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Pulmonary hypertension treatment

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https://www.readbyqxmd.com/read/29243189/congenital-portosystemic-venous-shunt
#1
REVIEW
M Papamichail, M Pizanias, N Heaton
Congenital portosystemic venous shunts are rare developmental anomalies resulting in diversion of portal flow to the systemic circulation and have been divided into extra- and intrahepatic shunts. They occur during liver and systemic venous vascular embryogenesis and are associated with other congenital abnormalities. They carry a higher risk of benign and malignant liver tumors and, if left untreated, can result in significant medical complications including systemic encephalopathy and pulmonary hypertension...
December 14, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29240058/-venous-thromboembolic-complications-in-patients-with-cardiovascular-implantable-electronic-devices
#2
R E Kalinin, I A Suchkov, I I Shitov, N D Mzhavanadze, V O Povarov
The problem of venous thromboembolic complications (VTECs) in patients with cardiovascular implantable electronic devices (CIEDs) is extremely important today because of an annually increasing number of surgical interventions for life-threatening arrhythmias and chronic heart failure. There are hitherto no clearly defined reliable risk factors for VTECs due to heterogeneity of the available literature data. Some sources point to elevated thrombus formation in patients with a large number of electrodes, in repeat operative interventions, in the presence of a temporary pacemaker, in implantation on the left side, silicon cover of an electrode, others refute these facts...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/29240049/-use-of-local-thrombolysis-in-patients-with-massive-pulmonary-thromboembolism-and-moderate-to-severe-pulmonary-hypertension
#3
Iu E Klevanets, A A Karpenko, A N Shilova
Presented herein are the results of treating a total of 110 patients with acute massive pulmonary thromboembolism. The patients included in the study were divided into 2 groups depending on the degree of severity of pulmonary hypertension. All patients underwent interventional treatment, i.e., endovascular mechanical fragmentation with local thrombolysis. Both short- and long-term outcomes were then analysed. Performing local thrombolysis made it possible to achieve regression of clinical manifestations of acute respiratory insufficiency in more than 98% of patients...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/29237441/potential-benefit-of-bosentan-therapy-in-borderline-or-less-severe-pulmonary-hypertension-secondary-to-idiopathic-pulmonary-fibrosis-an-interim-analysis-of-results-from-a-prospective-single-center-randomized-parallel-group-study
#4
Yosuke Tanaka, Mitsunori Hino, Akihiko Gemma
BACKGROUND: No drugs have been approved for the treatment of patients with pulmonary hypertension (PH) secondary to idiopathic pulmonary fibrosis (IPF), particularly those with idiopathic honeycomb lung. This study was conducted to investigate the long-term efficacy and safety of bosentan for PH based on changes in prognosis and respiratory failure. METHODS: IPF patients with borderline or less severe PH and completely organized honeycomb lung were randomized (1:1) to bosentan or no treatment for PH for 2 years and assessed at baseline and every 6 months for respiratory failure, activities of daily living (ADL), lung and heart functions by right cardiac catheterization, and other parameters...
December 13, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29237073/frequencies-of-borderline-pulmonary-hypertension-before-and-after-the-detect-algorithm-results-from-a-prospective-systemic-sclerosis-cohort
#5
Anna-Maria Hoffmann-Vold, Håvard Fretheim, Øyvind Midtvedt, Karin Kilian, Marianne Angelshaug, Asad Chaudhary, Ragnar Gunnarsson, Cathrine Brunborg, Torhild Garen, Arne K Andreassen, Einar Gude, Øyvind Molberg
Objective: The DETECT algorithm was developed for screening patients with SSc at high risk of pulmonary arterial hypertension (PAH). We evaluated the impact of this algorithm in a SSc population. Methods: Patients from the unselected, prospective Oslo University Hospital SSc study were divided into the Early and DETECT cohorts, respectively, depending on whether an incident right heart catheterization (RHC) was performed before (2009-13) or after (2014-17) the DETECT algorithm was instituted...
December 11, 2017: Rheumatology
https://www.readbyqxmd.com/read/29233198/clinical-efficacy-and-safety-of-switch-from-bosentan-to-macitentan-in-children-and-young-adults-with-pulmonary-arterial-hypertension
#6
Ebru Aypar, Dursun Alehan, Tevfik Karagöz, Hayrettin Hakan Aykan, İlker Ertugrul
BACKGROUND: Macitentan is an orally active, potent, dual endothelin receptor antagonist and is the only registered treatment for pulmonary arterial hypertension that significantly reduced morbidity and mortality in a long-term event-driven study. Aim Few studies compared the clinical efficacy and safety of switch from bosentan to macitentan only in adult patients with pulmonary arterial hypertension. We aimed to evaluate the clinical efficacy and safety of switch from bosentan to macitentan in children and young adults...
December 13, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29229649/isolated-tricuspid-regurgitation-outcomes-and-therapeutic-interventions
#7
REVIEW
Erin A Fender, Chad J Zack, Rick A Nishimura
Isolated tricuspid regurgitation (TR) can be caused by primary valvular abnormalities such as flail leaflet or secondary annular dilation as is seen in atrial fibrillation, pulmonary hypertension and left heart disease. There is an increasing recognition of a subgroup of patients with isolated TR in the absence of other associated cardiac abnormalities. Left untreated isolated TR significantly worsens survival. Stand-alone surgery for isolated TR is rarely performed due to an average operative mortality of 8%-10% and a paucity of data demonstrating improved survival...
December 11, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29229621/stem-cell-therapy-for-congenital-heart-disease-a-systematic-review
#8
REVIEW
Diamantis I Tsilimigras, Evangelos K Oikonomou, Demetrios Moris, Dimitrios Schizas, Konstantinos P Economopoulos, Konstantinos S Mylonas
BACKGROUND: Congenital heart disease (CHD) constitutes the most prevalent and heterogeneous group of congenital anomalies. Although surgery remains the gold standard treatment modality, stem cell therapy has been gaining ground as a complimentary or alternative treatment option in certain types of CHD. The aim of this study was to present the existing published evidence and ongoing research efforts on the implementation of stem cell-based therapeutic strategies in CHD. METHODS: A systematic review was conducted by searching Medline, ClinicalTrials...
December 12, 2017: Circulation
https://www.readbyqxmd.com/read/29229098/pulmonary-veno-occlusive-disease-an-important-consideration-in-patients-with-pulmonary-hypertension
#9
REVIEW
Ryan Balko, Hawa Edriss, Kenneth Nugent, Victor Test
Pulmonary veno-occlusive disease is a rare subcategory of pulmonary arterial hypertension (WHO Group 1). The disease is poorly understood and difficult to diagnose; it has no definitive cure to date. These patients present with nonspecific symptoms, including dyspnea, exercise intolerance, and weakness. Chest x-rays sometimes differ from idiopathic pulmonary arterial hypertension and may demonstrate alveolar infiltrates and pleural effusions. High resolution computed tomography scans reveal ground glass opacities, interlobular septal thickening, and lymphadenopathy...
November 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/29229085/prevalence-of-comorbidities-in-copd-patients-by-disease-severity-in-a-german-population
#10
Timm Greulich, Benjamin J D Weist, Andreas Rembert Koczulla, Sabina Janciauskiene, Andreas Klemmer, Wolfram Lux, Peter Alter, Claus F Vogelmeier
Chronic obstructive pulmonary disease (COPD) is commonly associated with multiple comorbidities. Our objective was to assess the prevalence of comorbidities in patients with COPD and to relate their prevalence to the severity of the disease by using a large German health care database. Based on the retrospective analysis of a two-year (2013-2014) database from the German Statutory Health Insurance system, we obtained a representative sample of 4,075,493 german insurants. This sample included 146,141 patients with COPD (age: ≥35 years)...
November 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/29222244/cardiovascular-care-of-patients-with-chronic-myeloid-leukemia-cml-on-tyrosine-kinase-inhibitor-tki-therapy
#11
REVIEW
Mary C Barber, Michael J Mauro, Javid Moslehi
Cardiovascular (CV) health has emerged as an important consideration in patients with chronic myeloid leukemia (CML) because of improved prognosis. Indeed, the success of BCR-ABL1 tyrosine kinase inhibitors (TKIs) has increased the focus on survivorship and late toxicity in oncological care. Survivorship issues in this population include CV disease prevention, given its prevalence in the general population. The introduction of BCR-ABL1 TKIs represented a unique concept of indefinite cancer therapy, only recently evolving to include "treatment-free remission...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29221952/danshensu-prevents-hypoxic-pulmonary-hypertension-in-rats-by-inhibiting-the-proliferation-of-pulmonary-artery-smooth-muscle-cells-via-tgf-%C3%AE-smad3-associated-pathway
#12
Ning Zhang, Mingqing Dong, Ying Luo, Feng Zhao, Yongjun Li
Hypoxic pulmonary hypertension is characterized by the remodeling of pulmonary artery. Previously we showed that tanshinone IIA, one lipid-soluble component from the Chinese herb Danshen, ameliorated hypoxic pulmonary hypertension by inhibiting pulmonary artery remodeling. Here we explored the effects of danshensu, one water-soluble component of Danshen, on hypoxic pulmonary hypertension and its mechanism. Rats were exposed to hypobaric hypoxia for 4 weeks to develop hypoxic pulmonary hypertension along with administration of danshensu...
December 5, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/29217599/ers-statement-on-obstructive-sleep-disordered-breathing-in-1-to-23-month-old-children
#13
Athanasios G Kaditis, Maria Luz Alonso Alvarez, An Boudewyns, Francois Abel, Emmanouel I Alexopoulos, Refika Ersu, Koen Joosten, Helena Larramona, Silvia Miano, Indra Narang, Hui-Leng Tan, Ha Trang, Marina Tsaoussoglou, Nele Vandenbussche, Maria Pia Villa, Dick Van Waardenburg, Silke Weber, Stijn Verhulst
The present statement was produced by a European Respiratory Society Task Force to summarise the evidence and current practice on the diagnosis and management of obstructive sleep disordered breathing (SDB) in children aged 1-23 months. A systematic literature search was completed and 159 articles were summarised to answer clinically relevant questions. SDB is suspected when symptoms or abnormalities related to upper airway obstruction are identified. Morbidity (pulmonary hypertension, growth delay, behavioural problems) and coexisting conditions (feeding difficulties, recurrent otitis media) may be present...
December 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29217526/first-in-human-phase-i-study-of-single-agent-vanucizumab-a-first-in-class-bi-specific-anti-ang-2-anti-vegf-antibody-in-adult-patients-with-advanced-solid-tumors
#14
Manuel Hidalgo, Maria Martinez-Garcia, Christophe Le Tourneau, Christophe Massard, Elena Garralda, Valentina Boni, Alvaro Taus, Joan Albanell, Marie-Paule Sablin, Marie Alt, Rastilav Bahleda, Andreea Varga, Christophe Boetsch, Izolda Franjkovic, Florian Heil, Angelika Lahr, Katharina Lechner, Anthony Morel, Tapan K Nayak, Simona Rossomanno, Kevin Smart, Kay-Gunnar Stubenrauch, Oliver Krieter
PURPOSE: Vanucizumab is an investigational anti-angiogenic, first-in-class, bi-specific monoclonal antibody targeting VEGF-A and angiopoietin-2 (Ang-2). This first-in-human study evaluated the safety, pharmacokinetics, pharmacodynamics, and antitumor activity of vanucizumab in adults with advanced solid tumors refractory to standard therapies. EXPERIMENTAL DESIGN: Patients received escalating bi-weekly (q2w; 3-30 mg/kg) or weekly (qw; 10-30 mg/kg) intravenous doses guided by a Bayesian logistic regression model with overdose control...
December 7, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/29203759/-right-hemicolectomy-under-spinal-anesthesia-due-to-cancer-of-ascending-large-bowel-case-report
#15
Gniewomir Ćwiertnia, Michał Dyaczyński
Surgery procedures of the abdomen cavity are commonly performed in general anaesthesia. Patients from high risk group with circulatory insufficiency, respiratory failure pose a problem. They undergo surgical procedures for life indications and emergency cases. Regional anaesthesia can be an alternative for general anaesthesia, and makes planned surgical treatment possible for this group of patients. The study presents the case of 79-year-old male with chronic obstructive pulmonary disease, after left lung upper lobectomy, arterial hypertension, who underwent operation due to ascending large bowel cancer under spinal anaesthesia as planned...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29202826/autonomic-nervous-system-involvement-in-pulmonary-arterial-hypertension
#16
REVIEW
Mylène Vaillancourt, Pamela Chia, Shervin Sarji, Jason Nguyen, Nir Hoftman, Gregoire Ruffenach, Mansoureh Eghbali, Aman Mahajan, Soban Umar
Pulmonary arterial hypertension (PAH) is a chronic pulmonary vascular disease characterized by increased pulmonary vascular resistance (PVR) leading to right ventricular (RV) failure. Autonomic nervous system involvement in the pathogenesis of PAH has been demonstrated several years ago, however the extent of this involvement is not fully understood. PAH is associated with increased sympathetic nervous system (SNS) activation, decreased heart rate variability, and presence of cardiac arrhythmias. There is also evidence for increased renin-angiotensin-aldosterone system (RAAS) activation in PAH patients associated with clinical worsening...
December 4, 2017: Respiratory Research
https://www.readbyqxmd.com/read/29202813/a-predominance-of-hypertensive-heart-disease-among-patients-with-cardiac-disease-in-buea-a-semi-urban-setting-south-west-region-of-cameroon
#17
Clovis Nkoke, Christelle Makoge, Anastase Dzudie, Liliane Kuate Mfeukeu, Engelbert Bain Luchuo, Alain Menanga, Samuel Kingue
OBJECTIVE: The pattern of heart disease is diverse within and among world regions. The little data on the spectrum of heart disease in Cameroon has been so far limited to major cities. We sought to describe the pattern of heart disease in Buea, the South West Region of Cameroon, a semi-urban setting. This was a descriptive cross-sectional study. Between June 2016 and April 2017 the echocardiography register of the Buea Regional Hospital was surveyed. We extracted data on the age, sex and echocardiographic diagnosis...
December 4, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29202543/-experts-consensus-on-the-management-of-the-right-heart-function-in-critically-ill-patients
#18
X T Wang, D W Liu, H M Zhang, Y Long, X D Guan, H B Qiu, K J Yu, J Yan, H Zhao, Y Q Tang, X Ding, X C Ma, W Du, Y Kang, B Tang, Y H Ai, H W He, D C Chen, H Chen, W Z Chai, X Zhou, N Cui, H Wang, X Rui, Z J Hu, J G Li, Y Xu, Y Yang, B Ouyan, H Y Lin, Y M Li, X Y Wan, R L Yang, Y Z Qin, Y G Chao, Z Y Xie, R H Sun, Z Y He, D F Wang, Q Q Huang, D P Jiang, X Y Cao, R G Yu, X Wang, X K Chen, J F Wu, L N Zhang, M G Yin, L X Liu, S W Li, Z J Chen, Z Luo
To establish the experts consensus on the right heart function management in critically ill patients. The panel of consensus was composed of 30 experts in critical care medicine who are all members of Critical Hemodynamic Therapy Collaboration Group (CHTC Group). Each statement was assessed based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) principle. Then the Delphi method was adopted by 52 experts to reassess all the statements. (1) Right heart function is prone to be affected in critically illness, which will result in a auto-exaggerated vicious cycle...
December 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29201166/small-interfering-rna-against-erk1-2-attenuates-cigarette-smoke-induced-pulmonary-vascular-remodeling
#19
Muqing Yu, Xiansheng Liu, Hongxu Wu, Wang Ni, Shixin Chen, Yongjian Xu
Cigarette smoke may contribute to pulmonary vascular remodeling (PVR), a result of the proliferation of pulmonary artery smooth muscle cells (PASMCs), before pulmonary hypertension in chronic obstructive pulmonary disease (COPD). Activated extracellular signal-regulated kinases 1 and 2 (ERK1/2) are considered to be involved the process of PVR. This study investigated the potential role of ERK1/2 in the proliferation of rat PASMCs (rPASMCs) and cigarette smoke-induced PVR in rats. A small interfering RNA (siRNA) against ERK1/2 (ERK1/2-siRNA) was synthesized, and it significantly reduced the expression of ERK1/2 and cyclin E1, significantly increased the proportion of cells arrested at G0/G1 phase and significantly suppressed the proliferation of rPASMCs treated with cigarette smoke extract compared with controls (all P<0...
November 2017: Experimental and Therapeutic Medicine
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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