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Stop the clot: When is laboratory evaluation for thrombophilia warranted? 阻止血栓何时需要对血栓性疾病进行实验室评估?
IF 3.4 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-03 DOI: 10.3949/ccjm.91a.24058
Jaideep Singh Bhalla, G Jay Bishop, Scott J Cameron
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引用次数: 0
Vaccine hesitancy in the time of COVID: How to manage a public health threat. COVID 时代的疫苗犹豫:如何应对公共卫生威胁。
IF 3.4 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-03 DOI: 10.3949/ccjm.91a.24062
H Clifford Lane, Steven M Gordon
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引用次数: 0
Foxglove, not quite gone or forgotten. 狐尾草,还没有完全消失或被遗忘。
IF 3.4 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-01 DOI: 10.3949/ccjm.91b.08024
Brian F Mandell
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引用次数: 0
Helicobacter pylori: A concise review of the latest treatments against an old foe. 幽门螺杆菌:针对老对手的最新疗法简评。
IF 3.4 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-01 DOI: 10.3949/ccjm.91a.24031
Wafa A Aldhaleei, Michael B Wallace, Dana M Harris, Yan Bi

Helicobacter pylori is a significant public health concern given its high prevalence, growing rates of antibiotic resistance, and carcinogenic effect, all of which create management challenges for internists, gastroenterologists, and other specialty physicians. With almost half of the world's human population harboring H pylori, carcinogenic sequelae are a concern to many practitioners. Recent guidelines recommend testing high-risk populations for H pylori using noninvasive or invasive methods. H pylori eradication regimens are tailored based on the presence of effective empiric therapy (local cure rates ≥ 90% for a given regimen) or antimicrobial susceptibility testing. When empiric therapy cure rates are not optimal, guidelines recommend antimicrobial susceptibility testing to improve eradication rates and reduce the progression of antibiotic resistance.

幽门螺杆菌是一个重大的公共卫生问题,因为它的发病率高、抗生素耐药性和致癌作用不断增加,所有这些都给内科医生、消化科医生和其他专科医生的管理带来了挑战。全球近一半的人口都携带幽门螺杆菌,其致癌后遗症是许多从业人员关注的问题。最新指南建议使用非侵入性或侵入性方法对幽门螺杆菌高危人群进行检测。根除幽门螺杆菌的治疗方案是根据是否存在有效的经验疗法(特定治疗方案的局部治愈率≥90%)或抗菌药物敏感性检测来定制的。当经验疗法治愈率不理想时,指南建议进行抗菌药物药敏试验,以提高根除率,减少抗生素耐药性的产生。
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引用次数: 0
Persistent erosions of the glans penis and foreskin. 阴茎龟头和包皮持续糜烂。
IF 3.4 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-01 DOI: 10.3949/ccjm.91a.23085
Zheng Gu, Dong-Lai Ma
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引用次数: 0
Digoxin is still useful, but is still causing toxicity. 地高辛仍然有用,但仍会引起中毒。
IF 3.4 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-01 DOI: 10.3949/ccjm.91a.23105
Alejandro Durán Crane, Michael Militello, Michael D Faulx

Digoxin, the oldest known cardiovascular drug, is still used today to treat heart failure and atrial fibrillation. Because it has a narrow therapeutic index and multiple interactions, it frequently causes toxicity with a wide range of symptoms and cardiac arrhythmias. More importantly, elevated serum digoxin levels have been linked to a higher risk of death in patients with heart failure or atrial fibrillation, even without signs or symptoms of toxicity. This article reviews the current state of digoxin use, its pharmacologic principles, and the mechanisms, clinical presentation, and management of toxicity.

地高辛是已知最古老的心血管药物,如今仍被用于治疗心力衰竭和心房颤动。由于地高辛的治疗指数较窄,且存在多种相互作用,因此经常会引起中毒症状和心律失常。更重要的是,血清地高辛水平升高与心力衰竭或心房颤动患者的死亡风险升高有关,即使没有中毒症状或体征。本文回顾了地高辛的使用现状、药理原理以及中毒的机制、临床表现和处理方法。
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引用次数: 0
Diabetic retinopathy: Screening, prevention, and treatment. 糖尿病视网膜病变:筛查、预防和治疗。
IF 3.4 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-01 DOI: 10.3949/ccjm.91a.24028
David D Chong, Nikhil Das, Rishi P Singh

Internists are integral in the multidisciplinary approach to diabetic retinopathy, contributing significantly to the management of diabetes and diabetes-related complications. Effective screening processes, timely referrals, and strategic diabetes management are imperative to prevent and mitigate the consequences of diabetic retinopathy. The evolution of treatments for diabetic retinopathy has markedly improved vision outcomes and reduced the burden on patients. Despite these advances, a collaborative approach to care is essential to prevent the progression of vision impairment and manage associated complications.

内科医生是糖尿病视网膜病变多学科治疗方法中不可或缺的一部分,对糖尿病和糖尿病相关并发症的管理做出了重要贡献。有效的筛查程序、及时的转诊和战略性糖尿病管理对于预防和减轻糖尿病视网膜病变的后果至关重要。糖尿病视网膜病变治疗方法的发展已显著改善了视力,减轻了患者的负担。尽管取得了这些进步,但要预防视力损害的恶化并控制相关并发症,必须采取合作性的护理方法。
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引用次数: 0
Recurrent syncope in a 62-year-old man. 一名 62 岁男子反复晕厥。
IF 3.4 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-01 DOI: 10.3949/ccjm.91a.24008
Cindy Hsin-Ti Lin, Michael Sheu, Faiz Anwer
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引用次数: 0
What fluids should I order for my patient with acute pancreatitis? 我应该为急性胰腺炎患者输什么液体?
IF 3.4 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-01 DOI: 10.3949/ccjm.91a.24027
Anusha Agarwal, Arjun Chatterjee, Prabhleen Chahal
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引用次数: 0
Do patients with sepsis benefit from intravenous albumin? 败血症患者是否能从静脉注射白蛋白中获益?
IF 3.4 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-01 DOI: 10.3949/ccjm.91a.23089
Ryan Dunn, Kealy Ham, Lisa Marks, Neera Agrwal
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引用次数: 0
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Cleveland Clinic Journal of Medicine
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