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https://www.readbyqxmd.com/read/29331270/severe-beta-blocker-and-calcium-channel-blocker-overdose-role-of-high-dose-insulin
#1
Karan Seegobin, Satish Maharaj, Ansuya Deosaran, Pramod Reddy
A 54-year-old female presented after taking an overdose of an unknown amount of hydrochlorothiazide, doxazocin, atenolol and amlodipine. She was initially refractory to treatment with conventional therapy (intravenous fluids, activated charcoal, glucagon 5 mg followed with glucagon drip, calcium gluconate 10%, and atropine). Furthermore, insulin at 4 U/kg was not effective in improving her hemodynamics. Shortly after high dose insulin was achieved with 10 U/kg, there was dramatic improvement in hemodynamics resulting in three of five vasopressors being weaned off in 8 h...
January 10, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29329828/frequency-and-prognostic-significance-of-acute-kidney-recovery-in-patients-who-underwent-transcatheter-aortic-valve-implantation
#2
Amir Azarbal, Kevin L Leadholm, Takamaru Ashikaga, Richard J Solomon, Harold L Dauerman
Acute kidney injury (AKI) after transcatheter aortic valve implantation (TAVI) is associated with increased mortality. As significant hemodynamic improvement may occur with relief of aortic stenosis, we hypothesized that TAVI patients may demonstrate the opposite phenomena: acute kidney recovery (AKR). We studied the incidence and predictors of AKR in post-TAVI patients. A total of 366 consecutive patients underwent TAVI (January 2012 to January 2017) at a single center. We defined AKR as a 25% improvement in glomerular filtration rate (GFR) at 48 hours after TAVI...
December 13, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29327897/peripheral-arterial-occlusive-disease-and-perioperative-risk
#3
Peter Poredos, Pavel Poredos
Surgical procedures represent a risk for different complications which may appear during the perioperative period. Cardiac ischemic events and vascular complications are the most important causes of increased morbidity and mortality and they are much more frequent in patients with manifest cardiovascular disease. This is particularly seen in patients with peripheral arterial occlusive disease (PAD), which represents advanced atherosclerosis frequently accompanied by the presence of coronary artery disease. Therefore, patients with PAD need careful preoperative examination, including estimation of functional capacity and the presence of other co-existing atherosclerotic diseases...
January 11, 2018: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/29327797/potassium-and-the-use-of-renin-angiotensin-aldosterone-system-inhibitors-in-heart-failure-with-reduced-ejection-fraction-data-from-biostat-chf
#4
Joost C Beusekamp, Jasper Tromp, Haye H van der Wal, Stefan D Anker, John G Cleland, Kenneth Dickstein, Gerasimos Filippatos, Pim van der Harst, Hans L Hillege, Chim C Lang, Marco Metra, Leong L Ng, Piotr Ponikowski, Nilesh J Samani, Dirk J van Veldhuisen, Aeilko H Zwinderman, Patrick Rossignol, Faiez Zannad, Adriaan A Voors, Peter van der Meer
BACKGROUND: Hyperkalaemia is a common co-morbidity in patients with heart failure with reduced ejection fraction (HFrEF). Whether it affects the use of renin-angiotensin-aldosterone system inhibitors and thereby negatively impacts outcome is unknown. Therefore, we investigated the association between potassium and uptitration of angiotensin-converting enzyme inhibitors (ACEi)/angiotensin receptor blockers (ARB) and its association with outcome. METHODS AND RESULTS: Out of 2516 patients from the BIOSTAT-CHF study, potassium levels were available in 1666 patients with HFrEF...
January 12, 2018: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29326185/enhancing-prescribing-of-guideline-recommended-medications-for-ischaemic-heart-diseases-a-systematic-review-and-meta-analysis-of-interventions-targeted-at-healthcare-professionals
#5
Thang Nguyen, Hoa Q Nguyen, Niken N Widyakusuma, Thao H Nguyen, Tam T Pham, Katja Taxis
OBJECTIVES: Ischaemic heart diseases (IHDs) are a leading cause of death worldwide. Although prescribing according to guidelines improves health outcomes, it remains suboptimal. We determined whether interventions targeted at healthcare professionals are effective to enhance prescribing and health outcomes in patients with IHDs. METHODS: We systematically searched PubMed and EMBASE for studies published between 1 January 2000 and 31 August 2017. We included original studies of interventions targeted at healthcare professionals to enhance prescribing guideline-recommended medications for IHDs...
January 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29325962/systematic-review-of-factors-influencing-surgical-performance-practical-recommendations-for-microsurgical-procedures-in-neurosurgery
#6
Evgenii Belykh, Naomi R Onaka, Iraklii T Abramov, Kaan Yağmurlu, Vadim A Byvaltsev, Robert F Spetzler, Peter Nakaji, Mark C Preul
BACKGROUND: Microneurosurgical techniques involve complex manual skills and hand-eye coordination that require substantial training. Many factors affect microneurosurgical skills. The goal of this study was to use a systematic evidence-based approach to analyze the quality of evidence for intrinsic and extrinsic factors that influence microneurosurgical performance and to make weighted practical recommendations. MATERIALS AND METHODS: A literature search of factors that may impact microsurgical performance was conducted using PubMed and Embase...
January 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29325446/reduction-of-ptsd-symptoms-with-pre-reactivation-propranolol-therapy-a-randomized-controlled-trial
#7
Alain Brunet, Daniel Saumier, Aihua Liu, David L Streiner, Jacques Tremblay, Roger K Pitman
OBJECTIVE: The authors assessed the efficacy of trauma memory reactivation performed under the influence of propranolol, a noradrenergic beta-receptor blocker, as a putative reconsolidation blocker, in reducing symptoms of posttraumatic stress disorder (PTSD). METHOD: This was a 6-week, double-blind, placebo-controlled, randomized clinical trial in 60 adults diagnosed with long-standing PTSD. Propranolol or placebo was administered 90 minutes before a brief memory reactivation session, once a week for 6 consecutive weeks...
January 12, 2018: American Journal of Psychiatry
https://www.readbyqxmd.com/read/29325034/ghrelin-preserves-ischemia-induced-vasodilation-of-male-rat-coronary-vessels-following-beta-adrenergic-receptor-blockade
#8
James T Pearson, Nicola Collie, Regis R Lamberts, Tadakatsu Inagaki, Misa Yoshimoto, Keiji Umetani, Philip Davis, Gerard Wilkins, Pete P Jones, Mikiyasu Shirai, Daryl O Schwenke
Acute myocardial infarction (MI) triggers an adverse increase in cardiac sympathetic nerve activity (SNA). While β-adrenergic receptor (β-AR)-blockers are routinely used for the management of MI, they may also counter β-AR-mediated vasodilation of coronary vessels. We have reported that ghrelin prevents sympathetic activation following MI. Whether ghrelin modulates coronary vascular tone following MI, either through the modulation of SNA, or directly as a vasoactive mediator, has never been addressed.We utilized synchrotron microangiography to image coronary perfusion and vessel internal diameter (ID) in anesthetized Sprague Dawley rats before, and then again 30 mins after induction of an MI (left coronary artery ligation)...
January 9, 2018: Endocrinology
https://www.readbyqxmd.com/read/29322605/declare-timi-58-participants-baseline-characteristics
#9
Itamar Raz, Ofri Mosenzon, Marc P Bonaca, Avivit Cahn, Eri T Kato, Michael G Silverman, Deepak L Bhatt, Lawrence A Leiter, Darren K McGuire, John Wilding, Ingrid Am Gause-Nilsson, Anna Maria Langkilde, Peter A Johansson, Marc S Sabatine, Stephen D Wiviott
BACKGROUND: Cardiovascular (CV) outcome trials with new glucose lowering agents (GLA) are designed to prove CV safety in high CV risk populations. However, the level of CV risk differs greatly among trials, which may influence comparability and generalizability of results. AIM: We describe baseline characteristics of participants randomized in the Dapagliflozin Effect on CardiovascuLAR Events (DECLARE-TIMI 58) trial, the pivotal study to assess CV outcomes with dapagliflozin...
January 11, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29318704/use-of-antihypertensive-drugs-and-risk-of-keratinocyte-carcinoma-a-meta-analysis-of-observational-studies
#10
Huilin Tang, Shuangshuang Fu, Suodi Zhai, Yiqing Song, Maryam M Asgari, Jiali Han
PURPOSE: Current epidemiologic evidence on the association between antihypertensive drugs and keratinocyte carcinoma (KC) risk is inconsistent. We sought to quantify this association by meta-analysis of observational studies. METHODS: We systematically reviewed observational studies published through August 2016 and reported the KC risk (basal cell carcinoma [BCC] and squamous cell carcinoma [SCC]) associated with antihypertensive drugs, including diuretics, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), beta-adrenergic blocking agents (β-blockers), and calcium channel blockers (CCBs)...
January 10, 2018: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29318637/factors-increasing-the-risk-for-a-severe-reaction-in-anaphylaxis-an-analysis-of-data-from-the-european-anaphylaxis-registry
#11
Margitta Worm, Wojciech Francuzik, Jean-Marie Renaudin, Maria Beatrice Bilo, Victòria Cardona, Kathrin Scherer Hofmeier, Alice Köhli, Andrea Bauer, George Christoff, Ewa Cichocka-Jarosz, Thomas Hawranek, Jonathan O'B Hourihane, Lars Lange, Vera Mahler, Antonella Muraro, Nikolaos G Papadopoulos, Claudia Pföhler, Iwona Poziomkowska-Gęsicka, Franziska Ruëff, Thomas Spindler, Regina Treudler, Montserrat Fernandez-Rivas, Sabine Dölle
BACKGROUND: Preventive measures to decrease the frequency and intensity of anaphylactic events are essential to provide optimal care for allergic patients. Aggravating factors may trigger or increase the severity of anaphylaxis and therefore need to be recognized and avoided. OBJECTIVE: To identify and prioritize factors associated with an increased risk of developing severe anaphylaxis. METHODS: Data from the Anaphylaxis Registry (122 centers in 11 European countries) was used in logistic regression models considering existing severity grading systems, elicitors, and symptoms to identify the relative risk of factors on the severity of anaphylaxis...
January 10, 2018: Allergy
https://www.readbyqxmd.com/read/29318439/mind-the-gap-mismatches-between-clinicians-and-patients-in-heart-failure-medication-management
#12
Ken Lee Chin, Marina Skiba, Christopher M Reid, Andrew Tonkin, Ingrid Hopper, Justin A Mariani, Danny Liew
PURPOSE: Previous studies on the 'treatment gap' in patients with heart failure (HF) have focused either on prescribing or patients' adherence to prescribed treatment. This study sought to determine whether or not recent initiatives to close the gap have also minimised any mismatches between physicians' expectation of their patients' medications, medications in the patients' possession and their actual medication use. METHODS: A cross-sectional observational survey was conducted from December 2015 to June 2016 in The Alfred Hospital HF clinic in Melbourne, Australia...
January 9, 2018: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/29316267/elderly-patients-with-suspected-chronic-digoxin-toxicity-a-comparison-of-clinical-characteristics-of-patients-receiving-and-not-receiving-digoxin-fab
#13
Hooman Arbabian, Hwee Min Lee, Andis Graudins
OBJECTIVE: The aim of the present study was to compare clinical features of patients with elevated serum digoxin concentrations who were treated with digoxin-Fab with those where the immunotherapy was not given by a tertiary hospital toxicology service. METHODS: This was a retrospective series of patients with supratherapeutic serum digoxin concentrations referred to the toxicology service from August 2013 to October 2015. Data collected included demographics, presenting complaint, digoxin dose, other medications taken, serum digoxin, potassium and creatinine concentration on presentation and initial and post-digoxin-Fab heart rate...
January 8, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29315692/comprehensive-review-of-cardiovascular-toxicity-of-drugs-and-related-agents
#14
REVIEW
Přemysl Mladěnka, Lenka Applová, Jiří Patočka, Vera Marisa Costa, Fernando Remiao, Jana Pourová, Aleš Mladěnka, Jana Karlíčková, Luděk Jahodář, Marie Vopršalová, Kurt J Varner, Martin Štěrba
Cardiovascular diseases are a leading cause of morbidity and mortality in most developed countries of the world. Pharmaceuticals, illicit drugs, and toxins can significantly contribute to the overall cardiovascular burden and thus deserve attention. The present article is a systematic overview of drugs that may induce distinct cardiovascular toxicity. The compounds are classified into agents that have significant effects on the heart, blood vessels, or both. The mechanism(s) of toxic action are discussed and treatment modalities are briefly mentioned in relevant cases...
January 5, 2018: Medicinal Research Reviews
https://www.readbyqxmd.com/read/29313593/a-patient-with-dilated-cardiomyopathy-and-portal-hypertension-which-beta-blocker-to-use
#15
Rathindranath Sarkar, Rudrajit Paul, Debaditya Roy, Asim Saha, Tanmay Jyoti Sau, Jayati Mondal
No abstract text is available yet for this article.
September 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29312724/long-term-results-of-radiofrequency-maze-procedure-for-persistent-atrial-fibrillation-with-concomitant-mitral-surgery
#16
Chia-Chen Wu, Jen-Ping Chang, Mien-Cheng Chen, Cheng-I Cheng, Wen-Jung Chung
Background: The radiofrequency (RF) maze procedure can effectively restore sinus rhythm in most patients with persistent atrial fibrillation (AF) and mitral disease. However, long-term results and predictors for late AF recurrence are still under investigation. Methods: From December 1995 to November 2011, 207 consecutive patients with persistent AF and mitral disease underwent RF maze procedure and concomitant mitral surgery. The mean age was 54±12.4 year-old...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29310230/effect-of-salinity-and-ph-on-the-calibration-of-the-extraction-of-pharmaceuticals-from-water-by-passil
#17
Hanna Męczykowska, Piotr Stepnowski, Magda Caban
High salinity and a relatively high pH are two factors characterizing the marine water environment, which is one of the main final reservoirs receiving pharmaceutical residues. The same factors have an undeniable impact on the extraction efficiency and kinetics of uptakes of polar analytes from water by sorbent-based passive sampling techniques. Recently, we presented a novel passive sampling technique, in which ionic liquids are applied as receiving phases for pharmaceutical monitoring in water (the Passive Sampling with Ionic Liquids technique)...
March 1, 2018: Talanta
https://www.readbyqxmd.com/read/29309742/abnormal-repolarization-duration-during-everyday-emotional-arousal-in-long-qt-syndrome-and-coronary-artery-disease
#18
Richard D Lane, Harry T Reis, Chiu-Hsieh Hsu, Karl B Kern, Jean Philippe Couderc, Arthur J Moss, Wojciech Zareba
BACKGROUND: Rare high arousal negative emotions are known triggers of sudden death in individuals with preexisting heart disease. Whether everyday fluctuations in emotional arousal influence arrhythmia risk is unknown. METHODS: We studied 160 patients with the congenital Long QT Syndrome (LQTS), 199 patients with coronary artery disease, and two groups of matched healthy volunteers (n=53 and 50, respectively). Three-day home visits including a 12-hour Holter recording each day were completed...
January 5, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29308931/age-dependent-sympathetic-neural-responses-to-%C3%AE-1-selective-beta-blockade-in-untreated-hypertension-related-tachycardia
#19
Dagmara Hering, Wiesława Kucharska, Marzena Chrostowska, Krzysztof Narkiewicz
BACKGROUND: Elevated heart rate (HR) increases cardiovascular morbidity and mortality in hypertension. The impact of beta-blockers on patient prognosis in hypertension is controversial. This study examined the age-related effects of betaxolol on HR, muscle sympathetic nerve activity (MSNA), blood pressure (BP) and sympathovagal balance in untreated males with hypertension and tachycardia. METHODS: Ten young (age 26 ± 1 years) and seven older (age 50 ± 4 years) males underwent measurement of BP, HR, HR variability (Poincare plot) and MSNA before and after 8 weeks treatment with betaxolol at the initial starting dose of 10 mg/day, which was increased to 20 mg/day once daily after 4 weeks in all subjects...
January 8, 2018: Blood Pressure
https://www.readbyqxmd.com/read/29308681/therapeutic-considerations-of-sarcopenia-in-heart-failure-patients
#20
Masakazu Saitoh, Nicole Ebner, Stephan von Haehling, Stefan D Anker, Jochen Springer
Sarcopenia is a common feature, and affects 20-47% of patients with heart failure (HF). Sarcopenia is also an independent predictor of impaired functional capacity, even after adjusting for clinical relevant variables, which is associated with adverse outcome in patients with HF. Areas covered: Several different pathophysiological pathways are involved in sarcopenic processes including altered nutrient intake and absorption, hormonal factor, inflammatory processes, oxidative stress, cellular proteolysis, and unhealthy lifestyle...
January 7, 2018: Expert Review of Cardiovascular Therapy
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