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The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee (, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi...
January 2020: Diabetes Care
Lisa R Sammaritano
Antiphospholipid syndrome is an autoimmune systemic disorder characterized by arterial, venous, or small vessel thrombosis and/or recurrent early pregnancy loss, fetal loss, or pregnancy morbidity in the setting of documented persistent antiphospholipid antibodies that include the lupus anticoagulant, or moderate-high titer anticardiolipin, or anti-β2Glycoprotein I antibodies. Associated clinical manifestations include livedo reticularis, cutaneous ulcerations, thrombocytopenia, hemolytic anemia, valvular heart disease, and nephropathy...
December 19, 2019: Best Practice & Research. Clinical Rheumatology
Luca Cabrini, Martina Baiardo Redaelli, Martina Filippini, Evgeny Fominskiy, Laura Pasin, Margherita Pintaudi, Valentina Paola Plumari, Alessandro Putzu, Carmine D Votta, Ottavia Pallanch, Lorenzo Ball, Giovanni Landoni, Paolo Pelosi, Alberto Zangrillo
BACKGROUND: tracheal intubation in patients at risk for secondary spinal cord injury is potentially difficult and risky. OBJECTIVES: to compare tracheal intubation techniques in adult patients at risk for secondary cervical spinal cord injury undergoing surgery. Primary outcome was first-attempt failure rate. Secondary outcomes were time to successful intubation and procedure complications. DESIGN: systematic review and meta-analysis of RCTs with trial sequential analysis (TSA)...
December 14, 2019: Acta Anaesthesiologica Scandinavica
Rohit P Shenoi, Nathan Timm
This clinical report is a revision of "Preparing for Pediatric Emergencies: Drugs to Consider." It updates the list, indications, and dosages of medications used to treat pediatric emergencies in the prehospital, pediatric clinic, and emergency department settings. Although it is not an all-inclusive list of medications that may be used in all emergencies, this resource will be helpful when treating a vast majority of pediatric medical emergencies. Dosage recommendations are consistent with current emergency references such as the Advanced Pediatric Life Support and Pediatric Advanced Life Support textbooks and American Heart Association resuscitation guidelines...
December 23, 2019: Pediatrics
Douglas A Simonetto, Ashwani K Singal, Guadalupe Garcia-Tsao, Stephen H Caldwell, Joseph Ahn, Patrick S Kamath
Disorders of the mesenteric, portal, and hepatic veins and mesenteric and hepatic arteries have important clinical consequences and may lead to acute liver failure, chronic liver disease, noncirrhotic portal hypertension, cirrhosis, and hepatocellular carcinoma. Although literature in the field of vascular liver disorders is scant, these disorders are common in clinical practice, and general practitioners, gastroenterologists, and hepatologists may benefit from expert guidance and recommendations for management of these conditions...
January 2020: American Journal of Gastroenterology
Robb D Kociol, Leslie T Cooper, James C Fang, Javid J Moslehi, Peter S Pang, Marwa A Sabe, Ravi V Shah, Daniel B Sims, Gaetano Thiene, Orly Vardeny
Fulminant myocarditis (FM) is an uncommon syndrome characterized by sudden and severe diffuse cardiac inflammation often leading to death resulting from cardiogenic shock, ventricular arrhythmias, or multiorgan system failure. Historically, FM was almost exclusively diagnosed at autopsy. By definition, all patients with FM will need some form of inotropic or mechanical circulatory support to maintain end-organ perfusion until transplantation or recovery. Specific subtypes of FM may respond to immunomodulatory therapy in addition to guideline-directed medical care...
January 6, 2020: Circulation
Amir Qaseem, Carrie A Horwitch, Sandeep Vijan, Itziar Etxeandia-Ikobaltzeta, Devan Kansagara
Description: The American College of Physicians (ACP) developed this guideline to provide clinical recommendations based on the current evidence of the benefits and harms of testosterone treatment in adult men with age-related low testosterone. This guideline is endorsed by the American Academy of Family Physicians. Methods: The ACP Clinical Guidelines Committee based these recommendations on a systematic review on the efficacy and safety of testosterone treatment in adult men with age-related low testosterone...
January 7, 2020: Annals of Internal Medicine
Fabio Sallustio, Claudia Curci, Vincenzo Di Leo, Anna Gallone, Francesco Pesce, Loreto Gesualdo
IgA Nephropathy (IgAN) is a primary glomerulonephritis problem worldwide that develops mainly in the 2nd and 3rd decade of life and reaches end-stage kidney disease after 20 years from the biopsy-proven diagnosis, implying a great socio-economic burden. IgAN may occur in a sporadic or familial form. Studies on familial IgAN have shown that 66% of asymptomatic relatives carry immunological defects such as high IgA serum levels, abnormal spontaneous in vitro production of IgA from peripheral blood mononuclear cells (PBMCs), high serum levels of aberrantly glycosylated IgA1, and an altered PBMC cytokine production profile...
December 26, 2019: International Journal of Molecular Sciences
Jaclyn R Duvall, Carrie E Robertson, Mark A Whealy, Ivan Garza
No abstract text is available yet for this article.
January 7, 2020: Neurology
Délia Szok, János Tajti, Aliz Nyári, László Vécsei
Neuropathic pain is a chronic secondary pain condition, which is a consequence of peripheral or central nervous (somatosensory) system lesions or diseases. It is a devastating condition, which affects around 7% of the general population. Numerous etiological factors contribute to the development of chronic neuropathic pain. It can originate from the peripheral part of the nervous system such as in the case of trigeminal or postherpetic neuralgia, peripheral nerve injury, painful polyneuropathies, or radiculopathies...
2019: Behavioural Neurology
Rafael de Cabo, Mark P Mattson
New England Journal of Medicine, Volume 381, Issue 26, Page 2541-2551, December 2019.
December 26, 2019: New England Journal of Medicine
Alessandra Chiarenza, Luca Esposto Ultimo, Daniele Falsaperla, Mario Travali, Pietro Valerio Foti, Sebastiano Emanuele Torrisi, Matteo Schisano, Letizia Antonella Mauro, Gianluca Sambataro, Antonio Basile, Carlo Vancheri, Stefano Palmucci
Several imaging findings of thoracic diseases have been referred-on chest radiographs or CT scans-to signs, symbols, or naturalistic images. Most of these imaging findings include the air bronchogram sign, the air crescent sign, the arcade-like sign, the atoll sign, the cheerios sign, the crazy paving appearance, the comet-tail sign, the darkus bronchus sign, the doughnut sign, the pattern of eggshell calcifications, the feeding vessel sign, the finger-in-gloove sign, the galaxy sign, the ginkgo leaf sign, the Golden-S sign, the halo sign, the headcheese sign, the honeycombing appearance, the interface sign, the knuckle sign, the monod sign, the mosaic attenuation, the Oreo-cookie sign, the polo-mint sign, the presence of popcorn calcifications, the positive bronchus sign, the railway track appearance, the scimitar sign, the signet ring sign, the snowstorm sign, the sunburst sign, the tree-in-bud distribution, and the tram truck line appearance...
December 4, 2019: Insights Into Imaging
Emanuele Rezoagli, Giacomo Bellani
No abstract text is available yet for this article.
December 16, 2019: Critical Care: the Official Journal of the Critical Care Forum
Robert G Hahn
The distribution and elimination kinetics of the water volume in infusion fluids can be studied by volume kinetics. The approach is a modification of drug pharmacokinetics, which uses repeated measurements of blood hemoglobin and urinary excretion as input variables in (usually) a two-compartment model with expandable walls. Study results show that crystalloid fluid has a distribution phase that gives these fluids a plasma volume expansion amounting to 50-60% of the infused volume as long as the infusion lasts, while the fraction is reduced to 15-20% within 30 min after the infusion ends...
December 20, 2019: Acta Anaesthesiologica Scandinavica
Mathieu Blot, Pascal Chavanet, Lionel Piroth
No abstract text is available yet for this article.
December 17, 2019: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
R Pasquali, F Casanueva, M Haluzik, L van Hulsteijn, S Ledoux, M P Monteiro, J Salvador, F Santini, H Toplak, O M Dekkers
Obesity is an emerging condition, with a prevalence of ~20%. Although the simple measurement of BMI is likely a simplistic approach to obesity, BMI is easily calculated, and there are currently no data showing that more sophisticated methods are more useful to guide the endocrine work-up in obesity. An increased BMI leads to a number of hormonal changes. Additionally, concomitant hormonal diseases can be present in obesity and have to be properly diagnosed - which in turn might be more difficult due to alterations caused by body fatness itself...
January 2020: European Journal of Endocrinology
Sima L Sharara, Joe Amoah, Zoi D Pana, Patricia J Simner, Sara E Cosgrove, Pranita D Tamma
BACKGROUND: Limited data exist regarding the efficacy of piperacillin-tazobactam (TZP) for the management of non-bacteremic pyelonephritis caused by ESBL-producing organisms. METHODS: We conducted a multicenter observational study comparing clinical outcomes in adults hospitalized with ESBL-producing pyelonephritis receiving TZP versus carbapenems using an inverse probability of treatment weighted propensity score analysis. Patients were eligible for inclusion if all of the following criteria were met: (1) urine cultures growing Escherichia coli, Klebsiella pneumoniae, K...
December 20, 2019: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Paul E Drawz, Srinivasan Beddhu, Holly J Kramer, Michael Rakotz, Michael V Rocco, Paul K Whelton
The majority of patients with chronic kidney disease (CKD) have elevated blood pressure (BP). In patients with CKD, hypertension is associated with increased risk for cardiovascular disease, progression of CKD, and all-cause mortality. New guidelines from the American College of Cardiology/American Heart Association (ACC/AHA) recommend new thresholds and targets for the diagnosis and treatment of hypertension in patients with and without CKD. A new aspect of the guidelines is the recommendation for measurement of out-of-office BP to confirm the diagnosis of hypertension and guide therapy...
December 5, 2019: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Eiman Y Ibrahim, Barbara E Ehrlich
Chemotherapy-induced peripheral neuropathy (CIPN) is an adverse effect of chemotherapy that is frequently experienced by patients receiving treatment for cancer. CIPN is caused by many of the most commonly used chemotherapeutic agents, including taxanes, vinca alkaloids, and bortezomib. Pain and sensory abnormalities may persist for months, or even years after the cessation of chemotherapy. The management of CIPN is a significant challenge, as it is not possible to predict which patients will develop symptoms, the timing for the appearance of symptoms can develop anytime during the chemotherapy course, there are no early indications that warrant a reduction in the dosage to halt CIPN progression, and there are no drugs approved to prevent or alleviate CIPN...
November 13, 2019: Critical Reviews in Oncology/hematology
Soraya Arzhan, Maria-Eleni Roumelioti, Mark L Unruh
BACKGROUND: Uremic pruritus (UP) and restless legs syndrome (RLS) are highly prevalent complaints among patients with end-stage renal disease (ESRD) undergoing chronic dialysis. These chronic troublesome symptoms lead to a significant decrease in quality of life (QOL) and increase in mortality rate. Despite their distressing characteristics, these symptoms usually remain under-recognized by healthcare providers. Therefore, careful history intake, and stepwise treatment are essential. Numerous pharmacological and non-pharmacological treatments have been demonstrated to help in controlling these 2 conditions...
December 18, 2019: Blood Purification
2020-01-06 00:24:59
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