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https://www.readbyqxmd.com/read/29667759/incidence-predictors-and-clinical-management-of-hyperkalaemia-in-new-users-of-mineralocorticoid-receptor-antagonists
#1
Marco Trevisan, Pietro de Deco, Hairong Xu, Marie Evans, Bengt Lindholm, Rino Bellocco, Peter Barany, Tomas Jernberg, Lars H Lund, Juan J Carrero
BACKGROUND: Concerns for hyperkalaemia limit the use of mineralocorticoid receptor antagonists (MRAs). The frequency of MRA-associated hyperkalaemia in real-world settings and the extent of subsequent MRA discontinuation are poorly quantified. METHODS AND RESULTS: Observational study including all Stockholm citizens initiating MRA therapy during 2007-2010. Hyperkalaemias were identified from all potassium (K+ ) measurements in healthcare. MRA treatment lengths and dosages were obtained from complete collection of pharmacy dispensations...
April 18, 2018: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29667726/interventions-for-infantile-haemangiomas-of-the-skin
#2
REVIEW
Monica Novoa, Eulalia Baselga, Sandra Beltran, Lucia Giraldo, Ali Shahbaz, Hector Pardo-Hernandez, Ingrid Arevalo-Rodriguez
BACKGROUND: Infantile haemangiomas (previously known as strawberry birthmarks) are soft, raised swellings of the skin that occur in 3% to 10% of infants. These benign vascular tumours are usually uncomplicated and tend to regress spontaneously. However, when haemangiomas occur in high-risk areas, such as near the eyes, throat, or nose, impairing their function, or when complications develop, intervention may be necessary. This is an update of a Cochrane Review first published in 2011...
April 18, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29667277/arrhythmic-manifestation-of-peripartum-cardiomyopathy-case-report
#3
Patryk Siedlecki, Małgorzata Kurpesa, Barbara Uznańska-Loch, Ewa Trzos, Jarosław Damian Kasprzak
We report a case of 26-year-old woman, with arrhythmic manifestation of peripartum cardiomyopathy with moderate heart failure. Ventricular arrhythmia recorded in ambulatory Holter ECG (premature ventricular contractions) was most severe during pregnancy, reduced when beta-blocker therapy was initiated and almost completely resolved after delivery. Then, 1 year after hospitalization in Cardiology Department, recurrence was observed with recorded short episode of nonsustained ventricular tachycardia.
April 17, 2018: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/29667175/first-line-drugs-for-hypertension
#4
REVIEW
James M Wright, Vijaya M Musini, Rupam Gill
BACKGROUND: This is the first update of a review published in 2009. Sustained moderate to severe elevations in resting blood pressure leads to a critically important clinical question: What class of drug to use first-line? This review attempted to answer that question. OBJECTIVES: To quantify the mortality and morbidity effects from different first-line antihypertensive drug classes: thiazides (low-dose and high-dose), beta-blockers, calcium channel blockers, ACE inhibitors, angiotensin II receptor blockers (ARB), and alpha-blockers, compared to placebo or no treatment...
April 18, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29666176/registry-based-randomised-clinical-trial-efficient-evaluation-of-generic-pharmacotherapies-in-the-contemporary-era
#5
REVIEW
Troels Yndigegn, Robin Hofmann, Tomas Jernberg, Chris P Gale
Randomised clinical trials are the gold standard for testing the effectiveness of clinical interventions. However, increasing complexity and associated costs may limit their application in the investigation of key cardiovascular knowledge gaps such as the re-evaluation of generic pharmacotherapies. The registry-based randomised clinical trial (RRCT) leverages data sampling from nationwide quality registries to facilitate high participant inclusion rates at comparably low costs and, therefore, may offer a mechanism by which such clinical questions may be answered...
April 17, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29666096/devil-is-in-the-detail
#6
John Roshan Jacob, Amal Paul, Anoop George Alex
A 15-year-old girl of Asian origin, hailing from a rural agrarian background, presented with history of multiple episodes of dizziness for 3 years. The episodes were precipitated mostly by emotional and/or physical stress and relieved on lying down, with a few episodes culminating in transient loss of consciousness. As preliminary cardiac and neurological evaluation were normal, she was being treated by the primary physician as a case of probable psychogenic syncope, supported by the consistent association of the episodes with emotional stress...
April 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29665297/esmolol-acutely-alters-oxygen-supply-demand-balance-in-exercising-muscles-of-healthy-humans
#7
David N Proctor, J Carter Luck, Stephan R Maman, Urs A Leuenberger, Matthew D Muller
Beta-adrenoreceptor antagonists (β blockers) reduce systemic O2 delivery and blood pressure (BP) during exercise, but the subsequent effects on O2 extraction within the active limb muscles are unknown. In this study, we examined the effects of the fast-acting, β1 selective blocker esmolol on systemic hemodynamics and leg muscle O2 saturation (near infrared spectroscopy, NIRS) during submaximal leg ergometry. Our main hypothesis was that esmolol would augment exercise-induced reductions in leg muscle O2 saturation...
April 2018: Physiological Reports
https://www.readbyqxmd.com/read/29664030/do-practice-gaps-exist-in-evidence-based-medication-prescription-at-hospital-discharge-in-patients-undergoing-coronary-artery-bypass-surgery-coronary-angioplasty
#8
Pradeep Pereira, Aditya Kapoor, Archana Sinha, Surendra K Agarwal, Shantanu Pande, Roopali Khanna, Nilesh Srivastava, Sudeep Kumar, Naveen Garg, Satyendra Tewari, Pravin Goel
Background & objectives: Prescription patterns of guideline-directed medical therapy (GDMT) after coronary artery bypass surgery [coronary artery bypass graft (CABG)] and percutaneous coronary intervention (PCI) at hospital discharge are often not optimal. In view of scarce data from the developing world, a retrospective analysis of medication advice to patients following CABG and PCI was conducted. Methods: Records of 5948 patients (post-PCI: 5152, post-CABG: 796) who underwent revascularization from 2010 to 2014 at a single tertiary care centre in north India were analyzed...
December 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/29660263/characteristics-and-long-term-prognosis-of-patients-with-heart-failure-and-mid-range-ejection-fraction-compared-with-reduced-and-preserved-ejection-fraction-a-systematic-review-and-meta-analysis
#9
Josephine Lauritsen, Finn Gustafsson, Jawdat Abdulla
AIMS: This study aimed to assess by a meta-analysis the clinical characteristics, all-cause and cardiovascular mortality, and hospitalization of patients with heart failure (HF) with mid-range ejection fraction (HFmrEF) compared with HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). METHODS AND RESULTS: Data from 12 eligible observational studies including 109 257 patients were pooled. HFmrEF patients were significantly different and occupied a mid-position between HFrEF and HFpEF: mean age 73...
April 16, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29658871/new-onset-ventricular-arrhythmias-in-patients-with-left-ventricular-dysfunction-after-coronary-surgery-incidence-risk-factors-and-prognosis
#10
Nan Cheng, Changqing Gao, Rong Wang, Ming Yang, Lin Zhang
BACKGROUND: The incidence, risk factors, and long-term prognosis of new-onset ventricular tachycardia (VT) and ventricular fibrillation (VF) after coronary artery bypass graft surgery (CABG) in patients with impaired left ventricular function have not been thoroughly examined. Methods: This study enrolled 612 consecutive patients with impaired left ventricular function (ejection fraction <50%) undergoing CABG at a single institution between March, 1996, and September, 2015. Outcomes were analyzed and compared, including in-hospital mortality and long-term survival...
March 26, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29655949/incidence-and-predictors-of-6-months-mortality-after-an-acute-heart-failure-event-in-rural-uganda-the-mbarara-heart-failure-registry-mahfer
#11
Fardous Charles Abeya, Boniface Amanee Elias Lumori, Suzan Joan Akello, Brian H Annex, Andrew J Buda, Samson Okello
OBJECTIVE: We sought to estimate the incidence and predictors of all-cause mortality 6 months after heart failure hospitalization in Uganda. METHODS: Mbarara Heart Failure Registry is a cohort of patients hospitalized with a clinical diagnosis of heart failure at Mbarara Regional Referral Hospital, Uganda. We measured serum electrolytes, cardiac markers, and echocardiograms. All participants were followed until death or end of 6 months. We used Fine and Gray models to estimate the incidence and predictors all-cause mortality...
March 29, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29650446/prognostic-impact-and-predictors-of-ejection-fraction-recovery-in-patients-with-alcoholic-cardiomyopathy
#12
Almudena Amor-Salamanca, Gonzalo Guzzo-Merello, Esther González-López, Fernando Domínguez, Alejandra Restrepo-Córdoba, Marta Cobo-Marcos, Manuel Gómez-Bueno, Javier Segovia-Cubero, Luis Alonso-Pulpón, Pablo García-Pavía
INTRODUCTION AND OBJECTIVES: Recovery of left ventricular ejection fraction (LVEF) has been described in alcoholic cardiomyopathy (ACM) after a period of alcohol withdrawal. Nevertheless, the prognostic impact of LVEF recovery in ACM and its determinants have not been studied. We sought to define the role of LVEF improvement in the long-term outcome of ACM and to identify predictors of LVEF recovery in these patients. METHODS: We evaluated 101 ACM patients during a median follow-up period of 82 months [interquartile range 36-134]...
April 9, 2018: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29650123/interplay-between-genetic-substrate-qtc-duration-and-arrhythmia-risk-in-patients-with-long-qt-syndrome
#13
Andrea Mazzanti, Riccardo Maragna, Gaetano Vacanti, Nicola Monteforte, Raffaella Bloise, Maira Marino, Lorenzo Braghieri, Patrick Gambelli, Mirella Memmi, Eleonora Pagan, Massimo Morini, Alberto Malovini, Martin Ortiz, Luciana Sacilotto, Riccardo Bellazzi, Lorenzo Monserrat, Carlo Napolitano, Vincenzo Bagnardi, Silvia G Priori
BACKGROUND: Long QT syndrome (LQTS) is a common inheritable arrhythmogenic disorder, often secondary to mutations in the KCNQ1, KCNH2, and SCN5A genes. The disease is characterized by a prolonged ventricular repolarization (QTc interval) that confers susceptibility to life-threatening arrhythmic events (LAEs). OBJECTIVES: This study sought to create an evidence-based risk stratification scheme to personalize the quantification of the arrhythmic risk in patients with LQTS...
April 17, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29629257/12-year-temporal-trend-in-referral-pattern-and-test-results-of-stress-echocardiography-in-a-tertiary-care-referral-center-with-moderate-volume-activities-and-cath-lab-facility
#14
Andrea Barbieri, Francesca Mantovani, Francesca Bursi, Ylenia Bartolacelli, Marcella Manicardi, Maria Giulia Lauria, Giuseppe Boriani
Background: Data on stress echocardiography (SE) time-related changes in referral patterns and diagnostic yield for detection of inducible ischemia could enhance Echo Lab quality benchmarks and performance measures. Aim: This study aims to evaluate temporal trends in SE test results among ambulatory patients with suspected or known coronary artery disease (CAD) in a tertiary care referral center with moderate (>100/year) volume SE activities and Cath-Lab facility...
January 2018: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/29628277/effect-of-beta-adrenergic-blockade-on-weight-changes-in-patients-with-chronic-heart-failure
#15
Shirley Sze, Pierpaolo Pellicori, Syed Kamzi, Alexandru Anton, Andrew L Clark
BACKGROUND: Weight loss is common in patients with chronic heart failure (CHF) and is associated with adverse outcome. Activation of the sympathetic nervous system has been implicated in weight loss, wasting and cachexia. However, the effect of sympathetic antagonism on weight change in patients with CHF is not well defined. METHODS: We evaluated changes in body weight, the incidence of cachexia (weight loss >6%) and significant weight gain (>5%) in unselected patients with CHF due to left ventricular systolic dysfunction (LVSD) (LV ejection fraction (LVEF) <40%) and studied the effect of beta-blockade on weight change...
March 22, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29626184/tachyphylaxis-to-the-sedative-action-of-mirtazapine
#16
Georgios Papazisis, Spyridon Siafis, Dimitrios Tzachanis
BACKGROUND The pharmacological term tachyphylaxis is used to describe rapidly occurring response desensitization, a situation where the biological response to a given drug dose diminishes when it is given continuously. This pharmacological phenomenon is well observed in some drug categories such as ephedrine, nitrates, beta blockers and H2 antagonists. Mirtazapine is a widely-used antidepressant with a multimodal mechanism of action. CASE REPORT In the present case, we report rapid onset and consistent tachyphylaxis regarding the sedative action of mirtazapine in a 30-year-old female...
April 7, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29626018/drug-therapies-in-chronic-heart-failure-a-focus-on-reduced-ejection-fraction
#17
Helena Bolam, Geraint Morton, Paul R Kalra
There are multiple evidence-based drug treatments for chronic heart failure (HF), both disease-modifying agents and those for symptom control. The majority of the evidence base supports drugs used in HF with reduced left ventricular ejection fraction. The mainstay of disease modification involves manipulation of neurohormonal activation that occurs in HF. In addition to established angiotensin-converting enzyme inhibitors, beta blockers and mineralocorticoid receptor antagonists (MRAs), newer agents are now available such as the angiotensin receptor neprilysin inhibitors...
March 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29625706/pharmaceutical-cognitive-doping-in-students-a-chimeric-way-to-get-a-head
#18
Louise Carton, Nicolas Cabé, Olivier Ménard, Sylvie Deheul, Anne-Sylvie Caous, David Devos, Olivier Cottencin, Régis Bordet
For students, the pressing demands for memorization, top-level performance, and peer competition create an environment favorable for pharmaceutical cognitive doping behavior. We aimed to describe recent practices and the benefit/risk ratio of such behavior and to discuss the issues at stake. The prevalence of pharmaceutical cognitive doping among students has been reported from 1.3% to 33% across studies, with variations depending on country and definition of pharmaceutical cognitive doping. The therapeutic classes most frequently cited as being diverted for doping purposes are psychostimulants and nootropics (methylphenidate, modafinil, piracetam), corticosteroids, sedative drugs and beta-blockers...
March 6, 2018: Thérapie
https://www.readbyqxmd.com/read/29625513/trends-characteristics-and-clinical-outcomes-of-patients-undergoing-percutaneous-coronary-intervention-in-korea-between-2011-and-2015
#19
Seungbong Han, Gyung Min Park, Yong Giun Kim, Mahn Won Park, Sung Ho Her, Seung Whan Lee, Young Hak Kim
BACKGROUND AND OBJECTIVES: We sought to evaluate nationwide trends, characteristics, and clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) in Korea. METHODS: From National Health Insurance claims data in Korea, 81,115 patients, who underwent PCI for the first episode of coronary artery disease between 2011 and 2015, were enrolled. Patients were categorized into angina (n=49,288) or acute myocardial infarction (AMI, n=31,887) groups and analyzed...
April 2018: Korean Circulation Journal
https://www.readbyqxmd.com/read/29625107/cephalosporin-antibiotics-are-weak-blockers-of-gabaa-receptor-mediated-synaptic-transmission-in-rat-brain-slices
#20
Dmitry V Amakhin, Elena B Soboleva, Aleksey V Zaitsev
Cephalosporins are beta-lactam antibiotics that are extensively used in medical practice and are reported to cause epileptic seizures in some patients. The primary cause of cephalosporin-induced convulsions is believed to be their ability to block GABAa receptors. However, direct evidence for the involvement of this mechanism has not yet been provided. The present study aims to investigate the ability of two cephalosporins - cefepime and ceftriaxone - to block inhibitory synaptic transmission in entorhinal cortex slices of rats...
April 3, 2018: Biochemical and Biophysical Research Communications
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