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https://www.readbyqxmd.com/read/28650919/a-sudden-death-risk-score-specifically-for-hypertension-based-on-25%C3%A2-648-individual-patient-data-from-six-randomized-controlled-trials
#1
Hai-Ha Le, Fabien Subtil, Marc Cerou, Ivanny Marchant, Muaamar Al-Gobari, Mor Fall, Yanis Mimouni, Behrouz Kassaï, Lars Lindholm, Lutgarde Thijs, François Gueyffier
OBJECTIVE: To construct a sudden death risk score specifically for hypertension (HYSUD) patients with or without cardiovascular history. METHODS: Data were collected from six randomized controlled trials of antihypertensive treatments with 8044 women and 17 604 men differing in age ranges and blood pressure eligibility criteria. In total, 345 sudden deaths (1.35%) occurred during a mean follow-up of 5.16 years. Risk factors of sudden death were examined using a multivariable Cox proportional hazards model adjusted on trials...
June 24, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28650912/the-effect-of-vasodilator-%C3%AE-blockers-on-renal-function-in-hypertensive-patients
#2
Lawrence H Kwon, Karan Wats, Clive Rosendorff
BACKGROUND: Not only is there a limited number of studies on the effects of vasodilator β-blocker (VBB) therapy on kidney function - specifically, glomerular filtration rate (GFR), serum creatinine (sCr) and proteinuria - but of those that have been reported, the results are mixed. This meta-analysis seeks to assess the efficacy of VBBs on selected renal parameters in hypertensive patients. METHODS: We conducted a meta-analysis of any prospective trial that provided both baseline and follow-up of at least 4 weeks of VBB therapy - carvedilol, labetalol, dilevalol, nebivolol and celiprolol in patients with hypertension...
June 24, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28649145/do-ssris-and-snris-reduce-the-frequency-and-or-severity-of-hot-flashes-in-menopausal-women
#3
Chris Stubbs, Lisa Mattingly, Steven A Crawford, Elizabeth A Wickersham, Jessica L Brockhaus, Laine H McCarthy
CLINICAL QUESTION: In menopausal women who experience regular hot flashes, does treatment with selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) reduce the frequency and/or severity of hot flashes? ANSWER: Yes. Review of the literature suggests that treatment with SSRIs or SNRIs reduces the frequency and severity of hot flashes in menopausal and post-menopausal women. Studies demonstrated that paroxetine (Paxil), citalopram (Celexa) and escitolapram (Lexapro) were the most effective SSRIs, and venlafaxine (Effexor) was the most effective first line SNRI, with desvenlafaxine as a second option...
May 2017: Journal of the Oklahoma State Medical Association
https://www.readbyqxmd.com/read/28648945/phosphodiesterase-5-inhibition-as-a-therapeutic-target-for-ischemic-stroke-a-systematic-review-of-preclinical-studies
#4
Joakim N E Ölmestig, Ida R Marlet, Atticus H Hainsworth, Christina Kruuse
Phosphodiesterase 5 inhibitors (PDE5i), such as sildenafil (Viagra®) are widely used for erectile dysfunction and pulmonary hypertension. Preclinical studies suggest that PDE5i may improve functional outcome following ischemic stroke. In this systematic review we aimed to evaluate the effects of selective PDE5i in animal models of brain ischaemia. A systematic search in Medline, Embase, and The Cochrane Library was performed including studies in English assessing the effects of selective PDE5i. 32 publications were included describing outcome in 3646 animals...
June 22, 2017: Cellular Signalling
https://www.readbyqxmd.com/read/28648615/structural-biology-and-the-design-of-new-therapeutics-from-hiv-and-cancer-to-mycobacterial-infections
#5
REVIEW
Sherine E Thomas, Vitor Mendes, So Yeon Kim, Sony Malhotra, Bernardo Ochoa-Montaño, Michal Blaszczyk, Tom L Blundell
Interest in applications of protein crystallography to medicine was evident as the first high-resolution structures emerged in the 50s and 60s. In Cambridge Max Perutz and John Kendrew sought to understand mutations in sickle cell and other genetic diseases related to haemoglobin, while in Oxford the group of Dorothy Hodgkin became interested in long-lasting zinc-insulin crystals for treatment of diabetes and later considered insulin redesign as synthetic insulins became possible. The use of protein crystallography in structure-guided drug discovery emerged as enzyme structures allowed the identification of potential inhibitor-binding sites and optimisation of interactions of hits using the structure of the target protein...
June 22, 2017: Journal of Molecular Biology
https://www.readbyqxmd.com/read/28648303/risk-of-esrd-and-mortality-associated-with-change-in-filtration-markers
#6
Casey M Rebholz, Lesley A Inker, Yuan Chen, Menglu Liang, Meredith C Foster, John H Eckfeldt, Paul L Kimmel, Ramachandran S Vasan, Harold I Feldman, Mark J Sarnak, Chi-Yuan Hsu, Andrew S Levey, Josef Coresh
BACKGROUND: Using change in estimated glomerular filtration rate (eGFR) based on creatinine concentration as a surrogate outcome in clinical trials of chronic kidney disease has been proposed. Risk for end-stage renal disease (ESRD) and all-cause mortality associated with change in concentrations of other filtration markers has not been studied in chronic kidney disease populations. STUDY DESIGN: Observational analysis of 2 clinical trials. SETTING & PARTICIPANTS: Participants in the MDRD (Modification of Diet in Renal Disease; n=317) Study and AASK (African American Study of Kidney Disease and Hypertension; n=373)...
June 22, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28646699/insulin-and-the-polycystic-ovary-syndrome
#7
REVIEW
Djuro Macut, Jelica Bjekić-Macut, Dario Rahelić, Mirjana Doknić
Polycystic ovary syndrome (PCOS) is the most prevalent endocrinopathy among women during reproductive age. PCOS is characterised by hyperandrogenaemia, hyperinsulinaemia, and deranged adipokines secretion from the adipose tissue. In addition to the reduced insulin sensitivity, PCOS women exhibit β-cell dysfunction as well. Low birth weight and foetal exposure to androgens may contribute to the development of the PCOS phenotype during life. Further metabolic complications lead to dyslipidaemia, worsening obesity and glucose tolerance, high prevalence of metabolic syndrome, and greater susceptibility to diabetes...
June 12, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28646095/estimated-reductions-in-provider-initiated-preterm-births-and-hospital-length-of-stay-under-a-universal-acetylsalicylic-acid-prophylaxis-strategy-a-retrospective-cohort-study
#8
Joel G Ray, Emily Bartsch, Alison L Park, Prakesh S Shah, Susie Dzakpasu
BACKGROUND: Hypertensive disorders, especially preeclampsia, are the leading reason for provider-initiated preterm birth. We estimated how universal acetylsalicylic acid (ASA) prophylaxis might reduce rates of provider-initiated preterm birth associated with preeclampsia and intrauterine growth restriction, which are related conditions. METHODS: We performed a cohort study of singleton hospital births in 2013 in Canada, excluding Quebec. We estimated the proportion of term births and provider-initiated preterm births affected by preeclampsia and/or intrauterine growth restriction, and the corresponding mean maternal and newborn hospital length of stay...
June 23, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28645696/exercise-training-improves-functional-status-in-hypertensive-older-adults-under-angiotensin-converting-enzymes-inhibitors-medication
#9
Liliana C Baptista, Aristides M Machado-Rodrigues, Manuel Teixeira Veríssimo, Raul A Martins
BACKGROUND: The study aims to analyze the effect of three types of treatment on functional status, and cardiovascular risk outcomes in hypertensive older adults with comorbidities. METHODS: Participants (n=418) underwent one of the following 3 conditions: i) multicomponent exercise training 3times/week (MEX; n=116); ii) angiotensin converting enzyme inhibitors used mono-dose daily (ACEi; n=70); iii) combined exercise and ACEi drugs (ACEiMEX; n=232). The trial was completed by 82% of the participants (n=342): MEX (n=90); ACEi (n=66); ACEiMEX (n=186)...
June 20, 2017: Experimental Gerontology
https://www.readbyqxmd.com/read/28644212/worsening-atrioventricular-conduction-after-hospital-discharge-in-patients-with-st-segment-elevation-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention-the-horizons-ami-trial
#10
Ioanna Kosmidou, Björn Redfors, Thomas McAndrew, Monica Embacher, Roxana Mehran, José M Dizon, Ori Ben-Yehuda, Gary S Mintz, Gregg W Stone
BACKGROUND: The chronic effects of ST-segment elevation myocardial infarction (STEMI) on the atrioventricular conduction (AVC) system have not been elucidated. This study aimed to evaluate the incidence, predictors, and outcomes of worsened AVC post-STEMI in patients treated with a primary percutaneous coronary intervention (PCI). PATIENTS AND METHODS: The current analysis included patients from the HORIZONS-AMI trial who underwent primary PCI and had available ECGs...
June 21, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28642330/effects-of-intensive-bp-control-in-ckd
#11
Alfred K Cheung, Mahboob Rahman, David M Reboussin, Timothy E Craven, Tom Greene, Paul L Kimmel, William C Cushman, Amret T Hawfield, Karen C Johnson, Cora E Lewis, Suzanne Oparil, Michael V Rocco, Kaycee M Sink, Paul K Whelton, Jackson T Wright, Jan Basile, Srinivasan Beddhu, Udayan Bhatt, Tara I Chang, Glenn M Chertow, Michel Chonchol, Barry I Freedman, William Haley, Joachim H Ix, Lois A Katz, Anthony A Killeen, Vasilios Papademetriou, Ana C Ricardo, Karen Servilla, Barry Wall, Dawn Wolfgram, Jerry Yee
The appropriate target for BP in patients with CKD and hypertension remains uncertain. We report prespecified subgroup analyses of outcomes in participants with baseline CKD in the Systolic Blood Pressure Intervention Trial. We randomly assigned participants to a systolic BP target of <120 mm Hg (intensive group; n=1330) or <140 mm Hg (standard group; n=1316). After a median follow-up of 3.3 years, the primary composite cardiovascular outcome occurred in 112 intensive group and 131 standard group CKD participants (hazard ratio [HR], 0...
June 22, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28641751/fetal-imaging-and-therapy-for-cdh-current-status
#12
Titilayo Oluyomi-Obi, Tim Van Mieghem, Greg Ryan
In congenital diaphragmatic hernia (CDH), herniation of the abdominal organs into the fetal chest causes pulmonary hypoplasia and pulmonary hypertension, the main causes of neonatal mortality. As antenatal ultrasound screening improves, the risk of postnatal death can now be better predicted, allowing for the identification of fetuses that might most benefit from a prenatal intervention. Fetoscopic tracheal occlusion is being evaluated in a large international randomized controlled trial. We present the antenatal imaging approaches that can help identify fetuses that might benefit from antenatal therapy, and review the evolution of fetal surgery for CDH to date...
June 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28640364/a-phase-2-study-of-the-efficacy-and-biomarker-on-the-combination-of-transarterial-chemoembolization-and-axitinib-in-the-treatment-of-inoperable-hepatocellular-carcinoma
#13
Stephen L Chan, Winnie Yeo, Frankie Mo, Anthony W H Chan, Jane Koh, Leung Li, Edwin P Hui, Charing C N Chong, Paul B S Lai, Tony S K Mok, Simon C H Yu
BACKGROUND: A surge of vascular endothelial growth factor (VEGF) after transarterial chemoembolization (TACE) may contribute to tumor progression. Axitinib is a potent antiangiogenic agent with main activity against VEGF receptors 1 to 3. To the authors' knowledge, its role in combination with TACE for the treatment of patients with inoperable hepatocellular carcinoma (HCC) is unclear. METHODS: A phase 2 clinical trial (ClinicalTrials.gov identifier NCT01352728) was conducted to evaluate the combination treatment...
June 22, 2017: Cancer
https://www.readbyqxmd.com/read/28639706/exercise-for-pregnant-women-with-gestational-diabetes-for-improving-maternal-and-fetal-outcomes
#14
REVIEW
Julie Brown, Gilles Ceysens, Michel Boulvain
BACKGROUND: Gestational diabetes mellitus (GDM) is associated with both short- and long-term complications for the mother and her baby. Exercise interventions may be useful in helping with glycaemic control and improve maternal and infant outcomes.The original review on Exercise for diabetic pregnant women has been split into two new review titles reflecting the role of exercise for pregnant women with gestational diabetes and for pregnant women with pre-existing diabetes. Exercise for pregnant women with gestational diabetes for improving maternal and fetal outcomes (this review) Exercise for pregnant women with pre-existing diabetes for improving maternal and fetal outcomes OBJECTIVES: To evaluate the effects of exercise interventions for improving maternal and fetal outcomes in women with GDM...
June 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28639575/account-for-clinical-heterogeneity-in-assessment-of-catheter-based-renal-denervation-among-resistant-hypertension-patients-subgroup-meta-analysis
#15
Xiao-Han Chen, Sehee Kim, Xiao-Xi Zeng, Zhi-Bing Chen, Tian-Lei Cui, Zhang-Xue Hu, Yi Li, Ping Fu
BACKGROUND: Catheter-based renal denervation (RDN) is a novel treatment for resistant hypertension (RH). A recent meta-analysis reported that RDN did not significantly reduce blood pressure (BP) based on the pooled effects with mild to severe heterogeneity. The aim of the present study was to identify and reduce clinical sources of heterogeneity and reassess the safety and efficacy of RDN within the identified homogeneous subpopulations. METHODS: This was a meta-analysis of 9 randomized clinical trials (RCTs) among patients with RH up to June 2016...
July 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28637384/long-term-effects-of-high-protein-diets-on-renal-function
#16
Anne-Lise Kamper, Svend Strandgaard
Chronic kidney disease (CKD) has a prevalence of approximately 13% and is most frequently caused by diabetes and hypertension. In population studies, CKD etiology is often uncertain. Some experimental and observational human studies have suggested that high-protein intake may increase CKD progression and even cause CKD in healthy people. The protein source may be important. Daily red meat consumption over years may increase CKD risk, whereas white meat and dairy proteins appear to have no such effect, and fruit and vegetable proteins may be renal protective...
June 21, 2017: Annual Review of Nutrition
https://www.readbyqxmd.com/read/28636188/selective-laser-trabeculoplasty-as-replacement-therapy-in-medically-controlled-glaucoma-patients
#17
Myrjam De Keyser, Maya De Belder, Jonas De Belder, Veva De Groot
PURPOSE: We examined selective laser trabeculoplasty (SLT) as a replacement therapy for medically controlled open-angle glaucoma (OAG) or ocular hypertensive patients. METHODS: A prospective randomized interventional clinical trial on 143 glaucoma patients. Patients were randomized to either receiving SLT or to the control group that continued on pressure lowering medication. Data were recorded 1 hr, 1 week, 1, 3, 6, 12 and 18 months after SLT. Primary outcome was number of medications at 12 and 18 months while maintaining a predetermined target intraocular pressure (IOP)...
June 21, 2017: Acta Ophthalmologica
https://www.readbyqxmd.com/read/28634748/exposure-response-relationship-of-ramucirumab-in-east-asian-patients-from-rainbow-a-randomized-clinical-trial-in-second-line-treatment-of-gastric-cancer
#18
Tae You Kim, Chia-Jui Yen, Salah-Eddin Al-Batran, David Ferry, Ling Gao, Yanzhi Hsu, Rebecca Cheng, Mauro Orlando, Atsushi Ohtsu
BACKGROUND: Ramucirumab is a recombinant human IgG1 neutralizing monoclonal antibody specific for vascular endothelial growth factor receptor-2. Second-line ramucirumab, in conjunction with paclitaxel (ramucirumab 8 mg/kg or placebo in combination with 80 mg/m(2) paclitaxel), has been shown to be effective and safe in patients with advanced gastric or gastroesophageal junction (GEJ) adenocarcinoma in RAINBOW, a global phase III randomized clinical trial. We conducted an exploratory exposure-response analysis of efficacy and safety of ramucirumab in East Asian patients from the RAINBOW trial...
June 20, 2017: Gastric Cancer
https://www.readbyqxmd.com/read/28634268/30-years-of-the-mineralocorticoid-receptor-mineralocorticoid-receptor-antagonists-60-years-of-research-and-development
#19
REVIEW
Peter Kolkhof, Lars Bärfacker
The cDNA of the mineralocorticoid receptor (MR) was cloned 30 years ago, in 1987. At that time, spirolactone, the first generation of synthetic steroid-based MR antagonists (MRAs), which was identified in preclinical in vivo models, had already been in clinical use for 30 years. Subsequent decades of research and development by Searle & Co., Ciba-Geigy, Roussel Uclaf and Schering AG toward identifying a second generation of much more specific steroidal MRAs were all based on the initial 17-spirolactone construct...
July 2017: Journal of Endocrinology
https://www.readbyqxmd.com/read/28634267/30-years-of-the-mineralocorticoid-receptor-the-role-of-the-mineralocorticoid-receptor-in-the-vasculature
#20
REVIEW
Jennifer J DuPont, Iris Z Jaffe
Since the mineralocorticoid receptor (MR) was cloned 30 years ago, it has become clear that MR is expressed in extra-renal tissues, including the cardiovascular system, where it is expressed in all cells of the vasculature. Understanding the role of MR in the vasculature has been of particular interest as clinical trials show that MR antagonism improves cardiovascular outcomes out of proportion to changes in blood pressure. The last 30 years of research have demonstrated that MR is a functional hormone-activated transcription factor in vascular smooth muscle cells and endothelial cells...
July 2017: Journal of Endocrinology
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