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Orthostatic Sodium Retention

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21. Management of Heart Failure (4th Edition)

contraction ? Vasoconstriction of arterial resistance vessels to maintain blood pressure ? Venous constriction to increase venous preload ? Salt and water retention to increase preload In general, these neurohormonal responses are compensatory mechanisms. However they can also aggravate HF by increasing ventricular afterload and increasing preload to the point where pulmonary and/or systemic congestion and oedema occur. In the setting of LV myocardial dysfunction, LVEF may be: ? Reduced (LVEF = 40 (...) indiscretion especially salt and fluid intake ? Inappropriate medications e.g. NSAIDs and COX-2 inhibitors ? Alcohol consumption Cardiac Causes ? Superimposed myocardial ischaemia or infarction (often asymptomatic) ? Hypertensive emergencies ? Arrhythmias ? Pulmonary embolism ? Secondary mitral or tricuspid regurgitation Systemic Conditions ? Superimposed infections ? Anaemia ? Thyroid disease ? Electrolyte disturbances ? Worsening renal disease Others ? Urinary retention ? Severe emotional or physical

2019 Ministry of Health, Malaysia

22. Treatment of Diabetes in Older Adults Full Text available with Trip Pro

targets are selected, careful monitoring of such patients is needed to avoid orthostatic hypotension. Patients with high disease complexity (group 3, poor health, ) could be considered for higher blood pressure targets (145 to 160/90 mm Hg). Choosing a blood pressure target involves shared decision-making between the clinician and patient, with full discussion of the benefits and risks of each target. 5.2 In patients aged 65 years and older with diabetes and hypertension, we recommend (...) problems in older adults with diabetes 5.11 In patients aged 65 years and older with diabetes and advanced chronic sensorimotor distal polyneuropathy, we suggest treatment regimens that minimize fall risk, such as the minimized use of sedative drugs or drugs that promote orthostatic hypotension and/or hypoglycemia. (2|⊕OOO) 5.12 In patients aged 65 years and older with diabetes and peripheral neuropathy with balance and gait problems, we suggest referral to physical therapy or a fall management program

2019 The Endocrine Society

23. Appropriate Use Criteria: Imaging of the Brain

, urinary retention requiring catheterization, persistent erectile failure, or symptomatic orthostatic hypotension). Imaging may be indicated in cases of atypical Parkinson’s disease to exclude treatable causes. Other movement disorders such as multiple system atrophy have characteristic imaging features that may be used to corroborate the diagnosis when clinically uncertain. 59,74,75 Dystonia is characterized by sustained muscle contractions, frequently causing repetitive twisting movements or abnormal (...) diffusion tensor imaging (DTI), which uses the data from the scan to make calculations. DTI may also be useful in neurosurgical planning. Functional MRI (fMRI) is primarily utilized for mapping primary brain activities related to motor, sensory, and language functions. Studies have demonstrated that fMRI is comparable to the intracarotid sodium amobarbital procedure (Wada test) and direct electrical stimulation for language localization. fMRI is noninvasive, does not require ionizing radiation, and has

2019 AIM Specialty Health

25. Management of Non-neurogenic Male LUTS

symptoms of bladder outlet obstruction treated with watchful waiting for four years. Urology, 2004. 64: 1144. 61. McConnell, J.D., et al. The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med, 2003. 349: 2387. 62. Roehrborn, C.G. Alfuzosin 10 mg once daily prevents overall clinical progression of benign prostatic hyperplasia but not acute urinary retention: results of a 2-year placebo-controlled study. BJU Int (...) . Clinical significance of intravesical prostatic protrusion in patients with benign prostatic enlargement. Urology, 2007. 70: 1096. 103. Mariappan, P., et al. Intravesical prostatic protrusion is better than prostate volume in predicting the outcome of trial without catheter in white men presenting with acute urinary retention: a prospective clinical study. J Urol, 2007. 178: 573. 104. Tan, Y.H., et al. Intravesical prostatic protrusion predicts the outcome of a trial without catheter following acute

2019 European Association of Urology

26. Using Clinical Laboratory Tests to Monitor Drug Therapy in Pain Management Patients

of Pathology and Laboratory Medicine University of North Carolina School of Medicine Chapel Hill, NC Marilyn A. Huestis National Institute on Drug Abuse Baltimore, MD Cheryl A. Kassed American Association for Clinical Chemistry Washington, DC Tim J. Lamer Department of Anesthesiology Mayo Clinic Rochester, MN Gwendolyn A. McMillin Department of Pathology University of Utah Salt Lake City, UT Stacy E. Melanson Department of Pathology Brigham and Women’s Hospital Boston, MA The AACC Academy Presents

2018 American Academy of Pain Medicine

27. Management of Non-neurogenic Male LUTS

symptoms of bladder outlet obstruction treated with watchful waiting for four years. Urology, 2004. 64: 1144. 61. McConnell, J.D., et al. The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med, 2003. 349: 2387. 62. Roehrborn, C.G. Alfuzosin 10 mg once daily prevents overall clinical progression of benign prostatic hyperplasia but not acute urinary retention: results of a 2-year placebo-controlled study. BJU Int (...) . Clinical significance of intravesical prostatic protrusion in patients with benign prostatic enlargement. Urology, 2007. 70: 1096. 103. Mariappan, P., et al. Intravesical prostatic protrusion is better than prostate volume in predicting the outcome of trial without catheter in white men presenting with acute urinary retention: a prospective clinical study. J Urol, 2007. 178: 573. 104. Tan, Y.H., et al. Intravesical prostatic protrusion predicts the outcome of a trial without catheter following acute

2018 European Association of Urology

28. Diagnosis and Treatment of Peripheral Arterial Diseases Full Text available with Trip Pro

pressure ≤85 mmHg is considered safe. In patients with LEAD, this is mainly based on data from the INternational VErapamil-SR/Trandolapril (INVEST) study. Caution should be exercised to avoid an SBP decrease below 110–120 mmHg, since a J-shape relationship between SBP and CV events has been reported in that trial in LEAD patients. In old and frail patients, these levels should be achieved only if well tolerated, without orthostatic hypotension. , In patients with PADs, an appropriate lifestyle and salt (...) in the case of CKD, with precautions in case of allergies. Nephrotoxicity can be limited by minimizing contrast agent volume and ensuring adequate hydration before and after imaging. The benefit of acetyl-cysteine to limit nephrotoxicity is uncertain. , Recent studies have suggested that statins or sodium bicarbonate could prevent contrast agent nephrotoxicity. , Further research is required. 4.1.4.5 Magnetic resonance angiography MRA is used for peripheral artery imaging using contrast (i.e. gadolinium

2017 European Society of Cardiology

29. CRACKCast E141 – Heat Illness

of diagnosis (Box 133.2) Cramps of most worked muscles Usually occur after exertion Copious sweating during exertion Copious hypotonic fluid replacement during exertion Hyperventilation not present in cool environment Heat oedema hydrostatic pressure and vasodilation of cutaneous vessels, combined with some degree of orthostatic pooling, lead to vascular leak and accumulation of interstitial fluid in the lower extremities. Increase aldosterone levels further encourage fluid retention Swollen feet/ankles (...) Tachycardia, orthostatic hypotension, clinical dehydration (may occur) Other major illnesses ruled out If in doubt, treat as heatstroke Labs : HypoNa HypoCl CPK elevation Heat exhaustion: management (Box 133.4) Rest Cool environment Assessment of volume status – orthostatic changes, BUN level, Hct, serum sodium concentration Fluid replacement – normal saline to replete volume if patient is orthostatic; replace free water deficits slowly to avoid cerebral oedema Healthy young patients are usually treated

2018 CandiEM

30. Implanting a baroreceptor stimulation device for resistant hypertension

cause of premature morbidity and death. It is a major, but modifiable, risk factor for cardiovascular disease (including stroke and myocardial infarction) and chronic kidney disease. The cause of primary hypertension, which is the most common form, is not fully understood. However, it is likely to involve multiple factors including an increase in sodium retention and a reduction in renal blood flow mediated by the sympathetic nervous system. Secondary hypertension, which is less common, is caused (...) considered that the following were theoretical adverse events: traumatic injury to the carotid artery or major neck veins; bleeding; cerebral embolisation causing stroke; wound dehiscence; late damage to the carotid artery; bradycardia; bradypnoea; excessive lowering of blood pressure; orthostatic hypotension; and device failure. 6 6 Committee comments Committee comments 6.1 The Committee reviewed the evidence separately for bilateral and unilateral implantation. It noted that much of the available

2015 National Institute for Health and Clinical Excellence - Interventional Procedures

31. Delirium in Adult Cancer Patients: ESMO Clinical Practice Guidelines

- mary tumour or metastasis) in 36 patients (6%). Study limitations include a low overall incidence of delirium (3.5 per 100 admis- sions) and retrospective design. Other delirium risk factors have been implicated in other studies, including age, dementia, depres- sion, alcohol abuse, poor functional status, organ dysfunction and abnormal levels of serum sodium, potassium or glucose, among others [40–44]. Moreover, many medications are implicated as risk factors for delirium, in particular opioids (...) Continued Table 1. Continued Indirectriskfactorsfordelirium Otherstatusorpredisposingcomorbidities[5,39] Visual impairment Urinary retention or use of urinary catheter Constipation Alcohol or drug abuse, or withdrawal (including nicotine) CNS diseases or trauma; history of stroke or transient ischaemia Liver failure Renal failure End-stage cardiac disease End-stage lung disease Endocrinopathy CNS, central nervous system; NSAID, non-steroidal anti-in?ammatory drug; SIADH, syndrome of inappropriate

2018 European Society for Medical Oncology

32. Hypertension management and renin-angiotensin-aldosterone system blockade in patients with diabetes, nephropathy and/or chronic kidney disease

that there may be a role for 24-hour blood pressure monitoring in the diagnosis of hypertension in children. 24 © Association of British Clinical Diabetologists 2017 8 The importance of lifestyle measures (weight loss and salt intake reduction) are highlighted by a number of guidelines, and indeed a recent study suggests that lower sodium intake may improve the efficacy of RAAS blockade. 27 There is evidence to suggest that management of blood pressure in patients with type 1 diabetes may be suboptimal (...) controlled trials that factors like salt intake, weight and body mass index (BMI), exercise frequency and alcohol intake all have a significant impact on blood pressure levels. 103–106 a Salt intake The KDIGO guidelines suggest lowering salt intake to less than 90 mmol of sodium per day (less than 2 g of sodium, which corresponds to 5 g of sodium chloride). High salt intake has a greater impact on blood pressure for patients with diabetes, especially in patients with CKD, due to their reduced ability

2017 Association of British Clinical Diabetologists

33. Management of Cardiac Involvement Associated With Neuromuscular Diseases: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

translation of a full-length dystrophin protein. The truncated protein is not stable and degrades, resulting in nearly complete absence of dystrophin protein. In contrast, the most common mutation that causes BMD is a multiple-exon deletion in the dystrophin gene that does not disrupt the reading frame. This type of deletion results in dystrophin protein that has an internal deletion with retention of the amino and carboxy termini that localize the protein to the cytoplasmic face of the sarcolemma, thus (...) . Supraventricular and ventricular tachycardia resulting in sudden death have been reported in adolescents and young adults with only mildly decreased LVEF. A history of syncope or orthostatic symptoms, as well as a family history of sudden death, may be predisposing factors. Friedreich Ataxia FA is an inherited neuromuscular disorder that arises from a triplet repeat expansion mutation in the first intron of the gene encoding frataxin ( FXN , also known as X25 ). In contrast with most other triplet repeat

2017 American Heart Association

34. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults

and Obesity e28 5.2.2. Sodium Intake e29 5.2.3. Potassium e29 5.2.4. Physical Fitness e29 5.2.5. Alcohol e29 5.3. Childhood Risk Factors and BP Tracking e31 5.4. Secondary Forms of Hypertension e32 5.4.1. Drugs and Other Substances With Potential to Impair BP Control e32 5.4.2. Primary Aldosteronism e32 5.4.3. Renal Artery Stenosis e34 5.4.4. Obstructive Sleep Apnea e34 6. Nonpharmacological Interventions e35 6.1. Strategies e35 6.2. Nonpharmacological Interventions e35 7. Patient Evaluation e38 7.1 (...) in children and adolescents NHLBI 2004 Statements Salt sensitivity of blood pressure AHA 2016 Cardiovascular team-based care and the role of advanced practice providers ACC 2015 Treatment of hypertension in patients with coronary artery disease AHA/ACC/ASH 2015 Ambulatory blood pressure monitoring in children and adolescents AHA 2014 An effective approach to high blood pressure control AHA/ACC/CDC 2014 Ambulatory blood pressure monitoring ESH 2013 Performance measures for adults with coronary artery

2017 American Heart Association

35. High Blood Pressure in Adults: Guideline For the Prevention, Detection, Evaluation and Management

of Hypertension... e138 3.3. Prevalence of High BP .. e138 3.4. Awareness, Treatment, and Control e139 4.MEASUREMENT OF BP .. e140 4.1. Accurate Measurement of BP in the Of?ce ... e140 4.2. Out-of-Of?ce and Self-Monitoring of BP . e141 4.3. Ambulatory BP Monitoring .. . e142 4.4. Masked and White Coat Hypertension . e143 5.CAUSES OF HYPERTENSION e146 5.1. Genetic Predisposition . e146 5.2. Environmental Risk Factors.. . e146 5.2.1. Overweight and Obesity .. e146 5.2.2. Sodium Intake .. e147 5.2.3. Potassium (...) of cardiovascular disease in women AHA/ACC 2011 (S1.5-26) Secondary prevention and risk-reduction therapy for patients with coronary and other atherosclerotic vascular disease AHA/ACC 2011 (S1.5-27) Assessment of cardiovascular risk in asymptomatic adults ACC/AHA 2010 (S1.5-28) Thoracic aortic disease ACC/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM 2010 (S1.5-29) Diagnosis, evaluation, and treatment of high blood pressure in children and adolescents NHLBI 2004 (S1.5-30) Statements Salt sensitivity of blood pressure

2017 American College of Cardiology

36. Role of Biomarkers for the Prevention, Assessment, and Management of Heart Failure: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

of these neurohormones appears to be related to arterial underfilling, and it likely represents a primitive response to conditions that threaten the viability of the organism such as dehydration or blood loss. Although neurohormone-mediated vasoconstriction of arteries and veins and retention of salt and water by the kidney have short-term beneficial aspects, sustained activation (as occurs in HF) leads to increased load on the heart and ultimately drives maladaptive cardiac remodeling and progression of cardiac (...) and the postdischarge period. Cardiac biomarkers reflect the pathophysiological aspects of AHF and include natriuretic peptides (myocyte stretch), cTns (myocyte necrosis), CRP (inflammation), copeptin (neurohormonal upregulation, vasoconstriction, and water retention), MR-proADM (vascular stress), and sST2 and galactin-3 (myocardial remodeling and fibrosis). Outcomes may be improved by treatment intensification among high-risk patients, and risk assessment is important to ensure that interventions

2017 American Heart Association

37. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary Full Text available with Trip Pro

risk in asymptomatic adults ACC/AHA 2010 Thoracic aortic disease ACC/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM 2010 Diagnosis, evaluation, and treatment of high blood pressure in children and adolescents NHLBI 2004 Statements Salt sensitivity of blood pressure AHA 2016 Cardiovascular team-based care and the role of advanced practice providers ACC 2015 Treatment of hypertension in patients with coronary artery disease AHA/ACC/ASH 2015 Ambulatory blood pressure monitoring in children and adolescents AHA

2017 American Heart Association

38. Syncope: Guideline For Evaluation and Management of Patients With

.ORTHOSTATIC HYPOTENSION: RECOMMENDATIONS . .. e73 6.1. Neurogenic Orthostatic Hypotension: Recommendations e73 6.2. Dehydration and Drugs: Recommendations e75 7.ORTHOSTATIC INTOLERANCE .. e76 8.PSEUDOSYNCOPE: RECOMMENDATIONS .. e76 9.UNCOMMON CONDITIONS ASSOCIATED WITH SYNCOPE .. e77 10.AGE, LIFESTYLE, AND SPECIAL POPULATIONS: RECOMMENDATIONS . .. e79 10.1. Pediatric Syncope: Recommendations ... e79 10.2. Adult Congenital Heart Disease: Recommendations e81 10.3. Geriatric Patients: Recommendations e81 (...) , laughing, swallowing, micturition, or defecation. These syncope events are closely associated with speci?c physical functions. Postural (orthostatic) tachycardia syndrome (POTS) A clinical syndrome usually characterized by all of the following: 1) frequent symptoms that occur with standing (e.g., lightheadedness, palpitations, tremulousness, generalized weakness, blurred vision, exercise intolerance, and fatigue); and 2) an increase in heart rate of$30 bpm during a positional change from supine

2017 American College of Cardiology

39. Management of Pregnancy in Patients With Complex Congenital Heart Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association Full Text available with Trip Pro

to the hypervolemia, with respective increases of ≈45% to 55% and 20% to 30%. Estrogen has a key role in plasma volume expansion and promotes sodium and water retention by upregulating the production of angiotensinogen, renin, and aldosterone. The disproportionate expansion of plasma volume relative to red cell mass contributes to the physiological anemia of pregnancy, with mean±SD hemoglobin concentrations of 10.9±0.6 and 12.4±1.0 g/dL for the second and third trimesters, respectively. Figure 1. Pregnancy (...) . Elevated core temperature may be teratogenic. Thus, patients should avoid exhaustive activity on hot days and prolonged hot bathing; the use of saunas or hot tubs should be discouraged. , Hydration. Maintenance of adequate maternal hydration (which may be influenced by environmental factors) is generally recommended for all pregnancies but may have more significance in the CHD population. Limitation of salt intake is prudent in those with impaired ventricular function who are vulnerable to heart

2017 American Heart Association

40. Benign Paroxysmal Positional Vertigo (BPPV) Full Text available with Trip Pro

7Intermountain Hearing and Balance Center, Salt Lake City, Utah, USA by this author for this author , 8 8Vestibular Disorders Association, Portland, Oregon, USA by this author for this author , , MSN, FNP-BC 9 9Ear, Nose & Throat Specialists of Northern Virginia, PC, Arlington, Virginia, USA by this author for this author , , PhD 10 10Alabama Hearing and Balance Associates, Inc, Birmingham, Alabama, USA by this author for this author , , MD 11 11Department of Otolaryngology–Head and Neck Surgery, College (...) of Colorado, Aurora, Colorado, USA 3 Department of Otolaryngology, Virginia Mason Medical Center, Seattle, Washington, USA 4 Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA 5 Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA 6 Barrow Neurological Institute and College of Medicine, University of Arizona, Phoenix, Arizona, USA 7 Intermountain Hearing and Balance Center, Salt Lake City, Utah, USA 8 Vestibular Disorders

2017 American Academy of Otolaryngology - Head and Neck Surgery

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