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Pulmonary Hypertension in Sickle Cell Anemia


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301. Wilms Tumor and Other Childhood Kidney Tumors Treatment (PDQ®): Health Professional Version

Wilms tumor. Table 1. Syndromes and Conditions Associated With Wilms Tumor a Syndrome/Condition Gene Overgrowth Phenotype Non-Overgrowth Phenotype High Risk of Wilms Tumor (>20%) WAGR syndrome WT1 deletion X Denys-Drash syndrome WT1 missense mutation X Perlman syndrome DIS3L2 mutation X Fanconi anemia with biallelic mutations in BRCA2 ( FANCD1 ) or PALB2 ( FANCN ) BRCA2 , PALB2 X Premature chromatid separation/mosaic variegated aneuploidy Biallelic BUB1B or TRIP13 mutation X Moderate Risk of Wilms (...) by fetal gigantism, renal dysplasia and nephroblastomatosis, islet cell hypertrophy, multiple congenital anomalies, and mental retardation. Survivors have a high risk of developing Wilms tumor (75%).[ ] Germline inactivating mutations in DIS3L2 on chromosome 2q37 are associated with Perlman syndrome. Preliminary data suggest that DIS3L2 plays a role in normal kidney development and in a subset of sporadic Wilms tumor cases.[ ] Simpson-Golabi-Behmel syndrome. Simpson-Golabi-Behmel syndrome

2017 PDQ - NCI's Comprehensive Cancer Database

302. Air Travel and Pregnancy

altitude. Thus, the barometric pressure is significantly lower than at sea level and there will be a concomitant reduction in the partial pressure of oxygen, in turn resulting in a reduction in blood oxygen saturation by around 10%. Such a reduction does not pose a problem for healthy individuals and this remains so in pregnancy. Owing to the higher count of red blood cells in the fetal circulation and the favourable properties of fetal haemoglobin, there is considered to be little, if any, change (...) than 7.5 g/dl ? recent haemorrhage ? otitis media and sinusitis ? serious cardiac or respiratory disease ? recent sickling crisis ? recent gastrointestinal surgery, including laparoscopic surgery, where there have been gastrointestinal procedures carried out and where suture lines on the intestine could come under stress due to the reduction in pressure and gaseous expansion ? a fracture, where significant leg swelling can occur in flight, is particularly hazardous in the first few days of a cast

2013 Royal College of Obstetricians and Gynaecologists

303. Prostate cancer

cells. PSA is secreted by prostate epithelial cells into prostatic fluid, where its function is to liquefy semen and thus allow spermatozoa to move more freely. Although PSA is secreted into prostatic fluid and semen, small amounts of PSA are present in blood. PSA test As a result of altered prostate architecture in prostate cancer, more PSA leaks out increasing the levels in the blood. However, blood PSA is an inaccurate marker for prostate cancer, because cancer can be present without increased (...) of PSA testing [ ]. Transrectal ultrasound (TRUS) biopsy false negatives False negative rates associated with TRUS biopsy can be as high as 45% [ ]. NICE recommends that for men with a negative TRUS biopsy, multiparametric MRI (mpMRI) is considered to determine whether a further biopsy is required [ ]. Triage of men with clinical suspicion of prostate cancer (elevated prostate specific-antigen [PSA] and abnormal digital rectal examination [DRE]) to mpMRI prior to prostate biopsy could allow more

2017 NICE Clinical Knowledge Summaries

304. Pre-conception - advice and management

[ ]. Advice on folic acid What advice should I give a woman planning pregnancy regarding folic acid? Assess the couple's risk of a neural tube defect (NTD) . Couples are at high risk of conceiving a child with an NTD if: Either partner has an NTD, they have had a previous pregnancy affected by an NTD, or they have a family history of an NTD. The woman is taking anti–epileptic medication. The woman has coeliac disease or other malabsorption state, diabetes mellitus , sickle cell anaemia, or thalassaemia (...) associated with first trimester maternal exposure to fluoxetine. Issued in June 2011. September 2010 — minor update. Text amended to include recommendations from the National Institute for Health and Care Excellence (NICE) public health guidance 27 about preparing for pregnancy for women with a body mass index (BMI) of 30 kg/m 2 or more. Issued September 2010. January 2009 — minor update to clarify the advice for folic acid supplementation in women with sickle-cell anaemia and thalassaemia. Issued

2017 NICE Clinical Knowledge Summaries

305. Esmya - ulipristal

tumour of the female reproductive tract in pre- menopausal women and have been reported to affect 20-40% of women during their reproductive years. Uterine fibroids are often asymptomatic, but when symptomatic, the primary symptoms are heavy uterine bleeding, anaemia, abdominal pressure, abdominal pain, increased urinary frequency and infertility. In particular, heavy menstrual blood loss is one of the most frequently disabling symptoms of uterine fibroids. Treatment Currently, the treatment (...) duration in Purkinje fibres, PGL-H-412 Dog/Beagle In vitro 1, 3, 10 µM (0.475, 1.425, 4.75 µg/mL) Ulipristal acetate is unlikely to have an effect on cardiac sodium channels. HERG tail current, PGL-H-413 Transfected HEK293 cells In vitro 10 µM (4.75 µg/mL) Ulipristal acetate had no effect on HERG tail current. Cardiovascular effects (arterial blood pressure, heart rate and ECG) in conscious, telemetered female beagle dogs PGL-H-416 Dog, Beagle 4 F/group The animals were orally dosed sequentially with 7

2012 European Medicines Agency - EPARs

306. Study of a Levonorgestrel 52 mg Intrauterine System for the Treatment of Heavy Menstrual Bleeding

disease or other known coagulopathy uncontrolled significant hypertension defined as a sitting systolic blood pressure greater than or equal to 160 mm Hg or diastolic blood pressure greater than or equal to 95 mm Hg at any screening or enrollment visit presence or history of venous thromboembolic diseases (deep vein thrombosis, pulmonary embolism), presence or history of arterial thromboembolic diseases (e.g., myocardial infarction, stroke) uncontrolled thyroid disorder sickle cell anemia diabetes (...) , longer, absent, irregular), hot flashes, sleeping disorder, or changes in mood (e.g., depression, nervous tension, and irritability) within 3 months prior to or during the screening period Screening blood laboratory value outside of the normal range that, in the the opinion of the investigator, requires treatment or further work-up (i.e., are considered clinically significant) Has poor venous access or significant history of inability to have blood samples drawn History of bicornuate uterus or any

2018 Clinical Trials

307. Point of Care Ultrasound Screening for Abnormal Fetal Growth During Routine Antenatal Visits

anemia (Hb > 9 gm/dl). Patients with sickle cell disease are excluded. Chronic pulmonary disease including asthma requiring regular use of medication and active TB. An asthma inhaler used on an as needed basis (PRN) for a cold or an asthma attack is not considered regular use. Heart disease except mitral value prolapse not requiring medication Cardiovascular disorders: chronic hypertension Liver disorders accounting for cholestasis Infectious diseases: HIV, CMV, toxoplasmosis, parvovirus B19 Note (...) ultrasound during routine antenatal visits to evaluate fetal AC and amniotic fluid DVP would decrease the false positive rates of fundal height measurement in diagnosing intrauterine growth abnormalities. Condition or disease Intervention/treatment Phase Prenatal Disorder Diagnostic Test: Point-of-care US Not Applicable Detailed Description: The prior studies of routine ultrasound in low risk patients focused on the usual ultrasound evaluation which involves the use of advanced equipment and providers

2018 Clinical Trials

308. Leukemoid Reaction in Infant Pertussis: Is There a Place for Hydroxyurea? A Case Report Full Text available with Trip Pro

Leukemoid Reaction in Infant Pertussis: Is There a Place for Hydroxyurea? A Case Report A 73-days old infant of 34 weeks' gestation was hospitalized with a co-infection of respiratory syncytial virus (RSV) and Bordetella pertussis (BP). She required invasive ventilation for 9 days in the context of malignant pertussis with persistent hypoxemia and hypercapnia secondary to a leukemoid reaction. Despite an increase of white blood cell (WBC) count up to 70 G/L and ensuing pulmonary hypertension (...) to decrease rapidly leukocyte counts in a leukemoid reaction associated with Bordetella pertussis infection. To our knowledge, hydroxyurea has never been used in malignant pertussis but is a well-known medication for oncologic and hematologic diseases such as acute myeloid leukemia or sickle cell anemia. Its effects in this setting are not well understood but the positive outcome in our patient supports the need for further studies.

2018 Frontiers in pediatrics

309. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock Full Text available with Trip Pro

: Reassessment should include a thorough clinical examination and evaluation of available physiologic variables (heart rate, blood pressure, arterial oxygen saturation, respiratory rate, temperature, urine output, and others, as available) as well as other noninvasive or invasive monitoring, as available. 4. We recommend further hemodynamic assessment (such as assessing cardiac function) to determine the type of shock if the clinical examination does not lead to a clear diagnosis (BPS). 5. We suggest (...) trials sponsored by Ferring Pharmaceuticals, Farron Labs, and Roche Genentec; also received funding from Asahi Kasei Pharma America (consulting), UpToDate (wrote two chapters on pulmonary embolism diagnosis), and was a pro bono consultant for BioAegis; participates as a member of the American Thoracic Society committee to develop the ATS/ESICM/SCCM Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome. Dr. Vincent participates in World

2016 European Respiratory Society

310. Iron Status and Cardiopulmonary Physiology

regurgitant jet (RVSP = TR velocity^2 * 4) Change in time from pulmonary valve opening to peak pulmonary flow velocity with altitude [ Time Frame: Measurement performed at baseline (2 weeks prior to commencing ascent to very high altitude) and at intervals during ascent to very high altitude (over a period of 2 weeks) ] The time from pulmonary valve opening to peak velocity flow is inversely correlated with pulmonary artery pressure. This time is measured on a pulsed wave (PW) Doppler trace (...) in the parasternal short axis view at the pulmonary valve level. The measurement is a time and the units are ms. Categories are: normal (>130 ms), borderline elevated (100-130 ms), elevated (80-100 ms) and severely elevated (<80 ms). Change in left ventricular stroke volume (LV SV) with altitude [ Time Frame: Measurement performed at baseline (2 weeks prior to commencing ascent to very high altitude) and at intervals during ascent to very high altitude (over a period of 2 weeks) ] The stroke volume of the left

2018 Clinical Trials

311. Balloon Angioplasty for Symptomatic Intracranial Artery Stenosis

with tandem lesions; The mRS baseline score of disabling stroke is more than 3; Non-atherosclerotic diseases (e.g. arterial dissection, moyamoya disease, vascular inflammatory lesions caused by infection, autoimmune diseases, post-irradiation, postpartum status; developmental or genetic abnormalities such as fibromuscular dysplasia, sickle cell anemia, suspected vasospasm); The target vessel is severely calcified and closely related to stenosis; It is suspected that the ischemic event is due to embolism (...) groups will receive risk factors management including blood pressure to maintain 130-140/90-100 mmHg and LDL lower than 70 mg/dl. The primary objective is to evaluate the safety and efficacy of intracranial angioplasty combined with aggressive medical care for symptomatic intracranial artery stenosis. The study consists of 11 visits including the day of screening and randomization, the day when the subject receive intracranial angioplasty and/or aggressive medical care, the day before the subject

2018 Clinical Trials

312. Sildenafil in US Heart Failure Patients (SilHF-US)

disease Documented episodes of sustained ventricular tachycardia Prior (past 30 days before the baseline visit) or ongoing use of oral nitrate therapy. Concomitant disease which interfere with assessment of dyspnea , severe COPD, asthma, restrictive lung disease, severe obesity Anemia (hemoglobin < 10g/dL) Uncontrolled hypertension ( SBP >160 mmHg and / or DBP > 90 mmHg) Symptomatic or orthostatic hypotension or systolic blood pressure < 90 mmHg Clinically important renal dysfunction (GFR < 40m ml/min (...) profile of PDE-5 inhibitors is favorable with reduction in filling pressures, both systemic and pulmonary, vascular resistance accompanied by improvement in symptoms and sub maximal and peak exercise performance. This pilot study will evaluate the use of the PDE5-inhibitor sildenafil in patients with heart failure, systolic dysfunction and documented secondary pulmonary hypertension. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Estimated Enrollment

2018 Clinical Trials

313. Biological Effects of Ultrasound Insonification of the Spleen

pressure ulcers sickle cell anemia or other anemia syndromes monocytosis thrombocytopenia diagnosed with fever of unknown origin (FUO) previously or currently implanted vagus nerve stimulator previously or currently implanted spinal cord stimulator other chronically-implanted electronic medical device history of seizures history of cancer Individuals who have taken any of the following medications within one week of receiving ultrasound delivery: anti-coagulant (Coumadin, Xarelto) anti-platelet (...) (substances in the body that indicate the status of a biological process or condition). These biomarkers include cytokines (proteins involved in the immune response), norepinephrine (chemical in the body that transmits signals), glucose (sugar in the blood), and blood cells that are involved in breathing, clotting, and the immune response. The study will be considered complete after completion of enrollment (10 participants in each group, for a study total of 60 participants), completion of study

2018 Clinical Trials

314. Frequency of Performing Umbilical Artery Doppler in the Third Trimester in High Risk Pregnancy

(such as cyanotic heart disease) or hematologic disorders (such as severe anemia, sickle cell anemia and β-thalassemia) (Baschat et al., 2012). Current preeclampsia or pregnancy-induced hypertension (PIH). PIH is diagnosed in women whose blood pressure reaches 140/90 mm Hg or greater for the first time after midpregnancy, but proteinuria is not identified. Preeclampsia is best described as pregnancy-specific syndrome that can affect virtually every organ system.It is much more than simply gestational (...) will be determined by the date of the last menstrual period and early ultrasound. III-Patient considered as high-risk pregnancies will be included in this study. The following will be considered as high-risk status: Previous obstetric history of preeclampsia or eclampsia, abruptio placenta, intra-uterine growth restriction or still birth. Pre-existing medical disorders like: Pregestational diabetes (Ang et al., 2006) Renal diseases (such as nephrotic syndrome, chronic renal failure, renal transplant

2018 Clinical Trials

315. Comparison of MMFS Dosages in Older Adults

(myocardial infarction; coronary angioplasty or bypass graft(s); valvular disease or repair; unstable angina pectoris; transient ischemic attack (TIA); cerebrovascular accidents (CVA); congestive heart failure or coronary artery disease (CAD), clinically important carotid or vertebrobasilar stenosis or plaque, pulmonary, respiratory, hepatic, renal (including poor kidney function, eGFR <55 mL/min), hematological (sickle cell anemia or thalassemia, sideroblastic anemia or anemia of any etiology (...) ), gastrointestinal, endocrine (diabetes type I or II), immunologic, dermatologic, neurological, psychiatric disease or disorder within 6 months, or any uncontrolled medical illness which in the opinion of the Investigator would jeopardize the safety of the subject. Nonetheless, subjects with controlled co-morbid conditions (including diabetes, hypertension, heart disease, etc.) are permitted if considered stable within three months of the study start. All concomitant medications, supplements, or other substances

2018 Clinical Trials

316. Assessment of the Evolution of Wound Biomarkers in Venous Leg Ulcers Treated With KLOX Biophotonic System

uncontrolled medical disorders such as serious cardiovascular, renal, liver or pulmonary disease, palliative care, or other chronic diseases such as lupus or sickle cell anemia; Patient with known moderate to severe anemia; Patient with history of malignancy within the wound or patient with prior diagnosis of malignant disease who is less than one year disease-free; Patient who has experienced a hip fracture in the past 3 months; Patient with known osteomyelitis or active cellulitis; Patients who (...) I to IV; Proven venous leg ulcer, clinically defined and confirmed by duplex, refilling time or venous hypertension; Ulcer to be treated must be measurable and with an area between 5 and 100 cm2 inclusively, with a maximum depth of 1 cm and maximum diameter less or equal to 10 cm; If applicable, patients (male a female) must be willing to adhere to a medically-accepted birth control method (verified by the Investigator); Stable wound surface area with an absolute change in wound area less than

2018 Clinical Trials

317. Management of Venous Leg Ulcers: Clinical Practice Guidelines of the Society for Vascular Surgery and the American Venous Forum Full Text available with Trip Pro

Definition We suggest use of a standard definition of venous ulcer as an open skin lesion of the leg or foot that occurs in an area affected by venous hypertension. [BEST PRACTICE] VENOUS ANATOMY AND PATHOPHYSIOLOGY Guideline 2.1 : Venous Anatomy Nomenclature We recommend use of the International Consensus Committee on Venous Anatomical Terminology for standardized venous anatomy nomenclature. [BEST PRACTICE] Guideline 2.2 : Venous Leg Ulcer Pathophysiology We recommend a basic practical knowledge (...) . [GRADE - 2; LEVEL OF EVIDENCE - C] Guideline 4.2: Débridement We recommend that venous leg ulcers receive thorough débridement at their initial evaluation to remove obvious necrotic tissue, excessive bacterial burden, and cellular burden of dead and senescent cells. [GRADE - 1; LEVEL OF EVIDENCE - B] We suggest that additional maintenance débridement be performed to maintain the appearance and readiness of the wound bed for healing. [GRADE - 2; LEVEL OF EVIDENCE - B] We suggest that the health care

2014 American Venous Forum

318. 2014 AHA/ACC Guideline for the Management of Patients With Non?ST-Elevation Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines

of chest pain (e.g., aortic dissection, expanding aortic aneurysm, pericarditis, pulmonary embolism) • Noncardiovascular causes of chest, back, or upper abdominal discomfort include: o Pulmonary causes (e.g., pneumonia, pleuritis, pneumothorax) o Gastrointestinal causes (e.g., gastroesophageal reflux, esophageal spasm, peptic ulcer, pancreatitis, biliary disease) o Musculoskeletal causes (e.g., costochondritis, cervical radiculopathy) o Psychiatric disorders o Other etiologies (e.g., sickle cell crisis (...) for cardiopulmonary resuscitation and emergency cardiovascular care—Part 9: postcardiac arrest care AHA 2010 (31) Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure NHLBI 2003 (32) Statements Key data elements and definitions for measuring the clinical management and outcomes of patients with acute coronary syndromes and coronary artery disease ACC/AHA 2013 (33) Practical clinical considerations in the interpretation of troponin elevations ACC

2014 Society for Cardiovascular Angiography and Interventions

319. Non-ST-Elevation Acute Coronary Syndromes: Guideline For the Management of Patients With

., gastroesophageal re- ?ux,esophagealspasm,pepticulcer,pancreatitis, biliary disease) o Musculoskeletal causes (e.g., costochondritis, cervi- cal radiculopathy) o Psychiatric disorders o Other etiologies (e.g., sickle cell crisis, herpes zoster) Inaddition,theclinicianshoulddifferentiateNSTE-ACSfrom acute coronary insuf?ciency due to a nonatherosclerotic causeandnoncoronarycausesofmyocardialoxygensupply- demand mismatch (41) (Section 2.2.2). 3.2.1. History NSTE-ACS most commonly presents as a pressure-type chest (...) 2011 (27) Assessment of cardiovascular risk in asymptomatic adults ACC/AHA 2010 (28) Myocardial revascularization ESC 2010 (29) Unstable angina and non–ST-elevation myocardial infarction NICE 2010 (30)† Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care—part 9: postcardiac arrest care AHA 2010 (31) Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure NHLBI 2003 (32) Statements Key data elements and de

2014 American College of Cardiology

320. Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack Full Text available with Trip Pro

is directly related to blood pressure (BP) starting with an SBP as low as 115 mm Hg. , The relationship with recurrent stroke has been less well studied but is presumably similar. The first major trial to demonstrate the effectiveness of hypertension treatment for secondary prevention of stroke was the Post-Stroke Antihypertensive Treatment Study (PATS). This Chinese study randomized 5665 patients with a recent TIA or minor stroke (hemorrhagic or ischemic) to indapamide or placebo. Patients were eligible (...) is uncertain, but restarting antihypertensive therapy is reasonable after the first 24 hours for patients who have preexisting hypertension and who are neurologically stable. Limited data specifically assess the optimal BP target for secondary stroke prevention. Randomized clinical trial evidence among high-risk patients with DM indicates that there is no benefit in achieving an aggressive SBP of <120 versus <140 mm Hg. Observational studies among hypertensive patients with DM and coronary artery disease

2014 American Heart Association

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