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Internal Medicine

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112 papers 100 to 500 followers
Vanessa Selak, Rod Jackson, Katrina Poppe, Billy Wu, Matire Harwood, Corina Grey, Romana Pylypchuk, Suneela Mehta, Andrew Kerr, Sue Wells
Background: Many prognostic models for cardiovascular risk can be used to estimate aspirin's absolute benefits, but few bleeding risk models are available to estimate its likely harms. Objective: To develop prognostic bleeding risk models among persons in whom aspirin might be considered for the primary prevention of cardiovascular disease (CVD). Design: Prospective cohort study. Setting: New Zealand primary care. Participants: The study cohort comprised 385 191 persons aged 30 to 79 years whose CVD risk was assessed between 2007 and 2016...
February 26, 2019: Annals of Internal Medicine
Jutta Bergler-Klein
The new guidelines on hypertension of the European Society of Cardiology (ESC) 2018 have refined the treatment cut-offs and therapy decisions in adults. This review highlights important recommendations of the guidelines and also on the situation of hypertension in Austria. The general treatment targets of blood pressure have been lowered to at least 130/80 mmHg for most patients. The definition of hypertension is specified as a repeated systolic blood pressure in the office of ≥140 and or diastolic BP ≥90 mmHg...
February 4, 2019: Wiener Klinische Wochenschrift
Francis J Alenghat, Andrew M Davis
No abstract text is available yet for this article.
February 4, 2019: JAMA: the Journal of the American Medical Association
Marin H Kollef, Kevin D Betthauser
PURPOSE OF REVIEW: This review provides the rationale for the development of new antibiotics to treat community-acquired pneumonia (CAP). It also provides an overview of the new antibiotics targeting CAP that have recently received approval by the regulatory agencies, and those antibiotics that are in the development pipeline. RECENT FINDINGS: CAP is one of the most common reasons for hospitalization and carries a significant morbidity and risk of mortality. Increasing antibiotic resistance amongst the common bacterial pathogens associated with CAP, especially staphylococci and Streptococcus pneumoniae, has made the empiric treatment of this infection increasingly problematic...
January 11, 2019: Current Opinion in Infectious Diseases
Lee-Lee Lai, Wan Nur Illyana Wan Yusoff, Shireene Ratna Vethakkan, Nik Raihan Nik Mustapha, Sanjiv Mahadeva, Wah-Kheong Chan
BACKGROUND: The recommendation in regards to screening for non-alcoholic fatty liver disease (NAFLD) among type 2 diabetes mellitus (T2DM) patients differs in major guidelines. AIM: To study the prevalence of NALFD and advanced fibrosis among T2DM patients. METHODS: Cross-sectional study of consecutive adult T2DM patients attending the Diabetes Clinic of a university hospital. Significant hepatic steatosis and advanced fibrosis was diagnosed based on transient elastography if the controlled attenuation parameter was ≥263dB/m and the liver stiffness measurement (LSM) was ≥9...
December 14, 2018: Journal of Gastroenterology and Hepatology
Jeffrey A Kraut, Nicolaos E Madias
No abstract text is available yet for this article.
October 18, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Rebecca L Larsen, Natasha M Savage
Eosinophilia is typically secondary, that is, reactive, in nature and is associated with a wide variety of neoplastic and non-neoplastic disorders. Clonal eosinophilia is also seen in a wide variety of hematopoietic neoplasms, and sub-classification can be diagnostically challenging. A proper evaluation of persistent eosinophilia involves correlation of clinical history, laboratory data, cellular morphology, and ancillary testing. Knowledge of appropriate ancillary testing is necessary for a timely diagnosis...
November 30, 2018: International Journal of Laboratory Hematology
Franz H Messerli, Sripal Bangalore
No abstract text is available yet for this article.
September 11, 2018: Journal of the American College of Cardiology
Peter W F Wilson, Tamar S Polonsky, Michael D Miedema, Amit Khera, Andrzej S Kosinski, Jeffrey T Kuvin
BACKGROUND: The 2013 American College of Cardiology/American Heart Association guidelines for the treatment of blood cholesterol found little evidence to support the use of nonstatin lipid-modifying medications to reduce atherosclerotic cardiovascular disease (ASCVD) events. Since publication of these guidelines, multiple randomized controlled trials evaluating nonstatin lipid-modifying medications have been published. METHODS: We performed a systematic review to assess the magnitude of benefit and/or harm from additional lipid-modifying therapies compared with statins alone in individuals with known ASCVD or at high risk of ASCVD...
November 3, 2018: Journal of the American College of Cardiology
Kenjiro Kimura, Tatsuo Hosoya, Shunya Uchida, Masaaki Inaba, Hirofumi Makino, Shoichi Maruyama, Sadayoshi Ito, Tetsuya Yamamoto, Yasuhiko Tomino, Iwao Ohno, Yugo Shibagaki, Satoshi Iimuro, Naohiko Imai, Masanari Kuwabara, Hiroshi Hayakawa, Hiroshi Ohtsu, Yasuo Ohashi
RATIONALE & OBJECTIVE: Epidemiologic and clinical studies have suggested that urate-lowering therapy may slow the progression of chronic kidney disease (CKD). However, definitive evidence is lacking. STUDY DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING & PARTICIPANTS: 467 patients with stage 3 CKD and asymptomatic hyperuricemia at 55 medical institutions in Japan. INTERVENTION: Participants were randomly assigned in a 1:1 ratio to receive febuxostat or placebo for 108 weeks...
August 31, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
S Magder
Measurement of arterial pressure is one of the most basic elements of patient management. Arterial pressure is determined by the volume ejected by the heart into the arteries, the elastance of the walls of the arteries, and the rate at which the blood flows out of the arteries. This review will discuss the three forces that determine the pressure in a vessel: elastic, kinetic, and gravitational energy. Emphasis will be placed on the importance of the distribution of arterial resistances, the elastance of the walls of the large vessels, and critical closing pressures in small arteries and arterioles...
October 11, 2018: Critical Care: the Official Journal of the Critical Care Forum
Luis Carlos Saiz, Javier Gorricho, Javier Garjón, Mª Concepción Celaya, Juan Erviti, Leire Leache
BACKGROUND: This is the first update of the review published in 2017. Hypertension is a prominent preventable cause of premature morbidity and mortality. People with hypertension and established cardiovascular disease are at particularly high risk, so reducing blood pressure to below standard targets may be beneficial. This strategy could reduce cardiovascular mortality and morbidity but could also increase adverse events. The optimal blood pressure target in people with hypertension and established cardiovascular disease remains unknown...
July 20, 2018: Cochrane Database of Systematic Reviews
Randall S Stafford
The recently released 2017 High Blood Pressure Guidelines depart from past guidelines in both their approach and recommendations. Developed by multiple health organizations, including the American College of Preventive Medicine, the guidelines continue to define normal blood pressure as <120/80 mmHg, but now define hypertension as ≥130/80 mmHg (previously ≥140/90 mmHg). This change categorizes 101 million Americans (46% of adults) as hypertensive (compared to 32% previously). The guidelines rely heavily on findings from the Systolic Blood Pressure Intervention Trial (SPRINT)...
October 2018: American Journal of Preventive Medicine
Bo M Havermans, Evelien P M Brouwers, Rianne J A Hoek, Johannes R Anema, Allard J van der Beek, Cécile R L Boot
BACKGROUND: Work stress prevention can reduce health risks for individuals, as well as organisational and societal costs. The success of work stress interventions depends on proper implementation. Failure to take into account the needs of employees and supervisors can hinder intervention implementation. This study aimed to explore employee and supervisor needs regarding organisational work stress prevention. METHODS: Semi-structured telephone interviews were conducted with employees (n = 7) and supervisors (n = 8) from different sectors, such as the finance, health care, and services industry...
May 21, 2018: BMC Public Health
Tadayuki Oshima, Liping Wu, Min Li, Hirokazu Fukui, Jiro Watari, Hiroto Miwa
BACKGROUND: Clostridium difficile infection (CDI) is a cause of increased morbidity and health care costs among hospitalized patients. Proton pump inhibitors (PPIs) are mainly used for the treatment of acid-related upper gastrointestinal diseases. The aim of the study was to assess the risks associated with initial and recurrent CDI in adult and pediatric patients treated with PPIs. METHODS: A systematic search was performed using PubMed (Medline), Embase, and Web of Science with the following search terms: ("proton pump inhibitor," "PPI," or "acid suppression") AND ("infection," "diarrhea," "diarrhoea," "colitis," or "disease") AND ("Clostridium difficile")...
January 2018: Journal of Gastroenterology
Tatiana V Boyko, Michael T Longaker, George P Yang
Significance: The incidence of pressure ulcers is increasing due to our aging population and the increase in the elderly living with disability. Learning how to manage pressure ulcers appropriately is increasingly important for all professionals in wound care. Recent Advances: Many new dressings and treatment modalities have been developed over the recent years and the goal of this review is to highlight their benefits and drawbacks to help providers choose their tools appropriately. Critical Issues: Despite an increased number of therapies available on the market, none has demonstrated any clear benefit over the others and pressure ulcer treatment remains frustrating and time-consuming...
February 1, 2018: Advances in Wound Care
Xavier Monnet, Jean-Louis Teboul
Many efforts have been made to predict, before giving fluid, whether it will increase cardiac output. Nevertheless, after fluid administration, it is also essential to assess the therapeutic efficacy and to look for possible adverse effects. Like for any drug, this step should not be missed. Basically, volume expansion is aimed at improving tissue oxygenation and organ function. To assess this final result, clinical signs are often unhelpful. The increase in urine output in case of acute kidney injury is a poor marker of the kidney perfusion improvement...
April 24, 2018: Annals of Intensive Care
Michel Burnier
No abstract text is available yet for this article.
March 14, 2018: European Heart Journal
Daniel De Backer, Jean-Louis Vincent
The central venous pressure (CVP) is the most frequently used variable to guide fluid resuscitation in critically ill patients, although its use has been challenged. In this viewpoint, we use a question and answer format to highlight the potential advantages and limitations of using CVP measurements to guide fluid resuscitation.
February 23, 2018: Critical Care: the Official Journal of the Critical Care Forum
Peter K Moore, Raymond K Hsu, Kathleen D Liu
Acute kidney injury (AKI) is a heterogeneous disorder that is common in hospitalized patients and associated with short- and long-term morbidity and mortality. When AKI is present, prompt workup of the underlying cause should be pursued, with specific attention to reversible causes. Measures to prevent AKI include optimization of volume status and avoidance of nephrotoxic medications. Crystalloids are preferred over colloids for most patients, and hydroxyethyl starches should be avoided. Volume overload in the setting of AKI is associated with adverse outcomes, so attention should be paid to overall fluid balance...
July 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
2018-03-09 04:03:20
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