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https://www.readbyqxmd.com/read/29147570/management-of-an-acute-catecholamine-induced-cardiomyopathy-and-circulatory-collapse-a-multidisciplinary-approach
#1
R T Casey, B G Challis, D Pitfield, R M Mahroof, N Jamieson, C J Bhagra, A Vuylsteke, S J Pettit, K C Chatterjee
A phaeochromocytoma (PC) is a rare, catecholamine-secreting neuroendocrine tumour arising from the adrenal medulla. Presenting symptoms of this rare tumour are highly variable but life-threatening multiorgan dysfunction can occur secondary to catecholamine-induced hypertension or hypotension and subsequent cardiovascular collapse. High levels of circulating catecholamines can induce an acute stress cardiomyopathy, also known as Takotsubo cardiomyopathy. Recent studies have focused on early diagnosis and estimation of the prevalence of acute stress cardiomyopathy in patients with PC, but very little is reported about management of these complex cases...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29145709/defining-a-unified-vascular-phenotype-in-systemic-sclerosis
#2
REVIEW
Yannick Allanore, Oliver Distler, Marco Matucci-Cerinic, Christopher P Denton
Microcirculation impairment and related vasculopathy is a hallmark of systemic sclerosis. Digital ulcers are second only to Raynaud's phenomenon as a vascular complication occurring in scleroderma patients. Digital ulcers are painful and generate disability. Furthermore, patients may develop recurrent digital ulcers and one may ask whether the outcomes of such patients might be different to those of unaffected ones. Recently several registries have provided relevant information about digital ulcers. Male sex and severe skin disease seem to be the main associated factors observed in several registries...
November 16, 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/29136712/-long-term-outcome-and-prognostic-factors-in-pregnant-women-with-pulmonary-arterial-hypertension-associated-with-congenital-heart-disease
#3
Q T Ou, J K Lu, J Zhang, Y Chen, Q Li, J L Zhang
Objective: To investigate the perinatal outcome, risk factors and long-term outcome of pregnancy complicated with pulmonary arterial hypertension(PAH) and congenital heart diseases (CHD). Methods: Clinical data of 110 pregnant women who were diagnosed as PAH-CHD were retrospectively analyzed in the Department of Obstetrics and Gynecology and Surgical Intensive Care Unit at Beijing Anzhen Hospital from 2004 to 2013. The survival and treatment status were followed up. Results: 110 subjects consisted of 11 mild PAH, 33 moderate and 66 severe ones...
November 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29118953/the-role-of-preoperative-sildenafil-therapy-in-controlling-of-postoperative-pulmonary-hypertension-in-children-with-ventricular-septal-defects
#4
Hamid Bigdelian, Mohsen Sedighi
Introduction: Most of the ventricular septal defects (VSD) are complicated with pulmonary arterial hypertension (PAH) which is the major cause of pulmonary hypertensive crisis and right ventricular failure. Methods: We reviewed clinical outcomes of 63 infants who underwent cardiac surgery and were divided into three groups. Control group (n=20) did not received sildenafil while group A (n = 22) received drug (0.3 mg/kg) before and after surgery. Group B (n=21) received drug at the initiation of surgery. Demographic data, preoperative and postoperative variables were compared among the patients...
2017: Journal of Cardiovascular and Thoracic Research
https://www.readbyqxmd.com/read/29109640/obstetric-critical-care-requirements-felt-by-the-obstetricians-an-experience-based-study
#5
Mohan Deep Kaur, Jyoti Sharma, Prasoon Gupta, Tarun Deep Singh, Saurav Mitra Mustafi
Background and Aims: Pregnancy is a state of physiological stress to a woman's health. Concomitant complications and infections during pregnancy may necessitate intensive monitoring and management of such patients in critical care settings. This study aims to determine the perceptions about the requirement of obstetric critical care based on the experience of obstetricians. Material and Methods: An observational, questionnaire-based study was conducted in 200 obstetricians working in various settings, who were approached during obstetric conferences...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29107602/maternal-ophthalmic-artery-doppler-ultrasonography-in-preeclampsia-and-pregnancy-outcomes
#6
Maria Teresa Pedrazzi Chaves, Sérgio Martins-Costa, Maria Lúcia da Rocha Oppermann, Ricardo Palma Dias, Valentino Magno, Julio Alejandro Peña, José Geraldo Lopes Ramos
OBJECTIVE: To examine the association of ophthalmic artery (OA) Doppler measure - the ratio of velocity peaks (PR) - to adverse pregnancy outcomes in preeclampsia. STUDY DESIGN AND MAIN OUTCOMES: Prospective cohort study of 56 women with preeclampsia that underwent Doppler measurements of OA flow, medial to optic nerve. PR results were classified as normal (PR < 0.78), abnormal (PR 0.78-0.98), or highly abnormal (PR ≥ 0.99). Attending clinicians were blinded to OA Doppler results...
October 19, 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29106923/impact-of-objective-echocardiographic-criteria-for-timing-of-congenital-diaphragmatic-hernia-repair
#7
Scott Deeney, Lisa W Howley, Maggie Hodges, Kenneth W Liechty, Ahmed I Marwan, Jason Gien, John P Kinsella, Timothy M Crombleholme
OBJECTIVE: To assess the impact of specific echocardiographic criteria for timing of congenital diaphragmatic hernia repair on the incidence of acute postoperative clinical decompensation from pulmonary hypertensive crisis and/or acute respiratory decompensation, with secondary outcomes including survival to discharge, duration of ventilator support, and length of hospitalization. STUDY DESIGN: The multidisciplinary congenital diaphragmatic hernia management team instituted a protocol in 2012 requiring the specific criterion of echocardiogram-estimated pulmonary artery pressure ≤80% systemic blood pressure before repairing congenital diaphragmatic hernias...
October 26, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29060958/a-case-of-hypertensive-crisis-without-a-surge-in-adrenal-hormones-after-radiofrequency-ablation-as-a-treatment-for-primary-hepatocellular-carcinoma
#8
Kyung Jin Lee, Soo Hyung Ryu
Radiofrequency ablation (RFA) is a minimally invasive procedure that has been considered as a relatively safe treatment for patients with small hepatocellular carcinoma (HCC). However, RFA has been shown to be associated with complications including mechanical and thermal damage. A 74-year-old man with hepatitis C virus-associated HCC was admitted to our hospital. Abdominal computed tomography revealed two lobulated-HCC in segments 4 and 5. He had no medical history of hypertension and cardiac disease. During RFA, blood pressure was elevated to 200/140 mmHg...
October 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29050867/acute-type-a-aortic-dissection-in-a-patient-with-paraganglioma
#9
Andreia Dos Santos Borrego, Pedro Carrilho Ferreira, Fausto J Pinto
Acute aortic dissection is the most common acute aortic syndrome. It is more prevalent in males and in the elderly, and has a high mortality. Hypertension is the main risk factor. Diagnosis is based on clinical features, laboratory tests and imaging exams. Treatment is usually surgical, although in some cases an endovascular approach is an alternative. Paraganglioma is an uncommon neuroendocrine tumor. Most produce catecholamines, and so usually manifest with hypertensive crisis, palpitations, headache and sweating...
October 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29046266/guidelines-and-mhealth-to-improve-quality-of-hypertension-and-type-2-diabetes-care-for-vulnerable-populations-in-lebanon-longitudinal-cohort-study
#10
Shannon Doocy, Kenneth E Paik, Emily Lyles, Hok Hei Tam, Zeina Fahed, Eric Winkler, Kaisa Kontunen, Abdalla Mkanna, Gilbert Burnham
BACKGROUND: Given the protracted nature of the crisis in Syria, the large noncommunicable disease (NCD) caseload of Syrian refugees and host Lebanese, and the high costs of providing NCD care, the implications for Lebanon's health system are vast. OBJECTIVE: The aim of this study was to evaluate the effectiveness of treatment guidelines and a mobile health (mHealth) app on quality of care and health outcomes in primary care settings in Lebanon. METHODS: A longitudinal cohort study was implemented from January 2015 to August 2016 to evaluate the effectiveness of treatment guidelines and an mHealth app on quality of care and health outcomes for Syrian and Lebanese patients in Lebanese primary health care (PHC) facilities...
October 18, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29042191/roadmap-to-achieve-25-hypertension-control-in-africa-by-2025
#11
Anastase Dzudie, Brian Rayner, Dike Ojji, Aletta E Schutte, Marc Twagirumukiza, Albertino Damasceno, Seringe Abdou Ba, Abdoul Kane, Euloge Kramoh, Jean Baptiste Anzouan Kacou, Basden Onwubere, Ruth Cornick, Karen Sliwa, Benedict Anisiuba, Ana Olga Mocumbi, Elijah Ogola, Mohamed Awad, George Nel, Harun Otieno, Ali Ibrahim Toure, Samuel Kingue, Andre Pascal Kengne, Pablo Perel, Alma Adler, Neil Poulter, Bongani Mayosi
BACKGROUND: The Pan-African Society of Cardiology (PASCAR) has identified hypertension as the highest area of priority action to reduce heart disease and stroke on the continent. OBJECTIVES: The aim of this PASCAR roadmap on hypertension was to develop practical guidance on how to implement strategies that translate existing knowledge into effective action and improve detection, treatment and control of hypertension and cardiovascular health in sub-Saharan Africa (SSA) by the year 2025...
October 14, 2017: Global Heart
https://www.readbyqxmd.com/read/28993436/efficacy-of-resveratrol-to-supplement-oral-nifedipine-treatment-in-pregnancy-induced-preeclampsia
#12
Jian Ding, Yan Kang, Yuqin Fan, Qi Chen
OBJECTIVE: Preeclampsia (PE) is a complication affecting pregnant women worldwide, which usually manifests as severe maternal hypertension. Resveratrol (RESV), a naturally existing polyphenol, is known to exhibit beneficial effects in cardiovascular disease including hypertension. We evaluated the outcome of treatment combining oral nifedipine (NIFE) and RESV against PE. DESIGN AND METHODS: Using a randomized group assignment, 400 PE patients were enrolled and received oral treatments of either NIFE + RESV or NIFE + placebo...
November 2017: Endocrine Connections
https://www.readbyqxmd.com/read/28992172/points-to-consider-in-renal-involvement-in-systemic-sclerosis
#13
REVIEW
Felice Galluccio, Ulf Müller-Ladner, Daniel E Furst, Dinesh Khanna, Marco Matucci-Cerinic
This article discusses points to consider when undertaking a clinical trial to test therapy for renal involvement in SSc, not including scleroderma renal crisis. Double-blind, randomized controlled trials vs placebo or standard background therapy should be strongly considered. Inclusion criteria should consider a pre-specified range of renal functions or stratification of renal function. Gender and age limitations are probably not necessary. Concomitant medications including vasodilators, immunosuppressants and endothelin receptor antagonists and confounding illnesses such as diabetes, kidney stones, hypertension and heart failure need to be considered...
September 1, 2017: Rheumatology
https://www.readbyqxmd.com/read/28979829/hypertensive-encephalopathy-a-case-of-a-male-who-bit-off-his-fingers
#14
Carole H Kim, Saba Syed
Although altered consciousness and other neurologic manifestations are frequently seen in hypertensive encephalopathy, behavioral and psychotic symptoms are rarely seen. We describe a patient with no previous psychiatric history who was admitted for hypertensive crisis. A few days after admission, his blood pressure remained uncontrolled and he started to exhibit episodes of confusion, agitation, and psychosis. During one particular episode, he overcame multiple staff members and physical restraints to bite off two of his fingers without any signs of pain...
June 11, 2017: Curēus
https://www.readbyqxmd.com/read/28975529/pulse-contour-analysis-of-arterial-waveform-in-a-high-fidelity-human-patient-simulator
#15
Paolo Persona, Elisabetta Saraceni, Francesca Facchin, Enrico Petranzan, Matteo Parotto, Fabio Baratto, Carlo Ori, Sandra Rossi
The measurement of cardiac output (CO) may be useful to improve the assessment of hemodynamics during simulated scenarios. The purpose of this study was to evaluate the feasibility of introducing an uncalibrated pulse contour device (MostCare, Vytech, Vygon, Padova, Italy) into the simulation environment. MostCare device was plugged to a clinical monitor and connected to the METI human patient simulator (HPS) to obtain a continuous arterial waveform analysis and CO calculation. In six different simulated clinical scenarios (baseline, ventricular failure, vasoplegic shock, hypertensive crisis, hypovolemic shock and aortic stenosis), the HPS-CO and the MostCare-CO were simultaneously recorded...
October 3, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28960144/blood-pressure-regulation-reviewing-evidence-for-interplay-between-common-dietary-sugars-and-table-salt
#16
Harry G Preuss, Dallas Clouatre, Anand Swaroop, Manashi Bagchi, Debasis Bagchi, Gilbert R Kaats
A popular concept is that the significant global progression in prevalence and intensification of elevated blood pressure (BP) levels is due in part to dietary indiscretions. Excess intake of several food sources causing overweight/obesity plays an important role in BP perturbations. However, certain nutrients are involved in ways other than via body fat accumulation, particularly table salt (sodium chloride) and popular refined carbohydrates like dietary sugars (sucrose, fructose, high fructose corn syrup)...
September 29, 2017: Journal of the American College of Nutrition
https://www.readbyqxmd.com/read/28958611/clevidipine-for-hypertension-treatment-in-pheochromocytoma-surgery
#17
C Luis-García, E Arbonés-Aran, C Teixell-Aleu, L Lorente-Poch, L Trillo-Urrutia
Pheochromocytoma is a catecholamine-producing tumour and laparoscopic adrenalectomy is its treatment of choice. During pneumoperitoneum insufflation and tumour handling there is a high risk of massive catecholamine release and hypertensive crisis. After tumour excision, severe arterial hypotension is a common effect, due to relative vasodilation and the residual effect of antihypertensive drugs. We report the case of a patient with pheochromocytoma who was treated with laparoscopic adrenalectomy. During surgical manipulation there was a sudden hypertensive peak that could be controlled quickly with clevidipine infusion...
September 25, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28938507/-hypertensive-emergencies
#18
Gerd Bönner
Hypertensive urgency and hypertensive emergency are associated with sudden, massive rise in blood pressure. An acute increase in blood pressure to values above 180/120 mmHg is considered critical. If not treated in time, it can quickly enter a life-threatening hypertensive emergency. The symptoms or organ damage determine the assessment as a crisis or an emergency. Rapid action is required. The therapy depends on the severity and the organ involvement. However the general principal is to avoid therapeutically induced hypotension...
September 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28937294/hypertensive-crisis-in-pregnancy-due-to-a-metamorphosing-pheochromocytoma-with-postdelivery-cushing-s-syndrome
#19
Katharina Langton, Matthias Gruber, Jimmy Masjkur, Charlotte Steenblock, Mirko Peitzsch, Jörn Meinel, Jacques Lenders, Stefan Bornstein, Graeme Eisenhofer
Pheochromocytomas in pregnancy are rare but potentially lethal. Even rarer is the combination of pheochromocytoma in pregnancy with subsequent development of ectopic Cushing's syndrome. We report a 36-year-old woman, previously diagnosed with essential hypertension, who developed severe hypertension in pregnancy complicated by insulin-dependent gestational diabetes. A cesarean section was performed at 32 weeks following a hypertensive crisis after routine administration of betamethasone. Postnatal persistence of signs and symptoms of catecholamine excess led to the diagnosis of a left adrenal pheochromocytoma...
September 22, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28906541/roadmap-to-achieve-25-hypertension-control-in-africa-by-2025
#20
Anastase Dzudie, Brian Rayner, Dike Ojji, Aletta E Schutte, Marc Twagirumukiza, Albertino Damasceno, Seringe Abdou Ba, Abdoul Kane, Euloge Kramoh, Jean Baptiste Kacou, Basden Onwubere, Ruth Cornick, Karen Sliwa, Benedict Anisiuba, Ana Olga Mocumbi, Elijah Ogola, Mohamed Awad, George Nel, Harun Otieno, Ali Ibrahim Toure, Samuel Kingue, Andre Pascal Kengne, Pablo Perel, Alma Adler, Neil Poulter, Bongani Mayosi
BACKGROUND AND AIM: The Pan-African Society of Cardiology (PASCAR) has identified hypertension as the highest area of priority for action to reduce heart disease and stroke on the continent. The aim of this PASCAR roadmap on hypertension was to develop practical guidance on how to implement strategies that translate existing knowledge into effective action and improve detection, treatment and control of hypertension and cardiovascular health in sub-Saharan Africa (SSA) by the year 2025...
July 2017: Cardiovascular Journal of Africa
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