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Interventions for preventing critical illness polyneuropathy and critical illness myopathy.
CONCLUSIONS: There is moderate quality evidence from two large trials that intensive insulin therapy reduces CIP/CIM, and high quality evidence that it reduces duration of mechanical ventilation, ICU stay and 180-day mortality, at the expense of hypoglycaemia. Consequences and prevention of hypoglycaemia need further study. There is moderate quality evidence which suggests no effect of corticosteroids on CIP/CIM and high quality evidence that steroids do not affect secondary outcomes, except for fewer new shock episodes. Moderate quality evidence suggests a potential benefit of early rehabilitation on CIP/CIM which is acc...
Source: Cochrane Database of Systematic Reviews - February 3, 2014 Category: Journals (General) Authors: Hermans G, De Jonghe B, Bruyninckx F, Van den Berghe G Tags: Cochrane Database Syst Rev Source Type: research

Proximal myopathy: diagnostic approach and initial management
Proximal myopathy presents as symmetrical weakness of proximal upper and/or lower limbs. There is a broad range of underlying causes including drugs, alcohol, thyroid disease, osteomalacia, idiopathic inflammatory myopathies (IIM), hereditary myopathies, malignancy, infections and sarcoidosis. Clinical assessment should aim to distinguish proximal myopathy from other conditions that can present similarly, identify patients who need prompt attention, like those with cardiac, respiratory or pharyngeal muscle involvement, and determine underlying cause of myopathy. Initial evaluation should include simple tests, like creatine...
Source: Postgraduate Medical Journal - July 16, 2013 Category: Journals (General) Authors: Suresh, E., Wimalaratna, S. Tags: Reviews Source Type: research