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Arterial blood pressure therapy

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https://www.readbyqxmd.com/read/29148022/hemodialysis-versus-peritoneal-dialysis-an-observational-study-in-two-international-centers
#1
Renhua Lu, Carla Estremadoyro, Xiaohuan Chen, Mingli Zhu, Leonardo C Ribeiro, Yucheng Yan, Alessandra Brendolan, Wei Fang, Carlo Crepaldi, Zhaohui Ni, Leyi Gu, Claudio Ronco
INTRODUCTION: Given that it is difficult to randomize end-stage renal disease (ESRD) patients to either hemodialysis (HD) or peritoneal dialysis (PD), differences between these renal replacement therapy (RRT) modalities are of major interest and remain controversial. METHODS: All data on maintenance dialysis patients during 2009 to 2013 in the Renji Hospital in Shanghai, China and in the San Bortolo Hospital in Vicenza, Italy were selected. Patients who changed their therapy from HD to PD or PD to HD during this study were excluded...
November 8, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29143147/-esc-guidelines-2017-on-peripheral-arterial-diseases-summary-of-the-most-important-recommendations-and-innovations
#2
C Espinola-Klein
The current European Society of Cardiology (ESC) guidelines on peripheral arterial diseases include recommendations on diagnostics and treatment of atherosclerotic manifestations in peripheral arteries. Because of the high coincidence of atherosclerosis in different arterial territories, screening for other atherosclerotic lesions is necessary in patients with clinical symptoms in one vascular bed. Consistent treatment of cardiovascular risk factors is important in all patients with peripheral atherosclerosis...
November 15, 2017: Herz
https://www.readbyqxmd.com/read/29141928/reversible-brain-lesion-following-growth-hormone-replacement-therapy-in-an-adolescent
#3
Adamos Hadjipanayis, Elisavet Efstathiou, Leda Theophilou, George Chrousos
A 12.6-year-old girl presented with a 2-month history of headache, recurrent vomiting and 5 kg weight loss. She had been receiving recombinant human growth hormone (rhGH) replacement therapy at a dose of 0.035 mg/kg for the past 10 months, due to short stature. Investigations before initiating rhGH, including brain MRI, had been normal. Physical examination revealed a nystagmus and a mildly elevated arterial blood pressure. Brain MRI revealed a lesion in the posterior aspect of the medulla oblongata, adjacent to the foramen of Magendie...
November 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29136223/baroreceptors-in-the-carotid-and-hypertension-systematic-review-and-meta-analysis-of-the-effects-of-baroreflex-activation-therapy-on-blood-pressure
#4
Manuel Wallbach, Michael J Koziolek
Activation of baroreceptors in the carotid modulates the autonomic nervous system. Baroreflex activation therapy (BAT), which activates baroreceptors in the carotid, has become available in the treatment of resistant hypertension. Besides this, a carotid implant modulating baroreceptors as well as pharmacological modulation of carotid bodies were quite recently presented. This review will underscore currently available and promising approaches that activate baroreceptors in the carotid, and thereby contribute to beneficial effects in patients with arterial hypertension, and discusses potential organoprotective BAT effects beyond blood pressure (BP) reduction...
November 9, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29132572/secondary-gains-advances-in-neurotrauma-management
#5
REVIEW
Brit Long, Alex Koyfman
Neurotrauma is a leading cause of death and is associated with many secondary injuries. A balance of mean arterial pressure (MAP) and intracranial pressure (ICP) is required to ensure adequate cerebral blood flow and cerebral perfusion pressure. Evaluation and management in the emergency department entails initial stabilization and resuscitation while assessing neurologic status. ICP management follows a tiered approach. Intubation requires consideration of preoxygenation, head of bed elevation, first pass success, and adequate analgesia and sedation...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29131886/determinant-factors-for-arterial-hemodynamics-in-hypertension-theoretical-insights-from-a-computational-model-based-study
#6
Fuyou Liang, Debao Guan, Jordi Alastruey
Hypertension is a well-documented predictive factor for cardiovascular events. Clinical studies have extensively demonstrated the differential hemodynamic consequences of various anti-hypertensive drugs, but failed to clearly elucidate the underlying mechanisms due to the difficulty in performing a quantitative deterministic analysis based on clinical data that carry confounding information stemming from inter-patient differences and the nonlinearity of cardiovascular hemodynamics. In the present study, a multi-scale model of the cardiovascular system was developed to quantitatively investigate the relationships between hemodynamic variables and cardiovascular properties under hypertensive conditions, aiming to establish a theoretical basis for assisting in the interpretation of clinical observations or optimization of therapy...
November 13, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/29131289/negative-predictors-of-treatment-success-in-outpatient-therapy-of-arterial-hypertension-in-poland-results-of-the-control-nt-observational-registry
#7
Krzysztof J Filipiak, Mariusz Tomaniak, Anna E Płatek, Filip M Szymański, Andrzej Tykarski
BACKGROUND: Identification of factors interfering with adequate control of arterial hypertension in the course of antihypertensive therapy is necessary to plan the strategy or reducing the incidence of cardiovascular disorders and optimize clinical practice guidelines. There have only been limited reliable studies describing the current status of hypertension treatment. AIM: The study objective was to conduct a screening assessment of the rate of uncontrolled hypertension among hypertensive patients coming to a routine follow-up visit, and to characterize patients with inadequate control of arterial hypertension in the aspect of their cardiovascular risk profile and therapeutic strategies used...
November 13, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/29126662/levosimendan-in-patients-with-cardiogenic-shock-complicating-myocardial-infarction-a-meta-analysis
#8
M Fang, H Cao, Z Wang
PURPOSE: Cardiac shock is the leading cause of death in patients with acute myocardial infarction. The objective of this systematic review and meta-analysis was to evaluate whether levosimendan, compared to any type of control, is associated with improved clinical outcomes in patients with cardiogenic shock complicating myocardial infarction. MATERIALS AND METHODS: The PubMed, EMBASE, Cochrane Central Register, and China National Knowledge Information databases were searched for pertinent studies published up until 1 May 2016...
November 7, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/29117189/cardiac-cycle-synchronized-electrical-muscle-stimulator-for-lower-limb-training-with-the-potential-to-reduce-the-heart-s-pumping-workload
#9
Ken-Ichiro Sasaki, Hiroo Matsuse, Ryuji Akimoto, Shiro Kamiya, Toshio Moritani, Motoki Sasaki, Yuta Ishizaki, Masanori Ohtsuka, Takaharu Nakayoshi, Takafumi Ueno, Naoto Shiba, Yoshihiro Fukumoto
BACKGROUND: The lower limb muscle may play an important role in decreasing the heart's pumping workload. Aging and inactivity cause atrophy and weakness of the muscle, leading to a loss of the heart-assisting role. An electrical lower limb muscle stimulator can prevent atrophy and weakness more effectively than conventional resistance training; however, it has been reported to increase the heart's pumping workload in some situations. Therefore, more effective tools should be developed...
2017: PloS One
https://www.readbyqxmd.com/read/29112634/baroreflex-sensitivity-and-blood-pressure-variability-can-help-in-understanding-the-different-response-to-therapy-during-acute-phase-of-septic-shock
#10
Marta Carrara, Bernardo Bollen Pinto, Giuseppe Baselli, Karim Bendjelid, Manuela Ferrario
BACKGROUND: Mean values of hemodynamic variables are poorly effective in evaluating an actual recovery of the short-term autonomic mechanisms for blood pressure (BP) and heart rate (HR) regulation. The aim of this work is to analyze the responses to therapy in the early phase of septic shock in order to verify possible associations between BP recovery and BP autonomic control. METHODS: This is an ancillary study from the multicenter prospective observational trial Shockomics (NCT02141607)...
November 6, 2017: Shock
https://www.readbyqxmd.com/read/29109872/severe-decompression-illness-case-report-prehospital-recognition-and-regional-transport-considerations
#11
Julie Estrada, David Meurer, Kevin De Boer, Karl Huesgen
A 46-year-old male presented to our tertiary care emergency department (ED) with shortness of breath and chest pain following an uneventful four-hour SCUBA dive at 100 feet. His prehospital emergency medical services (EMS) assessment revealed transient hypotension and hypoxia. He later developed progressive skin mottling. Serology was significant for acute kidney injury, transaminitis, hemoconcentration, and hypoxia on an arterial blood gas. Computed tomography (CT) angiography demonstrated intravascular gas throughout the mesenteric and pulmonary arteries as well as the portal venous system...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29108815/non-invasive-blood-pressure-monitoring-in-the-critically-ill-time-to-abandon-the-intra-arterial-catheter
#12
REVIEW
Karim Lakhal, Stephan Ehrmann, Thierry Boulain
Although its reliability is often questioned, non-invasive blood pressure (NIBP) monitoring with an oscillometric arm cuff is widely used, even in shocked critically ill patients. When correctly implemented, modern arm NIBP devices actually can provide accurate and precise measurements of mean blood pressure as well as clinically meaningful information such as identification of hypo- and hypertensive patients and monitoring of response to therapy. Even in specific circumstances such as arrhythmia, hypotension, vasopressor infusion and possibly in obese patients, arm NIBP could be useful, contrary to widespread belief...
November 3, 2017: Chest
https://www.readbyqxmd.com/read/29102275/motorized-adaptive-compression-system-for-enhancing-venous-return-a-feasibility-study-on-healthy-individuals
#13
Mahan Rahimi, Andrew P Blaber, Carlo Menon
Notwithstanding the extensive use of conventional compression devices in managing venous disorders, these modalities have shortages that diminish their treatment efficacy and lessen patient adherence to therapy. The purpose of this study was to develop an improved compression system that eliminates the flaws of the existing devices. A motorized bandage was designed that takes advantage of continuous feedback from force-sensing resistors to apply reproducible, controlled pressure on the lower extremities. The performance of the device in enhancing venous return was explored in a pilot test on 11 healthy participants, wherein graded lower body negative pressure was employed as a surrogate of passive standing...
December 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/29095204/improvement-of-blood-brain-barrier-integrity-in-traumatic-brain-injury-and-hemorrhagic-shock-following-treatment-with-valproic-acid-and-fresh-frozen-plasma
#14
Vahagn C Nikolian, Simone E Dekker, Ted Bambakidis, Gerald A Higgins, Isabel S Dennahy, Patrick E Georgoff, Aaron M Williams, Anuska V Andjelkovic, Hasan B Alam
OBJECTIVE: Combined traumatic brain injury and hemorrhagic shock are highly lethal. Following injuries, the integrity of the blood-brain barrier can be impaired, contributing to secondary brain insults. The status of the blood-brain barrier represents a potential factor impacting long-term neurologic outcomes in combined injuries. Treatment strategies involving plasma-based resuscitation and valproic acid therapy have shown efficacy in this setting. We hypothesize that a component of this beneficial effect is related to blood-brain barrier preservation...
October 31, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29094913/secondary-hypertension-discovering-the-underlying-cause
#15
Lesley Charles, Jean Triscott, Bonnie Dobbs
Most patients with hypertension have no clear etiology and are classified as having primary hypertension. However, 5% to 10% of these patients may have secondary hypertension, which indicates an underlying and potentially reversible cause. The prevalence and potential etiologies of secondary hypertension vary by age. The most common causes in children are renal parenchymal disease and coarctation of the aorta. In adults 65 years and older, atherosclerotic renal artery stenosis, renal failure, and hypothyroidism are common causes...
October 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/29092917/the-ageing-heart-the-systemic-and-coronary-circulation
#16
REVIEW
Shane Nanayakkara, Thomas H Marwick, David M Kaye
Most cardiovascular disease (CVD) occurs in patients over the age of 60. However, most evidence-based current cardiovascular guidelines lack evidence in an older population, due to the under-representation of older patients in randomised trials. Blood pressure rises with age due to increasing arterial stiffness, and stricter control results in improved outcomes. Myocardial ischaemia is also more common with increasing age, due to a combination of coronary artery disease and myocardial changes. However, despite higher rates of adverse outcomes, older patients are offered guideline-based therapy less frequently...
November 1, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29081177/-outcome-determinants-in-cardiac-arrest-patients-secondary-to-acute-myocardial-infarction-receiving-extra-corporeal-membrane-oxygenation-combined-with-percutaneous-coronary-intervention-therapy
#17
H X Fu, J F Ma, M F Hu, Z N Zhao, Y Wang, L Miao
Objective: To investigate the clinical efficacy and outcome determinants in cardiac arrest patients secondary to acute myocardial infarction treated with extracorporeal membrane oxygenation (ECMO) and percutaneous coronary intervention (PCI). Methods: The clinical data of 27 patients hospitalized from January 2014 to March 2017 in 3 hospitals were retrospectively analyzed. The clinical data of the surviving group (12 cases) and the death group (15 cases) were compared and the outcome determinants were explored...
October 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29080925/the-role-of-sympatho-inhibition-in-combination-treatment-of-obesity-related-hypertension
#18
REVIEW
Revathy Carnagarin, Cynthia Gregory, Omar Azzam, Graham S Hillis, Carl Schultz, Gerald F Watts, Damon Bell, Vance Matthews, Markus P Schlaich
Obesity-related hypertension is commonly characterized by increased sympathetic nerve activity and is therefore acknowledged as a predominantly neurogenic form of hypertension. The sustained sympatho-excitation not only contributes to the rise in blood pressure but also elicits a vicious cycle which facilitates further weight gain and progression of associated co-morbidities. While weight loss and exercise remain at the forefront of therapy for obesity and obesity-related hypertension, the difficulties in achieving and maintaining long-term weight loss with lifestyle measures and the variable blood pressure response to weight loss often necessitate prescription of antihypertensive drug therapy...
October 28, 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/29079252/effect-of-an-intensified-multifactorial-intervention-on-cardiovascular-outcomes-and-mortality-in-type-2-diabetes-j-doit3-an-open-label-randomised-controlled-trial
#19
Kohjiro Ueki, Takayoshi Sasako, Yukiko Okazaki, Masayuki Kato, Sumie Okahata, Hisayuki Katsuyama, Mikiko Haraguchi, Ai Morita, Ken Ohashi, Kazuo Hara, Atsushi Morise, Kazuo Izumi, Naoki Ishizuka, Yasuo Ohashi, Mitsuhiko Noda, Takashi Kadowaki
BACKGROUND: Limited evidence suggests that multifactorial interventions for control of glucose, blood pressure, and lipids reduce macrovascular complications and mortality in patients with type 2 diabetes. However, safe and effective treatment targets for these risk factors have not been determined for such interventions. METHODS: In this multicentre, open-label, randomised, parallel-group trial, undertaken at 81 clinical sites in Japan, we randomly assigned (1:1) patients with type 2 diabetes aged 45-69 years with hypertension, dyslipidaemia, or both, and an HbA1c of 6·9% (52·0 mmol/mol) or higher, to receive conventional therapy for glucose, blood pressure, and lipid control (targets: HbA1c <6·9% [52·0 mmol/mol], blood pressure <130/80 mm Hg, LDL cholesterol <120 mg/dL [or 100 mg/dL in patients with a history of coronary artery disease]) or intensive therapy (HbA1c <6·2% [44·3 mmol/mol], blood pressure <120/75 mm Hg, LDL cholesterol <80 mg/dL [or 70 mg/dL in patients with a history of coronary artery disease])...
October 24, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29071755/effect-of-aromatherapy-massage-on-anxiety-depression-and-physiologic-parameters-in-older-patients-with-the-acute-coronary-syndrome-a-randomized-clinical-trial
#20
Tahereh Bahrami, Nahid Rejeh, Majideh Heravi-Karimooi, Mojtaba Vaismoradi, Seyed Davood Tadrisi, Christina Sieloff
PURPOSE: This study aimed to investigate the effect of aromatherapy massage on anxiety, depression, and physiologic parameters in older patients with acute coronary syndrome. METHODS: This randomized controlled trial was conducted on 90 older women with acute coronary syndrome. The participants were randomly assigned into the intervention and control groups (n = 45). The intervention group received reflexology with lavender essential oil, but the control group only received routine care...
October 25, 2017: International Journal of Nursing Practice
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