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https://www.readbyqxmd.com/read/29909538/resistant-hypertension-time-to-consider-the-best-fifth-anti-hypertensive-treatment
#1
REVIEW
Andrea Pio-Abreu, Luciano F Drager
PURPOSE OF REVIEW: Resistant hypertension (RH) is a growing clinical condition worldwide associated with target-organ damage and poor prognosis compared to non-resistant counterparts. The purpose of this review is to perform a critical evaluation of preferable drug choices for managing RH highlighting the evidence that significant proportion of patients remained uncontrolled despite using four anti-hypertensive drugs. RECENT FINDINGS: Until recently, the fourth drug therapy was main derived from personal opinion or small interventional studies...
June 16, 2018: Current Hypertension Reports
https://www.readbyqxmd.com/read/29909517/metabolic-parameters-weight-loss-and-comorbidities-4-years-after-roux-en-y-gastric-bypass-and-sleeve-gastrectomy
#2
Corey J Lager, Nazanene H Esfandiari, Yingying Luo, Angela R Subauste, Andrew T Kraftson, Morton B Brown, Oliver A Varban, Rasimcan Meral, Ruth B Cassidy, Catherine K Nay, Amy L Lockwood, Darlene Bellers, Colleen M Buda, Elif A Oral
BACKGROUND: Sleeve gastrectomy (LSG) is now the predominant bariatric surgery performed, yet there is limited long-term data comparing important outcomes between LSG and Roux-en-Y gastric bypass (RYGB). This study compares weight loss and impact on comorbidities of the two procedures. METHODS: We retrospectively evaluated weight, blood pressure, hemoglobin A1c, cholesterol, and medication use for hypertension, diabetes, and hyperlipidemia at 1-4 years post-operatively in 380 patients who underwent RYGB and 334 patients who underwent LSG at the University of Michigan from January 2008 to November 2013...
June 16, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29909479/high-pressure-injection-injury-of-the-hand-peculiar-mri-features-and-treatment-implications
#3
Mark Collins, Adam McGauvran, Bassem Elhassan
High-pressure injection injuries of the hand are rare, but potentially devastating injuries. The amount of tissue damage is dependent on the magnitude of the pressure generated by the device and the composition of the injected material. The standard of care is emergent surgical debridement of the injected material and devitalized tissue. Although, preoperative advanced imaging is not routinely pursued, MRI may be helpful in determining the anatomic distribution of the foreign material, and associated soft tissue or osseous injury...
June 16, 2018: Skeletal Radiology
https://www.readbyqxmd.com/read/29909475/stress-genes-and-hypertension-contribution-of-the-isiah-rat-strain-study
#4
REVIEW
Olga E Redina, Arcady L Markel
PURPOSE OF REVIEW: Acute psychoemotional stress is one of the causes of a sharp increase in blood pressure. However, the question if the stress may promote the hypertensive disease development is still open. This review aims, firstly, to show that the genetically determined enhanced responsiveness to stress is linked to sustained hypertension development and, secondly, to characterize the main physiological mechanisms and genetic factors implicated in the pathogenesis of stress-sensitive hypertension...
June 16, 2018: Current Hypertension Reports
https://www.readbyqxmd.com/read/29909397/evolution-of-new-delhi-metallo-%C3%AE-lactamase-ndm-in-the-clinic-effects-of-ndm-mutations-on-stability-zinc-affinity-mono-zinc-activity
#5
Zishuo Cheng, Pei W Thomas, Lincheng Ju, Alexander Bergstrom, Kelly Mason, Delaney Clayton, Callie Miller, Christopher R Bethel, Jamie VanPelt, David L Tierney, Richard C Page, Robert A Bonomo, Walter Fast, Michael W Crowder
Infections by carbapenem-resistant Enterobacteriaceae (CRE) are difficult to manage owing to broad antibiotic resistance profiles and because of the inability of clinically-used β-lactamase inhibitors to counter the activity of metallo-β-lactamases often harbored by these pathogens. Of particular importance is New Delhi metallo-β-lactamase (NDM), which requires a dinuclear zinc ion cluster for catalytic activity. Here, we compare the structures and functions of clinical NDM variants 1-17. The impact of NDM variants on structure is probed by comparing comparing melting temperature and refolding efficiency and also by spectroscopy (UV-Vis, 1 H-NMR, and EPR) of di-cobalt metalloforms...
June 16, 2018: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/29909391/ectopic-varices-a-potential-cause-of-gastrointestinal-bleeding-in-patients-with-portal-hypertension
#6
Indira Bhavsar, Anthony W Rooney, Brooke Corning, Neeral L Shah
A newly diagnosed 53-year-old woman with cirrhosis has repeated gastrointestinal bleeding with resulting symptomatic anaemia. She underwent routine diagnostic endoscopic evaluation without localisation of the aetiology of her bleed. Ultimately, she was found to have ectopic varices in the small bowel as a result of underlying high portal pressures. She underwent transjugular intrahepatic portosystemic shunt for portal system decompression with resolution in her bleeding.
June 15, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29909379/unique-percutaneous-direct-puncture-technique-for-occlusion-of-a-hypoglossal-canal-dural-arteriovenous-fistula
#7
Orlando M Diaz, Maria M Toledo, John O F Roehm, Richard P Klucznik, Ponraj Chinnadurai, Gloria Viviana Lopez, Gavin W Britz
PURPOSE: To report percutaneous transcranial puncture, embolisation and occlusion of a very symptomatic hypoglossal canal/anterior condylar vein dural arteriovenous fistula (DAVF) using syngo iGuide navigational software in a patient in whom transarterial and transvenous embolisation and surgery had failed. METHODS: After unsuccessful arterial and venous embolisation and surgical treatment of a symptomatic hypoglossal canal DAVF, a 47-year-old man was transferred for further management...
June 16, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29909371/drivers-and-strategies-for-avoiding-overuse-a-cross-sectional-study-to-explore-the-experience-of-spanish-primary-care-providers-handling-uncertainty-and-patients-requests
#8
José Joaquín Mira, Irene Carrillo, Carmen Silvestre, Pastora Pérez-Pérez, Cristina Nebot, Guadalupe Olivera, Javier González de Dios, Jesús María Aranaz Andrés
OBJECTIVES: Identify the sources of overuse from the point of view of the Spanish primary care professionals, and analyse the frequency of overuse due to pressure from patients in addition to the responses when professionals face these demands. DESIGN: A cross-sectional study. SETTING: Primary care in Spain. PARTICIPANTS: A non-randomised sample of 2201 providers (general practitioners, paediatricians and nurses) was recruited during the survey...
June 15, 2018: BMJ Open
https://www.readbyqxmd.com/read/29909353/effect-of-sound-level-on-virtual-and-free-field-localization-of-brief-sounds-in-the-anterior-median-plane
#9
Frederic Marmel, Miriam I Marrufo-Pérez, Jan Heeren, Stephan Ewert, Enrique A Lopez-Poveda
The detection of high-frequency spectral notches has been shown to be worse at 70-80 dB sound pressure level (SPL) than at higher levels up to 100 dB SPL. The performance improvement at levels higher than 70-80 dB SPL has been related to an 'ideal observer' comparison of population auditory nerve spike trains to stimuli with and without high-frequency spectral notches. Insofar as vertical localization partly relies on information provided by pinna-based high-frequency spectral notches, we hypothesized that localization would be worse at 70-80 dB SPL than at higher levels...
June 14, 2018: Hearing Research
https://www.readbyqxmd.com/read/29909230/postural-stability-and-trunk-muscle-responses-to-the-static-and-perturbed-balance-tasks-in-individuals-with-and-without-symptomatic-degenerative-lumbar-disease
#10
Yun-Chung Lin, Chi-Chien Niu, Mohammad Nikkhoo, Meng-Ling Lu, Wen-Chien Chen, Chen-Ju Fu, Chih-Hsiu Cheng
BACKGROUND: Degenerative lumbar diseases (DLDs) are characterized by motor functional deficits and postural instability. In this study, we investigated the differences in the trunk muscle responses to postural control between the presurgical DLD patients and healthy individuals while performing the static and perturbed balance tasks. METHODS: Thirty-five DLD patients (aged 61.1 ± 8.0 years) and thirty-five asymptomatic controls (aged 62.9 ± 3.7 years) participated in this study...
June 11, 2018: Gait & Posture
https://www.readbyqxmd.com/read/29909161/-host-microbiota-crosstalk-and-cardiovascular-diseases
#11
Jacques Amar
When analyzing the microbiota-host crosstalk, we have to consider three participants in this dialogue: the gut microbiota, the intestinal barrier and bacterial translocation. Experimental data demonstrate that host microbiota crosstalk plays a causal on the regulation of blood pressure, glucose metabolism and the development of atherosclerosis. Host microbiota crosstalk is associated in humans with main cardiovascular risk factors notably hypertension and type 2 diabetes. Host microbiota crosstalk is associated in humans with the onset of cardiovascular diseases...
June 13, 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29909114/predicting-survival-from-large-echocardiography-and-electronic-health-record-datasets-optimization-with-machine-learning
#12
Manar D Samad, Alvaro Ulloa, Gregory J Wehner, Linyuan Jing, Dustin Hartzel, Christopher W Good, Brent A Williams, Christopher M Haggerty, Brandon K Fornwalt
OBJECTIVES: The goal of this study was to use machine learning to more accurately predict survival after echocardiography. BACKGROUND: Predicting patient outcomes (e.g., survival) following echocardiography is primarily based on ejection fraction (EF) and comorbidities. However, there may be significant predictive information within additional echocardiography-derived measurements combined with clinical electronic health record data. METHODS: Mortality was studied in 171,510 unselected patients who underwent 331,317 echocardiograms in a large regional health system...
June 9, 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29909004/sglt2-inhibitors-and-the-kidney-effects-and-mechanisms
#13
REVIEW
V Tsimihodimos, T D Filippatos, M S Elisaf
AIMS: Numerous clinical trials have shown that sodium glucose cotransporter 2 (SGLT2) inhibitors exert a favorable effect on the indices of renal function (albuminuria, glomerular filtration rate decline over time) and the incidence of hard renal endpoints such as renal death or time to initiation of renal replacement therapy. MATERIALS AND METHODS: In this review, we describe in detail the evidence regarding the nephroprotective mechanisms of SGLT2 inhibitors and describe the risk factors that may predispose to the development of acute kidney injury in patients receiving these drugs...
June 6, 2018: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/29908947/isochoric-vitrification-an-experimental-study-to-establish-proof-of-concept
#14
Yanfang Zhang, Gideon Ukpai, Alexandra Grigoropoulos, Matthew J Powell-Palm, Bradley P Weegman, Michael J Taylor, Boris Rubinsky
Ice-free vitreous cryopreservation (vitrification) is regarded as the principal method for avoiding ice crystallization damage in cryopreserved tissues and organs. We previously established the fundamental thermodynamics of isochoric (constant volume) systems for cryopreservation, and now extend this novel approach to vitrification in an isochoric system. This was achieved by measuring pressure changes in a 2 ml isochoric chamber containing a variety of aqueous solutions of the ubiquitous cryoprotective additives (CPA), dimethyl sulfoxide (Me2 SO) and Propane-diol...
June 14, 2018: Cryobiology
https://www.readbyqxmd.com/read/29908883/ex-vivo-experimental-validation-of-biomechanically-corrected-intraocular-pressure-measurements-on-human-eyes-using-the-corvis-st
#15
Ashkan Eliasy, Kai-Jung Chen, Riccardo Vinciguerra, Osama Maklad, Paolo Vinciguerra, Renato Ambrósio, Cynthia J Roberts, Ahmed Elsheikh
The purpose of this study was to assess the validity of the Corvis ST (Oculus; Wetzlar, Germany) biomechanical correction algorithm (bIOP) in determining intraocular pressure (IOP) using experiments on ex-vivo human eyes. Five ex-vivo human ocular globes (age 69 ± 3 years) were obtained and tested within 3-5 days post mortem. Using a custom-built inflation rig, the internal pressure of the eyes was controlled mechanically and measured using the CorVis ST (CVS-IOP). The CVS-IOP measurements were then corrected to produce bIOP, which was developed for being less affected by variations in corneal biomechanical parameters, including tissue thickness and material properties...
June 14, 2018: Experimental Eye Research
https://www.readbyqxmd.com/read/29908829/pre-hypertension-and-subclinical-cardiac-damage-a-meta-analysis-of-echocardiographic-studies
#16
Cesare Cuspidi, Carla Sala, Marijana Tadic, Elisa Gherbesi, Guido Grassi, Giuseppe Mancia
AIM: The association between pre-hypertension (pre-HTN) and subclinical cardiac damage remains undefined. We performed a systematic meta-analysis of echocardiographic studies in order to provide a comprehensive information on structural and functional cardiac changes in untreated pre-HTN subjects. DESIGN: Studies were identified by crossing the following search terms: "pre-hypertension", "high normal blood pressure" "heart" "left ventricular hypertrophy", "left ventricular function", "diastolic function", "left atrial size", "aortic root size", "echocardiography...
June 8, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29908726/digital-health-intervention-as-an-adjunct-to-a-workplace-health-program-in-hypertension
#17
Conor Senecal, R Jay Widmer, Matthew P Johnson, Lilach O Lerman, Amir Lerman
BACKGROUND: Hypertension is a common and difficult-to-treat condition; digital health tools may serve as adjuncts to traditional pharmaceutical and lifestyle-based interventions. Using a retrospective observational study we sought to evaluate the effect of a desktop and mobile digital health intervention (DHI) as an adjunct to a workplace health program in those previously diagnosed with hypertension. METHODS: As part of a workplace health program, 3330 patients were identified as previously diagnosed with hypertension...
May 30, 2018: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/29908724/three-dimensional-inferior-vena-cava-for-assessing-central-venous-pressure-in-patients-with-cardiogenic-shock
#18
Raphaëlle Huguet, Damien Fard, Thomas d'Humieres, Ophelie Brault-Meslin, Laureline Faivre, Louis Nahory, Jean-Luc Dubois-Randé, Julien Ternacle, Leopold Oliver, Pascal Lim
BACKGROUND: The inferior vena cava (IVC) has a complex three-dimensional (3D) shape, but measurements used to estimate central venous pressure (CVP) remain based on two-dimensional (2D) echocardiographic imaging. The aim of this study was to investigate the accuracy of IVC size and collapsibility index obtained by 3D echocardiography for assessing CVP in patients with cardiogenic shock. METHODS: Eighty consecutive echocardiographic examinations performed in 33 patients (mean age, 72 ± 15 years; mean left ventricular ejection fraction, 19 ± 10%) admitted for cardiogenic shock were prospectively included...
June 13, 2018: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/29908720/incidence-of-intraoperative-hearing-loss-during-middle-cranial-fossa-approach-for-repair-of-superior-semicircular-canal-dehiscence
#19
Michael Johanis, Isaac Yang, Quinton Gopen
INTRODUCTION: Superior semicircular canal dehiscence is a rare inner ear disorder characterized by an abnormal third opening between the superior semicircular canal and middle fossa. Symptoms include amplification of internal sounds, aural fullness, tinnitus, hearing loss, autophony, sound-induced vertigo (Tullio phenomenon), pressure-induced vertigo (Hennebert sign), disequilibrium, nystagmus, oscillopsia, and headache. While no cure exists for SSCD, surgical treatment has proven to effectively minimize these symptoms...
June 13, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29908708/is-the-clinical-presentation-of-chronic-heart-failure-different-in-elderly-versus-younger-patients-and-those-with-preserved-versus-reduced-ejection-fraction
#20
Eva Steinmann, Hans-Peter Brunner-La Rocca, Micha T Maeder, Beat A Kaufmann, Matthias Pfisterer, Peter Rickenbacher
BACKGROUND: Whether the clinical presentation and in particular prevalence of symptoms and signs of heart failure (HF) is different in elderly versus younger patients and in those with reduced (HFrEF) versus preserved (HFpEF) left ventricular ejection fraction (LVEF) is a matter of ongoing debate. AIMS: To compare detailed clinical characteristics of these important subgroups and to develop a prediction rule for the differentiation of HFpEF and HFrEF based on clinical parameters...
June 13, 2018: European Journal of Internal Medicine
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