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https://www.readbyqxmd.com/read/27905308/a-case-of-extreme-hypokalaemia
#1
L M Ten Bos, T C Veenstra, B D Westerhof, F H Bosch
Hypokalaemia is a common clinical problem. It can lead to severe disturbances in cardiac, neurological and muscle function. We present the case of a 45-year-old woman who was transported to our hospital with cardiac arrest following ventricular fibrillation. Blood sampling revealed severe acidosis (pH 7.02) and extreme hypokalaemia (0.9 mmol/l). The low serum potassium level was most likely caused by the combination of a very deficient diet and use of a thiazide diuretic. She never reported any symptoms. An acute intracellular shift of potassium due to epinephrine and perhaps also the cathecholamines in Red Bull may have further decreased the serum potassium concentration...
November 2016: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/27904156/effects-of-calcium-channel-blocker-benidipine-based-combination-therapy-on-target-blood-pressure-control-and-cardiovascular-outcome-a-sub-analysis-of-the-cope-trial
#2
Seiji Umemoto, Toshio Ogihara, Masunori Matsuzaki, Hiromi Rakugi, Yasuo Ohashi, Takao Saruta
We compared three benidipine-based regimens-that is, benidipine plus angiotensin receptor blocker (ARB), β-blocker (BB) or thiazide-and found that the benidipine-BB combination was less beneficial in reducing the risk of stroke than the benidipine-thiazide combination. This sub-analysis sought to compare the effects of reaching a target blood pressure (BP) (<140/90 mm Hg) on the cardiovascular outcomes among the three benidipine-based treatment groups in the Combination Therapy of Hypertension to Prevent Cardiovascular Events trial...
December 1, 2016: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://www.readbyqxmd.com/read/27893045/association-of-3-different-antihypertensive-medications-with-hip-and-pelvic-fracture-risk-in-older-adults-secondary-analysis-of-a-randomized-clinical-trial
#3
Rachel Puttnam, Barry R Davis, Sara L Pressel, Paul K Whelton, William C Cushman, Gail T Louis, Karen L Margolis, Suzanne Oparil, Jeffrey Williamson, Alokananda Ghosh, Paula T Einhorn, Joshua I Barzilay
Importance: On the basis of observational studies, the use of thiazide diuretics for the treatment of hypertension is associated with reduced fracture risk compared with nonuse. Data from randomized clinical trials are lacking. Objective: To examine whether the use of thiazide diuretics for the treatment of hypertension is associated with reduced fracture risk compared with nonuse. Design, Setting, and Participants: Using Veterans Affairs and Medicare claims data, this study examined hip and pelvic fracture hospitalizations in Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial participants randomized to first-step therapy with a thiazide-type diuretic (chlorthalidone), a calcium channel blocker (amlodipine besylate), or an angiotensin-converting enzyme inhibitor (lisinopril)...
November 21, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27884579/number-of-daily-antihypertensive-drugs-and-the-risk-of-osteoporotic-fractures-in-older-hypertensive-adults-national-health-insurance-service-senior-cohort
#4
So Yeon Kim, Sunyoung Kim, Sung Eun Choi, Byung Sung Kim, Hyun Rim Choi, Deri Hwang, Chang Won Won
BACKGROUND: Antihypertensive medication represents one of the most common prescriptions for senior individuals. Numerous studies have assessed the influence of antihypertensive treatment on the risk for osteoporotic fracture, yet much controversy remains. We analyzed the relationship between the incidence of osteoporotic fracture and the average number of daily antihypertensive drugs (NDAD) included in the prescription of elderly hypertensive patients. METHODS: The study population was derived from the National Health Insurance Service-Senior Cohort (2002-2013), and consisted of elderly patients (≥60 years) diagnosed with hypertension in 2009, who did not have osteoporotic fractures in 2008, and underwent at least one national health check-up between 2009 and 2013, and had complete records after 2010...
November 21, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27881180/polypharmacy-and-adverse-outcomes-after-hip-fracture-surgery
#5
Maria Härstedt, Cecilia Rogmark, Richard Sutton, Olle Melander, Artur Fedorowski
BACKGROUND: We aimed to explore the effects of polypharmacy and specific drug classes on readmissions and mortality after hip surgery. METHODS: We analyzed data on 272 consecutive hip fracture patients (72.1% females; age 82 ± 9 years) who underwent acute hip replacement. We collected detailed data on the pharmacological treatment upon admission and discharge. Patients were followed up over a period of 6 months after discharge using the Swedish National Hospital Discharge Register and the Swedish National Cause of Death Register...
November 24, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27879250/thiazide-diuretics-seem-to-protect-against-fracture
#6
Jacqui Wise
No abstract text is available yet for this article.
November 22, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27878562/full-dose-perindopril-indapamide-in-the-treatment-of-difficult-to-control-hypertension-the-fortissimo-study
#7
Yuri Aleksandrovich Karpov
BACKGROUND AND OBJECTIVE: Blood pressure (BP) control in hypertensive patients remains poor worldwide, particularly in high-risk patients with hypertension and diabetes. Guidelines recommend that such patients receive prompt pharmacological therapy at maximal doses to rapidly control BP. We aimed to evaluate efficacy and safety of single-pill combination (SPC) perindopril/indapamide (PER/IND) at full dose (10/2.5 mg) in hypertensive patients, including diabetics, with BP uncontrolled by previous medication...
November 22, 2016: Clinical Drug Investigation
https://www.readbyqxmd.com/read/27872838/new-slc12a3-disease-causative-mutation-of-gitelman-s-syndrome
#8
Teresa Grillone, Miranda Menniti, Francesco Bombardiere, Marco Flavio Michele Vismara, Stefania Belviso, Fernanda Fabiani, Nicola Perrotti, Rodolfo Iuliano, Emma Colao
Gitelman's syndrome (GS) is a salt-losing tubulopathy with an autosomal recessive inheritance caused by mutations of SLC12A3, which encodes for the thiazide-sensitive NaCl cotransporter. In this study we report a new mutation of SLC12A3 found in two brothers affected by GS. Hypokalemia, hypocalciuria and hyper-reninemia were present in both patients while hypomagnesemia was detected only in one. Both patients are compound heterozygotes carrying one well known GS associated mutation (c.2581 C > T) and a new one (c...
November 6, 2016: World Journal of Nephrology
https://www.readbyqxmd.com/read/27861386/statins-and-risk-for-new-onset-diabetes-mellitus-a-real-world-cohort-study-using-a-clinical-research-database
#9
Dukyong Yoon, Seung Soo Sheen, Sukhyang Lee, Yong Jun Choi, Rae Woong Park, Hong-Seok Lim
Although concern regarding the increased risk for new-onset diabetes mellitus (NODM) after statin treatment has been raised, there has been a lack of evidence in real-world clinical practice, particularly in East Asians. We investigated whether statin use is associated with risk for NODM in Koreans. We conducted a retrospective cohort study using the clinical research database from electronic health records. The study cohort consisted of 8265 statin-exposed and 33,060 matched nonexposed patients between January 1996 and August 2013...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27855717/hypertension-control-and-care-at-mulago-hospital-ambulatory-clinic-kampala-uganda
#10
Isaac Ssinabulya, Yvonne Nabunnya, Brian Kiggundu, Charles Musoke, Michael Mungoma, James Kayima
BACKGROUND: Hypertension is as prevalent in many developing countries, as in the developed world and is the leading cause of cardiovascular morbidity and mortality in Africa. The control of hypertension in this resource limited setting is inadequate, a situation that translates into poorer outcomes in form of increasing incidences of stroke, heart failure, kidney failure and therefore early cardiovascular death. METHODS: This was a chart review of all the patients seen during the months of September 2012 to February 2013...
November 17, 2016: BMC Research Notes
https://www.readbyqxmd.com/read/27853385/efficacy-of-ingenol-mebutate-gel-for-actinic-keratosis-in-patients-treated-by-thiazide-diuretics
#11
Elena Campione, Monia Di Prete, Laura Diluvio, Luca Bianchi, Augusto Orlandi
Actinic keratosis (AK) is considered as superficial squamous cell carcinoma. Chronic sun exposure plays a central role in its pathogenesis. In particular, ultraviolet B radiation causes direct damage to the DNA, producing pyrimidine dimers that suppress the protective role of p53. Other risk factors include advanced age, male sex, and fair skin type. Even some drugs used for treating blood hypertension, such as thiazide diuretics, can increase the risk of developing AK. Their photosensitizing action seems to be connected with reactive oxygen species production...
2016: Clinical, Cosmetic and Investigational Dermatology
https://www.readbyqxmd.com/read/27852221/non-coronary-chest-pain-does-not-affect-long-term-mortality-a-prospective-observational-study-using-a-matched-population-control
#12
Staffan Nilsson, Petter Järemo
BACKGROUND: Chest pain assumed to be of non-coronary origin (NCCP) may be linked to enhanced mortality due to coronary heart disease (CHD). The aim of this study was to follow NCCP patients, as defined in primary care, with respect to mortality and long-term morbidity of CHD. We further examined if NCCP associates with risk factors for CHD. METHODS: Patients consulting general practitioners (GPs) in 1998-2000 in three primary care centers in the southeast Sweden for chest pain regarded as NCCP were compared with controls matched for age, gender and residential area...
November 16, 2016: BMC Family Practice
https://www.readbyqxmd.com/read/27826706/clinical-associations-of-early-dysnatremias-in-critically-ill-neonates-and-infants-undergoing-cardiac-surgery
#13
Jon Kaufman, Daniel Phadke, Suhong Tong, Jennifer Eshelman, Sarah Newman, Christopher Ruzas, Eduardo M da Cruz, Suzanne Osorio
: Dysnatremias (DN) are common electrolyte disturbances in cardiac critical illness and are known risk factors for adverse outcomes in certain populations. Little information exists on DN in children with cardiac disease admitted to the cardiac intensive care unit (CICU) after undergoing cardiac surgery, either corrective or palliative. The aim was to determine the incidence and adverse outcomes associated with DN in neonates and infants undergoing cardiac surgery. Retrospective cohort and single center study performed at Children's Hospital Colorado from May 2013 to May 2014, in children under 1 year old admitted to the CICU after undergoing surgery for congenital or acquired cardiac disease...
November 8, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27815594/wnk-signalling-pathways-in-blood-pressure-regulation
#14
REVIEW
Meena Murthy, Thimo Kurz, Kevin M O'Shaughnessy
Hypertension (high blood pressure) is a major public health problem affecting more than a billion people worldwide with complications, including stroke, heart failure and kidney failure. The regulation of blood pressure is multifactorial reflecting genetic susceptibility, in utero environment and external factors such as obesity and salt intake. In keeping with Arthur Guyton's hypothesis, the kidney plays a key role in blood pressure control and data from clinical studies; physiology and genetics have shown that hypertension is driven a failure of the kidney to excrete excess salt at normal levels of blood pressure...
November 4, 2016: Cellular and Molecular Life Sciences: CMLS
https://www.readbyqxmd.com/read/27804084/ion-transport-its-regulation-in-the-endolymphatic-sac-suggestions-for-clinical-aspects-of-meniere-s-disease
#15
REVIEW
Nozomu Mori, Takenori Miyashita, Ryuhei Inamoto, Ai Matsubara, Terushige Mori, Kosuke Akiyama, Hiroshi Hoshikawa
Ion transport and its regulation in the endolymphatic sac (ES) are reviewed on the basis of recent lines of evidence. The morphological and physiological findings demonstrate that epithelial cells in the intermediate portion of the ES are more functional in ion transport than those in the other portions. Several ion channels, ion transporters, ion exchangers, and so on have been reported to be present in epithelial cells of ES intermediate portion. An imaging study has shown that mitochondria-rich cells in the ES intermediate portion have a higher activity of Na(+), K(+)-ATPase and a higher Na(+) permeability than other type of cells, implying that molecules related to Na(+) transport, such as epithelial sodium channel (ENaC), Na(+)-K(+)-2Cl(-) cotransporter 2 (NKCC2) and thiazide-sensitive Na(+)-Cl(-) cotransporter (NCC), may be present in mitochondria-rich cells...
November 1, 2016: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/27803420/acquired-gitelman-syndrome-in-an-anti-ssa-antibody-positive-patient-with-a-slc12a3-heterozygous-mutation
#16
Takeshi Kusuda, Tadashi Hosoya, Takayasu Mori, Katsuhito Ihara, Hidenori Nishida, Motoko Chiga, Eisei Sohara, Tatemitsu Rai, Ryuji Koike, Shinichi Uchida, Hitoshi Kohsaka
A 36-year-old woman developed hypokalemic metabolic alkalosis after anti SS-A antibody was found to be positive. Diuretic loading test results were compatible with Gitelman syndrome (GS). The patient had a heterozygous mutation in SLC12A3, which encodes for thiazide-sensitive NaCl cotransporter (NCCT). While the mutation may be responsible for a latent hypofunction of NCCTs, the underlying anti-SSA antibody-associated autoimmunity induced the manifestation of its hypofunction. To the best of our knowledge, this is the first report to demonstrate that anti SS-A antibody-associated autoimmunity may induce GS in a patient with a SLC12A3 heterozygous mutation...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27799135/drug-induced-cutaneous-lupus-erythematosus-88-new-cases
#17
Rasa Laurinaviciene, Linda Holm Sandholdt, Anette Bygum
BACKGROUND: An increasing number of drugs have been linked to drug-induced subacute cutaneous lupus erythematosus (DI-SCLE). The recognition and management of DI-SCLE can be challenging, as the condition may be triggered by different classes of drugs after variable lengths of time. OBJECTIVES: To determine the proportion of patients with cutaneous lupus erythematosus (CLE) whose drugs are an inducing or aggravating factor. MATERIALS & METHODS: We conducted a retrospective chart review of patients diagnosed with CLE at a dermatological department over a 21-year period...
October 31, 2016: European Journal of Dermatology: EJD
https://www.readbyqxmd.com/read/27798457/refractory-versus-resistant-hypertension
#18
Mohammed Siddiqui, David A Calhoun
PURPOSE OF REVIEW: Refractory hypertension is a recently proposed phenotype of antihypertensive treatment failure. As such it represents an extreme subtype of resistant or difficult-to-treat hypertension. Resistant hypertension is relatively common with an estimated prevalence of 10-20% of treated hypertensive patients. It is typically defined as having an uncontrolled blood pressure on three or more antihypertensive medications, including a diuretic. Refractory hypertension is rare with a prevalence of approximately 5% of patients with uncontrolled resistant hypertension...
January 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/27777360/trends-in-antihypertensive-medication-use-among-us-patients-with-resistant-hypertension-2008-to-2014
#19
Andrew Y Hwang, Chintan Dave, Steven M Smith
Little is known of US trends in antihypertensive drug use for patients with treatment-resistant hypertension (TRH). We analyzed antihypertensive use among patients with TRH (treated with ≥4 antihypertensive drugs concurrently) from July 2008 through December 2014 using Marketscan administrative data. We included adults aged 18 to 65 years, with ≥6 months of continuous enrollment, a hypertension diagnosis, and ≥1 episode of overlapping use of ≥4 antihypertensive drugs; patients with heart failure were excluded...
October 24, 2016: Hypertension
https://www.readbyqxmd.com/read/27773415/diuretics-in-primary-hypertension-reloaded
#20
EDITORIAL
Sundeep Mishra
Diuretics have long been cherished as drugs of choice for uncomplicated primary hypertension. Robust mortality and morbidity data is available for diuretics to back this strategy. Off-late the interest for diuretics has waned off perhaps due to availability of more effective drugs but more likely due to perceived lack of tolerance and side-effect profile of high-dose of diuretics required for mortality benefit. Low-dose diuretics particularly thiazide diuretics are safer but lack the mortality benefit shown by high-dose...
September 2016: Indian Heart Journal
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