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https://www.readbyqxmd.com/read/27910296/the-year-since-the-guidelines-a-concise-update-on-recent-advances-in-pulmonary-hypertension
#1
Abhishek Mishra, Maninder Singh, Edo Kaluski
Since the updated pulmonary hypertension (PH) guidelines published in 2015, two major landmark trials have provided additional insight regarding therapeutic algorithms of PH. In this review, we concisely summarized the key findings of peer‑reviewed studies published in the last one year in the field of PH. These studies have enhanced our therapeutic abilities by introducing a new potent agent, selexipag, and by demonstrating the advantage of upfront combination therapy (endothelin receptor antagonist and phosphodiesterase‑5 inhibitor) versus single agent therapy in group 1 PH...
February 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/27908896/depression-screening-with-patient-targeted-feedback-in-cardiology-depscreen-info-randomised-clinical-trial
#2
Bernd Löwe, Stefan Blankenberg, Karl Wegscheider, Hans-Helmut König, Dirk Walter, Alexandra M Murray, Benjamin Gierk, Sebastian Kohlmann
BACKGROUND: International guidelines advocate depression screening in patients with coronary heart disease (CHD) and other chronic illnesses, but evidence is lacking. AIMS: To test the differential efficacy of written patient-targeted feedback v. no written patient feedback after depression screening. METHOD: Patients with CHD or hypertension from three cardiology settings were randomised and screened for depression (ClinicalTrials.gov Identifier: NCT01879111)...
December 1, 2016: British Journal of Psychiatry: the Journal of Mental Science
https://www.readbyqxmd.com/read/27906755/optimal-blood-pressure-target-in-stroke-prevention
#3
Alexandra Yannoutsos, Céline Dreyfuss Tubiana, Michel E Safar, Jacques Blacher
PURPOSE OF REVIEW: A generalized single blood pressure (BP) goal may appear not suitable to achieve an optimal stroke prevention at the individual level. The aim of the present review is to consider the clinical relevance of individualized BP goal according to patient's age, comorbidities and established cerebrovascular disease. RECENT FINDINGS: Observational and interventional data support heterogeneity in target organ prevention in that lower BP values than recommended by hypertension guidelines are associated with further stroke risk reduction...
November 30, 2016: Current Opinion in Neurology
https://www.readbyqxmd.com/read/27906717/spectrum-of-postoperative-complications-in-pulmonary-hypertension-and-obesity-hypoventilation-syndrome
#4
Roop K Kaw
PURPOSE OF REVIEW: The purpose of this review is to identify chronic pulmonary conditions which may often not be recognized preoperatively especially before elective noncardiac surgery and which carry the highest risk of perioperative morbidity and mortality. RECENT FINDINGS: This review discusses some of the most recent studies that highlight the perioperative complications, and their prevention and management strategies. SUMMARY: Pulmonary hypertension is a well recognized risk factor for postoperative complications after cardiac surgery but the literature surrounding noncardiac surgery is sparse...
November 30, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27903844/therapeutic-approaches-to-pediatric-pseudotumor-cerebri-new-insights-from-literature-data
#5
Giovanna Vitaliti, Piero Pavone, Nassim Matin, Omidreza Tabatabaie, Salvatore Cocuzza, Michele Vecchio, Luigi Maiolino, Paola Di Mauro, Angelo Conti, Riccardo Lubrano, Agostino Serra, Raffaele Falsaperla
The pseudotumor cerebri syndrome (PTCS), also known as idiopathic intracranial hypertension (IIH), is characterized by signs and symptoms of increased intracranial pressure such as headache and cranial nerve palsies, in the absence of any space-occupying mass. This condition commonly affects overweight women of childbearing age, even if it is also frequent in men and children. Children with PTCS may present with atypical signs and symptoms, with a different prognosis compared to adults. However, the treatment is the same for both children and adults, even if there are no strict treatment guidelines in regards...
November 30, 2016: International Journal of Immunopathology and Pharmacology
https://www.readbyqxmd.com/read/27903665/pregnancy-in-pulmonary-arterial-hypertension
#6
REVIEW
Karen M Olsson, Richard Channick
Despite advanced therapies, maternal mortality in women with pulmonary arterial hypertension (PAH) remains high in pregnancy and is especially high during the post-partum period. However, recent data indicates that morbidity and mortality during pregnancy and after birth have improved for PAH patients. The current European Society of Cardiology/European Respiratory Society guidelines recommend that women with PAH should not become pregnant. Therefore, the risks associated with pregnancy must be emphasised and counselling offered to women at the time of PAH diagnosis and to women with PAH who become pregnant...
December 2016: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/27903661/risk-assessment-in-pulmonary-arterial-hypertension
#7
REVIEW
Amresh Raina, Marc Humbert
Regular patient assessment is essential for the management of chronic diseases, such as pulmonary arterial hypertension (PAH). Comprehensive patient assessment and risk stratification in PAH are important to guide treatment decisions and to monitor disease progression as well as patients' response to treatment. Approaches for assessing risk in PAH patients include the use of risk variables, as recommended in the 2015 European Society of Cardiology (ESC)/European Respiratory Society (ERS) pulmonary hypertension (PH) guidelines, and the application of risk equations and scores, such as the French registry risk equation and the REVEAL registry risk score...
December 2016: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/27903027/-esc-guidelines-2015-pulmonary-hypertension-diagnosis-and-treatment
#8
Christian Opitz, Stephan Rosenkranz, Hossein Ardeschir Ghofrani, Ekkehard Grünig, Hans Klose, Horst Olschewski, Marius Hoeper
Pulmonary hypertension (PH) is characterized by an increase in PAPmean > 25 mmHg associated with a reduced life expectancy. Recent advances in the management of these patients provided the basis for the updated recommendations of the 2015 joint guidelines of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS) on the diagnosis and treatment of pulmonary hypertension. The updated version includes important modifications with regards to hemodynamic definitions, clinical classification and diagnostic assessment of patients with PH...
November 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27902588/short-term-hypertension-management-in-community-is-associated-with-long-term-risk-of-stroke-and-total-death-in-china-a-community-controlled-trial
#9
Zengwu Wang, Guang Hao, Xin Wang, Wen Wang, Weiwei Chen, Manlu Zhu
BACKGROUND: It is not fully clear whether the effect of short-term management in community can reduce the long-term risk of stroke OBJECTIVES:: To evaluate whether short-term hypertension management is associated with long-term incidence of stroke and total death in community health centers in China. DESIGN: Community controlled trail. PARTICIPANTS: Six community health centers (4 active, 2 control) in China, patients with hypertension. CONTROL ARM: Patients were treated with normally therapy method...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27898507/blood-pressure-control-in-hypertension-pros-and-cons-of-available-treatment-strategies
#10
Giuseppe Mancia, Federico Rea, Cesare Cuspidi, Guido Grassi, Giovanni Corrao
The low rate of blood pressure (BP) control that characterizes the hypertensive population in real life is traditionally associated to factors such as low adherence of patients to the prescribed treatment regimen, physicians' therapeutic inertia, and deficiencies of the healthcare systems. This study will focus on a fourth factor that may also be importantly involved, i.e. reluctance to adopt drug treatment strategies that more effectively reduce an elevated BP. The point will be made that, vis-à-vis strategies based on patients' persistence in monotherapy, drug combinations are accompanied by a much more frequent BP control...
November 24, 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27896702/safety-of-regadenoson-stress-testing-in-patients-with-pulmonary-hypertension
#11
Victor M Moles, Thomas Cascino, Ashraf Saleh, Krasimira Mikhova, John J Lazarus, Michael Ghannam, Hong J Yun, Matthew Konerman, Richard L Weinberg, Edward P Ficaro, James R Corbett, Vallerie V McLaughlin, Venkatesh L Murthy
OBJECTIVES: We sought to determine the safety of regadenoson stress testing in patients with PH. BACKGROUND: PH is increasingly recognized at more advanced ages. As many as one-third of patients with PH have coronary artery disease. Because of their physical limitations, patients with PH are unable to adequately exercise. Regadenoson can potentially have an adverse impact due to their tenuous hemodynamics. Current guidelines suggest performing a coronary angiography in patients with PH who have angina or multiple coronary risk factors...
November 28, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/27895411/reoperation-in-an-adult-female-with-right-sided-hirschsprung-s-disease-complicated-by-refractory-hypertension-and-cough
#12
Zhi-Jian Wei, Lei Huang, A-Man Xu
Hirschsprung's disease (HD) is an intestinal malformation caused by the innate absence of ganglion cells in the neural plexus of the colorectal wall, and is most common in male infants. It is rare in adult, and is usually left-sided. Herein we reported based on the CARE guidelines a case of a 47-year-old adult female suffering from "right-sided" HD complicated by refractory hypertension and cough. The patient with a history of cesarean section and with digestive unfitness (abdominal pain, distention, and constipation) only since 20 years old had recurrence of HD after initial surgery due to the incomplete removal of the HD-affected bowel based on a diagnosis of "chronic ileus", leading to the relapse of the digestive symptoms and the emergence of some intractable circulatory and respiratory complications which could be hardly controlled by conservative treatment...
November 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27893055/assessment-of-use-vs-discontinuation-of-oral-anticoagulation-after-pulmonary-vein-isolation-in-patients-with-atrial-fibrillation
#13
Sara Själander, Fredrik Holmqvist, J Gustav Smith, Pyotr G Platonov, Milos Kesek, Peter J Svensson, Carina Blomström-Lundqvist, Fariborz Tabrizi, Jari Tapanainen, Dritan Poci, Anders Jönsson, Anders Själander
Importance: Pulmonary vein isolation (PVI) is a recommended treatment for patients with atrial fibrillation, but it is unclear whether it results in a lower risk of stroke. Objectives: To investigate the proportion of patients discontinuing anticoagulation treatment after PVI in association with the CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years [doubled], diabetes, stroke [doubled], vascular disease, age 65-74 years, sex category [female]) score, identify factors predicting stroke after PVI, and explore the risk of cardiovascular events after PVI in patients with and without guideline-recommended anticoagulation treatment...
November 23, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27890892/a-survey-of-actual-clinical-practice-concerning-blood-pressure-control-among-patients-with-hypertension-in-kanagawa-2014
#14
Nobuo Hatori, Hiroyuki Sakai, Kazuyoshi Sato, Masayuki Miyajima, Shouhei Yuasa, Shingo Kuboshima, Keiichi Kajiwara, Yoshikuni Hara, Kousuke Minamizawa, Masaaki Miyakawa
We performed a cross-sectional survey to investigate actual clinical practice concerning blood-pressure control among patients with hypertension in Kanagawa. The guidelines of the Japanese Society of Hypertension (JSH) for the management of patients with hypertension were revised in 2014. From October 1 to November 30, 2014, questionnaires on the care of patients with hypertension were sent via post to members of the Kanagawa Physicians Association in Kanagawa Prefecture, Japan. -Data on 1,105 patients (mean age: 68...
2016: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/27887750/chronic-kidney-disease
#15
REVIEW
Angela C Webster, Evi V Nagler, Rachael L Morton, Philip Masson
The definition and classification of chronic kidney disease (CKD) have evolved over time, but current international guidelines define this condition as decreased kidney function shown by glomerular filtration rate (GFR) of less than 60 mL/min per 1·73 m(2), or markers of kidney damage, or both, of at least 3 months duration, regardless of the underlying cause. Diabetes and hypertension are the main causes of CKD in all high-income and middle-income countries, and also in many low-income countries. Incidence, prevalence, and progression of CKD also vary within countries by ethnicity and social determinants of health, possibly through epigenetic influence...
November 22, 2016: Lancet
https://www.readbyqxmd.com/read/27884494/consensus-conference-on-tips-management-techniques-indications-contraindications
#16
Stefano Fagiuoli, Raffaele Bruno, Wilma Debernardi Venon, Filippo Schepis, Francesco Vizzutti, Pierluigi Toniutto, Marco Senzolo, Paolo Caraceni, Francesco Salerno, Paolo Angeli, Roberto Cioni, Alessandro Vitale, Maurizio Grosso, Andrea De Gasperi, Gennaro D'Amico, Alfredo Marzano
The trans jugular intrahepatic Porto systemic shunt (TIPS) is no longer viewed as a salvage therapy or a bridge to liver transplantation and is currently indicated for a number of conditions related to portal hypertension with positive results in survival. Moreover, the availability of self-expandable polytetrafluoroethylene (PTFE)-covered endoprostheses has dramatically improved the long-term patency of TIPS. However, since the last updated International guidelines have been published (year 2009) new evidence have come, which have open the field to new indications and solved areas of uncertainty...
October 29, 2016: Digestive and Liver Disease
https://www.readbyqxmd.com/read/27884454/-management-of-adverse-effects-related-to-human-immunoglobulin-therapy-recommendations-for-clinical-practice
#17
I Marie, P Chérin, M Michallet, E Pelus, J Dantal, J-C Crave, J-C Delain, J-F Viallard
Both intravenous and subcutaneous immunoglobulins are therapeutic modalities approved in various conditions, including primary and secondary immune deficiencies and autoimmune disorders. To date, immunoglobulins have more often been considered as a safe medication, with minor adverse effects such as hypertension, fever and chills, nausea, myalgia or headache. However, with the wider use of immunoglobulins in the treatment of autoimmune diseases, severe side effects have also been reported to occur in immunoglobulin-treated patients, especially anaphylaxis, aseptic meningitis, acute renal impairment, thrombotic events as well as haematological manifestations...
November 21, 2016: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/27884231/guidelines-for-the-management-of-hypertension
#18
REVIEW
Aram V Chobanian
This article summarizes pertinent data from clinical trials on the effects of antihypertensive therapy on cardiovascular complications. Prior definitions of hypertension and blood pressure goals of therapy are discussed, and differences between national and international guidelines on such goals are summarized. The results of the SPRINT study are summarized, and the impact of this study on future goals of treatment is discussed. New recommendations are provided on blood pressure goals, and the effects such goals might have on clinical practice are discussed...
January 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/27883326/renal-replacement-therapy-in-patients-with-heart-and-kidney-failure
#19
Dimitrios S Goumenos, Evangelos Papachristou, Marios Papasotiriou
The incidence of chronic kidney disease (CKD) in patients with chronic heart failure (CHF) is high as CKD and CHF share underlying risk factors such as arterial hypertension, diabetes mellitus and atherosclerosis. Cardiac failure leads to renal hypoperfusion and dysfunction and then fluid overload and need for aggressive diuretic therapy. However, development of diuretic resistance represents a significant problem in the management of these patients. The role of Renal Replacement Therapy (RRT) is important for patients who do not response to conservative management of fluid overload facilitating the failing heart to restore function...
November 1, 2016: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/27880998/recurrent-acute-portal-vein-thrombosis-in-liver-cirrhosis-treated-by-rivaroxaban
#20
Hyeyoung Yang, Seo Ree Kim, Myeong Jun Song
Cirrhosis can occur with the development of portal vein thrombosis (PVT). PVT may aggravate portal hypertension, and it can lead to hepatic decompensation. The international guideline recommends for anticoagulation treatment to be maintained for at least 3 months in all patients with acute PVT. Low-molecular-weight-heparin and changing to warfarin is the usual anticoagulation treatment. However, warfarin therapy is problematic due to a narrow therapeutic window and the requirement for frequent dose adjustment, which has prompted the development of novel oral anticoagulants for overcoming these problems...
November 25, 2016: Clinical and Molecular Hepatology
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