Pulmonary hypertension in majority countries: opportunities amidst challenges
This article provides a review of pulmonary hypertension in majority countries, focusing in detail on the most common causes in these regions, and highlights contextual challenges faced. Recent findings Epidemiological data confirms a complex and overlapping array of causes, with pulmonary hypertension because of conditions such as rheumatic heart disease, HIV, schistosomiasis, chronic lung disease and sickle cell disease. Delayed pulmonary hypertension diagnosis remains a concern and is ascribed to a lack of resources and lack of pulmonary hypertension awareness by health professionals. Pulmonary hypertension diagnosis is frequently considered once signs of right heart failure emerge, while echocardiography and right heart catheterization are unavailable in many settings. Accurate data on the prevalence of pulmonary hypertension in many of these regions are needed and could be achieved by establishing and frequent review of national databases where the incident and prevalent pulmonary hypertension cases are captured. Summary There is urgent need for pulmonary hypertension advocacy among clinicians in the primary, secondary and tertiary healthcare sectors of majority countries, and validated noninvasive diagnostic algorithms are needed. Increased awareness and early diagnosis are likely to improve outcomes of pulmonary hypertension patients in these regions, and potentially stimulate locally relevant research.
Conclusion: factors such as severe stroke, dysphagia, advanced age, male gender, coronary heart disease, lower Glasgow coma scale score, use of mechanical ventilation for more than 48 hours, and aspiration of colonized gastric juice were associated with aspiration pneumonia.
Condition: Chronic Kidney Disease + Hyperkalaemia +/- Heart Failure Interventions: Drug: Calcium Polystyrene Sulphonate 15g/60 mL water; Drug: Lokelma® 5 mg/45mL water; Drug: Lokelma® 10 mg/45 mL water; Drug: Veltassa® 8,4mg/80mL water; Drug: Sodium Polystyrene Sulphonate 15g/60 mL water Sponsors: AstraZeneca; Covance; Parexel; ERT: Clinical Trial Technology Solutions; Medidata Solutions Not yet recruiting
Conditions: Pheochromocytoma; Hypertension; Surgery Intervention: Procedure: Laparoscopic adrenalectomy Sponsor: Jagiellonian University Completed
Condition: Hypertension, Pulmonary Intervention: Drug: Selexipag Sponsor: Actelion Not yet recruiting
Condition: Pulmonary Arterial Hypertension Intervention: Drug: PAH medication Sponsor: Janssen-Cilag S.p.A. Not yet recruiting
Conclusions: Our findings confirm the inhibitory effects of TSP-1 on ADAMTS-13 activity in adult SCD patients. The negative correlation reported between TSP-1 and ADAMTS-13/vWF antigen ratio in pediatric subjects suggests a possible protective mechanism in younger individuals, although this is not related to the presence of SCD. This work emphasizes the impact of age on interpreting results related to the regulation of vWF expression and interaction with TSP-1 and ADAMTS-13 in SCD.Acta Haematol
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We report here the complete clinical course of a renal transplant recipient with critical COVID-19 pneumonia. In the early phase of SARS-Cov-2 infection, the patient exhibited extensive lung lesions and significant acute kidney and heart injuries, which required treatment in the ICU. After correcting the arrhythmia and heart failure, the patient recovered quickly from the acute kidney injury with a treatment of intensive diuresis and strict control of fluid intake. Without cessation of oral immunosuppressive agents, the patient presented a delayed and low antibody response against SARS-Cov-2 and reappeared positive for the...