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By EFRAIN PAEZ Internal Medicine since 1988. Interested in all aspects of Medicine.
Grace Levy-Clarke, Douglas A Jabs, Russell W Read, James T Rosenbaum, Albert Vitale, Russell N Van Gelder
TOPIC: To provide recommendations for the use of anti-tumor necrosis factor α (TNF-α) biologic agents in patients with ocular inflammatory disorders. CLINICAL RELEVANCE: Ocular inflammatory diseases remain a leading cause of vision loss worldwide. Anti-TNF-α agents are used widely in treatment of rheumatologic diseases. A committee of the American Uveitis Society performed a systematic review of literature to generate guidelines for use of these agents in ocular inflammatory conditions...
March 2014: Ophthalmology
Vicki A Morrison
The introduction of novel agents to the therapeutic armamentarium for oncologic, rheumatologic, and neurologic disorders has resulted in major clinical advances. These agents impact immune function, resulting in a discrete spectrum of infectious complications. Purine analogues and alemtuzumab alter cell-mediated immunity, resulting in opportunistic viral/fungal infections. Herpes zoster incidence increases with bortezomib. Hepatitis B reactivation may occur with rituximab. Cases of progressive multifocal leukoencephalopathy have occurred following monoclonal antibody therapy...
November 15, 2014: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Muneki Nakatani, Hideyuki Sasaki, Seigo Kurisu, Hiroyuki Yamaoka, Shohei Matsuno, Kenichi Ogawa, Hiroshi Yamasaki, Hisao Wakasaki, Hiroto Furuta, Masahiro Nishi, Takashi Akamizu, Kishio Nanjo
UNLABELLED: Aims/Introduction:  In order to diagnose diabetic symmetric polyneuropathy (DSPN) more simply and accurately, we identified symptoms that correlated with neurological functions and existed more frequently in diabetic than non-diabetic subjects. MATERIALS AND METHODS:   The relationships between 10 symptoms (numbness or paresthesia in toe and sole, numbness in hand, pain in foot or hand, coldness in legs, painful leg cramp, dizziness on standing, sweating restricted to face/trunk and frequent constipation/diarrhea) and clinical background, defined as DSPN and cardiovascular autonomic neuropathy (CAN) by the criteria proposed in the statement of the American Diabetes Association, and seven quantitative nerve function data were evaluated in 593 diabetic patients in Wakayama Medical University Hospital (WMUH)...
November 30, 2011: Journal of Diabetes Investigation
André Lacroix, Richard A Feelders, Constantine A Stratakis, Lynnette K Nieman
Chronic exposure to excess glucorticoids results in diverse manifestations of Cushing's syndrome, including debilitating morbidities and increased mortality. Genetic and molecular mechanisms responsible for excess cortisol secretion by primary adrenal lesions and adrenocorticotropic hormone (ACTH) secretion from corticotroph or ectopic tumours have been identified. New biochemical and imaging diagnostic approaches and progress in surgical and radiotherapy techniques have improved the management of patients...
August 29, 2015: Lancet
Bernadette Biondi, Leonard Wartofsky
Thyroid hormone deficiency can have important repercussions. Treatment with thyroid hormone in replacement doses is essential in patients with hypothyroidism. In this review, we critically discuss the thyroid hormone formulations that are available and approaches to correct replacement therapy with thyroid hormone in primary and central hypothyroidism in different periods of life such as pregnancy, birth, infancy, childhood, and adolescence as well as in adult patients, the elderly, and in patients with comorbidities...
June 2014: Endocrine Reviews
Roland Fries, Kaveh Shariat, Hubertus von Wilmowsky, Michael Böhm
BACKGROUND: Vasodilatory therapy of Raynaud's phenomenon represents a difficult clinical problem because treatment often remains inefficient and may be not tolerated because of side effects. METHODS AND RESULTS: To investigate the effects of sildenafil on symptoms and capillary perfusion in patients with Raynaud's phenomenon, we performed a double-blinded, placebo-controlled, fixed-dose, crossover study in 16 patients with symptomatic secondary Raynaud's phenomenon resistant to vasodilatory therapy...
November 8, 2005: Circulation
Joshua F Baker, Sally Pullman-Mooar, Said Ibrahim
No abstract text is available yet for this article.
October 2014: Rheumatology
Nathaniel R Smilowitz, Jessica L Mega, Jeffrey S Berger
No abstract text is available yet for this article.
December 23, 2014: Circulation
John I Allen
No abstract text is available yet for this article.
December 4, 2012: Annals of Internal Medicine
Kate Mulligan, Jenna Dixon, Chi-Ling Joanna Sinn, Susan J Elliott
Policy prescriptions for combating dengue fever tend to focus on addressing environmental and social conditions of poverty. However, while poverty has long been considered a determinant of dengue, the research evidence for such a relationship is not well established. Results of a systematic review of the research literature designed to identify and assess the current state of the empirical evidence for the dengue-poverty link reveal a mixed story. Of 260 peer-reviewed articles referencing dengue-poverty relationships, only 12 English-language studies empirically assessed these relationships...
February 2015: Pathogens and Global Health
L Deconinck, Y Yazdanpanah, R J Gilson, H Melliez, N Viget, V Joly, C A Sabin
OBJECTIVES: The aim of the study was to identify factors associated with the time between opportunistic disease (OD) diagnosis and antiretroviral therapy (ART) initiation in HIV-infected patients presenting for care with an OD, and to evaluate the outcomes associated with any delay. METHODS: A multicentre cohort study was undertaken in London, Paris and Lille/Tourcoing. The medical records of patients diagnosed from 2002 to 2012 were reviewed. RESULTS: A total of 437 patients were enrolled in the study: 70% were male, the median age was 40 years, 42% were from sub-Saharan Africa, 68% were heterosexual, the median CD4 count was 40 cells/μL, and the most common ODs were Pneumocystis pneumonia (37%), tuberculosis (24%), toxoplasmosis (12%) and Kaposi's sarcoma (11%)...
April 2015: HIV Medicine
Charles L Sprung, Djillali Annane, Didier Keh, Rui Moreno, Mervyn Singer, Klaus Freivogel, Yoram G Weiss, Julie Benbenishty, Armin Kalenka, Helmuth Forst, Pierre-Francois Laterre, Konrad Reinhart, Brian H Cuthbertson, Didier Payen, Josef Briegel
BACKGROUND: Hydrocortisone is widely used in patients with septic shock even though a survival benefit has been reported only in patients who remained hypotensive after fluid and vasopressor resuscitation and whose plasma cortisol levels did not rise appropriately after the administration of corticotropin. METHODS: In this multicenter, randomized, double-blind, placebo-controlled trial, we assigned 251 patients to receive 50 mg of intravenous hydrocortisone and 248 patients to receive placebo every 6 hours for 5 days; the dose was then tapered during a 6-day period...
January 10, 2008: New England Journal of Medicine
Amisha Wallia, Mark E Molitch
IMPORTANCE: The incidence and prevalence of type 2 diabetes mellitus are increasing. OBJECTIVE: To review currently available insulin therapy, as well as evidence on the use, application, initiation, and intensification of insulin in the outpatient setting. EVIDENCE REVIEW: Data sources included PubMed for trials and investigations in type 2 diabetes examining insulin use from January 1998 to April 2014. FINDINGS: The hemoglobin A1c target for most patients with type 2 diabetes is 7% but needs to be modified when there is increased risk of hypoglycemia, reduced life expectancy, extensive comorbidities, or reduced resources...
June 11, 2014: JAMA: the Journal of the American Medical Association
Julie L Welch, Dylan D Cooper
No abstract text is available yet for this article.
June 2014: Annals of Emergency Medicine
Susan M Goodman, Bruce N Cronstein, Vivian P Bykerk
OBJECTIVES: Methotrexate (MTX) is considered the 'anchor drug' in the therapy of rheumatoid arthritis (RA), yet many physicians do not optimise MTX regimens in spite of high RA disease activity. The recent development of an auto-injector for the subcutaneous (subQ) administration of MTX has prompted re-evaluation of MTX utilisation. The purpose of this systematic literature review is to determine the optimal dose, drug level, and route of administration for MTX in the context of relevant pharmacokinetics and pharmacogenomics...
March 2015: Clinical and Experimental Rheumatology
Michelle Lin, Salim Rezaie, Iltifat Husain
Mobile apps are increasingly being used at the bedside as a part of clinical care. With almost 300 emergency medicine-related apps available in the Apple App Store, it can be overwhelming deciding which are most useful for emergency department providers. A Top 10 list of apps is highlighted which illustrate the many ways that quality apps can positively impact the care of emergency department patients.
May 2014: Emergency Medicine Journal: EMJ
Victor Y Kong, George V Oosthuizen, Damian L Clarke
INTRODUCTION: Routine chest radiography (CXR) following tube thoracostomy (TT) is a standard practice in most trauma centres worldwide. Evidence supporting this routine practice is lacking and the actual yield is unknown. MATERIALS AND METHODS: We performed a retrospective review of 1042 patients over a 4-year period who had a routine post-insertion CXR performed in accordance with current ATLS® recommendations. RESULTS: A total 1042 TTs were performed on 1004 patients...
January 2015: Injury
Michael B Rothberg, Peter K Lindenauer, Maureen Lahti, Penelope S Pekow, Harry P Selker
BACKGROUND: The Joint Commission requires that all medical inpatients be assessed for venous thromboembolism (VTE) risk, but available risk stratification tools have never been validated. METHODS: We conducted a retrospective cohort study of patients age ≥18 years, admitted to 374 US hospitals in 2004-2005, with a primary diagnosis of pneumonia, heart failure, chronic obstructive pulmonary disease (COPD), stroke, and urinary tract infection, and length of stay ≥3 days...
April 2011: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
N A Zakai, P W Callas, A B Repp, M Cushman
BACKGROUND: We sought to define the risk factors present at admission for venous thromboembolism (VTE) in medical inpatients and develop a risk model for clinical use. METHODS: Between January 2002 and June 2009, 299 cases of hospital-acquired VTE were frequency matched to 601 controls. Records were abstracted using a standard form for characteristics of the thrombosis, medical conditions and other risk factors. Weighted logistic regression and survey methods were used to develop a risk model for hospital-acquired VTE that was validated by bootstrapping...
April 2013: Journal of Thrombosis and Haemostasis: JTH
Silvia Bozzato, Alessandro Squizzato, Marco P Donadini, Luigina Guasti, Francesco Dentali, Walter Ageno
Acutely ill medical patients may be at increased risk of venous thromboembolism, both during hospitalization and after discharge. International guidelines recommend thromboprophylaxis for high-risk medical patients with low bleeding risk for a maximum of 14 days. There are two approaches to identify the high-risk patient: adhering to the inclusion criteria used in randomized clinical trials or using risk assessment models. With both approaches, about 40% of medical inpatients should result at increased risk of venous thrombosis...
December 2013: Expert Review of Cardiovascular Therapy
2014-12-20 14:48:35
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