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This page shows you the most recent publications within this specialty of the MedWorm directory. This is page number 33.

Identification and management of osteoporosis in older adults
Abstract: Fractures resulting from osteoporosis are a major public health problem. Physicians should be aware of the major risk factors for osteoporosis and refer appropriately for bone densitometry. Risk factors include prior fracture, a family history of fracture, slender habitus, early menopause, treatment with drugs known to affect bone (glucocorticoids) and diseases known to affect bone (rheumatoid arthritis). The diagnosis of osteoporosis can be made if the bone density T-score is −2.5 or below. This information can be used with other risk factors to estimate the 10-year risk of fractures. Patients at the highest r...
Source: Medicine - December 26, 2012 Category: Internal Medicine Authors: Richard Eastell Source Type: research

Diagnosis and management of dementia in older people
Abstract: The diagnostic criteria for dementia are increasingly based on molecular rather than clinical features. In particular, dementias associated with fronto-temporal lobe degeneration are now classified as tau-positive or tau-negative, with specific genetic variants associated with sub-types of these two broad categories. Management guidelines for dementia in the community are well established, but this is not the case in the acute hospital setting where diagnosis may be more difficult and co-existing age-associated morbidities and informant history require specific attention. The management of behavioural and psychol...
Source: Medicine - December 26, 2012 Category: Internal Medicine Authors: John M. Starr, Lorna Hamilton Source Type: research

Delirium in hospitalized older adults
Abstract: Delirium is a common yet under-detected syndrome characterized by acute deterioration in mental status. Patients show attentional deficits and commonly also display altered levels of consciousness and psychotic features. The mechanisms remain poorly understood. Delirium is associated with multiple adverse outcomes including patient and carer distress, increased length of stay, long-term cognitive impairment, new institutionalization and death. Old age and dementia are the main predisposing factors, but there are a number of modifiable risk factors that are important within hospital environments. Treatment involve...
Source: Medicine - December 26, 2012 Category: Internal Medicine Authors: Atul Anand, Alasdair M.J. MacLullich Source Type: research

Pain management in older adults
Abstract: As our populations age healthcare professionals in most areas of practice will increasingly deal with older people and the health problems they present. One such problem is pain, but at the moment, the assessment and management of pain in this age group are poorly practised, particularly in those with dementia. The limited evidence base for many treatments and the concurrence of co-morbidities that complicate the use of many pharmacological treatments provide additional challenges. This paper will discuss the current recommendations regarding the assessment and management of pain, and suggest areas where research...
Source: Medicine - December 26, 2012 Category: Internal Medicine Authors: Patricia Schofield Source Type: research

Blackout and collapse
This article focuses on syncope, which is caused by transient global cerebral hypoperfusion. There are four main sub-types of syncope, with neurally mediated and orthostatic syncope being by far the most common. Cardiac arrhythmias account for only 20% of all syncopal episodes. The initial evaluation is extremely important and leads to a diagnosis in around half of cases. Only some patients need investigation and those requested depend on the history, whether the person has structural heart disease, and whether the syncope is frequent or severe. The evaluation of syncope is often unstructured and varies considerably among ...
Source: Medicine - December 26, 2012 Category: Internal Medicine Authors: Nicola Cooper Source Type: research

Falls
This article has been prepared as a concise reference that reviews the most recent evidence and covers the medical competencies on falls outlined in the Curriculum for General Internal Medicine (Acute) of the Federation of Royal Colleges of Physicians of the UK. As in the curriculum, the emphasis is on the acute setting. Important topics covered include the epidemiology of falls, definition and classification, causes and risk factors, cumulative effect of risk factors and the concept of individual falling threshold, physical and psychosocial consequences of falling, medical falls assessment in the acute setting, differenti...
Source: Medicine - December 26, 2012 Category: Internal Medicine Authors: Rose A. Kenny, Roman Romero-Ortuno, Lisa Cogan Source Type: research

Urinary incontinence in older people: an overview
This article discusses the assessment and management of the main subtypes of incontinence likely to be encountered in generalist practice for both the physiologically fit and frail older person.
Source: Medicine - December 26, 2012 Category: Internal Medicine Authors: Adrian Wagg Source Type: research

Dizziness in older adults
Abstract: Dizziness is a very common symptom in older adults. Its prevalence increases with age, with approximately one-third of elderly people experiencing the symptom. It may be caused by true vertigo, of peripheral or central cause, pre-syncope, disequilibrium or a combination of these. A detailed history and examination are essential in distinguishing common causes. Providing there is no evidence of central vertigo or of a cardiac cause, further investigation is rarely helpful in diagnosis or management. Management of the patient with dizziness should be holistic; it should not only focus on treatment of the underlying...
Source: Medicine - December 26, 2012 Category: Internal Medicine Authors: Rebecca Lee, Andrew Elder Source Type: research

The frailty syndrome
Abstract: Frailty is an emerging geriatric syndrome with a high prevalence in the community population. It can be seen as a state of extreme vulnerability and loss of resistance to external stressors resulting in an increased risk of several adverse outcomes. Although linked with ageing, disability and co-morbidity, many consider frailty as a distinct clinical and pathophysiological entity. A problem with this concept is the search for a suitable operational definition that can be used in clinical practice. Although many exist in literature, there is no agreement on the best measure. The more popular of these definitions i...
Source: Medicine - December 26, 2012 Category: Internal Medicine Authors: Franklin Wou, Simon Conroy Source Type: research

Practical advice for prescribing in old age
Abstract: The increase in inter-individual pharmacological variability with age makes prescribing in the older patient challenging. Notwithstanding the fact that it is frailty, rather than age, that predicts how well a person will cope with a given physiological challenge, the effects of drugs and the way they are handled by the body change in a number of ways with increasing age.With decreasing life expectancy, it may be that drugs used for secondary prevention become less appropriate, particularly where the adverse effects of these medications lead to reduction in short-term quality of life. Unfortunately, the process of...
Source: Medicine - December 26, 2012 Category: Internal Medicine Authors: Robert Caslake, Roy L. Soiza, Arduino A. Mangoni Source Type: research

The physiology of ageing
Abstract: Britain's ageing population is growing at its fastest rate to date, making it increasingly important for clinicians to understand the physiological changes associated with ageing and recognize the difference between changes secondary to ageing and changes that occur as a result of disease. Ageing is characterized by progressive and heterogeneous decline in physiological reserve of all organ systems, albeit at different rates which will vary in different individuals. Cellular senescence, whilst beneficial early in life, is likely to contribute. Age-related decline in reserve and compromise of homeostasis have impo...
Source: Medicine - December 26, 2012 Category: Internal Medicine Authors: Arunraj Navaratnarajah, Stephen H.D. Jackson Source Type: research

Principles of rehabilitation of older people
Abstract: Rehabilitation of older adults involves an active process, delivered through a coordinated multidisciplinary team approach, aiming to improve function and enable subjects to live their lives to the fullest potential. Frail, older adults are particularly vulnerable to functional decline as a result of illness and rehabilitation is an essential part of medical care for this population. The science of rehabilitation has developed considerably following the seminal work of pioneers such as Marjory Warren. Meta-analysis of the published rehabilitation research confirms the benefits of comprehensive multidisciplinary a...
Source: Medicine - December 26, 2012 Category: Internal Medicine Authors: David J. Stott, Terence J. Quinn Source Type: research

Editorial Board
Source: Medicine - December 26, 2012 Category: Internal Medicine Source Type: research

Contents
Source: Medicine - December 26, 2012 Category: Internal Medicine Source Type: research

Anna‐1 (anti‐Hu) associated sensory neuronopathy with malignant mixed mullerian tumor
Source: Muscle and Nerve - December 26, 2012 Category: Internal Medicine Authors: Christina N Fournier, Aarti Kalra, Daniel H Lachance, Corinne Zarwan, Jayashri Srinivasan Tags: Letter to the Editor Source Type: research

Pyogenic Granuloma:
We describe a case of pyogenic granuloma that we feel was indirectly related to a motorcycle accident. Clinicians should be familiar with both the diagnosis and treatment of this entity. Keywords: pyogenic granuloma; motorcycles; trauma; Kaposi’s sarcoma read more
Source: Postgraduate Medicine Online - December 26, 2012 Category: Internal Medicine Authors: admin Source Type: research

Hyperuricemia and Gout:
New Concepts in Diagnosis and Management Paul P. Doghramji, MD; Robert L. Wortmann, MD DOI: 10.3810/pgm.2012.11.2616 Abstract: Gout is a chronic, progressive condition for which hyperuricemia is the primary risk factor. The initial episodes of gout may be brief, only lasting for 3 to 5 days, and patients may experience pain-free intercritical periods that last from months to years. However, as the disease progresses, acute gout flares become more frequent and prolonged (typically lasting ≥ 5-10 days). Chronic gouty arthritis develops, with shorter pain-free intervals; tophi become visible and interarticular j...
Source: Postgraduate Medicine Online - December 26, 2012 Category: Internal Medicine Authors: admin Source Type: research

Chronic Hyperglycemia and Glucose Toxicity:
Pathology and Clinical Sequelae Carlos Campos, MD, MPH, CDE DOI: 10.3810/pgm.2012.11.2615 Abstract: Type 2 diabetes mellitus (DM) is a progressive disease characterized by elevated plasma glucose levels. Type 2 DM results from a combination of factors affecting both peripheral tissue insulin sensitivity and β-cell function. A survey of the scientific literature on DM, glucose toxicity, hyperglycemia, nephropathy, neuropathy, reactive oxygen species, and retinopathy cited on PubMed/Medline from January 1975 to May 2011 was conducted. The relevant publications, chosen at the author’s discretion, were us...
Source: Postgraduate Medicine Online - December 26, 2012 Category: Internal Medicine Authors: admin Source Type: research

Evolving Therapeutic Options for Type 2 Diabetes Mellitus:
Conclusions:The first OADs (sulfonylureas and biguanides) were discovered by chance. Although effective in reducing blood glucose levels, early sulfonylureas were associated with significant off-target effects, and the biguanide phenformin was discontinued due to adverse events. Although metformin is in the same drug class, it has a better safety profile and is now recommended as first-line treatment, except when contraindicated. Nonetheless, many patients require additional glucose control (even on metformin) with an agent that has a complementary mechanism of action. Developments in bench science have facilitated the sel...
Source: Postgraduate Medicine Online - December 26, 2012 Category: Internal Medicine Authors: admin Source Type: research

Effects of Multiple Doses of Albiglutide on the Pharmacokinetics, Pharmacodynamics, and Safety of Digoxin, Warfarin, or a Low-Dose Oral Contraceptive
Conclusion:Based on tolerability and the lack of clinically significant PK or PD interactions, no dose adjustments should be required when albiglutide is administered concomitantly with these medications. Keywords: albiglutide; interaction; digoxin; warfarin; contraceptive read more
Source: Postgraduate Medicine Online - December 26, 2012 Category: Internal Medicine Authors: admin Source Type: research

Novel Strategies for Managing Dyslipidemia:
Conclusion:Novel agents have the potential to be valuable additions to current treatment of dyslipidemia to reduce cardiovascular morbidity and mortality. These new drugs will not only have to be able to demonstrate an improvement in patients’ lipid profiles, but will also have to be able to demonstrate that they reduce cardiovascular morbidity and mortality, typically in combination with statin therapy. Keywords: hyperlipidemia; dyslipidemia; lipid-lowering drugs; atherosclerosis read more
Source: Postgraduate Medicine Online - December 26, 2012 Category: Internal Medicine Authors: admin Source Type: research

Evaluation of a Pretest Scoring System (4Ts) for the Diagnosis of Heparin-Induced Thrombocytopenia in a University Hospital Setting
Rodina Vatanparast, MD; Sarah Lantz, DO; Kristine Ward, MD; Pamela Ann Crilley, DO; Michael Styler, MD DOI: 10.3810/pgm.2012.11.2611 Abstract: The initial diagnosis of heparin-induced thrombocytopenia (HIT) is made on clinical grounds because the assays with the highest sensitivity (eg, heparin–platelet factor 4 antibody enzyme-linked immunosorbent assay [ELISA]) and specificity (eg, serotonin release assay) may not be readily available. The clinical utility of the pretest scoring system, the 4Ts, was developed and validated by Lo et al in the Journal of Thrombosis and Haemostasis in 2006. The pretest scoring s...
Source: Postgraduate Medicine Online - December 26, 2012 Category: Internal Medicine Authors: admin Source Type: research

Contemporary Approach to Electrical and Pharmacological Cardioversion of Atrial Fibrillation
Bharath Rajagopalan, MD; Anne B. Curtis, MD DOI: 10.3810/pgm.2012.11.2610 Abstract: In patients with atrial fibrillation (AF), a rhythm-control strategy may be adopted when there are unacceptable symptoms from AF, failure of rate control, and/or the presence of comorbidities, such as heart failure, that may improve with restoration of sinus rhythm. When a rhythm-control strategy is chosen and the patient is in persistent AF, cardioversion will be necessary to convert the rhythm to sinus. Patients with AF present for > 48 hours must be effectively anticoagulated both prior to and after cardioversion. With newer ora...
Source: Postgraduate Medicine Online - December 26, 2012 Category: Internal Medicine Authors: admin Source Type: research

Anticoagulants in Patients with Atrial Fibrillation and End-Stage Renal Disease
K. Scott Brimble, MD; Alistair J. Ingram, MD; John W. Eikelboom, MD; Robert G. Hart, MD DOI: 10.3810/pgm.2012.11.2609 Abstract: Atrial fibrillation (AF) is a common cardiac arrhythmia and is associated with an increased risk for thromboembolic stroke. Anticoagulant therapy has been shown to reduce the risk for ischemic stroke in patients with AF; however, these studies have excluded patients with end-stage renal disease (ESRD). This review examines the relationships between ESRD, AF, and the use of anticoagulants to prevent ischemic stroke. Medline and Embase were used to identify relevant articles. Identified review...
Source: Postgraduate Medicine Online - December 26, 2012 Category: Internal Medicine Authors: admin Source Type: research

A Review of Oral Anticoagulants in Patients with Atrial Fibrillation
Arnold J. Greenspon, MD DOI: 10.3810/pgm.2012.11.2608 Abstract: There is a high prevalence of atrial fibrillation in the United States, particularly in the elderly population. Patients with atrial fibrillation are at an increased risk of stroke and anticoagulant therapy is recommended. However, many eligible patients are not receiving therapy due to limitations and concerns related to the use of the vitamin K antagonist warfarin, such as slow onset of action, variable drug metabolism, risk of bleeding, and requirement for monitoring. Novel oral anticoagulants (NOACs) have been developed and may be used as an alternat...
Source: Postgraduate Medicine Online - December 26, 2012 Category: Internal Medicine Authors: admin Source Type: research

Attitudes Toward and Factors Affecting Influenza Vaccination Among Physicians and Nurses of a Tertiary-Care Hospital in the Central Anatolia Region of Turkey
Conclusion:Similar to other studies in the literature, vaccination rates were not at the desired level. According to our Hospital Infection Committee reports, vaccination rates at our hospital were lower compared with vaccination rates of the 2009 H1N1 pandemic. The underlying causes of health care professionals abstaining from influenza vaccination should be further evaluated. Keywords: influenza; vaccination; health care; physicians; nurses; side effects; Turkey read more
Source: Postgraduate Medicine Online - December 26, 2012 Category: Internal Medicine Authors: admin Source Type: research

Effect of Early Weight Loss on Type 2 Diabetes Mellitus After 2 Years of Gastric Banding
Conclusion:Shorter duration of T2DM and greater percent excess weight loss were associated with an increased likelihood of remission or improvement in T2DM status through LAGB after 2 years. Laparoscopic adjustable gastric banding is a potential adjunctive treatment for obese patients with T2DM. Keywords: laparoscopic adjustable gastric banding; obesity; type 2 diabetes mellitus; weight loss read more
Source: Postgraduate Medicine Online - December 26, 2012 Category: Internal Medicine Authors: admin Source Type: research

Higher-Dose (23 mg/day) Donepezil Formulation for the Treatment of Patients with Moderate-to-Severe Alzheimer’s Disease
This article reviews the rationale for using higher-dose donepezil, the clinical data supporting its use, and some of the practical implications that should be considered by practicing physicians when using donepezil 23 mg/day for patients with AD. Keywords: Alzheimer’s disease; moderate to severe; donepezil; efficacy; safety; higher dose read more
Source: Postgraduate Medicine Online - December 26, 2012 Category: Internal Medicine Authors: admin Source Type: research

Clinical application of copeptin levels in patients with disorders other than chest pain.
PMID: 23274044 [PubMed - as supplied by publisher]
Source: European Journal of Internal Medicine - December 26, 2012 Category: Internal Medicine Authors: Kapoor S Tags: Eur J Intern Med Source Type: research

Warming effect on miriplatin‐lipiodol suspension for potential use as a chemotherapeutic agent for transarterial chemoembolization of hepatocellular carcinoma: in vitro study
ConclusionThe viscosity and injection pressure through microcatheters of MPT/LPD was confirmed to reduce significantly as the temperature is elevated. MPT/LPD warmed to 40°C have half viscosity as that at room temperature and considered suitable for clinical use. Warming MPT/LPD may have potential to facilitate the procedure of TACE for HCC.
Source: Hepatology Research - December 26, 2012 Category: Internal Medicine Authors: Shinn‐ichi Kora, Hiroshi Urakawa, Toshimichi Mitsufuji, Akinobu Osame, Hideyuki Higashihara, Toshihiro Ohki, Kengo Yoshimitsu Tags: Original Article Source Type: research

Connective tissue growth factor, liver stiffness and transient elastography in biliary atresia
Sir, the recent report on “Correlation of connective tissue growth factor (CTGF) with liver stiffness measured by transient elastography in biliary atresia (BA)” is very interesting [1]. Honsawek et al. reported that “high serum CTGF was associated with a poor outcome in BA patients [1].” There are some considerations on this work. First, the unequal cases and controls in this report might reflect selection bias. Indeed, there are many highly similar reports by Honsawek et al. on biochemical parameters in BA [2 – 4].
Source: Hepatology Research - December 26, 2012 Category: Internal Medicine Authors: Somsri Wiwanitkit, Viroj Wiwanitkit Tags: Letter to the Editor Source Type: research

Detection of highly prevalent hepatitis B virus coinfection with human immunodeficiency virus in Indonesia
ConclusionsHBV coinfection, including occult HBV infection, was common in Indonesian HIV patients. Hepatic damage by the interaction of host immunity and HBV is still remaining issue in these immunosuppressive patients, and further study will be needed.
Source: Hepatology Research - December 26, 2012 Category: Internal Medicine Authors: Takako Utsumi, Yoshihiko Yano, Maria I. Lusida, Nasronudin, Mochamad Amin, Juniastuti, Soetjipto, Hak Hotta, Yoshitake Hayashi Tags: Original Article Source Type: research

Evaluation of the effect of sorafenib using serum NX‐des‐γ‐carboxyprothrombin in patients with hepatocellular carcinoma
ConclusionsNX‐DCP in combination with DCP could be a useful biomarker of sorafenib treatment for advanced HCC.
Source: Hepatology Research - December 26, 2012 Category: Internal Medicine Authors: Koji Miyahara, Kazuhiro Nouso, Yuki Morimoto, Takeshi Tomoda, Sayo Kobayashi, Yasuto Takeuchi, Hiroaki Hagihara, Kenji Kuwaki, Hideki Ohnishi, Fusao Ikeda, Yasuhiro Miyake, Shinichiro Nakamura, Hidenori Shiraha, Akinobu Takaki, Kazuhide Yamamoto, Tags: Original Article Source Type: research

A survey of non‐B, non‐C liver cirrhosis in Japan
Abstract In a nationwide survey of non‐B, non‐C liver cirrhosis (NBNC LC) in Japan at the 15th General Meeting of the Japan Society of Hepatology, 6999 NBNC LC patients were registered at 48 medical institutions. The percentage of NBNC LC among LC patients was approximately 26%. NBNC LC patients were categorized into 11 types according to etiological agents: nonalcoholic steatohepatitis (NASH), 14.5%; alcoholic liver disease (ALD), 55.1%; fatty liver disease (FLD), except NASH, ALD, and other known etiology, 2.5%; primary biliary cirrhosis, 8.0%; other biliary cirrhosis, 0.8%; autoimmune hepatitis, 6.8%; metabolic dise...
Source: Hepatology Research - December 26, 2012 Category: Internal Medicine Authors: Yasuaki Suzuki, Takaaki Ohtake, Shuhei Nishiguchi, Etsuko Hashimoto, Yutaka Aoyagi, Morikazu Onji, Yutaka Kohgo, Tags: Original Article Source Type: research

Pharmaco‐nutrient interactions – a systematic review of zinc and antihypertensive therapy
Conclusion: The available evidence suggests that use of ACE inhibitors and angiotensin 2 receptor antagonists or thiazide diuretics have the potential to reduce zinc levels in hypertensive patients. Additional research using larger participant numbers and accounting for dietary zinc intakes are required.
Source: International Journal of Clinical Practice - December 26, 2012 Category: Internal Medicine Authors: L. A. Braun, F. Rosenfeldt Tags: SYSTEMATIC REVIEW Source Type: research

MicroRNAs: New tools for diagnosis, prognosis, and therapy in hepatocellular carcinoma?
Abstract MicroRNAs (miRNAs) are evolutionarily conserved small noncoding RNAs involved in the regulation of gene expression and protein translation. Many studies have shown that they play a crucial role in driving organ and tissue differentiation during embryogenesis and in the fine‐tuning of fundamental biological processes, such as proliferation and apoptosis. Growing evidence indicates that their deregulation plays an important role in cancer onset and progression as well, where they act as oncogenes or oncosuppressors. In this review, we highlight the most recent findings regarding the role of miRNAs in hepatocellula...
Source: Hepatology - December 26, 2012 Category: Internal Medicine Authors: Silvia Giordano, Amedeo Columbano Tags: Review Source Type: research

Brahma related gene 1 (Brg1) bridges epigenetic regulation of pro‐inflammatory cytokine production to steatohepatitis
Conclusion: our data illustrate a Brg1‐dependent pathway that connects the epigenetic regulation of pro‐inflammatory genes to the pathogenesis of NASH and point to a potential druggable target in the therapeutic intervention of NASH. (HEPATOLOGY 2012.)
Source: Hepatology - December 26, 2012 Category: Internal Medicine Authors: Wenfang Tian, Huihui Xu, Fei Fang, Qi Chen, Yong Xu, Aiguo Shen Tags: Steatohepatitis and Metabolic Liver Disease Source Type: research

Cyclooxygenase Expression and Platelet Function in Healthy Dogs Receiving Low‐Dose Aspirin
Conclusions and Clinical ImportanceLow‐dose aspirin consistently inhibits platelet function in approximately one‐third of healthy dogs, despite decreased thromboxane synthesis and increased platelet COX expression in most dogs. COX isoform expression before treatment did not predict aspirin resistance.
Source: Journal of Veterinary Internal Medicine - December 26, 2012 Category: Veterinary Research Authors: A. Dudley, J. Thomason, S. Fritz, J. Grady, J. Stokes, R. Wills, L. Pinchuk, A. Mackin, K. Lunsford Tags: Standard Article Source Type: research

Noninvasive Clinical Assessment of Systolic Torsional Motions by Two‐Dimensional Speckle‐Tracking Echocardiography in Dogs with Myxomatous Mitral Valve Disease
Conclusions and Clinical ImportanceTorsional deformations assessed by 2D‐STE differed among clinical classes of MMVD. Myocardial torsional deformations by 2D‐STE may provide more detailed assessment of contractile function in dogs with MMVD.
Source: Journal of Veterinary Internal Medicine - December 26, 2012 Category: Veterinary Research Authors: R. Suzuki, H. Matsumoto, T. Teshima, H. Koyama Tags: Standard Article Source Type: research

Force Plate Gait Analysis in Doberman Pinschers with and without Cervical Spondylomyelopathy
Conclusions and Clinical ImportanceThe CV of PVF in all 4 limbs, especially the thoracic limbs, distinguished clinically normal Dobermans from those with CSM. Other kinetic parameters less reliably distinguished CSM‐affected from clinically normal Dobermans.
Source: Journal of Veterinary Internal Medicine - December 26, 2012 Category: Veterinary Research Authors: K. Foss, R.C. da Costa, P.J. Rajala‐Shultz, M.J. Allen Tags: Standard Article Source Type: research

Meaningful use drives physician EHR boom
“When the medical practice of Howard Axe, MD, found itself in need of a new electronic prescribing system two years ago, implementing a full electronic health record system with an e-prescribing component was never seriously considered. But a year and a half later, the 20-physician internal medicine and pediatrics practice in Arlington Heights, Ill., found itself [...]
Source: ICMCC: The International Council on Medical and Care Compunetics - December 24, 2012 Category: Information Technology Authors: Lodewijk Tags: News Compliance e-prescribing Incentives Meaningful Use Source Type: news

Long term health care consumption and cost expenditure in systolic heart failure.
CONCLUSION: Health care costs in chronic systolic heart failure are at least two-fold higher than in the general population. Quality of life is a strong independent predictor of health care consumption. PMID: 23269392 [PubMed - as supplied by publisher]
Source: European Journal of Internal Medicine - December 24, 2012 Category: Internal Medicine Authors: Mejhert M, Lindgren P, Schill O, Edner M, Persson H, Kahan T Tags: Eur J Intern Med Source Type: research

Hypomagnesemia in a department of internal medicine.
Conclusions: Hypomagnesemia in patients hospitalized in an internal medicine clinic was of multifactorial origin. A wide array of concurrent acid-base and electrolyte disorders was evident in this population. PMID: 23261516 [PubMed - as supplied by publisher]
Source: Magnesium Research - December 24, 2012 Category: Biochemistry Authors: Liamis G, Liberopoulos E, Alexandridis G, Elisaf M Tags: Magnes Res Source Type: research

Ancestral founder mutations in Calpain‐3in indian agarwal community– historical, clinical and molecular perspective
CONCLUSIONS:Founder mutations have immediate clinical application, at least in selected population groups. Clinically available gene panels may provide definitive molecular diagnosis for heterogeneous disorders like LGMD. © 2012 Wiley Periodicals, Inc.
Source: Muscle and Nerve - December 24, 2012 Category: Internal Medicine Authors: Arunkanth Ankala, Jordan N Kohn, Rashna Dastur, Pradnya Gaitonde, Satish V Khadilkar, Madhuri R Hegde Tags: Case of the Month Source Type: research

Hepatitis C screening: Getting it right
Conclusion: By taking a broader view of the evidence, the Task Force can write new guidelines that will serve efforts to curb the hepatitis C epidemic, rather than frustrate them. (HEPATOLOGY 2012)
Source: Hepatology - December 24, 2012 Category: Internal Medicine Authors: Brian R. Edlin Tags: Special Article Source Type: research

Recent advances in the management of TIA: a clinical review
Abstract Transient Ischaemic Attack (TIA) if untreated carries a high risk of early stroke and is associated with poorer long‐term survival. There have been recent advances in the understanding of TIA, its investigations, management and organisation of services for patient care. Clinically, patients are diagnosed TIA if they have transient sudden‐onset focal neurological symptoms which usually completely and rapidly resolve by presentation. Patients with residual symptoms should be evaluated as potentially having stroke, if they present within 4.5 hours of onset, should be urgently evaluated for their potential eligibi...
Source: Internal Medicine Journal - December 24, 2012 Category: Internal Medicine Authors: Thanh G Phan, Lauren Sanders, Velandai Srikanth Tags: Review Source Type: research

Local Perspective On A Rare Brain Tumour: Adult Medulloblastoma
ConclusionsCombined modality therapy (surgery followed by post‐operative radiotherapy and adjuvant chemotherapy) was well tolerated and associated with good outcomes in standard‐risk de novo patients. High‐risk and recurrent disease patients do extremely poorly regardless of treatment and better treatment strategies are needed in these patients.
Source: Internal Medicine Journal - December 24, 2012 Category: Internal Medicine Authors: Shu Fen Wong, Gabriel Mak, Mark A. Rosenthal, Lawrence Cher, Hui Gan Tags: Original Article Source Type: research

Emergency demand and repeat attendances by older patients
ConclusionsOlder patients are disproportionately represented amongst ED attendances. They also have an increasing propensity to re‐present to EDs, indicating a need to identify the clinical, social and health system related risk factors for re‐attendance by specific patients.
Source: Internal Medicine Journal - December 24, 2012 Category: Internal Medicine Authors: Judy Lowthian, Andrea Curtis, Johannes Stoelwinder, John McNeil, Peter Cameron Tags: Original Article Source Type: research

Hyperuricaemia and gout in New Zealand rural and urban Māori and non‐Māori communities
ConclusionsGout and hyperuricaemia were more prevalent in Maori, and participants with gout were more likely to have comorbidities. There was not a higher overall adjusted CVD risk in Maori participants with gout. Despite the high prevalence of gout, management remains sub‐optimal.
Source: Internal Medicine Journal - December 24, 2012 Category: Internal Medicine Authors: Lisa K Stamp, J. Elisabeth Wells, Suzanne Pitama, Allamanda Faatoese, RN Doughty, G Whalley, AM Richards, Vicky A Cameron Tags: Original Article Source Type: research

B‐type Natriuretic Peptide Levels Are Decreased by Reducing Dietary Salt Intake in Patients with Compensated Heart Failure with Preserved Ejection Fraction
ConclusionsChanges in BNP levels were associated with changes in the estimated daily salt excretion in outpatients with compensated heart failure. Salt restriction may be beneficial for the management of patients with heart failure.
Source: Internal Medicine Journal - December 24, 2012 Category: Internal Medicine Authors: Tsuneaki Sadanaga, Katsuyuki Ando, Shinichi Hirota, Hideo Mitamura, Takuya Tsuchihashi, Shun Kohsaka, Keiichi Fukuda, Satoshi Ogawa Tags: Original Article Source Type: research