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Zhanna Kobalava
The burden of cardiovascular diseases (CVD) in general and heart failure (HF) in particular continues to increase worldwide. CVD are major contributors to death and morbidity and recognized as important drivers of healthcare expenditure. Chronic overactivity of the renin-angiotensin-aldosterone system (RAAS) plays a key role in human hypertension and HF pathophysiology. RAAS is fundamental in the overall regulation of cardiovascular homeostasis through the actions of hormones, which regulate vascular tone, and specifically blood pressure through vasoconstriction and renal sodium and water retention...
September 2016: Journal of Hypertension
Chong-Jin Kim
With several lines of evidence, angiotensin-converting enzyme (ACE) inhibitors are recommended in patients with left ventricular systolic dysfunction or heart failure after myocardial infarction, and angiotensin receptor blockers (ARBs) are indicated in patients who are intolerant of ACE inhibitors. Up to 20% of patients cannot tolerate ACE inhibitors due to adverse reactions such as cough or angioedema, ARBs could be an alternative to ACE inhibitors. However, there is lack of data whether ARBs are comparable to ACE inhibitors in patients with myocardial infarction...
September 2016: Journal of Hypertension
Sharon Seth, David A Khan
BACKGROUND: Patients who have failed traditional treatment of chronic urticaria may require trials of alternative medications. Safety profiles, continuous laboratory monitoring, and physician comfort are often barriers to treatment. OBJECTIVES: To evaluate the safety of alternative agents used in chronic urticaria. METHODS: A retrospective chart review of electronic medical records from a single-center allergy and immunology clinic in a major academic hospital was conducted...
October 13, 2016: Journal of Allergy and Clinical Immunology in Practice
Andrea Zanichelli, Hilary J Longhurst, Marcus Maurer, Laurence Bouillet, Werner Aberer, Vincent Fabien, Irmgard Andresen, Teresa Caballero
BACKGROUND: Hereditary angioedema due to C1 inhibitor deficiency (C1-INH-HAE) causes swelling in the skin and upper airways and pain in the abdomen because of mucosal swelling. C1-INH-HAE is frequently misdiagnosed, leading to delays in diagnosis, inadequate treatment, and unnecessary procedures. OBJECTIVE: To evaluate the history of misdiagnosis in patients participating in the Icatibant Outcome Survey (IOS). METHODS: The IOS is an observational study in which safety and effectiveness of icatibant have been evaluated since 2009...
October 2016: Annals of Allergy, Asthma & Immunology
William D Johnson
No abstract text is available yet for this article.
October 2016: Annals of Allergy, Asthma & Immunology
Maria Vittoria De Angelis, Roberta Di Giacomo, Antonio Di Muzio, Marco Onofrj, Laura Bonanni
BACKGROUND: Movement disorder emergencies include any movement disorder which develops over hours to days, in which failure to appropriately diagnose and manage can result in patient morbidity or mortality.Movement disorder emergencies include acute dystonia: sustained or intermittent muscle contractions causing abnormal, often repetitive, movements. Acute dystonia is a serious challenge for emergency room doctors and neurologists, because of the high probability of misdiagnosis, due to the presence of several mimickers including partial seizures, meningitis, localized tetanus, serum electrolyte level abnormalities, strychnine poisoning, angioedema, malingering, catatonia, and conversion...
October 2016: Medicine (Baltimore)
G Cortellini, A Romano, A Santucci, A Barbaud, S Bavbek, D Bignardi, M Blanca, P Bonadonna, M T Costantino, J J Laguna, C Lombardo, L Losappio, J Makowska, A Nakonechna, O Quercia, E A Pastorello, V Patella, I Terreehorst, S Testi, J R Cernadas, J Dionicio Elera, D Lippolis, S Voltolini, D Grosseto
BACKGROUND: Hypersensitivity to acetylsalicylic acid (ASA) constitutes a serious problem for subjects with coronary artery disease. In such subjects, physicians have to choose the more appropriate procedure between challenge and desensitization. As the literature on this issue is sparse, the present study aims to establish in these subjects clinical criteria for eligibility for an ASA challenge and/or desensitization. METHODS: Collection and analysis of data on ASA challenges and desensitizations from 10 allergy centers, as well as consensus among the related physicians and an expert panel...
October 12, 2016: Allergy
Hiromasa Yakushiji, Arito Kaji, Keitarou Suzuki, Motohiro Yamada, Takahiko Horiuchi, Masahiro Sinozaki
We describe a patient with hereditary angioedema type I. The patient had experienced recurrent abdominal pain around the time of her menstrual period for 13 years. A laboratory examination showed reduced functional and antigenic levels of C4 and C1 inhibitor (C1-INH). To establish a diagnosis, we carried out a DNA analysis of the patient's C1-INH gene. We determined that the patient was heterozygous for a single base pair transposition of T to C at nucleotide 4429 in exon 4, which had not been reported in the literature...
2016: Internal Medicine
O F Ashubu, A D Ademola, A O Asinobi
Adverse drug reactions in children are an important public health problem. Children are at a higher risk of developing adverse drug reactions as they seldom express their own drug therapy experiences. Factors that have been implicated include polypharmacy especially with anti-infective and non-steroidal anti-inflammatory drugs; also concomitant use of traditional medicines which is prevalent in some cultures. Cutaneous drug allergy is a common manifestation of adverse drug reactions.
June 2016: Annals of Ibadan Postgraduate Medicine
A Frazer-Abel, L Sepiashvili, M M Mbughuni, M A V Willrich
Historically, complement disorders have been attributed to immunodeficiency associated with severe or frequent infection. More recently, however, complement has been recognized for its role in inflammation, autoimmune disorders, and vision loss. This paradigm shift requires a fundamental change in how complement testing is performed and interpreted. Here, we provide an overview of the complement pathways and summarize recent literature related to hereditary and acquired angioedema, infectious diseases, autoimmunity, and age-related macular degeneration...
2016: Advances in Clinical Chemistry
Roman Hakl
Hereditární angioedém je vzácné dominantně dědičné onemocnění způsobené deficitem inhibitoru C1-esterázy (C1-INH). Onemocnění se klinicky projevuje recidivami lokalizovaných otoků podkoží a sliznic. Nemoc je hendikepující a může být i smrtelná. Charakteristická je extrémní variabilita v četnosti a závažnosti symptomů. Článek se zabývá organizací péče o pacienty a zahrnuje aktuální léčebné možnosti onemocnění. Strategie léčby zahrnuje krátkodobou a dlouhodobou profylaxi a léčbu atak...
2016: Vnitr̆ní Lékar̆ství
Katherine N Cahill, Tanya M Laidlaw
The acute clinical symptoms that develop following the oral ingestion of aspirin, or any other inhibitor of cyclooxygenase-1, are well established in aspirin-exacerbated respiratory disease: nasal congestion, rhinorrhea, and bronchospasm. Less commonly, gastrointestinal distress, rash, angioedema, or urticaria also develops. However, the pathobiology that drives these clinical reactions is poorly understood. Use of an intranasal aspirin challenge protocol or administration of premedications inhibiting the leukotriene pathway decreases the severity of clinical reaction, which suggests the involvement of both local effector cells and cysteinyl leukotrienes in the pathogenesis of aspirin-induced reactions...
November 2016: Immunology and Allergy Clinics of North America
Francesco Gaeta, Maria J Torres, Rocco Luigi Valluzzi, Cristiano Caruso, Cristobalina Mayorga, Antonino Romano
Hypersensitivity reactions to β-lactam antibiotics are commonly reported. They can be classified as immediate or non-immediate according to the time interval between the last drug administration and their onset. Immediate reactions occur within one hour after the last drug administration and are manifested clinically by urticaria and/or angioedema, rhinitis, bronchospasm, and anaphylactic shock; they may be mediated by specific IgE-antibodies. Non-immediate reactions occur more than one hour after the last drug administration...
October 4, 2016: Current Pharmaceutical Design
Chen Amy Chen, Valerie Carlberg, Daniela Kroshinsky
Alopecia areata (AA) involves the immune-related destruction of hair follicles, resulting in patches of complete hair loss, most often on the scalp. The topical sensitizer squaric acid dibutylester (SADBE) is a popular treatment option given its low side-effect profile, hair regrowth potential, and lack of cross-reactivity with other chemicals. We describe a unique case of a 6-year-old girl who developed angioedema after SADBE treatment for AA.
October 4, 2016: Pediatric Dermatology
Anette Bygum, Inmaculada Martinez-Saguer, Murat Bas, Jeffrey Rosch, Jonathan Edelman, Mikhail Rojavin, Debora Williams-Herman
BACKGROUND: Treatment of hereditary angioedema (HAE) in 'older adults' (those aged ≥65 years) has not been well studied. The international Berinert Patient Registry collected data on the use of intravenous plasma-derived, pasteurized, nanofiltered C1-inhibitor concentrate (pnfC1-INH; Berinert(®)/CSL Behring) in patients of any age, including many older adults. METHODS: This observational registry, conducted from 2010 to 2014 at 30 US and seven European sites, gathered prospective (post-enrollment) and retrospective (pre-enrollment) usage and adverse event (AE) data on subjects treated with pnfC1-INH...
October 4, 2016: Drugs & Aging
Chirag Bavishi, Mohammed Ahmed, Vrinda Trivedi, Abdur Rahman Khan, Carlos Gongora, Sripal Bangalore, Franz H Messerli
The comparative efficacy and safety of angiotensin-converting enzyme inhibitors (ACEIs) with other agents in patients ≥65 years of age with cardiovascular diseases or at-risk are unknown. Electronic databases were systematically searched to identify all randomized controlled trials that compared ACEIs with control (placebo or active) and reported long-term cardiovascular outcomes. We required the mean age of patients in the studies to be ≥65 years. Random-effects model was used to pool study results. Sixteen trials with 104,321 patients and a mean follow-up of 2...
August 22, 2016: American Journal of Cardiology
Kanokvalai Kulthanan, Papapit Tuchinda, Leena Chularojanamontri, Pattriya Chanyachailert, Wiwat Korkij, Amornsri Chunharas, Siriwan Wananukul, Wanida Limpongsanurak, Suwat Benjaponpitak, Wanee Wisuthsarewong, Kobkul Aunhachoke, Vesarat Wessagowit, Pantipa Chatchatee, Penpun Wattanakrai, Orathai Jirapongsananuruk, Jettanong Klaewsongkram, Nopadon Noppakun, Pakit Vichyanond, Puan Suthipinittharm, Kiat Ruxrungtham, Srisupalak Singalavanija, Jarungchit Ngamphaiboon
Urticaria is a common skin condition that can compromise quality of life and may affect individual performance at work or school. Remission is common in majority of patients with acute spontaneous urticaria (ASU); however, in chronic cases, less than 50% had remission. Angioedema either alone or with urticaria is associated with a much lower remission rate. Proper investigation and treatment is thus required. This guideline, a joint development of the Dermatological Society of Thailand, the Allergy, Asthma, and Immunology Association of Thailand and the Pediatric Dermatological Society of Thailand, is graded and recommended based on published evidence and expert opinion...
September 2016: Asian Pacific Journal of Allergy and Immunology
Lisa S MacBeth, Gerald W Volcheck, Juraj Sprung, Toby N Weingarten
PURPOSE: Two types of bradykinin-mediated angioedema, hereditary angioedema (HAE) and acquired angioedema (AAE), result from deficiency or dysfunction of C1 esterase inhibitor, leading to an overproduction of bradykinin, which can lead to vascular permeability and life-threatening angioedema of the airway. The objective of this study was to review perioperative outcomes in a series of patients with HAE and AAE and to review current knowledge about anesthetic complications in patients with HAE or AAE...
November 2016: Journal of Clinical Anesthesia
Laura López-Delgado, Juan Carlos López-Fernández
No abstract text is available yet for this article.
September 26, 2016: Medicina Clínica
Veronica Squeglia, Alessandro Barbarino, Maria Bova, Carmela Gravante, Angelica Petraroli, Giuseppe Spadaro, Massimo Triggiani, Arturo Genovese, Gianni Marone
BACKGROUND: Hereditary angioedema with C1-inhibitor deficiency (C1-INH-HAE) is characterized by recurrent attacks of swelling that affect various body sites. Such attacks are a frequent cause of visits to the emergency department and are often treated in the hospital. In recent years, self-administration of C1-inhibitor (C1-INH) concentrates at home has become an increasingly used option, with a positive impact on patient outcomes and quality of life. METHODS: This was an observational study of 6 months' duration in 56 patients with C1-INH-HAE referred to a HAE center in southern Italy...
September 29, 2016: Orphanet Journal of Rare Diseases
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