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https://www.readbyqxmd.com/read/29911017/free-floating-right-heart-thrombus-with-acute-massive-pulmonary-embolism-a-case-report-and-review-of-the-literature
#1
Fida Charif, Mohamad Jihad Mansour, Righab Hamdan, Claudette Najjar, Pierre Nassar, Mohamad Issa, Elie Chammas, Mohamad Saab
Free-floating right heart thrombus (RHT) is an extreme medical emergency in the context of acute massive pulmonary embolism (PE). Despite the advances in early diagnosis, the management is still very debatable due to lack of consensus. We reported the case of a 66-year-old male, with a history of moderate renal dysfunction and dilated cardiomyopathy, who presented to the emergency department for acute dyspnea. His angiographic magnetic resonance imaging revealed bilateral extensive PE. Transthoracic echocardiography showed RHT with moderate right ventricular dysfunction and pulmonary hypertension...
April 2018: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/29909960/etiology-and-treatment-outcomes-of-persistent-postoperative-inflammation-in-primary-resident-performed-cataract-surgeries-at-a-large-tertiary-care-public-hospital
#2
Saagar N Patel, Shazia F Ali, Cameron Clarke, Jonathan Kim, Michael Murri, Marie Tuft, Christina Y Weng, Zaina Al-Mohtaseb
PURPOSE: To determine the risk factors, intraoperative and postoperative complications, therapeutic interventions, and visual outcomes for persistent postoperative inflammation in primary resident-performed cataract surgeries. SETTING: Ben Taub General Hospital, Houston, Texas, USA. DESIGN: Retrospective case series. METHODS: Primary resident-performed cataract surgeries from January 2012 to June 2015 were analyzed for persistent postoperative inflammation, defined as persistent anterior chamber inflammatory reaction after a standard 1-month topical corticosteroid and nonsteroidal antiinflammatory drug (NSAID) drops taper...
June 14, 2018: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/29909741/long-term-follow-up-of-a-female-patient-with-non-classical-11%C3%AE-hydroxylase-deficiency-and-two-novel-mutations-in-cyp11b1
#3
Sabina Zacharieva, Ralitsa Robeva, Silvia Andonova, Radoslava Vazharova, Lubomir Balabanski, Maya Atanasoska, Draga Toncheva, Atanaska Elenkova, Alexey Savov
11β-Hydroxylase deficiency is the second most common enzyme disorder after 21-hydroxylase deficiency causing congenital adrenal hyperplasia (CAH11β ). In females, the clinical phenotype of CAH11β classic forms is associated with ambiguous genitalia, virilization and hypertension, while most common complaints in milder non-classic forms include hirsutism, acne, menstrual disturbances, and infertility. Herein, we present clinical and genetic characteristics of an adult woman with 11β-hydroxylase deficiency, hypertension and infertility; she has been followed up from her first pregnancy to her early menopause...
June 17, 2018: Gynecological Endocrinology
https://www.readbyqxmd.com/read/29909581/switch-maintenance-therapy-with-docetaxel-and-bevacizumab-after-induction-therapy-with-cisplatin-pemetrexed-and-bevacizumab-in-advanced-non-squamous-non-small-cell-lung-cancer-a-phase-ii-study
#4
Koji Nishimoto, Masato Karayama, Naoki Inui, Hideki Yasui, Hironao Hozumi, Yuzo Suzuki, Kazuki Furuhashi, Tomoyuki Fujisawa, Noriyuki Enomoto, Yutaro Nakamura, Nao Inami, Shun Matsuura, Yusuke Kaida, Takashi Matsui, Kazuhiro Asada, Hiroyuki Matsuda, Masato Fujii, Mikio Toyoshima, Shiro Imokawa, Takafumi Suda
Switch maintenance therapy, using alternative agents that were not administered during induction chemotherapy, is a treatment option for advanced non-squamous non-small cell lung cancer (NSCLC). Bevacizumab is known to increase the efficacy of other chemotherapeutic agents; however, switch maintenance therapy with docetaxel and bevacizumab has not been adequately studied. The goal of this study was to evaluate the efficacy and safety of switch maintenance therapy with docetaxel and bevacizumab following induction therapy with cisplatin, pemetrexed, and bevacizumab...
June 16, 2018: Medical Oncology
https://www.readbyqxmd.com/read/29909538/resistant-hypertension-time-to-consider-the-best-fifth-anti-hypertensive-treatment
#5
REVIEW
Andrea Pio-Abreu, Luciano F Drager
PURPOSE OF REVIEW: Resistant hypertension (RH) is a growing clinical condition worldwide associated with target-organ damage and poor prognosis compared to non-resistant counterparts. The purpose of this review is to perform a critical evaluation of preferable drug choices for managing RH highlighting the evidence that significant proportion of patients remained uncontrolled despite using four anti-hypertensive drugs. RECENT FINDINGS: Until recently, the fourth drug therapy was main derived from personal opinion or small interventional studies...
June 16, 2018: Current Hypertension Reports
https://www.readbyqxmd.com/read/29909475/stress-genes-and-hypertension-contribution-of-the-isiah-rat-strain-study
#6
REVIEW
Olga E Redina, Arcady L Markel
PURPOSE OF REVIEW: Acute psychoemotional stress is one of the causes of a sharp increase in blood pressure. However, the question if the stress may promote the hypertensive disease development is still open. This review aims, firstly, to show that the genetically determined enhanced responsiveness to stress is linked to sustained hypertension development and, secondly, to characterize the main physiological mechanisms and genetic factors implicated in the pathogenesis of stress-sensitive hypertension...
June 16, 2018: Current Hypertension Reports
https://www.readbyqxmd.com/read/29909105/rationale-and-design-of-the-strain-surveillance-of-chemotherapy-for-improving-cardiovascular-outcomes-succour-trial
#7
Tomoko Negishi, Paaladinesh Thavendiranathan, Kazuaki Negishi, Thomas H Marwick
OBJECTIVES: This study sought to evaluate the hypothesis that global longitudinal strain (GLS) guidance of cardioprotective therapy would improve cardiac function of at-risk patients undergoing potentially cardiotoxic chemotherapy, compared with usual care. BACKGROUND: The conventional criteria for diagnosis of chemotherapy-related cardiac dysfunction (CTRCD) are dependent on the recognition of heart failure symptoms and/or changes in left ventricular ejection fraction...
June 8, 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29907919/discontinuation-of-hormone-therapy-for-elderly-breast-cancer-patients-after-hypofractionated-whole-breast-radiotherapy
#8
Michela Dispinzieri, Eliana La Rocca, Elisabetta Meneghini, Alba Fiorentino, Laura Lozza, Serena Di Cosimo, Massimiliano Gennaro, Vito Cosentino, Milena Sant, Emanuele Pignoli, Riccardo Valdagni, Francesca Bonfantini, Maria Carmen De Santis
The purpose of the study was to examine adherence to hormone therapy (HT) in elderly breast cancer patients (≥ 65 years old) treated with hypofractionated radiotherapy. We analyzed data on 550 ER-positive breast cancer patients given hypofractionated whole-breast radiotherapy from June 2009 to September 2016. Baseline comorbidities considered in the hypertension-augmented Charlson Comorbidity Index (hCCI) were retrospectively retrieved. Total hCCI scores were classified as no comorbidity (hCCI = 0), low burden of comorbidity (hCCI = 1), and high burden of comorbidity (hCCI ≥ 2)...
June 16, 2018: Medical Oncology
https://www.readbyqxmd.com/read/29905927/multicenter-randomized-double-blind-phase-2-trial-of-folfiri-with-regorafenib-or-placebo-as-second-line-therapy-for-metastatic-colorectal-cancer
#9
Hanna K Sanoff, Richard M Goldberg, Anastasia Ivanova, Seamus O'Reilly, Samer S Kasbari, Richard D Kim, Ray McDermott, Dominic T Moore, William Zamboni, William Grogan, Allen Lee Cohn, Tanios S Bekaii-Saab, Gregory Leonard, Theresa Ryan, Olugbenga O Olowokure, Nishan H Fernando, John McCaffrey, Bassel F El-Rayes, Anne M Horgan, Gary Bradley Sherrill, George Hosni Yacoub, Bert H O'Neil
BACKGROUND: Regorafenib, a multikinase inhibitor that inhibits angiogenesis, growth, and proliferation, prolongs survival as monotherapy in patients with refractory colorectal cancer. This international, double-blind, placebo-controlled, multicenter trial assessed the efficacy of regorafenib with folinic acid, fluorouracil, and irinotecan (FOLFIRI) as a second-line treatment for metastatic colorectal cancer. METHODS: Patients with metastatic colorectal cancer who progressed on first-line oxaliplatin and fluoropyrimidine enrolled at 45 sites in the United States and Ireland...
June 15, 2018: Cancer
https://www.readbyqxmd.com/read/29905883/hypertonic-saline-or-mannitol-for-treating-elevated-intracranial-pressure-in-traumatic-brain-injury-a-meta-analysis-of-randomized-controlled-trials
#10
Jiajie Gu, Haoping Huang, Yuejun Huang, Haitao Sun, Hongwu Xu
Hyperosmolar therapy is regarded as the mainstay for treatment of elevated intracranial pressure (ICP) in traumatic brain injury (TBI). This still has been disputed as application of hypertonic saline (HS) or mannitol for treating patients with severe TBI. Thus, this meta-analysis was performed to further compare the advantages and disadvantages of mannitol with HS for treating elevated ICP after TBI. We conducted a systematic search on PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Wan Fang Data, VIP Data, SinoMed, and China National Knowledge Infrastructure (CNKI) databases...
June 15, 2018: Neurosurgical Review
https://www.readbyqxmd.com/read/29905796/heart-failure-with-preserved-ejection-fraction-from-mechanisms-to-therapies
#11
Carolyn S P Lam, Adriaan A Voors, Rudolf A de Boer, Scott D Solomon, Dirk J van Veldhuisen
This review aims to provide a translational perspective on recent developments in heart failure with preserved ejection fraction (HFpEF), linking mechanistic insights to potential therapies. A key concept in this review is that HFpEF is a haemodynamic condition wherein the heart fails to keep up with the circulatory demands of the body, or does so at the expense of raised left ventricular filling pressures. We, therefore, propose that the 'final common pathway' for development of congestion, i.e. basic haemodynamic mechanisms of increased left ventricular end-diastolic pressure, left atrial hypertension, pulmonary venous congestion, and plasma volume expansion, represents important initial targets for therapy in HFpEF...
June 13, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29905775/long-term-heart-transplant-outcomes-after-lowering-fixed-pulmonary-hypertension-using-left-ventricular-assist-devices
#12
Roxana Moayedifar, Andreas Zuckermann, Arezu Aliabadi-Zuckermann, Julia Riebandt, Philipp Angleitner, Kamen Dimitrov, Thomas Schloeglhofer, Angela Rajek, Guenther Laufer, Daniel Zimpfer
OBJECTIVES: Fixed pulmonary hypertension (fPH) is a contraindication for heart transplantation (HTX). Left ventricular assist device (LVAD) implantation as a bridge to candidacy can reverse fPH in patients with terminal heart failure by chronic left ventricular unloading. We report our institutional experience with terminal heart failure patients and fPH that were successfully bridged to candidacy and underwent subsequent HTX. METHODS: We retrospectively reviewed the data of 79 patients with terminal heart failure and fPH who were successfully bridged to candidacy for HTX with 6 different LVAD devices at our centre from October 1998 to September 2016 (Novacor n = 4, MicroMed DeBakey n = 29, DuraHeart n = 2, HeartMate II n = 14, HVAD n = 29 and MVAD n = 1)...
June 13, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29905555/goodpascher-s-syndrome-the-challenges-in-a-timely-diagnosis-and-treatment-in-medical-practice-clinical-case
#13
V Talash, T Bevzenko, T Yarmola, L Tkachenko, H Pustovoyt
The article presents a clinical case with intravital diagnosis of Goodpascher's syndrome in a 22 years old patient. In this work we analyze clinical, laboratory-instrumental, pathologoanatomic and pathomorphological aspects of the disease, which was accompanied by glomerulonephritis with rapidly progressive renal insufficiency, anemia, arterial hypertension and symptoms of lung injury. Article emphasizes on the necessity of timely diagnosis of Goodpascher's syndrome and following administration of immunosuppressive therapy...
May 2018: Georgian Medical News
https://www.readbyqxmd.com/read/29904380/antiphospholipid-syndrome-nephropathy-from-pathogenesis-to-treatment
#14
REVIEW
Maria G Tektonidou
Kidney damage is a well-recognized complication of the antiphospholipid syndrome (APS), either primary or systemic lupus erythematosus (SLE)-associated APS. Kidney involvement in APS involves a variety of manifestations, such as renal artery thrombosis or stenosis, renal vein thrombosis, allograft loss due to thrombosis after kidney transplantation, and injury to the renal microvasculature, also known as APS nephropathy. Biopsy in patients with APS nephropathy includes acute thrombotic microangiopathy lesions and chronic intrarenal vascular lesions such as interlobular fibrous intimal hyperplasia, arterial and arteriolar recanalizing thrombosis, fibrous arterial occlusion, and focal cortical atrophy...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29903786/comorbidities-and-the-use-of-comedications-in-people-living-with-hiv-on-antiretroviral-therapy-in-japan-a-cross-sectional-study-using-a-hospital-claims-database
#15
Daniel J Ruzicka, Kentaro Imai, Kenichi Takahashi, Toshio Naito
OBJECTIVES: To investigate the prevalence of chronic comorbidities and the use of comedications in people living with HIV (PLWH) and on antiretrovirals in Japan, by using a hospital claims database. DESIGN: Observational, retrospective, cross-sectional study. SETTING: A hospital claims database of Japanese hospitals that have advanced medical treatment capabilities (ie, advanced treatment hospitals, general hospitals, acute care hospitals), which include those providing acute and chronic care (excluding nursing homes or hospices)...
June 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29902367/a-retrospective-study-evaluating-the-tolerability-and-effectiveness-of-adjunctive-antihypertensive-drugs-in-patients-with-inadequate-response-to-initial-treatment
#16
Rajeev Ayyagari, Jipan Xie, David Cheng, Eric Q Wu, Xing-Yue Huang, Stephanie Chen
Real-world tolerability and effectiveness of nebivolol as first add-on therapy were compared with hydrochlorothiazide, metoprolol, and amlodipine. Medical records of hypertensive adults initiating nebivolol, hydrochlorothiazide, metoprolol, or amlodipine as first add-on therapy between December 16, 2010 and July 21, 2011 were retrospectively abstracted (N = 1600; 400/treatment). Outcomes included medication-related side-effect rates and blood pressure (BP) reduction and control. Compared with nebivolol, metoprolol and amlodipine had significantly higher side-effect rates (incidence rate ratio [95% CI]: 1...
June 2018: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29901810/on-x-mitral-valve-replacement-a-single-centre-experience-in-318-patients
#17
Giacomo Murana, Jacopo Alfonsi, Carlo Savini, Carlo Mariani, Giuditta Coppola, Valeria Lo Coco, Emanuele Pilato, Davide Pacini, Roberto Di Bartolomeo
OBJECTIVES: If mitral valve repair is not feasible, mitral valve replacement remains the only option. Based on our overall experience with the On-X mitral valve, the aim of this study was to investigate early and late outcomes after mitral valve replacement using this latest generation prosthesis. METHODS: From 1998 to 2016, 600 patients received an On-X prosthesis in the mitral position. Of them, we excluded all patients who had combined aortic procedures and retrospectively analysed 318 consecutive patients who had a mitral valve replacement...
June 12, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29901746/brain-mri-fiber-tracking-reveals-white-matter-alterations-in-hypertensive-patients-without-damage-at-conventional-neuroimaging
#18
Lorenzo Carnevale, Valentina D'Angelosante, Alessandro Landolfi, Giovanni Grillea, Giulio Selvetella, Marianna Storto, Giuseppe Lembo, Daniela Carnevale
Aims: Hypertension is one of the main risk factor for dementia. The subtle damage provoked by chronic high blood pressure in the brain is usually evidenced by conventional magnetic resonance imaging (MRI), in terms of white matter (WM) hyperintensities or cerebral atrophy. However, it is clear that by the time brain damage is visible, it may be too late hampering neurodegeneration. Aim of this study was to characterize a signature of early brain damage induced by hypertension, before the neurodegenerative injury manifests...
June 12, 2018: Cardiovascular Research
https://www.readbyqxmd.com/read/29901646/transient-ischemic-attack-characterized-by-external-strabismus-of-the-left-eye-a-case-report
#19
Xue Wang, Yang Yu, Wenxia Zhang, Hongmei Meng
RATIONALE: Patients rarely display eye movement dysfunctions as the primary symptom in transient ischemic attack. PATIENT CONCERNS: A 58-year-old patient with a history of hypertension and smoking presented with a 1-month history of paroxysmal exotropia of the left eye and double vision. No obvious abnormality was found in imaging examination and the patient ignored his symptoms. Eleven days later, the symptoms worsened and brain imaging provided an abnormal signal involving the left cerebellar hemisphere and the bilateral occipital lobe...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29901555/spectrum-of-pediatric-autoimmune-liver-disease-and-validation-of-its-diagnostic-scores-in-indian-children
#20
Vikrant Sood, Bikrant Bihari Lal, Dinesh Rawat, Rajeev Khanna, Archana Rastogi, Chhagan Bihari, Guresh Kumar, Seema Alam
OBJECTIVES: There is limitedliterature on the spectrum of pediatric autoimmune liver disease (AILD, encompassing both autoimmune hepatitis/AIH and autoimmune sclerosing cholangitis/ASC) in Asian populations and its diagnostic scores similarly require further validation. This work thus aimed to study the clinical characteristics, and to validate available diagnostic criteria in the local pediatric AILD cohort. METHODS: A review of all pediatric AILD cases, presenting over a 6 year (2011-2017) period was done, along with comparison of the available diagnostic scores: original (1999), simplified (2008) score and new proposed (2017) score...
June 12, 2018: Journal of Pediatric Gastroenterology and Nutrition
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