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Med. Interna

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By Vianey Barona I am medical teacher, my speciality is internal medicine. I work for public healtcare.
Timo Gaber, Cindy Strehl, Frank Buttgereit
Immune cells constantly patrol the body via the bloodstream and migrate into multiple tissues where they face variable and sometimes demanding environmental conditions. Nutrient and oxygen availability can vary during homeostasis, and especially during the course of an immune response, creating a demand for immune cells that are highly metabolically dynamic. As an evolutionary response, immune cells have developed different metabolic programmes to supply them with cellular energy and biomolecules, enabling them to cope with changing and challenging metabolic conditions...
May 2017: Nature Reviews. Rheumatology
Elias B Hanna, David Luke Glancy
Heightened awareness of the characteristic patterns of ST-segment depression and T-wave inversion is paramount to quickly identifying life-threatening disorders. This paper reviews how to distinguish the various causes of these abnormalities.
June 2011: Cleveland Clinic Journal of Medicine
John F Garvey, Martino F Pengo, Panagis Drakatos, Brian D Kent
Obstructive sleep apnea (OSA) is probably the most common respiratory disorder, with recent data from the United States and Europe suggesting that between 14% and 49% of middle-aged men have clinically significant OSA. The intimate relationship between OSA and obesity means that its prevalence will only increase as the global obesity epidemic evolves. At an individual level, OSA leads to a significant decrease in quality of life (QOL) and functional capacity, alongside a markedly increased risk of cardiovascular disease and death...
May 2015: Journal of Thoracic Disease
James C Watson, P James B Dyck
Peripheral neuropathy is one of the most prevalent neurologic conditions encountered by physicians of all specialties. Physicians are faced with 3 distinct challenges in caring for patients with peripheral neuropathy: (1) how to efficiently and effectively screen (in less than 2 minutes) an asymptomatic patient for peripheral neuropathy when they have a disorder in which peripheral neuropathy is highly prevalent (eg, diabetes mellitus), (2) how to clinically stratify patients presenting with symptoms of neuropathy to determine who would benefit from specialty consultation and what testing is appropriate for those who do not need consultation, and (3) how to treat the symptoms of painful peripheral neuropathy...
July 2015: Mayo Clinic Proceedings
T Kumazaki, Y Ehara, T Sakai
The hamstring muscles were analyzed anatomically and physiologically to clarify the specific reasons for the incidence of muscle strain of the hamstrings. For the anatomical study, hamstring muscles of 13 embalmed cadavers were dissected. For the physiological study, the knee flexor torque and surface electromyographic (EMG) signals were measured during isometric contraction of hamstring muscles in 10 healthy adults. The biceps femoris muscle long head (BF-L) and semimembranosus muscle (SM) had hemi-pennate architecture and their fiber length per total muscle length (FL/TML) was smaller than that of semtendinosus muscle (ST) and biceps femoris muscle short head (BF-S) with other architecture...
December 2012: International Journal of Sports Medicine
Amogh Hedge, Suyash Mohan, Winston Eng Hoe Lim
Deep neck infections (DNI) have a propensity to spread rapidly along the interconnected deep neck spaces and compromise the airway, cervical vessels and spinal canal. The value of imaging lies in delineating the anatomical extent of the disease process, identifying the source of infection and detecting complications. Its role in the identification and drainage of abscesses is well known. This paper pictorially illustrates infections of important deep neck spaces. The merits and drawbacks of imaging modalities used for assessment of DNI, the relevant anatomy and the possible sources of infection of each deep neck space are discussed...
May 2012: Singapore Medical Journal
Antje Sundseth, Bente Thommessen, Ole Morten Rønning
BACKGROUND AND PURPOSE: Very early mobilization (VEM) is considered to contribute to the beneficial effects of stroke units, but there are uncertainties regarding the optimal time to start mobilization. We hypothesized that VEM within 24 hours after admittance to the hospital would reduce poor outcome 3 months poststroke compared with mobilization between 24 and 48 hours. METHODS: We conducted a prospective, randomized, controlled trial with blinded assessment at follow-up...
September 2012: Stroke; a Journal of Cerebral Circulation
Lei Ding, Thomas L Saunders, Grigori Enikolopov, Sean J Morrison
Several cell types have been proposed to create niches for haematopoietic stem cells (HSCs). However, the expression patterns of HSC maintenance factors have not been systematically studied and no such factor has been conditionally deleted from any candidate niche cell. Thus, the cellular sources of these factors are undetermined. Stem cell factor (SCF; also known as KITL) is a key niche component that maintains HSCs. Here, using Scf(gfp) knock-in mice, we found that Scf was primarily expressed by perivascular cells throughout the bone marrow...
January 25, 2012: Nature
Sabitha Rajan
Skin and soft-tissue infections (SSTIs) are a common presenting problem in both inpatients and outpatients. SSTIs have been broadly classified as complicated or uncomplicated, but specific disease processes and patient characteristics are important in guiding clinical management. Early recognition of the extent of infection, close follow-up, and familiarity with local antibiotic susceptibility data are critical to successful treatment.
January 2012: Cleveland Clinic Journal of Medicine
Thomas H Brannagan
Twenty million people in the United States are estimated to have peripheral neuropathy. However, many patients are not aware of their diagnosis, are not given the diagnosis or being treated, or the diagnosis is delayed. Currently, the only treatments available for neuropathy are aimed at treating the underlying medical conditions that cause the neuropathy or treating symptoms such as pain. Neither treats the actual nerve fiber dysfunction or fiber loss, or helps nerve fibers regenerate. Idiopathic neuropathy, that is neuropathy for which a cause is not identified, is common, accounting in referral series for 25% in all neuropathy patients and 50% or more of patients with small fiber neuropathy...
May 2012: Journal of the Peripheral Nervous System: JPNS
Jack C Salerno, Stephen P Seslar
Supraventricular tachycardia is the most common rhythm disturbance in children. We reviewed the spectrum of this common rhythm disorder from symptom recognition and epidemiology to management, with special attention to advancements in the available treatment options.
March 2009: Archives of Pediatrics & Adolescent Medicine
Nataliya Razumilava, Gregory J Gores
Cholangiocarcinomas (CCAs) are tumors that develop along the biliary tract. Depending on their site of origin, they have different features and require specific treatments. Classification of CCAs into intrahepatic, perihilar, and distal subgroups has helped standardize the registration, treatment, and study of this lethal malignancy. Physicians should remain aware that cirrhosis and viral hepatitis B and C are predisposing conditions for intrahepatic CCA. Treatment options under development include locoregional therapies and a chemotherapy regimen of gemcitabine and cisplatin...
January 2013: Clinical Gastroenterology and Hepatology
Roger Chou, Tracy Dana, Christina Bougatsos, Ian Blazina, Amy J Starmer, Katie Reitel, David I Buckley
BACKGROUND: Pressure ulcers are associated with substantial health burdens but may be preventable. PURPOSE: To review the clinical utility of pressure ulcer risk assessment instruments and the comparative effectiveness of preventive interventions in persons at higher risk. DATA SOURCES: MEDLINE (1946 through November 2012), CINAHL, the Cochrane Library, grant databases, clinical trial registries, and reference lists. STUDY SELECTION: Randomized trials and observational studies on effects of using risk assessment on clinical outcomes and randomized trials of preventive interventions on clinical outcomes...
July 2, 2013: Annals of Internal Medicine
David B Seder, Richard R Riker, Andy Jagoda, Wade S Smith, Scott D Weingart
Airway management is central to the resuscitation of the neurologically ill. These patients often have evolving processes that threaten the airway and adequate ventilation. Therefore, airway, ventilation, and sedation were chosen as an Emergency Neurological Life Support (ENLS) protocol. Reviewed topics include airway management; the decision to intubate; when and how to intubate with attention to cardiovascular status; mechanical ventilation settings; and the use of sedation, including how to select sedative agents based on the patient's neurological status...
September 2012: Neurocritical Care
Eric D Hsi, Robert B Lorsbach, Falko Fend, Ahmet Dogan
B-cell lymphomas with plasmablastic features are a heterogeneous group of lymphomas. While they may share overlapping morphologic or immunophenotypic features, distinct clinicopathologic or molecular genetic features exist for some that have allowed their recognition as distinct entities. Session 2 of the 2009 Society for Hematopathology/European Association for Haematopathology Workshop dealt with the theme of plasmablastic lymphomas (PBLs) and related disorders. Topics included human herpesvirus 8-associated Castleman disease and PBLs, PBLs occurring in the setting of HIV infection, anaplastic large cell lymphoma kinase+ diffuse large B-cell lymphoma, and other lymphomas with plasmablastic or plasmacytic features...
August 2011: American Journal of Clinical Pathology
Robert B Lorsbach, Eric D Hsi, Ahmet Dogan, Falko Fend
Session 1 of the 2009 Workshop of the Society for Hematopathology/European Association of Haematopathology, Cleveland, OH, focused on plasma cell neoplasms. This report summarizes the salient diagnostic, clinical, and genetic features of plasma cell myeloma (PCM) and related neoplasms. Based on the cases submitted to the workshop, we highlight common diagnostic issues and unusual manifestations of plasma cell neoplasms, such as t(11;14)+ PCM, plasma cell leukemia, and nonsecretory plasmacytoma, as well as plasmablastic transformation of PCM...
August 2011: American Journal of Clinical Pathology
Hubert H Fernandez
Most, if not all, currently available drugs for Parkinson disease address dopaminergic loss and relieve symptoms. However, their adverse effects can be limiting and they do not address disease progression. Moreover, nonmotor features of Parkinson disease such as depression, dementia, and psychosis are now recognized as important and disabling. A cure remains elusive. However, promising interventions and agents are emerging. As an example, people who exercise regularly are less likely to develop Parkinson disease, and if they develop it, they tend to have slower progression...
January 2012: Cleveland Clinic Journal of Medicine
Matthew N Simmons, Ryan K Berglund, J Stephen Jones
Screening, diagnosis, and management of prostate cancer can be complicated, with no clear consensus about key issues. We present our approach, which reflects the guidelines of the American Urological Association (AUA).
May 2011: Cleveland Clinic Journal of Medicine
Daniel Gotthardt, Carina Riediger, Karl Heinz Weiss, Jens Encke, Peter Schemmer, Jan Schmidt, Peter Sauer
Fulminant hepatic failure is characterized by the development of severe liver injury with impaired synthetic capacity and encephalopathy in patients with previous normal liver or at least well compensated liver disease. The etiology of fulminant hepatic failure refers to a wide variety of causes, of which toxin-induced or viral hepatitis are most common. In spite of specific therapeutic options in distinctive etiologies, orthotopic liver transplantation is the only therapy proven to improve patient survival in the majority of patients...
September 2007: Nephrology, Dialysis, Transplantation
Cees G M Kallenberg, Peter Heeringa, Coen A Stegeman
Wegener's granulomatosis and microscopic polyangiitis are idiopathic systemic vasculitides strongly associated with antineutrophil cytoplasmic autoantibodies (ANCA). In Wegener's granulomatosis, ANCA are mostly directed against proteinase 3 (PR3), whereas in microscopic polyangiitis ANCA are directed against myeloperoxidase; increases in levels of these autoantibodies precede or coincide with clinical relapses in many cases. In vitro, ANCA can further activate primed neutrophils to release reactive oxygen species and lytic enzymes, and, in conjunction with neutrophils, can damage and lyse endothelial cells...
December 2006: Nature Clinical Practice. Rheumatology
2014-05-27 00:25:20
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