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By Inessa Yurtsev RN graduated in 2008 from SFSU with Bachelor degree in nursing. I work at Kaiser Santa Clara hospital on medical surgical floor. I plan to go to Grad school
J L Mehta, L M Lopez
Abrupt withdrawal of adrenergic blockers in a hypertensive subject may result in acute hypertensive crisis. This crisis results from marked increase in adrenergic discharge and upregulation of adrenoceptors. In a patient with hypertensive crisis following abrupt cessation of clonidine hydrochloride and metoprolol tartrate, intravenous administration of labetalol hydrochloride rapidly reduced blood pressure and heart rate to precrisis levels. The patient was subsequently maintained in a normotensive state by continued oral use of labetalol...
February 1987: Archives of Internal Medicine
Dena Ettehad, Connor A Emdin, Amit Kiran, Simon G Anderson, Thomas Callender, Jonathan Emberson, John Chalmers, Anthony Rodgers, Kazem Rahimi
BACKGROUND: The benefits of blood pressure lowering treatment for prevention of cardiovascular disease are well established. However, the extent to which these effects differ by baseline blood pressure, presence of comorbidities, or drug class is less clear. We therefore performed a systematic review and meta-analysis to clarify these differences. METHOD: For this systematic review and meta-analysis, we searched MEDLINE for large-scale blood pressure lowering trials, published between Jan 1, 1966, and July 7, 2015, and we searched the medical literature to identify trials up to Nov 9, 2015...
March 5, 2016: Lancet
Atul Verma, Laurent Macle, Jafna Cox, Allan C Skanes
Catheter ablation of atrial fibrillation (AF) offers a promising treatment for the maintenance of sinus rhythm in patients for whom a rhythm control strategy is desired. While the precise mechanisms of AF are incompletely understood, there is substantial evidence that in many cases (particularly for paroxysmal AF), ectopic activity most commonly located in and around the pulmonary veins of the left atrium plays a central role in triggering and/or maintaining arrhythmic episodes. Catheter ablation involves electrically disconnecting the pulmonary veins from the rest of the left atrium to prevent AF from being triggered...
January 2011: Canadian Journal of Cardiology
Jason K Wasserman, Jeffrey J Perry, Dar Dowlatshahi, Grant Stotts, Marco L A Sivilotti, Andrew Worster, Marcel Emond, Jane Sutherland, Ian G Stiell, Mukul Sharma
OBJECTIVE: A cardiac source is often implicated in strokes where the deficit includes aphasia. However, less is known about the etiology of isolated aphasia during transient ischemic attack (TIA). Our objective was to determine whether patients with isolated aphasia are likely to have a cardioembolic etiology for their TIA. METHODS: We prospectively studied a cohort of TIA patients in eight tertiary-care emergency departments. Patients with isolated aphasia were identified by the treating physician at the time of emergency department presentation...
November 2015: CJEM
Spyros D Mentzelopoulos, Sotirios Malachias, Christos Chamos, Demetrios Konstantopoulos, Theodora Ntaidou, Androula Papastylianou, Iosifinia Kolliantzaki, Maria Theodoridi, Helen Ischaki, Dimosthemis Makris, Epaminondas Zakynthinos, Elias Zintzaras, Sotirios Sourlas, Stavros Aloizos, Spyros G Zakynthinos
IMPORTANCE: Among patients with cardiac arrest, preliminary data have shown improved return of spontaneous circulation and survival to hospital discharge with the vasopressin-steroids-epinephrine (VSE) combination. OBJECTIVE: To determine whether combined vasopressin-epinephrine during cardiopulmonary resuscitation (CPR) and corticosteroid supplementation during and after CPR improve survival to hospital discharge with a Cerebral Performance Category (CPC) score of 1 or 2 in vasopressor-requiring, in-hospital cardiac arrest...
July 17, 2013: JAMA: the Journal of the American Medical Association
Ann White, Joshua Broder
This article is a 2-part series about patients with aortic emergencies. Patients with acute aortic disease who present to the emergency department represent some of the highest acuity patients that emergency clinicians will ever encounter in acute care settings. Part 1 focuses on aortic aneurysms in the thorax or abdomen. An aortic aneurysm involves transverse dilatation, leading to rupture and hemorrhage. Diagnosis is largely based on clinical presentation and carefully selected imaging studies. Emergency interventions are guided by whether or not the patient is hypertensive or in shock...
July 2012: Advanced Emergency Nursing Journal
Christopher E Clark, Roy J Powell
BACKGROUND: Patients sometimes have differences of > or =20/10 mmHg in their blood pressure depending on which arm is measured. The prevalence and prognostic value of this finding in general practice are unknown. If these differences are due to peripheral vascular disease, these patients may be at increased risk of cardiovascular or cerebrovascular events. OBJECTIVE: Our aim was to establish the frequency and prognostic value of a blood pressure difference between arms in one rural general practice...
October 2002: Family Practice
Christopher E Clark, John L Campbell, Roy J Powell, John F Thompson
BACKGROUND: A blood pressure (BP) difference between the upper limbs is often encountered in primary care. Knowledge of its prevalence and importance in the accurate measurement of BP is poor, representing a source of error. Current hypertension guidelines do not emphasize this. OBJECTIVES: To establish the prevalence of an inter-arm blood pressure difference (IAD) and explore its association with other indicators of peripheral vascular disease (PVD) in a hypertensive primary care population...
October 2007: Family Practice
C E Clark, J L Campbell, P H Evans, A Millward
A blood pressure (BP) difference between arms was first reported over 100 years ago. Knowledge of its prevalence and relevance to the accurate measurement of BP remains poor. Current hypertension guidelines do not emphasise it. The objectives of this study were to establish the best estimate of prevalence of the inter-arm difference (IAD) in the population, to consider its implications for accurate BP measurement and treatment, and to discuss its aetiology and potential as a risk marker for cardiovascular disease...
December 2006: Journal of Human Hypertension
Ho-Ming Su, Tsung-Hsien Lin, Po-Chao Hsu, Chun-Yuan Chu, Wen-Hsien Lee, Szu-Chia Chen, Chee-Siong Lee, Wen-Chol Voon, Wen-Ter Lai, Sheng-Hsiung Sheu
An interarm systolic blood pressure (SBP) difference of 10 mmHg or more have been associated with peripheral artery disease and adverse cardiovascular outcomes. We investigated whether an association exists between this difference and ankle-brachial index (ABI), brachial-ankle pulse wave velocity (baPWV), and echocardiographic parameters. A total of 1120 patients were included in the study. The bilateral arm blood pressures were measured simultaneously by an ABI-form device. The values of ABI and baPWV were also obtained from the same device...
2012: PloS One
Christopher E Clark, Anna M Steele, Rod S Taylor, Angela C Shore, Obioha C Ukoumunne, John L Campbell
OBJECTIVE: Differences in blood pressure between arms are associated with vascular disease and increased mortality; this has not been reported in diabetes. We explored these associations, and assessed reference standard and pragmatic measurement techniques, in people with diabetes and in nondiabetic controls. RESEARCH DESIGN AND METHODS: A prospective cohort study in Devon, England, recruited 727 people with type 1 or type 2 diabetes and 285 nondiabetic controls...
June 2014: Diabetes Care
Christopher E Clark, Rod S Taylor, Angela C Shore, Obioha C Ukoumunne, John L Campbell
BACKGROUND: Differences in systolic blood pressure (SBP) of 10 mm Hg or more or 15 mm Hg or more between arms have been associated with peripheral vascular disease and attributed to subclavian stenosis. We investigated whether an association exists between this difference and central or peripheral vascular disease, and mortality. METHODS: We searched Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane, and Medline In Process databases for studies published before July, 2011, showing differences in SBP between arms, with data for subclavian stenosis, peripheral vascular disease, cerebrovascular disease, cardiovascular disease, or survival...
March 10, 2012: Lancet
C E Clark, J L Campbell, R J Powell
Objectives of this study were to measure the prevalence of a difference in blood pressure (BP) between arms and determine whether a difference is associated with increased risk of cardiovascular events or death. A prospective cohort study of 247 patients with hypertension was undertaken in one rural general practice in England. The main outcome measures were mean difference in BP between arms and new episodes of myocardial infarction, cerebrovascular event, onset of angina or peripheral vascular disease or death...
August 2007: Journal of Human Hypertension
Christopher E Clark, Rod S Taylor, Angela C Shore, John L Campbell
OBJECTIVE: To determine whether a difference in systolic blood pressure readings between arms can predict a reduced event free survival after 10 years. DESIGN: Cohort study. SETTING: Rural general practice in Devon, United Kingdom. PARTICIPANTS: 230 people receiving treatment for hypertension in primary care. INTERVENTION: Bilateral blood pressure measurements recorded at three successive surgery attendances...
March 20, 2012: BMJ: British Medical Journal
Ido Weinberg, Philimon Gona, Christopher J O'Donnell, Michael R Jaff, Joanne M Murabito
BACKGROUND: An increased interarm systolic blood pressure difference is an easily determined physical examination finding. The relationship between interarm systolic blood pressure difference and risk of future cardiovascular disease is uncertain. We described the prevalence and risk factor correlates of interarm systolic blood pressure difference in the Framingham Heart Study (FHS) original and offspring cohorts and examined the association between interarm systolic blood pressure difference and incident cardiovascular disease and all-cause mortality...
March 2014: American Journal of Medicine
James A Russell
New England Journal of Medicine, Volume 0, Issue 0, Ahead of Print.
April 24, 2014: New England Journal of Medicine
Lindsay Ayers Lucas, Chris Somerville
An 80-year-old man who reported having a myocardial infarction in 1975, at 44 years of age, presented with a 5-day history of shortness of breath at rest. He received a diagnosis of acute-on-chronic exacerbation of systolic heart failure, and his left ventricular ejection fraction was estimated to..
January 16, 2014: New England Journal of Medicine
Pablo Perel, Ian Roberts
BACKGROUND: Colloid solutions are widely used in fluid resuscitation of critically ill patients. There are several choices of colloid and there is ongoing debate about the relative effectiveness of colloids compared to crystalloid fluids. OBJECTIVES: To assess the effects of colloids compared to crystalloids for fluid resuscitation in critically ill patients. SEARCH METHODS: We searched the Cochrane Injuries Group Specialised Register (searched 16 March 2012), Cochrane Central Register of Controlled Trials 2011, issue 3 (The Cochrane Library), MEDLINE (Ovid) 1946 to March 2012, Embase (Ovid) 1980 to March 2012, ISI Web of Science: Science Citation Index Expanded (1970 to March 2012), ISI Web of Science: Conference Proceedings Citation Index-Science (1990 to March 2012), PubMed (searched 16 March 2012), www...
June 13, 2012: Cochrane Database of Systematic Reviews
G Michael Felker, Kerry L Lee, David A Bull, Margaret M Redfield, Lynne W Stevenson, Steven R Goldsmith, Martin M LeWinter, Anita Deswal, Jean L Rouleau, Elizabeth O Ofili, Kevin J Anstrom, Adrian F Hernandez, Steven E McNulty, Eric J Velazquez, Abdallah G Kfoury, Horng H Chen, Michael M Givertz, Marc J Semigran, Bradley A Bart, Alice M Mascette, Eugene Braunwald, Christopher M O'Connor
BACKGROUND: Loop diuretics are an essential component of therapy for patients with acute decompensated heart failure, but there are few prospective data to guide their use. METHODS: In a prospective, double-blind, randomized trial, we assigned 308 patients with acute decompensated heart failure to receive furosemide administered intravenously by means of either a bolus every 12 hours or continuous infusion and at either a low dose (equivalent to the patient's previous oral dose) or a high dose (2...
March 3, 2011: New England Journal of Medicine
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