Kathleen A Linder, Preeti N Malani
No abstract text is available yet for this article.
September 7, 2023: JAMA
Jessica P Cerdeña, Vanessa Grubbs, Amy L Non
No abstract text is available yet for this article.
December 10, 2022: Lancet
Varun U Shetty, Parul Chaudhuri, Camille Sabella
No abstract text is available yet for this article.
January 2019: Pediatrics in Review
Shruti S Joshi, Trisha Singh, David E Newby, Jagdeep Singh
Patients with type 2 diabetes mellitus are at a higher risk of developing heart failure compared with the healthy population. In recent landmark clinical trials, sodium-glucose co-transporter 2 (SGLT2) inhibitor therapies improve blood glucose control and also reduce cardiovascular events and heart failure hospitalisations in patients with type 2 diabetes. Intriguingly, such clinical benefits have also been seen in patients with heart failure in the absence of type 2 diabetes although the underlying mechanisms are not clearly understood...
February 26, 2021: Heart
Timothy D Henry, Matthew I Tomey, Jacqueline E Tamis-Holland, Holger Thiele, Sunil V Rao, Venu Menon, Deborah G Klein, Yoshifumi Naka, Ileana L Piña, Navin K Kapur, George D Dangas
Cardiogenic shock (CS) remains the most common cause of mortality in patients with acute myocardial infarction. The SHOCK trial (Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock) demonstrated a survival benefit with early revascularization in patients with CS complicating acute myocardial infarction (AMICS) 20 years ago. After an initial improvement in mortality related to revascularization, mortality rates have plateaued. A recent Society of Coronary Angiography and Interventions classification scheme was developed to address the wide range of CS presentations...
April 13, 2021: Circulation
Christopher R Carpenter, Michael L Malone
No abstract text is available yet for this article.
December 2020: Journal of the American Geriatrics Society
Lisa Duffett, Lana A Castellucci, Melissa A Forgie
Pulmonary embolism is a common and potentially fatal cardiovascular disorder that must be promptly diagnosed and treated. The diagnosis, risk assessment, and management of pulmonary embolism have evolved with a better understanding of efficient use of diagnostic and therapeutic options. The use of either clinical probability adjusted or age adjusted D-dimer interpretation has led to a reduction in diagnostic imaging to exclude pulmonary embolism. Direct oral anticoagulation therapies are safe, effective, and convenient treatments for most patients with acute venous thromboembolism, with a lower risk of bleeding than vitamin K antagonists...
August 5, 2020: BMJ: British Medical Journal
A Richard Kitching, Hans-Joachim Anders, Neil Basu, Elisabeth Brouwer, Jennifer Gordon, David R Jayne, Joyce Kullman, Paul A Lyons, Peter A Merkel, Caroline O S Savage, Ulrich Specks, Renate Kain
The anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAVs) are a group of disorders involving severe, systemic, small-vessel vasculitis and are characterized by the development of autoantibodies to the neutrophil proteins leukocyte proteinase 3 (PR3-ANCA) or myeloperoxidase (MPO-ANCA). The three AAV subgroups, namely granulomatosis with polyangiitis (GPA), microscopic polyangiitis and eosinophilic GPA (EGPA), are defined according to clinical features. However, genetic and other clinical findings suggest that these clinical syndromes may be better classified as PR3-positive AAV (PR3-AAV), MPO-positive AAV (MPO-AAV) and, for EGPA, by the presence or absence of ANCA (ANCA+ or ANCA- , respectively)...
August 27, 2020: Nature Reviews. Disease Primers
Nisha S Mehta, Oliver T Mytton, Edward W S Mullins, Tom A Fowler, Catherine L Falconer, Orla B Murphy, Claudia Langenberg, Wikum J P Jayatunga, Danielle H Eddy, Jonathan S Nguyen-Van-Tam
BACKGROUND: Few pediatric cases of coronavirus disease 2019 (COVID-19) have been reported and we know little about the epidemiology in children, although more is known about other coronaviruses. We aimed to understand the infection rate, clinical presentation, clinical outcomes, and transmission dynamics for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in order to inform clinical and public health measures. METHODS: We undertook a rapid systematic review and narrative synthesis of all literature relating to SARS-CoV-2 in pediatric populations...
December 3, 2020: Clinical Infectious Diseases
O Joe Hines, Stephen J Pandol
The risks, measurements of severity, and management of severe acute pancreatitis and its complications have evolved rapidly over the past decade. Evidence suggests that initial goal directed therapy, nutritional support, and vigilance for pancreatic complications are best practice. Patients can develop pancreatic fluid collections including acute pancreatic fluid collections, pancreatic pseudocysts, acute necrotic collections, and walled-off necrosis. Several randomized controlled trials and cohort studies have recently highlighted the advantage of managing these conditions with a progressive approach, with initial draining for infection followed by less invasive techniques...
December 2, 2019: BMJ: British Medical Journal
Gaston Murias, Umberto Lucangelo, Lluis Blanch
PURPOSE OF REVIEW: The purpose of the review is to alert clinicians to the prevalent and frequently underrecognized problem of asynchrony in mechanically ventilated patients. To provide a mechanistic model of patient-ventilator asynchrony to help personnel understand how different asynchronies develop. To provide practical advice on how to recognize and solve different asynchronies in different contexts. RECENT FINDINGS: Patient-ventilator asynchrony is a serious problem that is associated with prolonged mechanical ventilation, prolonged ICU and hospital stays, and increased mortality...
February 2016: Current Opinion in Critical Care
Bertrand Guidet, Helene Vallet, Jacques Boddaert, Dylan W de Lange, Alessandro Morandi, Guillaume Leblanc, Antonio Artigas, Hans Flaatten
BACKGROUND: There is currently no international recommendation for the admission or treatment of the critically ill older patients over 80 years of age in the intensive care unit (ICU), and there is no valid prognostic severity score that includes specific geriatric assessments. MAIN BODY: In this review, we report recent literature focusing on older critically ill patients in order to help physicians in the multiple-step decision-making process. It is unclear under what conditions older patients may benefit from ICU admission...
November 26, 2018: Annals of Intensive Care
Donna M Windish, Marie Diener-West
As educators seek confirmation of successful trainee achievement, medical education must move toward a more evidence-based approach to teaching and evaluation. Although medical training often provides physicians with a general background in biostatistics, many are not prepared to apply these skills. This can hinder clinician educators as they wish to develop, analyze and disseminate their scholarly work. This paper is intended to be a concise educational tool and guide for choosing and interpreting statistical tests aimed toward medical education assessment...
June 2006: Journal of General Internal Medicine
Justas Simonavičius, Christian Knackstedt, Hans-Peter Brunner-La Rocca
Loop diuretics remain the cornerstone of congestion management in contemporary chronic heart failure care. However, their use is not supported by high quality data, and there is doubt about the safety in the outpatient heart failure setting. Still, congestion is related to a worse outcome, and there is general consensus among experts that congestion should not be tolerated in heart failure patients. Recommendations in international guidelines, regarding decongestion strategies in chronic heart failure, are limited...
January 2019: Heart Failure Reviews
Piero Amodio
Hepatic encephalopathy (HE) is a peculiar kind of brain dysfunction caused by liver insufficiency and/or portal-systemic shunting. It is related to gut-derived substances. It is a relevant cause of morbidity and hospitalisation for patients with cirrhosis. The prognosis of HE is important in terms of survival and re-hospitalisation. It is related to impaired quality of life, falls and poor driving; presents a relevant burden for caregivers and health services; and may negatively impact on patient's job and income...
June 2018: Liver International: Official Journal of the International Association for the Study of the Liver
Ivano Dones, Vincenzo Levi
The origin and the neural pathways involved in chronic neuropathic pain are still not extensively understood. For this reason, despite the wide variety of pain medications available on the market, neuropathic pain is challenging to treat. The present therapeutic alternative considered as the gold standard for many kinds of chronic neuropathic pain is epidural spinal cord stimulation (SCS). Despite its proved efficacy, the favourable cost-effectiveness when compared to the long-term use of poorly effective drugs and the expanding array of indications and technical improvements, SCS is still worldwide largely neglected by general practitioners, neurologists, neurosurgeons and pain therapists, often bringing to a large delay in considering as a therapeutic option for patients affected by neuropathic chronic pain...
July 24, 2018: Brain Sciences
Scott C Bell, Joseph S Elborn, Catherine A Byrnes
Interest in bronchiectasis has increased over the past two decades, as shown by the establishment of disease-specific registries in several countries, the publication of management guidelines and a growing number of clinical trials to address evidence gaps for treatment decisions. This review considers the evidence for defining and treating pulmonary exacerbations, the approaches for eradication of newly identified airway pathogens and the methods to prevent exacerbations through long-term treatments from a pragmatic practice-based perspective...
November 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
Bilal A Jalil, Rodrigo Cavallazzi
Volume resuscitation is of utmost importance in the treatment of shock. It is imperative that this resuscitation be guided using a reliable method of ascertaining volume status to avoid the ill-effects of hypovolemia while also avoiding those of over-resuscitation. There are numerous tools and methods available in this era to aid the bedside physician in guiding volume resuscitation, many of which will be described in this review of literature. The methods to assess preload responsiveness are broadly divided into static and dynamic measurements...
November 2018: American Journal of Emergency Medicine
Yvette S Zeng, Connie Wang, Kristina E Ward, Anne L Hume
CONTEXT: The aim of palliative care is to improve quality of life for patients with serious illnesses by treating their symptoms and adverse effects. Hospice care also aims for this for patients with a life expectancy of six months or less. When conventional therapies do not provide adequate symptom management or produce their own adverse effects, patients, families, and caregivers may prefer complementary or alternative approaches in their care. OBJECTIVES: The objectives of this study were to evaluate the available evidence on the use of complementary or alternative medicine (CAM) in hospice and palliative care and to summarize their potential benefits...
November 2018: Journal of Pain and Symptom Management
Simon Finfer, John Myburgh, Rinaldo Bellomo
Intravenous fluid therapy is one of the most common interventions in acutely ill patients. Each day, over 20% of patients in intensive care units (ICUs) receive intravenous fluid resuscitation, and more than 30% receive fluid resuscitation during their first day in the ICU. Virtually all hospitalized patients receive intravenous fluid to maintain hydration and as diluents for drug administration. Until recently, the amount and type of fluids administered were based on a theory described over 100 years ago, much of which is inconsistent with current physiological data and emerging knowledge...
September 2018: Nature Reviews. Nephrology
2018-09-01 13:14:14
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