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Hypertensive Urgency

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https://www.readbyqxmd.com/read/27929246/hypertensive-urgency-not-really-an-urgent-problem
#1
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
#2
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...
November 8, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27819767/image-guided-thermal-ablation-of-adrenal-metastases-hemodynamic-and-endocrine-outcomes
#3
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
#4
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...
November 3, 2016: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/27790975/unusual-case-of-pheochromocytoma-presenting-with-diabetic-ketoacidosis
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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 (OAB), with special attention to hypertension. MATERIALS AND METHODS: After baseline assessment, patients recorded their 24-hour urinary frequency/volume, blood pressure, and heart rate for 3 days, and were stratified into 4 groups based on mean blood pressure (no hypertension, controllable, untreated, and uncontrolled hypertension)...
August 23, 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
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/27469152/promotion-of-kidney-care-in-countries-with-limited-resources-how-does-the-national-kidney-foundation-of-south-africa-fare
#15
Anthony M Meyers
INTRODUCTION: An often-quoted remark is to present problems as challenges, which invariably end up in the "in-box", eventually to be swept under the carpet. The chronic kidney disease burden in the South African black population poses a challenging crisis requiring immediate intervention even in a country with limited resources. Aims, materials, and methods: The National Kidney Foundation of South Africa (NKFSA) reports on 3 major projects. The schools project is aimed at prevention, early diagnosis, and appropriate management of chronic kidney disease (CKD) on a national basis...
2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27458500/successful-use-of-cyclosporine-as-treatment-for-eosinophilic-cystitis-a-case-report
#16
Sohaib Aleem, Bharat Kumar, Mary Beth Fasano, Elizabeth Takacs, Antoine Emile Azar
BACKGROUND: Eosinophilic cystitis is a rare inflammatory disorder characterized by eosinophilic infiltration of all layers of the urinary bladder wall. Due to lack of consensus and potential for side effect from various therapeutic options, treatment of the disease is often challenging. CASE PRESENTATION: A 64-year old woman with hypertensive nephropathy resulting in stage III chronic kidney disease, obstructive sleep apnea, and obstructive lung disease presented with a 4 month history of dysuria, urgency, frequency, and persistent hematuria...
2016: World Allergy Organization Journal
https://www.readbyqxmd.com/read/27403366/valproate-induced-hypertensive-urgency
#17
Mauran Sivananthan, Sarah Mohiuddin
Valproate is a medication used in the treatment of seizures, bipolar disorder, migraines, and behavioral problems. Here we present a case of an 8-year-old boy who presented with hypertensive urgency after initiation of valproate. Primary treatment of his hypertension was ineffective. Blood pressure stabilization was achieved following discontinuation of valproate. Clinicians should be aware of the risk of developing hypertensive urgency with administration of valproate.
2016: Case Reports in Psychiatry
https://www.readbyqxmd.com/read/27399424/145%C3%A2-unplanned-reoperation-after-craniotomy-for-tumor-a-national-surgical-quality-improvement-program-analysis
#18
Hormuzdiyar H Dasenbrock, Sandra C Yan, Vamsidhar Chavakula, William B Gormley, Timothy R Smith, Elizabeth Claus, Ian F Dunn
INTRODUCTION: Although reoperation has been utilized as a metric of quality of care, no national analysis has evaluated the rate of, reasons for, and predictors of unplanned reoperation after craniotomy for tumor. METHODS: Patients who underwent cranial tumor resection were extracted from the prospective National Surgical Quality Improvement Program (NSQIP) registry (2012-2014). Multivariable logistic regression examined predictors of an unplanned cranial reoperation...
August 2016: Neurosurgery
https://www.readbyqxmd.com/read/27398370/emergency-department-use-by-people-with-hiv-in-ontario-a-population-based-cohort-study
#19
Ryan Ng, Claire E Kendall, Ann N Burchell, Ahmed M Bayoumi, Mona R Loutfy, Janet Raboud, Richard H Glazier, Sean Rourke, Tony Antoniou
BACKGROUND: Emergency department use may reflect poor access to primary care. Our objective was to compare rates and causes of emergency department use between adults living with and without HIV. METHODS: We conducted a population-based study involving Ontario residents living with and without HIV between Apr. 1, 2011, and Mar. 31, 2012. We frequency matched adults with HIV to 4 HIV-negative people by age, sex and census division, and used random-effects negative binomial regression to compare rates of emergency department use...
April 2016: CMAJ Open
https://www.readbyqxmd.com/read/27383862/pathology-image-of-the-month-recurrent-urinary-tract-infections-in-a-48-year-old-female-hyperintensities-in-the-globus-pallidi
#20
Ellen E Connor, Anthony Vinson, Ritu Bhalla, Robin R McGoey
A 48-year-old female presented to her physician complaining of intermittent lower abdominal pain radiating to the right lower back. At the time of presentation, she was afebrile and denied any urinary symptoms such as dysuria, frequency or urgency. Physical exam was unremarkable, other than obesity, and her abdominal exam was noncontributory. Medical history, however, was notable for recurrent, Proteus mirabilis culture-proven urinary tract infections requiring antibiotic treatment for the prior three years along with hypertension, uterine fibroids post hysterectomy, diabetes and asthma...
March 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
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