An 89-year-old man presents with worsening heart failure

Clinical introduction An 89-year-old man with a history of heart failure with preserved ejection fraction presented with worsening dyspnoea, reduced exercise capacity and peripheral oedema. His medical history was significant for hypertension, paroxysmal atrial fibrillation (AF), chronic obstructive pulmonary disease and Lyme disease (1983). Admission cardiovascular medications included aspirin 75 mg once a day, perindopril 6 mg once a day, furosemide 40 mg two times a day, flecainide 100 mg two times a day and simvastatin 40 mg one a night. On examination, he was normothermic and clinically in heart failure with raised jugular venous pressure, bibasal pulmonary crepitations and oedema up to abdomen. Cardiac markers were negative. Other laboratory tests demonstrated a normocytic anaemia, C reactive protein 18.7 mg/L (0–7.9), urea 19.4 mmol/L (2.8–7.2) and creatinine 162 µmol/L (72–127), which had trended above a baseline of 110 µmol/L for 4 months. Electrolytes including sodium, potassium, magnesium, corrected calcium and inorganic phosphate were within normal range. His admission...
Source: Heart - Category: Cardiology Authors: Tags: Drugs: cardiovascular system, Echocardiography, Image challenges, Hypertension, Right sided valvular heart disease, Clinical diagnostic tests, Epidemiology, Metabolic disorders Source Type: research

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Conclusions Exercise training combined with multinutrient supplementation had a limited effect on ameliorating the adverse musculoskeletal consequences of ADT, likely related to the modest intervention adherence.
Source: Medicine and Science in Sports and Exercise - Category: Sports Medicine Tags: CLINICAL SCIENCES Source Type: research
Conclusion These findings demonstrate that T2D and HTN attenuate tolerance to uncompensable heat stress (32°C WBGT); however, these chronic diseases do not significantly impact thermal and cardiovascular strain, or the validity of ACIGH recommendations during moderate-intensity work.
Source: Medicine and Science in Sports and Exercise - Category: Sports Medicine Tags: APPLIED SCIENCES Source Type: research
In conclusion, awareness of the risk factors associated with IFIS, their detailed preoperative assessment and intraoperative measures and surgical intervention is crucial in addressing IFIS. Lack of awareness can turn a routine, uneventful surgery into one with significant visual morbidity.
Source: International Ophthalmology - Category: Opthalmology Source Type: research
September 19, 2021 (RARITAN, N.J.) – The Janssen Pharmaceutical Companies of Johnson &Johnson today announced preliminary results from the Phase 1b CHRYSALIS-2 (NCT04077463) study evaluating RYBREVANT® (amivantamab-vmjw) in combination with lazertinib in the treatment of patients with non-small cell lung cancer (NSCLC) characterized by epidermal growth factor receptor (EGFR) exon 19 deletion or L858R mutations whose disease had progressed after treatment with osimertinib and platinum chemotherapy.[i] While previously reported results have demonstrated durable responses with RYBREVANT® in combination with ...
Source: Johnson and Johnson - Category: Pharmaceuticals Tags: Innovation Source Type: news
September 19, 2021 (RARITAN, N.J.) – The Janssen Pharmaceutical Companies of Johnson &Johnson today announced a new analysis from the CHRYSALIS (NCT02609776) study evaluating RYBREVANT® (amivantamab-vmjw) monotherapy and a combination regimen with lazertinib in advanced non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutations who progressed after osimertinib.[1] The analysis showed higher activity and longer duration of response (DOR) in patients treated with the combination therapy, demonstrating the potential benefit of targeting the extracellular (outer) and cataly...
Source: Johnson and Johnson - Category: Pharmaceuticals Tags: Innovation Source Type: news
Exclusive: NHS launching large trial of approach that could boost number of transplants and their success rateThousands of lives could be saved globally by giving patients a 10p statin before transplants, doctors have said, as the NHS launches the world ’s largest clinical trial in organ donors.The medical breakthrough is predicted to dramatically increase the supply of organs for transplant. Currently, demand for organs vastly exceeds the number available. Every year thousands of people die waiting for a transplant, including hundreds in Britain.Continue reading...
Source: Guardian Unlimited Science - Category: Science Authors: Tags: Organ donation Statins Medical research NHS Health Society Science UK news Source Type: news
In conclusion, inhibiting the lysosomal oxidation of LDL in atherosclerotic lesions by antioxidants targeted at lysosomes causes the regression of atherosclerosis and improves liver and muscle characteristics in mice and might be a promising novel therapy for atherosclerosis in patients. NANOG Expression versus Cellular Senescence https://www.fightaging.org/archives/2021/09/nanog-expression-versus-cellular-senescence/ Are there many strategies that can reverse cellular senescence? There are certainly strategies that can lower levels of cellular senescence over time, both in cell cultures and in living an...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Acute respiratory distress syndrome is a heterogenous syndrome with many etiologies for which there are no definitive pharmacologic treatments, despite decades of research. We explore some adjunctive pharmacologic therapies, including neuromuscular blockade, corticosteroids, and inhaled pulmonary vasodilators. Additionally, we explore some investigative therapies, including Vitamin C, beta-agonists, statins, mesenchymal stromal cells, and granulocyte –macrophage colony stimulating factor. We do discuss the potential role of steroids in acute respiratory distress syndrome with severe acute respiratory syndrome coronav...
Source: Critical Care Clinics - Category: Intensive Care Authors: Source Type: research
Contributors : Lingfang Zhuang ; Kangni Jia ; Zhigang Li ; Jiaxin Zhao ; Jian Hu ; Hang Zhang ; Qin Fan ; Chunkai Huang ; Hongyang Xie ; Lin Lu ; Weifeng Shen ; Guang Ning ; Jiqiu Wang ; Kang Chen ; Xiaoxiang YanSeries Type : Expression profiling by high throughput sequencingOrganism : Mus musculusHere, we investigates the effects of dual-specificity tyrosine-regulated kinase 1B (DYRK1B) on mitochondrial bioenergetics, cardiac hypertrophy, and heart failure.We engineered DYRK1B transgenic and the effects of DYRK1B and its downstream mediators were subsequently elucidated using RNA-seq analysis. In this dataset, we inquire ...
Source: GEO: Gene Expression Omnibus - Category: Genetics & Stem Cells Tags: Expression profiling by high throughput sequencing Mus musculus Source Type: research
The sarcolemmal voltage-gated L-type Ca2+ channel (CaV1.1), also known as the dihydropyridine receptor (DHPR), is encoded by CACNA1S and localized in the T-tubule. During skeletal muscle excitation-contraction coupling (ECC), CaV1.1 activated by membrane depolarizations triggers opening of the sarcoplasmic Ca2+ release channel (RyR1) to release Ca2+ for myofibril contraction. Recently, both recessive and dominant CACNA1S mutations are identified as a cause of a novel congenital myopathy with alternations in calcium homeostasis and impaired ECC.
Source: Neuromuscular Disorders - Category: Neurology Authors: Source Type: research
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