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Hypertensive Urgency

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https://www.readbyqxmd.com/read/28074727/-flank-pain-caused-by-a-renal-artery-dissection
#1
J C Karper, W M T Janssen, J C Breek, R Oosterhof-Berktas, J Gravendeel, T K Kremer Hovinga
BACKGROUND: A spontaneous renal artery dissection is a very rare diagnosis. The clinical presentation can vary and its course can be atypical. There are no guidelines available regarding treatment; however, the options are a conservative (medication) or interventional (radiological or surgical) approach. CASE DESCRIPTION: A 45-year-old man presented to the emergency department with hypertensive urgency after earlier episodes of flank pain. The cause appeared to be a spontaneous bilateral renal artery dissection with infarction...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28067468/sticking-to-the-script-a-curious-case-of-confusion-in-an-esrd-patient
#2
Barry R Gorlitsky, John T Herion
A 60-year-old male Dialysis patient presented with altered mental status and Hypertensive Urgency. He had a significant lesion noted on his glans penis. He was treated for infection and hypertension with expectant management, without significant improvement in his mental acuity. Laboratory and radiologic workup were unrevealing for the etiology. Upon detailed review it was noted he had recently been given Acyclovir for a presumed Herpes Simplex Virus infection. He had been prescribed what is considered correct dosing for an ESRD patient...
January 9, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28057629/alarming-prevalence-of-emergency-hypertension-levels-in-the-general-public-identified-by-a-hypertension-awareness-campaign
#3
Stephanie P B Caligiuri, Jose Alejandro Austria, Grant N Pierce
BACKGROUND: Hypertension is a major cause of mortality and morbidity today. The "silent" nature of hypertension makes it critical to determine its prevalence and its severity in the general public and to identify strategies to identify people unaware of its presence. A mobile hypertension awareness campaign was created to: (i) determine the prevalence and types of hypertension in an urban North American center, (ii) increase hypertension awareness, and (iii) identify reasons for lack of therapy adherence...
January 5, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28055998/-hypertensive-crisis-urgency-and-hypertensive-emergency
#4
Javier Sobrino Martínez, Mónica Doménech Feria-Carot, Alberto Morales Salinas, Antonia Coca Payeras
Hypertensive crises lumped several clinical situations with different seriousness and prognosis. The differences between hypertensive urgency and hypertensive emergency depends on if this situation involves a vital risk for the patient. This risk is defined more by the severity of the organ damage than for the higher values of blood pressure. The hypertensive urgency not involves an immediately risk for the patient, for these reason, the treatment can be completed after discharged. Otherwise, the hypertensive emergency is a critical clinical condition that requires hospital assistance...
November 18, 2016: Medwave
https://www.readbyqxmd.com/read/28000548/hypertensive-crisis-pharmacotherapy-and-complications
#5
Priyanka Wani-Parekh, Carlos Garcia-Blanco, Melissa Mendez, Debabrata Mukherjee
Cardiovascular diseases (CVD) are the number one cause of death globally compared to any other cause. CVD accounts for approximately 17.3 million deaths per year and are rising. Hypertension is the leading risk factor for cardiovascular diseases. Approximately 80 million people suffer from hypertension in the U.S. While, majority of these individuals are on antihypertensive medications only 54% of individuals with hypertension are optimally controlled. Heart failure and stroke are some of the devastating complications of uncontrolled hypertension...
December 20, 2016: Cardiovascular & Hematological Disorders Drug Targets
https://www.readbyqxmd.com/read/27984052/beta-adrenergic-receptor-blockers-in-hypertension-alive-and-well
#6
William H Frishman
βeta-Adrenergic receptor blockers (β-blockers) are an appropriate treatment for patients having systemic hypertension (HTN) who have concomitant ischemic heart disease (IHD), heart failure, obstructive cardiomyopathy, aortic dissection or certain cardiac arrhythmias. β-blockers can be used in combination with other antiHTN drugs to achieve maximal blood pressure control. Labetalol can be used in HTN emergencies and urgencies. β-blockers may be useful in HTN patients having a hyperkinetic circulation (palpitations, tachycardia, HTN, and anxiety), migraine headache, and essential tremor...
October 27, 2016: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/27929246/hypertensive-urgency-not-really-an-urgent-problem
#7
Allen F Shaughnessy
No abstract text is available yet for this article.
November 1, 2016: American Family Physician
https://www.readbyqxmd.com/read/27875733/relationship-between-ambient-temperature-and-frequency-and-severity-of-cardiovascular-emergencies-a-prospective-observational-study-based-on-out-of-hospital-care-data
#8
Mario Hensel, Markus Stuhr, Daniel Geppert, Jan F Kersten, Jürgen Lorenz, Thoralf Kerner
OBJECTIVE: To test the hypothesis that more cardiovascular emergencies occur at low rather than at high temperatures under moderate climatic conditions. METHODS: This was a prospective observational study performed in a prehospital setting. Data from the Emergency Medical Service in Hamburg (Germany) and from the local weather station were evaluated over a 5-year period. Temperature data were matched with the associated rescue mission data. Lowess-Regression analysis was performed to assess the relationship between the temperature and the frequency of individual cardiovascular emergencies...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27819767/image-guided-thermal-ablation-of-adrenal-metastases-hemodynamic-and-endocrine-outcomes
#9
Ana E Espinosa De Ycaza, Tasha L Welch, Naykky Singh Ospina, Rene Rodriguez-Gutierrez, Thomas D Atwell, Dana Erickson, Irina Bancos
Objective Image guided thermal ablation of adrenal metastases has been increasingly used for local tumor control. This procedure has been associated with hypertensive urgency; however endocrine complications have not been clearly described. Our objective was to assess the hemodynamic behavior and risk for adrenal insufficiency related to adrenal ablation. Additionally, we sought to understand the utility of preprocedural α-blockade to prevent peri-procedural hemodynamic complications. Methods This is a retrospective study of patients undergoing image guided ablation of adrenal metastases between 2003 and 2015 at our institution...
November 7, 2016: Endocrine Practice
https://www.readbyqxmd.com/read/27818251/mesoporous-silica-nanoparticles-as-a-new-carrier-methodology-in-the-controlled-release-of-the-active-components-in-a-polypill
#10
Antonio L Doadrio, José M Sánchez-Montero, Juan C Doadrio, Antonio J Salinas, María Vallet-Regí
Polypill is a medication designed for preventing heart attacks through a combination of drugs. Current formulations contain blood pressure-lowering drugs and others, such statins or acetylsalicylic acid. These drugs exhibit different physical chemical features, and consequently different release kinetics. Therefore, the concentration in plasma of some of them after the release process can be out of the therapeutic range. This paper investigates a new methodology for the control dosage of a polypill recently reported containing hydrochlorothiazide, amlodipine, losartan and simvastatin in a 12...
January 15, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/27790975/unusual-case-of-pheochromocytoma-presenting-with-diabetic-ketoacidosis
#11
Yub Raj Sedhai, Kruthika Reddy, Dhruvan Patel, James A Lozada
Pheochromocytoma is a rare catecholamine-secreting tumour that arises from chromaffin cells in the adrenal medulla or extra-adrenal sympathetic ganglia. It classically presents with paroxysmal headaches, hypertension, palpitations and sweating related to catecholamine excess. Diabetes is reported to be present in approximately one-third of patients with pheochromocytoma; however, diabetic ketoacidosis is an extremely rare complication. We present a case of an African-American male aged 30 years who initially presented with diabetic ketoacidosis and hypertensive urgency whose blood pressure and glycaemic control improved remarkably following tumour excision...
October 19, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27711179/prevalence-risk-factors-and-complications-of-diabetes-in-the-kilimanjaro-region-a-population-based-study-from-tanzania
#12
John W Stanifer, Charles R Cleland, Gerald Jamberi Makuka, Joseph R Egger, Venance Maro, Honest Maro, Francis Karia, Uptal D Patel, Matthew J Burton, Heiko Philippin
BACKGROUND: In sub-Saharan Africa, diabetes is a growing burden, yet little is known about its prevalence, risk factors, and complications. To address these gaps and help inform public health efforts aimed at prevention and treatment, we conducted a community-based study assessing diabetes epidemiology. METHODS AND FINDINGS: We conducted a stratified, cluster-designed, serial cross-sectional household study from 2014-2015 in the Kilimanjaro Region, Tanzania. We used a three-stage cluster probability sampling method to randomly select individuals...
2016: PloS One
https://www.readbyqxmd.com/read/27707618/insight-into-the-cerebral-hyperperfusion-syndrome-following-carotid-endarterectomy-from-the-national-vascular-quality-initiative
#13
Grace J Wang, Adam W Beck, Randall R DeMartino, Philip P Goodney, Caron B Rockman, Ronald M Fairman
BACKGROUND: Cerebral hyperperfusion syndrome (CHS), characterized by severe ipsilateral headache, seizures, and intracranial hemorrhage, is a rare, poorly understood complication that can be fatal following carotid endarterectomy (CEA). The purpose of the study was to determine the factors associated with CHS as captured in the Vascular Quality Initiative. METHODS: Analysis was conducted on 51,001 procedures captured from the CEA module of the Vascular Quality Initiative from 2003 to 2015...
October 1, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27649290/translating-research-into-improved-patient-care-in-pulmonary-arterial-hypertension
#14
Sebastien Bonnet, Steeve Provencher, Christophe Guignabert, Frédéric Perros, Olivier Boucherat, Ralph Theo Schermuly, Paul M Hassoun, Marlene Rabinovitch, Mark R Nicolls, Marc Humbert
Despite important advances in its therapeutic management, pulmonary arterial hypertension (PAH) remains an incurable disease. Although numerous drugs exhibited beneficial effects in preclinical settings, only few have reached clinical trial phases, highlighting the challenges of translating preclinical investigations into clinical trials. Potential reasons for delayed PAH drug development may include the inherent limitations of the currently available animal and in vitro models, potential lack of appropriate standardization of the experimental design, regulatory agencies requirements, competing clinical trials and insufficient funding...
September 20, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27642731/-ambulatory-care-is-usually-sufficient-for-patients-presenting-with-hypertensive-urgency
#15
Martin Middeke
No abstract text is available yet for this article.
September 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27577571/situational-analysis-of-facilitators-and-barriers-to-availability-and-utilization-of-magnesium-sulfate-for-eclampsia-and-severe-preeclampsia-in-the-public-health-system-in-brazil
#16
Fátima Aparecida Lotufo, Mary Angela Parpinelli, Maria José Osis, Fernanda Garanhani Surita, Maria Laura Costa, José Guilherme Cecatti
BACKGROUND: Eclampsia is the main cause of maternal death in Brazil. Magnesium sulfate is the drug of choice for seizure prevention and control in the management of severe preeclampsia and eclampsia. Despite scientific evidence demonstrating its effectiveness and safety, there have been delays in managing hypertensive disorders, including timely access to magnesium sulfate. To conduct a general situational analysis on availability and use of magnesium sulfate for severe preeclampsia and eclampsia in the public health system...
2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27565397/nocturnal-polyuria-and-hypertension-in-patients-with-lifestyle-related-diseases-and-overactive-bladder
#17
Osamu Yokoyama, Osamu Nishizawa, Yukio Homma, Masayuki Takeda, Momokazu Gotoh, Hidehiro Kakizaki, Hironobu Akino, Koichi Hayashi, Koji Yonemoto
PURPOSE: The objective of this multicenter cross-sectional study was to investigate the relationship of nocturnal polyuria in patients with common lifestyle related diseases and overactive bladder, with special attention to hypertension. MATERIALS AND METHODS: After baseline assessment, patients recorded 24-hour urinary frequency/volume, blood pressure and heart rate for 3 days. They were stratified into 4 groups based on mean blood pressure, including no hypertension, and controllable, untreated and uncontrolled hypertension, respectively...
August 24, 2016: Journal of Urology
https://www.readbyqxmd.com/read/27508815/-op-7a-06-treating-hypertensive-crises-between-guidelines-and-real-world-an-anti-hypertensive-role-of-anti-anxiety-drugs
#18
M Gabba, F Salinaro, R Mussinelli, M Boldrini, A Raimondi, C Belotti, A Maggi, T Perrone, M A Bressan, S Perlini
OBJECTIVE: Current ESH Guidelines are extensively devoted to diagnosis, management and follow-up of arterial hypertension in the "chronic" setting, whereas less attention is given to the acute management of hypertensive crises, a group of potentially life-threatening complications. Moreover, epidemiological data concerning hypertensive crises are limited. DESIGN AND METHOD: During 2014, 457 consecutive patients with an initial systolic blood pressure (SBP) >170 mmHg and/or diastolic blood pressure (DBP) >110 mmHg were enrolled after being admitted to an Emergency Department (ED) serving a population of more than 50000 inhabitants, RESULTS: : Hypertensive crises represented 0...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27508801/-op-lb-02-05-a-patient-with-malignant-hypertension-successfully-treated-with-eculizumab-and-bosentan-suggestions-of-significant-interactions-of-complement-and-the-endothelin-system-in-blood-pressure-control
#19
A Mitchell, B Nokay, H Guberina, U Behlen-Wilm, M Nagel, M Kirschfink, T Wiech, A Kribben, A Bienholz
OBJECTIVE: Malignant hypertension as borne out by uncontrolled hypertension with accelerated target organ damage has a variable and often dire prognosis. Loss of kidney function is a hallmark of the condition and is frequently accompanied by thrombotic microangiopathy (TMA). DESIGN AND METHOD: Here we present the case of a patient with malignant hypertension, who was successfully treated using a combination of in-label and off-label medication according to the following pathophysiological concepts: 1) Innate immunity has been identified as a player in blood pressure (BP) control, 2) the complement inhibitor eculizumab has become available for treating atypical hemolytic uremic syndrome (aHUS), which shares many features of malignant hypertension, 3) endothelin (ET) antagonism, although not currently approved for these indications, has been shown to be effective for treating proteinuria and as a possible adjunct for the treatment of resistant hypertension...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27476847/thirty-day-readmission-and-reoperation-after-surgery-for-spinal-tumors-a-national-surgical-quality-improvement-program-analysis
#20
Aditya V Karhade, Viren S Vasudeva, Hormuzdiyar H Dasenbrock, Yi Lu, William B Gormley, Michael W Groff, John H Chi, Timothy R Smith
OBJECTIVE The goal of this study was to use a large national registry to evaluate the 30-day cumulative incidence and predictors of adverse events, readmissions, and reoperations after surgery for primary and secondary spinal tumors. METHODS Data from adult patients who underwent surgery for spinal tumors (2011-2014) were extracted from the prospective National Surgical Quality Improvement Program (NSQIP) registry. Multivariable logistic regression was used to evaluate predictors of reoperation, readmission, and major complications (death, neurological, cardiopulmonary, venous thromboembolism [VTE], surgical site infection [SSI], and sepsis)...
August 2016: Neurosurgical Focus
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