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https://www.readbyqxmd.com/read/28432600/potentially-inappropriate-antihypertensive-prescriptions-to-elderly-patients-results-of-a-prospective-observational-study
#1
Paola H Ponte Márquez, Olga H Torres, Anonio San-José, Xavier Vidal, Antonia Agustí, Francesc Formiga, Alfonso López-Soto, Nieves Ramírez-Duque, Antonio Fernández-Moyano, Juana Garcia-Moreno, Juan A Arroyo, Domingo Ruiz
INTRODUCTION: Previous studies of antihypertensive treatment of older patients have focused on blood pressure control, cardiovascular risk or adherence, whereas data on inappropriate antihypertensive prescriptions to older patients are scarce. OBJECTIVES: The aim of the study was to assess inappropriate antihypertensive prescriptions to older patients. METHODS: An observational, prospective multicentric study was conducted to assess potentially inappropriate prescription of antihypertensive drugs, in patients aged 75 years and older with arterial hypertension (HTN), in the month prior to hospital admission, using four instruments: Beers, Screening Tool of Older Person's Prescriptions (STOPP), Screening Tool to Alert Doctors to the Right Treatment (START) and Assessing Care of Vulnerable Elders 3 (ACOVE-3)...
April 21, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28431475/validation-of-the-essen-stroke-risk-score-in-different-subtypes-of-ischemic-stroke
#2
Yi Liu, Yongjun Wang, William A Li, Aoshuang Yan, Yilong Wang
OBJECTIVE: Predictive scores are important tools for stratifying patients based on their risk of future vascular events and for selecting preventive therapies. The aim of this study is to validate the Essen Stroke Risk Score (ESRS) for stratifying stroke recurrence in different subtypes of non-atrial fibrillation ischemic stroke in a large Chinese cohort. METHODS: Data were derived from the Blood pressure and clinical Outcome in Stroke Survivors registry, which includes a cohort of 2204 stroke patients...
April 21, 2017: Neurological Research
https://www.readbyqxmd.com/read/28424575/contribution-of-autonomic-reflexes-to-the-hyperadrenergic-state-in-heart-failure
#3
REVIEW
Edgar Toschi-Dias, Maria Urbana P B Rondon, Chiara Cogliati, Nazareno Paolocci, Eleonora Tobaldini, Nicola Montano
Heart failure (HF) is a complex syndrome representing the clinical endpoint of many cardiovascular diseases of different etiology. Given its prevalence, incidence and social impact, a better understanding of HF pathophysiology is paramount to implement more effective anti-HF therapies. Based on left ventricle (LV) performance, HF is currently classified as follows: (1) with reduced ejection fraction (HFrEF); (2) with mid-range EF (HFmrEF); and (3) with preserved EF (HFpEF). A central tenet of HFrEF pathophysiology is adrenergic hyperactivity, featuring increased sympathetic nerve discharge and a progressive loss of rhythmical sympathetic oscillations...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28422915/enteral-tranexamic-acid-attenuates-vasopressor-resistance-and-changes-in-%C3%AE-1-adrenergic-receptor-expression-in-hemorrhagic-shock
#4
Marco Santamaria, Federico Aletti, Joyce B Li, Aaron Tan, Monica Chang, Jessica Leon, Geert W Schmid-Schönbein, Erik B Kistler
BACKGROUND: Irreversible hemorrhagic shock is characterized by hyporesponsiveness to vasopressor and fluid therapy. Little is known, however, about the mechanisms that contribute to this phenomenon. Previous studies have shown that decreased intestinal perfusion in hemorrhagic shock leads to proteolytically-mediated increases in gut permeability, with subsequent egress of vasoactive substances systemically. Maintenance of blood pressure is achieved in part by α1 receptor modulation, which may be affected by vasoactive factors; we thus hypothesized that decreases in hemodynamic stability and vasopressor response in shock can be prevented by enteral protease inhibition...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28422842/the-role-of-renoscintigraphy-and-surgery-in-the-management-of-page-kidney-a-case-report
#5
Yu-Li Chiu, Chin Hu, Sin-Di Lee, Po-Yin Chen, Cheng-Pin Wang
RATIONALE: Page kidney is an uncommon condition that hypertension occurs secondary to microvascular ischemia and alternation of small-vessel hemodynamics due to external compression of renal parenchyma and activation of the renin-angiotensin-aldosterone system. There are no specific guidelines for the management of Page kidney in the literatures. PATIENT CONCERNS: A 17-year-old teenager who had Fontan procedure for tricuspid and pulmonary atresia in early childhood suffered from sudden onset of severe left flank pain during cardiac catheterization procedure...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28420565/analysis-of-prognostic-factors-for-acute-kidney-injury-with-continuous-renal-replacement-therapy-in-severely-burned-patients
#6
Jaechul Yoon, Youngmin Kim, Haejun Yim, Yong Suk Cho, Dohern Kym, Jun Hur, Wook Chun, Hyeong Tae Yang
BACKGROUND: Acute kidney injury (AKI) is a critical complications in severely burned patients associated with high morbidity and mortality. The purpose of this study was to investigate the impact of severity of AKI at the time of continuous renal replacement therapy (CRRT) start on patient outcome and to identify the prognostic factors in severely burned patients with CRRT application. METHODS: From January 2007 to June 2010, 84 burn patients with more than 40% of total body surface area (TBSA) burned who treated with continuous renal replacement therapy for acute kidney injury were analyzed retrospectively...
April 15, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28420471/-mixed-venous-arterial-carbon-dioxide-difference-combined-with-passive-leg-raising-in-guiding-volume-management-for-patients-post-off-pump-coronary-artery-bypass-grafting
#7
Likun Huo, Peijun Li, Chang Xie, Chenglei Yan, Jie Li
OBJECTIVE: To investigate whether mixed venous-arterial carbon dioxide difference (Pv-aCO2) combined with passive leg raising (PLR) could better guide volume management for patients post off-pump coronary artery bypass grafting (OPCABG). METHODS: Eighty patients experienced OPCABG, and admitted to Tianjin Chest Hospital from June 1st to October 1st in 2016 were enrolled. They were randomly divided into two groups: observation group given Pv-aCO2 combined with PLR directed therapy and control group given central venous pressure (CVP) directed therapy, 40 cases in each group...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28420463/-changes-of-small-intestinal-villi-microcirculation-in-sidestream-dark-field-imaging-with-different-target-blood-pressure-in-rabbits-during-endotoxin-shock
#8
Fei Gao, Xiaoyun Fu, Mingjiang Qian, Yu Zhang, Guangsu Li, Jie Hu
OBJECTIVE: Changes of small intestine villus microcirculation perfusion in sidestream dark-field (SDF) imaging in the rabbits during endotoxic shock after fluid resuscitation with different target mean arterial pressure (MAP), and evaluation of feasibility of monitoring small intestine villus microcirculation by SDF were studied. METHODS: Sixty standard New Zealand white rabbits were randomly divided into two groups: low target MAP group (group A, n = 30) and high target MAP group (group B, n = 30)...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28416296/hiv-infection-and-aortic-stiffness
#9
REVIEW
Luisa Helena Maia Leite, Ariel Cohen, Franck Boccara
People living with human immunodeficiency virus (HIV) infection and receiving antiretroviral therapy now have the same life expectancy as the general population. However, they have a higher risk of atherosclerotic cardiovascular events because of a complex and polyfactorial vasculopathy, combining the effects of antiretroviral therapy, the HIV virus itself, immune activation, chronic inflammation and metabolic disturbances. Whether people living with HIV infection experience increased vascular aging compared with the general population remains controversial...
April 14, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28409014/comparable-effect-of-aliskiren-or-a-diuretic-added-on-an-angiotensin-ii-receptor-blocker-on-augmentation-index-in-hypertension-a-multicentre-prospective-randomised-study
#10
Toru Miyoshi, Takashi Murakami, Satoru Sakuragi, Masayuki Doi, Seiji Nanba, Atsushi Mima, Youkou Tominaga, Takafumi Oka, Yutaka Kajikawa, Kazufumi Nakamura, Hiroshi Ito
BACKGROUND: The effects of antihypertensive drug combination therapy on central blood pressure (BP) and augmentation index (AI) have not been fully elucidated. We investigated the effects of the direct renin inhibitor, aliskiren, or a diuretic added to an angiotensin II receptor blocker on AI in patients with essential hypertension. METHODS: A 24-week, prospective, multicentre, randomised, open-label study enrolled 103 patients already treated with valsartan. Participants were randomly allocated to receive either valsartan with aliskiren (V+A), or valsartan with trichlormethiazide (V+T)...
2017: Open Heart
https://www.readbyqxmd.com/read/28408022/left-ventricular-assist-device-as-a-bridge%C3%A2-to-recovery-for-patients-with-advanced-heart-failure
#11
Djordje G Jakovljevic, Magdi H Yacoub, Stephan Schueler, Guy A MacGowan, Lazar Velicki, Petar M Seferovic, Sandeep Hothi, Bing-Hsiean Tzeng, David A Brodie, Emma Birks, Lip-Bun Tan
BACKGROUND: Left ventricular assist devices (LVADs) have been used as an effective therapeutic option in patients with advanced heart failure, either as a bridge to transplantation, as destination therapy, or in some patients, as a bridge to recovery. OBJECTIVES: This study evaluated whether patients undergoing an LVAD bridge-to-recovery protocol can achieve cardiac and physical functional capacities equivalent to those of healthy controls. METHODS: Fifty-eight male patients-18 implanted with a continuous-flow LVAD, 16 patients with LVAD explanted (recovered patients), and 24 heart transplant candidates (HTx)-and 97 healthy controls performed a maximal graded cardiopulmonary exercise test with continuous measurements of respiratory gas exchange and noninvasive (rebreathing) hemodynamic data...
April 18, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28405824/redo-renal-denervation-using-a%C3%A2-multi-electrode-radiofrequency-system-in-patients-with-persistent-therapy-resistant-hypertension
#12
J Daemen, L Feyz, L Van Zandvoort, N M Van Mieghem
OBJECTIVES: Renal sympathetic denervation has been studied as a potential therapeutic option for patients with therapy-resistant hypertension; however, a significant proportion of patients do not show a significant reduction in blood pressure and are classified as non-responders. The objective of the present study was to assess whether a redo renal denervation procedure increases response rates. METHODS: We present a case series of three consecutive renal denervation non-responders treated with the multi-electrode radiofrequency St...
April 12, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28400117/phosphatidylinositol-3-kinase-inhibition-induces-vasodilator-effect-of-sevoflurane-via-reduction-of-rho-kinase-activity
#13
Yasunori Miyamoto, Guo-Gang Feng, Shiho Satomi, Katsuya Tanaka, Yoshihiro Fujiwara, Hiroyuki Kinoshita
AIMS: This study was aimed to examine whether a volatile anesthetic sevoflurane in clinical doses reduces vasoconstriction under the inhibition of phosphatidylinositol 3-kinase (PI3K) in the rat and human arteries and whether the intravenous administration of the PI3K inhibitor decreases blood pressure in rats under the sevoflurane inhalation. MATERIALS AND METHODS: Rat arteries (n=5-6) and human omental arteries (n=5-6) were subjected to isometric force recordings and western immunoblotting for Rho kinase, mitogen-activated protein kinase, and protein kinase C...
April 8, 2017: Life Sciences
https://www.readbyqxmd.com/read/28395656/citrate-shows-protective-effects-on-cardiovascular-and-renal-function-in-ischemia-induced-acute-kidney-injury
#14
Anja Bienholz, Jonas Reis, Pinar Sanli, Herbert de Groot, Frank Petrat, Hana Guberina, Benjamin Wilde, Oliver Witzke, Fuat H Saner, Andreas Kribben, Joel M Weinberg, Thorsten Feldkamp
BACKGROUND: Ischemia and reperfusion (I/R) is one of the major causes of acute kidney injury (AKI). Citrate reduces hypoxia-induced mitochondrial energetic deficits in isolated proximal tubules. Moreover, citrate anticoagulation is now frequently used in renal replacement therapy. In the present study a rat model of I/R-induced AKI was utilized to examine renal protection by citrate in vivo. METHODS: AKI was induced by bilateral renal clamping (40 min) followed by reperfusion (3 h)...
April 10, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28383856/-dapagliflozin-forxiga%C3%A2-sglt-2-cotransporter-inhibitor-as-glucose-lowering-agent-in-type-2-diabetes
#15
REVIEW
A J Scheen
Dapagliflozin, a specific inhibitor of sodium-glu¬cose cotransporters type 2 (SGLT2, inhibits glucose reabsorp¬tion in renal tubules and thus promotes glucosuria. This effect results in a reduction in fasting and postprandial glycaemia and a decrease of glycated haemoglobin (HbA1c), with a minor risk of hypoglycaemia, a weight reduction and a reduction in arterial blood pressure. The efficacy of empagliflozin on HbA1c reduction increases according to the level of hyper¬glycaemia but decreases in patients with renal insufficiency...
October 2016: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28383324/cerebral-autoregulation-oriented-therapy-at-the-bedside-a-comprehensive-review
#16
Lucia Rivera-Lara, Andres Zorrilla-Vaca, Romergryko G Geocadin, Ryan J Healy, Wendy Ziai, Marek A Mirski
This comprehensive review summarizes the evidence regarding use of cerebral autoregulation-directed therapy at the bedside and provides an evaluation of its impact on optimizing cerebral perfusion and associated functional outcomes. Multiple studies in adults and several in children have shown the feasibility of individualizing mean arterial blood pressure and cerebral perfusion pressure goals by using cerebral autoregulation monitoring to calculate optimal levels. Nine of these studies examined the association between cerebral perfusion pressure or mean arterial blood pressure being above or below their optimal levels and functional outcomes...
April 6, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28381584/predicting-the-risk-of-bleeding-during-dual-antiplatelet-therapy-after-acute-coronary-syndromes
#17
Joakim Alfredsson, Benjamin Neely, Megan L Neely, Deepak L Bhatt, Shaun G Goodman, Pierluigi Tricoci, Kenneth W Mahaffey, Jan H Cornel, Harvey D White, Keith Aa Fox, Dorairaj Prabhakaran, Kenneth J Winters, Paul W Armstrong, E Magnus Ohman, Matthew T Roe
OBJECTIVES: Dual antiplatelet therapy (DAPT) with aspirin + a P2Y12 inhibitor is recommended for at least 12 months for patients with acute coronary syndrome (ACS), with shorter durations considered for patients with increased bleeding risk. However, there are no decision support tools available to predict an individual patient's bleeding risk during DAPT treatment in the post-ACS setting. METHODS: To develop a longitudinal bleeding risk prediction model, we analysed 9240 patients with unstable angina/non-ST segment elevation myocardial infarction (NSTEMI) from the Targeted Platelet Inhibition to Clarify the Optimal Strategy to Medically Manage Acute Coronary Syndromes (TRILOGY ACS) trial, who were managed without revascularisation and treated with DAPT for a median of 14...
April 5, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28377560/recent-advances-in-the-pathophysiology-of-arterial-hypertension-potential-implications-for-clinical-practice
#18
Dagmara Hering, Andrzej Trzebski, Krzysztof Narkiewicz
Hypertension remains a major and growing public health problem associated with the greatest global rate of cardiovascular morbidity and mortality. Although numerous factors contribute to poor control of blood pressure (BP) and to pseudoresistance (eg, unawareness, lifestyle habits, nonadherence to medication, insufficient treatment, drug‑induced hypertension, undiagnosed secondary causes), true resistant hypertension (RH) is reported in 10.1% of patients treated for elevated BP. While the mechanisms underlying RH remain complex and not entirely understood, sympathetic activation involved in the pathophysiology of hypertension, disease progression, and adverse complications is further augmented in patients with drug‑resistant hypertension...
March 1, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28374725/-the-spa-and-health-resort-based-treatment-of-the-women-of-various-employments-presenting-with-arterial-hypertension
#19
E L Apsheva, A A El'garov, M A Kalmykova, M A El'garov
AIM: The objective of the present study was to evaluate the effectiveness of balneotherapy for the women of various employments presenting with arterial hypertension. MATERIAL AND METHODS: The study included 57 women with stage I (n=29) and II (n=28) hypertension. One study group was comprised of 28 female motor drivers including taxi-drivers (n=12), personal car drivers (n=7), and trolleybus drivers (n=9) at the mean age of 46,2±6,9 years suffering from occupational emotional stress (OES) and systematic psychoemotional tension (PET)...
2017: Voprosy Kurortologii, Fizioterapii, i Lechebnoĭ Fizicheskoĭ Kultury
https://www.readbyqxmd.com/read/28374150/transplantation-of-bone-marrow-derived-mscs-improves-renal-function-and-na-k-atpase-activity-in-rats-with-renovascular-hypertension
#20
Rafaelle Lira, Mariana Oliveira, Marcela Martins, Caroline Silva, Simone Carvalho, Ana Carolina Stumbo, Erika Cortez, Karine Verdoorn, Marcelo Einicker-Lamas, Alessandra Thole, Laís de Carvalho
Renovascular hypertension (RVH) is a progressive disease, leading to chronic kidney disease when untreated and no specific treatment is available. Therefore, development of new therapeutic modalities is imperative. RVH is triggered by renal artery stenosis and subsequent renin-angiotensin-aldosterone system activation; it can be experimentally induced by the 2 Kidneys-1 Clip (2K1C) model. This study investigates the therapeutic potential of renal subcapsular mesenchymal stem cell (MSC) infusion in 2K1C rats...
April 3, 2017: Cell and Tissue Research
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