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https://www.readbyqxmd.com/read/28239753/six-minute-walk-test-in-evaluation-of-children-with-pulmonary-arterial-hypertension
#1
Malgorzata Zuk, Anna Migdal, Dorota Jagiellowicz-Kowalska, Katarzyna Mazurkiewicz, Anna Sadel-Wieczorek, Grazyna Brzezinska-Rajszys
Six-minute walk test (6MWT) is a submaximal exercise test applied for evaluation of adults with pulmonary arterial hypertension (PAH). It was widely used as an endpoint in the clinical trials. The aim of the study was to assess the usefulness of 6MWT in management of children with PAH and to establish correlations with other clinical features. 164 6MWT were performed in 15 children between 5 and 18 years with PAH confirmed by right heart catheterization (102 in patients with shunt, 62 without shunt). Distance in 6MWT (6MWD)-% of predicted for age and gender, desaturation at the maximum effort, peak heart rate (HR)-% of maximal HR, were compared to the level of NTproBNP, WHO-FC, echocardiography parameters, and events of PAH treatment intensification...
February 27, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28239668/evaluation-of-cognitive-impairment-in-elderly-population-with-hypertension-from-a-low-resource-setting-agreement-and-bias-between-screening-tools
#2
María Lazo-Porras, María A Pesantes, J Jaime Miranda, Antonio Bernabe-Ortiz
INTRODUCTION: The evaluation of cognitive impairment in adulthood merits attention in societies in transition and especially in people with chronic diseases. Screening tools available for clinical practice and epidemiological studies have been designed in high-income but not in resource-constrained settings. The aim of this study was to assess the agreement and bias of three common tools used for screening of cognitive impairment in people with hypertension: the modified Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), and the Leganés Cognitive Test (LCT)...
December 2016: ENeurologicalSci
https://www.readbyqxmd.com/read/28239607/how-to-face-chronic-liver-disease-the-sinusoidal-perspective
#3
REVIEW
Anabel Fernández-Iglesias, Jordi Gracia-Sancho
Liver microcirculation plays an essential role in the progression and aggravation of chronic liver disease. Hepatic sinusoid environment, mainly composed by hepatocytes, liver sinusoidal endothelial cells, Kupffer cells, and hepatic stellate cells, intimately cooperate to maintain global liver function and specific phenotype of each cell type. However, continuous liver injury significantly deregulates liver cells protective phenotype, leading to parenchymal and non-parenchymal dysfunction. Recent data have enlightened the molecular processes that mediate hepatic microcirculatory injury, and consequently, opened the possibility to develop new therapeutic strategies to ameliorate liver circulation and viability...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28239592/hand-dominance-and-blood-group-association-in-epistaxis
#4
Leena Jain, Sadat Qureshi, Ashish Maurya, Shalini Jadia, S Mrityunjay
The present work was undertaken to study the association of epistaxis with hand dominance and blood group. The present cross sectional study was conducted among 360 cases of epistaxis who reported to the E.N.T outpatient department of tertiary care centre in central India during the period of July 2014 to July 2015. Examination was carried out by self prepared Performa which included demographic information, detailed history and clinical examination findings. Total of 360 patients were included in the study, the mean age being 31...
March 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28238999/race-genomics-and-chronic-disease-what-patients-with-african-ancestry-have-to-say
#5
Carol R Horowitz, Kadija Ferryman, Rennie Negron, Tatiana Sabin, Mayra Rodriguez, Randi F Zinberg, Erwin Böttinger, Mimsie Robinson
BACKGROUND: Variants of the APOL1 gene increase risk for kidney failure 10-fold, and are nearly exclusively found in people with African ancestry. To translate genomic discoveries into practice, we gathered information about effects and challenges incorporating genetic risk in clinical care. METHODS: An academic-community-clinical team tested 26 adults with self-reported African ancestry for APOL1 variants, conducting in-depth interviews about patients' beliefs and attitudes toward genetic testing- before, immediately, and 30 days after receiving test results...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28238543/comparison-of-auscultatory-and-oscillometric-bp-readings-in-children-with-obesity-and-the-effect-on-diagnosing-arterial-hypertension
#6
Salvador Fonseca-Reyes, Enrique Romero-Velarde, Edith Torres-Gudiño, Daniel Illescas-Zarate, Avril M Forsyth-MacQuarrie
OBJECTIVE: The level of agreement between two blood pressure (BP) reading methods, auscultatory vs oscillometric, was examined using a mercury sphygmomanometer and an electronic device in children and adolescents with different levels of obesity. The readings were compared to see their impact on the diagnosis of pre-hypertension/hypertension. METHODS: Blood pressure readings were taken in children with obesity (body mass index ≥ 95th percentile) and severe obesity (≥120% 95th percentile)...
February 23, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28237536/early-experience-of-macitentan-for-pulmonary-arterial-hypertension-in-adult-congenital-heart-disease
#7
S Herbert, W Gin-Sing, L Howard, R M R Tulloh
BACKGROUND: Endothelin receptor antagonists (ERA) have been recognised as effective therapy for pulmonary arterial hypertension in congenital heart disease (CHD-PH), and Eisenmenger syndrome (ES) since the Breathe 5 study. A new dual receptor antagonist - Macitentan - is currently undergoing trials to determine its efficacy in simple ES. To date there is little information on this therapy in CHD and we report our first experience, some with more complex diseases. METHODS: Data was collected prospectively from September 2014...
February 6, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28237388/using-administrative-data-to-look-at-changes-in-the-level-and-distribution-of-out-of-pocket-medical-expenditure-an-example-using-medicare-data-from-australia
#8
Xinyang Hua, Guido Erreygers, John Chalmers, Tracey-Lea Laba, Philip Clarke
OBJECTIVES: Australia's universal health insurance system Medicare generates very large amounts of data on out-of-pocket expenditure (OOPE), but only highly aggregated statistics are routinely published. Our primary purpose is to develop indices from the Medicare administrative data to quantify changes in the level and distribution of OOPE on out-of-hospital medical services over time. METHODS: Data were obtained from the Australian Hypertension and Absolute Risk Study, which involved patients aged 55 years and over (n=2653)...
February 22, 2017: Health Policy
https://www.readbyqxmd.com/read/28237383/the-curious-case-of-a-cardiac-tamponade-in-the-hypertensive-patient-presenting-as-abdominal-fullness
#9
William Li, Rogin Subedi, Bhaskara Madhira
Cardiac tamponade is a medical emergency consisting of an accumulation of fluid in the pericardial space which is rapidly progressing and fatal. Because cardiac tamponade is ultimately a clinical diagnosis, mindful consideration for atypical presentations is essential for the reduction of mortality in the acute setting. Our patient was a 77year-old female admitted after presenting with general malaise, weakness, somnolence, altered mental status and urinary incontinence found to have CML (chronic myeloid leukemia) on confirmatory bone marrow biopsy after suspicions arose from a leukocytosis of 34,000 cells per mcL with 85% neutrophils and elevated blasts (8%)...
January 19, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28237379/readmission-after-gastrointestinal-bleeding-in-children-a-retrospective-cohort-study
#10
Thomas M Attard, Mikaela Miller, Chaitanya Pant, Mike Thomson
INTRODUCTION: To compare the demographic, clinical, and therapeutic characteristics in a cohort of patients discharged following acute gastrointestinal bleeding, representing to the emergency department (ED) and readmitted within 30 days of discharge with the characteristics of non-readmitted patients. STUDY DESIGN: Hospitalization data was obtained from the Pediatric Hospital Information System including 49 tertiary children's hospitals in the US. Children 1-21 years of age diagnosed with acute gastrointestinal bleeding, admitted between January 2007 and September 2015 were included...
February 23, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28237284/comparison-of-delay-times-from-symptom-onset-to-medical-contact-in-blacks-versus-whites-with-acute-myocardial-infarction
#11
Amy Leigh Miller, DaJuanicia Simon, Matthew T Roe, Michael C Kontos, Deborah Diercks, Ezra Amsterdam, Deepak L Bhatt
Clinical outcomes in acute myocardial infarction (AMI) worsen with increasing delay between symptom onset and clinical presentation. Previous studies have shown that black patients with AMI have longer presentation delays. The objective of this analysis is to explore the potential contribution of community factors to presentation delays in black patients with AMI. We linked clinical data for 346,499 consecutive patients with AMI from Acute Coronary Treatment Intervention Outcomes Network Registry-Get With the Guidelines™ (2007-2014) to socioeconomic and community information from the American Community Survey...
January 25, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28236794/pharmaceutical-care-practice-in-patients-with-chronic-kidney-disease
#12
Dadier Antonio Arroyo Monterroza, José Francisco Castro Bolivar
INTRODUCTION: The impact of chronic kidney disease in health is no longer just a patient-physician issue, not only in terms of the increase in the number of patients diagnosed, but also regarding the human and economic cost for health systems. That is why Pharmaceutical Care should include SOPs structured by criteria reached by consensus to conduct Pharmaceutical Care Practice, which will enable to prevent, identify and solve any negative outcomes in patients that are associated with medication...
March 1, 2017: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/28236181/intracranial-pressure-monitoring-after-primary-decompressive-craniectomy-in-traumatic-brain-injury-a-clinical-study
#13
Edoardo Picetti, Maria Luisa Caspani, Corrado Iaccarino, Giulia Pastorello, Pierpaolo Salsi, Edoardo Viaroli, Franco Servadei
BACKGROUND: Intracranial pressure (ICP) monitoring represents an important tool in the management of traumatic brain injury (TBI). Although current information exists regarding ICP monitoring in secondary decompressive craniectomy (DC), little is known after primary DC following emergency hematoma evacuation. METHODS: Retrospective analysis of prospectively collected data. Inclusion criteria were age ≥18 years and admission to the intensive care unit (ICU) for TBI and ICP monitoring after primary DC...
February 24, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28236046/prevalence-and-distribution-of-calcified-nodules-in-carotid-arteries-in-correlation-with-clinical-symptoms
#14
Karolin Johanna Paprottka, Damiana Saam, Johannes Rübenthaler, Andreas Schindler, Nora Navina Sommer, Philipp Marius Paprottka, Dirk André Clevert, Maximilian Reiser, Tobias Saam, Andreas Helck
PURPOSE: Calcified nodules ("CN") are responsible for up to 5% of coronary-infarcts and, therefore, classified as minor criteria of "vulnerable" atherosclerotic plaque. We sought to evaluate prevalence and distribution of CN in carotid arteries in correlation with clinical symptoms. METHODS: 178 consecutive patients with unilateral ischemic stroke and carotid plaques ≥2 mm by duplex ultrasound underwent a carotid-black-blood-3T-MRI with fat-saturated pre- and post-contrast T1w-, PDw-, T2w- and TOF images using dedicated surface-coils...
February 24, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28236021/high-incidence-of-cardiac-dysfunction-and-response-to-antiviral-treatment-in-patients-with-chronic-hepatitis-c-virus-infection
#15
Wolfgang Poller, Ziya Kaya, Marion Muche, Mario Kasner, Carsten Skurk, Kai Kappert, Rudolf Tauber, Felicitas Escher, Heinz-Peter Schultheiss, Hans-Jörg Epple, Ulf Landmesser
AIMS: Hepatitis C virus (HCV) has been associated with cardiomyopathies. Former anti-HCV therapies employing interferon could have serious side effects in patients with advanced heart failure since interferon may adversely impact upon cardiac function. We, therefore, examined whether the novel, interferon-free and highly virus-selective anti-HCV combination therapy might be applicable even in advanced or end-stage heart failure. METHODS AND RESULTS: In a retrospective series of HCV-positive patients admitted to our institution with suspected cardiac disease, coronary, valvular or hypertensive heart disease was diagnosed in 70/146 (47...
February 24, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28235962/critical-illness-associated-cerebral-microbleeds
#16
Evgenia M Fanou, Jonathan M Coutinho, Patrick Shannon, Tim-Rasmus Kiehl, Marcel M Levi, M Elizabeth Wilcox, Richard I Aviv, Daniel M Mandell
- BACKGROUND AND PURPOSE: Cerebral microbleeds (petechial hemorrhages) are a well-known consequence of cerebral amyloid angiopathy and chronic hypertension among other causes. We report 12 patients with a clinically and radiologically distinct microbleed phenomenon in the cerebral white matter. METHODS: These patients were assessed at the University Health Network (Toronto, Canada) between 2004 and 2014. RESULTS: Median age was 40 years (range, 27-63 years), and 7 out of 12 patients were women...
February 24, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28230899/shared-care-across-the-interface-between-primary-and-specialty-care-in-management-of-long-term-conditions
#17
REVIEW
Susan M Smith, Gráinne Cousins, Barbara Clyne, Shane Allwright, Tom O'Dowd
BACKGROUND: Shared care has been used in the management of many chronic conditions with the assumption that it delivers better care than primary or specialty care alone; however, little is known about the effectiveness of shared care. OBJECTIVES: To determine the effectiveness of shared care health service interventions designed to improve the management of chronic disease across the primary/specialty care interface. This is an update of a previously published review...
February 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28230776/effects-and-side-effects-of-using-sorafenib-and-sunitinib-in-the-treatment-of-metastatic-renal-cell-carcinoma
#18
REVIEW
Caroline Randrup Hansen, Daniela Grimm, Johann Bauer, Markus Wehland, Nils E Magnusson
In recent years, targeted therapies have proven beneficial in terms of progression-free survival (PFS) and overall survival (OS) in the treatment of metastatic renal cell carcinoma (mRCC). The tyrosine kinase inhibitors (TKIs) sorafenib and sunitinib are included in international clinical guidelines as first-line and second-line therapy in mRCC. Hypertension is an adverse effect of these drugs and the degree of hypertension associates with the anti-tumour effect. Studies have compared newer targeted drugs to sorafenib and sunitinib in terms of PFS, OS, quality of life and safety profiles...
February 21, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28230728/optimistic-bias-risk-factors-and-development-of-high-blood-pressure-and-obesity-among-african-american-adolescents-in-mississippi-usa
#19
Monique S White, Clifton C Addison, Brenda W Campbell Jenkins, Vanessa Bland, Adrianne Clark, Donna Antoine LaVigne
Childhood obesity has reached epidemic proportions and is linked to hypertension among African American youth. Optimistic bias influences behavior of youth causing them to underestimate their susceptibility to negative health outcomes. This study explored adolescent behaviors and prevalence of high blood pressure and obesity in a school district. We examined the relationship between individual health risk practices and optimistic bias on health outcomes; 433 African American high school students were administered a survey and had their obesity and blood pressure measured by the school nurse...
February 20, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28229983/establishment-and-application-of-early-risk-stratification-method-for-acute-abdominal-pain-in-adults
#20
Yu Wang, Hong Zhao, Zhen Zhou, Ci Tian, Hong-Li Xiao, Bao-En Wang
BACKGROUND: Acute abdominal pain is a common symptom of emergency patients. The severity was always evaluated based on physicians' clinical experience. The aim of this study was to establish an early risk stratification method (ERSM) for addressing adults with acute abdominal pain, which would guide physicians to take appropriate and timely measures following the established health-care policies. METHODS: In Cohort 1, the records of 490 patients with acute abdominal pain that developed within the past 72 h were enrolled in this study...
2017: Chinese Medical Journal
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