MedWorm: Internal Medicine Top 20

Radiographic and CT findings in pandemic swine-origin influenza A (H1N1).

European Journal of Internal Medicine — Tue, 09 Mar 2010 15:37:15 +0100

Authors: Theodorou DJ, Theodorou SJ, Tsoumani A, Gossios K, Akritidis N PMID: 20206868 [PubMed - as supplied by publisher] (Source: European Journal of Internal Medicine)

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Influenza Vaccines: From Surveillance Through Production to Protection

Mayo Clinic Proceedings — Mon, 01 Mar 2010 18:02:04 +0100

Influenza is an important contributor to population and individual morbidity and mortality. The current influenza pandemic with novel H1N1 has highlighted the need for health care professionals to better understand the processes involved in creating influenza vaccines, both for pandemic as well as for seasonal influenza. This review presents an overview of influenza-related topics to help meet this need and includes a discussion of the burden of disease, virology, epidemiology, viral surveillance, and vaccine strain selection. We then present an overview of influenza vaccine—related topics, including vaccine production, vaccine efficacy and effectiveness, influenza vaccine misperceptions, and populations that are recommended to receive vaccination. English-language articles in PubMed...

The Scope and Targeting of Influenza Vaccination Reminders Among US Adults: Evidence From a Nationally Representative Survey [Research Letters]

Archives of Internal Medicine — Mon, 22 Feb 2010 20:50:44 +0100

(Source: Archives of Internal Medicine)

Fixed-dose enoxaparin thromboprophylaxis feasible for morbidly obese

MedWire News - Thrombosis — Wed, 10 Mar 2010 17:27:11 +0100

US researchers say that enoxaparin administered at a 0.5-mg/kg dose may be effective at preventing thrombosis in morbidly obese patients without increasing the risk for bleeding. (Source: MedWire News - Thrombosis)

CYP2C19-17 linked to elevated clopidogrel bleeding risk

MedWire News - Thrombosis — Wed, 03 Feb 2010 16:06:04 +0100

Patients carrying the cytochrome P450 2C19-17 variant have an enhanced response to clopidogrel treatment, increasing their risk for bleeding, caution German researchers. (Source: MedWire News - Thrombosis)

Surgery Alone May Be Reasonable for Stage I Small-Cell Lung Cancer

Medscape Internal Medicine Headlines — Thu, 25 Feb 2010 14:15:35 +0100

Analysis of 205 patients with stage I small-cell lung cancer from the SEER database showed a 5-year survival rate of 50.3% for lobectomy alone. Medscape Medical News (Source: Medscape Internal Medicine Headlines)

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Thinking beyond the bladder: antidiuretic treatment of nocturia

International Journal of Clinical Practice — Wed, 10 Mar 2010 00:00:00 +0100

Nocturia is a bothersome and highly prevalent urological condition characterised by the need to wake to void at night. Contrary to popular misconception, nocturia is equally common in men and women, and although its prevalence increases with age, a significant proportion of younger people are also affected. Nocturia leads to repeated fragmentation of sleep and consequently to a serious decline in daytime functioning and in overall quality of life and health. As such, its impact should not be underestimated by clinicians. Traditionally, nocturia has been regarded as a symptom of benign prostatic enlargement and/or overactive bladder syndrome, with treatment therefore directed towards increasing the capacity of the bladder to hold urine. Such treatments have proven largely ineffective in man...

Nonobese population in a developing country has a high prevalence of nonalcoholic fatty liver and significant liver disease

Hepatology — Thu, 11 Mar 2010 00:00:00 +0100

There is a paucity of community-based epidemiological data on nonalcoholic fatty liver (NAFL) among nonaffluent populations in developing countries. Available studies are radiological and/or biochemical and lack histological assessment, limiting their strength. We conducted a prospective epidemiological study comprising a 1:3 subsample of all adult (>18 years) inhabitants of a rural administrative unit of West Bengal, India. Subjects positive for hepatitis B virus and/or hepatitis C virus infection and consuming any amount of alcohol were excluded. Diagnosis of NAFL was by dual radiological screening protocol consisting of ultrasonographic and computed tomographic examination of the liver. Transient elastographic examination and liver biopsy were performed in a subset to identify significa...

Cigarette smoking exacerbates nonalcoholic fatty liver disease in obese rats

Hepatology — Tue, 23 Feb 2010 00:00:00 +0100

Conclusion: CS causes oxidative stress and worsens the severity of NAFLD in obese rats. Further studies should assess whether this finding also occurs in patients with obesity and NAFLD. (HEPATOLOGY 2010.) (Source: Hepatology)

Knee strengthening exercises at home, but not dietary intervention, reduce knee pain and improve knee function in overweight and obese people over 2 years

Evidence-Based Medicine — Mon, 22 Feb 2010 17:41:20 +0100

(Source: Evidence-Based Medicine)

No difference between short-course and long-course antibiotics for bacterial meningitis in children, but available evidence limited

Evidence-Based Medicine — Mon, 22 Feb 2010 17:41:19 +0100

(Source: Evidence-Based Medicine)

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Narrative Review: Thrombocytosis, Polycythemia Vera, and JAK2 Mutations: The Phenotypic Mimicry of Chronic Myeloproliferation.

Annals of Internal Medicine — Tue, 02 Mar 2010 00:00:00 +0100

Authors: Spivak JL The myeloproliferative disorders polycythemia vera, essential thrombocytosis, and primary myelofibrosis are clonal disorders arising in a pluripotent hematopoietic stem cell, causing an unregulated increase in the number of erythrocytes, leukocytes, or platelets, alone or in combination; eventual marrow dominance by the progeny of the involved stem cell; and a tendency to arterial or venous thrombosis, marrow fibrosis, splenomegaly, or transformation to acute leukemia, albeit at widely varying frequencies. The discovery of an activating mutation (V617F) in the gene for JAK2 (Janus kinase 2), a tyrosine kinase utilized by hematopoietic cell receptors for erythropoietin, thrombopoietin, and granulocyte colony-stimulating factor, provided an explanation for the shared c...

Institute of Medicine recommendations for the prevention and control of hepatitis B and C

Hepatology — Mon, 22 Feb 2010 00:00:00 +0100

Conclusion: To address the situation, the Institute of Medicine report makes recommendations in four areas: improved surveillance for HBV and HCV; improved knowledge and awareness among healthcare and social-service providers and the public, especially at-risk people; improved HBV vaccine coverage; and improved viral hepatitis services and access to those services. HEPATOLOGY, 2010 (Source: Hepatology)

Corticosteroids added to antibiotic therapy aid pain resolution in adults with sore throat, particularly severe or exudative sore throat

Evidence-Based Medicine — Mon, 22 Feb 2010 17:41:20 +0100

(Source: Evidence-Based Medicine)

Deflazacort

Journal of Postgraduate Medicine — Tue, 09 Mar 2010 16:15:37 +0100

Joshi N, Rajeshwari KJournal of Postgraduate Medicine 2009 55(4):296-300Conventional oral steroids like prednisolone have various adverse effects both during short-term and long-term use. Hence a search for an alternative oral steroid with fewer side-effects is underway throughout the world. Deflazacort, an oxazoline derivative, is a step in this direction. The number of large randomized trials using deflazacort for steroid-responsive disorders in children is limited. Use of deflazacort has been explored largely in patients with Duchenne's muscular dystrophy. Preliminary data suggest reduced osteoporosis, lesser growth retardation and weight gain with use of deflazacort, as compared to other steriods. In view of the limited data demonstrating superiority of deflazacort over the avai...

Acral melanoma in type VI skin

Internal Medicine Journal — Fri, 05 Mar 2010 00:00:00 +0100

(Source: Internal Medicine Journal)

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Neuraminidase inhibitors produce a small reduction in duration of seasonal influenza in children and reduce transmission in affected households, but effects on serious complications unclear

Evidence-Based Medicine — Mon, 22 Feb 2010 17:41:20 +0100

(Source: Evidence-Based Medicine)

Warfarin sensitivity falls after valve surgery

MedWire News - Thrombosis — Sat, 27 Feb 2010 15:47:34 +0100

Research indicates that a decrease in sensitivity to warfarin in the months after heart valve surgery may place patients at risk for receiving subtherapeutic anticoagulant therapy. (Source: MedWire News - Thrombosis)

Hospital Cost of Care, Quality of Care, and Readmission Rates: Penny Wise and Pound Foolish? [Original Investigation]

Archives of Internal Medicine — Mon, 22 Feb 2010 20:50:44 +0100

Conclusions The associations are inconsistent between hospitals' cost of care and quality of care and between hospitals' cost of care and mortality rates. Most evidence did not support the "penny wise and pound foolish" hypothesis that low-cost hospitals discharge patients earlier but have higher readmission rates and greater downstream inpatient cost of care. (Source: Archives of Internal Medicine)

Getting to "No": Strategies Primary Care Physicians Use to Deny Patient Requests [Original Investigation]

Archives of Internal Medicine — Mon, 22 Feb 2010 20:50:44 +0100

Conclusions Strategies for saying no may be used to communicate appropriate care plans, to reduce provision of medically inappropriate services, and to preserve the physician-patient relationship. These findings should be considered in the context of physician education and training in light of increasing health care costs. (Source: Archives of Internal Medicine)