Patrick B Mark, Kenneth Mangion, Alastair J Rankin, Elaine Rutherford, Ninian N Lang, Mark C Petrie, Sokratis Stoumpos, Rajan K Patel
Chronic kidney disease (CKD) is a risk factor for premature cardiovascular disease. As kidney function declines, the presence of left ventricular abnormalities increases such that by the time kidney replacement therapy is required with dialysis or kidney transplantation, more than two-thirds of patients have left ventricular hypertrophy. Historically, much research in nephrology has focussed on the structural and functional aspects of cardiac disease in CKD, particularly using echocardiography to describe these abnormalities...
December 2022: Clinical Kidney Journal
Luis Carlos Saiz, Javier Gorricho, Javier Garjón, Mª Concepción Celaya, Juan Erviti, Leire Leache
BACKGROUND: This is the third update of the review first published in 2017. Hypertension is a prominent preventable cause of premature morbidity and mortality. People with hypertension and established cardiovascular disease are at particularly high risk, so reducing blood pressure to below standard targets may be beneficial. This strategy could reduce cardiovascular mortality and morbidity but could also increase adverse events. The optimal blood pressure target in people with hypertension and established cardiovascular disease remains unknown...
November 18, 2022: Cochrane Database of Systematic Reviews
Alejandro Placenti, Franco Fratebianchi
Thirty years ago, the traditional approach to mechanical ventilation consisted of the normalization of PaCO2 and pH at the expense of using a tidal volume (VT) of 10-15 mL kg-1. But then, the use of 6-8 mL kg-1 became a dogma for ventilating patients either with acute respiratory distress syndrome (ARDS) or without lung disease in the operating theatre. It is currently recognized that even low tidal volumes may be excessive for some patients and insufficient for others, depending on its distribution in the aerated lung parenchyma...
November 8, 2022: Anaesthesiology Intensive Therapy
Philippe Gabriel Steg, John Kikoïne
No abstract text is available yet for this article.
November 16, 2022: Circulation
John Selickman, John J Marini
Clinicians monitor mechanical ventilatory support using airway pressures-primarily the plateau and driving pressure, which are considered by many to determine the safety of the applied tidal volume. These airway pressures are influenced not only by the ventilator prescription, but also by the mechanical properties of the respiratory system, which consists of the series-coupled lung and chest wall. Actively limiting chest wall expansion through external compression of the rib cage or abdomen is seldom performed in the ICU...
November 8, 2022: Annals of Intensive Care
Merve Fritsch, Ida Rangus, Christian H Nolte
PURPOSE OF REVIEW: Thalamic aphasia is a rare language disorder resulting from lesions to the thalamus. While most patients exhibit mild symptoms with a predominance of lexical-semantic difficulties, variations in phenotype have been described. Overall, the exact mechanisms of thalamic aphasia await empirical research. The article reviews recent findings regarding phenotypes and possible underlying mechanisms of thalamic aphasia. RECENT FINDINGS: Variations in phenotype of thalamic aphasia may be related to different lesion locations...
November 16, 2022: Current Neurology and Neuroscience Reports
Ângelo Zambam de Mattos, Douglas Alano Simonetto, Carlos Terra, Alberto Queiroz Farias, Paulo Lisboa Bittencourt, Tales Henrique Soares Pase, Marlon Rubini Toazza, Angelo Alves de Mattos
Mortality in cirrhosis is mostly associated with the development of clinical decompensation, characterized by ascites, hepatic encephalopathy, variceal bleeding, or jaundice. Therefore, it is important to prevent and manage such complications. Traditionally, the pathophysiology of decompensated cirrhosis was explained by the peripheral arterial vasodilation hypothesis, but it is currently understood that decompensation might also be driven by a systemic inflammatory state (the systemic inflammation hypothesis)...
September 7, 2022: World Journal of Gastroenterology: WJG
Doran Drew, Ariel Hendin, Debra Eagles
No abstract text is available yet for this article.
November 11, 2022: CJEM
Vladimír Tesař
From a certain stage, chronic kidney disease progresses to terminal kidney failure that requires renal replacement therapy with dialysis or transplantation. The progression can be significantly slowed by blocking the renin angiotensin aldosterone system (RAAS) with angiotensin converting enzyme (ACE) inhibitors or angiotensin II type 1 receptor blockers (ARB). Another new option to enhance the effect of blocking the RAAS system is the use of sodium glucose cotransporter 2 (SGLT2) inhibitors, or gliflozins. Dapagliflozin is currently available and reimbursed for patients with both diabetic and non-diabetic kidney disease...
2022: Vnitr̆ní Lékar̆ství
Hiroyoshi Takeuchi, Yasuhiro Mori, Yuichiro Tsutsumi
UNLABELLED: Tardive dyskinesia (TD), a movement disorder associated with antipsychotics, most frequently affects the lower face and jaw muscles, but can also affect walking, breathing and use of the hands and limbs. Knowledge of TD among physicians may be limited, and the pathophysiology of TD is poorly understood. We conducted this review to summarise the current knowledge surrounding the pathophysiology of TD and present recommendations for prevention and treatment based on a literature search and roundtable discussion attended by psychiatrists in Japan...
2022: Therapeutic Advances in Psychopharmacology
Robert M Carey, Andrew E Moran, Paul K Whelton
IMPORTANCE: Hypertension, defined as persistent systolic blood pressure (SBP) at least 130 mm Hg or diastolic BP (DBP) at least 80 mm Hg, affects approximately 116 million adults in the US and more than 1 billion adults worldwide. Hypertension is associated with increased risk of cardiovascular disease (CVD) events (coronary heart disease, heart failure, and stroke) and death. OBSERVATIONS: First-line therapy for hypertension is lifestyle modification, including weight loss, healthy dietary pattern that includes low sodium and high potassium intake, physical activity, and moderation or elimination of alcohol consumption...
November 8, 2022: JAMA
Koshi Hashimoto
Subclinical thyroid dysfunction is defined by serum thyroid-stimulating hormone (TSH) levels either greater or less than the reference range with normal thyroxine (T4) concentrations, and consists of subclinical hypothyroidism (SCH) and subclinical hyperthyroidism (SCHyper). For the proper diagnosis of SCH, it is most important to be able to correctly evaluate the serum TSH levels, which have numerous unique characteristics. We also need to be versed in TSH harmonization, which was recently launched world-wide...
July 28, 2022: Endocrine Journal
Deborah Wagner, S L Kronick, H Nawer, J A Cranford, S M Bradley, R W Neumar
BACKGROUND: American Heart Association (AHA) Advanced Cardiac Life Support (ACLS) guidelines support the use of either amiodarone or lidocaine for cardiac arrest due to ventricular tachycardia or ventricular fibrillation (VT/VF) based on studies of out of hospital cardiac arrest. Studies comparing amiodarone and lidocaine in adult populations with in-hospital VT/VF arrest are lacking. RESEARCH QUESTION: Does treatment with amiodarone vs. lidocaine therapy have differential associations with outcomes among adult patients with in-hospital cardiac arrest (IHCA) from VT/VF? STUDY DESIGN AND METHODS: Retrospective cohort study of adult patients receiving amiodarone or lidocaine for VT/VF in-hospital cardiac arrest refractory to cardiopulmonary resuscitation (CPR) and defibrillation between January 1, 2000, to December 31, 2014, within the American Heart Association Get With the Guidelines-Resuscitation® (GWTG-R) participating hospitals...
November 1, 2022: Chest
William G Herrington, Natalie Staplin, Christoph Wanner, Jennifer B Green, Sibylle J Hauske, Jonathan R Emberson, David Preiss, Parminder Judge, Kaitlin J Mayne, Sarah Y A Ng, Emily Sammons, Doreen Zhu, Michael Hill, Will Stevens, Karl Wallendszus, Susanne Brenner, Alfred K Cheung, Zhi-Hong Liu, Jing Li, Lai Seong Hooi, Wen Liu, Takashi Kadowaki, Masaomi Nangaku, Adeera Levin, David Cherney, Aldo P Maggioni, Roberto Pontremoli, Rajat Deo, Shinya Goto, Xavier Rossello, Katherine R Tuttle, Dominik Steubl, Michaela Petrini, Dan Massey, Jens Eilbracht, Martina Brueckmann, Martin J Landray, Colin Baigent, Richard Haynes
BACKGROUND: The effects of empagliflozin in patients with chronic kidney disease who are at risk for disease progression are not well understood. The EMPA-KIDNEY trial was designed to assess the effects of treatment with empagliflozin in a broad range of such patients. METHODS: We enrolled patients with chronic kidney disease who had an estimated glomerular filtration rate (eGFR) of at least 20 but less than 45 ml per minute per 1.73 m2 of body-surface area, or who had an eGFR of at least 45 but less than 90 ml per minute per 1...
November 4, 2022: New England Journal of Medicine
(no author information available yet)
The sixth edition of the Japanese Gastric Cancer Treatment Guidelines was completed in July 2021, incorporating new evidence that emerged after publication of the previous edition. It consists of a text-based "Treatments" part and a "Clinical Questions" part including recommendations and explanations for clinical questions. The treatments parts include a comprehensive description regarding surgery, endoscopic resection and chemotherapy for gastric cancer. The clinical question part is based on the literature search and evaluation by an independent systematic review team...
November 7, 2022: Gastric Cancer
Joseph Phan, Mario Ramos, Theodore Soares, Mayur S Parmar
Stroke is the most common cause of epilepsy and ultimately leads to a decrease in the quality of life of those affected. Ischemic and hemorrhagic strokes can both lead to poststroke epilepsy (PSE). Significant risk factors for PSE include age < 65age less than 65 years, stroke severity measured by the National Institutes of Health Stroke Scale (NIHSS), cortical involvement, and genetic factors such as TRPM6 polymorphism. The diagnosis of PSE is made by using imaging modalities, blood biomarkers, and prognostic criteria...
2022: Oxidative Medicine and Cellular Longevity
Josef S Smolen, Robert B M Landewé, Sytske Anne Bergstra, Andreas Kerschbaumer, Alexandre Sepriano, Daniel Aletaha, Roberto Caporali, Christopher John Edwards, Kimme L Hyrich, Janet E Pope, Savia de Souza, Tanja A Stamm, Tsutomu Takeuchi, Patrick Verschueren, Kevin L Winthrop, Alejandro Balsa, Joan M Bathon, Maya H Buch, Gerd R Burmester, Frank Buttgereit, Mario Humberto Cardiel, Katerina Chatzidionysiou, Catalin Codreanu, Maurizio Cutolo, Alfons A den Broeder, Khadija El Aoufy, Axel Finckh, João Eurico Fonseca, Jacques-Eric Gottenberg, Espen A Haavardsholm, Annamaria Iagnocco, Kim Lauper, Zhanguo Li, Iain B McInnes, Eduardo F Mysler, Peter Nash, Gyula Poor, Gorica G Ristic, Felice Rivellese, Andrea Rubbert-Roth, Hendrik Schulze-Koops, Nikolay Stoilov, Anja Strangfeld, Annette van der Helm-van Mil, Elsa van Duuren, Theodora P M Vliet Vlieland, René Westhovens, Désirée van der Heijde
OBJECTIVES: To provide an update of the EULAR rheumatoid arthritis (RA) management recommendations addressing the most recent developments in the field. METHODS: An international task force was formed and solicited three systematic literature research activities on safety and efficacy of disease-modifying antirheumatic drugs (DMARDs) and glucocorticoids (GCs). The new evidence was discussed in light of the last update from 2019. A predefined voting process was applied to each overarching principle and recommendation...
November 10, 2022: Annals of the Rheumatic Diseases
Jeehoon Kang, Kyung Woo Park, Huijin Lee, Doyeon Hwang, Han-Mo Yang, Seung-Woon Rha, Jang-Whan Bae, Nam Ho Lee, Seung Ho Hur, Jung-Kyu Han, Eun-Seok Shin, Bon-Kwon Koo, Hyo-Soo Kim
Background: Long term outcomes of antiplatelet monotherapy in patients who receive percutaneous coronary intervention (PCI) are unknown. The HOST-EXAM Extended study reports the post-trial follow-up results of the original HOST-EXAM trial. Methods: From March 2014 through May 2018, 5438 patients who maintained dual antiplatelet therapy without clinical events for 12±6 months after PCI with drug-eluting stents (DES) were randomly assigned in a 1:1 ratio to receive clopidogrel 75mg once daily or aspirin 100mg once daily...
November 7, 2022: Circulation
Ricardo Kienitz, Lara Kay, Isabelle Beuchat, Sarah Gelhard, Sophie von Brauchitsch, Catrin Mann, Alexandra Lucaciu, Jan-Hendrik Schäfer, Kai Siebenbrodt, Johann-Philipp Zöllner, Susanne Schubert-Bast, Felix Rosenow, Adam Strzelczyk, Laurent M Willems
Status epilepticus (SE) is an acute, life-threatening medical condition that requires immediate, effective therapy. Therefore, the acute care of prolonged seizures and SE is a constant challenge for healthcare professionals, in both the pre-hospital and the in-hospital settings. Benzodiazepines (BZDs) are the first-line treatment for SE worldwide due to their efficacy, tolerability, and rapid onset of action. Although all BZDs act as allosteric modulators at the inhibitory gamma-aminobutyric acid (GABA)A receptor, the individual agents have different efficacy profiles and pharmacokinetic and pharmacodynamic properties, some of which differ significantly...
August 16, 2022: CNS Drugs
Elliott M Antman, Jane A Leopold, William H Sauer, Paul C Zei
New England Journal of Medicine, Volume 387, Issue 16, October 2022.
October 20, 2022: New England Journal of Medicine
2022-11-22 00:24:58
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