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Refractory hypertension

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https://www.readbyqxmd.com/read/29682125/two-cases-of-micro-arteriovenous-fistula-in-the-lower-extremity-with-misdiagnosis-of-refractory-cellulitis
#1
Miyako Tanaka, Fukashi Serizawa, Yohei Nagaoka, Takuya Jimbo, Kazuki Kawashima, Takeshi Asakura, Hiroshi Otomo, Kenichi Yokota
We report our experience of two cases of refractory cellulitis caused by peripheral micro-arteriovenous fistulas (AVFs) in the lower extremity. The micro-AVFs were so small that they could not be located accurately; further, the patients' symptoms differed markedly from those previously reported for AVF. AVF is known to cause ischemic symptoms. In contrast, micro-AVF causes congestive symptoms and remains undetected in the majority of patients. Identification of this pathology is crucial to enable effective treatment by the ligation of the incompetent perforator vein that increases venous hypertension, leading to congestive symptoms...
March 25, 2018: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29682027/decompressive-craniectomy-in-diffuse-traumatic-brain-injury-an-industrial-hospital-study
#2
Niraj Kumar Choudhary, Rinku Bhargava
Context: High intracranial pressure is the most frequent cause of mortality and disability after severe traumatic brain injury (TBI) which is treated by first-line therapeutic measures. When these measures fail, second-line therapies are started. Among second-line therapies, decompressive craniectomy (DC) has been used. It improves the functional outcome in these patients. Aim: This study aims to analyze the clinicoradiological factors associated with the prognosis of severe TBI in patients undergoing DC...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29674606/hirschsprung-s-disease-related-giant-sigmoid-volvulus-complicated-by-refractory-hypertension-in-an-elderly-man
#3
Shaohan Wu, Xiaofang Sun, Yawei Yu, Yiyu Shen
BACKGROUND Sigmoid volvulus (SV) is a life-threatening condition occasionally seen in adults. Adult Hirschsprung's disease (HD)-related SV is rarely complicated by difficult-to-control hypertension. In this report we present the case of an elderly man with a rare constellation of HD, SV, and refractory hypertension. CASE REPORT An 82-year-old man had long-term constipation, moderate abdominal pain, and progressive abdominal distension. A CT scan revealed the typical "coffee bean sign". Blood pressure was abnormal high...
April 20, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29674401/licorice-induced-apparent-mineralocorticoid-excess-compounded-by-excessive-use-of-terbutaline-and-high-water-intake
#4
Laust Frisenberg Buhl, Frederik Nørregaard Pedersen, Marianne Skovsager Andersen, Dorte Glintborg
This case highlights the clinical course of a 54-year-old male patient presenting with hypertension and long-term refractory hypokalaemia. He reported long-term malaise, fatigue and physical discomfort. Diarrhoea, vomiting, over-the-counter drugs, dietary supplements and any kind of medical abuse were all denied. Physical examination was normal. Suppressed plasma renin activity along with a low aldosterone level and elevated urinary cortisone/cortisol metabolite excretion ratio raised the suspicion of apparent mineralocorticoid excess (AME)...
April 19, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29668568/transjugular-intrahepatic-portosystemic-shunt-insertion-for-the-management-of-portal-hypertension-in-children
#5
Lauren Johansen, Patrick McKiernan, Khalid Sharif, Simon McGuirk
OBJECTIVES: To describe our 20-year experience with transjugular intrahepatic portosystemic shunt (TIPSS) procedures for children with resistant portal hypertension (PHTN). METHODS: Retrospective review of all children that had a TIPSS performed at Birmingham Children's Hospital from 1 January 1995 - 1 January 2015. RESULTS: 40 children underwent 42 attempted TIPSS for resistant PHTN with recurrent variceal bleeding (n = 35), refractory ascites (n = 4), and hypersplenism (n = 1)...
April 17, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29666358/revisiting-atrioventricular-nodal-ablation-and-cardiac-pacing-of-atrial-fibrillation-in-a-patient-with-dextrocardia
#6
Munish Sharma, Ritesh Neupane, Koroush Khalighi
BACKGROUND Poorly controlled ventricular rate associated with atrial fibrillation (AF) leads to tachycardia-induced left ventricular dysfunction. Atrioventricular (AV) nodal ablation and cardiac pacing is the standard of care in refractory congestive heart failure (CHF) due to AF with moderate to rapid ventricular response that failed conventional medical therapy. If the patient is not a candidate for AF ablation with pulmonary vein isolation and elimination of AF foci, this is an effective approach, but it does have some challenges when done in a patient with dextrocardia and situs inversus...
April 18, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29663677/the-carotid-sinus-nerve-structure-function-and-clinical-implications
#7
Andrea Porzionato, Veronica Macchi, Carla Stecco, Raffaele De Caro
Interest has been renewed in the anatomy and physiology of the carotid sinus nerve (CSN) and its targets (carotid sinus and carotid body), due to recent proposals of surgical procedures for a series of common pathologies, such as carotid sinus syndrome, hypertension, heart failure and insulin resistance. The CSN originates from the glossopharyngeal nerve soon after its appearance from the jugular foramen. It shows frequent communications with the sympathetic trunk (usually at the level of the superior cervical ganglion) and the vagal nerve (main trunk, pharyngeal branches or superior laryngeal nerve)...
April 16, 2018: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
https://www.readbyqxmd.com/read/29662638/an-open-label-single-armed-exploratory-study-of-apatinib-a-novel-vegfr-2-tyrosine-kinase-inhibitor-in-patients-with-relapsed-or-refractory-non-hodgkin-lymphoma
#8
Ling Li, Sa Xiao, Lei Zhang, Xin Li, Xiaorui Fu, Xinhua Wang, Jingjing Wu, Zhenchang Sun, Xudong Zhang, Yu Chang, Feifei Nan, Jiaqin Yan, Zhaoming Li, Mengyuan Shi, Ken H Young, Mingzhi Zhang
Background: Apatinib, a novel small molecule vascular endothelial growth factor receptor-2 (VEGFR-2) tyrosine kinase inhibitor, have shown remarkable efficacy in many solid cancers. But evidence of antitumor activity in patients with lymphoma is still limited. We conducted an open-label, single-armed, exploratory study in relapse or refractory non-Hodgkin lymphoma patients for the efficacy and safety of apatinib. Experimental design: Patients with relapse or refractory non-Hodgkin patients meet the criteria were eligible for enrollment...
March 23, 2018: Oncotarget
https://www.readbyqxmd.com/read/29656621/effect-of-myoarchitectonic-spinolaminoplasty-on-concurrent-hypertension-in-patients-with-cervical-spondylotic-myelopathy
#9
Kazushige Itoki, Ryu Kurokawa, Tetsuro Shingo, Phyo Kim
OBJECTIVE: When treating patients with cervical spondylotic myelopathy (CSM), we often note amelioration in concomitant hypertension after surgery. To assess the effects of surgery and the mechanisms thereof, blood pressure (BP) and parasympathetic nervous activity were monitored prospectively in CSM patients undergoing surgery. METHODS: Sixty-eight consecutive CSM patients who underwent surgery with myoarchitectonic spinolaminoplasty were enrolled. BP and electrocardiography were recorded preoperatively and at 1, 3, and 6 months postoperatively...
March 2018: Neurospine
https://www.readbyqxmd.com/read/29656442/treatment-emergent-hypertension-and-efficacy-in-the-phase-3-study-of-e7080-lenvatinib-in-differentiated-cancer-of-the-thyroid-select
#10
Lori J Wirth, Makoto Tahara, Bruce Robinson, Sanjeev Francis, Marcia S Brose, Mouhammed Amir Habra, Kate Newbold, Naomi Kiyota, Corina E Dutcus, Elton Mathias, Matthew Guo, Steven I Sherman, Martin Schlumberger
BACKGROUND: Hypertension (HTN) is an established class effect of vascular endothelial growth factor receptor (VEGFR) inhibition. In the phase 3 Study of (E7080) Lenvatinib in Differentiated Cancer of the Thyroid (SELECT) trial, HTN was the most frequent adverse event of lenvatinib, an inhibitor of VEGFR1, VEGFR2, VEGFR3, fibroblast growth factor receptor 1 (FGFR1), FGFR2, FGFR3, FGFR4, platelet-derived growth factor receptor α (PDGFRα), ret proto-oncogene (RET), and stem cell factor receptor (KIT)...
April 14, 2018: Cancer
https://www.readbyqxmd.com/read/29643047/-a-case-of-circulatory-collapse-during-laparoscopic-hepatectomy
#11
Can Huang, Wei-Jun Fu, Shu-Min Cai, Zhen-Hua Zeng
We report a case of intractable circulatory failure event in a hypertensive patient during laparoscopy hepatectomy and analyze the diagnosis and treatment by multidisciplinary physicians. This case suggests that both surgeons and anesthesiologists should give attention to oral angiotensin II receptor antagonist during the preoperative period to avoid refractory hypotension. In addition, the use of EV1000 hemodynamic monitoring system in intensive care provides more convenience for clinical liquid management...
March 20, 2018: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/29625772/pulmonary-sarcoidosis
#12
REVIEW
Paolo Spagnolo, Giulio Rossi, Rocco Trisolini, Nicola Sverzellati, Robert P Baughman, Athol U Wells
Sarcoidosis is a granulomatous disease of unknown cause, occurs worldwide and has a highly variable prevalence. The disease is typically dominant in the lungs, although it can affect virtually any organ and is unpredictable in its clinical course. The severity of pulmonary sarcoidosis ranges from incidentally discovered radiographic abnormalities in asymptomatic patients to a chronic progressive disease that is refractory to treatment. Mortality from sarcoidosis appears to have increased in the past three decades, with respiratory failure being the most common cause of sarcoidosis-related death...
April 3, 2018: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29619573/-idiopathic-systemic-capillary-leak-syndrome-clarkson-disease-a-rare-cause-of-recurrent-life-threatening-edema
#13
REVIEW
S Dasdelen, S-O Grebe
This case report describes the episodic occurrence of severe generalized edema in a young female patient, who developed hypertension with a massive hemoconcentration (hematocrit >0.5, hemoglobin >20g/dl) and hypoalbuminemia during the course of these acute disease phases. After the first two disease exacerbations were overcome, there was a complete regression of symptoms. After a long symptom-free interval, a new exacerbation occurred as a result of which critical organ ischemia occurred due to the severe hypotension and massive edema...
April 4, 2018: Der Internist
https://www.readbyqxmd.com/read/29619550/perspectives-on-diagnosis-and-management-of-adult-idiopathic-intracranial-hypertension
#14
Irini Chatziralli, Panagiotis Theodossiadis, George Theodossiadis, Ioannis Asproudis
PURPOSE: The purpose of this review is to shed light into the diagnostic challenges regarding idiopathic intracranial hypertension (IIH), giving more emphasis to the role of optical coherence tomography (OCT) in IIH, while it also presents recent advances in the management of IIH. METHODS: A literature search in PubMed was performed for studies about the diagnosis and management of IIH published before June 30, 2017. Then, a comprehensive review of the eligible studies and the relevant references was performed...
April 4, 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/29616843/phase-1-trial-of-ibrutinib-and-carfilzomib-combination-therapy-for-relapsed-or-relapsed-and-refractory-multiple-myeloma
#15
Ajai Chari, Sarah Larson, Beata Holkova, Robert F Cornell, Cristina Gasparetto, Chatchada Karanes, Jeffrey V Matous, Ruben Niesvizky, Jason Valent, Matthew Lunning, Saad Z Usmani, Larry D Anderson, Lipo Chang, Yihua Lee, Yvonne Pak, Zeena Salman, Thorsten Graef, Elizabeth Bilotti, Saurabh Chhabra
This phase 1, dose-finding study investigated ibrutinib and carfilzomib ± dexamethasone in patients with relapsed or relapsed/refractory multiple myeloma (≥2 lines of therapy including bortezomib and an immunomodulatory agent). Of 43 patients enrolled, 74% were refractory to bortezomib and 23% had high-risk cytogenetics. No dose-limiting toxicities were observed. The recommended phase 2 dose was ibrutinib 840 mg and carfilzomib 36 mg/m2 with dexamethasone. The most common ≥ grade 3 (>10%) treatment-emergent adverse events were hypertension, anemia, pneumonia, fatigue, diarrhea, and thrombocytopenia...
April 4, 2018: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/29615351/the-incidence-of-delayed-complications-in-acute-type-b-aortic-dissections-is-underestimated
#16
Benedikt Reutersberg, Matthias Trenner, Bernhard Haller, Sarah Geisbüsch, Christian Reeps, Hans-Henning Eckstein
OBJECTIVE: Acute type B aortic dissections (TBADs) can have immediate or delayed complications within the first 2 weeks. Because the majority of clinical series retrospectively categorized TBAD, the incidence and outcome of delayed complications in initially uncomplicated TBAD within the first 14 days are not well described. METHODS: We retrospectively analyzed 86 patients (78% male; age, 62.5 ± 13 years) with acute TBAD treated consecutively between January 2004 and May 2016 at a tertiary referral center...
March 31, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29607187/the-present-and-future-role-of-ultrasound-targeted-microbubble-destruction-in-preclinical-studies-of-cardiac-gene-therapy
#17
REVIEW
Lijun Qian, Barsha Thapa, Jian Hong, Yanmei Zhang, Menglin Zhu, Ming Chu, Jing Yao, Di Xu
Multiple limitations for cardiac pharmacologic therapies like intolerance, individual variation in effectiveness, side effects, and high cost still remain, despite the recent progress in diagnosis and health support. Gene therapy is poised to be an attractive alternative in various ways for the future, refractory cardiac diseases being one aspect of it. As a novel therapy to deliver the objective gene to organs of living animals, ultrasound targeted microbubble destruction (UTMD) has therapeutic potential in cardiovascular disorders...
February 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29589184/controlled-versus-uncontrolled-resistant-hypertension-are-they-in-the-same-bag
#18
REVIEW
J C Yugar-Toledo, V Brunelli, J F Vilela-Martin, A Fattori, H Moreno
PURPOSE OF REVIEW: Resistant hypertension (RHTN) is a condition in which besides the antihypertensive therapy using at least three different drugs (including a diuretics), brachial blood pressure does not reach the target (e.g., 140/90 mmHg). RECENT FINDINGS: Despite the diversity of clinical presentations, we divide RHTN in two major groups according to blood pressure and number of drugs taken: controlled (C-RHTN) and uncontrolled (UC-RHTN) resistant hypertension, with refractory hypertension (RfHTN) included in the latter subgroup...
March 27, 2018: Current Hypertension Reports
https://www.readbyqxmd.com/read/29580026/letter-to-the-editor-regarding-cisternostomy-for-refractory-posttraumatic-intracranial-hypertension
#19
Jacek Szczygielski, Vanessa Hubertus, Joachim Oertel
No abstract text is available yet for this article.
April 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29579616/impact-of-prophylactic-cavotricuspid-isthmus-ablation-in-atrial-fibrillation-recurrence-after-a-first-pulmonary-vein-isolation-procedure
#20
João Mesquita, António Miguel Ferreira, Diogo Cavaco, Pedro Carmo, Márcio Madeira, Pedro Freitas, Francisco Moscoso Costa, Francisco Morgado, Miguel Mendes, Pedro Adragão
INTRODUCTION: PVI is a well-established therapy for patients with drug refractory atrial fibrillation (AF). However, it remains unclear whether prophylactic cavotricuspid isthmus (CTI) ablation at the time of PVI improves long-term freedom from AF. OBJECTIVE: To compare the outcomes of patients who underwent PVI alone vs. PVI + prophylactic CTI ablation. METHODS: Propensity score (PS) matching analysis based on a registry dataset of 1931 consecutive patients who underwent a first AF catheter ablation...
May 15, 2018: International Journal of Cardiology
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