Cerebral Aspects of Portal Hypertension
Portal hypertension has cerebral consequences via its causes and complications, namely hepatic encephalopathy (HE), a common and devastating brain disturbance caused by liver insufficiency and portosystemic shunting. The pathogenesis involves hyperammonemia and systemic inflammation. Symptoms are disturbed personality and reduced attention. HE is minimal or grades I to IV (coma). Bouts of HE are episodic and often recurrent. Initial treatment is of events that precipitated the episode and exclusion of nonhepatic causes. Specific anti-HE treatment is lactulose. By recurrence, rifaximin is add-on. Anti-HE treatment is effica...
Source: Clinics in Liver Disease - April 27, 2024 Category: Gastroenterology Authors: Karen Louise Thomsen, Michael S ørensen, Kristoffer Kjærgaard, Peter Lykke Eriksen, Mette Munk Lauridsen, Hendrik Vilstrup Source Type: research
Pharmacologic Treatment of Portal Hypertension
Portal hypertension is the key mechanism driving the transition from compensated to decompensated cirrhosis. In this review, the authors described the pathophysiology of portal hypertension in cirrhosis and the rationale of pharmacologic treatment of portal hypertension. We discussed both etiologic and nonetiologic treatment of portal hypertension and the specific clinical scenarios how nonselective beta-blocker can be used in patients with cirrhosis. Finally, the authors summarized the evidence for emerging alternatives for portal hypertension in patients with cirrhosis. (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - April 27, 2024 Category: Gastroenterology Authors: Yu Jun Wong, Juan G. Abraldes Source Type: research
Radiological and Surgical Treatments of Portal Hypertension
Interventions for portal hypertension are continuously evolving and expanding beyond the realm of medical management. When complications such as varices and ascites persist despite conservative interventions, procedures including transjugular intrahepatic portosystemic shunt creation, transvenous obliteration, portal vein recanalization, splenic artery embolization, surgical shunt creation, and devascularization are all potential interventions detailed in this article. Selection of the optimal procedure to address the underlying cause, treat symptoms, and, in some cases, bridge to liver transplantation depends on the speci...
Source: Clinics in Liver Disease - April 27, 2024 Category: Gastroenterology Authors: Charlotte Hunt, Mausam Patel, Maria del Pilar Bayona Molano, Madhukar S. Patel, Lisa B. VanWagner Source Type: research
Infectious Complications of Portal Hypertension
Patients with cirrhosis and clinically significant portal hypertension are at high risk of developing bacterial infections (BIs) that are the most common trigger of acute decompensation and acute-on-chronic liver failure. Furthermore, after decompensation, the risk of developing BIs further increases in an ominous vicious circle. BIs may be subtle, and they should be ruled out in all patients at admission and in case of deterioration. Timely administration of adequate empirical antibiotics is the cornerstone of treatment. Herein, we reviewed current evidences about pathogenesis, clinical implications and management of BIs ...
Source: Clinics in Liver Disease - April 27, 2024 Category: Gastroenterology Authors: Simone Incicco, Paolo Angeli, Salvatore Piano Source Type: research
The Pathophysiology of Portal Hypertension
This article reviews the pathophysiology of portal hypertension that includes multiple mechanisms internal and external to the liver. This article starts with a review of literature describing the cellular and molecular mechanisms of portal hypertension, microvascular thrombosis, sinusoidal venous congestion, portal angiogenesis, vascular hypocontractility, and hyperdynamic circulation. Mechanotransduction and the gut –liver axis, which are newer areas of research, are reviewed. Dysfunction of this axis contributes to chronic liver injury, inflammation, fibrosis, and portal hypertension. Sequelae of portal hypertension a...
Source: Clinics in Liver Disease - April 27, 2024 Category: Gastroenterology Authors: Resham Ramkissoon, Sheng Cao, Vijay H. Shah Source Type: research
Hemorrhagic Adverse Events of Transthoracic Needle Biopsy of the Lung in Patients with Pulmonary Hypertension: A Systematic Review and Meta-AnalysisPercutaneous
To compare the risk of hemorrhagic complications of transthoracic needle biopsy such as pulmonary hemorrhage and hemoptysis between patients with pulmonary hypertension and patients without pulmonary hypertension. (Source: Journal of Vascular and Interventional Radiology : JVIR)
Source: Journal of Vascular and Interventional Radiology : JVIR - April 27, 2024 Category: Radiology Authors: Daniel Jang, Rachel Darling, Gaurav Choudhary, Matthew Jankowich Tags: Clinical Study Source Type: research
Dietary Modification Combined with Nutrition Education and Counseling for Metabolic Comorbidities in Multiple Sclerosis: Implications for Clinical Practice and Research
AbstractPurpose of ReviewMetabolic comorbidities such as obesity, diabetes, hypertension, and dyslipidemia are common to multiple sclerosis (MS) and are associated with negative outcomes of the disease. Dietary intervention has the potential to improve MS co-morbidities; thus, it is a high priority for people living with MS to self-manage their disease. The present review aimed to summarize the recent evidence on the impacts of combining dietary modification with nutrition education and counseling on managing metabolic comorbidity markers in MS.Recent Findings Evidence suggests important roles for tailored dietary change...
Source: Current Nutrition Reports - April 27, 2024 Category: Nutrition Source Type: research
Prevalence of risk factors for development of cardiovascular diseases in urban and rural areas of Eastern Croatia: a cross-sectional study
CONCLUSIONS: In the examined sample, the prevalence of cardiovascular risk factors is generally high. Participants from rural areas are significantly more susceptible to cardiovascular risk factors than participants from urban areas.PMID:38669153 | DOI:10.21101/cejph.a7709 (Source: Central European Journal of Public Health)
Source: Central European Journal of Public Health - April 26, 2024 Category: International Medicine & Public Health Authors: Mirta Klapec-Basar Tanja Kova č Renata Apati ć Željko Mudri Tin Basar Stjepan Juri ć Rudika Gmajni ć Robert Lovri ć Source Type: research
Computational model captures cardiac growth in hypertensive pregnancies and in the postpartum period
In this study, we evaluated whether this model could capture heart growth beyond normal pregnancy. After further validation of our normal pregnancy predictions, we tested our model predictions of three rat studies of hypertensive pregnancies. Next, we simulated the postpartum period and examined the impact of lactation on cardiac growth in rats. We demonstrate that our multiscale model can capture cardiac growth associated with new-onset hypertension during pregnancy and lactation status in the postpartum period. We conclude by elaborating on the potential clinical utility of our model in the future.PMID:38668702 | DOI:10....
Source: American Journal of Physiology. Heart and Circulatory Physiology - April 26, 2024 Category: Physiology Authors: Molly S Kaissar Kyoko Yoshida Source Type: research
Isolated superior mesenteric artery dissection with concomitant vascular aberrancy: Extremely rare cases and clinical implications
CONCLUSION: Vascular aberrancy may be a new identified risk factor for ISMAD. Even in ISMAD cases with vascular aberrancy, conservative treatment still can be used as first line therapy.PMID:38664953 | DOI:10.1177/17085381241251426 (Source: Vascular)
Source: Vascular - April 26, 2024 Category: Surgery Authors: Lei Dou Bin Zhang Hao Tang Huiyuan Yang Lei Liu Source Type: research
NETosis Drives Blood Pressure Elevation and Vascular Dysfunction in Hypertension
CONCLUSIONS: These observations identify a role of NETosis in the pathogenesis of hypertension. Moreover, they define an important role of EC stretch and TRPV4 as initiators of NETosis. Finally, they define a role of citrullinated histones as drivers of EC dysfunction in hypertension.PMID:38666386 | DOI:10.1161/CIRCRESAHA.123.323897 (Source: Circulation Research)
Source: Circulation Research - April 26, 2024 Category: Cardiology Authors: Jaya Krishnan Elizabeth M Hennen Mingfang Ao Annet Kirabo Taseer Ahmad N éstor de la Visitación David M Patrick Source Type: research
Hypertension Prevalence and Control Among People With and Without HIV - United States, 2022
CONCLUSIONS: PWH were more likely to have hypertension than people without HIV. Geographic and racial disparities in hypertension prevalence and control were observed among PWH. Optimal care for PWH includes comprehensive strategies to screen for, prevent, and manage hypertension.PMID:38668635 | DOI:10.1093/ajh/hpae048 (Source: American Journal of Hypertension)
Source: American Journal of Hypertension - April 26, 2024 Category: Cardiology Authors: Xingran Weng Lyudmyla Kompaniyets Kate Buchacz Angela M Thompson-Paul Rebecca C Woodruff Karen W Hoover Ya-Lin A Huang Jun Li Sandra L Jackson Source Type: research
Association of Cardiovascular Health in Young Adulthood with Long-Term Blood Pressure Trajectories
CONCLUSIONS: Moderate or low CVH status in YA is associated with elevated mid-life BP trajectory. These data suggest that young adult CVH promotion may be important for primordial prevention of hypertension.PMID:38666584 | DOI:10.1093/ajh/hpae047 (Source: American Journal of Hypertension)
Source: American Journal of Hypertension - April 26, 2024 Category: Cardiology Authors: James W Guo Hongyan Ning Norrina B Allen Orna Reges Kelley Pettee Gabriel Donald M Lloyd-Jones Source Type: research
Prevalence of risk factors for development of cardiovascular diseases in urban and rural areas of Eastern Croatia: a cross-sectional study
CONCLUSIONS: In the examined sample, the prevalence of cardiovascular risk factors is generally high. Participants from rural areas are significantly more susceptible to cardiovascular risk factors than participants from urban areas.PMID:38669153 | DOI:10.21101/cejph.a7709 (Source: Central European Journal of Public Health)
Source: Central European Journal of Public Health - April 26, 2024 Category: International Medicine & Public Health Authors: Mirta Klapec-Basar Tanja Kova č Renata Apati ć Željko Mudri Tin Basar Stjepan Juri ć Rudika Gmajni ć Robert Lovri ć Source Type: research
Computational model captures cardiac growth in hypertensive pregnancies and in the postpartum period
In this study, we evaluated whether this model could capture heart growth beyond normal pregnancy. After further validation of our normal pregnancy predictions, we tested our model predictions of three rat studies of hypertensive pregnancies. Next, we simulated the postpartum period and examined the impact of lactation on cardiac growth in rats. We demonstrate that our multiscale model can capture cardiac growth associated with new-onset hypertension during pregnancy and lactation status in the postpartum period. We conclude by elaborating on the potential clinical utility of our model in the future.PMID:38668702 | DOI:10....
Source: American Journal of Physiology. Heart and Circulatory Physiology - April 26, 2024 Category: Physiology Authors: Molly S Kaissar Kyoko Yoshida Source Type: research
