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Refractory hypertension

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https://www.readbyqxmd.com/read/28528859/efficacy-side-effects-and-monitoring-of-oral-cyclosporine-in-interstitial-cystitis-bladder-pain-syndrome
#1
Iryna M Crescenze, Barbara Tucky, Jianbo Li, Courtenay Moore, Daniel Shoskes
OBJECTIVE: To evaluate the efficacy of oral Cyclosporine A (CyA) in treatment of refractory interstitial cystitis/bladder pain syndrome (IC/BPS) and assess safety using drug level and renal function monitoring. METHODS: Patients with IC/BPS who failed at least 2 prior treatments were enrolled in an open-label study of oral CyA. Medication was started at 3 mg/kg divided twice daily for 3 months. Dose was adjusted based on side effects and drug level measured 2 hours after the morning dose (C2)...
May 18, 2017: Urology
https://www.readbyqxmd.com/read/28527079/endolymphatic-hydrops-in-idiopathic-intracranial-hypertension-prevalence-and-clinical-outcome-after-lumbar-puncture-preliminary-data
#2
Angelo Ranieri, Michele Cavaliere, Stefania Sicignano, Pietro Falco, Federico Cautiero, Roberto De Simone
Idiopathic intracranial hypertension is characterized by raised intracranial pressure (ICP) without any underlying pathology, presenting with (IIH) or without papilledema (IIHWOP). Headache, often on daily basis, is the most frequent symptom. Among audiovestibular symptoms, tinnitus and dizziness are commonly reported, while vertigo and hearing impairment are infrequent reports. Endolymphatic hydrops (ELH) is the typical histopathologic feature of Ménière disease, a condition featured by episodes of vertigo, dizziness, fluctuating hearing loss, tinnitus, and aural fullness...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28524699/comparison-of-ambulatory-blood-pressure-lowering-effects-of-higher-doses-of-different-calcium-antagonists-in-uncontrolled-hypertension-the-calcium-antagonist-controlled-release-high-dose-therapy-in-uncontrolled-refractory-hypertensive-patients-carillon-study
#3
Hiroyuki Mizuno, Satoshi Hoshide, Naoko Tomitani, Kazuomi Kario
BACKGROUND: Data are sparse regarding ambulatory blood pressure (BP) reduction of up-titration from a standard dose to a high dose in both nifedipine controlled-release (CR) and amlodipine. This was a prospective, randomized, multicenter, open-label trial. PATIENTS AND METHODS: Fifty-one uncontrolled hypertensives medicated by two or more antihypertensive drugs including a renin-angiotensin system inhibitor and a calcium antagonist were randomly assigned to either the nifedipine CR (80 mg)/candesartan (8 mg) group or the amlodipine (10 mg)/candesartan (8 mg) group...
May 19, 2017: Blood Pressure
https://www.readbyqxmd.com/read/28516363/posterior-reversible-encephalopathy-syndrome-presenting-in-the-anterior-circulation-with-malignant-intracranial-hypertension-requiring-surgical-decompression-a-case-report-and-literature-review
#4
S Hernández-Durán, A Barrantes-Freer, V Rohde, C von der Brelie
Posterior reversible encephalopathy syndrome (PRES) is thought to result from endothelial dysfunction and breakdown of the blood-brain barrier with subsequent vasogenic edema. Abrupt hypertension has been identified as one of its risk factors. We present a rare case of PRES in the anterior circulation with sudden onset of left hemiparesis and rapid neurological deterioration on the basis of hypertensive crisis. Due to refractory intracranial hypertension, the patient required emergent right decompressive craniectomy...
May 17, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28513820/intra-abdominal-hypertension-and-abdominal-compartment-syndrome-in-acute-pancreatitis-hepato-pancreato-biliary-operations-and-liver-transplantation
#5
Alexsander K Bressan, Chad G Ball
Intra-abdominal hypertension, even preceding the onset of abdominal compartment syndrome, is still recognized as an adverse prognostic factor. Unfortunately, most of the current supporting evidence within the critical care environment remains observational in nature. In acute pancreatitis, an active role for intra-abdominal hypertension early in the disease process follows a strong intuitive basis, and it is corroborated by preliminary evidence from animal models. Additional studies are needed to better characterize the optimal fluid resuscitation strategy, as well as the importance of intra-abdominal hypertension as an early therapeutic target...
May 17, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28513071/juvenile-idiopathic-arthritis-in-multiplex-families-longitudinal-follow-up
#6
Munira Al Marri, Alya Qari, Sulaiman M Al-Mayouf
OBJECTIVE: To describe the physical, social, educational and employment status and clinical outcomes of patients with juvenile idiopathic arthritis (JIA) from multiplex families. METHODS: All familial JIA patients were treated and had regular follow-up between 1990 and 2015 at King Faisal Specialist Hospital and Research Center (KFSH-RC), Riyadh, were included. Demographic data, disease duration, active arthritis and articular and extra-articular damage at last follow-up visit were reviewed...
May 16, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28511969/the-current-role-of-decompressive-craniectomy-for-severe-traumatic-brain-injury
#7
REVIEW
S Honeybul, K M Ho, C R P Lind, G R Gillett
There is little doubt that decompressive craniectomy can reduce mortality however, the results of a recent study has provided more evidence to inform the debate regarding clinical and ethical concerns that it merely converts death into survival with severe disability or in a vegetative state. The recently published RESCUEicp trial compared last-tier secondary decompressive craniectomy with continued medical management for refractory intracranial hypertension after severe traumatic brain injury. Patients were randomly assigned to decompressive craniectomy with medical therapy or to receive continued medical therapy with the option of adding barbiturates...
May 13, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28509668/norepinephrine-in-septic-shock-when-and-how-much
#8
Olfa Hamzaoui, Thomas W L Scheeren, Jean-Louis Teboul
PURPOSE OF REVIEW: Norepinephrine is the first-line agent recommended during resuscitation of septic shock to correct hypotension because of depressed vascular tone. Important clinical issues are the best timing to start norepinephrine, the optimal blood pressure target, and the best therapeutic options to face refractory hypotension of when high doses of norepinephrine are required to reach the target. RECENT FINDINGS: Recent literature has reported benefits of early administration of norepinephrine because of the following reasons: profound and durable hypotension is an independent factor of increased mortality, early administration of norepinephrine increases cardiac output, improves microcirculation and avoid fluid overload...
May 13, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28494828/treatment-of-persistent-pulmonary-hypertension-of-the-newborn-use-of-pulmonary-vasodilators-in-term-neonates
#9
Caitlyn Luecke, Christopher McPherson
Persistent pulmonary hypertension of the newborn (PPHN) represents a challenging condition associated with significant morbidity. A successful transition from intrauterine to extrauterine life is contingent on adequate pulmonary vasodilation. Several pathophysiologies contribute to the failure of this cascade and may result in life-threatening hypoxia and acidosis in the newborn. Management includes optimal respiratory support, adequate sedation and analgesia, and support of vascular tone and cardiac function...
May 1, 2017: Neonatal Network: NN
https://www.readbyqxmd.com/read/28494001/partial-spleen-embolization-reduces-the-risk-of-portal-hypertension-induced-upper-gastrointestinal-bleeding-in-patients-not-eligible-for-tips-implantation
#10
Matthias Buechter, Alisan Kahraman, Paul Manka, Guido Gerken, Alexander Dechêne, Ali Canbay, Axel Wetter, Lale Umutlu, Jens M Theysohn
INTRODUCTION: Upper gastrointestinal bleeding (UGIB) is a severe and life-threatening complication among patients with portal hypertension (PH). Covered transjugular intrahepatic portosystemic shunt (TIPS) is the treatment of choice for patients with refractory or recurrent UGIB despite pharmacological and endoscopic therapy. In some patients, TIPS implantation is not possible due to co-morbidity or vascular disorders. Spleen embolization (SE) may be a promising alternative in this setting...
2017: PloS One
https://www.readbyqxmd.com/read/28488102/transjugular-intrahepatic-portosystemic-shunt-for-portal-hypertension-in-hepatocellular-carcinoma-with-portal-vein-tumor-thrombus
#11
Bin Qiu, Kai Li, Xiaoqun Dong, Fu-Quan Liu
PURPOSE: In patients with hepatocellular carcinoma (HCC), limited therapeutic options are available for portal hypertension resulted from portal vein tumor thrombus (PVTT). We aimed to determine safety and efficacy of TIPS for treatment of symptomatic portal hypertension in HCC with PVTT. METHODS: We evaluated clinical characteristics of 95 patients with HCC and PVTT out of 992 patients who underwent TIPS. The primary endpoints included success rate, procedural mortality, serious complications, decrease in portosystemic pressure gradient, and symptom relief...
May 9, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28486884/effect-of-intravesical-botulinum-toxin-injection-on-symptoms-of-autonomic-dysreflexia-in-a-patient-with-chronic-spinal-cord-injury-a-case-report
#12
Il-Young Jung, Kyo Ik Mo, Ja-Ho Leigh
CONTEXT: There are few treatment options for managing autonomic dysreflexia in patients with chronic spinal cord injury (SCI). According to some studies, intravesical botulinum toxin for SCI patients with autonomic dysreflexia has a preventive effect on symptoms of autonomic dysreflexia. However, the usefulness of an intravesical botulinum toxin injection has never been reported for autonomic dysreflexia in an adult patient with chronic cervical SCI, although there has been for one pediatric patient...
May 9, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28485834/profile-and-outcomes-of-women-with-pregnancy-related-acute-kidney-injury-requiring-dialysis-at-a-center-in-ethiopia
#13
Delayehu Bekele, Momina Ahmed, Ahmed Ibrahim, Seman Kedir, Grace Chan
OBJECTIVE: To describe the clinical profile and outcomes of women with pregnancy-related acute kidney injury (AKI) undergoing dialysis at Saint Paul's Hospital Millennium Medical College, Addis Ababa, where the first publicly funded large-scale dialysis service in Ethiopia was established. METHODS: In a hospital-based retrospective study, clinical records were reviewed for all women with pregnancy-related AKI attending the hemodialysis unit at the study center between August 2013 and July 2015...
May 9, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28471306/salvage-lenvatinib-therapy-in-metastatic-anaplastic-thyroid-cancer
#14
Nicole M Iniguez Ariza, Mabel Ryder, Crystal R Hilger, Keith C Bible
BACKGROUND: Historical anaplastic thyroid cancer (ATC) outcomes have been terrible, with a median survival of only 5 months and <20% 1-year survival. Improved outcomes are now achieved with aggressive initial therapy in stages IVA and IVB disease, but patients with distant metastatic disease (stage IVC) still do poorly; improved therapies are sorely needed. Kinase inhibitors have emerged as promising agents in the therapy of advanced medullary and differentiated thyroid cancer, but there are limited data regarding use of lenvatinib in ATC...
May 4, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28469849/antenatal-gastrointestinal-anomalies-in-neonates-subsequently-found-to-have-alveolar-capillary-dysplasia
#15
Dimple Goel, Ju Lee Oei, Kei Lui, Meredith Ward, Antonia W Shand, David Mowat, Andrew J Gifford, Christine Loo
Alveolar capillary dysplasia (ACD) is a rare condition with variable presentation and clinical course. Clinicians should consider this diagnosis in neonates presenting with nonlethal congenital gastrointestinal malformation, a period of well-being after birth then unremitting hypoxemia and refractory pulmonary hypertension. Lung biopsy and FOXF1 gene testing may help in diagnosis.
May 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28468020/novel-approaches-to-reducing-the-risk-of-variceal-hemorrhage
#16
Frederik Nevens
BACKGROUND: Complications of advanced liver disease occur at the moment of clinical significant portal hypertension. Nitric oxide (NO) dysfunction and fibrosis play an important role in the pathophysiology of PH, but other mechanisms are also involved. Non-selective beta blockers (NSBB) stay the cornerstone in the primary and secondary prevention of variceal bleeding, but their safety in advanced cirrhosis has been recently debated and new drugs are under investigation. Transjugular intrahepatic portosystemic shunt and balloon tamponade are the standard therapy in case of refractory variceal bleeding, but both interventions have drawbacks...
2017: Digestive Diseases
https://www.readbyqxmd.com/read/28466536/a-retrospective-analysis-of-3954-patients-in-phase-2-3-trials-of-bortezomib-for-the-treatment-of-multiple-myeloma-towards-providing-a-benchmark-for-the-cardiac-safety-profile-of-proteasome-inhibition-in-multiple-myeloma
#17
Jacob P Laubach, Javid J Moslehi, Sanjeev A Francis, Jesús F San Miguel, Pieter Sonneveld, Robert Z Orlowski, Philippe Moreau, Laura Rosiñol, Edward A Faber, Peter Voorhees, Maria-Victoria Mateos, Loreta Marquez, Huaibao Feng, Avinash Desai, Helgi van de Velde, Jennifer Elliott, Hongliang Shi, Edward Dow, Nishith Jobanputra, Dixie-Lee Esseltine, Liviu Niculescu, Kenneth C Anderson, Sagar Lonial, Paul G Richardson
This retrospective analysis aimed to establish the overall cardiac safety profile of bortezomib using patient-level data from one phase 2 and seven phase 3 studies in previously untreated and relapsed/refractory multiple myeloma (MM). Seven clinically relevant primary [congestive heart failure (CHF), arrhythmias, ischaemic heart disease (IHD), cardiac death] and secondary (hypertension, dyspnoea, oedema) cardiac endpoints were defined based on MedDRA v16.0 preferred terms. 2509 bortezomib-treated patients and 1445 patients in non-bortezomib-based control arms were included...
May 3, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28451851/obesity-associated-hypertension-the-upcoming-phenotype-in-african-american-women
#18
REVIEW
Rohan Samson, Andrea Qi, Abhishek Jaiswal, Thierry H Le Jemtel, Suzanne Oparil
PURPOSE OF REVIEW: The present obesity epidemic particularly affects African-American women. Whether the obesity epidemic will alter the hypertension phenotype in African-American women is entertained. RECENT FINDINGS: The prevalence of morbid obesity is steadily increasing in African-American women, who are prone to developing hypertension (HTN) even in the absence of obesity. The obesity-associated hypertension phenotype is characterized by marked sympathetic nervous system activation and resistance/refractoriness to antihypertensive therapy...
May 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28448184/erythropoietin-mediates-brain-vascular-kidney-crosstalk-and-may-be-a-treatment-target-for-pulmonary-and-resistant-essential-hypertension
#19
Emine Meltem Onal, Alan Alper Sag, Oguzhan Sal, Aslihan Yerlikaya, Baris Afsar, Mehmet Kanbay
Organ crosstalk pathways represent the next frontier for target-mining in molecular medicine for existing syndromes. Pulmonary hypertension and resistant essential hypertension are syndromes that have been proven elusive in etiology, and frequently refractory to first-line management. Underlying crosstalk mechanisms, not yet considered in these treatments, may hinder outcomes or unlock novel treatments. This review focuses systematically on erythropoietin, a synthesizable molecule, as a mediator of brain-kidney crosstalk...
2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/28443951/bariatric-surgery-in-individuals-with-severe-cognitive-impairment-report-of-two-cases
#20
Everton Cazzo, Martinho Antonio Gestic, Murillo Pimentel Utrini, Felipe David Mendonça Chaim, Elaine Cristina Cândido, Luciana Bueno da Silveira Jarolavsky, Ana Maria Neder de Almeida, José Carlos Pareja, Elinton Adami Chaim
CONTEXT: Bariatric surgery has become the gold-standard treatment for refractory morbid obesity. Obesity is frequently associated with certain syndromes that include coexisting cognitive deficits. However, the outcomes from bariatric surgery in this group of individuals remain incompletely determined. CASE REPORT: A 25-year-old male with Prader-Willi syndrome, whose intelligence quotient (IQ) was 54, was admitted with a body mass index (BMI) of 55 kg/m2, associated with glucose intolerance...
April 20, 2017: São Paulo Medical Journal, Revista Paulista de Medicina
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