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Hypertensive Urgency

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https://www.readbyqxmd.com/read/29340938/pharmacologic-treatment-of-hypertensive-urgency-in-the-outpatient-setting-a-systematic-review
#1
Claudia L Campos, Charles T Herring, Asima N Ali, Deanna N Jones, James L Wofford, Augustus L Caine, Robert L Bloomfield, Janine Tillett, Karen S Oles
BACKGROUND: Hypertensive urgency (HU), defined as acute severe uncontrolled hypertension without end-organ damage, is a common condition. Despite its association with long-term morbidity and mortality, guidance regarding immediate management is sparse. Our objective was to summarize the evidence examining the effects of antihypertensive medications to treat. METHODS: We searched the PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Database of Abstracts of Reviews of Effects (DARE), Cochrane Database of Systematic Reviews, Web of Science, Google Scholar, and Embase through May 2016...
January 16, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29313905/renal-complications-of-anaesthesia
#2
REVIEW
J McKinlay, E Tyson, L G Forni
Peri-operative acute kidney injury is common, accounting for 30-40% of all in-hospital cases of acute kidney injury. It is associated with clinically significant morbidity and mortality even with what was hitherto regarded as relatively trivial increases in serum creatinine, and carries over a 12-fold relative risk of death following major abdominal surgery. Comorbid conditions such as diabetes, hypertension, liver disease and particularly pre-existing chronic kidney disease, as well as the type and urgency of surgery, are major risk factors for the development of postoperative acute kidney injury...
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/29224251/efficacy-and-safety-of-fesoterodine-treatment-for-overactive-bladder-symptoms-in-elderly-women-with-and-without-hypertension
#3
Osamu Yokoyama, Hidetomi Yamagami, Shintaro Hiro, Shinichi Hotta, Masaki Yoshida
OBJECTIVE: To assess fesoterodine treatment in elderly women with overactive bladder with and without hypertension. METHODS: Data for 2527 elderly women with overactive bladder symptoms, including urgency urinary incontinence, were pooled from 10 double-blind, placebo-controlled fesoterodine studies. RESULTS: A total of 1523 elderly women (60.3%) had a history of hypertension, and 1004 women (39.7%) had no hypertension history. Overactive bladder symptoms, mean bodyweight and mean body mass index at baseline were significantly higher in women with overactive bladder and hypertension versus those without hypertension (P < 0...
December 10, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/29205506/systematic-review-and-meta-analysis-on-the-efficacy-and-tolerability-of-mirabegron-for-the-treatment-of-storage-lower-urinary-tract-symptoms-overactive-bladder-comparison-with-placebo-and-tolterodine
#4
REVIEW
Arcangelo Sebastianelli, Giorgio I Russo, Steven A Kaplan, Kevin T McVary, Ignacio Moncada, Stavros Gravas, Christopher Chapple, Giuseppe Morgia, Sergio Serni, Mauro Gacci
A systematic review and meta-analysis was carried out to evaluate the efficacy and safety of mirabegron 50 mg and 100 mg in the treatment of storage lower urinary tract symptoms/overactive bladder in comparison with a placebo and tolterodine 4 mg. A total of 491 articles were collected and eight randomized studies were identified as eligible for this meta-analysis. Overall, eight trials were included in the meta-analysis evaluating 10 248 patients. Mirabegron at both doses of 50 mg and 100 mg, and and tolterodine 4 mg were significantly associated with the reduction of incontinence episodes per 24 h, reduction of mean number of micturitions per 24 h, increase of voided volume and reduction of urgency episodes per 24 h, compared to a placebo...
December 3, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/29190995/predictors-of-hypertension-urgency-in-primary-aldosteronism-patients-during-the-first-24-hours-after-surgery
#5
Juping Zhao, Jun Dai, Wenlong Zhou, Haofei Wang, Wenbin Rui, Wei He, Zhe Zhu, Yu Zhu, Danfeng Xu, Fukang Sun
Study about blood pressure variation in the first 24 hours post-operation is limited in patients with adrenal aldosterone-producing adenoma. We aim to evaluate the potential predictors for postoperative hypertension urgency during the first 24 hours after laparoscopic adrenalectomy in patients with aldosterone-producing adenoma. Clinical data of 177 patients with aldosterone-producing adenoma were retrospectively collected from January 2009 to December 2015 and the potential factors that may influence postoperative blood pressure during the first 24 hours after surgery were analyzed...
November 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29174704/diagnostic-and-therapeutic-approach-to-the-hypertensive-crisis
#6
REVIEW
Guillermo Arbe, Irene Pastor, Jonathan Franco
High blood pressure is a problem with elevated prevalence in the world population. The acute forms of presentation are "hypertensive crises," which represent a frequent cause for emergency room and primary care consultations. Hypertensive crises are divided into hypertensive emergencies and hypertensive urgencies, depending on whether or not there is acute damage to the target organ, respectively. Each situation has a different prognosis and treatment. More specifically, hypertensive emergencies are potentially serious and usually require rapid reductions in blood pressure, whereas hypertensive urgencies can be treated as outpatients by reducing blood pressure in hours or days...
November 24, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/29154426/microvascular-dysfunction-and-cardiac-fibrosis-in-heart-failure-with-preserved-ejection-fraction-a-case-report
#7
Nikhil Narang, Diego Medvedofsky, Kathryn Dryer, Sanjiv J Shah, Charles J Davidson, Amit R Patel, John E A Blair
We report the case of a 55-year-old woman with heart failure with preserved ejection fraction (HFpEF), who presented with hypertensive urgency and pulmonary oedema. The patient was medically optimized and underwent cardiac catheterization revealing pulmonary hypertension, elevated pulmonary capillary wedge pressure, normal cardiac index, and non-obstructive coronary disease. Invasive evaluation of coronary flow revealed blunted coronary flow reserve and increased index of microvascular resistance. Cardiac magnetic resonance imaging demonstrated reduced global myocardial perfusion and diffuse interstitial fibrosis...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29122210/strategies-to-increase-patient-safety-in-hemodialysis-application-of-the-modal-analysis-system-of-errors-and-effects-fema-system
#8
María Dolores Arenas Jiménez, Gabriel Ferre, Fernando Álvarez-Ude
BACKGROUND: Haemodialysis (HD) patients are a high-risk population group. For these patients, an error could have catastrophic consequences. Therefore, systems that ensure the safety of these patients in an environment with high technology and great interaction of the human factor is a requirement. OBJECTIVES: To show a systematic working approach, reproducible in any HD unit, which consists of recording the complications and errors that occurred during the HD session; defining which of those complications could be considered adverse event (AE), and therefore preventable; and carrying out a systematic analysis of them, as well as of underlying real or potential errors, evaluating their severity, frequency and detection; as well as establishing priorities for action (Failure Mode and Effects Analysis system [FMEA systems])...
November 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/29097857/like-the-eye-of-the-tiger-inpatient-psychiatric-facility-exclusionary-criteria-and-its-knockout-of-the-emergency-psychiatric-patient
#9
Veronica Tucci, John Liu, Anu Matorin, Asim Shah, Nidal Moukaddam
Context: Over 6% of all emergency department (ED) visits in the United States involve primary mental health or behavioral issues. The patients are stabilized in the ED but frequently require admission to an inpatient psychiatric unit or institution for longer term treatment and management. To facilitate this process, an emergency physician (EP) must first "medically clear" the patient as stable for transfer. At present, there is no interdisciplinary consensus regarding the necessary elements of the medical clearance or stability assessment process...
October 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28977576/postinfarction-left-ventricular-free-wall-rupture-a-17-year-single-centre-experience
#10
Francesco Formica, Serena Mariani, Gurmeet Singh, Stefano D'Alessandro, Luigi Amerigo Messina, Norman Jones, Oluwaseun Adebayo Bamodu, Fabio Sangalli, Giovanni Paolini
OBJECTIVES: Left ventricular free wall rupture (LVFWR) is a catastrophic complication following acute myocardial infarction with an estimated incidence of 0.2-7.6% and mortality can be as high as 60%. This study aimed to identify the risk factors for morbidity and mortality in patients affected by LVFWR. METHODS: This is a retrospective study of 35 patients who underwent surgery for LVFWR between January 2000 and December 2016 at our institution. RESULTS: The mean age of patients was 68...
August 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28976377/-hypertension-in-the-elderly
#11
Filiz Özerkan Çakan
Hypertension (HT) is a common problem in elderly persons (age >65 years), reaching a prevalence as high as 60 to 80%. Isolated systolic HT mostly occurs in older patients. Treatment of HT in all patients, independent of age, consists of lifestyle modifications and antihypertensive therapy. Randomized trials have provided clear evidence of benefit from treating HT in elderly patients, including those over the age of 80 years. Drug therapy should be started in elderly hypertensive patients if lifestyle changes are insufficient and in the absence of a hypertensive emergency or urgency, blood pressure reduction should always be gradual...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28938507/-hypertensive-emergencies
#12
Gerd Bönner
Hypertensive urgency and hypertensive emergency are associated with sudden, massive rise in blood pressure. An acute increase in blood pressure to values above 180/120 mmHg is considered critical. If not treated in time, it can quickly enter a life-threatening hypertensive emergency. The symptoms or organ damage determine the assessment as a crisis or an emergency. Rapid action is required. The therapy depends on the severity and the organ involvement. However the general principal is to avoid therapeutically induced hypotension...
September 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28927394/laboratory-markers-of-cardiac-and-metabolic-complications-after-generalized-tonic-clonic-seizures
#13
Robert D Nass, Sina Meiling, René P Andrié, Christian E Elger, Rainer Surges
BACKGROUND: Generalized tonic-clonic seizures (GTCS) frequently lead to emergency inpatient referrals. Laboratory blood values are routinely performed on admission to detect underlying causes and metabolic or cardiac complications. Our goal was to assess the nature and frequency of complications occurring in association with GTCS. METHODS: We retrospectively extracted data from emergency protocols and discharge letters of adult patients admitted to the Department of Epileptology between 01/2010 and 06/2015...
September 19, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28866866/hospital-and-out-of-hospital-mortality-in-670-hypertensive-emergencies-and-urgencies
#14
Haythem Guiga, Clémentine Decroux, Pierre Michelet, Anderson Loundou, Dimitri Cornand, François Silhol, Bernard Vaisse, Gabrielle Sarlon-Bartoli
Long-term mortality in patients with acute severe hypertension is unclear. The authors aimed to compare short-term (hospital) and long-term (12 months) mortality in these patients. A total of 670 adults presenting for acute severe hypertension between January 1, 2015, and December 31, 2015, were included. A total of 57.5% were hypertensive emergencies and 66.1% were hospitalized: 98% and 23.2% of those with hypertensive emergencies and urgencies, respectively (P = .001). Hospital mortality was 7.9% and was significantly higher for hypertensive emergencies (12...
November 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28807040/management-of-upper-gastrointestinal-bleeding-in-emergency-departments-from-bleeding-symptoms-to-diagnosis-a-prospective-multicenter-observational-study
#15
Pierre-Clément Thiebaud, Youri Yordanov, Jacques-Emmanuel Galimard, Pierre-Alexis Raynal, Sébastien Beaune, Laurent Jacquin, François-Xavier Ageron, Dominique Pateron
BACKGROUND: Upper gastrointestinal bleeding (UGB) is common in emergency departments (EDs) and can be caused by many eso-gastro-duodenal lesions. Most available epidemiological data and data on the management of UGB comes from specialized departments (intensive care units or gastroenterology departments), but little is known from the ED perspective. We aimed to determine the distribution of symptoms revealing UGB in EDs and the hemorrhagic lesions identified by endoscopy. We also describe the characteristics of patients consulting for UGB, UGB management in the ED and patients outcomes...
August 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28782308/a-prospective-observational-study-to-determine-the-prevalence-and-clinical-profile-of-patients-of-hypertensive-crisis-in-a-tertiary-care-hospital
#16
Santosh B Salagre, Shobha M Itolikar, Kapil Gedam
BACKGROUND: Hypertension can present in crisis form as 'hypertensive urgency'(HU) or as 'hypertensive emergency' (HE). Both the conditions are associated with significant morbidity and mortality. AIM: To evaluate the clinical characteristics, course of illness, end-organ damage and survival outcome in patients with hypertensive crisis. METHODOLOGY: This prospective observational year-long study was conducted after due ethical considerations on 120 adult non-pregnant patients who presented with blood pressure of >180/120 mm Hg in the emergency medical services of a tertiary care hospital...
June 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28702269/marker-negative-pheochromocytoma-associated-with-inferior-vena-cava-thrombosis
#17
S Poudyal, M Pradhan, S Chapagain, B R Luitel, P R Chalise, U K Sharma, P R Gyawali
Pheochromocytoma associated with inferior vena cava (IVC) thrombosis is very rare. A 27-year-old female presented with right flank pain and hypertensive urgency. Contrast-enhanced CT abdomen and gadolinium-contrast MRI abdomen revealed right adrenal mass suspicious of malignancy with invasion and compression to the right IVC wall along with IVC thrombus extending from the level of renal veins to the level of confluence with hepatic veins. Her routine laboratory investigations including 24-hour urine fractionated metanephrines, vanillylmandelic acid, and cortisol were normal...
2017: Case Reports in Urology
https://www.readbyqxmd.com/read/28701447/what-is-urgent-about-hypertensive-urgency
#18
Cian Hackett, Scott Garrison, Michael R Kolber
No abstract text is available yet for this article.
July 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28692167/modern-management-of-hypertensive-emergencies-and-urgencies-do-we-need-more-technology-paramedics-or-physicians
#19
Kyriakos Dimitriadis, Costas Tsioufis, Dimitris Tousoulis
No abstract text is available yet for this article.
July 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28671393/top-20-research-studies-of-2016-for-primary-care-physicians
#20
REVIEW
Mark H Ebell, Roland Grad
This article summarizes the top 20 original research studies and four practice guidelines of 2016, based on regular literature surveillance and as selected by members of the Canadian Medical Association. The studies, known as POEMs (patient-oriented evidence that matters), were rated highly because of their relevance, validity, and potential to change practice. Key hypertension treatment findings include reduced mortality (a benefit not demonstrated in lower-risk persons or persons with diabetes mellitus) but also an increase in harms with a more aggressive blood pressure target in high-risk persons with hypertension and without diabetes...
May 1, 2017: American Family Physician
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