collection
https://read.qxmd.com/read/38418204/changes-in-alcohol-intake-and-serum-urate-changes-longitudinal-analyses-of-annual-medical-examination-database
#1
JOURNAL ARTICLE
Sho Fukui, Masato Okada, Tomohiro Shinozaki, Takahiro Asano, Takehiro Nakai, Hiromichi Tamaki, Mitsumasa Kishimoto, Hiroshi Hasegawa, Takeaki Matsuda, Javier Marrugo, Sara K Tedeschi, Hyon Choi, Daniel H Solomon
INTRODUCTION: Despite the established cross-sectional association between alcohol intake and serum urate (SU), its longitudinal association remains unknown. This study aimed to determine whether changes in alcohol intake have a clinically relevant association with SU change. METHOD: We conducted retrospective analyses using systematically collected annual medical examination data from October 2012 to October 2022 in a Japanese preventive medicine centre. The exposure was changes in alcohol intake between two consecutive visits...
February 28, 2024: Annals of the Rheumatic Diseases
https://read.qxmd.com/read/38224592/gabapentinoids-and-risk-for-severe-exacerbation-in-chronic-obstructive-pulmonary-disease-a-population-based-cohort-study
#2
JOURNAL ARTICLE
Alvi A Rahman, Sophie Dell'Aniello, Erica E M Moodie, Madeleine Durand, Janie Coulombe, Jean-François Boivin, Samy Suissa, Pierre Ernst, Christel Renoux
BACKGROUND: North American and European health agencies recently warned of severe breathing problems associated with gabapentinoids, including in patients with chronic obstructive pulmonary disease (COPD), although supporting evidence is limited. OBJECTIVE: To assess whether gabapentinoid use is associated with severe exacerbation in patients with COPD. DESIGN: Time-conditional propensity score-matched, new-user cohort study. SETTING: Health insurance databases from the Régie de l'assurance maladie du Québec in Canada...
February 2024: Annals of Internal Medicine
https://read.qxmd.com/read/37245039/hypovolemia-with-peripheral-edema-what-is-wrong
#3
REVIEW
Randal O Dull, Robert G Hahn
Fluid normally exchanges freely between the plasma and interstitial space and is returned primarily via the lymphatic system. This balance can be disturbed by diseases and medications. In inflammatory disease states, such as sepsis, the return flow of fluid from the interstitial space to the plasma seems to be very slow, which promotes the well-known triad of hypovolemia, hypoalbuminemia, and peripheral edema. Similarly, general anesthesia, for example, even without mechanical ventilation, increases accumulation of infused crystalloid fluid in a slowly equilibrating fraction of the extravascular compartment...
May 27, 2023: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/37148365/cardiovascular-manifestations-in-idiopathic-inflammatory-myopathies
#4
REVIEW
Meera Shah, Samuel Katsuyuki Shinjo, Jessica Day, Latika Gupta
Cardiovascular involvement in idiopathic inflammatory myopathies (IIM) is an understudied area which is gaining increasing recognition in recent times. Recent advances in imaging modalities and biomarkers have allowed the detection of subclinical cardiovascular manifestations in IIM. However, despite the availability of these tools, the diagnostic challenges and underestimated prevalence of cardiovascular involvement in these patients remain significant. Notably, cardiovascular involvement remains one of the leading causes of mortality in patients with IIM...
May 6, 2023: Clinical Rheumatology
https://read.qxmd.com/read/36858433/rheumatology-s-animal-kingdom-a-digital-art-series
#5
JOURNAL ARTICLE
Brian Robert Smith
During my first 2 years of medical school, I noticed how many syndromes and symptoms are named after animals. These visual metaphors are especially memorable because they evoke clear and vivid images and shapes.
March 1, 2023: Journal of Rheumatology
https://read.qxmd.com/read/37003604/myocarditis-in-patients-with-idiopathic-inflammatory-myopathies-clinical-presentation-and-outcomes
#6
JOURNAL ARTICLE
Melody P Chung, Jana Lovell, William Kelly, Christopher A Mecoli, Jemima Albayda, Lisa Christopher-Stine, Nisha A Gilotra, Julie J Paik
OBJECTIVE: To determine the clinical phenotype and outcomes of patients with idiopathic inflammatory myopathies (IIMs) and myocarditis. METHODS: Using the Johns Hopkins Myositis Center Research Registry, we identified 31 adult patients with IIM-out of a total of 3082 with confirmed or suspected muscle disease-with an encounter code of myocarditis from 2004 to 2021. Of these, 14 adult patients with IIM were adjudicated to have clinical myocarditis. Information about demographics, autoantibodies, and clinical outcomes was retrospectively collected and analyzed...
April 1, 2023: Journal of Rheumatology
https://read.qxmd.com/read/37028976/cardiogenic-shock-classification-and-associated-mortality-risk
#7
REVIEW
Katherine L Hill, Mark A Rustin, Michele A Asche, Courtney E Bennett, Parag C Patel, Jacob C Jentzer
The Society for Cardiovascular Angiography and Interventions (SCAI) Shock Classification was developed to create standardized language describing the severity of cardiogenic shock (CS). The purposes of this review were to evaluate short-term and long-term mortality rates at each SCAI shock stage for patients with or at risk for CS, which has not been studied previously, and to propose using the SCAI Shock Classification to develop algorithms for clinical status monitoring. A detailed literature search was conducted for articles published from 2019 through 2022 in which the SCAI shock stages were used to assess the mortality risk...
May 2023: Mayo Clinic Proceedings
https://read.qxmd.com/read/37028979/oral-anticoagulation-in-patients-with-advanced-chronic-kidney-disease-and-atrial-fibrillation-beyond-anticoagulation
#8
REVIEW
Sofie A M Dhaese, An S De Vriese
The optimal approach to prevent stroke and systemic embolism in patients with advanced chronic kidney disease (CKD) and atrial fibrillation remains unresolved. We conducted a narrative review to explore areas of uncertainty and opportunities for future research. First, the relationship between atrial fibrillation and stroke is more complex in patients with advanced CKD than in the general population. The currently employed risk stratification tools do not adequately discriminate between patients deriving a net benefit and those suffering a net harm from oral anticoagulation...
May 2023: Mayo Clinic Proceedings
https://read.qxmd.com/read/32107033/preoperative-cardiac-risk-assessment
#9
REVIEW
David Raslau, Dennis M Bierle, Christopher R Stephenson, Michael A Mikhail, Esayas B Kebede, Karen F Mauck
Major adverse cardiac events are common causes of perioperative mortality and major morbidity. Preventing these complications requires thorough preoperative risk assessment and postoperative monitoring of at-risk patients. Major guidelines recommend assessment based on a validated risk calculator that incorporates patient- and procedure-specific factors. American and European guidelines define when stress testing is needed on the basis of functional capacity assessment. Favoring cost-effectiveness, Canadian guidelines instead recommend obtaining brain natriuretic peptide or N-terminal prohormone of brain natriuretic peptide levels to guide postoperative screening for myocardial injury or infarction...
May 2020: Mayo Clinic Proceedings
https://read.qxmd.com/read/31821139/gabapentin-for-alcohol-use-disorder-a-good-option-or-cause-for-concern
#10
REVIEW
Vania Modesto-Lowe, Gregory C Barron, Benjamin Aronow, Margaret Chaplin
The anticonvulsant drug gabapentin is used off-label to treat alcohol-related withdrawal, cravings, anxiety, and insomnia. Although it is well tolerated and has demonstrated efficacy for mild alcohol withdrawal and early abstinence, there is concern about its potential for abuse. Gabapentin should be prescribed only as a second-line alternative to standard therapies, and only after screening for opioid or other prescription drug abuse to determine if heightened monitoring is warranted. Clinicians should be aware of gabapentin's limitations for treating alcohol use disorder and be attentive to emerging data on risks and benefits...
December 2019: Cleveland Clinic Journal of Medicine
https://read.qxmd.com/read/25211048/survival-in-copd-impact-of-lung-dysfunction-and-comorbidities
#11
JOURNAL ARTICLE
Massimo Miniati, Simonetta Monti, Ivana Pavlickova, Matteo Bottai
Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality in industrialized countries. Recent studies investigated the impact of comorbidities on the survival in COPD, but most of them lacked a referent group of comorbidity-matched, nonobstructed individuals.We examined the 10-year mortality in a sample of 200 COPD patients and 201 nonobstructed controls. They were part of a larger cohort enrolled in a European case-control study aimed at assessing genetic susceptibility to COPD...
September 2014: Medicine (Baltimore)
https://read.qxmd.com/read/25085989/perioperative-beta-blockers-in-noncardiac-surgery-the-evidence-continues-to-evolve
#12
REVIEW
Muzammil Mushtaq, Steven L Cohn
The effectiveness and safety of giving beta-blockers to patients undergoing noncardiac surgery remain controversial. The use of these drugs in this clinical scenario increased after the publication of two positive trials in the late 1990s and was encouraged by national organizations and clinical guidelines. However, when several subsequent studies failed to show a benefit, recommendations became more limited and use decreased. This paper reviews recent evidence for and against the perioperative use of beta-blockers...
August 2014: Cleveland Clinic Journal of Medicine
https://read.qxmd.com/read/25085986/sleep-apnea-abcs-airway-breathing-circulation
#13
REVIEW
Reena Mehra
Obstructive sleep apnea (OSA) is increasingly common but largely underrecognized. Untreated, it is associated with heart disease, stroke, and sudden nocturnal death. Simple clinical assessments can determine if a patient is likely to have OSA and is a candidate for diagnostic polysomnography. Continuous positive airway pressure (CPAP) is the mainstay of treatment and ameliorates symptoms as well as long-term sequelae. Patient education and effective troubleshooting and evaluation of CPAP adherence issues increase successful adjustment to therapy...
August 2014: Cleveland Clinic Journal of Medicine
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