Hasil untuk "Internal medicine"

A. DeTore, V. President

J. Rex, M. G. Rinaldi, M. Pfaller

H. Kuper, H. Adami, H. Adami et al.

K. Brockow, A. Romano, M. Blanca et al.

M. Weir

Benjamin A Lipsky, A. Berendt, H. Deery et al.

Benjamin A. Lipsky, Anthony R. Berendt, H. Gunner Deery, John M. Embil, Warren S. Joseph, Adolf W. Karchmer, Jack L. LeFrock, Daniel P. Lew, Jon T. Mader, Carl Norden, and James S. Tan Medical Service, Veterans Affairs Puget Sound Health Care System, and Division of General Internal Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington; Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford, United Kingdom; Northern Michigan Infectious Diseases, Petoskey, Michigan; Section of Infectious Diseases, Department of Medicine, University of Manitoba, Winnipeg, Manitoba; Section of Podiatry, Department of Primary Care, Veterans Affairs Medical Center, Coatesville, Pennsylvania; Division of Infectious Diseases, Department of Medicine, Harvard Medical School, and Beth Israel Deaconess Medical Center, Boston, Massachusetts; Dimensional Dosing Systems, Sarasota, Florida; Department of Medicine, Service of Infectious Diseases, University of Geneva Hospitals, Geneva, Switzerland; Department of Internal Medicine, The Marine Biomedical Institute, and Department of Orthopaedics and Rehabilitation, University of Texas Medical Branch, Galveston, Texas; Department of Medicine, New Jersey School of Medicine and Dentistry, and Cooper Hospital, Camden, New Jersey; and Department of Internal Medicine, Summa Health System, and Northeastern Ohio Universities College of Medicine, Akron, Ohio

C. West, L. Dyrbye, D. Satele et al.

George Cierny, Jon T. Mader, Johan J. Penninck

T. Shanafelt, C. West, J. Sloan et al.

J. Barsuk, E. Cohen, J. Feinglass et al.

O. Tkacheva, Y. Kotovskaya, N. Runikhina et al.

The paper represents clinical guidelines on frailty, developed by Russian Association of gerontologists and geriatricians. The guidelines are dedicated to geriatricians, internal medicine specialists, general practitioners, family doctors and other specialists, dealing with adult patients. The paper includes screening and diagnostic tools and treatment options for patients with frailty, along with prevention, rehabilitation and medical care organization in this cohort of patients.

C. Atkins, J. Bonagura, S. Ettinger et al.

Hritika D. Pai MPT, K Vijaya Kumar PhD, Prasanna Mithra MD, DNB et al.

D. Clark, Amar Parikh, J. M. Dendy et al.

1Vanderbilt University Medical Center, Division of Cardiovascular Medicine, Department of Internal Medicine, Nashville, TN; 2Vanderbilt University Medical Center, Department of Orthopaedic Surgery and Sports Medicine, Nashville, TN; 3Monroe Carell Jr. Children’s Hospital at Vanderbilt, Thomas P. Graham Division of Pediatric Cardiology, Department of Pediatrics, Nashville, TN; 4Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN *Co-senior authors listed in alphabetical order * Drs. Hughes and Soslow contributed equally as co-senior authors.

Fatoş Dilan Köseoğlu, Bülent Özlek

Aims: The aim of this study was to assess the prevalence of anemia and iron deficiency in patients with heart failure with preserved ejection fraction (HFpEF) and its impact on clinical outcomes. Methods: We retrospectively analyzed 212 patients with HFpEF and identified anemia as a serum hemoglobin level of less than 13 g/dL in men and less than 12 g/dL in women. Additionally, ID was defined as a serum ferritin concentration < 100 ng/mL or 100–299 ng/mL with transferrin saturation < 20%. Patients were followed up for an average of 66.2 ± 12.1 months, with the endpoint being all-cause mortality among patients with HFpEF, both with and without anemia and iron deficiency. Furthermore, we explored other predictors of all-cause mortality. Results: The average age of the entire group was 70.6 ± 10.5 years, with females comprising 55% of the patients. Anemia was present in 81 (38.2%) patients, while 108 (50.9%) had iron deficiency. At the end of the follow-up period, 60 (28.3%) of the patients had passed away. Patients with anemia displayed more heart failure (HF) symptoms, diastolic dysfunction, higher NT-pro-BNP levels, and worse baseline functional capacity than those without. Similarly, patients with iron deficiency showed more pronounced HF symptoms and worse functional capacity than those without. The results from the multivariable analyses revealed that anemia (hazard ratio [HR]: 5.401, 95% confidence interval [CI]: 4.303–6.209, log-rank <i>p</i> = 0.001), advanced age, iron deficiency (HR: 3.502, 95% CI: 2.204–6.701, log-rank <i>p</i> = 0.015), decreased left ventricular ejection fraction, chronic kidney disease, and paroxysmal nocturnal dyspnea were all independently associated with all-cause mortality. Conclusions: It is essential to consider anemia and iron deficiency as common comorbidities in managing and prognosis HFpEF, as they significantly increase mortality risk.

Nuri Barış Hasbal, Fatih Palıt, Murat Yaşar Taş et al.

Do Young Kim, Sung Hea Kim, Eung-Ju Kim et al.

Abstract Introduction The ROsulord® sAfety for patients with Dyslipidemia study (ROAD study) in the Republic of Korea investigated the safety and efficacy of rosuvastatin in routine clinical practice. Methods This non-interventional, multicenter, prospective, observational study was conducted over a period of approximately 4.6 years and involved 14,243 participants. During this study, we assessed the adverse events, changes in laboratory test results, and efficacy endpoints associated with rosuvastatin use. Results The findings revealed a notably low adverse event rate of 1.63%, indicating a favorable safety profile for rosuvastatin in the management of dyslipidemia. Importantly, no clinically significant incidences of statin-associated myopathy, hepatotoxicity, or diabetes were observed during the study period. Moreover, this study demonstrated significant improvements in lipid profiles among patients receiving rosuvastatin treatment, with a reduction in total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels. These improvements contributed to a lower cardiovascular risk in the study population. Conclusion Overall, these findings suggest that rosuvastatin is safe and effective in managing dyslipidemia in real-world clinical settings, providing clinicians with valuable insights into the benefits and risks associated with statin therapy in this patient population.

Isobel Jacob, Gareth Jones, Peter Francis et al.

Background: The purpose of this review was to synthesise and determine the age-related change per annum in muscle thickness of the anterior thigh across the adult lifespan. Methods: Electronic databases (PubMed, SPORTDiscus and MEDLINE) were searched for primary studies that were screened for eligibility. Results: Following screening against eligibility criteria, 27 studies were included in the quantitative analysis. Linear regression revealed a 0.02 cm (95 % CI: −0.01, −0.03, p < 0.05) decline in mean muscle thickness per annum from 18 to 80 years of age, a 0.03 cm (95 % CI: −0.01 to −0.05) decline per annum between 20 and 49 years of age and a 0.05 cm (95 % CI: −0.03, −0.07) decline per annum between 50 and 80 years of age. There was a 1.5 cm (t (25) = 6.12, p < 0.05; 95 % CI= 0.98- 1.97 cm) mean difference in muscle thickness between the youngest (18–29yrs: 5.13 cm ± 0.38) and oldest adults (70–80yrs) 3.63 cm ± 0.63). There was no difference in the rate of decline of mean muscle thickness between males (−0.05 cm/annum, 95 % CI= −0.08, −0.02) and females (−0.04 cm/annum, 95 % CI= −0.07, −0.02). There was a larger difference in anterior thigh muscle thickness between the youngest and oldest in females (4.98 cm vs. 3.34 cm, 33 %, p < 0.05) compared with males (5.23 cm vs. 3.98 cm, 24 %, p < 0.05). Conclusion: Mean anterior thigh thickness was estimated to decrease at a rate of 0.02 cm per annum and this rate of decrease was greater after 50 years of age. Females were more susceptible to age-related reductions in anterior thigh muscle thickness than males.

Haoran Zhang, Yuwei Wang, Yaping Zhang et al.

Abstract Background Housing has been associated with dementia risk and disability, but associations of housing with differential patterns of neuropsychiatric symptoms (NPS) among dementia-free older adults remain to be explored. The present study sought to explore the contribution of housing status on NPS and subsyndromes associated with cognitive dysfunction in community-dwelling dementia-free elderly in Singapore. Methods A total of 839 dementia-free elderly from the Epidemiology of Dementia in Singapore (EDIS) study aged ≥ 60 were enrolled in the current study. All participants underwent clinical, cognitive, and neuropsychiatric inventory (NPI) assessments. The housing status was divided into three categories according to housing type. Cognitive function was measured by a comprehensive neuropsychological battery. The NPS were assessed using 12-term NPI and were grouped into four clinical subsyndromes: psychosis, hyperactivity, affective, and apathy. Associations of housing with composite and domain-specific Z-scores, as well as NPI scores, were assessed using generalized linear models (GLM). Binary logistic regression models analysed the association of housing with the presence of NPS and significant NPS (NPI total scores ≥ 4). Results Better housing status (5-room executive apartments, condominium, or private housing) was associated with better NPS (OR = 0.49, 95%CI = 0.24 to 0.98, P < 0.05) and significant NPS profile (OR = 0.20, 95%CI = 0.08 to 0.46, P < 0.01), after controlling for demographics, risk factors, and cognitive performance. Compared with those living in 1–2 room apartments, older adults in better housing had lower total NPI scores (β=-0.50, 95%CI=-0.95 to -0.04, P = 0.032) and lower psychosis scores (β=-0.36, 95%CI=-0.66 to -0.05, P = 0.025), after controlling for socioeconomic status (SES) indexes. Subgroup analysis indicated a significant correlation between housing type and NPS in females, those of Malay ethnicity, the more educated, those with lower income, and those diagnosed with cognitive impairment, no dementia (CIND). Conclusions Our study showed a protective effect of better housing arrangements on NPS, especially psychosis in a multi-ethnic Asian geriatric population without dementia. The protective effect of housing on NPS was independent of SES and might have other pathogenic mechanisms. Improving housing could be an effective way to prevent neuropsychiatric disturbance among the elderly.

L. Wilson

L A Wilson Professor of Medicine, Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; tonywislon@gmail.com T he intern is presenting the history of an ‘‘elderly man’’ who has lost the use of his legs over the past three days. And while he talks, I worry that my anguish at the minimal prospects of neurological help for such patients may evolve into resigned acceptance, as my time as a neurologist in London becomes more remote. 416 Practical Neurology