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Clinical hypertension

Karel Kostev, Alexander Lucas, Louis Jacob
BACKGROUND: The goal of this study was to analyze the frequency of blood pressure (BP) and estimated glomerular filtration rate (eGFR) testing in type 2 diabetes mellitus (T2DM) patients followed in general and diabetological practices in Germany. METHODS: The study included individuals who had at least two concultations due to T2DM diagnosis (ICD-10: E11) between January and December 2016. Patients were followed in 557 general and diabetological practices. The primary outcome was the frequency of BP and eGFR testing in T2DM patients in 2016...
March 12, 2018: Experimental and Clinical Endocrinology & Diabetes
M Crowther, K van der Spuy, F Roodt, M B Nejthardt, J G Davids, J Roos, E Cloete, T Pretorius, G L Davies, J G van der Walt, C van der Westhuizen, M Flint, J L C Swanevelder, B M Biccard
Hypertension is not consistently associated with postoperative cardiovascular morbidity and is therefore not considered a major peri-operative risk factor. However, hypertension may predispose to peri-operative haemodynamic changes known to be associated with peri-operative morbidity and mortality, such as intra-operative hypotension and tachycardia. The objective of this study was to determine whether pre-operative hypertension was independently associated with haemodynamic changes known to be associated with adverse peri-operative outcomes...
March 12, 2018: Anaesthesia
Wessel M C M Vorselaars, Gerlof D Valk, Menno R Vriens, Jan Westerink, Wilko Spiering
OBJECTIVE: The aldosterone-to-renin ratio is widely used and is the recommended screening modality for primary aldosteronism by the Endocrine Society Guideline. However, studies on its diagnostic accuracy have been inconsistent, which is mainly because of methodological limitations. We set out to evaluate this diagnostic value by using a highly standardized study protocol, which is in line with the Endocrine Society Guideline recommendations regarding indications for screening, testing conditions and reference standards in daily clinical practice...
March 9, 2018: Journal of Hypertension
Sedigheh Asgary, Ali Rastqar, Mahtab Keshvari
Cardiovascular disease (CVD) is now the leading cause of death globally and is a growing health concern. Lifestyle factors, including nutrition, play an important role in the etiology and treatment of CVD. Functional foods based on their basic nutritional functions can decrease the risk of many chronic diseases and have some physiological benefits. They contain physiologically active components either from plant or animal sources, marketed with the claim of their ability to reduce heart disease risk, focusing primarily on established risk factors, which are hyperlipidemia, diabetes, metabolic syndrome, obesity/overweight, elevated lipoprotein A level, small dense low-density lipoprotein cholesterol (LDL-C), and elevated inflammatory marker levels...
March 12, 2018: Journal of the American College of Nutrition
Joshua I Rosenbloom, Methodius G Tuuli, Molly J Stout, Omar M Young, Candice L Woolfolk, Julia D López, George A Macones, Alison G Cahill
OBJECTIVE:  To determine the factors associated with severe maternal morbidity in a modern cohort of women laboring at term and to create a prediction model. STUDY DESIGN:  This is a retrospective cohort study of all term, laboring patients with live births at a single tertiary care center from 2004 to 2014. The primary outcome was composite maternal morbidity including organ failure, amniotic fluid embolism, anesthesia complications, sepsis, shock, thrombotic events, transfusion, or hysterectomy...
February 8, 2018: American Journal of Perinatology
Takahiro Osada, Timo Krings
BACKGROUND: Pial arterial supplies are sometimes found in patients with dural arteriovenous fistulas (DAVFs), though their characteristics have rarely been clarified. OBJECTIVE: To investigate the characteristics of pial arterial supplies in DAVFs and to discuss their pathophysiology and treatment. METHODS: Two hundred four consecutive patients with intracranial DAVFs over 11 yr were retrospectively reviewed. Clinical factors and radiological findings, including the presence of pial arterial supplies, were evaluated...
March 8, 2018: Neurosurgery
Kakharman Yesmembetov, Zhansaya Muratova, Sergey Borovskiy, Irina Ten, Kulpash Kaliaskarova
We report the clinical case of 23-year-old patient with liver cirrhosis of unknown genesis, significant resistant ascites, and 2 episodes of bleeding from esophageal varices. Evaluation did not find any cause of liver disease, and the patient was placed on the transplant wait list due to subcompensated liver function (Model for End-Stage Liver Disease score of 16, Child-Pugh class B) and poorly controlled severe portal hypertension. After treatment with diuretics, largevolume paracentesis, antibiotics, and vasoconstrictors, hepatorenal syndrome and spontaneous bacterial peritonitis resolved and liver function improved significantly...
March 2018: Experimental and Clinical Transplantation
Kakharman Yesmembetov, Natalya Satlikova, Zhanat Spatayev, Kulpash Kaliaskarova
We present a 21-year-old patient, remarkable for huge hepatomegaly with the liver, occupying almost the entire abdominal cavity, and mild portal hypertension due to splenic vein compression. After ultrasonography-guided liver biopsy, performed to establish the diagnosis, the patient had bleeding from the liver. Fortunately, emergency laparotomy was started immediately, and the patient was saved. Macroscopically, the liver appeared to be of purple-red color, flabby to the touch, and able to be easily wrinkled with fingers...
March 2018: Experimental and Clinical Transplantation
Yuan Dai, Weijia Luo, Jiang Chang
Rho kinases (ROCKs) are the first discovered RhoA effectors that are now widely known for their effects on actin organization. Recent studies have shown that ROCKs play important roles in cardiac physiology. Abnormal activation of ROCKs participate in multiple cardiovascular pathological processes, including cardiac hypertrophy, apoptosis, fibrosis, systemic hypertension, and pulmonary hypertension. ROCK inhibitors, fasudil and statins, have shown beneficial cardiovascular effects in many animal studies, clinical trials, and applications...
February 2018: Current Opinion in Physiology
K Wegleiter, M Waltner-Romen, R Trawoeger, U Kiechl-Kohlendorfer, E Griesmaier
Fetal angiotensin II receptor antagonist exposure is associated with major complications and even death when administered during pregnancy. Neonates frequently require intensive care treatment, and mortality is high. Despite this well-known risk potential, a considerable number of women still receive angiotensin II receptor antagonists during pregnancy to treat arterial hypertension. Although clinical symptoms in the neonatal period are well described, few reports address long-term follow-up after fetal exposure to angiotensin II receptor antagonists...
2018: Case Reports in Pediatrics
Jane Goudge, Tobias Chirwa, Sandra Eldridge, Francesc Xavier F Gómez-Olivé, Chodziwadziwa Kabudula, Felix Limbani, Eustasius Musenge, Margaret Thorogood
Introduction: In low/middle-income countries with substantial HIV and tuberculosis epidemics, health services often neglect other highly prevalent chronic conditions, such as hypertension, which as a result are poorly managed. This paper reports on a study to assess the effect on hypertension management of lay health workers (LHW) working in South African rural primary healthcare clinics to support the provision of integrated chronic care. Methods: A pragmatic cluster randomised trial with a process evaluation in eight rural clinics assessed the effect of adding two LHWs supporting nurses in providing chronic disease care in each intervention clinic over 18 months...
2018: BMJ Global Health
Yoshinari Enomoto, Go Hashimoto, Naohiko Sahara, Hikari Hashimoto, Hiroki Niikura, Keijiro Nakamura, Raisuke Iijima, Hidehiko Hara, Makoto Suzuki, Mahito Noro, Masao Moroi, Kaoru Sugi, Masato Nakamura
A 70-years-old male with a history of hypertension and drug resistant paroxysmal atrial fibrillation (AF) presented to our hospital for catheter ablation to his symptomatic AF. He had no prior surgical or percutaneous procedure to close or exclude the left atrial appendage (LAA). A transesophageal echocardiography (TEE) was performed to rule out intra-cardiac thrombus prior to the ablation procedure. Although the TEE imaging at multiple acquisition angles was obtained, the LAA could not be visualized and an absence of the LAA was suspected...
March 12, 2018: International Heart Journal
Karin Rådholm, Gemma Figtree, Vlado Perkovic, Scott D Solomon, Kenneth W Mahaffey, Dick de Zeeuw, Greg Fulcher, Terrance D Barrett, Wayne Shaw, Mehul Desai, David R Matthews, Bruce Neal
BACKGROUND : Canagliflozin is a sodium glucose cotransporter 2 inhibitor that reduces the risk of cardiovascular events. We report the effects on heart failure and cardiovascular death overall, in those with and without a baseline history of heart failure, and in other participant subgroups. METHODS : The CANVAS Program (Canagliflozin Cardiovascular Assessment Study) enrolled 10 142 participants with type 2 diabetes mellitus and high cardiovascular risk. Participants were randomly assigned to canagliflozin or placebo and followed for a mean of 188 weeks...
March 11, 2018: Circulation
Kristen Nicole DiFilippo, Wen-Hao David Huang, Karen M Chapman-Novakofski
OBJECTIVE: To identify the availability and quality of apps supporting Dietary Approaches to Stop Hypertension (DASH) education. METHODS: The researchers identified DASH apps over 1 month in the Apple App Store. Five registered dietitians used the App Quality Evaluation (AQEL) to evaluate app quality on 7 domains. Interrater reliability was tested using intraclass correlations. RESULTS: One paid and 3 free DASH apps were evaluated. Interrater reliability (n = 5) was good for 3 apps and fair for 1 app...
March 8, 2018: Journal of Nutrition Education and Behavior
M C Jiménez-González, D Santiago-Germán, E F Castillo-Henkel, J A Alvarado-Moreno, J Hernández-Juárez, A Leaños-Miranda, A Majluf-Cruz, I Isordia-Salas
INTRODUCTION: Numerous polymorphisms in candidate genes coding for haemostatic system proteins have been proposed as risk factors for thrombosis. METHODS: We performed a case-control study of consecutive ischaemic stroke survivors aged ≤ 45 years, treated at our neurology department from 2006 to 2014. Polymerase chain reaction-restriction fragment length polymorphism identified the following polymorphisms: Thr325Ile and Ala147Thr in TAFI, 4G/5G in PAI-1, PLA1/A2 in platelet glycoprotein IIb/IIIa, Glu298Asp in eNOS, and C677T in 5,10-MTHFR...
March 8, 2018: Neurología: Publicación Oficial de la Sociedad Española de Neurología
Guillermo Pousada, Mauro Lago-Docampo, Adolfo Baloira, Diana Valverde
BACKGROUND AND OBJECTIVE: Pulmonary arterial hypertension associated with systemic lupus erythematosus (PAH-SLE) is a rare disease with a low incidence rate. In this study, PAH related genes and genetic modifiers were characterised molecularly in patients with PAH-SLE. PATIENTS AND METHODS: Three patients diagnosed with PAH-SLE and 100 control individuals were analysed after signing an informed consent. RESULTS: Two out of the three analysed patients with PAH-SLE were carriers of pathogenic mutations in the genes BMPR2 and ENG...
March 8, 2018: Medicina Clínica
S D Yang, P Q Li, Y G Huang, W Li, L Z Ma, L Wu, N Wang, J M Lu, W Q Chen, Guang-Ming Liu, Y M Xiong, Y L Chen, Ying Zhang
Enterovirus A-71 (EV-A71) may be fatal, but the natural history, symptoms, and signs are poorly understood. This study aimed to examine the natural history of fatal EV-A71 infection and to identify the symptoms and signs of early warning of deterioration. This was a clinical observational study of fatal cases of EV-A71 infection treated at five Chinese hospitals between 1 January 2010 and 31 December 2012. We recorded and analysed 91 manifestations of EV-A71 infection in order to identify early prognosis indicators...
March 12, 2018: Epidemiology and Infection
Elliot M Silver, William Ochoa
BACKGROUND Chronic intake of high-dose corticosteroids is associated with multiple adverse clinical effects, including hypertension, insulin resistance, impaired wound healing, immunosuppression, myopathy, and osteoporosis. In cases of autoimmune disease, use of steroid-sparing treatment modalities is preferred over chronic steroid therapy to limit these side effects. Glucocorticoid-induced myopathy is a less common side effect of chronic steroid use in patients treated with <10 mg/day of prednisone. However, doses exceeding 40-60 mg/day can induce clinically significant myopathy and weakness...
March 11, 2018: American Journal of Case Reports
Lena Van den Eeden, Nathalie Lambrechts, Veerle Verheyen, Mario Berth, Greet Schoeters, Yves Jacquemyn
INTRODUCTION: Air pollution is a hot topic and is known to cause multiple health issues. Especially pregnant women seem to be vulnerable to environmental issues. There are data suggesting that exposure contributes to hypertensive disorders.This study aims to evaluate the effects of exposure to particulate matter (PM) and outdoor air pollutants on the clinical pregnancy outcome for mother and child and to determine which biochemical changes in maternal, placental and cord blood best explain this effect...
March 9, 2018: BMJ Open
Siddharth Pandey, Ajay Aggarwal, Manoj Kumar, Satyanarayan Sankhwar
Spontaneous renal artery dissection (SRAD) is a rare entity with less than 200 cases reported in literature. It usually affects middle-aged men and the clinical presentation is non-specific. Many times it is associated with conditions such as hypertension, fibromuscular dysplasia or vasculitides. We report the case of a patient who initially had renal infarct due to SRAD and then progressed to have bowel ischaemia. The renal infarct preceded bowel ischaemia in this patient and to the best of our knowledge this is the first such association reported in literature...
March 9, 2018: BMJ Case Reports
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