Framingham score, renal dysfunction, and cardiovascular risk in liver transplant patients
Cardiovascular (CV) events represent major impediments to the long‐term survival of liver transplantation (LT) patients. The aim of this study was to assess whether the Framingham risk score (FRS) at transplantation can predict the development of post‐LT cardiovascular events (CVEs). Patients transplanted between 2006 and 2008 were included. Baseline features, CV risk factors, and CVEs occurring after LT (ischemic heart disease, stroke, heart failure, de novo arrhythmias, and peripheral arterial disease) were recorded. In total, 250 patients (69.6% men) with a median age of 56 years (range, 18‐68 years) were included. At transplantation, 34.4%, 34.4%, and 33.2% of patients, respectively, had a low, moderate, and high FRS with a median FRS of 14.9 (range, 0.09‐30); 14.4% of LT recipients developed at least 1 CVE at a median of 2.619 years (range, 0.006‐6.945 years). In the univariate analysis, factors associated with the development of CVEs were the continuous FRS at LT (P = 0.003), age (P = 0.007), creatinine clearance [estimated glomerular filtration rate (eGFR); P = 0.020], and mycophenolate mofetil use at discharge (P = 0.011). In the multivariate analysis, only the eGFR [hazard ratio (HR), 0.98; 95% confidence interval (CI), 0.97‐1.00; P = 0.009] and FRS (HR, 1.06; 95% CI, 1.02‐1.10; P = 0.002) remained in the model. Moreover, an association was also found between the FRS and...
Conclusion: The incidence of major complications was low which only occurred in SHPT patients. Most of the patients with complications recovered spontaneously. MWA is safe for the treatment of HPT. PMID: 31818158 [PubMed - in process]
CONCLUSION: Despite some limitations, the higher number of quality-adjusted life years gained vs rehab and the high probability of reaching a cost-utility ratio lower than the Italian informal acceptability range (€25,000-40,000) make rehab/aboBoNT-A a cost-effective healthcare programme for treating patients with post-stroke spasticity in Italy. PMID: 31820010 [PubMed - as supplied by publisher]
Is sildenafil a safe and effective treatment option for preeclampsia in pregnancy? A new review examines the evidence.Nephrology Dialysis Transplantation
Authors: Peris A, Girardi E, Bombardi M, Seghieri G PMID: 31820873 [PubMed - as supplied by publisher]
(Elsevier) High blood pressure in the lungs, known as pulmonary arterial hypertension (PAH), is a potentially fatal disease caused by obstruction of blood flow in the lungs. A new study in The American Journal of Pathology, published by Elsevier, sheds light on the pathology underlying PAH and shows that dofetilide, an FDA-approved KV11.1 channel blocker for the treatment of cardiac arrhythmias (brand name: Tikosyn), may be used for treatment of PAH.
Researchers analyzed 11 years of data from more than 65,000 people, ages 40-79, living in the American Southeast. More than two-thirds of the participants were black, and about two-thirds were at high risk for heart attack or stroke at the start of the study period.
Publication date: Available online 10 December 2019Source: The LancetAuthor(s): Maria-Victoria Mateos, Michele Cavo, Joan Blade, Meletios A Dimopoulos, Kenshi Suzuki, Andrzej Jakubowiak, Stefan Knop, Chantal Doyen, Paulo Lucio, Zsolt Nagy, Ludek Pour, Mark Cook, Sebastian Grosicki, Andre Crepaldi, Anna Marina Liberati, Philip Campbell, Tatiana Shelekhova, Sung-Soo Yoon, Genadi Iosava, Tomoaki FujisakiSummaryBackgroundStandard-of-care treatment for patients with newly diagnosed multiple myeloma includes combination therapies for patients who are not eligible for autologous stem-cell transplantation. At the primary analysis ...
ConclusionsPost-stroke delirium may frequently go undetected by the CAM-ICU, even in the setting of fluctuating consciousness.
Publication date: Available online 11 December 2019Source: American Heart JournalAuthor(s): Geoffrey Lau, Maria Koh, Peter A. Kavsak, Michael J. Schull, David W.J. Armstrong, Jacob A. Udell, Peter C. Austin, Xuesong Wang, Dennis T. KoABSTRACTBackgroundHigh-sensitivity cardiac troponin (hs-cTn) assays enhance detection of lower circulating troponin concentrations, but the impact on outcomes in clinical practice is unclear. Our objective was to compare outcomes of chest pain patients discharged from emergency departments (EDs) using hs-cTn and conventional troponin (cTn) assays.MethodsWe conducted an observational study of c...
The University of Arkansas for Medical Sciences is awarded a $4 million grant by the Patient-Centered Outcomes Research Institute to study digital delivery of health care to patients with heart failure.