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Beta-lactamases are enzymes that open the beta-lactam ring, inactivating the antibiotic. The first plasmid-mediated beta-lactamase in gram-negative bacteria was discovered in Greece in the 1960s. It was named TEM after the patient from whom it was isolated (Temoniera) [ 2 ]. Subsequently, a closely related enzyme was discovered and named TEM-2.

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INTRODUCTION. Thrombotic thrombocytopenic purpura (TTP) is a thrombotic microangiopathy (TMA) caused by severely reduced activity of the von Willebrand factor-cleaving protease ADAMTS13. It is characterized by small-vessel platelet-rich thrombi that cause thrombocytopenia, microangiopathic hemolytic anemia, and …UpToDate. With powerful and practical knowledge at your fingertips, UpToDate® is the only clinical decision support resource associated with improved patient outcomes. Purchase personal or group subscriptions for up to 19. Purchase UpToDate Online.Reversible posterior leukoencephalopathy syndrome (RPLS) is a clinical radiographic syndrome of heterogeneous etiologies that are grouped together because of similar findings on neuroimaging studies. It is also often referred to as: To continue reading this article, you must sign in with your personal, hospital, or group practice subscription ...INTRODUCTION. —. Acute rhinosinusitis (ARS) is defined as symptomatic inflammation of the nasal cavity and paranasal sinuses ( figure 1) lasting less than four weeks. The term "rhinosinusitis" is preferred to "sinusitis" since inflammation of the sinuses rarely occurs without concurrent inflammation of the nasal mucosa [ 1 ].Disclaimer: This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or …

These include fever of unknown origin, bacteremic seeding of heart valves and prosthetic devices, preterm birth of low birth weight children, and an increased risk for coronary heart disease and cerebrovascular events. The complications, diagnosis, and treatment of odontogenic infections will be reviewed here.INTRODUCTION. Acute pulmonary embolism (PE) is a common and sometimes fatal disease. The approach to the evaluation should be efficient while simultaneously avoiding the risks of unnecessary testing so that therapy can be promptly initiated and potential morbidity and mortality avoided [].

UpToDate is an online clinical resource tool for physicians and patients that provides information on various specialties and topics. Click on one of the specialties to see sections associated with each, such as Practice Changing UpDates, What's New, Patient Education, Calculators, and Drug Information. The signs and symptoms of anemia include paleness, weakness, and fatigue. Impaired kidney function — The excess proteins and high blood calcium levels associated with MM can damage the kidneys. Kidney function is abnormal at diagnosis in about half of individuals with multiple myeloma.

The Insider Trading Activity of Kornitzer Benjamin on Markets Insider. Indices Commodities Currencies StocksEVALUATION AND DIAGNOSIS. The history and physical examination in patients presenting with a severely elevated blood pressure (or an acute rise in blood pressure over a previously normal baseline, even if the presenting pressure is <180/120 mmHg) should determine whether any of the following are present [ 1,5 ]: Acute head …Powerful and practical clinical knowledge at your fingertips, a personal subscription to UpToDate provides consistent, convenient access to enhance your daily medical practice. UpToDate helps you stay current on the latest evidence-based recommendations across 25 specialties to find answers to your clinical questions. Subscribe.Although hypokalemia can be transiently induced by the entry of potassium into the cells, most cases result from unreplenished gastrointestinal or urinary losses due, for example, to vomiting, diarrhea, or diuretic therapy [ 1-3 ]. (See "Causes of hypokalemia in adults" .) Potassium replacement is primarily indicated when hypokalemia is due to ...

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Disclaimer: This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options.Jun 10, 2022 · INTRODUCTION. —. Tetanus is a nervous system disorder characterized by muscle spasms that is caused by the toxin-producing anaerobe Clostridium tetani, which is found in the soil. The clinical features of tetanus and its relationship to traumatic injuries were well known among the ancient Greeks and Egyptians and to many clinicians before the ... Treatment of osteomyelitis includes consideration of issues related to debridement, management of infected foreign bodies (if present), antibiotic selection, and duration of therapy; these issues are discussed in the following sections. General issues related to treatment of osteomyelitis are discussed here.Polycystic ovary syndrome (PCOS) is a condition that causes irregular menstrual periods, symptoms of excess androgens (acne, hirsutism, and scalp hair loss), and ovaries that appear "polycystic" on pelvic ultrasound. The condition occurs in approximately 5 to 10 percent of females. Many females with PCOS are overweight or …Intravenous thrombolysis can be administered up to 4.5 hours after symptom onset, and mechanical thrombectomy can be administered up to 24 hours after symptom onset. (See "Approach to reperfusion therapy for acute ischemic stroke" and "Intravenous thrombolytic therapy for acute ischemic stroke: Therapeutic use" and "Mechanical …

The diagnosis of iron deficiency (low iron stores, as measured by iron studies or other testing) is a major public health goal and an important aspect of the care of many adults. This topic will review the causes of iron deficiency in adults and an approach to the diagnostic evaluation. Treatment of iron deficiency in adults is discussed ...To encourage domestic travel, Thailand is partnering with Tinder to offer trips designed for singles around Thailand. Trips are scheduled in December 2020 and January 2021. With in..."I want African realities to be explored by Africans." Chimamanda Adichie is vocal about many things and African literature ranks highly on that list. The Nigerian author, in a vid...With so much change in the world of patient care, it is clear that access to continuously updated and reliable data is critical for both provider and patient satisfaction. …Severe sepsis in adults: Rapid overview of emergency management during first hour. Table 1. Securing the airway (if indicated), correcting hypoxemia, and establishing venous access for the early administration of fluids and antibiotics are priorities in the management of patients with sepsis and septic shock [ 3,4 ].Mar 28, 2024 · Generalized anxiety disorder (GAD) is characterized by excessive worry and anxiety that are difficult to control, cause significant distress and impairment, and occur on more days than not for at least six months [ 1 ]. GAD is a relatively common disorder, most often with an adult onset and chronic course [ 2-6 ]. If your organization permits Single Sign-On (SSO) for UpToDate, you may use your email address here. If not, please enter your Username. Close Subscribe. Subscribe. UpToDate offers a number of subscriptions and add-on products, allowing you to have the most up-to-date information and improve patient care. About Us ...

Apr 1, 2024 · For over a century, open appendectomy was the only standard treatment for appendicitis. Contemporary management of appendicitis is more sophisticated and nuanced: laparoscopic appendectomy has surpassed open appendectomy in usage, some patients with perforated appendicitis may benefit from initial antibiotic therapy followed by interval ... Peripheral artery disease (PAD), specifically atherosclerotic disease leading to peripheral artery obstruction, may be silent or present with a variety of symptoms and signs indicative of extremity ischemia. The clinical manifestations of arterial insufficiency (regardless of etiology) are due to a lack of blood flow to the musculature relative ...

Medicine Matters Sharing successes, challenges and daily happenings in the Department of Medicine Nadia Hansel, MD, MPH, is the interim director of the Department of Medicine in th...Symptoms and signs — Rhabdomyolysis is characterized clinically by the triad of myalgias, muscle weakness, and red to brown urine due to myoglobinuria [ 1 ]. Biochemically, several serum muscle enzymes are elevated, including CK. The degree of muscle pain and other symptoms varies widely. Most of the symptoms of rhabdomyolysis …Patient level information — UpToDate offers two types of patient education materials. The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials.Neurofibromatosis type 1 (NF1), previously known as von Recklinghausen disease, is the most common type. The hallmarks of NF1 are the multiple café-au-lait macules and associated cutaneous neurofibromas. The condition is called segmental NF1 when clinical features are limited to one area of the body due to somatic mosaicism of a …Feb 27, 2024 · The clinical approach to S. aureus bacteremia consists of careful history and physical examination, infectious disease consultation, and diagnostic evaluation including echocardiography and additional imaging as needed. History and physical examination. History – A careful history and physical examination is essential. Disclaimer: This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options.UpToDate is a trusted source of clinical information for health professionals. However, the page you are looking for can't be found. Try searching for a different topic or language.Jun 14, 2023 · EVALUATION AND DIAGNOSIS. The history and physical examination in patients presenting with a severely elevated blood pressure (or an acute rise in blood pressure over a previously normal baseline, even if the presenting pressure is <180/120 mmHg) should determine whether any of the following are present [ 1,5 ]: Acute head injury or trauma.

For over 30 years, clinicians around the world have trusted the evidence-based content in the UpToDate® clinical decision support (CDS) system to help make crucial care decisions when it matters most. Founded by clinicians for clinicians, and backed by an expert editorial team in over 25 specialties, UpToDate provides the latest medical ...

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UpToDate® registrants and Individual subscribers can now answer their clinical questions anytime, anywhere by downloading this app onto an Android™ phone or tablet. UpToDate is the leading clinical decision support resource with evidence-based clinical information – including drug topics and recommendations that clinicians rely on at the ...Apr 5, 2024 · INTRODUCTION. —. Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality worldwide. The clinical presentation of CAP varies, ranging from mild pneumonia characterized by fever and productive cough to severe pneumonia characterized by respiratory distress and sepsis. UpToDate is a trusted online resource that provides reliable and current information on various medical topics. Whether you are a physician, a patient, or a student, you can sign in with your email, username, or organization account to access UpToDate's evidence-based answers to your clinical questions. UpToDate is an online resource that helps you make informed decisions about medical care. Access the latest evidence, expert opinions, and patient education with your subscription. UpToDate is a trusted online resource that provides reliable and current information on various medical topics. Whether you are a physician, a patient, or a student, you can sign in with your email, username, or organization account to access UpToDate's evidence-based answers to your clinical questions. Diagnosis — The clinical diagnosis of cystitis is made in a patient who has classic signs and symptoms (ie, dysuria, urinary frequency, urgency, and/or suprapubic pain). For females who have atypical urinary symptoms, the diagnosis is supported by the presence of pyuria and bacteriuria on urinalysis and/or culture.Mar 20, 2024 · Acute pancreatitis should be suspected in patients with severe acute upper abdominal pain but requires biochemical or radiologic evidence to establish the diagnosis. This topic will review the clinical manifestations and diagnosis of acute pancreatitis. The etiology, pathogenesis, assessment of severity, and management of acute pancreatitis are ... Measures to cut down on leveraged crypto trades could entice institutional buyers and make bitcoin more useful as a currency. In an effort to curb cryptocurrency speculation, finan...A table summarizing the emergency management of acute hyponatremia in adults is provided ( table 1 ). An alternative approach, recommended in by European organizations, is to treat with two 150 mL bolus infusions of 3 percent saline, each given over 20 minutes, measuring the serum sodium between infusions [ 28 ]. UpToDate is a trusted and evidence-based clinical resource tool that provides comprehensive and updated information on various medical topics. Log in to access the full content and features of UpToDate, or register for a free trial or subscription.

Oct 31, 2023 · Atrial fibrillation (AF) is the most commonly treated cardiac arrhythmia. AF is generally associated with an irregularly irregular ventricular rhythm and absence of distinct P waves. This topic will provide a broad overview of the classification, clinical presentation, diagnosis, management, and sequelae of AF, including new-onset AF. Although hypokalemia can be transiently induced by the entry of potassium into the cells, most cases result from unreplenished gastrointestinal or urinary losses due, for example, to vomiting, diarrhea, or diuretic therapy [ 1-3 ]. (See "Causes of hypokalemia in adults" .) Potassium replacement is primarily indicated when hypokalemia is due to ...CLINICAL MANIFESTATIONS. Major clinical features and organ involvement. Constitutional symptoms — Constitutional symptoms such as fatigue, fever, and weight loss are present in most patients with systemic lupus erythematosus (SLE) at some point during the course of the disease.Instagram:https://instagram. best workout for fat loss femalefine arts museum houstonlogo triviasports direct uk Display complete list of interactions for an individual item by clicking item name. Add another item to analyze for potential interactions. NOTE: This tool does not address chemical compatibility related to I.V. drug preparation or administration. View interaction detail by clicking on link (s) below. panda house ann arbordirect cache access INTRODUCTION. —. Status epilepticus is a medical and neurologic emergency that requires prompt evaluation and treatment. The rapid evaluation and treatment of convulsive status epilepticus is discussed below. The definition, classification, clinical features, and diagnosis of convulsive status epilepticus in adults are reviewed … thinking. fast and slow "I want African realities to be explored by Africans." Chimamanda Adichie is vocal about many things and African literature ranks highly on that list. The Nigerian author, in a vid...Patient level information — UpToDate offers two types of patient education materials. The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials.