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A Patient With Severe Hyponatremia and Hypokalemia: Osmotic Demyelination Fol…
Severe hyponatremia is a rare, but important, complication of thiazide diuretics. This often is associated with hypokalemia and other metabolic abnormalities, including hypophosphatemia and metabolic alkalosis.
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Nephrotic Syndrome and a Maculopapular Rash
A 26-year-old man was referred by his general practitioner due to new onset of peripheral edema with decreased urination. He reported that his urine was foamy but without gross hematuria. During the prior week, he had developed a rash. His medical history was unremarkable, except for attention deficit disorder, for which he used methylphenidate
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Connection between the heart and the gut
A 45-year-old man with ulcerative colitis was admitted with bloody diarrhoea and chest pain. Inflammatory markers and high-sensitivity troponin were elevated (C reactive protein 57 mg/L, white cell count 10.65×109/L, neutrophil 6.6×109/L, Troponin-I 663 mmol/L).
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Skin Wound Healing: An Update on the Current Knowledge and Concepts
The integrity of healthy skin plays a crucial role in maintaining physiological homeostasis of the human body. The skin is the largest organ system of the body. As such, it plays pivotal roles in the protection against mechanical forces and infections, fluid imbalance, and thermal dysregulation. At the same time, it allows for flexibility to enable joint function in some areas of the body a…
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Fluid management in acute kidney injury
Acute kidney injury (AKI) and fluids are closely linked through oliguria, which is a marker of the former and a trigger for administration of the latter. Recent progress in this field has challenged the physiological and clinical rational of using oliguria as a trigger for the administration of fluid and brought attention to the delicate balance between benefits and harms of different aspects o…
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Conners CBRS Update
The following updates have been made to the Conners Comprehensive Behavior Rating Scales™ (Conners CBRS™): (1) Validity scale interpretation, (2) T-score interpretation, (3) renaming the Aggressive Behaviors scale to Defiant/Aggressive Behaviors, (4) re-scoring the Violence Potential scale, and (5) adjusting triggers for the Other Clinical Indicators. These changes should improve the utilit…
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Strategies to increase nitric oxide signalling in cardiovascular disease
Nitric oxide (NO) is a key signalling molecule in the cardiovascular, immune and central nervous systems, and crucial steps in the regulation of NO bioavailability in health and disease are well characterized. Although early approaches to therapeutically modulate NO bioavailability failed in clinical trials, an enhanced understanding of fundamental subcellular signalling has enabled a range of …
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Rheumatoid arthritis in adults: management
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service
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2015 American College of Rheumatology Guideline for the Treatment of Rheumato…
Guidelines and recommendations developed and/or endorsed by the American College of Rheumatology (ACR) are intended to provide guidance for particular patterns of practice and not to dictate the care of a particular patient. The ACR considers adherence to the recommendations within this guideline to be voluntary, with the ultimate determination regarding their application to be made by the phys…
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Tailoring Natural Killer cell immunotherapy to the tumour microenvironment
Natural killer (NK) cells are cytotoxic and cytokine-secreting cells that can mediate potent anti-tumour activity. Accumulating evidence indicates that NK cell functions are severely compromised within the confines of the tumour microenvironment thus impairing the efficacy and development of NK cell-based therapies. Here we review the various cellular and molecular pathways that tumours have…
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