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Acute Pulmonary Hypertension

Mika Nagaoka, Ayumi Goda, Kaori Takeuchi, Hanako Kikuchi, Mayumi Finger, Takumi Inami, Kyoko Soejima, Toru Satoh
BACKGROUND: Sleep apnea (SA) can cause repeated nocturnal arterial oxygen desaturation and result in acute increase in pulmonary arterial pressure (PAP). The presence of SA is associated with a poor prognosis in patients with chronic left-sided heart failure, but little is known for patients with pulmonary arterial hypertension (PAH). Methods and Results: We enrolled 151 patients with PAH (44±16 years old, male/female=37/114). They were all in the Nice Classification group 1 (idiopathic PAH/associated PAH=52/48%, mean PAP of 46±16 mmHg)...
October 16, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Yuri Sonoda, Kenichiro Yamamura, Kanako Ishii, Kazuhiro Ohkubo, Kenji Ihara, Yasunari Sakai, Shouichi Ohga
Prostaglandin I2 (PGI2) causes hyperthyroidism, a critical complication in patients with pulmonary arterial hypertension (PAH). However, it remains unknown whether PGI2 may have unfavorable effects on thyroid functions in children with congenital portosystemic venous shunt syndrome (CPSVS). We present a boy with CPSVS who developed PAH at 7 years of age. During the PGI2 therapy, he experienced thyrotoxicosis at 17 years of age. The literature review showed that the past 12 patients with PAH (median 11 years of age) developed hyperthyroidism during 1 to 11 years of PGI2 treatments...
October 16, 2018: Journal of Clinical Research in Pediatric Endocrinology
Chien-Cheng Huang, Chung-Han Ho, Yi-Chen Chen, Chien-Chin Hsu, Yi-Fong Wang, Hung-Jung Lin, Jhi-Joung Wang, How-Ran Guo
The purpose of this study was to evaluate the effects of hyperbaric oxygen therapy (HBOT) on reducing neurological sequelae (NS) in patients with carbon monoxide poisoning (COP). Using a nationwide database of insurance claims in Taiwan, we conducted a population-based cohort study to identify 24,046 patients with COP diagnosed between 1999 and 2012, including 6793 (28.2%) patients who received HBOT and 17,253 (71.8%) patients who did not. We followed the two cohorts of patients and compared the occurrence of NS...
October 13, 2018: Journal of Clinical Medicine
Hyeon-A Kim, Hyo-Rim Suh, Ben Kang, Byung-Ho Choe
The incidence of inflammatory bowel disease (IBD) is rapidly increasing worldwide. Indigo naturalis is known to have an antiinflammatory effect. Indigo naturalis has been traditionally used in the treatment of IBD in China and Japan. Currently, it is used as a primary or adjunctive drug in patients with ulcerative colitis. There are some reports of the effects of indigo naturalis when used in patients with ulcerative colitis. However, its usage has been associated with adverse events, including liver dysfunction, headache, gastrointestinal disturbance, and pulmonary hypertension...
October 16, 2018: Intestinal Research
Dehui Zeng, Pingbo Yao, Hong Zhao
Abundant evidence indicted that P2X7 receptor show a essential role in human health and some human diseases including hypertension, atherosclerosis, pulmonary inflammation, tuberculosis infection, psychiatric disorders, and cancer. P2X7 receptor also has an important role in some central nervous system diseases such as neurodegenerative disorders. Recently, more research suggested that P2X7 receptor also plays a crucial role in bone and joint diseases. But the effect of P2X7 receptor on skeletal and joint diseases has not been systematically reviewed...
October 14, 2018: Journal of Cellular Physiology
Paul S Jansson, David C Leisten, Todd M Sarkisian, Susan R Wilcox, Jarone Lee
BACKGROUND: Hydrochlorothiazide (HCTZ) is a commonly prescribed sulfonamide thiazide-type diuretic medication that has been associated with rare cases of noncardiogenic pulmonary edema. CASE REPORT: A man in his 50s with a medical history notable for hypertension was transferred to our institution for evaluation of refractory hypoxemia. After taking an initial dose of HCTZ earlier in the day, he developed progressive respiratory failure and was intubated at a referring hospital...
October 9, 2018: Journal of Emergency Medicine
Mario Naranjo, Kevin Bryan Lo, Kenechukwu Mezue, Janani Rangaswami
Pulmonary hypertension is not uncommon in patients with renal disease and vice versa; therefore, influences treatments and outcomes. There is a large body of literature on pulmonary hypertension in patients with kidney disease, its prognostic implications, economic burden, and management strategies. However, the converse, namely the hemodynamic effects of pulmonary hypertension on kidney function (acute and chronic kidney injury) is less studied and described. There is also increasing interest in the effects of pulmonary hypertension on kidney transplant outcomes...
October 8, 2018: Current Cardiology Reviews
Shreepal Jain, Bharat Dalvi
Patients having atrial septal defect (ASD) with moderate and more importantly severe pulmonary arterial hypertension (PAH) pose a clinical dilemma. Closing ASD in those with irreversible PAH and not closing it when the PAH is reversible can cost patients dearly, both in terms of quality of life and longevity. In our experience, there is no single parameter that can help in decision making in this difficult subset of patients and therefore we recommend a multi-dimensional approach, which takes into consideration clinical, radiological, electrocardiographic and hemodynamic variables as a whole...
September 2018: Journal of Thoracic Disease
Matthieu Turpin, Christelle Chantalat-Auger, Florence Parent, Françoise Driss, François Lionnet, Anoosha Habibi, Bernard Maître, Alice Huertas, Xavier Jaïs, Jason Weatherald, David Montani, Olivier Sitbon, Gérald Simonneau, Fréderic Galactéros, Marc Humbert, Pablo Bartolucci, Laurent Savale
The long-term effects of chronic blood exchange transfusions (BETs) on pre-capillary pulmonary hypertension complicating sickle cell disease (SCD) are unknown.13 homozygous SS SCD patients suffering from pre-capillary pulmonary hypertension and treated by chronic BETs were evaluated retrospectively. Assessments included haemodynamics, New York Heart Association Functional Class (NYHA FC), 6-min walk distance (6MWD) and blood tests.Before initiating BETs, all patients were NYHA FC III or IV, median (range) 6MWD was 223 (0-501) m and median (range) pulmonary vascular resistance (PVR) was 3...
October 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Sergio Barros-Gomes, Abdallah El Sabbagh, Mackram F Eleid, Sunil V Mankrad
Non-atherosclerotic myocardial infarction (MI) is an important but often misdiagnosed cause of acute MI. Furthermore, non-atherosclerotic MI with concomitant acute stroke and pulmonary embolism due to in-transit thrombus across a patent foramen ovale (PFO) is a rare but potentially fatal combination (1, 2, 3). Early detection of this clinical entity can facilitate delivery of targeted therapies and avoid poor outcome (1, 2). Here, we describe a 68-year-old female with hypertension, tobacco abuse and chronic obstructive pulmonary disease presenting with facial droop, right arm weakness and aphasia...
December 1, 2018: Echo Research and Practice
Jon Klokk Slettedal, Leiv Sandvik, Amund Ringvold
Background: Pseudoexfoliation syndrome (PES) is a common eye condition, indicating a risk of various eye diseases. Whether or not PES has extra-ocular physiological or even pathophysiological implications has been a matter of controversy for years. Methods: In total 1888 persons were examined for PES in 1985-86. Of these, 1864 (98·7%) had died and were therefore available for analysis by 01.01.2016. Age and cause(s) of death were recorded. 9 diagnostic groups (cardiovascular disease, cerebrovascular disease, neoplasms, systemic hypertension, diabetes mellitus (DM), chronic obstructive pulmonary disease (COPD), Parkinson's disease, aortic aneurysm (AA), and amyloidosis) based on ICD-coding were analyzed for both a possible association between PES and lifespan, as well as PES and specific systemic diseases...
October 2018: Heliyon
Jesse A Codner, Xiaoying Lou, Yazan M Duwayri, Edward P Chen, Jose N Binongo, Rena Moon, William D Jordan, Bradley G Leshnower
OBJECTIVE: Controversy exists about the optimal treatment of acute uncomplicated type B aortic dissection (auTBAD). Optimal medical therapy (OMT) provides excellent short-term outcomes, but long-term results are poor. Ideally, auTBAD patients who will fail to respond to OMT in the chronic phase could be identified and undergo thoracic endovascular aortic repair. The purpose of this study was to identify radiographic predictors of auTBAD patients who will fail to respond to OMT. METHODS: A review of the Emory aortic database from 2000 to 2017 identified 320 auTBAD patients initially treated with OMT...
October 3, 2018: Journal of Vascular Surgery
Triin Habicht, Marge Reinap, Kaija Kasekamp, Riina Sikkut, Laura Aaben, Ewout van Ginneken
This analysis of the Estonian health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. In 2017, the Estonian government took the historic step of expanding the revenue base of the health system, which has been a longstanding challenge. However, in terms of percentage of GDP it remains a small increase and long-term financial sustainability could still pose a problem. That said, if these additional funds are invested wisely, they could play a positive role in further improving the health system...
March 2018: Health Systems in Transition
Best Anyama, Omar Viswanath, Carolina De La Cuesta, Murlikrishna Kannan, Michael Wittels, Steve Xydas, Alan David Kaye, David A Farcy
Background: A massive pulmonary embolism (PE) is associated with high mortality once cardiac arrest occurs. Surgical embolectomy is indicated in patients who have massive PE. Case Report: A 62-year-old male emergently underwent surgical embolectomy after sustaining an intraoperative cardiac arrest caused by a massive PE during an open reduction with internal fixation of a closed comminuted midshaft tibia fracture. Postoperatively, the patient developed pulmonary hypertension and acute renal failure...
2018: Ochsner Journal
Christopher Vercammen-Grandjean, David W Schopfer, Ning Zhang, Mary A Whooley
BACKGROUND: Hospitalization with acute exacerbation of chronic obstructive pulmonary disease (COPD) is common and costly to the health care system. Pulmonary rehabilitation (PR) can improve symptom burden and morbidity associated with COPD. The use of PR among Medicare beneficiaries is poor, and the use by Veterans Health Administration (VHA) beneficiaries is unknown. We sought to determine whether participation in PR was similarly poor among eligible veterans compared with Medicare beneficiaries...
September 24, 2018: Journal of Cardiopulmonary Rehabilitation and Prevention
Maria Ruiz, Zain Shahid, Oswaldo Renteria, Sergio Huerta
INTRODUCTION: An open appendectomy used to be one of the most common cases performed by interns and physical exam dictated operative intervention. We hypothesized that the management of acute appendicitis has drastically changed from these previous practices. METHODS: A retrospective, single institution study was performed at the VA North Texas Health Care System between July 2005 to June 2017 for all patients who underwent an appendectomy. Using postgraduate year (PGY)-level (PGY 1-3 and PGY 4-5) as a dependent variable, univariate analyses, and multiple logistic regression analyses were performed...
September 21, 2018: Journal of Surgical Education
Tammo Delhaas, Yvette Koeken, Heiner Latus, Christian Apitz, Dietmar Schranz
Aims: To quantitatively evaluate the basic pathophysiological process involved in the creation of Eisenmenger syndrome in pediatric pulmonary arterial hypertension (PAH) patients by either atrial septostomy (AS) or Potts shunt (PS) as well as to predict the effects of AS or PS in future PAH patients. Methods: The multi-scale lumped parameter CircAdapt model of the cardiovascular system was used to investigate the effects of AS and PS on cardiovascular hemodynamics and mechanics, as well as on oxygen saturation in moderate to severe PAH...
2018: Frontiers in Physiology
Kyle H Cichos, Jessica L Churchill, Sierra G Phillips, Shawna L Watson, Gerald McGwin, Elie S Ghanem, Brent A Ponce
INTRODUCTION: Hip fractures and metabolic syndrome (MetS) are becoming major global healthcare burdens as populations age. This study sought to determine the impact of MetS in hip fracture patients on perioperative outcomes following operative fixation or arthroplasty. METHODS: Data from the 2004-2014 Nationwide Inpatient Sample was used to select 3,348,207 discharges with hip fracture. MetS patients were identified by having at least 3 of 4 component comorbidities: hypertension, dyslipidemia, obesity, and diabetes...
September 8, 2018: Injury
A Claire Watkins, Nathan L Maassel, Mehrdad Ghoreishi, Murtaza Y Dawood, Si M Pham, Zachary N Kon, Bradley S Taylor, Bartley P Griffith, James S Gammie
BACKGROUND: Cardiac surgery for structural heart disease has poor outcomes in the presence of cardiogenic shock or advanced heart failure. We applied venoarterial extracorporeal membrane oxygenation (ECMO) to restore end-organ function and resuscitate patients before high-risk cardiac operation. METHODS: Twelve patients with cardiogenic shock and end-organ failure were evaluated for cardiac surgery. The average Society of Thoracic Surgeons (STS) mortality risk was 24% (±13)...
September 17, 2018: Annals of Thoracic Surgery
Meng Zhang, Ning Wang, Zhenguo Zhai, Mingyuan Zhang, Rongrong Zhou, Yanyan Liu, Yuanhua Yang
Background: The incidence and risk factors of chronic thromboembolic pulmonary hypertension (CTEPH) after acute pulmonary embolism (PE) were still controversial. A systematic review and meta-analysis was conducted to assess the incidence and risk factors of CTEPH after acute PE. Methods: Embase, Medline, China National Knowledge Infrastructure, Wanfang databases, and various reference lists were searched to identify studies published up to May 2018. Only cohort studies that used right heart catheterization for CTEPH diagnosis were included...
August 2018: Journal of Thoracic Disease
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