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Refractory hypertension

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https://www.readbyqxmd.com/read/28079252/outcomes-of-surgical-shunts-and-transjugular-intrahepatic-portasystemic-stent-shunts-for-complicated-portal-hypertension
#1
I Hosokawa, R Adam, M-A Allard, G Pittau, E Vibert, D Cherqui, A Sa Cunha, H Bismuth, M Miyazaki, D Castaing
BACKGROUND: Transjugular intrahepatic portasystemic stent shunt (TIPSS), instead of surgical shunt, has become the standard treatment for patients with complicated portal hypertension. This study compared outcomes in patients who underwent TIPSS or surgical shunting for complicated portal hypertension. METHODS: This was a retrospective study of all consecutive patients who received portasystemic shunts from 1994 to 2014 at a single institution. Patients who underwent surgical shunting were compared with those who had a TIPSS procedure following one-to-one propensity score matching...
January 12, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28072930/left-ventricular-outflow-tract-obstruction-be-prepared
#2
J S Evans, S J Huang, A S McLean, M Nalos
The current trend to treat hypotension in critically ill patients is to place a greater emphasis on inotropic support and less on fluid resuscitation in order to limit the potential harm from fluid overload. This combination may trigger left ventricular outflow tract obstruction (LVOTO) in susceptible patients. Although LVOTO is classically described in patients with hypertrophic cardiomyopathy it has been reported in other conditions including septic shock, apical ballooning syndrome, myocardial infarction, respiratory failure, and post valvular surgery...
January 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28059660/effects-of-decompressive-craniectomy-on-functional-outcomes-and-death-in-poor-grade-aneurysmal-subarachnoid-hemorrhage-a-systematic-review-and-meta-analysis
#3
Naif M Alotaibi, Ghassan Awad Elkarim, Nardin Samuel, Oliver G S Ayling, Daipayan Guha, Aria Fallah, Abdulrahman Aldakkan, Blessing N R Jaja, Airton Leonardo de Oliveira Manoel, George M Ibrahim, R Loch Macdonald
OBJECTIVE Patients with poor-grade aneurysmal subarachnoid hemorrhage (aSAH) (World Federation of Neurosurgical Societies Grade IV or V) are often considered for decompressive craniectomy (DC) as a rescue therapy for refractory intracranial hypertension. The authors performed a systematic review and meta-analysis to assess the impact of DC on functional outcome and death in patients after poor-grade aSAH. METHODS A systematic review and meta-analysis were performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
January 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28051803/%C3%A2-observational-cohort-study-of-hepatic-encephalopathy-after-transjugular-intrahepatic-portosystemic-shunt-tips
#4
Michaela Routhu, Vaclav Safka, Sunil Kumar Routhu, Tomas Fejfar, Vaclav Jirkovsky, Antonin Krajina, Eva Cermakova, Ladislav Hosak
:  Introduction and Aim: Hepatic encephalopathy (HE) is a common complication of transjugular intrahepatic portosystemic shunting (TIPS). It is associated with a reduced quality of life and poor prognosis. The aim of this study was to compare two groups of patients who did and did not develop overt HE after TIPS. We looked for differences between these groups before TIPS. MATERIALS AND METHODS: A study of 895 patients was conducted based on a retrospective analysis of clinical data...
January 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28050183/the-effects-of-sertraline-in-controlling-refractory-hypertension-in-women-with-premenstrual-syndrome
#5
Fatemeh Ranjbar, Fariborz Akbarzadeh, Mahboub Asadlou
Objective: The aim of this study was to evaluate the effect of Premenstrual Syndrome (PMS) treatment with selective serotonin reuptake inhibitor (SSRI) on treatment response of refractory hypertension of the patients. Method: This was a triple-blind randomized clinical trial conducted on female patients suffering from refractory hypertension and PMS at the same time. We obtained informed consent from 40 patients who had inclusion criteria and selected 20 patients for the intervention (sertraline 50 mg daily) and 20 for the control groups...
October 2016: Iranian Journal of Psychiatry
https://www.readbyqxmd.com/read/28045673/orbital-atherectomy-in-the-renal-artery-a-new-frontier-for-an-emerging-technology
#6
Javier A Valle, Ehrin J Armstrong, Stephen W Waldo
Orbital atherectomy has been developed as a method to modify calcified plaque in the peripheral vasculature, with extensive experience and data supporting its use in infrainguinal peripheral arterial disease. However, calcific atherosclerotic disease occurs in other vascular beds and may benefit from the application of this technology. In this case report, we describe the first reported use of orbital atherectomy in a renal artery. A 55-year-old male with severe drug-refractory hypertension was found to have renal artery stenosis, with severe calcification of the right renal artery...
January 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28018454/idiopathic-midaortic-syndrome-with-malignant-hypertension-in-3-year-old-boy
#7
Kyung Jin Ahn, Ja Kyoung Yoon, Gi Beom Kim, Bo Sang Kwon, Eun Jung Bae, Chung Il Noh
Midaortic syndrome (MAS) is a rare vascular disease that commonly causes renovascular hypertension. The lumen of the abdominal aorta narrows and the ostia of the branches show stenosis. MAS is associated with diminished pulses in the lower extremities compared with the upper extremities, severe hypertension with higher blood pressure in the upper rather than lower extremities, and an abdominal bruit. The clinical symptoms are variable, and recognition in children with hypertension can aid early diagnosis and optimal treatment...
November 2016: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/28012056/pachymeningitis-in-granulomatosis-with-polyangiitis-case-series-with-earlier-onset-in-younger-patients-and-literature-review
#8
Violeta Higuera-Ortiz, Abraham Reynoso, Natllely Ruiz, Rosa Delia Delgado-Hernández, Gilberto Gómez-Garza, Luis Felipe Flores-Suárez
The objective of this study is to describe the characteristics of patients with pachymeningitis (PM) in granulomatosis with polyangiitis (GPA) from Latin America, including three young patients. This is a retrospective case series. Patients were classified according to the ACR criteria, the 2012 Chapel Hill Consensus Conference Nomenclature and the EMA algorithm. Demographic, clinical, serological, and neuroimaging characteristics are described. Thirteen patients (nine females, four males) were identified. Mean age ± SD of PM diagnosis was 35...
December 23, 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/28003699/an-unusual-presentation-of-autonomic-dysreflexia-in-a-patient-with-cold-abscess-of-cervical-spine-for-anterolateral-decompression
#9
Susmita Sarangi, Dipali Taneja, Bhavna Saxena
A young female having complaints of quadriparesis along with bladder and bowel involvement, diagnosed to have osseous destruction of C4, C6, C7, T2 vertebral bodies with pre- and para-vertebral abscess, was taken up for anterolateral decompression and fusion of cervical spine. She presented with anxiety, agitation, sweating and headache and was in hypertensive crisis which was refractory to antihypertensives, anxiolytics and analgesics but showed a reasonable response to intravenous dexmedetomidine and finally responded dramatically to rectal evacuation...
December 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28000176/pathology-and-molecular-mechanisms-of-coarctation-of-the-aorta-and-its-association-with-the-ductus-arteriosus
#10
REVIEW
Utako Yokoyama, Yasuhiro Ichikawa, Susumu Minamisawa, Yoshihiro Ishikawa
Coarctation of the aorta (CoA) is defined as a congenital stenosis of the thoracic aorta and is one of the most common congenital cardiovascular diseases. Despite successful surgical treatment for CoA, arterial abnormalities, including refractory hypertension, aortic aneurysm, and proatherogenic phenotypic changes, frequently affect patients' quality of life. Emerging evidence from morphological and molecular biological investigations suggest that the area of CoA is characterized by phenotypic modulation of smooth muscle cells, intimal thickening, and impaired elastic fiber formation...
December 20, 2016: Journal of Physiological Sciences: JPS
https://www.readbyqxmd.com/read/28000099/phase-1-study-of-ixazomib-alone-or-combined-with-lenalidomide-dexamethasone-in-japanese-patients-with-relapsed-refractory-multiple-myeloma
#11
Kenshi Suzuki, Hiroshi Handa, Takaaki Chou, Kenichi Ishizawa, Takatoshi Takubo, Yoichi Kase
We report the first clinical investigation conducted in Japan to confirm the safety, tolerability, and pharmacokinetics of ixazomib alone and combined with lenalidomide-dexamethasone (Rd) in Japanese patients with relapsed/refractory multiple myeloma. Adult patients with measurable disease and ≥2 prior lines of therapy received oral ixazomib 4.0 mg on days 1, 8, 15 alone or combined with lenalidomide 25 mg on days 1-21 and dexamethasone 40 mg on days 1, 8, 15, 22 in 28-day cycles. Fourteen patients who had received a median of seven prior therapies were enrolled (seven per cohort)...
December 20, 2016: International Journal of Hematology
https://www.readbyqxmd.com/read/27990104/hepatic-encephalopathy-due-to-congenital-multiple-intrahepatic-portosystemic-venous-shunts-successfully-treated-by-percutaneous-transhepatic-obliteration
#12
Shinsuke Takenaga, Kenichi Narita, Yo Matsui, Kunihiko Fukuda
Hepatic encephalopathy due to intrahepatic portosystemic venous shunts (IPSVS) in a non-cirrhotic condition is rare. Here we report a rare case of a patient with congenital multiple IPSVS successfully treated by percutaneous transhepatic obliteration. The patient was a 67-year-old woman who presented to our hospital with progressive episodes of consciousness disorder and vomiting. Laboratory tests revealed hyperammonemia (192.0 μg/dL), and computed tomography revealed multiple IPSVS in both lobes. There was no evidence of underlying liver disease or hepatic trauma...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27987591/nintedanib-plus-pemetrexed-versus-placebo-plus-pemetrexed-in-patients-with-relapsed-or-refractory-advanced-non-small-cell-lung-cancer-lume-lung-2-a-randomized-double-blind-phase-iii-trial
#13
Nasser H Hanna, Rolf Kaiser, Richard N Sullivan, Osvaldo Rudy Aren, Myung-Ju Ahn, Beatrice Tiangco, Isabelle Voccia, Joachim von Pawel, Vladimir Kovcin, Jason Agulnik, Birgit Gaschler-Markefski, José Barrueco, Patricia Sikken, Charles Schloss, Joo-Hang Kim
OBJECTIVES: LUME-Lung 2 investigated the efficacy/safety of nintedanib plus pemetrexed in patients with pretreated non-squamous non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Patients with stage IIIB/IV or recurrent non-squamous NSCLC who had received one prior chemotherapy regimen were randomized (1:1 stratified by histology [adenocarcinoma/non-adenocarcinoma], prior bevacizumab, Eastern Cooperative Oncology Group performance status and presence of brain metastases) to receive intravenous pemetrexed 500mg/m(2) on Day 1 plus nintedanib 200mg orally twice daily or matching placebo on Days 2-21, every 3 weeks until progression/unacceptable toxicity...
December 2016: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
https://www.readbyqxmd.com/read/27984545/efficacy-of-dexamethasone-intravitreal-implant-for-refractory-macular-edema-caused-by-retinal-vein-occlusion
#14
Rehan M Hussain, Thomas A Ciulla, Lauren M Ciulla, Bethany Sink, Alon Harris
PURPOSE: To investigate efficacy of dexamethasone intravitreal (DEX) implant in treating refractory macular edema caused by retinal vein occlusion. METHODS: Retrospective chart review. RESULTS: Twenty-two eyes with refractory macular edema caused by retinal vein occlusion were treated with a mean of 2.2 DEX over 12 months. Patient had previously received a mean of 7 treatments (laser, bevacizumab, and/or triamcinolone) for macular edema present for at least 4 months duration (mean 20...
December 14, 2016: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/27984174/emergency-tips-in-a-child-pugh-b-patient-when-does-the-window-of-opportunity-open-and-close
#15
REVIEW
Jonel Trebicka
Transjugular intrahepatic portosystemic shunt (TIPS) is used to treat complications of cirrhosis such as variceal bleeding and refractory ascites, but it also bears the risk of liver failure, overt hepatic encephalopathy (HE) and cardiac decompensation. Variceal bleeding may be controlled using endoscopic and medical treatment in patients with compensated cirrhosis; in decompensated patients, however, TIPS improves survival. Therefore, an early TIPS (within 72h or if later, still early after bleeding) might improve the survival of patients by preventing an inflammatory response and bacterial translocation...
October 29, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27977576/outcome-of-primary-trabeculotomy-ab-interno-trabectome-surgery-in-patients-with-steroid-induced-glaucoma
#16
Philip Ngai, Grace Kim, Garrick Chak, Ken Lin, Masahiro Maeda, Sameh Mosaed
To determine the efficacy and safety of Trabectome surgery on patients with steroid response, ranging from ocular hypertension refractory to maximal medical therapy to the development of steroid-induced glaucoma.A nonrandomized, nonblinded, retrospective study of 20 subjects with steroid response was conducted. All 20 eyes underwent Trabectome surgery alone. Nine subjects had steroid response with unremarkable visual field, 3 had mild steroid-induced glaucoma, and 8 had advanced steroid-induced glaucoma. Outcome measures included intraocular pressure (IOP), number of glaucoma medications, need for secondary glaucoma surgery, and steroid regimen...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27974106/fulminant-bilateral-papilloedema-during-low-dose-steroid-taper-in-a-child-with-systemic-idiopathic-arthritis-treated-with-tocilizumab
#17
Lulu Burstzyn, Simon Levin, Brian Rotenberg, Tamara Van Hooren, Andrew Leung, Roberta Berard, Daniela S Ardelean
Systemic juvenile idiopathic arthritis (SJIA) is one of the most severe forms of arthritis that affects children younger than 16 years of age at onset. SJIA often requires corticosteroids to control the inflammation. However, long-term corticosteroid use may have adverse effects, including intracranial hypertension (IH). Biologic therapies have been used as corticosteroid sparing agents. We report the first case of a child with steroid-dependent SJIA treated with tocilizumab, an IL-6 receptor monoclonal antibody, who developed fulminant IH, bilateral papilloedema and vision loss when oral prednisone was weaned from 2 to 1 mg per day...
December 14, 2016: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/27965382/predictors-for-venous-sinus-stent-retreatment-in-patients-with-idiopathic-intracranial-hypertension
#18
Amgad El Mekabaty, Nancy A Obuchowski, Mark G Luciano, Seby John, Charlotte Y Chung, Abhay Moghekar, Stephen Jones, Ferdinand K Hui
BACKGROUND: Venous sinus stenting for dural sinus stenoses is an emerging alternative to cerebrospinal fluid diversion in cases of medically refractory idiopathic intracranial hypertension. Juxta-stent 're-stenoses' have been reported and managed alternatively with ventricular shunting or stent revision. Identification of factors that might predispose patients to recurrent narrowing may help to select or exclude patients with idiopathic intracranial hypertension for venous sinus stenting...
December 13, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27960613/prevalence-clinical-characteristics-and-echocardiography-parameters-of-non-resistant-resistant-and-refractory-hypertension-in-chinese
#19
Gaozhen Cao, Cong Chen, Qingshan Lin, Yan Chen, Zhe Zhen, Yuan Zou, Juhua Liu, Min Wu, Run Wang, Mingya Liu, Chunting Zhao, Shukun Lu, Ming-Yen Ng, Hung-Fat Tse, Kai-Hang Yiu
OBJECTIVES: Refractory and resistant hypertension is defined as hypertension that is uncontrolled despite the use of multiple antihypertensives. The aim of the present study is to evaluate the prevalence, both in young and elderly, and the pattern of left ventricular hypertrophy (LVH) in South-Eastern Chinese patients with refractory, resistant and non-resistant hypertension. METHODS: A total of 1455 patients (age 60.3 ± 13.9, male 55.7%) with essential hypertension were recruited...
December 28, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27957419/pulmonary-vein-isolation-alone-and-combined-with-renal-sympathetic-denervation-in-chronic-kidney-disease-patients-with-refractory-atrial-fibrillation
#20
Márcio G Kiuchi, Shaojie Chen, Gustavo R E Silva, Luis M R Paz, Tetsuaki Kiuchi, Ary G de Paula Filho, Gladyston L L Souto
BACKGROUND: Atrial fibrillation (AF) commonly occurs in association with chronic kidney disease (CKD), resulting in adverse outcomes. Combining pulmonary vein isolation (PVI) and renal sympathetic denervation (RSD) may reduce the recurrence of AF in patients with CKD and hypertension. We considered that RSD could reduce the recurrence of AF in patients with CKD by modulating sympathetic hyperactivity. Our goal was to compare the impact of PVI + RSD with that of PVI alone in patients with concurrent AF and CKD...
December 2016: Kidney Research and Clinical Practice
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