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https://www.readbyqxmd.com/read/28107561/beta-blockers-for-hypertension
#1
REVIEW
Charles S Wiysonge, Hazel A Bradley, Jimmy Volmink, Bongani M Mayosi, Lionel H Opie
BACKGROUND: Beta-blockers refer to a mixed group of drugs with diverse pharmacodynamic and pharmacokinetic properties. They have shown long-term beneficial effects on mortality and cardiovascular disease (CVD) when used in people with heart failure or acute myocardial infarction. Beta-blockers were thought to have similar beneficial effects when used as first-line therapy for hypertension. However, the benefit of beta-blockers as first-line therapy for hypertension without compelling indications is controversial...
January 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28107357/vasopressor-use-for-severe-hypotension-a-multicentre-prospective-observational-study
#2
Francois Lamontagne, Deborah J Cook, Maureen O Meade, Andrew Seely, Andrew G Day, Emmanuel Charbonney, Karim Serri, Yoanna Skrobik, Paul Hebert, Charles St-Arnaud, Hector Quiroz-Martinez, Michaël Mayette, Daren K Heyland
BACKGROUND: The optimal approach to titrate vasopressor therapy is unclear. Recent sepsis guidelines recommend a mean arterial pressure (MAP) target of 65 mmHg and higher for chronic hypertensive patients. As data emerge from clinical trials comparing blood pressure targets for vasopressor therapy, an accurate description of usual care is required to interpret study results. Our aim was to measure MAP values during vasopressor therapy in Canadian intensive care units (ICUs) and to compare these with stated practices and guidelines...
2017: PloS One
https://www.readbyqxmd.com/read/28107093/adult-clonidine-overdose-prolonged-bradycardia-and-central-nervous-system-depression-but-not-severe-toxicity
#3
Geoffrey K Isbister, Simon P Heppell, Colin B Page, Nicole M Ryan
CONTEXT: There are limited reports of adult clonidine overdose. We aimed to describe the clinical effects and treatment of clonidine overdose in adults. METHODS: This was a retrospective review of a prospective cohort of poisoned patients who took clonidine overdoses (>200 μg). Demographic information, clinical effects, treatment, complications (central nervous system and cardiovascular effects) and length of stay (LOS) were extracted from a clinical database or medical records...
January 20, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28104770/decline-in-cardiovascular-mortality-possible-causes-and-implications
#4
REVIEW
George A Mensah, Gina S Wei, Paul D Sorlie, Lawrence J Fine, Yves Rosenberg, Peter G Kaufmann, Michael E Mussolino, Lucy L Hsu, Ebyan Addou, Michael M Engelgau, David Gordon
If the control of infectious diseases was the public health success story of the first half of the 20th century, then the decline in mortality from coronary heart disease and stroke has been the success story of the century's past 4 decades. The early phase of this decline in coronary heart disease and stroke was unexpected and controversial when first reported in the mid-1970s, having followed 60 years of gradual increase as the US population aged. However, in 1978, the participants in a conference convened by the National Heart, Lung, and Blood Institute concluded that a significant recent downtick in coronary heart disease and stroke mortality rates had definitely occurred, at least in the US Since 1978, a sharp decline in mortality rates from coronary heart disease and stroke has become unmistakable throughout the industrialized world, with age-adjusted mortality rates having declined to about one third of their 1960s baseline by 2000...
January 20, 2017: Circulation Research
https://www.readbyqxmd.com/read/28104467/incidence-and-risk-factors-of-acute-kidney-injury-after-esophageal-cancer-surgery-a-nested-case-control-study
#5
Wen Wang, Tong Wang, Xiaoshuang Feng, Li Sun
BACKGROUND: Acute kidney injury (AKI) has been increasingly recognized as a common and serious postoperative complication. Although many studies have been conducted to investigate postoperative AKI after thoracic surgery, little is known about AKI after esophageal surgery. Thus, we conducted this study to determine the incidence and identify risk factors of postoperative AKI after esophageal cancer surgery. MATERIALS AND METHODS: A retrospective nested case-control study of patients undergoing elective esophageal cancer surgery between July 2013 and July 2016 in a single tertiary specialized cancer hospital was performed...
January 16, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28104166/kidney-donor-risk-index-as-the-predictor-for-the-short-term-clinical-outcomes-after-kidney-transplant-from-deceased-donor-with-acute-kidney-injury
#6
H Jun, C W Jung, S Lim, M G Kim
BACKGROUND: The Kidney Donor Risk Index (KDRI) scoring system for deceased donors has been widely introduced for postoperative evaluation of graft function. We analyzed the usefulness of the KDRI in deceased donors with acute kidney injury (AKI). METHODS: Forty-nine recipients from deceased donors with AKI between January 2009 and December 2014 were reviewed retrospectively. Data collected from donor medical records included age, height, weight, hypertension or diabetes history, cause of death, serum creatinine (sCr), and donation after cardiac death...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28104143/sinistral-portal-hypertension-after-live-segmental-pancreas-donation-a-long-term-sequelae-presenting-with-life-threatening-upper-gastrointestinal-hemorrhage
#7
O K Serrano, R D Cunha, T Mettler, D E R Sutherland, R Kandaswamy
INTRODUCTION: Variceal hemorrhage from sinistral portal hypertension has never been reported as a complication of live pancreas donation. CASE REPORT: We present a 68-year-old patient who underwent a simultaneous live-donor laparoscopic segmental pancreatectomy and nephrectomy for the purposes of donating to her daughter. Her postoperative course was significant for an episode of acute pancreatitis with a pseudocyst formation. More than a decade later, she presented with variceal hemorrhage from sinistral portal hypertension, which after a diagnostic work-up, prompted a laparoscopic splenectomy...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28104114/re-evaluating-cut-off-points-for-the-expansion-of-deceased-donor-criteria-for-kidney-transplantation-in-japan
#8
Y Nakagawa, M Ikeda, T Ando, M Tasaki, K Saito, K Takahashi, A Aikawa, M Kikuchi, K Akazawa, Y Tomita
BACKGROUND: A shortage of donors poses a serious problem for organ transplantation around the world. In response, the concept of the expanded criteria donor (ECD) has been defined to include donors with traditionally less favorable characteristics. That definition has now been accepted and is being applied in kidney transplantation in the United States and Europe. However, the ECD has not yet been defined for deceased donor kidney transplantation in Japan. PATIENTS AND METHODS: We analyzed data on graft survival and relevant risk factors in patients who received deceased donor kidney transplants through the East Japan Branch of the Japan Organ Transplant network (n = 1051)...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28103324/use-of-proton-pump-inhibitors-predicts-heart-failure-and-death-in-patients-with-coronary-artery-disease
#9
Ana María Pello Lázaro, Carmen Cristóbal, Juan Antonio Franco-Peláez, Nieves Tarín, Álvaro Aceña, Rocío Carda, Ana Huelmos, María Luisa Martín-Mariscal, Jesús Fuentes-Antras, Juan Martínez-Millá, Joaquín Alonso, Óscar Lorenzo, Jesús Egido, Lorenzo López-Bescós, José Tuñón
OBJECTIVES: Proton-pump inhibitors (PPIs) seem to increase the incidence of cardiovascular events in patients with coronary artery disease (CAD), mainly in those using clopidogrel. We analysed the impact of PPIs on the prognosis of patients with stable CAD. METHODS: We followed 706 patients with CAD. Primary outcome was the combination of secondary outcomes. Secondary outcomes were 1) acute ischaemic events (any acute coronary syndrome, stroke, or transient ischaemic attack) and 2) heart failure (HF) or death...
2017: PloS One
https://www.readbyqxmd.com/read/28101638/refractory-skin-lesion-hypertension-and-acute-kidney-injury-in-a-young-boy-answers
#10
Valeriya M Feygina, Thomas F Hahn, Dianne G Muchant
No abstract text is available yet for this article.
January 18, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28101637/refractory-skin-lesion-hypertension-and-acute-kidney-injury-in-a-young-boy-questions
#11
Valeriya M Feygina, Thomas F Hahn, Dianne G Muchant
No abstract text is available yet for this article.
January 18, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28101502/pregnant-woman-with-atypical-hemolytic-uremic-syndrome-delivered-a-healthy-newborn-under-eculizumab-treatment
#12
Erol Demir, Halil Yazici, Yasemin Ozluk, Isin Kilicaslan, Aydin Turkmen
Pregnancy-associated thrombotic microangiopathy is a very rare condition; however, it significantly increases fetal or maternal morbidity and mortality. Pregnancy may trigger atypical hemolytic uremic syndrome (aHUS) or thrombotic thrombocytopenic purpura. The risk for pregnancy-associated aHUS is highest during the second pregnancy. The outcome is usually poor with 50-60% mortality; renal dysfunction and hypertension are the rule in those who survive the acute episode. After the development of complement regulation mechanisms and aHUS pathogenesis, eculizumab has been widely used as a first-line treatment in aHUS...
September 2016: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/28101432/atypical-hemolytic-uremic-syndrome-in-first-trimester-pregnancy-successfully-treated-with-eculizumab
#13
Gabriela Andries, Michael Karass, Srikanth Yandrapalli, Katherine Linder, Delong Liu, John Nelson, Rahul Pawar, Savneek Chugh
BACKGROUND: Atypical hemolytic uremic syndrome is a rare disorder which is known to cause acute thrombotic microangiopathy during pregnancy with poor maternal and fetal outcomes. Atypical hemolytic uremic syndrome is caused mostly by dysregulation of alternative complement pathway secondary to genetic mutations. Most of the cases reported have been in the post-partum period. We report a rare case of a patient who presents with thrombotic microangiopathy in the first trimester of her eleventh pregnancy and was successfully treated with eculizumab...
2017: Experimental Hematology & Oncology
https://www.readbyqxmd.com/read/28100879/association-between-prior-aspirin-use-and-morphological-features-of-culprit-lesions-at-first-presentation-of-acute-coronary-syndrome-assessed-by-optical-coherence-tomography
#14
Taishi Yonetsu, Tetsumin Lee, Tadashi Murai, Yoshinori Kanno, Rikuta Hamaya, Sadamitsu Ichijo, Takayuki Niida, Masahiro Hada, Makoto Araki, Junji Matsuda, Eisuke Usui, Masahiro Hoshino, Yoshihisa Kanaji, Tsunekazu Kakuta
BACKGROUND: The effect of prior use of aspirin (ASA) on the onset of acute coronary syndrome (ACS) has not been clarified. This study used optical coherence tomography (OCT) to investigate the morphological features of culprit lesions of ACS in patients with prior ASA use.Methods and Results:In total, 442 patients with their first ACS episode undergoing OCT for the culprit lesions were investigated. Clinical characteristics, OCT findings, and adverse events at 30 days were compared between patients with prior ASA use and ASA-naïve patients (non-ASA)...
January 19, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28100576/perioperative-management-of-a-large-late-presenting-phaeochromocytoma
#15
Duncan Macrosson, Andrew Love
A 77-year-old man presenting to the emergency department with an acute coronary syndrome was later found to have a phaeochromocytoma. The lateness of this presentation was likely due to the protective α blocking effects of long-term terazosin therapy for his prostatism. α blockers such as terazosin are a well-recognised medical therapy in the perioperative optimisation of phaeochromocytoma because they treat the adrenergic effects of catecholamine release from the tumour such as hypertension. This patient was diagnosed with an ST elevation myocardial infarction (STEMI)...
January 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28099637/factors-associated-with-maternal-death-in-an-intensive-care-unit
#16
Suzanne Vieira Saintrain, Juliana Gomes Ramalho de Oliveira, Maria Vieira de Lima Saintrain, Zenilda Vieira Bruno, Juliana Lima Nogueira Borges, Elizabeth De Francesco Daher, Geraldo Bezerra da Silva
Objective: To identify factors associated with maternal death in patients admitted to an intensive care unit. Methods: A cross-sectional study was conducted in a maternal intensive care unit. All medical records of patients admitted from January 2012 to December 2014 were reviewed. Pregnant and puerperal women were included; those with diagnoses of hydatidiform mole, ectopic pregnancy, or anembryonic pregnancy were excluded, as were patients admitted for non-obstetrical reasons...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28099082/therapeutics-targeting-drivers-of-thoracic-aortic-aneurysms-and-acute-aortic-dissections-insights-from-predisposing-genes-and-mouse-models
#17
Dianna M Milewicz, Siddharth K Prakash, Francesco Ramirez
Thoracic aortic diseases, including aneurysms and dissections of the thoracic aorta, are a major cause of morbidity and mortality. Risk factors for thoracic aortic disease include increased hemodynamic forces on the ascending aorta, typically due to poorly controlled hypertension, and heritable genetic variants. The altered genes predisposing to thoracic aortic disease either disrupt smooth muscle cell (SMC) contraction or adherence to an impaired extracellular matrix, or decrease canonical transforming growth factor beta (TGF-β) signaling...
January 14, 2017: Annual Review of Medicine
https://www.readbyqxmd.com/read/28096671/local-mild-hypothermia-therapy-as-an-augmentation-strategy-for-minimally-invasive-surgery-of-hypertensive-intracerebral-hemorrhage-a-meta-analysis-of-randomized-clinical-trials
#18
Yu Han, Ke Sheng, Meilan Su, Nan Yang, Dong Wan
BACKGROUND: Previous studies reported that the mild hypothermia therapy (MHT) could significantly improve the clinical outcomes for patients with hypertensive intracerebral hemorrhage (HICH). Therefore, this meta-analysis was conducted to systematically assess whether the addition of local MHT (LMHT) could significantly improve the efficacy of minimally invasive surgery (MIS) in treating HICH. METHODS: Randomized clinical trials on the combined application of MIS and LMHT (MIS+LMHT) vs MIS alone for treating HICH were searched up to September 2016 in databases...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28093502/heat-strain-volume-depletion-and-kidney-function-in-california-agricultural-workers
#19
Sally Moyce, Diane Mitchell, Tracey Armitage, Daniel Tancredi, Jill Joseph, Marc Schenker
BACKGROUND: Agricultural work can expose workers to increased risk of heat strain and volume depletion due to repeated exposures to high ambient temperatures, arduous physical exertion and limited rehydration. These risk factors may result in acute kidney injury (AKI). METHODS: We estimated AKI cumulative incidence in a convenience sample of 283 agricultural workers based on elevations of serum creatinine between preshift and postshift blood samples. Heat strain was assessed based on changes in core body temperature and heart rate...
January 16, 2017: Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28091982/death-from-pulmonary-embolism-of-cyanoacrylate-glue-following-gastric-varix-endoscopic-injection
#20
Michael Philip Burke, Chris O'Donnell, Yeliena Baber
We present the case of a 25 year old woman with a complex past medical history including Crigler-Najjar syndrome (Type 1) with a liver transplant in 1993 and subsequent development of cirrhosis with portal hypertension in the transplanted liver. The deceased presented to hospital with hematemesis and investigations showed a large gastric varix. The varix was injected with cyanoacrylate glue. Within 30 min of injection the patient became acutely hypoxic. Urgent chest X-ray demonstrated radio opaque glue within the pulmonary arteries...
January 14, 2017: Forensic Science, Medicine, and Pathology
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