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Hemodynamic review

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https://www.readbyqxmd.com/read/28432726/combination-therapy-with-glp-1-receptor-agonist-and-sglt2-inhibitor
#1
REVIEW
Ralph A DeFronzo
The SGLT2 inhibitors (SGLTi) and glucagon-like-1 receptor agonists (GLP-1 RAs) effectively reduce HbA1c, but via very different mechanisms, making them an effective duet for combination therapy. Recently, drugs in both of these antidiabetic classes have been shown to reduce cardiovascular events, most likely by different mechanisms. SGLT2i appear to exert their CV protective actions by hemodynamic effects, while GLP-1 RAs work via anti-atherogenic/anti-inflammatory mechanisms, raising the possibility that combined therapy with these two classes may produce additive CV benefits...
April 22, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28432473/vasopressin-and-vasopressin-antagonists-in-heart-failure
#2
Julie K Vishram-Nielsen, Finn Gustafsson
Despite the introduction of multiple new pharmacological agents over the past three decades in the field of heart failure (HF), overall prognosis remains poor. Hyponatremia is prevalent in HF patients and has been suggested as a contributor to poor response to standard therapy. Elevated levels of arginine vasopressin (AVP), a peptide hormone produced in the hypothalamus, play a role in development of hyponatremia, and AVP and its surrogate, copeptin, are related to changes in osmolality, hemodynamics, neuro-hormones as well as in overall outcome in HF patients...
April 22, 2017: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/28427551/cardiopulmonary-exercise-factors-predict-survival-in-patients-with-advanced-interstitial-lung-disease-referred-for-lung-transplantation
#3
Aimee M Layton, Hilary F Armstrong, Hanyoung P Kim, Kimbery S Meza, Frank D'Ovidio, Selim M Arcasoy
BACKGROUND: The purpose of this work was to determine if parameters assessed during Cardiopulmonary Exercise Testing (CPET) while using supplemental oxygen can independently predict one-year transplant-free survival in patients with Interstitial Lung Disease (ILD) referred for lung transplant evaluation. METHODS: We performed a chart review of patients with ILD who completed CPET with 30% FiO2 and gathered spirometry, pulmonary hemodynamic, six-minute walk, and CPET data...
May 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28427379/novel-mutation-identified-in-severe-early-onset-tumor-necrosis-factor-receptor-associated-periodic-syndrome-a-case-report
#4
Suhas M Radhakrishna, Amy Grimm, Lori Broderick
BACKGROUND: Tumor Necrosis Factor Receptor-Associated Periodic Syndrome (TRAPS) is the second most common heritable autoinflammatory disease, typically presenting in pre-school aged children with fever episodes lasting 1-3 weeks. Systemic symptoms can include rash, myalgia, ocular inflammation, and serositis. CASE PRESENTATION: Here we report an unusual presentation of TRAPS in a 7 month old girl who presented with only persistent fever. She was initially diagnosed with incomplete Kawasaki Disease and received IVIG and infliximab; however, her fevers quickly recurred...
April 20, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28426506/applications-of-noninvasive-hemodynamic-monitoring-in-obstetric-management
#5
John T Sullivan
Clinicians managing obstetric patients are dependent on valid hemodynamic measurements to guide care. Heart rate and noninvasive blood pressure guide most current care. New hemodynamic monitors are being used to report research findings and are being investigated by clinicians for their value to supplement standard monitoring. These include arterial pulse contour analysis, Doppler velocimetry, and bioimpedance among others. This chapter serves to present these new devices with a critical review of their advantages and limitations, and most importantly the validity of their measurements...
June 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28425346/ambrisentan-a-review-of-its-use-in-pulmonary-arterial-hypertension
#6
Belinda N Rivera-Lebron, Michael G Risbano
Pulmonary arterial hypertension (PAH) is a progressive disease defined by an elevation in pulmonary arterial pressure that can lead to right heart failure and death. Ambrisentan is a selective endothelin receptor antagonist approved for the treatment of idiopathic, heritable PAH and connective tissue disease-associated PAH. Ambrisentan has been shown to improve exercise capacity and hemodynamics with an acceptable side-effect profile. It has also proven to be safely used in combination with other PAH-specific medications, especially with phosphodiesterase-5 inhibitors...
April 1, 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/28425226/a-review-of-pediatric-pulmonary-hypertension-with-new-guidelines
#7
Serdar Kula, Ayhan Pektaş
This study aims to review pediatric pulmonary hypertension (PH) by comparing the guidelines of the European Society of Cardiology (ESC)/European Respiratory Society (ERS), the American Heart Association (AHA)/American Thoracic Society (ATS), and the European Pediatric Pulmonary Vascular Disease Network (EPPVDN). All three sets of guidelines define PH as having a mean pulmonary artery pressure of ≥25 mmHg and accept the validity of the World Health Organization (WHO) classification system. Every child with a high index of suspicion for PH should undergo an initial work-up of chest X-rays, electrocardiography, and echocardiography...
April 18, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28425064/a-pathway-to-personalizing-therapy-for-metastases-using-liver-on-a-chip-platforms
#8
A S Khazali, A M Clark, A Wells
Metastasis accounts for most cancer-related deaths. The majority of solid cancers, including those of the breast, colorectum, prostate and skin, metastasize at significant levels to the liver due to its hemodynamic as well as tumor permissive microenvironmental properties. As this occurs prior to detection and treatment of the primary tumor, we need to target liver metastases to improve patients' outcomes. Animal models, while proven to be useful in mechanistic studies, do not represent the heterogeneity of human population especially in drug metabolism lack proper human cell-cell interactions, and this gap between animals and humans results in costly and inefficient drug discovery...
April 19, 2017: Stem Cell Reviews
https://www.readbyqxmd.com/read/28422424/pregnancy-outcomes-in-women-with-different-doses-of-corticosteroid-supplementation-during-labor-and-delivery
#9
Takao Owa, Kazuya Mimura, Aiko Kakigano, Shinya Matsuzaki, Keiichi Kumasawa, Masayuki Endo, Takuji Tomimatsu, Tadashi Kimura
AIM: The aim of this study was to report the pregnancy outcomes of women who received different doses of corticosteroid supplementation during labor and delivery. METHODS: We conducted a retrospective review of 102 pregnant women who received oral corticosteroid therapy, delivered at Osaka University Hospital, and were administered intravenous corticosteroid supplementation during labor and delivery. From January 2008 to May 2012, 47 women were administered a high dose of corticosteroids (HD group)...
April 19, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28421173/cerebral-autoregulation-brain-injury-and-the-transitioning-premature-infant
#10
REVIEW
Zachary A Vesoulis, Amit M Mathur
Improvements in clinical management of the preterm infant have reduced the rates of the two most common forms of brain injury, such as severe intraventricular hemorrhage and white matter injury, both of which are contributory factors in the development of cerebral palsy. Nonetheless, they remain a persistent challenge and are associated with a significant increase in the risk of adverse neurodevelopment outcomes. Repeated episodes of ischemia-reperfusion represent a common pathway for both forms of injury, arising from discordance between systemic blood flow and the innate regulation of cerebral blood flow in the germinal matrix and periventricular white matter...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28419082/diffuse-optical-tomography-to-investigate-the-newborn-brain
#11
REVIEW
Chuen Wai Lee, Robert J Cooper, Topun Austin
Over the past 15 years, functional near-infrared spectroscopy (fNIRS) has emerged as a powerful technology for studying the developing brain. Diffuse Optical Tomography (DOT) is an extension of fNIRS that combines hemodynamic information from dense optical sensor arrays over a wide field of view. Using image reconstruction techniques, DOT can provide images of the hemodynamic correlates to neural function that are comparable to those produced by functional MRI (fMRI). This review article explains the principles of DOT, and highlights the growing literature on the use of DOT in the study of healthy development of the infant brain, and the study of novel pathophysiology in infants with brain injury...
April 18, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28417646/cerebral-hemodynamic-assessment-and-neuroimaging-across-the-lifespan-in-sickle-cell-disease
#12
Lori C Jordan, Michael R DeBaun
Children and adults with sickle cell anemia (SCA) have a higher risk of strokes compared to age- and race-matched peers. Velocity in the middle cerebral or distal internal carotid artery as measured by transcranial Doppler ultrasound is a recognized method to identify children but not adults with SCA at high-risk for first stroke. For both children and adults with SCA that have had a stroke, no methods clearly identify individuals at highest risk of recurrent strokes or an initial silent stroke, the most common neurological injury...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28417295/drug-induced-pulmonary-arterial-hypertension-a-review
#13
REVIEW
Lohit Garg, Ghulam Akbar, Sahil Agrawal, Manyoo Agarwal, Leila Khaddour, Rishin Handa, Aakash Garg, Mahek Shah, Brijesh Patel, Bhavinkumar D Dalal
Pulmonary arterial hypertension (PAH) is a subgroup of PH patients characterized hemodynamically by the presence of pre-capillary PH, defined by a pulmonary artery wedge pressure (PAWP) ≤15 mmHg and a PVR >3 Wood units (WU) in the absence of other causes of pre-capillary PH. According to the current classification, PAH can be associated with exposure to certain drugs or toxins such as anorectic agents, amphetamines, or selective serotonin reuptake inhibitors. With the improvement in awareness and recognition of the drug-induced PAH, it allowed the identification of additional drugs associated with an increased risk for the development of PAH...
April 18, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28416934/sepsis-and-septic-shock-current-treatment-strategies-and-new-approaches
#14
REVIEW
Gizem Polat, Rustem Anil Ugan, Elif Cadirci, Zekai Halici
Sepsis is a complex condition characterized by the simultaneous activation of inflammation and coagulation in response to microbial insult. These events manifest as systemic inflammatory response syndrome or sepsis symptoms through the release of proinflammatory cytokines, procoagulants, and adhesion molecules from immune cells and/or damaged endothelium. Today, sepsis is a severe multisystem disease with difficult treatments for its manifestations and high mortality rates. In the last two decades in particular, many studies have been conducted on sepsis that cause shock, multiorgan dysfunction, and organ failure by especially leading to hemodynamic changes...
February 2017: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28416327/executive-functioning-and-substance-use-in-adolescence-neurobiological-and-behavioral-perspectives
#15
REVIEW
Jungmeen Kim-Spoon, Rachel E Kahn, Nina Lauharatanahirun, Kirby Deater-Deckard, Warren K Bickel, Pearl H Chiu, Brooks King-Casas
The current review is guided by the theoretical perspective that emphasizes the regulating role of executive functioning (Carver, Johnson, & Joormann, 2009) and presents studies that elucidate the ways that executive functioning (inhibition and working memory) explain individual differences in adolescent substance use independently or by regulating the reactive system (reward and punishment sensitivity). Behavioral studies indicate that main effects of executive functioning on adolescent substance use are often nonsignificant or weak in effect sizes...
April 14, 2017: Neuropsychologia
https://www.readbyqxmd.com/read/28413187/noninvasive-fractional-flow-reserve-derived-from-coronary-computed-tomography-angiography%C3%A3-is-this-just-another-new-diagnostic-test-or-the-long-awaited-game-changer
#16
Hiromasa Otake, Charles A Taylor, Hitoshi Matsuo, Nobuhiro Tanaka, Takashi Akasaka
Despite the clinical importance of ischemia evaluation, obtaining fractional flow reserve (FFR) value has, heretofore, only been available during invasive cardiac catheterization. Although there is a clear linkage between morphology and physiology, a significant gap still exists. FFR derived from coronary computed tomography angiography (FFRCT) is a novel method of quantifying the hemodynamic significance of coronary artery stenoses by translating morphological information into hemodynamic data. Improved diagnostic performance of FFRCThas been repeatedly demonstrated in comparison with coronary computed tomography angiography alone with an invasive FFR reference standard...
April 11, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28412426/unraveling-the-rv-ejection-doppler%C3%A2-envelope-insight-into-pulmonary-artery-hemodynamics-and-disease%C3%A2-severity
#17
Hiroko Takahama, Robert B McCully, Robert P Frantz, Garvan C Kane
OBJECTIVES: The purpose of this study was to characterize the profiles of right ventricular outflow tract (RVOT) Doppler flow velocity envelopes in patients with pulmonary arterial hypertension (PAH) and to establish whether changes in the RVOT flow profile related to patient outcome. BACKGROUND: The RVOT systolic flow profile is frequently abnormal, with findings of a mid-systolic flow deceleration and notching, previously proposed as an indicator of elevated pulmonary vascular resistance (PVR)...
April 7, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28412071/emergency-medicine-myths-cerebral-edema-in-pediatric-diabetic-ketoacidosis-and-intravenous-fluids
#18
Brit Long, Alex Koyfman
BACKGROUND: Pediatric diabetic ketoacidosis (DKA) is a disease associated with several complications that can be severe. One complication includes cerebral edema (CE), and patients may experience significant morbidity with this disease. OBJECTIVE: This review evaluates the myths concerning CE in pediatric DKA including mechanism, presentation of edema, clinical assessment of dehydration, and association with intravenous (i.v.) fluids. DISCUSSION: Multiple complications may occur in pediatric DKA...
April 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28411716/pathophysiology-of-varicose-veins
#19
Benjamin N Jacobs, Elizabeth A Andraska, Andrea T Obi, Thomas W Wakefield
BACKGROUND: Varicose veins, a common problem with effects on quality of life, account for a significant cost burden on the health care system. Despite their prevalence, the pathophysiologic mechanism of varicose veins remains incompletely understood. The fundamental issue is whether venous hypertension and valvular incompetence precede and influence the development of vein wall changes or whether the reverse is true. METHODS: We have reviewed the English-language literature to provide the most current understanding of the hemodynamic and cellular and molecular processes that underlie the development of varicose veins...
May 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28411233/vasculopathy-in-the-setting-of-cardiorenal-syndrome-the-roles-of-protein-bound-uremic-toxins
#20
Jingbin Guo, Lu Lu, Yue Hua, Kevin Huang, Ian Wang, Li Huang, Qiang Fu, Aihua Chen, Paul Chan, Huimin Fan, Zhong-Min Liu, Bing Hui Wang
Chronic kidney disease (CKD) often leads to and accelerates the progression of cardiovascular disease (CVD), whilst CVD also causes kidney dysfunction. This bidirectional interaction leads to the development of a complex syndrome known as cardiorenal syndrome (CRS). CRS not only involves both the heart and the kidney, but also the vascular system through a vast array of contributing factors. In addition to hemodynamic, neuro-hormonal, mechanical and biochemical factors, the non-dialyzable protein-bound uremic toxins (PBUTs) are also key contributing factors that have been demonstrated through in vitro, in vivo and clinical observations...
April 14, 2017: American Journal of Physiology. Heart and Circulatory Physiology
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