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Pulmonary hypertension diagnosis and treatment

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https://www.readbyqxmd.com/read/27903659/pulmonary-hypertension-the-importance-of-correctly-diagnosing-the-cause
#1
Sanjay Mehta, Jean-Luc Vachiéry
Pulmonary hypertension (PH) is a complex condition that can occur as a result of a wide range of disorders, including left heart disease, lung disease and chronic pulmonary thromboembolism. Contemporary PH patients are older and frequently have a multitude of comorbidities that may contribute to or simply coincide with their PH. Identifying the cause of PH in these complicated patients can be challenging but is essential, given that the aetiology of the disease has a significant impact on the management options available...
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
#2
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/27899401/neonatal-and-childhood-neurodevelopmental-health-and-educational-outcomes-of-children-exposed-to-antidepressants-and-maternal-depression-during-pregnancy-protocol-for-a-retrospective-population-based-cohort-study-using-linked-administrative-data
#3
Deepa Singal, Marni Brownell, Dan Chateau, Chelsea Ruth, Laurence Y Katz
INTRODUCTION: Antidepressants are commonly prescribed during pregnancy; however, there are inconsistent data on the safety of these medications during the prenatal period. To address this gap, this study will investigate short-term and long-term neurodevelopmental, physical and mental health, and educational outcomes of children who have been exposed to selective serotonin reuptake inhibitors (SSRIs) or selective serotonin norepinephrine reuptake inhibitors (SNRIs) and/or maternal depression during pregnancy...
November 29, 2016: BMJ Open
https://www.readbyqxmd.com/read/27894061/direct-bilirubin-a-new-risk-factor-of-adverse-outcome-in-idiopathic-pulmonary-arterial-hypertension
#4
Xi-Qi Xu, Zi-Chao Lv, Qian-Qian Liu, Qin-Hua Zhao, Yan Wu, Kai Sun, Xin Jiang, Lan Wang, Fu-Hua Peng, Zhi-Cheng Jing
BACKGROUND: Previous studies have shown that elevated total bilirubin was associated with advanced heart failure, yet no study has ascertained the predictive value of direct serum bilirubin (DBIL) in idiopathic pulmonary arterial hypertension (IPAH). This study aimed to investigate the predictive value of both baseline and follow-up DBIL in patients with IPAH. METHODS: Serum DBIL was measured in 404 IPAH patients at enrollment. Almost 92% patients received specific drugs after diagnosis confirmed...
November 7, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27886893/erectile-dysfunction-agents-and-nonarteritic-anterior-ischemic-optic-neuropathy
#5
REVIEW
Howard D Pomeranz
Phosphodiesterase-5 inhibitors (PDE5I) are used for treatment of erectile dysfunction and pulmonary arterial hypertension and have been implicated as a causative factor for development of nonarteritic anterior ischemic optic neuropathy (NAION). Controversy remains regarding a cause and effect between PDE5I use and NAION because the mechanism by which NAION occurs is still not well understood. Because neuro-ophthalmologists have accepted that there is a potential relationship between ingestion of the PDE5I class of medications and NAION, the neuro-ophthalmologist should inquire about PDE5I use when evaluating a patient with a new diagnosis of NAION, and counsel patients regarding the implication of continued use of PDE5I...
February 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/27872176/the-evolving-landscape-of-combination-therapy-for-pulmonary-arterial-hypertension
#6
REVIEW
Matthew Griffin, Terence K Trow
Pulmonary arterial hypertension (PAH) is a progressively fatal disease, and the goal in treatment is to prevent disease progression. The standard of care often involves medications from multiple therapeutic classes, and there has been significant interest both in the choice of agent as well as the timing of initiation. There is a growing body of support for starting multiple medications at the time of diagnosis, or 'upfront ', rather than using sequential addition to prevent clinical deterioration.
November 21, 2016: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/27870387/primary-myelofibrosis-2017-update-on-diagnosis-risk-stratification-and-management
#7
Ayalew Tefferi
: Disease overview: Primary myelofibrosis (PMF) is a myeloproliferative neoplasm (MPN) characterized by stem cell-derived clonal myeloproliferation that is often but not always accompanied by JAK2, CALR or MPL mutation, abnormal cytokine expression, bone marrow fibrosis, anemia, splenomegaly, extramedullary hematopoiesis (EMH), constitutional symptoms, cachexia, leukemic progression and shortened survival. DIAGNOSIS: Diagnosis is based on bone marrow morphology...
December 2016: American Journal of Hematology
https://www.readbyqxmd.com/read/27851839/diagnosis-treatment-and-clinical-management-of-pulmonary-arterial-hypertension-in-the-contemporary-era-a-review
#8
Bradley A Maron, Nazzareno Galiè
Importance: Pulmonary arterial hypertension (PAH) is characterized by severe remodeling of the distal pulmonary arteries, increased pulmonary vascular resistance, and right ventricular dysfunction that promotes heart failure. Once regarded as largely untreatable, evidence-based decision making now guides clinical management of PAH and improves outcomes. However, misconceptions regarding the approach to PAH in the modern era are common and associated with substandard clinical care. Observations: The clinical profile of PAH has changed substantially since its original description...
November 16, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27825176/-pulmonary-hypertension-cologne-consensus-conference-2016
#9
Stephan Rosenkranz, Hossein Ardeschir Ghofrani, Ekkehard Grünig, Hans Klose, Horst Olschewski, Christian Opitz, Marius Hoeper
Recently, the updated European Guidelines on the Diagnosis and Treatment of Pulmonary Hypertension (PH) have been published. The practical implementation of the guidelines considering country-specific aspects, current data and individual features is essential for clinical patient care. In order to accomplish this, in June 2016 the 2(nd) Cologne Consensus Conference organized by the PH working groups of the German Society of Cardiology (DGK), the German Society of Respiratory Medicine (DGP) and the German Society of Pediatric Cardiology (DGPK) was held in Cologne, Germany...
November 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27816427/causes-of-death-in-184-patients-with-type-1-gaucher-disease-from-the-united-states-who-were-never-treated-with-enzyme-replacement-therapy
#10
Neal J Weinreb, Deborah S Barbouth, Robert E Lee
Treatment for type 1 Gaucher disease (GD1) decreases morbidity from hematological cytopenias, hepatosplenomegaly and bone complications. Consequently, untreated symptomatic patients for study of late outcomes are hard to find. We identified 184 untreated GD1 patients (67.4% Ashkenazi; splenectomy 51.1%) who died between 1950 and 2010. Here, we report confirmed causes of death for these patients compared with the overall US population. Median age of death 66years (2-97years); causes of death (COD) with a high proportional mortality rate (PMR) included malignancies (PMR 1...
October 24, 2016: Blood Cells, Molecules & Diseases
https://www.readbyqxmd.com/read/27809901/combined-pulmonary-fibrosis-and-emphysema-a-retrospective-analysis-of-clinical-characteristics-treatment-and-prognosis
#11
Lijuan Zhang, Chunling Zhang, Fushi Dong, Qi Song, Fangzhou Chi, Lu Liu, Yupeng Wang, Chunli Che
BACKGROUND: Combined pulmonary fibrosis and emphysema (CPFE) is increasingly acknowledged as a separate syndrome with distinct clinical, physiological and radiological characteristics. We sought to identify physiologic and radiographic indices that predict mortality in CPFE. METHODS: Data on clinical characteristics, pulmonary function, high-resolution computed tomography (HRCT) and treatment were compared between patients with usual interstitial pneumonia (UIP) plus emphysema (CPFE group) and those with IPF alone (IPF group)...
November 3, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27801422/-clinical-guidelines-for-the-diagnosis-and-treatment-of-chronic-thromboembolic-pulmonary-hypertension-part-2
#12
I E Chazova, T V Martynyuk
The paper gives current approaches to treating chronic thromboembolic pulmonary hypertension (CTEPH) from the document «Federal Guidelines for the Diagnosis and Treatment of CTEPH» approved at the Third Russian Congress on Pulmonary Hypertension on December 11, 2015. The guidelines had been elaborated to optimize the treatment of patients with CTEPH on the basis of an analysis of the data of the present-day registries and multicenter randomized clinical trials, national and international guidelines and consensus documents, and documents published in recent years...
2016: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/27801347/-the-diagnosis-and-treatment-of-pulmonary-hypertension-after-delivery-of-twin-pregnancy
#13
T Zhang, C G Yang, X J Bao
No abstract text is available yet for this article.
November 1, 2016: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/27793993/severe-pulmonary-vein-stenosis-resulting-from-ablation-for-atrial-fibrillation-presentation-management-and-clinical-outcomes
#14
Erin A Fender, R Jay Widmer, David O Hodge, George M Cooper, Kristi H Monahan, Laura A Peterson, David R Holmes, Douglas L Packer
BACKGROUND: -The frequency of pulmonary vein stenosis (PVS) after ablation for atrial fibrillation (AF) has decreased but it remains a highly morbid condition. While treatment strategies including PV dilation and stenting have been described, the long-term impacts of these interventions are unknown. We evaluated the presentation of severe PVS, and examined the risk for restenosis after intervention utilizing either balloon angioplasty (BA) alone or BA with stenting. METHODS: -This was a prospective, observational study of 124 patients with severe PVS evaluated between 2000 and 2014...
October 28, 2016: Circulation
https://www.readbyqxmd.com/read/27776659/ct-pulmonary-angiography-of-adult-pulmonary-vascular-diseases-technical-considerations-and-interpretive-pitfalls
#15
Bedros Taslakian, Larry A Latson, Mylene T Truong, Eric Aaltonen, Maria C Shiau, Francis Girvin, Jeffrey B Alpert, Maj Wickstrom, Jane P Ko
Computed tomography pulmonary angiography (CTPA) has become the primary imaging modality for evaluating the pulmonary arteries. Although pulmonary embolism is the primary indication for CTPA, various pulmonary vascular abnormalities can be detected in adults. Knowledge of these disease entities and understanding technical pitfalls that can occur when performing CTPA are essential to enable accurate diagnosis and allow timely management. This review will cover a spectrum of acquired abnormalities including pulmonary embolism due to thrombus and foreign bodies, primary and metastatic tumor involving the pulmonary arteries, pulmonary hypertension, as well as pulmonary artery aneurysms and stenoses...
November 2016: European Journal of Radiology
https://www.readbyqxmd.com/read/27770122/discrepancy-in-blood-pressure-between-the-left-and-right-arms-importance-of-clinical-diagnosis-and-role-of-radiological-imaging
#16
P X Kuan, P W Tan, A T Jobli, A R Norsila
INTRODUCTION: Differences in systolic blood pressure reading between arms are common but could signal trouble if the discrepancy is significant. Early detection of aortic dissection could invariably determine patient's survivability. Hence, a high index of suspicion with prompt diagnostic imaging is vital for accurate diagnosis. CASE PRESENTATION: A previously healthy 35-year-old lady was referred from district hospital for hypertensive cardiomyopathy complicated by acute pulmonary oedema...
August 2016: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/27760453/-pulmonary-hypertension-in-grown-ups-with-congenital-heart-disease-recommendations-of-the-cologne-consensus-conference-2016
#17
H Kaemmerer, C Apitz, K Brockmeier, A Eicken, M Gorenflo, A Hager, F deHaan, M Huntgeburth, R Kozlik-Feldmann, O Miera, G P Diller
The 2015 European Guidelines on Diagnosis and Treatment of Pulmonary Hypertension are also valid for Germany. The guidelines contain detailed recommendations for different forms of PH, and specifically address PH associated with congenital heart disease (CHD). However, the practical implementation of the European Guidelines in Germany requires the consideration of several country-specific issues and already existing novel data. This requires a detailed commentary to the guidelines, and in some aspects an update already appears necessary...
October 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27760452/-chronic-thromboembolic-pulmonary-hypertension-recommendations-of-the-cologne-consensus-conference-2016
#18
H Wilkens, S Konstantinides, I Lang, A C Bunck, M Gerges, F Gerhardt, A Grgic, C Grohé, S Guth, M Held, J Hinrichs, M M Hoeper, W Klepetko, T Kramm, U Krüger, M Lankeit, B C Meyer, K M Olsson, H-J Schäfers, M Schmidt, H J Seyfarth, S Ulrich, C B Wiedenroth, E Mayer
The 2015 European Guidelines on Pulmonary Hypertension did not cover only pulmonary arterial hypertension (PAH), but also other significant subgroups of pulmonary hypertension (PH). In June 2016, a Consensus Conference organized by the PH working groups of the German Society of Cardiology (DGK), the German Society of Respiratory Medicine (DGP) and the German Society of Pediatric Cardiology (DGPK) was held in Cologne, Germany to discuss open and controversial issues surrounding the practical implementation of the European Guidelines...
October 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27760451/-pulmonary-hypertension-due-to-chronic-lung-disease-recommendations-of-the-cologne-consensus-conference-2016
#19
H Olschewski, J Behr, H Bremer, M Claussen, P Douschan, M Halank, M Held, M M Hoeper, S Holt, H Klose, S Krüger, T J Lange, F Reichenberger, D Skowasch, S Ulrich, H Wilkens, W Seeger
The 2015 European Guidelines on Pulmonary Hypertension did not cover only pulmonary arterial hypertension (PAH) but also some aspects of pulmonary hypertension (PH) associated with chronic lung disease. The European Guidelines point out that the drugs currently used to treat patients with PAH (prostanoids, endothelin receptor antagonists, phosphodiesterase-5 inhibitors, sGC stimulators) have not been sufficiently investigated in other forms of PH. Therefore, the European Guidelines do not recommend the use of these drugs in patients with chronic lung disease and PH...
October 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27760450/-pulmonary-hypertension-associated-with-left-heart-disease-recommendations-of-the-cologne-consensus-conference-2016
#20
S Rosenkranz, I M Lang, R Blindt, D Bonderman, L Bruch, G P Diller, R Felgendreher, C Gerges, W Hohenforst-Schmidt, S Holt, C Jung, I Kindermann, T Kramer, W M Kübler, V Mitrovic, A Riedel, A Rieth, A Schmeisser, R Wachter, J Weil, C Opitz
The 2015 European Guidelines on Diagnosis and Treatment of Pulmonary Hypertension are also valid for Germany. While the guidelines contain detailed recommendations regarding pulmonary arterial hypertension (PAH), they contain only a relatively short paragraph on other, much more common forms of PH such as PH due to left heart disease. Despite the lack of data, targeted PAH treatments are increasingly being used for PH associated with left heart disease. This development is of concern because of limited ressources and the need to base treatments on scientific evidence...
October 2016: Deutsche Medizinische Wochenschrift
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