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persistent pulmonary hypertension

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https://www.readbyqxmd.com/read/29346252/sarcoidosis-with-pleural-effusion-as-the-presenting-symptom
#1
Estefania Rivera, Yaron Gesthalter, Paul Vardelaan, Alex Chee, Adnan Majid
A 65-year-old woman, never smoker, with medical history of hypertension, nonischemic cardiomyopathy, and moderate pulmonary hypertension presented with symptomatic bilateral pleural effusions. Thoracentesis revealed a lymphocyte predominant transudate and was negative for malignancy, microbiologic cultures were negative for an infectious cause. Chest tomography showed mediastinal and bilateral hilar lymphadenopathy, lymph node biopsy with endobronchial ultrasound-guided transbronchial needle aspiration showed non-necrotizing granulomas compatible with sarcoidosis...
January 16, 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29341967/new-modalities-for-the-administration-of-inhaled-nitric-oxide-in-intensive-care-units-after-cardiac-surgery-or-for-neonatal-indications-a-prospective-observational-study
#2
Philippe Gaudard, Claudio Barbanti, Bertrand Rozec, Philippe Mauriat, Mimoun M'rini, Gilles Cambonie, Jean Michel Liet, Claude Girard, Pierre Louis Leger, Ziad Assaf, Pierre Damas, Gauthier Loron, Laurent Lecourt, Julien Amour, Philippe Pouard
BACKGROUND: Nitric oxide (NO) has a well-known efficacy in pulmonary hypertension (PH), with wide use for 20 years in many countries. The objective of this study was to describe the current use of NO in real life and the gap with the guidelines. METHODS: This is a multicenter, prospective, observational study on inhaled NO administered through an integrated delivery and monitoring device and indicated for PH according to the market authorizations. The characteristics of NO therapy and ventilation modes were observed...
January 16, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29336713/persistent-pulmonary-hypertension-without-underlying-cardiac-disease-as-a-presentation-of-pulmonary-interstitial-glycogenosis
#3
Gordon Gray Still, Shuo Li, Mark Wilson, Paul Sammut
INTRODUCTION: Pulmonary interstitial glycogenosis (PIG) is an idiopathic lung condition that remains clinically underrecognized despite a growing body of literature. CASE REPORT: We present a case of PIG with pulmonary hypertension without underlying cardiac disease. This patient presented with respiratory distress and spontaneous pneumothorax at 6 months of age. Laboratory and imaging investigations demonstrated nonspecific features, but refractory pulmonary hypertension was confirmed on cardiac catheterization...
January 16, 2018: Fetal and Pediatric Pathology
https://www.readbyqxmd.com/read/29331003/oral-sildenafil-use-in-neonates-with-persistent-pulmonary-hypertension-of-newborn
#4
Ali Shabbir Hussain, Rehan Ali, Shakeel Ahmed, Farah Naz, Anila Haroon
BACKGROUND: The prevalence of PPHN has been estimated at 1.9 per 1000 live births. After the discovery of iNO's, its efficacy and benefit in PPHN is well established. Even in the best of centers equipped with iNo and ECMO the mortality is around 20%. Also, iNO is expensive and difficult to administer and monitor which makes it difficult choice in our part of the world. Furthermore About 40% of patients do not respond or have rebound pulmonary hypertension after discontinuation. Owing to these reasons, other treatment modalities like phosphodiesterase inhibitors such as Sildenafil need to be evaluated...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29321132/intersection-of-pulmonary-hypertension-and-right-ventricular-dysfunction-in-patients-on-left-ventricular-assist-device-support-is-there-a-role-for-pulmonary-vasodilators
#5
Christopher T Sparrow, Shane J LaRue, Joel D Schilling
Left ventricular assist devices (LVADs) improve survival and quality of life in patients with advanced heart failure. Despite these benefits, combined post- and precapillary pulmonary hypertension can be particularly problematic in patients on LVAD support, often exacerbating right ventricular (RV) dysfunction. Both persistently elevated pulmonary vascular resistance and RV dysfunction are associated with adverse outcomes, including death after LVAD. These observations have led to significant interest in the use of pulmonary vasodilators to treat pulmonary hypertension and preserve RV function among LVAD-supported patients...
January 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29316539/cyanosis-and-stroke-due-to-functional-cor-triatriatum-dexter-in-a-neonate
#6
Rachel L León, Nicholas B Zaban, Marcus S Schamberger, Chang Y Ho, Ulrike Mietzsch
Small remnants of the right valve of the sinus venosus are commonly found in adults, but the incidence and risk associated with these embryonic remnants in neonates are not well studied. The following report describes a cyanotic neonate with a large Eustachian valve remnant creating a functional cor triatriatum dexter who was initially diagnosed with persistent pulmonary hypertension of the newborn. The cyanosis in this infant improved over the first postnatal week with conservative management, but she suffered multifocal subcortical stroke, likely related to her intracardiac shunt...
January 10, 2018: Neonatology
https://www.readbyqxmd.com/read/29306907/new-aspects-in-the-pathomechanism-of-diseases-of-civilization-particularly-psychosomatic-disorders-part-2-chronic-hypocapnia-and-hypercapnia-in-the-medical-practice
#7
Andras Sikter, Zoltan Rihmer, Roberto de Guevara
The authors seek to find new connections between recent results of biology and older theories. This paper aims to assemble the jigsaw puzzle. The theoretical background of the hypothesis was described in the previous issue of the journal (Sikter et al. 2017a). Human stress response often coexists with persistent hypocapnia or hypercapnia - developing via psychosomatic pathomechanism - which can lead to mental and psychosomatic illnesses. Chronic hypocapnia mainly generates hyperarousal disorders which may be reversible for an extended time, however, vicious cycles may start when hypoxia and/or severe somatic diseases are simultaneously present (commonly in the elderly), which conditions often end with death without medical help...
September 2017: Neuropsychopharmacologia Hungarica
https://www.readbyqxmd.com/read/29302380/a-case-of-fatal-pulmonary-hypoplasia-with-congenital-diaphragmatic-hernia-thoracic-myelomeningocele-and-thoracic-dysplasia
#8
Ai Ito, Hideshi Fujinaga, Sachiko Matsui, Kumiko Tago, Yuka Iwasaki, Shuhei Fujino, Junko Nagasawa, Shoichiro Amari, Masao Kaneshige, Yuka Wada, Shigehiro Takahashi, Keiko Tsukamoto, Osamu Miyazaki, Takako Yoshioka, Akira Ishiguro, Yushi Ito
Background  Congenital diaphragmatic hernia (CDH) is fatal in severe cases of pulmonary hypoplasia. We experienced a fatal case of pulmonary hypoplasia due to CDH, thoracic myelomeningocele (MMC), and thoracic dysplasia. This constellation of anomalies has not been previously reported. Case Report  A male infant with a prenatal diagnosis of thoracic MMC with severe hydrocephalus and scoliosis was born at 36 weeks of gestation. CDH was found after birth and the patient died of respiratory failure due to pulmonary hypoplasia and persistent pulmonary hypertension of the newborn at 30 hours of age despite neonatal intensive care...
October 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29298856/persistent-pulmonary-hypertension-of-the-newborn-in-extremely-preterm-infants-a-japanese-cohort-study
#9
Hidehiko Nakanishi, Hideyo Suenaga, Atsushi Uchiyama, Satoshi Kusuda
OBJECTIVE: To investigate the characteristics of persistent pulmonary hypertension of the newborn (PPHN) in extremely preterm infants and its impact on neurodevelopmental outcomes at 3 years of age. DESIGN: A retrospective multicentre cohort study. SETTINGS: 202 tertiary perinatal centres registered in the Neonatal Research Network of Japan (NRNJ). PATIENTS: Infants born at <28 weeks of gestational age (GA), between 2003 and 2012, were extracted from tertiary perinatal centres participating in NRNJ...
January 3, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29290032/foxm1-promotes-pulmonary-artery-smooth-muscle-cell-expansion-in-pulmonary-arterial-hypertension
#10
Alice Bourgeois, Caroline Lambert, Karima Habbout, Benoit Ranchoux, Stéphanie Paquet-Marceau, Isabelle Trinh, Sandra Breuils-Bonnet, Renée Paradis, Valérie Nadeau, Roxane Paulin, Steeve Provencher, Sébastien Bonnet, Olivier Boucherat
Pulmonary arterial hypertension (PAH) is a progressive vascular remodeling disease characterized by a persistent elevation of pulmonary artery pressure, leading to right heart failure and premature death. Exaggerated proliferation and resistance to apoptosis of pulmonary artery smooth muscle cells (PASMCs) is a key component of vascular remodeling. Despite major advances in the field, current therapies for PAH remain poorly effective in reversing the disease or significantly improving long-term survival. Because the transcription factor FOXM1 is necessary for PASMC proliferation during lung morphogenesis and its overexpression stimulates proliferation and evasion of apoptosis in cancer cells, we thus hypothesized that upregulation of FOXM1 in PAH-PASMCs promotes cell expansion and vascular remodeling...
December 30, 2017: Journal of Molecular Medicine: Official Organ of the "Gesellschaft Deutscher Naturforscher und Ärzte"
https://www.readbyqxmd.com/read/29282032/riociguat-in-patients-with-chronic-thromboembolic-pulmonary-hypertension-results-from-an-early-access-study
#11
Vallerie V McLaughlin, Pavel Jansa, Jens E Nielsen-Kudsk, Michael Halank, Gérald Simonneau, Ekkehard Grünig, Silvia Ulrich, Stephan Rosenkranz, Miguel A Gómez Sánchez, Tomás Pulido, Joanna Pepke-Zaba, Joan Albert Barberá, Marius M Hoeper, Jean-Luc Vachiéry, Irene Lang, Francine Carvalho, Christian Meier, Katharina Mueller, Sylvia Nikkho, Andrea M D'Armini
BACKGROUND: Following positive results from the Phase III CHEST-1 study in patients with inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH), the Phase IIIb CTEPH early access study (EAS) was designed to assess the safety and tolerability of riociguat in real-world clinical practice, as well as to provide patients with early access to riociguat before launch. Riociguat is approved for the treatment of inoperable and persistent/recurrent CTEPH. METHODS: We performed an open-label, uncontrolled, single-arm, early access study in which 300 adult patients with inoperable or persistent/recurrent CTEPH received riociguat adjusted from 1 mg three times daily (tid) to a maximum of 2...
December 28, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29281101/sildenafil-for-improving-outcomes-in-patients-with-corrected-valvular-heart-disease-and-persistent-pulmonary-hypertension-a-multicenter-double-blind-randomized-clinical-trial
#12
Javier Bermejo, Raquel Yotti, Rocío García-Orta, Pedro L Sánchez-Fernández, Mario Castaño, Javier Segovia-Cubero, Pilar Escribano-Subías, José Alberto San Román, Xavier Borrás, Angel Alonso-Gómez, Javier Botas, María G Crespo-Leiro, Sonia Velasco, Antoni Bayés-Genís, Amador López, Roberto Muñoz-Aguilera, Eduardo de Teresa, José R González-Juanatey, Arturo Evangelista, Teresa Mombiela, Ana González-Mansilla, Jaime Elízaga, Javier Martín-Moreiras, José M González-Santos, Eduardo Moreno-Escobar, Francisco Fernández-Avilés
Aims: We aimed to determine whether treatment with sildenafil improves outcomes of patients with persistent pulmonary hypertension (PH) after correction of valvular heart disease (VHD). Methods and results: The sildenafil for improving outcomes after valvular correction (SIOVAC) study was a multricentric, randomized, parallel, and placebo-controlled trial that enrolled stable adults with mean pulmonary artery pressure ≥ 30 mmHg who had undergone a successful valve replacement or repair procedure at least 1 year before inclusion...
December 21, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29275886/the-extent-of-left-atrial-low-voltage-areas-included-in-pulmonary-vein-isolation-is-associated-with-freedom-from-recurrent-atrial-arrhythmia
#13
Dong Huang, Jing-Bo Li, Tarek Zghaib, Esra Gucuk Ipek, Muhammad Balouch, David D Spragg, Hiroshi Ashikaga, Harikrishna Tandri, Sunil K Sinha, Joseph E Marine, Ronald D Berger, Hugh Calkins, Saman Nazarian
BACKGROUND: The extent of left atrial (LA) baseline low-voltage areas (LVA-B), which may be a surrogate for fibrosis, is associated with recurrent atrial fibrillation (AF) after ablation. This study aimed to assess the relationship between the extent of LVA-B isolated by ablation (LVA-I) and AF recurrence. METHODS: The study cohort included 159 consecutive patients with drug-refractory AF who underwent an initial AF ablation with LA voltage mapping during sinus rhythm...
January 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29251627/pbx-transcription-factors-drive-pulmonary-vascular-adaptation-to-birth
#14
David J McCulley, Mark D Wienhold, Elizabeth A Hines, Timothy A Hacker, Allison Rogers, Ryan J Pewowaruk, Rediet Zewdu, Naomi C Chesler, Licia Selleri, Xin Sun
A critical event in the adaptation to extrauterine life is relaxation of the pulmonary vasculature at birth, allowing for a rapid increase in pulmonary blood flow that is essential for efficient gas exchange. Failure of this transition leads to pulmonary hypertension (PH), a major cause of newborn mortality associated with preterm birth, infection, hypoxia, and malformations including congenital diaphragmatic hernia (CDH). While individual vasoconstrictor and dilator genes have been identified, the coordination of their expression is not well understood...
December 18, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29250221/sinus-rhythm-restoration-after-radiofrequency-ablation-improves-survival-in-patients-undergoing-mitral-valve-surgery-a-eight-year-single-center-study
#15
Carlo Rostagno, Irene Capecchi, Sandro Gelsomino, Enrico Carone, Pier Luigi Stefàno
Background: The usefulness of radiofrequency (RF) ablation in restoring sinus rhythm in patients with permanent atrial fibrillation (AF) undergoing surgery for mitral valve has been demonstrated. But whether sinus rhythm recovery affects long-term survival is less clear. Methods: This study included 301 consecutive patients (126 men and 175 women, age 69±6 years) undergoing radiofrequency ablation of persistent atrial fibrillation along with mitral valve surgery...
June 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29223466/long-term-pulmonary-and-cardiovascular-morbidities-of-neonatal-hyperoxia-exposure-in-mice
#16
Renuka T Menon, Amrit Kumar Shrestha, Corey L Reynolds, Roberto Barrios, Binoy Shivanna
Pulmonary hypertension (PH) frequently occurs in infants with bronchopulmonary dysplasia (BPD), causing increased mortality and right ventricular (RV) dysfunction that persists into adulthood. A first step in developing better therapeutic options is identifying and characterizing an appropriate animal model. Previously, we characterized the short-term morbidities of a model in which C57BL/6J wild-type (WT) mice were exposed to 70% O2 (hyperoxia) during the neonatal period. Here, we aimed to determine the long-term morbidities using lung morphometry, echocardiography (Echo), and cardiac magnetic resonance imaging (cMRI)...
December 7, 2017: International Journal of Biochemistry & Cell Biology
https://www.readbyqxmd.com/read/29217006/incidence-prognostic-impact-and%C3%A2-predictive-factors-of-readmission-for-heart-failure-after-transcatheter-aortic-valve-replacement
#17
Eric Durand, Maxime Doutriaux, Nicolas Bettinger, Christophe Tron, Charles Fauvel, Fabrice Bauer, Jean-Nicolas Dacher, Najime Bouhzam, Pierre-Yves Litzler, Alain Cribier, Hélène Eltchaninoff
OBJECTIVES: The aim of this study was to assess the incidence, prognostic impact, and predictive factors of readmission for congestive heart failure (CHF) in patients with severe aortic stenosis treated by transcatheter aortic valve replacement (TAVR). BACKGROUND: TAVR is indicated in patients with severe symptomatic aortic stenosis in whom surgery is considered high risk or is contraindicated. Readmission for CHF after TAVR remains a challenge, and data on prognostic and predictive factors are lacking...
December 11, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29212620/one-year-outcome-for-congenital-diaphragmatic-hernia-results-from-the-french-national-register
#18
François Barrière, Fabrice Michel, Anderson D Loundou, Virginie Fouquet, Elsa Kermorvant, Sébastien Blanc, Elisabeth Carricaburu, Amélie Desrumaux, Odile Pidoux, Alexis Arnaud, Nicolas Berte, Thierry Blanc, Frederic Lavrand, Guillaume Levard, Isabelle Rayet, Sylvain Samperiz, Anne Schneider, Marie-Odile Marcoux, Norbert Winer, Yann Chaussy, Valérie Datin-Dorriere, Quentin Ballouhey, Aurélien Binet, Charles Muszynski, Jean Breaud, Armelle Garenne, Laurent Storme, Julia Boubnova
OBJECTIVE: To evaluate the status of congenital diaphragmatic hernia (CDH) management in France and to assess predictors of adverse outcomes. STUDY DESIGN: We reviewed the first-year outcome of all cases of CDH reported to the French National Register in 2011. RESULTS: A total of 158 cases were included. Of these, 83% (131) were prenatally diagnosed, with a mortality rate of 39% (44 of 112) for live born infants with a known outcome at hospital discharge...
December 4, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29204652/effect-of-nasal-continuous-positive-airway-pressure-on-infants-with-meconium-aspiration-syndrome-a-randomized-clinical-trial
#19
Aakash Pandita, Srinivas Murki, Tejo Pratap Oleti, Baswaraj Tandur, Sai Kiran, Sachin Narkhede, Amrut Prajapati
Importance: Nasal continuous positive airway pressure (NCPAP) as a primary respiratory therapy in meconium aspiration syndrome (MAS) has not been studied extensively. Nasal continuous positive airway pressure, when applied in newborns with MAS, may resolve atelectasis by sufficiently expanding partially obstructed small airways and stabilizing the collapsing terminal airways to enhance oxygen exchange. Objective: To compare NCPAP vs standard care in neonates with moderate to severe respiratory failure due to MAS in reducing the need for invasive ventilation...
December 4, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/29199910/impact-of-four-times-daily-dosing-of-oral-treprostinil-on-tolerability-and-daily-dose-achieved-in-pulmonary-hypertension
#20
James C Coons, Cheryl Bunner, David C Ishizawar, Michael G Risbano, Belinda Rivera-Lebron, Michael A Mathier, Stephen Y Chan, Marc A Simon
Oral treprostinil (TRE) is a prostacylin that is approved for the treatment of patients with pulmonary arterial hypertension (PAH). Dosing is approved for two or three times daily (t.i.d.); however, adverse effects, including gastrointestinal-related symptoms, may limit the ability to reach optimal doses. We report our experience with a four times daily (q.i.d.) regimen of oral TRE for goal-directed therapy of PAH. We describe three patients that were transitioned from infusion or inhaled TRE to oral TRE with initial t...
January 2018: Pulmonary Circulation
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