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Clinical hypertension

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https://www.readbyqxmd.com/read/28813123/pharmacotherapy-for-hypertension-in-adults-aged-18-to-59-years
#1
REVIEW
Vijaya M Musini, Francois Gueyffier, Lorri Puil, Douglas M Salzwedel, James M Wright
BACKGROUND: Hypertension is an important risk factor for adverse cardiovascular events including stroke, myocardial infarction, heart failure and renal failure. The main goal of treatment is to reduce these events. Systematic reviews have shown proven benefit of antihypertensive drug therapy in reducing cardiovascular morbidity and mortality but most of the evidence is in people 60 years of age and older. We wanted to know what the effects of therapy are in people 18 to 59 years of age...
August 16, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28812942/acute-hypertensive-response-in-patients-with-intracerebral-hemorrhage-pathophysiology-and-treatment
#2
Adnan I Qureshi, Mushtaq H Qureshi
Acute hypertensive response is a common systemic response to occurrence of intracerebral hemorrhage which has gained unique prominence due to high prevalence and association with hematoma expansion and increased mortality. Presumably, the higher systemic blood pressure predisposes to continued intraparenchymal hemorrhage by transmission of higher pressure to the damaged small arteries and may interact with hemostatic and inflammatory pathways. Therefore, intensive reduction of systolic blood pressure has been evaluated in several clinical trials as a strategy to reduce hematoma expansion and subsequent death and disability...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28812917/predictive-role-of-cha2ds2-vasc-score-for-cardiovascular-events-and-death-in-patients-with-arterial-hypertension-and-stable-sinus-rhythm
#3
Carmine Mazzone, Giovanni Cioffi, Cosimo Carriere, Giulia Barbati, Giorgio Faganello, Giulia Russo, Antonella Cherubini, Gianfranco Sinagra, Nadia Zeriali, Andrea Di Lenarda
Background The CHA2DS2-VASc score well stratifies the risk for thromboembolic events in non-valvular atrial fibrillation (NVAF) patients. This score may also predict thromboembolic events in sinus rhythm populations. Purpose The purpose of this study was to assess the prognostic role of CHA2DS2-VASc in a Caucasian community population of patients with arterial hypertension and sinus rhythm. Methods A total of 12,599 arterial hypertension residents not receiving anticoagulation were selected from a community population in Trieste between November 2009 and October 2014: 11,159 sinus rhythm and 1440 NVAF patients...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28812826/a-policy-analysis-on-the-proactive-prevention-of-chronic-disease-learnings-from-the-initial-implementation-of-integrated-measurement-for-early-detection-mido
#4
Roberto Tapia-Conyer, Rodrigo Saucedo-Martínez, Ricardo Mújica-Rosales, Héctor Gallardo-Rincón, Evan Lee, Craig Waugh, Lucía Guajardo, Braulio Torres-Beltrán, Úrsula Quijano-González, Mauricio López-Mendez, Elena Rose Atkinson
Mexico, like many low- and middle-income countries (LMICs), faces an epidemic of chronic non-communicable diseases (NCDs), specifically diabetes, hypertension, obesity, and lipid disorders. Many people with these NCDs may not be aware that they have a disease, pointing to the need for broader screening programs. The traditional prevention policy in Mexico was based on screening with a paper-based risk factor questionnaire. However, this was used to screen patients already seeking healthcare services at facilities, and screening goals were set as a function of the number of questionnaires applied, not number of individuals screened...
February 20, 2017: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/28812381/retrospective-review-of-sglt2-inhibitor-exposures-reported-to-13-poison-centers
#5
Scott E Schaeffer, Carol DesLauriers, Henry A Spiller, Alfred Aleguas, Salvador Baeza, Mark L Ryan
BACKGROUND: SGLT2 inhibitors are a new class of oral antidiabetics prescribed in the United States since 2013. They act by inhibiting reabsorption of glucose in the proximal convoluted tubule of the kidney, allowing excess glucose to be excreted. Little has been reported regarding effects of non-therapeutic exposure to this class of medication. METHODS: Retrospective records from 13 poison centers were examined for human exposures to SGLT2 inhibitors between 1st January 2013 and 31st December 2016...
August 16, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28811809/peppered-and-rare-gastric-and-duodenal-pseudomelanosis-a-case-series
#6
Sami Samiullah, Hadi Bhurgri, Arooj Babar, Fatima Samad, Moaz M Choudhary, Michael Demyen
Upper Gastrointestinal (GI) pseudomelanosis is an uncommon entity characterized by endoscopic visualization of speckled dark mucosal pigmentation. While described in the rectum and colon, 'melanosis' or more aptly 'pseudomelanosis' is rare in the duodenum and exceedingly rare in the stomach. Five cases of pseudomelanosis were encountered at our department. Four females and one male were diagnosed, with a mean age of 70 years. All patients exhibited duodenal pseudomelanosis, with one demonstrating gastric antral pseudomelanosis as well...
May 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28811763/microalbuminuria-in-type-2-diabetes-mellitus-the-tip-of-iceberg-of-diabetic-complications
#7
Tauseef Ahmad, Imran Ulhaq, Minaz Mawani, Najmul Islam
OBJECTIVE: To determine the prevalence of microalbuminuria and its association with hypertension and other diabetic complications among Type-2 diabetic patients attending at Aga Khan University Hospital Karachi. METHODS: 1280 Type-2 diabetes patients who visited the outpatient department of Aga Khan University Hospital from September 2014 to August 2016 were included in the study. Microalbuminuria was diagnosed if spot urinary microalbumin excretion was confirmed to be more than 20mg/l...
May 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28811356/clinical-characteristics-of-heart-involvement-in-chinese-patients-with-takayasu-arteritis
#8
Jing Li, Hongchao Li, Fei Sun, Zhe Chen, Yunjiao Yang, Jiuliang Zhao, Mengtao Li, Xinping Tian, Xiaofeng Zeng
OBJECTIVE: To understand the characteristics of heart involvement in Chinese patients with Takayasu arteritis (TA). METHODS: The medical charts of 411 patients with TA (325 women, 86 men) were retrospectively reviewed. The comparison of clinical manifestations was carried out between the patients with TA with (n = 164) and without (n = 247) heart involvement. RESULTS: The median age at disease onset was 23.0 years (18.0-30.0) in 411 patients with TA, and 23...
August 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28809670/cardio-pulmonary-stethoscope-clinical-validation-with-heart-failure-and-hemodialysis-patients
#9
Magdy F Iskander, Todd B Seto, Ruthsenne Rg Perron, Eunjung Lim, Farhan Qazi
OBJECTIVE: The purpose of this study is to evaluate the accuracy of a noninvasive radiofrequency-based device, the Cardio-Pulmonary Stethoscope (CPS), to monitor heart and respiration rates and detect changes in lung water content in human experiments and clinical trials. METHODS: Three human populations (healthy subjects (n=4), heart failure (n=12) and hemodialysis (n=13) patients) were enrolled in this study. The study was conducted at the University of Hawaii and The Queen's Medical Center in Honolulu, HI...
August 14, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28808903/clinical-outcomes-of-aortic-repair-in-young-adult-patients-with-acta2-mutations
#10
Yoshimasa Seike, Kenji Minatoya, Hiroaki Sasaki, Hiroshi Tanaka, Tatsuya Itonaga, Yosuke Inoue, Hiroko Morisaki, Takayuki Morisaki, Hatsue Ishibashi-Ueda, Junjiro Kobayashi
OBJECTIVES: Actin, alpha-2, smooth muscle, aorta (ACTA2) mutations are one of the major causes of familial thoracic aortic aneurysms and dissections. The aim of this study was to review our clinical results of young adult patients with aortic disease caused by ACTA2 mutations. METHODS: We reviewed the medical records of 251 patients (<50 years old) who underwent surgery for thoracic aortic diseases between 2004 and 2014. Among them, nine patients (3.5%) had ACTA2 mutations...
August 14, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28808765/presentation-and-symptom-interval-in-children-with-central-nervous-system-tumors-a-single-center-experience
#11
Chiara Stocco, Chiara Pilotto, Eva Passone, Agostino Nocerino, Raffaello Tosolini, Anna Pusiol, Paola Cogo
PURPOSE: The aim of this study is to describe the symptoms and signs of central nervous system (CNS) tumors in a pediatric population and to assess the time interval between the onset of the disease and the time of the diagnosis. METHODS: A retrospective observational study was conducted at our Oncology Pediatric Unit between January 2000 and November 2011. We included 75 children between 5 months and 16 years (mean age of 7.8 ± 4.7 years), with male to female ratio of 3:2...
August 14, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28808759/life-threatening-bleeding-episodes-in-primary-immune-thrombocytopenia-a-single-center-retrospective-study-of-169-inpatients
#12
Hiroyuki Tsuda, Takahiro Tsuji, Mayumi Tsuji, Hiroshi Yamasaki
Bleeding is the most important clinical outcome in patients with immune thrombocytopenia (ITP), and the goal of therapy in such cases is to treat or prevent bleeding. The frequency of and risk factors for bleeding events in ITP have only recently been identified in several large-scale studies. However, there is little published information about severe life-threatening bleeding in ITP. To clarify the clinical features of life-threatening bleeding in patients with primary ITP, we systematically reviewed the medical records of all ITP patients that were admitted to our hospital between January 1, 1992, and December 31, 2015...
August 14, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28808495/the-most-frequent-abca3-nonsense-mutation-p-tyr1515-y1515x-causing-lethal-neonatal-respiratory-failure-in-a-term-neonate
#13
AlNashmi AlAnazi, Ralph Epaud, Humariya Heena, Alix de Becdelievre, Abeer Mohammad Miqdad, Pascale Fanen
Defects in the surfactant biosynthesis are associated with respiratory distress syndrome, commonly occurring in premature infants due to lung immaturity. However, interstitial lung diseases have also been observed in full-term infants with mutations in the SFTPC, SFTPB, NKX2-1, or ABCA3 genes, involved in the surfactant metabolism. Herein, we report a newborn baby with neonatal respiratory distress and diffuse lung disease caused by ABCA3 mutation. The baby died at 5 weeks of age after developing pulmonary hypertension...
July 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/28808366/clinical-features-and-outcomes-of-patients-with-posterior-reversible-encephalopathy-syndrome
#14
M S Kalaiselvan, M K Renuka, A S Arunkumar
AIMS: The aim of this study was to study the clinical features and outcomes of patients with posterior reversible encephalopathy syndrome (PRES) admitted to the Intensive Care Unit (ICU). SUBJECTS AND METHODS: All adult patients admitted to our ICU with acute onset neurologic symptoms with focal vasogenic edema on magnetic resonance imaging (MRI) were included in the study. Data were collected on demography, coexisting illness, admission severity of illness, neurological symptoms, blood pressure, treatment initiated, and MRI findings...
July 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28807582/comparative-efficacy-of-angiotensin-ii-antagonists-in-essential-hypertension-systematic-review-and-network-meta-analysis-of-randomised-controlled-trials
#15
Bernice Tsoi, Leo E Akioyamen, Ashley Bonner, Claudia Frankfurter, Mitchell Levine, Eleanor Pullenayegum, Ron Goeree, Daria O'Reilly
BACKGROUND: Evidence on the long-term clinical benefits of individual members of angiotensin II receptor blockers is limited given the lack of head-to-head studies. We conducted a network meta-analysis to determine the comparative efficacy of different members within this drug class with respect to outcomes of (i) blood pressure reduction (at 24 and 52 weeks) and (ii) prevention of cardiovascular disease (>104 weeks). METHODS: A systematic literature review was conducted - Protocol registration: (PROSPERO - CRD42014007067) - to identify relevant literature from the following databases: Cochrane Library, PubMed, MEDLINE and Embase; searched from inception to July 2016...
July 14, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28807551/the-optimal-cut-off-of-blood-pressure-related-to-left-ventricular-diastolic-dysfunction-and-remodeling-in-asian-diabetic-patients
#16
Ju Young Jung, Sung Keun Park, Jae-Hong Ryoo, Chang-Mo Oh, Jeong Gyu Kang, Kanghee Moon, Keum Ok Lee, Joong-Myung Choi
BACKGROUND: Although a recent randomized trial found no difference between intensive and standard blood pressure (BP) control in patients with diabetes mellitus (DM), the debate over the optimal BP target continues. Thus, the present study investigated the effect of BP on the subclinical left ventricular (LV) function and structural changes in diabetic patients. METHOD: A total of 2649 patients with DM who received echocardiography were enrolled in this study. Study population was stratified by three groups according to BP and presence of hypertension (normal, <130/80mmHg; prehypertension, ≥130/80mmHg without hypertension; hypertension, ≥140/90mmHg or history of hypertension)...
August 11, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28807040/management-of-upper-gastrointestinal-bleeding-in-emergency-departments-from-bleeding-symptoms-to-diagnosis-a-prospective-multicenter-observational-study
#17
Pierre-Clément Thiebaud, Youri Yordanov, Jacques-Emmanuel Galimard, Pierre-Alexis Raynal, Sébastien Beaune, Laurent Jacquin, François-Xavier Ageron, Dominique Pateron
BACKGROUND: Upper gastrointestinal bleeding (UGB) is common in emergency departments (EDs) and can be caused by many eso-gastro-duodenal lesions. Most available epidemiological data and data on the management of UGB comes from specialized departments (intensive care units or gastroenterology departments), but little is known from the ED perspective. We aimed to determine the distribution of symptoms revealing UGB in EDs and the hemorrhagic lesions identified by endoscopy. We also describe the characteristics of patients consulting for UGB, UGB management in the ED and patients outcomes...
August 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28806578/klotho-dysfunction-a-pathway-linking-the-aging-process-to-bipolar-disorder
#18
Izabela Guimarães Barbosa, Natalia Pessoa Rocha, Gokay Alpak, Erica Leandro Marciano Vieira, Rodrigo Barreto Huguet, Fabio Lopes Rocha, Breno Satler de Oliveira Diniz, Antonio Lucio Teixeira
AIM: Although accelerated aging profile has been described in bipolar disorder (BD), the biology linking BD and aging is still largely unknown. Reduced levels and/or activity of a protein named Klotho is associated with decreased life span, premature aging and occurrence of age-related diseases. Therefore, this study was designed to evaluate plasma levels of Klotho in BD patients and controls. METHODS: Forty patients with type 1 BD and 30 controls were enrolled in this study...
August 11, 2017: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/28806384/transient-amaurosis-and-diplopia-after-inferior-alveolar-nerve-block
#19
Onur Odabaşi, Onur Şahin, Mehmet Emrah Polat
A 40-year-old female patient was admitted to the authors' oral and maxillofacial clinic for removal of her lower left second molar under local anesthesia. The patient's medical history revealed that she had cardiac arhythmia and hypertension. Inferior alveolar nerve block was achieved using 2 mL of sefacaine (%3 mepivacaine HCL, without epinephrine). The patient complained of loss of vision in her left eye. All procedures were stopped immediately. Within 2 minutes the patient reported diplopia. All of the symptoms disappeared about 5 minutes after initial observation...
August 10, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28806209/refractory-intracranial-hypertension-the-role-of-decompressive-craniectomy
#20
Martin Smith
Raised intracranial pressure (ICP) is associated with worse outcomes after acute brain injury, and clinical guidelines advocate early treatment of intracranial hypertension. ICP-lowering therapies are usually administered in a stepwise manner, starting with safer first-line interventions, while reserving higher-risk options for patients with intractable intracranial hypertension. Decompressive craniectomy is a surgical procedure in which part of the skull is removed and the underlying dura opened to reduce brain swelling-related raised ICP; it can be performed as a primary or secondary procedure...
August 10, 2017: Anesthesia and Analgesia
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