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Holger Thiele, E Magnus Ohman, Suzanne de Waha-Thiele, Uwe Zeymer, Steffen Desch
Cardiogenic shock (CS) remains the most common cause of death in patients admitted with acute myocardial infarction (AMI) and mortality remained nearly unchanged in the range of 40-50% during the last two decades. Early revascularization, vasopressors and inotropes, fluids, mechanical circulatory support, and general intensive care measures are widely used for CS management. However, there is only limited evidence for any of the above treatment strategies except for revascularization and the relative ineffectiveness of intra-aortic balloon pumping...
July 4, 2019: European Heart Journal
Rosemary Dineen, Christopher J Thompson, Mark Sherlock
Adrenal crisis is an acute life-threatening emergency contributing to the excess mortality that is reported in patients with adrenal insufficiency. The incidence of adrenal crisis is estimated to be 8 per 100 patient years in patients with adrenal insufficiency. Patients with adrenal crisis present systemically unwell with nonspecific signs and symptoms often leading to misdiagnosis and delayed treatment. An adrenal crisis may be the first presentation of adrenal insufficiency or can occur in patients who have been established on glucocorticoid replacement therapy...
2019: Therapeutic Advances in Endocrinology and Metabolism
Bernhard Hellmich, Ana Agueda, Sara Monti, Frank Buttgereit, Hubert de Boysson, Elisabeth Brouwer, Rebecca Cassie, Maria Cinta Cid, Bhaskar Dasgupta, Christian Dejaco, Gulen Hatemi, Nicole Hollinger, Alfred Mahr, Susan P Mollan, Chetan Mukhtyar, Cristina Ponte, Carlo Salvarani, Rajappa Sivakumar, Xinping Tian, Gunnar Tomasson, Carl Turesson, Wofgang Schmidt, Peter M Villiger, Richard Watts, Chris Young, Raashid Ahmed Luqmani
BACKGROUND: Since the publication of the European League Against Rheumatism (EULAR) recommendations for the management of large vessel vasculitis (LVV) in 2009, several relevant randomised clinical trials and cohort analyses have been published, which have the potential to change clinical care and therefore supporting the need to update the original recommendations. METHODS: Using EULAR standardised operating procedures for EULAR-endorsed recommendations, the EULAR task force undertook a systematic literature review and sought opinion from 20 experts from 13 countries...
July 3, 2019: Annals of the Rheumatic Diseases
Matthew Tung, Jerome Cerullo Crowley
No abstract text is available yet for this article.
June 27, 2019: American Journal of Respiratory and Critical Care Medicine
Craig R Rackley, Neil R MacIntyre
Since the first description of mechanical ventilation, our understanding of the positive and negative effects of this form of life support has continued to evolve. In order to maintain "normal" aeration of the lungs and "normal" blood gas measurements, patients often require much higher airway pressures and tidal volumes than would be expected in a healthy, spontaneously breathing adult. In the early days of mechanical ventilation the goal was to normalize the blood gas, but over the last several decades, we have developed a much better appreciation for the deleterious effects of mechanical ventilation...
June 27, 2019: Chest
Daisuke Kasugai, Akihiko Hirakawa, Masuyuki Ozaki, Kazuki Nishida, Takao Ikeda, Kunihiko Takahashi, Shigeyuki Matsui, Norimichi Uenishi
BACKGROUND: The management of refractory septic shock remains a major challenge in critical care and its early indicators are not fully understood. We hypothesized that the maximum norepinephrine dosage within 24 hours of intensive care unit (ICU) admission may be a useful indicator of early mortality in patients with septic shock. METHODS: In this retrospective single-center observational study, patients with septic shock admitted to the emergency ICU of an academic medical center between April 2011 and March 2017 were included...
June 27, 2019: Journal of Intensive Care Medicine
Matthew Banks, David Graham, Marnix Jansen, Takuji Gotoda, Sergio Coda, Massimiliano di Pietro, Noriya Uedo, Pradeep Bhandari, D Mark Pritchard, Ernst J Kuipers, Manuel Rodriguez-Justo, Marco R Novelli, Krish Ragunath, Neil Shepherd, Mario Dinis-Ribeiro
Gastric adenocarcinoma carries a poor prognosis, in part due to the late stage of diagnosis. Risk factors include Helicobacter pylori infection, family history of gastric cancer-in particular, hereditary diffuse gastric cancer and pernicious anaemia. The stages in the progression to cancer include chronic gastritis, gastric atrophy (GA), gastric intestinal metaplasia (GIM) and dysplasia. The key to early detection of cancer and improved survival is to non-invasively identify those at risk before endoscopy. However, although biomarkers may help in the detection of patients with chronic atrophic gastritis, there is insufficient evidence to support their use for population screening...
July 5, 2019: Gut
Peter Hr Green, Stefano Guandalini
No abstract text is available yet for this article.
June 28, 2019: Gastroenterology
Freek W A Verheugt, Jurriën M Ten Berg, Robert F Storey, Thomas Cuisset, Christopher B Granger
For secondary prevention of coronary artery disease (CAD), oral antiplatelet therapy is essential. In case of coronary intervention, temporary dual antiplatelet therapy is mandatory as well. Recently, low-dose oral anticoagulation has entered the CAD arena. Atrial fibrillation (AF) is often seen in CAD and vice versa. In most patients stroke prevention in AF consists of oral anticoagulation. In many cases of CAD in patients with AF, anticoagulation has to be combined with antiplatelet agents (so called, dual pathway antithrombotic therapy)...
June 27, 2019: Journal of the American College of Cardiology
T Wall, A Sherwin, D Ma, D J Buggy
Surgery is an important treatment modality for the majority of solid organ cancers. Unfortunately, cancer recurrence following surgery of curative intent is common, and typically results in refractory disease and patient death. Surgery and other perioperative interventions induce a biological state conducive to the survival and growth of residual cancer cells released from the primary tumour intraoperatively, which may influence the risk of a subsequent metastatic disease. Evidence is accumulating that anaesthetic and analgesic interventions could affect many of these pathophysiological processes, influencing risk of cancer recurrence in either a beneficial or detrimental way...
June 26, 2019: British Journal of Anaesthesia
Kim F Chiang, Shreya J Shah, Randall S Stafford
No abstract text is available yet for this article.
June 28, 2019: JAMA: the Journal of the American Medical Association
Zhi-Chun Gu, An-Hua Wei, Chi Zhang, Xin-Hua Wang, Le Zhang, Long Shen, Zheng Li, Mang-Mang Pan, Xiao-Yan Liu, Jun Pu, Hou-Wen Lin
BACKGROUND & AIMS: There is controversy over whether use of non-vitamin K antagonist oral anticoagulants (NOACs) associates with increased risk of major gastrointestinal bleeding (GIB) compared with conventional therapies (such as vitamin K antagonists or anti-platelet agents). We performed a systematic review and meta-analysis of data from randomized controlled trials and high-quality real-world studies. METHODS: We performed a systematic search of the MEDLINE, EMBASE, Cochrane Library, and ClinicalTrials...
June 10, 2019: Clinical Gastroenterology and Hepatology
Pamela S Douglas, Blase A Carabello, Roberto M Lang, Leo Lopez, Patricia A Pellikka, Michael H Picard, James D Thomas, Paul Varghese, Tracy Y Wang, Neil J Weissman, Rebecca Wilgus
No abstract text is available yet for this article.
June 20, 2019: Journal of the American College of Cardiology
Christian Mueller, Kenneth McDonald, Rudolf A de Boer, Alan Maisel, John G F Cleland, Nikola Kozhuharov, Andrew J S Coats, Marco Metra, Alexandre Mebazaa, Frank Ruschitzka, Mitja Lainscak, Gerasimos Filippatos, Petar M Seferovic, Wouter C Meijers, Antoni Bayes-Genis, Thomas Mueller, Mark Richards, James L Januzzi
Natriuretic peptide [NP; B-type NP (BNP), N-terminal proBNP (NT-proBNP), and midregional proANP (MR-proANP)] concentrations are quantitative plasma biomarkers for the presence and severity of haemodynamic cardiac stress and heart failure (HF). End-diastolic wall stress, intracardiac filling pressures, and intracardiac volumes seem to be the dominant triggers. This paper details the most important indications for NPs and highlights 11 key principles underlying their clinical use shown below. NPs should always be used in conjunction with all other clinical information...
June 2019: European Journal of Heart Failure
Bruce C V Campbell
No abstract text is available yet for this article.
June 21, 2019: Stroke; a Journal of Cerebral Circulation
Alain Cohn, Michel André Maréchal, David Tannenbaum, Christian Lukas Zünd
Civic honesty is essential to social capital and economic development, but is often in conflict with material self-interest. We examine the trade-off between honesty and self-interest using field experiments in 355 cities spanning 40 countries around the globe. We turned in over 17,000 lost wallets with varying amounts of money at public and private institutions, and measured whether recipients contacted the owner to return the wallets. In virtually all countries citizens were more likely to return wallets that contained more money...
June 20, 2019: Science
Ishan S Kamat, Vignesh Ramachandran, Harish Eswaran, Danielle Guffey, Daniel M Musher
Because of the diverse etiologies of community acquired pneumonia (CAP) and the limitations of current diagnostic modalities, serum procalcitonin levels have been proposed as a novel tool to guide antibiotic therapy. Outcome data from procalcitonin-guided therapy trials have shown similar mortality, but the essential question is whether the sensitivity and specificity of procalcitonin levels enable the practitioner to distinguish bacterial pneumonia, which requires antibiotic therapy, from viral pneumonia, which does not...
June 25, 2019: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Helen K Reddel, J Mark FitzGerald, Eric D Bateman, Leonard B Bacharier, Allan Becker, Guy Brusselle, Roland Buhl, Alvaro A Cruz, Louise Fleming, Hiromasa Inoue, Fanny Wai-San Ko, Jerry A Krishnan, Mark L Levy, Jiangtao Lin, Søren E Pedersen, Aziz Sheikh, Arzu Yorgancioglu, Louis-Philippe Boulet
No abstract text is available yet for this article.
June 2019: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Alok A Khorana, Shannon E McKernin, Jordan Berlin, Theodore S Hong, Anirban Maitra, Cassadie Moravek, Matthew Mumber, Richard Schulick, Herbert J Zeh, Matthew H G Katz
PURPOSE: The purpose of this guideline update is to incorporate recently reported practice-changing evidence into ASCO's recommendations on potentially curable pancreatic adenocarcinoma. METHODS: ASCO convened an Expert Panel to evaluate data from PRODIGE 24/CCTG PA.6, a phase III, multicenter, randomized clinical trial of postoperative leucovorin calcium, fluorouracil, irinotecan hydrochloride, and oxaliplatin (FOLFIRINOX) versus gemcitabine alone, presented at the 2018 ASCO Annual Meeting...
June 10, 2019: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Yojiro Hashiguchi, Kei Muro, Yutaka Saito, Yoshinori Ito, Yoichi Ajioka, Tetsuya Hamaguchi, Kiyoshi Hasegawa, Kinichi Hotta, Hideyuki Ishida, Megumi Ishiguro, Soichiro Ishihara, Yukihide Kanemitsu, Yusuke Kinugasa, Keiko Murofushi, Takako Eguchi Nakajima, Shiro Oka, Toshiaki Tanaka, Hiroya Taniguchi, Akihito Tsuji, Keisuke Uehara, Hideki Ueno, Takeharu Yamanaka, Kentaro Yamazaki, Masahiro Yoshida, Takayuki Yoshino, Michio Itabashi, Kentaro Sakamaki, Keiji Sano, Yasuhiro Shimada, Shinji Tanaka, Hiroyuki Uetake, Shigeki Yamaguchi, Naohiko Yamaguchi, Hirotoshi Kobayashi, Keiji Matsuda, Kenjiro Kotake, Kenichi Sugihara
The number of deaths from colorectal cancer in Japan continues to increase. Colorectal cancer deaths exceeded 50,000 in 2016. In the 2019 edition, revision of all aspects of treatments was performed, with corrections and additions made based on knowledge acquired since the 2016 version (drug therapy) and the 2014 version (other treatments). The Japanese Society for Cancer of the Colon and Rectum guidelines 2019 for the treatment of colorectal cancer (JSCCR guidelines 2019) have been prepared to show standard treatment strategies for colorectal cancer, to eliminate disparities among institutions in terms of treatment, to eliminate unnecessary treatment and insufficient treatment and to deepen mutual understanding between healthcare professionals and patients by making these guidelines available to the general public...
June 15, 2019: International Journal of Clinical Oncology
2019-07-08 00:24:58
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