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https://www.readbyqxmd.com/read/28822963/%C3%AE-1a-subtype-adrenergic-agonist-therapy-for-failing-right-ventricle
#1
Patrick M Cowley, Guan-Ying Wang, Sunil K Joshi, Philip M Swigart, David H Lovett, Paul C Simpson, Anthony J Baker
Failure of the right ventricle (RV) is a serious disease with a poor prognosis and limited treatment options. Signaling by α1-adrenergic receptors (α1-ARs), in particular the α1A-subtype, mediate cardioprotective effects in multiple heart failure models. Recent studies show that chronic treatment with the α1A-subtype agonist A61603 improves function and survival in a model of LV failure. The goal of this study was to determine if chronic A61603 treatment is beneficial in a RV failure model. We used tracheal instillation of the fibrogenic antibiotic bleomycin in mice to induce pulmonary fibrosis, pulmonary hypertension, and RV failure within 2 wk...
August 19, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28822254/a-systematic-review-of-hypertension-outcomes-and-treatment-strategies-in-older-adults
#2
REVIEW
Julienne K Kirk, Julie Allsbrook, Maggie Hansell, Emily M Mann
OBJECTIVE: To evaluate the literature regarding blood pressure control and management in older adult patient population over 70 years of age. METHODS: A literature search was conducted using PubMed and capturing the data from 2006 to 2016. Terms used included MeSH headings for hypertension/therapy and antihypertension agents. A systematic review of published studies was performed. Articles including older patients (average age 70 years or older) being treated for hypertension were included...
July 25, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28821888/risk-factors-for-epistaxis-in-patients-followed-in-general-practices-in-germany
#3
D U Seidel, L Jacob, K Kostev, A M Sesterhenn
<p>BACKGROUND: The goal of the present study was to analyze the risk factors for epistaxis in patients followed in general practices in Germany.</p> <p>METHODS: The current study sample included patients aged 18 years or older who received a first epistaxis diagnosis between January 2012 and December 2016 (index date). Epistaxis patients and controls without epistaxis were matched (1:1) on the basis of age, gender, insurance status and physician. </p> <p>RESULTS: A total of 16,801 patients with epistaxis and 16,801 control subjects were included in this study...
August 19, 2017: Rhinology
https://www.readbyqxmd.com/read/28821777/decompressive-craniectomy-in-the-management-of-intracranial-hypertension-after-traumatic-brain-injury-a-systematic-review-and-meta-analysis
#4
Danfeng Zhang, Qiang Xue, Jigang Chen, Yan Dong, Lijun Hou, Ying Jiang, Junyu Wang
We aim to perform a systematic review and meta-analysis to examine the prognostic value of decompressive craniectomy (DC) in patients with traumatic intracranial hypertension. PubMed, EMBASE, Cochrane Controlled Trials Register, Web of Science, http://clinicaltrials.gov/ were searched for eligible studies. Ten studies were included in the systematic review, with four randomized controlled trials involved in the meta-analysis, where compared with medical therapies, DC could significantly reduce mortality rate [risk ratio (RR), 0...
August 18, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28821388/a-case-control-analysis-investigating-risk-factors-and-outcomes-for-nephrocalcinosis-and-renal-calculi-in-neonates
#5
Melissa Huynh, Roderick Clark, Jenny Li, Guido Filler, Sumit Dave
INTRODUCTION: Studies on outcomes and risk factors for neonatal nephrocalcinosis (NC) and renal calculi (RC) are limited, and often do not include controls for comparison. We conducted a case-control analysis to identify risk factors associated with NC and/or RC in neonates and studied the natural course of these anomalies. STUDY DESIGN: Infants diagnosed with NC/RC on ultrasound within the first year of life and corresponding gestational age- and gender-matched controls were identified from the neonatal intensive care unit database at our institution over a 10-year period...
July 27, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28820870/controversies-in-the-identification-and-management-of-acute-pulmonary-hypertension-in-preterm-neonates
#6
REVIEW
Regan E Giesinger, Kiran More, Jodie Odame, Amish Jain, Robert P Jankov, Patrick J McNamara
It is increasingly recognized that the abnormal physiologic consequences of pulmonary hypertension (PH) may contribute to poor cardiopulmonary health in premature babies. Conflicting literature has led to clinical uncertainty, pathological misinterpretation and variability in treatment approaches among practitioners. There are several disorders with overlapping and interrelated presentations and other disorders with a similar clinical phenotype but diverse pathophysiological contributors. In this review, we provide a diagnostic approach for acute HRF in the preterm neonate, outline the pathophysiological conditions that may present as acute PH and discuss the implications of high pulmonary vascular resistance (PVR) on the cardiovascular system...
August 18, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28819824/-update-pulmonary-arterial-hypertension-definitions-diagnosis-therapy
#7
N Sommer, M J Richter, K Tello, F Grimminger, W Seeger, H A Ghofrani, H Gall
The term pulmonary arterial hypertension comprises a group of pulmonary vascular diseases of different etiologies that are characterized by similar precapillary vascular remodeling processes and result in exertional dyspnea and right heart insufficiency. The specific pharmacological treatment approach considers the risk of mortality and phenotypical properties and includes treatment with phosphodiesterase type 5 inhibitors, endothelin receptor antagonists and prostanoids, as well as with more novel substances, such as a soluble guanylyl cyclase stimulator and an oral prostacyclin receptor agonist...
August 17, 2017: Der Internist
https://www.readbyqxmd.com/read/28819362/recurrent-csf-rhinorrhea-misdiagnosed-as-chronic-allergic-rhinitis-with-subsequent-development-of-bacterial-meningitis
#8
Michael T Ulrich, Lawrence K Loo, Michael B Ing
INTRODUCTION: Cerebrospinal fluid (CSF) rhinorrhea results from an abnormal communication of the dura mater to the nasal mucosa. The majority of cases of CSF rhinorrhea are the result of trauma or surgery involving the skull base. Spontaneous CSF rhinorrhea is a rare clinical entity with increased risk of ascending infection. Delay in diagnosis places the patient at risk of developing meningitis. CASE PRESENTATION: A 36-year-old African American female with significant medical history of obesity and hypertension presented to the emergency department with headache, altered level of consciousness, fever, and neck stiffness...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28818881/selexipag-for-the-treatment-of-connective-tissue-disease-associated-pulmonary-arterial-hypertension
#9
Sean Gaine, Kelly Chin, Gerry Coghlan, Richard Channick, Lilla Di Scala, Nazzareno Galiè, Hossein-Ardeschir Ghofrani, Irene M Lang, Vallerie McLaughlin, Ralph Preiss, Lewis J Rubin, Gérald Simonneau, Olivier Sitbon, Victor F Tapson, Marius M Hoeper
Patients with connective tissue disease-associated pulmonary arterial hypertension (PAH-CTD) have a poor prognosis compared with other aetiologies. The underlying CTD can influence treatment response and outcomes. We characterised the GRIPHON study PAH-CTD subgroup and evaluated response to selexipag.Of 334 patients with PAH-CTD, PAH was associated with systemic sclerosis (PAH-SSc) in 170, systemic lupus erythematosus (PAH-SLE) in 82 and mixed CTD/CTD-other in 82. For the primary composite endpoint of morbidity/mortality, hazard ratios (HR) and 95% CI were calculated using Cox proportional hazard models...
August 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28818746/patients-with-atrial-fibrillation-and-coronary-artery-disease-double-trouble
#10
REVIEW
Ewelina Michniewicz, Elżbieta Mlodawska, Paulina Lopatowska, Anna Tomaszuk-Kazberuk, Jolanta Malyszko
Coronary artery disease (CAD) is the most common cardiovascular disease while atrial fibrillation (AF) is the most common cardiac arrhythmia. Both diseases share associated risk factors - hypertension, diabetes mellitus, sleep apnea, obesity and smoking. Moreover, inflammation plays a causative role in both diseases. The prevalence of CAD in patients with AF is from 17% to 46.5% while the prevalence of AF among patients with CAD is low and it is estimated from 0.2% to 5%. AF is a well-established factor of poor short- and long-term prognosis in patients with acute myocardial infarction (AMI) and is associated with a marked increase in overall mortality...
August 14, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28818254/medical-treatment-strategies-to-reduce-perioperative-morbidity-and-mortality-after-carotid-surgery
#11
A Ross Naylor
There is a paucity of high-quality evidence regarding what constitutes "optimal medical therapy" for the purposes of reducing morbidity/mortality after carotid endarterectomy (CEA). All patients should be prescribed antiplatelet therapy. Low-dose aspirin (75 to 325 mg) should be continued throughout the perioperative period and there is no evidence that higher doses confer additional benefit. There is emerging evidence that early implementation of dual antiplatelet therapy in recently symptomatic patients (aspirin 75 mg plus clopidogrel 75 mg) can reduce recurrent cerebral events before CEA and that dual antiplatelet therapy will significantly reduce stroke due to early postoperative carotid thrombosis...
March 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28818233/transcatheter-embolization-of-persistent-embryonic-veins-in%C3%A2-venous-malformation-syndromes
#12
Naiem Nassiri, Dustin Crystal, Lauren A Huntress, Susan Murphy
Persistent embryonic veins represent a major source of venous hypertension and morbidity in venous malformation syndromes, such as Klippel-Trénaunay syndrome and congenital lipomatous overgrowth, vascular malformations, epidermal nevus, and skeletal deformities syndrome. Surgical stripping and phlebectomy are the most commonly reported alternatives to compression therapy for refractory cases. These techniques, although effective in those patients who meet the necessary anatomic criteria, can be associated with bleeding, wound-related complications, and recurrence...
September 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28817980/pathways-to-pulmonary-hypertension-in-sickle-cell-disease-the-search-for-prevention-and-early-intervention
#13
Natalie R Shilo, Claudia R Morris
Pulmonary hypertension (PH) develops in a significant number of patients with sickle cell disease (SCD), resulting in increased morbidity and mortality. This review focuses on PH pathophysiology, risk stratification, and new recommendations for screening and treatment for patients with SCD. Areas covered: An extensive PubMed literature search was performed. While the pathophysiology of PH in SCD is yet to be fully deciphered, it is known that the etiology is multifactorial; hemolysis, hypercoagulability, hypoxemia, ischemic-reperfusion injury, oxidative stress, and genetic susceptibility all contribute in varying degrees to endothelial dysfunction...
August 18, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28817706/hiv-infection-antiretroviral-therapy-and-measures-of-endothelial-function-inflammation-metabolism-and-oxidative-stress
#14
Andrew Dysangco, Ziyue Liu, James H Stein, Michael P Dubé, Samir K Gupta
BACKGROUND: HIV-infected patients have an increased risk of cardiovascular disease (CVD). Impaired endothelial function is an early risk factor for CVD in the general population. It is presumed that HIV infection is associated with impaired endothelial function, but results have been inconsistent. OBJECTIVES: Our objectives were to determine the relationships between HIV infection, virologic suppression with antiretroviral therapy (ART), in vivo measures of conduit artery and microvascular endothelial function, and circulating biomarkers of pathways associated with CVD...
2017: PloS One
https://www.readbyqxmd.com/read/28817465/new-insights-into-the-recognition-classification-and-management-of-systemic-sclerosis-associated-pulmonary-hypertension
#15
Christopher J Mullin, Stephen C Mathai
PURPOSE OF REVIEW: Pulmonary hypertension is a common complication of systemic sclerosis (SSc), and remains a leading cause of morbidity and mortality. We will review recent developments in the recognition, classification and treatment of pulmonary hypertension in SSc. RECENT FINDINGS: Advances in screening for pulmonary arterial hypertension (PAH) and use of exercise haemodynamics may help to identify pulmonary vascular disease earlier in SSc. Recent studies have led to changes in recommendations for adjunct therapy and selection of pulmonary vasodilators for the treatment of SSc-associated PAH...
August 16, 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/28817373/cabozantinib-as-salvage-therapy-for-patients-with-tyrosine-kinase-inhibitor-refractory-differentiated-thyroid-cancer-results-of-a-multicenter-phase-ii-international-thyroid-oncology-group-trial
#16
Maria E Cabanillas, Jonas A de Souza, Susan Geyer, Lori J Wirth, Michael E Menefee, Stephen V Liu, Komal Shah, John Wright, Manisha H Shah
Purpose Sorafenib and lenvatinib are oral multikinase inhibitors targeting vascular endothelial growth factor receptor (VEGFR) and approved for radioiodine (RAI)-refractory differentiated thyroid cancer (DTC). However, there are no approved second- or third-line therapies. MET is implicated in resistance to VEGFR inhibitors. Cabozantinib is an oral multikinase inhibitor targeting MET in addition to VEGFR and is approved for medullary thyroid cancer. In a phase I study of cabozantinib, five of eight patients with DTC previously treated with a VEGFR-targeted therapy had an objective response to cabozantinib...
August 17, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28816536/optimizing-lenvatinib-therapy-in-patients-with-metastatic-radioactive-iodine-resistant-differentiated-thyroid-cancers
#17
Sina Jasim, Nicole M Iniguez-Ariza, Crystal R Hilger, Ashish V Chintakuntlawar, Mabel M Ryder, John C Morris, Keith C Bible
BACKGROUND AND OBJECTIVES: Lenvatinib is approved for use in advanced radioactive iodine resistant differentiated thyroid cancers (RAIR-DTCs); its efficacy is indisputable, but toxicities are great, creating daunting challenges for patients and providers. Few data regarding early adverse events and impact on quality of life (QOL) exist; we sought to add clarity to these issues by analyzing our initial post-approval lenvatinib experience. METHODS: Standardized patient education was implemented, providing detailed instructions and expert provider contacts to facilitate timely reporting of toxicities and guide responsive actions...
August 17, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28814664/pulmonary-arterial-hypertension-treatment-with-carvedilol-for-heart-failure-a-randomized-controlled-trial
#18
Samar Farha, Didem Saygin, Margaret M Park, Hoi I Cheong, Kewal Asosingh, Suzy Aa Comhair, Olivia R Stephens, Emir C Roach, Jacqueline Sharp, Kristin B Highland, Frank P DiFilippo, Donald R Neumann, W H Wilson Tang, Serpil C Erzurum
BACKGROUND: Right-sided heart failure is the leading cause of death in pulmonary arterial hypertension (PAH). Similar to left heart failure, sympathetic overactivation and β-adrenoreceptor (βAR) abnormalities are found in PAH. Based on successful therapy of left heart failure with β-blockade, the safety and benefits of the nonselective β-blocker/vasodilator carvedilol were evaluated in PAH. METHODS: PAH Treatment with Carvedilol for Heart Failure (PAHTCH) is a single-center, double-blind, randomized, controlled trial...
August 17, 2017: JCI Insight
https://www.readbyqxmd.com/read/28814374/from-bench-laboratory-to-bed-hospital-home-how-to-explore-effective-natural-and-synthetic-pak1-blockers-longevity-promoters-for-cancer-therapy
#19
REVIEW
Hiroshi Maruta, Mok-Ryeon Ahn
PAK family kinases are RAC/CDC42-activated kinases that were first found in a soil amoeba 4 decades ago, and 2 decades later, were discovered in mammals as well. Since then at least 6 members of this family have been identified in mammals. One of them called PAK1 has been best studied so far, mainly because it is essential not only for malignant cell growth and metastasis, but also for many other diseases/disorders such as diabetes (type 2), AD (Alzheimer's disease), hypertension, and a variety of inflammatory or infectious diseases, which definitely shorten our lifespan...
August 9, 2017: European Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/28814329/severe-persistent-pulmonary-hypertension-of-the-newborn-and-dysmorphic-features-in-neonate-with-a-deletion-involving-twist1-and-phf14-a-case-report
#20
Carina Schinagl, Guro Reinholt Melum, Olaug Kristin Rødningen, Kathrine Bjørgo, Jannicke Hanne Andresen
BACKGROUND: Persistent pulmonary hypertension is a well-known disease of the newborn that in most cases responds well to treatment with nitric oxide and treatment of any underlying causes. Genetic causes of persistent pulmonary hypertension of the newborn are rare. The TWIST1 gene is involved in morphogenetics, and deletions are known to cause Saethre-Chotzen syndrome. Deletions of PHF14 have never been reported in neonates, but animal studies have shown a link between severe defects in lung development and deletions of this gene...
August 17, 2017: Journal of Medical Case Reports
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