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https://www.readbyqxmd.com/read/27898549/hypertensive-crisis-during-norepinephrine-syringe-exchange
#1
Roland A Snijder, Johannes T A Knape, Toine C G Egberts, Annemoon M D E Timmerman
A 67-year critically ill patient suffered from a hypertensive crisis (200 mm Hg) because of a norepinephrine overdose. The overdose occurred when the clinician exchanged an almost-empty syringe and the syringe pump repeatedly reported an error. We hypothesized that an object between the plunger and the syringe driver may have caused the exertion of too much force on the syringe. Testing this hypothesis in vitro showed significant peak dosing errors (up to +572%) but moderate overdose (0.07 mL, +225%) if a clamp was used on the intravenous infusion line and a large overdose (0...
November 28, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27877063/copd-patients-medical-care-and-support-in-greece-during-financial-crisis
#2
George Mitonas, Alexia Juvana, Zoe Daniil, Chryssa Hatzoglou, Konstantinos Gourgoulianis
BACKGROUND: The need to follow a multidisciplinary strategy in chronic obstructive pulmonary disease (COPD) management and rehabilitation in community settings in Greece raises significant questions, given the severe austerity measures being imposed at present. The aim of this study was to investigate the clinical profile of patients with COPD along with the care provided in rural community settings in Greece. METHODS: Two primary health care centers and 200 newly diagnosed patients over a 12-month period were involved in the study...
2016: International Journal of General Medicine
https://www.readbyqxmd.com/read/27856296/tyramine-and-histamine-risk-assessment-related-to-consumption-of-dry-fermented-sausages-by-the-spanish-population
#3
M L Latorre-Moratalla, O Comas-Basté, S Bover-Cid, M C Vidal-Carou
Tyramine and histamine are the main dietary bioactive amines related to acute adverse health effects. Dry fermented sausages can easily accumulate high levels of these hazards and are frequently consumed in Spain. The present work aims to assess the exposure to tyramine and histamine from the consumption of dry fermented sausages by the Spanish population and to assess the risk to suffer acute health effects from this exposure. A probabilistic estimation of the exposure to these hazards was derived combining probability distributions of these amines in dry fermented sausages (n = 474) and their consumption by the Spanish population...
November 14, 2016: Food and Chemical Toxicology
https://www.readbyqxmd.com/read/27833402/short-term-outcomes-and-safety-of-computed-tomography-guided-percutaneous-microwave-ablation-of-solitary-adrenal-metastasis-from-lung-cancer-a-multi-center-retrospective-study
#4
Min Men, Xin Ye, Weijun Fan, Kaixian Zhang, Jingwang Bi, Xia Yang, Aimin Zheng, Guanghui Huang, Zhigang Wei
OBJECTIVE: To retrospectively evaluate the short-term outcomes and safety of computed tomography (CT)-guided percutaneous microwave ablation (MWA) of solitary adrenal metastasis from lung cancer. MATERIALS AND METHODS: From May 2010 to April 2014, 31 patients with unilateral adrenal metastasis from lung cancer who were treated with CT-guided percutaneous MWA were enrolled. This study was conducted with approval from local Institutional Review Board. Clinical outcomes and complications of MWA were assessed...
November 2016: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/27828782/pheochromocytoma-multisystem-crisis-triggered-by-glucocorticoid-administration-and-aggravated-by-citrate-dialysis
#5
Chuen Jye Yeoh, Shin Yi Ng, Brian K P Goh
Pheochromocytoma multisystem crisis is the most severe presentation of pheochromocytoma. We report on a 68-year-old survivor of pheochromocytoma multisystem crisis, whose clinical course was triggered inadvertently by a short innocuous course of oral dexamethasone to suppress inflammation and swelling after a left orbital floor fracture repair. He presented first with severe epigastric pain and headache, and subsequently experienced insults to neurological, cardiac, respiratory, hepatobiliary, renal, and immune system in his prolonged intensive care unit stay...
November 8, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27816151/management-of-hypertensive-crisis-for-the-obstetrician-gynecologist
#6
REVIEW
Jamil ElFarra, Cynthia Bean, James N Martin
Hypertensive disorders of pregnancy are among the leading preventable contributors of maternal and fetal adverse outcomes, including maternal and fetal death. Blood pressure increase has a strong association with unfavorable pregnancy outcomes, including stroke and pulmonary edema. A persistent blood pressure measurement greater than or equal to 160/110 mm Hg lasting for more than 15 minutes, during pregnancy or postpartum, is considered an obstetric emergency and requires rapid appropriate treatment. Following evidence-based guidelines, implementing institutional polices, and understanding the classification and pathophysiology of hypertensive disorders of pregnancy are essential and can significantly improve the rate of preventable complications...
December 2016: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/27795624/rifampicin-and-anti-hypertensive-drugs-in-chronic-kidney-disease-pharmacokinetic-interactions-and-their-clinical-impact
#7
A Agrawal, S K Agarwal, T Kaleekal, Y K Gupta
Patients on dialysis have an increased incidence of tuberculosis (TB). Rifampicin, a first-line antitubercular therapy (ATT) drug, is a potent inducer of hepatic cytochrome P450 (CYP). There is potential for pharmacokinetic interaction between rifampicin and anti-hypertensives that are CYP substrates: amlodipine and metoprolol. Therefore, hypertensive patients receiving rifampicin-based ATT are at risk for worsening of hypertension. However, this hypothesis has not yet been systematically studied. In this prospective study, hypertensive CKD 5D patients with TB were followed after rifampicin initiation...
September 2016: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/27793243/anesthesia-in-pregnant-women-with-hellp-syndrome-case-report
#8
Eduardo Barbin Zuccolotto, Eugenio Pagnussatt Neto, Glínia Cavalcante Nogueira, José Roberto Nociti
BACKGROUND AND OBJECTIVES: HELLP syndrome, characterized by hemolysis, high levels of liver enzyme, and low platelet count, is an advanced clinical stage of pre-eclampsia, progressing to high maternal (24%) and perinatal (up 40%) mortality, despite childbirth care in a timely manner. The goal is to describe the anesthetic management of a case with indication to emergency cesarean. CASE REPORT: Female patient, 36 years old, gestational age of 24 weeks, with hypertensive crisis (BP 180/100mmHg) and severe headache, was admitted to the operating room for a cesarean section after diagnosis of HELLP syndrome...
November 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27790151/the-impact-of-opium-consumption-on-blood-glucose-serum-lipids-and-blood-pressure-and-related-mechanisms
#9
REVIEW
Hamid Najafipour, Ahmad Beik
Aim: Substance abuse has become a universal crisis in our modern age. Among illegal substances, opium and its derivatives have been ranked second in terms of usage after cannabis in the world. In many Asian regions, the use of opium enjoys a high social acceptance; hence, some common people and even medical practitioners believe that opium lowers blood glucose and pressure and treat dyslipidemia. How much this belief is scientifically justified? Method: The results of available studies on both humans and animals searched in different search engines up to mid-2016 were integrated (78 articles)...
2016: Frontiers in Physiology
https://www.readbyqxmd.com/read/27777613/prevalence-care-seeking-and-health-service-utilization-for-non-communicable-diseases-among-syrian-refugees-and-host-communities-in-lebanon
#10
Shannon Doocy, Emily Lyles, Baptiste Hanquart, Michael Woodman
BACKGROUND: Given the large burden of non-communicable diseases (NCDs) among both Syrian refugees and the host communities within which they are settled, humanitarian actors and the government of Lebanon face immense challenges in addressing health needs. This study assessed health status, unmet needs, and utilization of health services among Syrian refugees and host communities in Lebanon. METHODS: A cross-sectional survey of Syrian refugees and host communities in Lebanon was conducted using a two-stage cluster survey design with probability proportional to size sampling...
2016: Conflict and Health
https://www.readbyqxmd.com/read/27777044/renin-angiotensin-aldosterone-system-inhibitors-in-hypertension-is-there-evidence-for-benefit-independent-of-blood-pressure-reduction
#11
Chirag Bavishi, Sripal Bangalore, Franz H Messerli
The renin-angiotensin-aldosterone system (RAAS) plays a pivotal role in the pathogenesis of hypertension (HTN). Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) are first line anti-HTN drug classes that are potent, effective and largely safe. Direct renin inhibitors (DRIs) have shown similar blood pressure (BP) reduction but more side effects. The efficacy of ACEIs and ARBs (for cardiovascular, cerebrovascular and renal protection) has been promoted to extend beyond what could be explained by BP reduction alone...
October 21, 2016: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/27754180/ed-08-4-diagnosis-and-treatment-of-hypertensive-emergency-in-children
#12
Lin Shi
According to the seventh report of Joint National Committee (JNC 7), hypertensive emergency (HE), a kind of hypertensive crisis, is defined as a sudden and abrupt elevation in blood pressure so as to cause acute target organ dysfunctions, including central nervous system, cardiovascular system or kidneys. Patients with HE require immediate reduction in markedly elevated blood pressure. Currently, there are no international guidelines for children HE, so the JNC definition is commonly used. Hypertensive emergency in children is rare but a life-threatening emergency...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754160/pl-03-1-hypertension-management-in-the-era-of-digital-information-and-communication-technologies
#13
Steven Steinhubl
Despite having the basic tools necessary to appropriately identify and manage individuals with hypertension for over half a century it remains the single greatest contributing risk factor to morbidity and mortality worldwide today. Since diagnosis and effective treatment availability are not issues, this major failing in care can be attributed to inadequate systems of care: systems that have led to only <20% of hypertensive individuals globally having their blood pressure adequately controlled. Even in the US, where it is one of the most common reasons for a primary care visit, and with over $42...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27749244/uk-scleroderma-study-group-ukssg-guidelines-on-the-diagnosis-and-management-of-scleroderma-renal-crisis
#14
Bernadette M Lynch, Edward P Stern, Voon Ong, Mark Harber, Aine Burns, Christopher P Denton
The UK Scleroderma Study Group developed guidelines on the diagnosis and management of scleroderma renal crisis (SRC) based on best available evidence and clinical experience. SRC is characterised by the acute onset of severe hypertension and acute kidney injury. Current strategies to reduce the associated morbidity and mortality include identifying at risk patients to aid early diagnosis. ACE inhibitor therapy should be lifelong in all patients, regardless of whether they require renal replacement therapy...
September 2016: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/27747725/high-dose-verapamil-in-episodic-and-chronic-cluster-headaches-and-cardiac-adverse-events-is-it-as-safe-as-we-think
#15
Joachim Alexandre, Xavier Humbert, Marion Sassier, Paul Milliez, Antoine Coquerel, Sophie Fedrizzi
Cluster headache (CH) is a primary headache disorder with relatively effective treatments. Although few sufficiently controlled trials are available, verapamil is recommended as the first-line prophylactic drug for CH by the French Headache Society (with a low level of evidence, level B) and by the EFNS (European Federation of Neurological Societies, level A). Daily doses of more than 480 mg (and up to 1200 mg daily) are frequently used off-label, while 360 mg daily is the only dosage to have demonstrated its effectiveness in a double-blind trial against placebo, and the usual label posology used by cardiologists is 240 mg daily in hypertension...
December 2015: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/27729064/histopathological-analysis-of-spontaneous-large-necrosis-of-adrenal-pheochromocytoma-manifested-as-acute-attacks-of-alternating-hypertension-and-hypotension-a-case-report
#16
Nobumasa Ohara, Yasuyuki Uemura, Naomi Mezaki, Keita Kimura, Masanori Kaneko, Hirohiko Kuwano, Katsuya Ebe, Toshio Fujita, Takeshi Komeyama, Hiroyuki Usuda, Yuto Yamazaki, Takashi Maekawa, Hironobu Sasano, Kenzo Kaneko, Kyuzi Kamoi
BACKGROUND: Pheochromocytomas are rare catecholamine-producing neuroendocrine tumors. Hypertension secondary to pheochromocytoma is often paroxysmal, and patients occasionally present with sudden attacks of alternating hypertension and hypotension. Spontaneous, extensive necrosis within the tumor that is associated with catecholamine crisis is an infrequent complication of adrenal pheochromocytoma, but its pathogenesis remains unclear. CASE PRESENTATION: A 69-year-old Japanese man developed acute-onset episodic headaches, palpitations, and chest pains...
October 12, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27708487/the-use-of-continuous-electrocardiographic-holter-monitoring-in-pediatric-cardiology
#17
Zijo Begic, Edin Begic, Senka Mesihovic-Dinarevic, Izet Masic, Senad Pesto, Mirza Halimic, Almira Kadic, Amra Dobraca
OBJECTIVE: To show the place and role of continuous electrocardiographic twenty-four-hour ECG monitoring in daily clinical practice of pediatric cardiologists. METHODS: According to protocol, 2753 patients underwent dynamic continuous ECG Holter monitoring (data collected from the "Register of ECG Holter monitoring" of Pediatric Clinic, UCC Sarajevo in period April 2003- April 2015). RESULTS: There were 50,5% boys and 49,5% girls, aged from birth to 19 years (1,63% - neonates and infants, 2,6% - toddlers, 9,95% - preschool children, 35,5% - gradeschoolers and 50,3% children in puberty and adolescence)...
July 16, 2016: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/27692921/-patient-with-homozygous-sickle-cell-disease-and-free-flap-surgery-ensuring-the-success-of-the-procedure
#18
S Deneuve, L Maire, V Bachelot, M-A Dammacco, P Zrounba, E Delay
Sickle cell anaemia is rare in France but frequent in Africa, leading to rigid, sickle-like shape red blood cells which bind together blocking microcirculation under certain circumstances. The vaso-occlusive crisis is the most frequent clinical manifestation especially in case of homozygous disease. Sickle cells disease is therefore usually considerated as a contraindication to microsurgery, however sometimes, a free flap procedure is mandatory. We here report the case of a 47-year-old man suffering with homozygous sickle cell anaemia and needing an antebrachial free flap procedure for a tongue reconstruction...
September 28, 2016: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/27651893/high-altitude-related-hypertensive-crisis-and-acute-kidney-injury-in-an-asymptomatic-healthy-individual
#19
Edward Gilbert-Kawai, Daniel Martin, Michael Grocott, Denny Levett
BACKGROUND: High-altitude exposure causes a mild to moderate rise in systolic and diastolic blood pressure. This case report describes the first documented case of a hypertensive crisis at altitude, as well as the first report of the occurrence of acute kidney injury in the context of altitude-related hypertension. CASE PRESENTATION: A healthy, previously normotensive 30-year old, embarked on a trek to Everest Base Camp (5300 m). During his 11-day ascent the subject developed increasingly worsening hypertension...
2016: Extreme Physiology & Medicine
https://www.readbyqxmd.com/read/27651807/formulation-and-in-vitro-evaluation-of-a-fast-disintegrating-sustained-dual-release-bucoadhesive-bilayer-tablet-of-captopril-for-treatment-of-hypertension-crises
#20
Sahar Abbasi, Gholamhossein Yousefi, Ali Asghar Ansari, Soliman Mohammadi-Samani
Hypertension crisis is one of the main health problems and its effective treatment is of high importance. For this purpose, fast-disintegrating and sustained release formulations of captopril, as a drug of choice, were prepared using conventional mucoadhesive polymers hydroxypropyl methylcellulose (HPMC), sodium carboxymethyl cellulose (Na-CMC), hydroxypropyl cellulose (HPC), Carbopol 934 (CP934) and sodium alginate (Na-alg). The optimum sustained release formulations were selected based on mean dissolution time (MDT)...
July 2016: Research in Pharmaceutical Sciences
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