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Liu Longjian - - 2014
Heart failure (HF) is typically a chronic disease, with progressive deterioration occurring over a period of years or even decades. HF poses an especially large public health burden. It represents a new epidemic of cardiovascular disease, affecting nearly 5.8 million people in the United States, and over 23 million worldwide. ...
Johnson Frances L - - 2014
Heart failure is a clinical syndrome that is heterogeneous in both pathophysiology and etiology. This article describes some of the common mechanisms underlying heart failure, and reviews common causes. Informative diagnostic testing is reviewed.
Sayer Gabriel - - 2014
The renin-angiotensin-aldosterone system (RAAS) plays a critical role in the pathophysiology of heart failure with reduced ejection fraction (HFrEF). Targeting components of the RAAS has produced significant improvements in morbidity and mortality. Angiotensin-converting enzyme (ACE) inhibitors remain first-line therapy for all patients with a reduced ejection fraction. Angiotensin-receptor blockers may ...
Zhang David Y - - 2014
Heart failure (HF) is a syndrome characterized by upregulation of the sympathetic nervous system and abnormal responsiveness of the parasympathetic nervous system. Studies in the 1980s and 1990s demonstrated that inhibition of the renin-angiotensin-aldosterone system with angiotensin-converting enzyme inhibitors improved symptoms and mortality in HF resulting from systolic dysfunction, thus ...
Patarroyo-Aponte Maria - - 2014
Heart failure is one of the most prevalent cardiovascular diseases in the United States, and is associated with significant morbidity, mortality, and costs. Prompt diagnosis may help decrease mortality, hospital stay, and costs related to treatment. A complete heart failure evaluation comprises a comprehensive history and physical examination, echocardiogram, and ...
Subzposh Faiz - - 2014
Heart failure remains a major health problem in the United States, affecting 5.8 million Americans. Its prevalence continues to rise due to the improved survival of patients. Despite advances in treatment, morbidity and mortality remain very high, with a median survival of about 5 years after the first clinical symptoms. This ...
Adigopula Sasikanth - - 2014
ACC Stage C heart failure includes those patients with prior or current symptoms of heart failure in the context of an underlying structural heart problem who are primarily managed with medical therapy. Although there is guideline-based medical therapy for those with heart failure with reduced ejection fraction (HFrEF), therapies in heart ...
Baran David A - - 2014
From humble beginnings in 1963 with a single desperately ill patient, mechanical circulatory support has expanded exponentially to where it is a viable alternative for advanced heart failure patients. Some of these patients are awaiting transplant but others will have a mechanical heart pump as their ultimate treatment. The history ...
Stein Harald - - 2014
Hodgkin's disease (HD) is a fatal disorder with the unique histologic features of few dysplastic Hodgkin- and Reed-Sternberg (HRS) cells surrounded by an abundance of nonatypical bystander cells in primary biopsies. By using the first Hodgkin cell line L428 the cytokine receptor CD30 was discovered. CD30 proved to be an ...
Klein Liviu - - 2014
Sudden cardiac deaths account for 350,000 to 380,000 deaths in the United States annually. Implantable cardioverter-defibrillators have improved sudden death outcomes in patients with heart failure, but only a minority of patients with defibrillators receives appropriate therapy for ventricular arrhythmias. The risk prediction for sudden death and selection of patients ...
Younes Anas - - 2014
Hodgkin lymphoma (HL) is a relatively rare but highly curable human cancer. Because very few patients relapse and will require subsequent therapy, new drug development for HL has not been seen as a high priority by the pharmaceutical industry. Brentuximab vedotin, an antibody-drug conjugate that targets CD30 receptors, became the ...
André Marc P E - - 2014
Combination chemoradiotherapy achieves excellent results for the treatment of localized Hodgkin lymphoma. However, late toxic effects occur, mostly related to the radiotherapy administered after the standard adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) chemotherapy. The most serious sequelae are radiation-induced secondary cancers. Reducing radiotherapy has not yet prevented late malignancies. However, ...
Rose-Jones Lisa J - - 2014
Heart failure with preserved ejection fraction (HFpEF) is a complex clinical syndrome based on traditional heart failure symptoms with documentation of increased left ventricular filling pressures and preserved left ventricular ejection fraction. The exact mechanisms that induce HFpEF are not known. End-diastolic ventricular stiffness does not seem to be acting ...
Hay Annette E - - 2014
Because long-term survival of patients with nonbulky stage IA to IIA Hodgkin lymphoma is dependent on disease control and avoidance of late toxic effects associated with the treatment received, the initial choice of treatment can be associated with trade-offs that balance optimum disease control with avoidance of these late effect ...
Feitell Scott - - 2014
Heart failure is a costly and difficult disease to treat. However, new metrics make it an imperative to keep these patients out of the hospital. Implementing and maintaining patients on successful treatment plans is difficult. A multitude of factors make transitioning care to the outpatient setting difficult. A careful and ...
Borchmann Peter - - 2014
The key question in advanced-stage Hodgkin lymphoma for many years now has been, should intensified chemotherapy be applied upfront or be reserved for relapsing patients. The early intensification approach with BEACOPPescalated (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone) aims at curing patients with first-line chemotherapy definitely. The added toxicity of ...
Hutchings Martin - - 2014
Fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) is the most accurate tool for staging, treatment monitoring, and response evaluation in Hodgkin lymphoma (HL). Early determination of treatment sensitivity by FDG-PET is the best tool to guide individualized, response-adapted treatment. Several ongoing or recently completed trials have investigated the use ...
Fritz Joseph V - - 2014
Imaging equipment is experiencing advances in speed, sensitivity, safety, and workflow. There is an increasing trend toward physiologic imaging and quantitation, requiring greater consistency across manufacturers and clinics. The Human Connectome Project is symbolic of the drive toward combining multimodality anatomic and functional imaging with quantitation and sophisticated atlases. Advanced ...
Bertelson John A - - 2014
Dementia, whether secondary to Alzheimer disease or another process, is a significant cause of morbidity and mortality worldwide. Although dementia remains a clinical diagnosis, for many years imaging has served as a key component in the assessment of patients with cognitive impairment. There have been tremendous advancements in the neuroimaging ...
McVige Jennifer W - - 2014
Chiari malformations are anatomic anomalies that comprise a broad spectrum of neurologic conditions. The most common malformation, a Chiari type I malformation, can present with a variety of signs and symptoms, most frequently an occipital Valsalva-induced headache. Cranial and spinal magnetic resonance (MR) imaging is used to identify the degree ...
Vespa Paul M - - 2014
Critically ill neurologic patients are common in the hospital practice of neurology and are often in extreme states requiring accurate and specific information. Imaging, especially using advanced imaging techniques, can provide an important means of garnering this information. This article focuses on the clinical utilization of selective imaging methods that ...
Reksten Tove R - - 2014
Primary Sjögren's syndrome (pSS) is an autoimmune chronic inflammatory disorder affecting 0.2% to 3.0% of the population, with a 9:1 female to male ratio. Features are oral and ocular dryness, local and systemic autoantibody production, and progressive focal mononuclear cell infiltration in the affected salivary and lacrimal glands. Lymphoma is ...
Sankar Vidya - - 2014
Classification criteria provide a formalized approach to studying course and management of rheumatic disease, as well as a measure of improvement in care. Understanding the purposes of classification criteria sets and the differences between different classification criteria is crucial for understanding rheumatic disease and for the design and conduct of ...
Delli Konstantina - - 2014
Salivary gland biopsy is a technique broadly applied for the diagnosis of Sjögren's syndrome (SS), lymphoma accompanying SS, sarcoidosis, amyloidosis, and other connective tissue disorders. SS has characteristic microscopic findings involving lymphocytic infiltration surrounding the excretory ducts in combination with destruction of acinar tissue. This article focuses on the main ...
Jensen Siri Beier - - 2014
In this article, salivary gland dysfunction and xerostomia in Sjögren's syndrome (SS) are discussed, with a focus on the pathophysiology of salivary dysfunction in SS, the clinical presentation of dry mouth in SS, how to assess salivary gland hypofunction and xerostomia in SS, and the impact of salivary gland dysfunction ...
Napeñas Joel J - - 2014
Numerous oral manifestations associated with salivary gland dysfunction, and particularly Sjögren's syndrome, have been reported in the literature. This article discusses the evidence on a wide range of oral manifestations associated with Sjögren's syndrome.
Pinto Andres - - 2014
This article provides an overview of the published literature in English in the past 63 years involving the management of xerostomia and other oral complications of Sjögren's syndrome. The evidence supporting studied interventions was evaluated using published criteria.
Turner Michael D - - 2014
Although the cause and molecular pathways of Sjögren's syndrome are still unknown, basic, clinical, and translational science have started to identify linkages to other known processes. With the advent of newer, more sensitive, and more accurate chemokine, cytokine, and genetic analysis, the molecular progression of the disease may be understood. ...
Madero-Visbal Rafael - - 2014
Sjögren's syndrome, a chronic and progressive autoimmune disorder mainly characterized by xerophthalmia, xerostomia, and parotid enlargement, is primarily managed medically, but some patients will require surgical management. Patients with Sjögren's syndrome have an increased risk of non-Hodgkin lymphoma. Superficial parotidectomy is indicated for diagnostic purposes and can be therapeutic in ...
Ienopoli Sabatino - - 2014
Sjögren syndrome is a chronic autoimmune disease that typically affects the salivary and lacrimal glands. Aside from the common glandular signs and symptoms, Sjögren syndrome may also cause mononuclear infiltration and immune complex deposition involving extraglandular sites producing several extraglandular manifestations (EGM). The prevalence of EGMs varies greatly depending on ...
Wu Jason J - - 2014
Primary Sjögren's syndrome can have multiple extra-glandular manifestations ranging from mild to severe. Treatment for extra-glandular manifestations is organ specific and therapies are targeted based on the primary organs involved. Preferred treatment options used for extra-glandular manifestations of Sjögren's syndrome are usually extrapolated from the physician's experience in treating similar ...
Varma Priya - - 2014
In 2005, 1.6 million people were estimated to be living with limb loss; by 2050, the rate is expected to double to 3.6 million in the United States. Past data have shown that the rates of dysvascular amputations were increasing. However, recent studies looking at single diseases of peripheral arterial ...
Sheehan Terrence Patrick - - 2014
The amputee gets lost in the American health care system because of fragmentation across the continuum. The journey of the diabetic patient with limb loss through the health care system is even more precarious than that of the traumatic amputee. Interventions to address these secondary conditions and improve the health ...
Meier Robert H RH - - 2014
Providing rehabilitation services for the person with an amputation has become more difficult in today's health care environment. Amputation rehabilitation calls for specialized, multidisciplinary rehabilitation training. In examining the principles of amputation rehabilitation, one must understand the lessons learned from the Veterans Affairs Amputation System of Care and return to ...
Schnur David - - 2014
The best level of amputation must take into consideration the newest socket designs, methods of prosthetic suspension, and technologically advanced components. In some instances stump revision should be considered, to provide a better prosthetic fitting and function. Targeted reinnervation is a new neural-machine interface that has been developed to help ...
Uustal Heikki - - 2014
Most people with amputations should not experience pain that interferes with their quality of life or requires regular medication more than 6 months following the amputation surgery. In fact, most people with amputations do not experience significant pain more than 3 months following the amputation. However, the clinician must specifically define what ...
Belon Howard P - - 2014
Individuals experience multiple changes as a result of amputation. These changes not only are physical in nature but also may include psychological, financial, and comfort changes across the spectrum of an individual's life. It is important to assess the emotional responses that an individual may experience postsurgery and throughout the ...
Johnson Shawn Swanson - - 2014
Ideally, a collaborative team approach is already in place between the certified prosthetist (CP) and the occupational therapist (OT) before patients are casted for a prosthesis. Once an individual has completed their preprosthetic rehabilitation program and received an operational prosthesis from a CP, it is imperative that an OT provides ...
Esquenazi Alberto - - 2014
Gait analysis combined with sound clinical judgment plays an important role in elucidating the factors involved in the pathologic prosthetic gait and the selection and effects of available interventions to optimize it. Detailed clinical evaluation of walking contributes to the analysis of the prosthetic gait, but evaluation in the gait ...
Yoo Stanley - - 2014
In 2005 there were an estimated 1.6 million individuals in the United States living with limb loss. This number has been projected to more than double by 2050 to 3.6 million, making an understanding of management of the individual with amputation essential for the physiatrist. This article highlights common complications ...
Neumeister Michael W - - 2014
Although the mechanism is unknown, botulinum toxin type A injection may be an effective, localized, nonsurgical treatment option without addictive properties or systemic side effects for the treatment of ischemic digits. Clinical research supports the safety and efficacy of injection of botulinum toxin type A for the treatment of Raynaud ...
Heinemann Allen W - - 2014
Outcome measurement is crucial to assuring high-quality patient services and improving the quality of services provided by prosthetists. This article summarizes recent evidence on the measurement properties of outcome measures, and updates previously published summaries of outcome instruments. The review focuses on measures of mobility, functional status, quality of life, ...
Meier Robert H RH - - 2014
This article provides a generalized overview of amputation classifications and the idealized outcomes for upper and lower amputations at their respective levels. The following levels are discussed: above knee/transfemoral, below knee/transtibial, above elbow/transhumeral, below elbow/transradial, and bilateral for upper and lower extremities. This classification defines a framework for clinicians to ...
Diaz Roberto - - 2014
Surgical treatment of Dupuytren's disease includes radical fasciectomy, limited fasciectomy, percutaneous needle aponeurotomy (PNA), and treatment with collagenase injections. The most commonly performed procedure is limited fasciectomy. However, techniques such as PNA and collagenase injections are being performed with higher frequency because they are minimally invasive. PNA is generally recommended ...
Zajonc Horst - - 2014
Minimally invasive surgery is becoming part of the practice of hand surgery, which includes the adoption of endoscopic techniques for the treatment of cubital tunnel syndrome. Endoscopic cubital tunnel release allows for the advantages of minimal skin incisions and the low morbidity of an in situ release as well as ...
Slutsky David J - - 2014
Scaphoid fractures can be treated with minimal soft tissue dissection using percutaneous methods. Arthroscopy is a helpful tool when using these percutaneous scaphoid screw insertion techniques. Arthroscopy aids in optimal guidewire positioning, it is invaluable in assessing the quality of fracture reduction, and it allows one to evaluate the vascularity ...
Georgopoulos Rachel - - 2014
Consideration of the unified airway model when managing patients with rhinitis and or asthma allows a more comprehensive care plan and therefore improved patient outcomes. Asthma is linked to rhinitis both epidemiologically and biologically, and this association is even stronger in individuals with atopy. Rhinitis is not only associated with ...
Parker Michael J - - 2014
The ability to accurately obtain and interpret spirometry is essential for physicians caring for patients with asthma and inflammatory disease of the airway. This article reviews the basic equipment, setting, and personnel needed to obtain quality spirometric data. The fundamental measurements obtained in routine office spirometry and recommendations that are ...
Masson Puneet - - 2014
Varicoceles are an abnormal dilation of the pampiniform plexus of veins within the scrotum. Varicoceles are highly prevalent and can result in a myriad of deleterious effects on male reproduction. Numerous therapeutic options are available for correcting varicoceles, including surgical varicocelectomy and radiographic venous embolization. Varicocele correction is a more ...
Fornadley John A - - 2014
Therapy for asthma has undergone substantial changes in the past three decades, prompted by a better understanding of the role of inflammation in reversible airway disease. Improved therapies and a workable algorithm of therapy guidelines have provided an improved quality of life for the patient with asthma. This article outlines ...
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