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https://www.readbyqxmd.com/read/28822828/targeted-lowering-of-central-blood-pressure-in-patients-with-hypertension-baseline-recruitment-rationale-and-design-of-a-randomized-controlled-trial-the-low-cbp-study
#1
James E Sharman, Tony Stanton, Christopher M Reid, Anthony Keech, Philip Roberts-Thomson, Simon Stewart, Robert Greenough, Michael Stowasser, Walter P Abhayaratna
BACKGROUND: High blood pressure (BP) is the most common modifiable cause of death from cardiovascular disease. Lowering BP with medication improves patient outcomes, but even in populations with normal upper arm (brachial) BP there remains considerable residual risk for cardiovascular disease and this may be due to persistently elevated central BP. There has never been a trial to determine the value of targeted central BP lowering among patients with hypertension, and this was the aim of this study...
August 16, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28822777/managing-the-course-of-diabetic-kidney-disease-from-the-old-to-the-new
#2
REVIEW
Ronald M Goldenberg, Murray Berall, Christopher T M Chan, David Z I Cherney, Julie A Lovshin, Philip A McFarlane, Peter A Senior, Subodh Verma, Jordan J Weinstein
Diabetic kidney disease (DKD) is a group of chronic kidney diseases that is associated with significant cardiovascular as well as all-cause morbidity and mortality. Although DKD is often progressive in nature, its evolution can be modified by intensive management of glycemia and blood pressure and inhibition of the renin-angiotensin-aldosterone system. This review provides an overview of how multifactorial interventions can provide renal protection and includes a discussion of the nonglycemic effects of incretin-based diabetes therapies (glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase 4 inhibitors) and sodium-glucose cotransporter-2 inhibitors within the kidney in patients with type 2 diabetes...
August 16, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28822610/evaluation-of-fever-in-the-emergency-department
#3
REVIEW
Sarah DeWitt, Summer A Chavez, Jack Perkins, Brit Long, Alex Koyfman
BACKGROUND: Fever is one of the most common complaints in the emergency department (ED) and is more complex than generally appreciated. The broad differential diagnosis of fever includes numerous infectious and non-infectious etiologies. An essential skill in emergency medicine is recognizing the pitfalls in fever evaluation. OBJECTIVE OF REVIEW: This review provides an overview of the complaint of fever in the ED to assist the emergency physician with a structured approach to evaluation...
August 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28822434/-risk-factors-of-bacterial-nosocomial-infection-after-pediatric-liver-transplantation
#4
H Zhu, W Gao
Objective: To analyze the risk factors of nosocomial infection after liver transplantation in children, so as to provide scientific evidence for the prevention and control of nosocomial infection. Method: Clinical data of 223 pediatric patients undergoing liver transplantation between January 2014 and December 2015 were analyzed retrospectively. Univariate and multivariate analyses were carried out to investigate the risk factors of infection after transplantation. Result: Totally 51 children were infected among the 223 patients, the infection rate was 22...
August 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28822254/a-systematic-review-of-hypertension-outcomes-and-treatment-strategies-in-older-adults
#5
REVIEW
Julienne K Kirk, Julie Allsbrook, Maggie Hansell, Emily M Mann
OBJECTIVE: To evaluate the literature regarding blood pressure control and management in older adult patient population over 70 years of age. METHODS: A literature search was conducted using PubMed and capturing the data from 2006 to 2016. Terms used included MeSH headings for hypertension/therapy and antihypertension agents. A systematic review of published studies was performed. Articles including older patients (average age 70 years or older) being treated for hypertension were included...
July 25, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28821350/frequency-and-prognostic-significance-of-abnormal-liver-function-tests-in-patients-with-cardiogenic-shock
#6
Toni Jäntti, Tuukka Tarvasmäki, Veli-Pekka Harjola, John Parissis, Kari Pulkki, Alessandro Sionis, Jose Silva-Cardoso, Lars Køber, Marek Banaszewski, Jindrich Spinar, Valentin Fuhrmann, Jukka Tolonen, Valentina Carubelli, Salvatore diSomma, Alexandre Mebazaa, Johan Lassus
Cardiogenic shock (CS) is a cardiac emergency often leading to multiple organ failure and death. Assessing organ dysfunction and appropriate risk stratification are central for the optimal management of these patients. The purpose of this study was to assess the prevalence of abnormal liver function tests (LFTs), as well as early changes of LFTs and their impact on outcome in CS. We measured LFTs in 178 patients in CS from serial blood samples taken at 0 hours, 12 hours, and 24 hours. The associations of LFT abnormalities and their early changes with all-cause 90-day mortality were estimated using Fisher's exact test and Cox proportional hazards regression analysis...
July 14, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28820798/how-to-better-identify-patients-at-high-risk-of-postoperative-complications
#7
Daniel Talmor, Barry Kelly
PURPOSE OF REVIEW: Preoperative risk assessment and perioperative factors may help identify patients at increased risk of postoperative complications and allow postoperative management strategies that improve patient outcomes. This review summarizes historical and more recent scoring systems for predicting patients with increased morbidity and mortality in the postoperative period. RECENT FINDINGS: Most prediction scores predict postoperative mortality with, at best, moderate accuracy...
August 17, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28820067/a-comprehensive-review-on-ebola-ebov-virus-future-prospects
#8
Dr Abdru Rauf, Muhammad, Abdur Rauf, Ahsan Khan, Muhammad Rizwan, Seema Patel, Haroon Khan, Adel Mahasneh, Mohammad S Mubarak
Ebola virus (EBOV) was discovered for the first time in 1976. It belongs to the family Filoviridae, which causes hemorrhagic fever that could lead to death in a few days. West Africa faced a major outbreak where symptoms appeared in the form of chills, myalgia, fever, diarrhea, and vomiting, and the disease finally reached a severe state as a result of hemorrhagic complications and failure of multiple organs. EBOV spreads by contact with body fluids of an infected person such as blood, saliva, urine, and seminal fluid, and also spreads by a contact with contaminated surfaces...
August 16, 2017: Infectious Disorders Drug Targets
https://www.readbyqxmd.com/read/28820038/comparison-of-clevidipine-and-nicardipine-for-acute-blood-pressure-reduction-in-patients-with-stroke
#9
Teresa A Allison, Stephanie Bowman, Brian Gulbis, Heather Hartman, Sara Schepcoff, Kiwon Lee
OBJECTIVE: The aim of this study was to determine whether clevidipine (CLEV) achieved faster blood pressure control compared to nicardipine (NIC) in patients presenting with either an acute ischemic stroke (AIS) or a spontaneous intracerebral hemorrhage (ICH). METHODS: This was a retrospective, observational, cohort study conducted in patients with AIS or ICH admitted to the emergency department of a Comprehensive Stroke Center from November 2011 to June 2013 who received CLEV or NIC continuous infusion for acute blood pressure management...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28819653/targeting-cytokines-in-gvhd-therapy
#10
Sandeep Kumar, Hemn Mohammadpour, Xuefang Cao
Transplantation of donor-derived allogeneic hematopoietic cells causes increased survival in patients suffering from various blood cancers and other hematologic and immunologic diseases. However, this health benefit is limited to certain patients. One major complication is graft-versus-host disease (GVHD) that occurs when donor-derived immune cells recognize host cells/tissues as foreign and perpetrate subsequent destruction. Cytokines are a major class of effector molecules that are involved in GVHD pathogenesis...
2017: Journal of Immunology Research and Therapy
https://www.readbyqxmd.com/read/28819614/acute-compartment-syndrome-after-an-olecranon-fracture-in-a-patient-with-mild-hemophilia-b
#11
John M Reynolds, Christy Christophersen, Mary K Mulcahey
INTRODUCTION: Compartment syndrome is a serious condition characterized by compartmental pressures within 20 mmHg of diastolic blood pressure, or clinical signs of pain, paresthesia, pallor, and lack of pulses. Often a surgical intervention is necessary. Increased surveillance for compartment syndrome is important when a patient with a bleeding disorder sustains a traumatic injury. CASE REPORT: We present a case of forearm compartment syndrome in a patient with mild hemophilia B who sustained an olecranon fracture...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28819361/unilateral-headache-status-after-intra-aortic-balloon-pump-placement
#12
Garret M Weber, Alan L Gass, Shalvi B Parikh
INTRODUCTION: Intra-aortic balloon pump (IABP) counterpulsation is a catheter-based treatment for coronary artery disease and decompensated heart failure to increase coronary blood flow and improve cardiac output. IABP is generally well tolerated, and complications are usually related to peripheral vasculature or red blood cell and platelet consumption. The usual insertion site via femoral artery renders the patient bedbound. Recently, axillary artery has been used in patients with atherosclerotic peripheral vascular disease and documented small arteries or in those awaiting transplant to ensure ambulation and prevent deconditioning...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28819358/surgical-treatment-for-chronic-pancreatitis-past-present-and-future
#13
REVIEW
Stephanie Plagemann, Maria Welte, Jakob R Izbicki, Kai Bachmann
The pancreas was one of the last explored organs in the human body. The first surgical experiences were made before fully understanding the function of the gland. Surgical procedures remained less successful until the discovery of insulin, blood groups, and finally the possibility of blood donation. Throughout the centuries, the surgical approach went from radical resections to minimal resections or only drainage of the gland in comparison to an adequate resection combined with drainage procedures. Today, the well-known and standardized procedures are considered as safe due to the high experience of operating surgeons, the centering of pancreatic surgery in specialized centers, and optimized perioperative treatment...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28818261/contemporary-medical-therapies-of-atherosclerotic-carotid-artery-disease
#14
Suk F Cheng, Martin M Brown
Contemporary medical therapy consists of identification and treatment of all patient-modifiable vascular risk factors. Specific atherosclerotic disease therapies are designed to reduce the risk of thrombosis, and the disease progression in order to reduce the risk of future cardiovascular events. Contemporary medical management emphasizes the need to support the patient in achieving lifestyle modifications and to adjust medication to achieve individualized target values for specific quantifiable risk factors...
March 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28817994/maternal-serum-and-fetal-cord-blood-ischemia-modified-albumin-concentrations-in-normal-pregnancy-and-preeclampsia-a-systematic-review-and-meta-analysis
#15
Varikasuvu Seshadri Reddy, Pragathi Duggina, Mrudula Vedhantam, Munikumar Manne, Neelakant Varma, Nagaram Srinivas
BACKGROUND/AIMS: A meta-analysis of maternal serum ischemia-modified albumin (IMA) and fetal cord blood IMA concentrations in normal pregnancy (NP) compared to nonpregnant healthy controls (HC) and in preeclampsia (PE) compared to normal pregnant controls were studied. METHODS: All major databases were searched for eligible studies. We included 8 studies comparing serum IMA between NP and HC, 14 studies comparing serum IMA between PE and NP and 5 studies comparing cord-blood IMA between PE and NP groups...
August 17, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28817862/practice-guidelines-for-hypertension
#16
David Zeigler, Anish Patel, Candace Zeigler
Hypertension is very prevalent in South Dakota affecting approximately one-third of the adult population. Management and treatment of the disease has recently been the subject of considerable debate centered on what should be the blood pressure goal depending on the patient's age and co-morbid conditions. Recently, a randomized trial of intensive versus standard blood pressure control indicated that a systolic blood pressure of less than 120 mmHg in patients at high risk for cardiovascular events but without diabetes, resulted in significantly lower rates of non-fatal major cardiovascular events and death from any cause...
2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28817334/community-health-worker-support-for-disadvantaged-patients-with-multiple-chronic-diseases-a-randomized-clinical-trial
#17
Shreya Kangovi, Nandita Mitra, David Grande, Hairong Huo, Robyn A Smith, Judith A Long
OBJECTIVES: To determine whether a community health worker (CHW) intervention improved outcomes in a low-income population with multiple chronic conditions. METHODS: We conducted a single-blind, randomized clinical trial in Philadelphia, Pennsylvania (2013-2014). Participants (n = 302) were high-poverty neighborhood residents, uninsured or publicly insured, and diagnosed with 2 or more chronic diseases (diabetes, obesity, tobacco dependence, hypertension). All patients set a disease-management goal...
August 17, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28817302/comparative-effectiveness-and-costs-of-insulin-pump-therapy-for-diabetes
#18
Ronald T Ackermann, Amisha Wallia, Raymond Kang, Andrew Cooper, Theodore A Prospect, Lewis G Sandy, Deneen Vojta
OBJECTIVES: Continuous subcutaneous insulin infusion (CSII), or "insulin pump" therapy, is an alternative to multiple daily insulin injections (MDII) for management of diabetes. This study evaluates patterns of healthcare utilization, costs, and blood glucose control for patients with diabetes who initiate CSII. STUDY DESIGN: Pre-post with propensity-matched comparison design involving commercially insured US adults (aged 18-64 years) with insulin-requiring diabetes who transitioned from MDII to CSII between July 1, 2009, and June 30, 2012 ("CSII initiators"; n = 2539), or who continued using MDI (n = 2539)...
June 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28817182/centralized-patient-reported-outcome-data-collection-in-transplantation-is-feasible-and-clinically-meaningful
#19
Bronwen E Shaw, Ruta Brazauskas, Heather R Millard, Rachel Fonstad, Kathryn E Flynn, Amy Abernethy, Jenny Vogel, Charney Petroske, Deborah Mattila, Rebecca Drexler, Stephanie J Lee, Mary M Horowitz, J Douglas Rizzo
BACKGROUND: Allogeneic hematopoietic cell transplantation (HCT) cures many patients, but often with the risk of late effects and impaired quality of life. The value of quantifying patient-reported outcomes (PROs) is increasingly being recognized, but the routine collection of PROs is uncommon. This study evaluated the feasibility of prospective PRO collection by an outcome registry at multiple time points from unselected HCT patients undergoing transplantation at centers contributing clinical data to the Center for International Blood and Marrow Transplant Research (CIBMTR), and then it correlated the PRO data with clinical and demographic data...
August 17, 2017: Cancer
https://www.readbyqxmd.com/read/28816965/blue-rubber-bleb-nevus-syndrome-our-experience-and-new-endoscopic-management
#20
Wenguo Chen, Hongtan Chen, Guodong Shan, Ming Yang, Fengling Hu, Qi Li, Lihua Chen, Guoqiang Xu
The aim of our study is to enhance the awareness of blue rubber bleb nevus syndrome (BRBNS) through the patients in our hospital and introduced a new measure of endoscopic intervention.A retrospective review of 5 patients, who were diagnosed as BRBNS in our hospital from January 2013 to January 2017, was conducted. Data were collected with regard to demographics, clinical presentation, endoscopic and imaging findings, management, and follow-up data.In total of 5 patients, the mean age was 28.8 years, range 16 to 44 years (male/female, 1/4) with the average initial age of onset 15...
August 2017: Medicine (Baltimore)
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