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https://www.readbyqxmd.com/read/29678158/dexmedetomidine-infusion-as-an-analgesic-adjuvant-during-laparoscopic-%C3%B1-holecystectomy-a-randomized-controlled-study
#1
Kateryna Bielka, Iurii Kuchyn, Volodymyr Babych, Kseniia Martycshenko, Oleksii Inozemtsev
BACKGROUND: Dexmedetomidine (DEX) has sedative, sympatholytic and analgesic effects and might be beneficial if used as an adjuvant to: improve analgesia; modulate haemodynamic responses to intubation and pneumoperitoneum and; reduce the number of opioid-associated adverse events. The aim of this study was to evaluate the efficacy and safety of DEX infusion during elective laparoscopic cholecystectomy (LC). METHODS: A randomized, single-centre, parallel-group, placebo-controlled study was carried out between May 2016 and June 2017...
April 20, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29667019/what-is-new-in-heart-failure-management-in-2017-update-on-acc-aha-heart-failure-guidelines
#2
REVIEW
Biykem Bozkurt
PURPOSE OF REVIEW: The goal of this paper is to provide a summary of the new recommendations in the most recent 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. The intent is to provide the background and the supporting evidence for the recommendations and to provide practical guidance for management strategies in treatment of heart failure patients...
April 17, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29656442/treatment-emergent-hypertension-and-efficacy-in-the-phase-3-study-of-e7080-lenvatinib-in-differentiated-cancer-of-the-thyroid-select
#3
Lori J Wirth, Makoto Tahara, Bruce Robinson, Sanjeev Francis, Marcia S Brose, Mouhammed Amir Habra, Kate Newbold, Naomi Kiyota, Corina E Dutcus, Elton Mathias, Matthew Guo, Steven I Sherman, Martin Schlumberger
BACKGROUND: Hypertension (HTN) is an established class effect of vascular endothelial growth factor receptor (VEGFR) inhibition. In the phase 3 Study of (E7080) Lenvatinib in Differentiated Cancer of the Thyroid (SELECT) trial, HTN was the most frequent adverse event of lenvatinib, an inhibitor of VEGFR1, VEGFR2, VEGFR3, fibroblast growth factor receptor 1 (FGFR1), FGFR2, FGFR3, FGFR4, platelet-derived growth factor receptor α (PDGFRα), ret proto-oncogene (RET), and stem cell factor receptor (KIT)...
April 14, 2018: Cancer
https://www.readbyqxmd.com/read/29643163/effect-of-intratracheal-dexmedetomidine-administration-on-recovery-from-general-anaesthesia-after-gynaecological-laparoscopic-surgery-a-randomised-double-blinded-study
#4
Fei Wang, Haoxiang Zhong, Xiaoyan Xie, Weiping Sha, Caili Li, Zhenping Li, Zhuomei Huang, Chaojin Chen
OBJECTIVES: To examine the efficacy of intratracheal dexmedetomidine (Dex) injection for the prevention of the laryngeal response on emergence from general anaesthesia following gynaecological laparoscopic surgery. DESIGN: Prospective, randomised, double-blinded, controlled trial. SETTING: A general hospital, Guangdong Province, China. PARTICIPANTS: All patients who underwent elective laparoscopic gynaecological surgery, aged 18-60 years old, 40-80 kg in weight, American Society of Anesthesiologists class I-II were eligible...
April 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29624870/characteristics-and-risk-factors-of-pulmonary-arterial-hypertension-in-patients-with-primary-sj%C3%A3-gren-s-syndrome
#5
Shumin Yan, Mengtao Li, Hui Wang, Xiaoxi Yang, Jiuliang Zhao, Qian Wang, Yongtai Liu, Jinzhi Lai, Zhuang Tian, Hui Song, Yan Zhao, Xiaofeng Zeng
AIM: To describe baseline characteristics of patients with primary Sjögren's syndrome (pSS) with right heart catheterization (RHC)-confirmed pulmonary arterial hypertension (PAH) and explore risk factors for PAH in pSS. METHODS: This case-control study included consecutive patients hospitalized with pSS-PAH from 2007 to 2015, and pSS patients without PAH (in a 4 : 1 ratio) as controls. All patients fulfilled the 2002 American-European Consensus Group classification criteria for pSS-PAH was defined according to RHC-based European Society of Cardiology/European Respiratory Society guidelines...
April 6, 2018: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/29623176/renal-artery-stenosis-to-stent-or-not-to-stent
#6
Hassan N Ibrahim
The column in this issue is supplied by Hassan N. Ibrahim, M.D., director of the Division of Kidney Diseases and Hypertension in the Department of Medicine at Houston Methodist Hospital and a fellow of the American Society of Nephrology. Dr. Ibrahim joined Houston Methodist in May 2017 after serving as a professor of medicine and chief of nephrology at the University of Minnesota.
January 2018: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29605953/does-cigarette-smoking-harm-microsurgical-free-flap-reconstruction
#7
Denis Ehrl, Paul I Heidekrueger, Elisabeth M Haas, Michaela Coenen, Riccardo Giunta, Milomir Ninkovic, P Niclas Broer
BACKGROUND:  Free tissue transfers can successfully address a wide range of reconstructive requirements. While the negative influence of cigarette smoking is well documented, its effects in the setting of microsurgical free flap reconstruction remain debated. This study evaluates the impact of cigarette smoking on microsurgical reconstructions. METHODS:  Over a 7-year period, 897 patients underwent 969 microvascular free flap reconstructions at a single surgical center...
April 1, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29594504/management-of-high-blood-pressure-in-children-similarities-and-differences-between-us-and-european-guidelines
#8
Tammy M Brady, Amalia Stefani-Glücksberg, Giacomo D Simonetti
Over the last several decades, many seminal longitudinal cohort studies have clearly shown that the antecedents to adult disease have their origins in childhood. Hypertension (HTN), which has become increasingly prevalent in childhood, represents one of the most important risk factors for cardiovascular diseases (CVD) such as heart disease and stroke. With the risk of adult HTN much greater when HTN is manifest in childhood, the future burden of CVD worldwide is therefore concerning. In an effort to slow the current trajectory, professional societies have called for more rigorous, evidence-based guideline development to aid primary care providers and subspecialists in improving recognition, diagnosis, evaluation, and treatment of pediatric HTN...
March 28, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29556676/blood-pressure-and-collateral-circulation-in-acute-ischemic-stroke
#9
A Wufuer, P Mijiti, R Abudusalamu, H Dengfeng, C Jian, M Jianhua, Z Xiaoning
BACKGROUND: This study aimed to evaluate the effect of different blood pressure (BP) parameters on the collateral circulation in a retrospective cohort of patients with acute ischemic stroke and ipsilateral internal carotid artery (ICA) occlusion. METHODS: The degree of intracranial collaterals was graded according to the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) Collateral Flow Grading System...
March 20, 2018: Herz
https://www.readbyqxmd.com/read/29505770/perinatal-outcomes-associated-with-abnormal-cardiac-remodeling-in-women-with-treated-chronic-hypertension
#10
Anne M Ambia, Jamie L Morgan, C Edward Wells, Scott W Roberts, Monika Sanghavi, David B Nelson, F Gary Cunningham
BACKGROUND: Adverse maternal outcomes associated with chronic hypertension include accelerated hypertension and resultant target organ damage. One example is long-standing hypertension leading to maternal cardiac dysfunction. Our group has previously identified that features of such injury manifest as cardiac remodeling with left ventricular hypertrophy. Moreover, these features of cardiac remodeling identified in women with chronic hypertension during pregnancy were associated with adverse perinatal outcomes...
March 2, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29504458/beyond-jnc-8-implications-for-evaluation-and-management-of-hypertension-in-underserved-populations
#11
Joseph Burns, Dharam Persaud-Sharma, Dollie Green
In the United States, hypertension is a significant medical problem that affects nearly 1 in 3 adults, causes thousands of deaths annually, and costs the nation billions of dollars annually for medical management in terms of hospitalisations, lost wages, and pharmacotherapy. The management guidelines of hypertension have greatly varied between different healthcare organisations including the American College of Cardiology (ACC), the European Society of Cardiology (ESC) and the Joint National Committee (JNC-7, 8)...
March 5, 2018: Acta Cardiologica
https://www.readbyqxmd.com/read/29481482/evaluation-of-contralateral-and-bilateral-prophylactic-mastectomy-and-reconstruction-outcomes-comparing-alloplastic-and-autologous-reconstruction
#12
Patrick Bletsis, Alexandra Bucknor, Anmol Chattha, Parisa Kamali, Austin Chen, Renata Flecha-Hirsch, Berend van der Lei, Bernard T Lee, Samuel J Lin
BACKGROUND: Over the last decade, there has been a 12% increase in prophylactic mastectomy (PM) per year. The aim of the study was to analyze complication rates and associated risk factors in patients undergoing PM and reconstruction. METHODS: We reviewed patients undergoing PM (contralateral and bilateral) from 2010 to 2015 at a single academic institution. Data on patient characteristics and postoperative outcomes were obtained. Postoperative complications were categorized into minor and major groups...
February 23, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29464919/is-the-measurement-of-blood-pressure-by-automatic-monitor-in-the-south-american-pediatric-population-accurate-saycare-study
#13
Keisyanne Araújo-Moura, Augusto César Ferreira De Moraes, Elsie C O Forkert, Gabriela Berg, Gabriel Grizzo Cucato, Claúdia Lucia de Moraes Forjaz, Paula Moliterno, Diego Gaitan-Charry, Carlos A Delgado, Esther M González-Gil, Luis Alberto Moreno, Heráclito Barbosa Carvalho, Francisco Leonardo Torres-Leal
OBJECTIVE: This study aimed to test the validity of an automatic oscillometric device to measure the blood pressure (BP) in children (n = 191) and adolescents (n = 127) aged 3 to 18 years. METHODS: Systolic BP (SBP) and diastolic BP (DBP) levels were measured simultaneous by automatic device and mercury column with Y-connection. To verify the validity, Bland-Altman plots and limits of agreement of 95% (95% LOA), specificity and sensitivity of the device, and the grade of British Hypertension Society (BHS) criteria were used...
March 2018: Obesity
https://www.readbyqxmd.com/read/29451696/randomized-phase-2-trial-of-pemetrexed-pemetrexed-bevacizumab-and-pemetrexed-carboplatin-bevacizumab-in-patients-with-stage-iiib-iv-non-small-cell-lung-cancer-and-an-eastern-cooperative-oncology-group-performance-status-of-2
#14
David R Spigel, John D Hainsworth, Mathew J Joseph, Dianna L Shipley, M Kelly Hagan, Dana S Thompson, Howard A Burris, F Anthony Greco
BACKGROUND: The best treatment for patients with advanced non-small cell lung cancer (NSCLC) and a poor performance status is not well defined. In this phase 2 trial, patients were randomized to receive treatment with either single-agent pemetrexed or 1 of 2 combination regimens. METHODS: Patients with newly diagnosed, histologically confirmed nonsquamous NSCLC and an Eastern Cooperative Oncology Group (ECOG) performance status of 2 were stratified by age and serum albumin level and were randomized (1:1:1) to 1 of 3 regimens: pemetrexed (arm 1), pemetrexed and bevacizumab (arm 2), or pemetrexed, carboplatin, and bevacizumab (arm 3)...
May 1, 2018: Cancer
https://www.readbyqxmd.com/read/29395721/can-total-knee-arthroplasty-be-performed-safely-as-an-outpatient-in-the-medicare-population
#15
P Maxwell Courtney, Mark I Froimson, R Michael Meneghini, Gwo-Chin Lee, Craig J Della Valle
BACKGROUND: The Centers for Medicare and Medicaid Services has solicited public comments for the 2017 Proposed Rule to consider removing total knee arthroplasty (TKA) from the Inpatient Only List. The purpose of this study is to compare the complication rates between outpatient (same-day discharge), short-stay (discharge within 1 day), and inpatient TKA and to identify the ideal candidates for a short-stay or outpatient procedure. METHODS: We queried the American College of Surgeons-National Surgical Quality Improvement Program database for patients over age 65 years who underwent TKA from 2014 to 2015...
January 16, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29395184/management-of-hypertension-and-high-low-density-lipoprotein-in-pediatric-type-1-diabetes
#16
Michelle L Katz, Zijing Guo, Lori M Laffel
OBJECTIVE: To evaluate hypertension and hyperlipidemia management patterns in youth with type 1 diabetes and to assess perceived effectiveness of management strategies and barriers to management. STUDY DESIGN: An electronic survey, including clinical scenarios, fielded to pediatric providers (members of the American Diabetes Association Diabetes in Youth Interest Group, Pediatric Endocrine Society, or T1D Exchange). RESULTS: Respondents (N = 207, 86% MDs, 68% female) were practicing clinicians for youth with type 1 diabetes...
January 30, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29375010/aggressive-systolic-blood-pressure-control-in-older-subjects-benefits-and-risks
#17
REVIEW
Steven G Chrysant
Systolic hypertension, especially isolated systolic hypertension (ISH) is very common in older subjects aged ≥ 65 years and is a major risk factor for cardiovascular disease (CVD), strokes, heart failure (HF) and chronic kidney disease (CKD). It is also, directly and linearly related with these complications irrespective of sex, or ethnicity, but it is worse with the advancement of age. Effective control of systolic blood pressure (SBP), is associated with significant reduction in the incidence of these complications...
March 2018: Postgraduate Medicine
https://www.readbyqxmd.com/read/29360196/expression-of-micrornas-in-the-ascites-of-patients-with-peritoneal-carcinomatosis-and-peritonitis
#18
Philipp Schindler, Juozas Kupcinskas, Simonas Juzenas, Jurgita Skieceviciene, Violeta Salteniene, Christian Schulz, Jochen Weigt, Peter Malfertheiner, Alexander Link
BACKGROUND: Peritoneal carcinomatosis (PCA) has a prognostic role in patients with gastrointestinal cancers. The differential diagnosis may be challenging due to the low sensitivity of cytology. Although microRNAs (miRNAs) have been a focus of various specimens and diseases, to the best of the authors' knowledge only limited knowledge exists regarding ascites. Herein, the authors systematically evaluated preanalytical factors and the potential of miRNAs as biomarkers of ascites. METHODS: The authors prospectively analyzed samples from patients with PCA, spontaneous bacterial peritonitis (SBP), and portal hypertension (no SBP/PCA)...
January 23, 2018: Cancer Cytopathology
https://www.readbyqxmd.com/read/29357124/role-of-perivascular-adipose-tissue-in-health-and-disease
#19
Maria S Fernández-Alfonso, Beatriz Somoza, Dmitry Tsvetkov, Artur Kuczmanski, Mick Dashwood, Marta Gil-Ortega
Perivascular adipose tissue (PVAT) is cushion of fat tissue surrounding blood vessels, which is phenotypically different from other adipose tissue depots. PVAT is composed of adipocytes and stromal vascular fraction, constituted by different populations of immune cells, endothelial cells, and adipose-derived stromal cells. It expresses and releases an important number of vasoactive factors with paracrine effects on vascular structure and function. In healthy individuals, these factors elicit a net anticontractile and anti-inflammatory paracrine effect aimed at meeting hemodynamic and metabolic demands of specific organs and regions of the body...
December 12, 2017: Comprehensive Physiology
https://www.readbyqxmd.com/read/29336765/robotic-inguinal-hernia-repair
#20
David S Edelman
Laparoscopic inguinal hernia repair has certain advantages over open repair including less pain and earlier return to normal activity. Concurrent robotic inguinal hernia repair at the time of prostatectomy has been shown to have a lower recurrence rate than open repair. Robotic surgery adds high definition visualization and articulating instruments which enhances dexterity that makes laparoscopic hernia repair more refined. A series of robotic, laparoscopic, inguinal hernia repairs by a single surgeon with an extensive laparoscopic hernia experience at a single institution was undertaken to determine the role of robotic laparoscopic inguinal hernia repair in minimally invasive surgery...
December 1, 2017: American Surgeon
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