evidence to support this widely used intervention has attracted considerable attention, prompting further trials of oxygen therapy in myocardial infarction patients...
19, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28075105/heart-failure-due-to-reduced-ejection-fraction-medical-management
#18
William E Chavey, Robrt V Hogikyan, R Van Harrison, John M Nicklas
Heart failure is an increasingly common condition resulting in high rates of morbidity and mortality. For patients who have heart failure and reduced ejection fraction, randomized clinical trials demonstrate consistent mortality benefit from angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, direct-acting vasodilators, beta blockers, and aldosterone antagonists. Additionally, some data show benefits from two new classes of drugs: angiotensin receptor blocker/neprilysin inhibitor and sinus node modulator...
January 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28050897/fluid-resuscitation-in-human-sepsis-time-to-rewrite-history
#19
REVIEW
Liam Byrne, Frank Van Haren
Fluid resuscitation continues to be recommended as the first-line resuscitative therapy for all patients with severe sepsis and septic shock. The current acceptance of the therapy is based in part on long history and familiarity with its use in the resuscitation of other forms of shock, as well as on an incomplete and incorrect understanding of the pathophysiology of sepsis. Recently, the safety of intravenous fluids in patients with sepsis has been called into question with both prospective and observational data suggesting improved outcomes with less fluid or no fluid...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28055075/oral-pharmacologic-treatment-of-type-2-diabetes-mellitus-a-clinical-practice-guideline-update-from-the-american-college-of-physicians
#20
Amir Qaseem, Michael J Barry, Linda L Humphrey, Mary Ann Forciea
Description: The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on oral pharmacologic treatment of type 2 diabetes in adults. This guideline serves as an update to the 2012 ACP guideline on the same topic. This guideline is endorsed by the American Academy of Family Physicians. Methods: This guideline is based on a systematic review of randomized, controlled trials and observational studies published through December 2015 on the comparative effectiveness of oral medications for type 2 diabetes...
February 21, 2017: Annals of Internal Medicine
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