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REVIEW
Andrea Di Matteo, Joan M Bathon, Paul Emery
Rheumatoid arthritis is a chronic, systemic, autoimmune inflammatory disease that mainly affects the joints and periarticular soft tissues. In this Seminar, we provide an overview of the main aspects of rheumatoid arthritis. Epidemiology and advances in the understanding of rheumatoid arthritis pathogenesis will be reviewed. We will discuss the clinical manifestations of rheumatoid arthritis, classification criteria, and the value of imaging in the diagnosis of the disease. The advent of new medications and the accumulated scientific evidence demand continuous updating regarding the diagnosis and management, including therapy, of rheumatoid arthritis...
November 25, 2023: Lancet
#2
REVIEW
Raja Ravender, Maria-Eleni Roumelioti, Darren W Schmidt, Mark L Unruh, Christos Argyropoulos
Diabetes mellitus (DM) and chronic kidney disease (CKD) are common in middle aged and older adult individuals. DM may accelerate the aging process, and the age-related declines in the estimated glomerular filtration rate (eGFR) can pose a challenge to diagnosing diabetic kidney disease (DKD) using standard diagnostic criteria especially with the absence of severe albuminuria among older adults. In the presence of CKD and DM, older adult patients may need multidisciplinary care due to susceptibility to various health issues, e...
January 8, 2024: Journal of Clinical Medicine
#3
REVIEW
Joshua J Neumiller, Radica Z Alicic, Katherine R Tuttle
Diabetes is the leading cause of chronic kidney disease (CKD) and kidney failure worldwide. CKD frequently coexists with heart failure and atherosclerotic cardiovascular disease in the broader context of cardio-kidney-metabolic syndrome. Diabetes and CKD are associated with increased risk of all-cause and cardiovascular death as well as decreased quality of life. The role of metabolic and hemodynamic abnormalities has long been recognized as an important contributor to the pathogenesis and progression of CKD in diabetes, while a more recent and growing body of evidence supports activation of both systemic and local inflammation as important contributors...
January 2024: Clinical Kidney Journal
#4
REVIEW
Keong Chong, Jack Keng-Jui Chang, Lee-Ming Chuang
Several recent advances provide multiple health benefits to individuals with type 2 diabetes mellitus (T2DM). Pharmacological therapy is governed by person-centered factors, including comorbidities and treatment goals. Adults with T2DM who have an established/high risk of atherosclerotic cardiovascular disease, heart failure, and/or chronic kidney disease, require a treatment regimen that includes agents that are proven to reduce cardiorenal risk. Weight management plays a key role in reducing glucose for patients with T2DM...
January 6, 2024: Kaohsiung Journal of Medical Sciences
#5
REVIEW
Saif Al-Chalabi, Akheel A Syed, Philip A Kalra, Smeeta Sinha
BACKGROUND: There is a marked increase in the global prevalence of obesity over the last decades with an estimated 1.9 billion adults living with overweight or obesity. This is associated with a sharp rise in prevalence of cardiorenal metabolic diseases such as type 2 diabetes mellitus, chronic kidney disease, and heart failure. With recent evidence of the efficacy of sodium glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists on cardiorenal protection and weight reduction, it is reasonable to investigate common causative pathways for cardiorenal metabolic diseases...
2024: Cardiorenal Medicine
#6
JOURNAL ARTICLE
Louis-Patrick Haraoui, Martin J Blaser
Our perception of microbes has considerably changed since the recognition of their pathogenic potential in the 19th century. The discovery of antibiotics and their subsequent widespread adoption have substantially altered the landscape of medicine, providing us with treatment options for many infectious diseases and enabling the deployment of previously risky interventions (eg, surgical procedures and chemotherapy), while also leading to the rise of AMR. The latter is commonly viewed as the predominant downside of antibiotic use...
December 5, 2023: Clinical Infectious Diseases
#7
JOURNAL ARTICLE
Dina Mansour, Steven Masson, John Hammond, Joanna A Leithead, Jill Johnson, Mussarat Nazia Rahim, Andrew C Douds, Lynsey Corless, Debbie L Shawcross, Michael A Heneghan, Dhiraj Tripathi, Stuart McPherson, Emily Bonner, Gemma Botterill, Rebecca West, Mhairi Donnelly, Allison Grapes, Coral Hollywood, Valerie Ross
The prevalence of cirrhosis has risen significantly over recent decades and is predicted to rise further. Widespread use of non-invasive testing means cirrhosis is increasingly diagnosed at an earlier stage. Despite this, there are significant variations in outcomes in patients with cirrhosis across the UK, and patients in areas with higher levels of deprivation are more likely to die from their liver disease. This three-part best practice guidance aims to address outpatient management of cirrhosis, in order to standardise care and to reduce the risk of progression, decompensation and mortality from liver disease...
2023: Frontline Gastroenterology
#8
REVIEW
Bruno Garcia, Alexander Zarbock, Rinaldo Bellomo, Matthieu Legrand
The renin-angiotensin system (RAS) plays a crucial role in regulating blood pressure and the cardio-renal system. The classical RAS, mainly mediated by angiotensin I, angiotensin-converting enzyme, and angiotensin II, has been reported to be altered in critically ill patients, such as those in vasodilatory shock. However, recent research has highlighted the role of some components of the counterregulatory axis of the classical RAS, termed the alternative RAS, such as angiotensin-converting Enzyme 2 (ACE2) and angiotensin-(1-7), or peptidases which can modulate the RAS like dipeptidyl-peptidase 3, in many critical situations...
November 20, 2023: Critical Care: the Official Journal of the Critical Care Forum
#9
JOURNAL ARTICLE
Lisa K Stamp, Carl Horsley, Leanne Te Karu, Nicola Dalbeth, Murray Barclay
Colchicine has an important role in managing various conditions, including gout, familial Mediterranean fever, amyloidosis, Behcet's syndrome, recurrent pericarditis, and calcium pyrophosphate deposition disease. The adverse effect profile of colchicine is well understood. However, due to its narrow therapeutic index, colchicine has been associated with overdose and fatalities. When ingested in toxic amounts, the mainstay of management is supportive care. Strategies to minimise the risk of colchicine poisoning can focus on three broad causes: unauthorised access, intentional overdose, and inappropriate dosing...
November 29, 2023: Rheumatology
#10
REVIEW
Guadalupe Garcia-Tsao, Juan G Abraldes, Nicole E Rich, Vincent Wai-Sun Wong
DESCRIPTION: Cirrhosis is a major cause of morbidity and mortality in the United States and worldwide. It consists of compensated, decompensated, and further decompensated stages; median survival is more than 15 years, 2 years, and 9 months for each stage, respectively. With each stage, there is progressive worsening of portal hypertension and the vasodilatory-hyperdynamic circulatory state, resulting in a progressive decrease in effective arterial blood volume and renal perfusion. Vasoconstrictors reduce portal pressure via splanchnic vasoconstriction and are used in the management of variceal hemorrhage...
January 2024: Gastroenterology
#11
JOURNAL ARTICLE
Daniel J Minter, Ayesha Appa, Henry F Chambers, Sarah B Doernberg
Staphylococcus aureus bacteremia (SAB) carries a high risk for excess morbidity and mortality. Despite its prevalence, significant practice variation continues to permeate clinical management of this syndrome. Since the publication of the 2011 Infectious Diseases Society of America (IDSA) guidelines on management of methicillin-resistant Staphylococcus aureus infections, the field of SAB has evolved with the emergence of newer diagnostic strategies and therapeutic options. In this review, we seek to provide a comprehensive overview of the evaluation and management of SAB, with special focus on areas where the highest level of evidence is lacking to inform best practices...
November 10, 2023: Clinical Infectious Diseases
#12
REVIEW
Fnu Sapna, Fnu Raveena, Maria Chandio, Karoona Bai, Mohammad Sayyar, Giustino Varrassi, Mahima Khatri, Satesh Kumar, Tamam Mohamad
Heart failure is a substantial and escalating global health challenge, affecting millions worldwide. This complex syndrome arises from diverse etiologies, encompassing ischemic heart disease, hypertension, valvular abnormalities, and cardiomyopathies. Heart failure is characterized by the heart's inability to pump blood efficiently to meet the body's metabolic demands, leading to debilitating symptoms, frequent hospitalizations, and high mortality rates. Traditionally, the management of Heart failure has focused on alleviating symptoms, reducing fluid retention, and enhancing cardiac contractility...
October 2023: Curēus
#13
REVIEW
Stavroula A Paschou, Almog Shalit, Eleni Gerontiti, Kleoniki I Athanasiadou, Theodoros Kalampokas, Theodora Psaltopoulou, Irene Lambrinoudaki, Eleni Anastasiou, Bruce H R Wolffenbuttel, Dimitrios G Goulis
During the last decades, gestational diabetes mellitus (GDM) prevalence has been on the rise. While insulin remains the gold standard treatment for GDM, metformin use during pregnancy is controversial. This review aimed to comprehensively assess the available data on the efficacy and safety of metformin during pregnancy, both for the mother and the offspring. Metformin has been validated for maternal efficacy and safety, achieving comparable glycemic control with insulin. Additionally, it reduces maternal weight gain and possibly the occurrence of hypertensive disorders...
October 5, 2023: Endocrine
#14
REVIEW
Junhao Lv, Luying Guo, Rending Wang, Jianghua Chen
BACKGROUND: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) were initially developed as glucose-lowering agents in patients with type-2 diabetes. However, available data from clinical trials and meta-analyses suggest that SGLT2i have pleiotropic benefits in reducing mortality and delaying the progression of chronic kidney disease (CKD) in both diabetic and nondiabetic patients. Thus, we herein review the current evidence regarding the efficacy and safety of SGLT2i in patients with nondiabetic CKD and appraise the recently reported clinical trials that might facilitate the management of CKD in routine clinical practice...
October 2023: Kidney Diseases
#15
REVIEW
Monarch Shah, Alaa S Awad, Emaad M Abdel-Rahman
Nonsteroidal mineralocorticoid receptor antagonists (MRAs) present a promising therapeutic option in cardiorenal diseases, mitigating the limitations of steroidal MRAs. Finerenone, a third-generation nonsteroidal MRA, has demonstrated beneficial effects in heart failure (HF) and chronic kidney disease (CKD). Clinical trials, including FIDELIO-DKD and FIGARO-DKD, revealed finerenone's efficacy in improving kidney and cardiovascular (CV) outcomes. Patients with CKD and type 2 diabetes (T2DM) on finerenone experienced reduced rates of cardiovascular events, including hospitalization for HF...
September 29, 2023: Journal of Clinical Medicine
#16
JOURNAL ARTICLE
Antonis Fanouriakis, Myrto Kostopoulou, Jeanette Andersen, Martin Aringer, Laurent Arnaud, Sang-Cheol Bae, John Boletis, Ian N Bruce, Ricard Cervera, Andrea Doria, Thomas Dörner, Richard A Furie, Dafna D Gladman, Frederic A Houssiau, Luís Sousa Inês, David Jayne, Marios Kouloumas, László Kovács, Chi Chiu Mok, Eric F Morand, Gabriella Moroni, Marta Mosca, Johanna Mucke, Chetan B Mukhtyar, György Nagy, Sandra Navarra, Ioannis Parodis, José M Pego-Reigosa, Michelle Petri, Bernardo A Pons-Estel, Matthias Schneider, Josef S Smolen, Elisabet Svenungsson, Yoshiya Tanaka, Maria G Tektonidou, Yk Onno Teng, Angela Tincani, Edward M Vital, Ronald F van Vollenhoven, Chris Wincup, George Bertsias, Dimitrios T Boumpas
OBJECTIVES: To update the EULAR recommendations for the management of systemic lupus erythematosus (SLE) based on emerging new evidence. METHODS: An international Task Force formed the questions for the systematic literature reviews (January 2018-December 2022), followed by formulation and finalisation of the statements after a series of meetings. A predefined voting process was applied to each overarching principle and recommendation. Levels of evidence and strengths of recommendation were assigned, and participants finally provided their level of agreement with each item...
January 2, 2024: Annals of the Rheumatic Diseases
#17
REVIEW
Franz H Messerli, Sripal Bangalore, John M Mandrola
In their recent guidelines, the European Society of Hypertension upgraded β blockers, putting them on equal footing with thiazide diuretics, renin-angiotensin system blockers (eg, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers), and calcium channel blockers. The reason offered for upgrading β blockers was the observation that they are often used for many other clinical conditions commonly encountered with hypertension. This upgrade would allow for the treatment of two conditions with a single drug (a so-called twofer)...
October 13, 2023: Lancet
#18
REVIEW
Steven F Moss, Shailja C Shah, Mimi C Tan, Hashem B El-Serag
Helicobacter pylori is the most common chronic bacterial infection worldwide and the most significant risk factor for gastric cancer, which remains a leading cause of cancer-related death globally. H pylori and gastric cancer continue to disproportionately impact racial and ethnic minority and immigrant groups in the United States. The approach to H pylori case-finding thus far has relied on opportunistic testing based on symptoms or high-risk indicators, such as racial or ethnic background and family history...
February 2024: Gastroenterology
#19
REVIEW
Prabhat Singh, Lokesh Goyal, Deobrat C Mallick, Salim R Surani, Kanica Yashi
Diabetic kidney disease (DKD) causes a progressive decline in renal function, leading to end-stage kidney disease (ESKD), and increases the likelihood of cardiovascular events and mortality. The recent introduction of the sodium-glucose co-transporter 2 (SGLT-2) inhibitor has been a game changer in managing chronic kidney disease (CKD) and congestive heart failure (CHF). These agents not only slow down the progression of kidney disease but also have cardioprotective benefits, including for patients with congestive heart failure and atherosclerotic cardiovascular disease...
September 26, 2023: Journal of Clinical Medicine
#20
REVIEW
Farah Yasmin, Muhammad Aamir, Hala Najeeb, Abdul Raafe Atif, Abdul Hannan Siddiqui, Muhammad Nadeem Ahsan, Abdul Moeed, Syed Hasan Ali, Haya Muhammad Tahir, Muhammad Sohaib Asghar
BACKGROUND AND OBJECTIVES: The incidence of morbidity and mortality in patients with type 2 diabetes mellitus is substantially correlated with cardiovascular disease and chronic kidney disease. The current guidelines recommend the use of renin-angiotensin system blockers, but recent studies probed into the effects of finerenone to mitigate the risk of cardiorenal events. This meta-analysis was performed to demonstrate the effects of finerenone on cardiorenal events, comprising cardiovascular mortality, heart failure, change in estimated glomerular filtration rate, and serum potassium levels...
October 2023: Annals of Medicine and Surgery
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