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https://www.readbyqxmd.com/read/29121095/the-pedunculopontine-tegmentum-controls-renal-sympathetic-nerve-activity-and-cardiorespiratory-activities-in-nembutal-anesthetized-rats
#1
Anne M Fink, Caron Dean, Mariann R Piano, David W Carley
Elevated renal sympathetic nerve activity (RSNA) accompanies a variety of complex disorders, including obstructive sleep apnea, heart failure, and chronic kidney disease. Understanding pathophysiologic renal mechanisms is important for determining why hypertension is both a common sequelae and a predisposing factor of these disorders. The role of the brainstem in regulating RSNA remains incompletely understood. The pedunculopontine tegmentum (PPT) is known for regulating behaviors including alertness, locomotion, and rapid eye movement sleep...
2017: PloS One
https://www.readbyqxmd.com/read/29120929/risk-factors-for-opioid-induced-respiratory-depression-and-failure-to-rescue-a-review
#2
Kapil Gupta, Arun Prasad, Mahesh Nagappa, Jean Wong, Lusine Abrahamyan, Frances Chung
PURPOSE OF REVIEW: The primary objective of this review is to identify the risk factors for opioid-induced respiratory depression (OIRD) in the postoperative period. RECENT FINDINGS: In the postoperative period, OIRD has often been reported resulting in morbidity and mortality. The risk factors which predispose surgical patients to increased risk of OIRD are not clearly defined. A literature search was performed for adult surgical patients who were prescribed opioids during their hospital stay and any available reports on postoperative respiratory depression/respiratory events...
November 7, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29094913/secondary-hypertension-discovering-the-underlying-cause
#3
Lesley Charles, Jean Triscott, Bonnie Dobbs
Most patients with hypertension have no clear etiology and are classified as having primary hypertension. However, 5% to 10% of these patients may have secondary hypertension, which indicates an underlying and potentially reversible cause. The prevalence and potential etiologies of secondary hypertension vary by age. The most common causes in children are renal parenchymal disease and coarctation of the aorta. In adults 65 years and older, atherosclerotic renal artery stenosis, renal failure, and hypothyroidism are common causes...
October 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28947309/wilson-s-disease-and-cardiac-myopathy
#4
Donald J Grandis, Gregory Nah, Isaac R Whitman, Eric Vittinghoff, Thomas A Dewland, Jeffrey E Olgin, Gregory M Marcus
Wilson's disease is a well-characterized disorder known to cause liver and brain disease due to abnormal copper deposition. Data regarding copper infiltration of the heart is conflicting, and the risk of heart disease has not been well described. We aimed to determine whether Wilson's disease is associated with cardiac myopathy, clinically evident in the atria as atrial fibrillation (AF) and in the ventricles as heart failure (HF). We longitudinally assessed 14.3 million patients in the California Healthcare Cost and Utilization Project database from 2005 through 2009 for diagnoses of Wilson's disease, AF, HF, and covariates using International Classification of Diseases-9th Edition codes...
August 30, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28882233/prognostic-significance-of-central-apneas-throughout-a-24-hour-period-in-patients%C3%A2-with-heart-failure
#5
RANDOMIZED CONTROLLED TRIAL
Michele Emdin, Gianluca Mirizzi, Alberto Giannoni, Roberta Poletti, Giovanni Iudice, Francesca Bramanti, Claudio Passino
BACKGROUND: Large trials using noninvasive mechanical ventilation to treat central apnea (CA) occurring at night ("sleep apnea") in patients with systolic heart failure (HF) have failed to improve prognosis. The prevalence and prognostic value of CA during daytime and over an entire 24-h period are not well described. OBJECTIVES: This study evaluated the occurrence and prognostic significance of nighttime, daytime, and 24-h CA episodes in a large cohort of patients with systolic HF...
September 12, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28845959/sleep-disorders-restless-legs-syndrome
#6
REVIEW
Deepa Burman
Restless legs syndrome (RLS) is a common disorder that often is underdiagnosed and undertreated. Patients with RLS describe an urge to move their legs, especially in the evenings and during periods of inactivity. The prevalence of clinically significant RLS is approximately 2% to 3% in adults in Europe and North America. RLS can be an independent disorder or may occur in conjunction with other conditions (eg, iron deficiency, pregnancy, chronic renal failure). Diagnosis is based on clinical history. Routine polysomnography typically is not recommended unless there is suspicion of other sleep disorders (eg, obstructive sleep apnea)...
September 2017: FP Essentials
https://www.readbyqxmd.com/read/28729411/recognized-obstructive-sleep-apnea-is-associated-with-improved-in-hospital-outcomes-after-st-elevation-myocardial-infarction
#7
Divyanshu Mohananey, Pedro A Villablanca, Tanush Gupta, Sahil Agrawal, Michael Faulx, Venugopal Menon, Samir R Kapadia, Brian P Griffin, Stephen G Ellis, Milind Y Desai
BACKGROUND: Obstructive sleep apnea (OSA) is an independent risk factor for many cardiovascular conditions such as coronary artery disease, myocardial infarction, systemic hypertension, pulmonary hypertension, and stroke. However, the association of OSA with outcomes in patients hospitalized for ST-elevation myocardial infarction remains controversial. METHODS AND RESULTS: We used the nation-wide inpatient sample between 2003 and 2011 to identify patients with a primary discharge diagnosis of ST-elevation myocardial infarction and then used the International Classification of Diseases, Clinical Modification code 327...
July 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28676955/a-novel-approach-for-acoustic-estimation-of-neck-fluid-volume-between-men-and-women
#8
Mehrnaz Shokrollahi, Frank Rudzicz, Daniel Vena, T Douglas Bradley, Azadeh Yadollahi
Obstructive Sleep apnea can be caused by fluid shift from the legs to the neck that narrows the upper airway (UA) and contributes to changes in tracheal sound. Tracheal sound is generated from the turbulent airflow in the pharynx and respiratory airways and it has recently been used to estimate increases in neck fluid volume (NFV). However, tracheal sound is also highly variable among people, especially across the sexes. In this paper, a novel method is proposed to select tracheal sound features towards estimating NFV in men and women separately...
July 5, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/28671280/impact-of-obstructive-sleep-apnea-in-transsphenoidal-pituitary-surgery-an-analysis-of-inpatient-data
#9
Sei Y Chung, Michael J Sylvester, Varesh R Patel, Michael Zaki, Soly Baredes, James K Liu, Jean Anderson Eloy
OBJECTIVES/HYPOTHESIS: Although previous studies have reported increased perioperative complications among obstructive sleep apnea (OSA) patients undergoing any surgery requiring general anesthesia, there is a paucity of literature addressing the impact of OSA on postoperative transsphenoidal surgery (TSS) complications. The aim of this study was to analyze postoperative outcomes in transsphenoidal pituitary surgery patients with OSA. Secondarily, we examined patient characteristics and comorbidities...
July 3, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28594706/diagnosis-of-tuberous-sclerosis-complex-in-a-patient-referred-for-uncontrolled-hypertension-and-renal-dysfunction-a-case-highlighting-the-importance-of-proper-diagnostic-work-up-of-hypertensive-patients
#10
Pantelis A Sarafidis, Athanasios Bikos, Charalampos Loutradis, Stergios Tzikas, Efstratios Vakirlis, Eugenia Avdelidou, Dimitrios Zafeiriou, Aikaterini Papagianni, Vasileios Vassilikos
: We report a case of a 39-year-old woman with resistant hypertension and renal dysfunction. The patient was hospitalized 3 months earlier for dyspnea at the Department of Cardiology, where she was diagnosed with heart failure (left ventricle injection fraction: 25-30%), pulmonary hypertension, chronic kidney disease (serum creatinine: 1.58 mg/dl), and resistant hypertension and discharged with optimal heart failure treatment. At presentation to our clinic, apart from uncontrolled hypertension for more than 10 years and history of pre-eclampsia and fetal loss, the patient had obesity (BMI: 38 kg/m) and facial fibromas...
June 7, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28529812/diabetic-muscle-infarction-masquerading-as-necrotizing-fasciitis
#11
Kalyana C Janga, Ankur Sinha, Perry Wengrofsky, Phone Oo, Sheldon Greenberg, Regina Tarkovsky, Kavita Sharma
A 43-year-old male patient with past medical history of diabetes mellitus (DM), end stage renal disease (ESRD) on hemodialysis (HD), congestive heart failure (CHF), obstructive sleep apnea (OSA), and chronic anemia presented with complaints of left thigh pain. A computerized tomogram (CT) of the thigh revealed evidence of edema with no evidence of a focal collection or gas formation noted. The patient's clinical symptoms persisted and he underwent magnetic resonance imaging (MRI) of his thigh which was reported to show small areas of muscle necrosis with fluid collection...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/28457559/periodic-limb-movements-of-sleep-are-associated-with-an-increased-prevalence-of-atrial-fibrillation-in-patients-with-mild-sleep-disordered-breathing
#12
Jiang Xie, C Anwar A Chahal, Naima Covassin, Phillip J Schulte, Prachi Singh, Narat Srivali, Virend K Somers, Sean M Caples
BACKGROUND: Growing evidence indicates that periodic limb movements of sleep (PLMS) may be related to increased risk of developing cardiovascular disease. However, the association of PLMS with atrial fibrillation (AF) is unclear, especially in patients with sleep-disordered breathing (SDB). This study sought to investigate whether PLMS were associated with increased AF prevalence, independent of established risk factors. METHODS: We performed a cross-sectional study of patients who underwent attended polysomnography at Mayo Clinic from 2011 to 2014...
April 22, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28405876/laparoscopic-sleeve-gastrectomy-in-kidney-transplant-candidates-a-case-series
#13
Sergio Carandina, Laurent Genser, Manuela Bossi, Laura Montana, Alexandre Cortes, Marie Seman, Marc Danan, Christophe Barrat
BACKGROUND: Patients with a body mass index (BMI) >35 kg/m(2) who need kidney transplant present with increased postoperative mortality and reduced kidney graft survival compared to patients with a lower BMI. For this reason, obese patients are often excluded from the transplantation waiting list. The aim of this study was to evaluate the feasibility and the results of laparoscopic sleeve gastrectomy (LSG) for obese patients awaiting a kidney transplant. METHODS: This was a retrospective study on patients with dialysis-dependent renal failure (DDRF) operated on at two first-level bariatric centers in Paris (France)...
October 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28401379/kidney-lung-pathophysiological-crosstalk-its-characteristics-and-importance
#14
REVIEW
Pilar Domenech, Tomas Perez, Agustina Saldarini, Pedro Uad, Carlos G Musso
Crosstalk between the lung and the kidney is based on the similarities that these organs share. This is why different diseases that affect one organ can have repercussions on the other. Patients with acute kidney injury can present complications such as pulmonary edema and require mechanical ventilation in respiratory failure. This interaction occurs due to the increase in systemic immune mediators that cause inflammatory reactions, oxidative stress, and an increase in vascular permeability in the lung. With regard to lung-induced renal damage, the kidney can also be affected by chemical mediators, which are translocated into the bloodstream...
July 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28154583/renal-denervation-for-chronic-heart-failure-background-and-pathophysiological-rationale
#15
REVIEW
Michael Böhm, Sebastian Ewen, Felix Mahfoud
The activation of the sympathetic nervous system is associated with cardiovascular hospitalizations and death in heart failure. Renal denervation has been shown to effectively reduce sympathetic overdrive in certain patients with uncontrolled hypertension. Pilot trials investigating renal denervation as a potential treatment approach for heart failure were initiated. Heart failure comorbidities like obstructive sleep apnea, metabolic syndrome and arrhythmias could also be targets for renal denervation, because these occurrences are also mediated by the activation of the sympathetic nervous system...
January 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28040612/association-of-obstructive-sleep-apnea-with-adverse-pregnancy-related-outcomes-in-military-hospitals
#16
Dennis L Spence, Rhonda C Allen, Monica A Lutgendorf, Virginia R Gary, John D Richard, Sara C Gonzalez
BACKGROUND: Obstructive sleep apnea (OSA) is associated with significant morbidity and mortality in non-obstetrical and obstetrical patients. OBJECTIVES: To estimate the prevalence of OSA and its relationship with pregnancy-related complications in a general obstetric population of Department of Defense beneficiaries receiving direct-care at military treatment facilities. STUDY DESIGN: A retrospective cohort study of all women (N=305,001) who gave birth at a military treatment facility from 2008 to 2014...
March 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27886849/prevalence-and-burden-of-comorbidities-in-chronic-obstructive-pulmonary-disease
#17
REVIEW
Alexandru Corlateanu, Serghei Covantev, Alexander G Mathioudakis, Victor Botnaru, Nikolaos Siafakas
The classical definition of Chronic Obstructive Pulmonary Disease (COPD) as a lung condition characterized by irreversible airway obstruction is outdated. The systemic involvement in patients with COPD, as well as the interactions between COPD and its comorbidities, justify the description of chronic systemic inflammatory syndrome. The pathogenesis of COPD is closely linked with aging, as well as with cardiovascular, endocrine, musculoskeletal, renal, and gastrointestinal pathologies, decreasing the quality of life of patients with COPD and, furthermore, complicating the management of the disease...
November 2016: Respiratory Investigation
https://www.readbyqxmd.com/read/27766526/implementation-of-a-novel-postoperative-monitoring-system-using-automated-modified-early-warning-scores-mews-incorporating-end-tidal-capnography
#18
Joseph M Blankush, Robbie Freeman, Joy McIlvaine, Trung Tran, Stephen Nassani, I Michael Leitman
Modified Early Warning Scores (MEWS) provide real-time vital sign (VS) trending and reduce ICU admissions in post-operative patients. These early warning calculations classically incorporate oxygen saturation, heart rate, respiratory rate, systolic blood pressure, and temperature but have not previously included end-tidal CO2 (EtCO2), more recently identified as an independent predictor of critical illness. These systems may be subject to failure when physiologic data is incorrectly measured, leading to false alarms and increased workload...
October 20, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27547150/right-ventricular-enlargement-within-months-of-arteriovenous-fistula-creation-in-2-hemodialysis-patients
#19
Loheetha Ragupathi, Drew Johnson, Gregary D Marhefka
Surgically created arteriovenous fistulae (AVF) for hemodialysis can contribute to hemodynamic changes. We describe the cases of 2 male patients in whom new right ventricular enlargement developed after an AVF was created for hemodialysis. Patient 1 sustained high-output heart failure solely attributable to the AVF. After AVF banding and subsequent ligation, his heart failure and right ventricular enlargement resolved. In Patient 2, the AVF contributed to new-onset right ventricular enlargement, heart failure, and ascites...
August 2016: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/27508727/-op-4d-08-disordered-sleep-breathing-sdb-is-the-major-determinant-of-non-dipping-and-nocturnal-hypertension-in-kidney-transplant-patients
#20
F Mallamaci, R Tripepi, M C Versace, F Provenzano, A Mafrica, C Torino, G D'Arrigo, D Leonardis, G Tripepi, C Zoccali
OBJECTIVE: In renal transplant patients, the prevalence of nocturnal hypertension by far exceeds that of hypertension as assessed by clinic, daytime, and average 24-hour ABPM and night-time systolic BP (SBP) and the night-day ratio but no other BP metrics are independently associated with IMT in this population (Transplantation 2015 Dec 17). BP during nighttime may provide information for the assessment of CV risk attributable to BP burden in renal transplant patients but the determinants of this phenomenon are still undefined in these patients...
September 2016: Journal of Hypertension
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