Hiroaki Hiraiwa, Takahiro Okumura, Toyoaki Murohara
In this comprehensive state-of-the-art review, we provide an evidence-based analysis of current drug therapies for patients with heart failure with preserved ejection fraction (HFpEF) in the acute and chronic phases with concurrent hypertension. Additionally, we explore the latest developments and emerging evidence on the efficacy, safety, and clinical outcomes of common and novel drug treatments in the management of HFpEF with concurrent hypertension. During the acute phase of HFpEF, intravenous diuretics, mineralocorticoid receptor antagonists (MRAs), and vasodilators are pivotal, while in the chronic phase, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers have proven effective in enhancing clinical outcomes...
April 4, 2024: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
Peter van der Meer, Niels Grote Beverborg
No abstract text is available yet for this article.
March 13, 2024: European Heart Journal
Daniël H van Raalte, Petter Bjornstad, David Z I Cherney, Ian H de Boer, Paola Fioretto, Daniel Gordin, Frederik Persson, Sylvia E Rosas, Peter Rossing, Jennifer A Schaub, Katherine Tuttle, Sushrut S Waikar, Hiddo J L Heerspink
Diabetic kidney disease (DKD), defined as co-existing diabetes and chronic kidney disease in the absence of other clear causes of kidney injury, occurs in approximately 20-40% of patients with diabetes mellitus. As the global prevalence of diabetes has increased, DKD has become highly prevalent and a leading cause of kidney failure, accelerated cardiovascular disease, premature mortality and global health care expenditure. Multiple pathophysiological mechanisms contribute to DKD, and single lifestyle or pharmacological interventions have shown limited efficacy at preserving kidney function...
April 3, 2024: Nature Reviews. Nephrology
Driss Laghlam, Sarah Benghanem, Sofia Ortuno, Nadia Bouabdallaoui, Stephane Manzo-Silberman, Olfa Hamzaoui, Nadia Aissaoui
Cardiogenic shock (CS) is characterized by low cardiac output and sustained tissue hypoperfusion that may result in end-organ dysfunction and death. CS is associated with high short-term mortality, and its management remains challenging despite recent advances in therapeutic options. Timely diagnosis and multidisciplinary team-based management have demonstrated favourable effects on outcomes. We aimed to review evidence-based practices for managing patients with ischemic and non-ischemic CS, detailing the multi-organ supports needed in this critically ill patient population...
March 30, 2024: Annals of Intensive Care
Alejandro Del Rio Verduzco, Ahva Salari, Parna Haghparast
INTRODUCTION: Chronic insomnia affects 5% to 10% of the US population, increasing the demand for treatment options and the corresponding research to prove their validity.1 This review compares recommendations from 3 clinical guidelines and summarizes hypnotic medications, including their newly reported side effects not mentioned in the guidelines. In addition, we aim to provide an overview of what pharmacotherapies are available for prescribers and patients. METHODS: A literature search was conducted for articles published prior to January 10, 2022, and case reports and clinical studies were retrieved from PubMed and Google Scholar...
October 2023: Mental Health Clinician
Manuel C Vallejo, Sangeeta Kumaraswami, Mark I Zakowski
No abstract text is available yet for this article.
April 5, 2024: Anesthesiology
Brit Long, Michael Gottlieb
No abstract text is available yet for this article.
April 3, 2024: Academic Emergency Medicine
Stephan von Haehling, Birgit Assmus, Tarek Bekfani, Elke Dworatzek, Frank Edelmann, Djawid Hashemi, Kristian Hellenkamp, Tibor Kempf, Philipp Raake, Katharina A Schütt, Rolf Wachter, Paul Christian Schulze, Gerd Hasenfuss, Michael Böhm, Johann Bauersachs
The aetiology of heart failure with preserved ejection fraction (HFpEF) is heterogenous and overlaps with that of several comorbidities like atrial fibrillation, diabetes mellitus, chronic kidney disease, valvular heart disease, iron deficiency, or sarcopenia. The diagnosis of HFpEF involves evaluating cardiac dysfunction through imaging techniques and assessing increased left ventricular filling pressure, which can be measured directly or estimated through various proxies including natriuretic peptides. To better narrow down the differential diagnosis of HFpEF, European and American heart failure guidelines advocate the use of different algorithms including comorbidities that require diagnosis and rigorous treatment during the evaluation process...
April 11, 2024: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Fernando Ramasco, Jesús Nieves-Alonso, Esther García-Villabona, Carmen Vallejo, Eduardo Kattan, Rosa Méndez
Sepsis and septic shock are associated with high mortality, with diagnosis and treatment remaining a challenge for clinicians. Their management classically encompasses hemodynamic resuscitation, antibiotic treatment, life support, and focus control; however, there are aspects that have changed. This narrative review highlights current and avant-garde methods of handling patients experiencing septic shock based on the experience of its authors and the best available evidence in a context of uncertainty. Following the first recommendation of the Surviving Sepsis Campaign guidelines, it is recommended that specific sepsis care performance improvement programs are implemented in hospitals, i...
February 3, 2024: Journal of Personalized Medicine
Nicolas Grillot, Antoine Roquilly
No abstract text is available yet for this article.
April 2, 2024: Anaesthesia
Davide Schilirò, Ettore Silvagni, Benedetta Ciribè, Federico Fattorini, Vincenzo Maccarrone, Elena Elefante, Viola Signorini, Dina Zucchi, Chiara Cardelli, Alessandra Bortoluzzi, Chiara Tani
Systemic lupus erythematosus (SLE) is classically regarded as the landmark of systemic autoimmune diseases, characterised by protean, multi-systemic manifestations and a highly variable clinical course.Over the last years, both clinical and translational clinical research efforts led to significant steps forward in management and treatment of SLE. However, numerous aspects of SLE, from pathogenesis to treatment, still remain challenging, and several unmet needs persist for both patients and physicians. Following the previous annual reviews of this series, herewith, we aim to report the most relevant new updates on SLE, issued in 2023...
March 2024: Clinical and Experimental Rheumatology
Biykem Bozkurt
The prevention and treatment strategies for heart failure (HF) have evolved in the past two decades. The stages of HF have been redefined, with recognition of the pre-HF state, which encompasses asymptomatic patients who have developed either structural or functional cardiac abnormalities or have elevated plasma levels of natriuretic peptides or cardiac troponin. The first-line treatment of patients with HF with reduced ejection fraction includes foundational therapies with angiotensin receptor-neprilysin inhibitors, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, β-blockers, mineralocorticoid receptor antagonists, sodium-glucose cotransporter 2 (SGLT2) inhibitors and diuretics...
March 26, 2024: Nature Reviews. Cardiology
Na Wang, Chun Zhang
Diabetic kidney disease (DKD) is a major cause of chronic kidney disease (CKD), and it heightens the risk of cardiovascular incidents. The pathogenesis of DKD is thought to involve hemodynamic, inflammatory, and metabolic factors that converge on the fibrotic pathway. Genetic predisposition and unhealthy lifestyle practices both play a significant role in the development and progression of DKD. In spite of the recent emergence of angiotensin receptors blockers (ARBs)/angiotensin converting enzyme inhibitor (ACEI), sodium-glucose cotransporter 2 (SGLT2) inhibitors, and nonsteroidal mineralocorticoid receptors antagonists (NS-MRAs), current therapies still fail to effectively arrest the progression of DKD...
March 7, 2024: International Journal of Molecular Sciences
Marco Mangiafico, Luca Costanzo
Superficial venous thrombosis (SVT), an inflammatory-thrombotic process of a superficial vein, is a relatively common event that may have several different underlying causes. This phenomenon has been generally considered benign, and its prevalence has been historically underestimated; the estimated incidence ranges from about 0.3 to 1.5 event per 1000 person-years, while the prevalence is approximately 3 to 11%, with different reports depending on the population studied. However, such pathology is not free of complications; indeed, it could extend to the deep circulation and embolize to pulmonary circulation...
February 19, 2024: Healthcare (Basel, Switzerland)
Jonel Trebicka, Ruben Hernaez, Debbie Lindsay Shawcross, Alexander L Gerbes
The progression of cirrhosis with clinically significant portal hypertension towards decompensated cirrhosis remains clinically challenging and the evolution towards acute-on-chronic liver failure (ACLF), with one or more extrahepatic organ failures, is associated with very high mortality. In the last decade, significant progress has been made in the understanding of the mechanisms leading to decompensation and ACLF. As portal hypertension advances, bacterial translocation across an impaired gut barrier culminates in endotoxaemia, systemic inflammation and cirrhosis-associated immune dysfunction (CAID)...
March 25, 2024: Gut
Michael Gottlieb, Nicholas Chien, Brit Long
No abstract text is available yet for this article.
March 25, 2024: Annals of Emergency Medicine
William Shomali, Jason Gotlib
DISEASE OVERVIEW: The eosinophilias encompass a broad range of non-hematologic (secondary or reactive) and hematologic (primary or clonal) disorders with the potential for end-organ damage. DIAGNOSIS: Hypereosinophilia (HE) has generally been defined as a peripheral blood eosinophil count greater than 1.5 × 109 /L, and may be associated with tissue damage. After the exclusion of secondary causes of eosinophilia, diagnostic evaluation of primary eosinophilias relies on a combination of various tests...
March 29, 2024: American Journal of Hematology
Matteo Lisi, Giovanni Andrea Luisi, Maria Concetta Pastore, Giulia Elena Mandoli, Giovanni Benfari, Federica Ilardi, Alessandro Malagoli, Simona Sperlongano, Michael Y Henein, Matteo Cameli, Antonello D'Andrea
International Guidelines consider left ventricular ejection fraction (LVEF) as an important parameter to categorize patients with heart failure (HF) and to define recommended treatments in clinical practice. However, LVEF has some technical and clinical limitations, being derived from geometric assumptions and is unable to evaluate intrinsic myocardial function and LV filling pressure (LVFP). Moreover, it has been shown to fail to predict clinical outcome in patients with end-stage HF. The analysis of LV antegrade flow derived from pulsed-wave Doppler (stroke volume index, stroke distance, cardiac output, and cardiac index) and non-invasive evaluation of LVFP have demonstrated some advantages and prognostic implications in HF patients...
March 20, 2024: Heart Failure Reviews
Danielle Adebayo, Florence Wong
BACKGROUND: Better understanding of disease pathophysiology has led to advances in managing ascites and its associated complications including hepatorenal syndrome-acute kidney Injury (HRS-AKI), especially medicinal and interventional advances. AIM: To review the latest changes in the management of ascites and HRS-AKI. METHODS: A literature search was conducted in Pubmed, using the keywords cirrhosis, ascites, renal dysfunction, acute kidney injury, hepatorenal syndrome, beta-blockers, albumin, TIPS and vasoconstrictors, including only publications in English...
March 25, 2024: Alimentary Pharmacology & Therapeutics
Karin Mueller Storrer, Carolina de Souza Müller, Maxwell Cássio de Albuquerque Pessoa, Carlos Alberto de Castro Pereira
Connective tissue disease-associated interstitial lung disease (CTD-ILD) represents a group of systemic autoimmune disorders characterized by immune-mediated organ dysfunction. Systemic sclerosis, rheumatoid arthritis, idiopathic inflammatory myositis, and Sjögren's syndrome are the most common CTDs that present with pulmonary involvement, as well as with interstitial pneumonia with autoimmune features. The frequency of CTD-ILD varies according to the type of CTD, but the overall incidence is 15%, causing an important impact on morbidity and mortality...
2024: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
2024-04-09 00:24:58
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