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Pulmonary Hypertension in Sickle Cell Anemia

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321. 2014 AHA/ACC Guideline for the Management of Patients With Non-ST-Elevation Acute Coronary Syndromes Full Text available with Trip Pro

care AHA 2010 Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure NHLBI 2003 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 Practical clinical considerations in the interpretation of troponin elevations ACC 2012 Testing of low-risk patients presenting to the emergency department with chest pain AHA (...) can indicate alternative diagnoses in patients with chest pain, several of which are life threatening. Aortic dissection is suggested by back pain, unequal palpated pulse volume, a difference of ≥15 mm Hg between both arms in systolic blood pressure (BP), or a murmur of aortic regurgitation. Acute pericarditis is suggested by a pericardial friction rub. Cardiac tamponade can be reflected by pulsus paradoxus. Pneumothorax is suspected when acute dyspnea, pleuritic chest pain, and differential

2014 American Heart Association

322. Guidelines for the Primary Prevention of Stroke: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

factors. Retaining most of the Framingham covariates, one alternative stroke risk scoring system omits cigarette smoking and antihypertensive medication and adds “time to walk 15 feet” and serum creati- nine. 21 Another score is derived from a mixed cohort of stroke and stroke-free patients and includes history of stroke, marital status, blood pressure (BP) as a categorical variable, high-den- sity lipoprotein (HDL) cholesterol, impaired expiratory flow, physical disability, and a depression score. 22 (...) , including sickle cell disease and patent foramen ovale. (Stroke. 2014;45:3754-3832.) Key Words: AHA Scientific Statements ? atrial fibrillation ? diabetes mellitus ? hyperlipidemias ? hypertension ? intracranial aneurysm ? ischemia ? prevention and control ? smoking ? stroke Guidelines for the Primary Prevention of Stroke A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association The American Academy of Neurology affirms the value of these guidelines

2014 American Heart Association

323. Guidelines for the Prevention of Stroke in Patients with Stroke and Transient Ischemic Attack (Secondary Stroke Prevention)

that otherwise, the benefit of treating arterial hyperten- sion in the setting of acute stroke 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 evi- dence among high-risk patients with DM indicates that there is no benefit in achieving an aggressive SBP of 8% of first (...) , intervention for vascular obstruction, antithrombotic therapy for cardioembolism, and antiplatelet therapy for noncardioembolic stroke. Recommendations are also provided for the prevention of recurrent stroke in a variety of specific circumstances, including aortic arch atherosclerosis, arterial dissection, patent foramen ovale, hyperhomocysteinemia, hypercoagulable states, antiphospholipid antibody syndrome, sickle cell disease, cerebral venous sinus thrombosis, and pregnancy. Special sections address use

2014 Congress of Neurological Surgeons

324. Specification, implementation and management of information technology (IT) systems in hospital transfusion laboratories

applications which interface directly to the LIMS. Supporting blood “tracking” applications are not covered in detail, but the interoperability with the LIMS is referenced where appropriate. Whilst these guidelines are not specifically addressing cells and tissues, organisations should consider the requirements and potential need to manage cells and tissues through the blood transfusion IT system. Wherever possible, other BCSH transfusion guidelines are cross referenced to avoid duplication of information (...) be the facility to update this table to allow for new components and products to be added by appropriately authorised personnel. Systems must be able to receive blood components labelled from any of the UK Blood Establishments and other products as defined by the users. If organisations require the ability to manage 17 cells and tissues imported from outside the UK there should be a procedure on entering information into the LIMS to ensure the donor/patient traceability chain is maintained. 2.1.1 Stock

2014 British Committee for Standards in Haematology

325. Transitions of Care for Children with Special Health Care Needs

and who also require health and related services of a type or amount beyond that required by children generally.” 2 Examples of adolescent populations with special health care needs that need transition support range widely, including those with chronic illnesses such as diabetes or sickle cell disease and individuals with developmental disabilities that are associated with a host of challenges ranging from higher risks of specific health outcomes to the need for special support in navigating (...) of pediatricians report making referrals to adult physicians and less than 15 percent report providing transition education materials to adolescents and their parents. 19 Potentially serious health-related consequences may be associated with suboptimal or incomplete transition to adult care. Gaps in care in transitions have been associated with poor health outcomes, increased hospitalizations and more complications and failure to access care in populations with diabetes, arthritis, and sickle cell disease. 20

2014 Effective Health Care Program (AHRQ)

326. Venous thromboembolism (VTE) prophylaxis in pregnancy and the puerperium

service. Aust N Z J Obstet Gynaecol. 2008; 48(1):44-9. 34. Won HS, Kim do Y, Yang MS, Lee SJ, Shin HH, Park JB. Pregnancy-induced hypertension, but not gestational diabetes mellitus, is a risk factor for venous thromboembolism in pregnancy. Korean Circ J. 2011; 41(1):23-7. 35. Danilenko-Dixon DR, Heit JA, Silverstein MD, Yawn BP, Petterson TM, Lohse CM, et al. Risk factors for deep vein thrombosis and pulmonary embolism during pregnancy or post partum: a population-based, case-control study. Am J (...) if hospitalised • Consider # LMWH prophylaxis Pre-pregnancy therapeutic anticoagulation Antenatal therapeutic anticoagulation Socio-demographic • Age = 35 years • BMI = 30 kg/m 2 • Cigarette smoker (>10/day) Medical history • Systemic lupus erythematosus • Cardiac or lung disease • Sickle cell disease • Gross varicose veins • Inflammatory conditions • Nephrotic syndrome • Cancer • Pre-existing diabetes • Ovarian hyperstimulation Pregnancy related • Immobility (e.g. bed rest, long distance travel

2014 Clinical Practice Guidelines Portal

327. Guidelines for the screening, care and treatment of persons with hepatitis C infection

, including insulin resistance and diabetes. Addressing co-morbidities such as high body mass index and smoking is also important, as are measures to avoid reinfection through ensuring the availability of safe blood transfusions and sterile medical equipment. Of these various conditions or behaviours, the Guidelines Development Group assessed the value of conducting alcohol screening and behavioural interventions to limit alcohol intake. Alcohol use can accelerate the progression of HCV-related cirrhosis (...) screen blood transfusions for bloodborne viruses. 36 The most well documented example of health-care associated transmission is the generalized epidemic of HCV infection resulting from unsafe injection practices in Egypt, where HCV prevalence is 25% in some regions. 8 Persons who received untested blood products prior to the introduction of screening of blood for HCV in high-income countries are also at risk. Universal access to safe blood transfusion requires the implementation of key strategies

2014 World Health Organisation Guidelines

328. Venous thromboembolism (VTE) prophylaxis in pregnancy and the puerperium

service. Aust N Z J Obstet Gynaecol. 2008; 48(1):44-9. 34. Won HS, Kim do Y, Yang MS, Lee SJ, Shin HH, Park JB. Pregnancy-induced hypertension, but not gestational diabetes mellitus, is a risk factor for venous thromboembolism in pregnancy. Korean Circ J. 2011; 41(1):23-7. 35. Danilenko-Dixon DR, Heit JA, Silverstein MD, Yawn BP, Petterson TM, Lohse CM, et al. Risk factors for deep vein thrombosis and pulmonary embolism during pregnancy or post partum: a population-based, case-control study. Am J (...) if hospitalised • Consider # LMWH prophylaxis Pre-pregnancy therapeutic anticoagulation Antenatal therapeutic anticoagulation Socio-demographic • Age = 35 years • BMI = 30 kg/m 2 • Cigarette smoker (>10/day) Medical history • Systemic lupus erythematosus • Cardiac or lung disease • Sickle cell disease • Gross varicose veins • Inflammatory conditions • Nephrotic syndrome • Cancer • Pre-existing diabetes • Ovarian hyperstimulation Pregnancy related • Immobility (e.g. bed rest, long distance travel

2014 Clinical Practice Guidelines Portal

329. Cardiovascular Function and Treatment in ß-Thalassemia Major Full Text available with Trip Pro

, including those in the cardiovascular system. This leads to iron loading and an increased requirement for iron chelation. 2.1.3 Sickle Cell Anemia The cardiovascular manifestations of sickle cell anemia are beyond the scope of this document but typically include a greater propensity to sickle cell crisis (severe generalized attacks of pain), as well as pulmonary hypertension, thrombosis, and stroke. Patients with sickle cell anemia are increasingly being transfused to prevent cardiovascular (...) differs from that in nonanemic patients because of the cardiovascular adaptation to chronic anemia in non–cardiac-loaded TM patients, which includes resting tachycardia, low blood pressure, enlarged end-diastolic volume, high ejection fraction, and high cardiac output. Chronic anemia also leads to background symptomatology such as dyspnea, which can mask the clinical diagnosis of cardiac dysfunction. Central to early identification of cardiac iron overload in TM is the estimation of cardiac iron

2013 American Heart Association

330. Tropical Travel Trouble 007 Mega Malaria Extravaganza

) or urea >20 mmol/L. Raised bilirubin >50 umol/L (3 mg/dL) with a parasite count >100,000/uL. Pulmonary oedema either radiographically confirmed or saturations <92% on room air with a respiratory rate >30/min. Significant bleeding. Shock : capillary refill >3 seconds. Evidence of poor perfusion to their peripheries or s systolic blood pressure <70 mmHg in children or <80 mmHg in adults. Hyperparasitaemia : >2%. Severe Vivax: Same as falciparum but no parasite density threshold. Severe Knowlesi (...) : Parasite density >100,000/uL. Jaundice and parasite density > 20,000/uL. Q5. What is the mechanism of “immunity” to malaria? Answer and interpretation Innate immunity: Haemoglobinopathies (Thalessaemia). RBC enzyme deficiencies (G6PD). RBC surface components (Duffy blood group). Sickle cell haemoglobin. Incomplete immunity from prior repeated exposure: In populations who are continually exposed to malaria (inoculation rate >10/year) a partial immunity to clinical disease and a reduced risk

2018 Life in the Fast Lane Blog

331. ACCF Clinical Expert Consensus Document on Practical Clinical Considerations in the Interpretation of Troponin Elevations

and the Universal De?nition of MI (13) Classi?cation of MI Type ACS acute coronary syndromes; AMI acute myocardial infarction; BP blood pressure; CABG coronary artery bypass grafting; CAD coronary artery disease; CT cardiothoracic; MI myocardial infarction; PCI percutaneous coronary intervention; SCD sudden cardiac death; STEMI ST-segment elevation myocardial infarction. 2432 Newby et al. JACC Vol. 60, No. 23, 2012 Interpretation of Troponin Elevations December 11, 2012:2427–63 Downloaded From: http (...) incremental bene?t from aggressive treatment strategy. In such patients, the main goal would be to identify the underlying cause of the troponin elevation—conditions such as myocarditis, pericarditis, cardiac contusion, sepsis, pulmonary embolism (PE), and heart failure. Therapy in these circumstances should target the underlying cause. Treatment in patients without troponin elevation, but with a high pre-test probability of ACS, should be directed by identi?cation of other markers of risk. Those

2012 Society for Cardiovascular Angiography and Interventions

332. First-trimester abortion in women with medical conditions

? Uncontrolled asthma ? Restrictive lung disease ? Pulmonary hypertension Rheumatological ? Lupus flare ? Lupus inhibitor requiring anticoagulation GI ? Hepatic disease elevated PT ? Esophageal varices with history of bleeding ? Uncontrolled inflammatory bowel disease Hematological ? Severe anemia ? Sickle cell disease with a history of crisis ? Idiopathic thrombocytopenia purpura with active thrombocytopenia ? Thrombophilia requiring anticoagulation Oncology ? Counseling regarding treatment options (...) blood pressure N160 or diastolic blood pressure N105) Endocrine ? Uncontrolled hyperthyroidism, uncontrolled diabetes, pheochromocytoma Cardiac ? Congenital (cyanotic disease, right or left ventricular dilation, uncontrolled tachyarrhythmia) ? Coronarydisease—(historyofmyocardialinfarction,treatmentangina) ? Cardiomyopathy — (dilated, hypertrophic, history of peripartum cardiomyopathy) ? Valvular disease— (AS peak gradient=60 mmHg, MS valve area b1.5 cm2, MR or AR with LV dilation) Pulmonary

2012 Society of Family Planning

333. Diagnosis and management of thrombocytopenic purpura and other thrombotic microangiopathies

the diagnosis and monitor the course of the disease and possible need for additional treatments. Table 1. Differential diagnosis of thrombocytopenia and microangiopathic haemolytic anaemia Autoimmune haemolysis/Evans syndrome Disseminated intravascular coagulation Pregnancy‐associated e.g. HELLP (haemolysis, elevated liver enzymes and low platelets), eclampsia, haemolytic uraemic syndrome Drugs eg quinine, simvastatin, interferon, Calcineurin inhibitors Malignant hypertension Infections, typically viral (...) film Anaemia, thrombocytopenia, fragments on film Reticulocyte count Raised Haptoglobin Reduced Clotting screen including fibrinogen Normal Urea and electrolytes Renal impairment Troponin T/Troponin I For cardiac involvement Liver function tests Usually normal Calcium May reduce with PEX Lactate dehydrogenase Raised due to haemolysis Urinalysis For protein Direct antiglobulin test Negative Blood group and antibody screen To allow provision of blood products Hepatitis A/B/C and human

2012 British Committee for Standards in Haematology

334. Substudy of CADRE: for People With Extreme Phenotype: BIOCADRE

Biological: biological analysis biological analysis will be performed in the 6 groups of patients Other: peripheral arterial tonometry peripheral arterial tonometry will be performed in the 6 groups of patients pulmonary hypertension Sickle cell patients with pulmonary hypertension as a vascular main complication Biological: biological analysis biological analysis will be performed in the 6 groups of patients Other: peripheral arterial tonometry peripheral arterial tonometry will be performed in the 6 (...) : Sickle cell disease (SCD) is the most frequent monogenic disease in the world, due to a unique mutation on the β-globin gene. Most affected individuals live in sub-Saharan Africa, yet, the natural history of the disease in Africa remains largely unknown. SCD usually presents in childhood and is characterized by the association of a chronic hemolytic anemia with episodes of acute vaso-occlusive events and progressive vascular organ damage. SCD is now widely recognized as a vascular disease with marked

2017 Clinical Trials

335. Decompression Tables for Diving at Altitude

: 18 Years to 40 Years (Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: Yes Criteria Inclusion Criteria: Exclusion Criteria: smoking, cardiorespiratory disease (including hypertension, airways obstruction), seizure disorder, pregnancy, history of middle ear or sinus disease or high altitude cerebral or pulmonary edema (HACE, HAPE), inability to perform middle ear autoinflation, anemia, sickle cell disease and sickle cell trait. Individuals with VO2peak <35 mL.kg-1.min-1 (males (...) by breathing 100% O2 for 120 minutes at 1.3 ATA. This will simulate, for example, a 2 hour dive at 12,000 ft to 65 fsw breathing 50% O2. The diver will then return to 15,000 ft and remain at that altitude for 24 hours to allow for AMS symptoms to recur (if indeed they do). Lake Louise AMS scores will be collected every 8 hours. AMS symptoms will be treated with acetaminophen, NSAIDs and anti-emetics as needed. Subjects will be assessed clinically every 12 hours for high altitude pulmonary edema (HAPE

2017 Clinical Trials

336. Identification of a soluble guanylate cyclase in RBCs: preserved activity in patients with coronary artery disease Full Text available with Trip Pro

. Collectively, our data demonstrate that an intact sGC/PDE5/PKG-dependent signaling pathway exists in RBCs, which remains fully responsive to NO and sGC stimulators/activators in patients with endothelial dysfunction. Targeting this pathway may be helpful in diseases with NO deficiency in the microcirculation like sickle cell anemia, pulmonary hypertension, and heart failure.Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved. (...) Identification of a soluble guanylate cyclase in RBCs: preserved activity in patients with coronary artery disease Endothelial dysfunction is associated with decreased NO bioavailability and impaired activation of the NO receptor soluble guanylate cyclase (sGC) in the vasculature and in platelets. Red blood cells (RBCs) are known to produce NO under hypoxic and normoxic conditions; however evidence of expression and/or activity of sGC and downstream signaling pathway including phopshodiesterase

2017 Redox biology

337. STEMICOOL Pilot Trial to Assess Cooling as an Adjunctive Therapy to PCI In Patients With Acute MI

, coagulopathy, cryoglobulinemia or sickle cell anemia, or will refuse blood transfusions. The patient has a height of <1.5 meters (4 feet 11 inches). The patient is known to be pregnant or is expected to become pregnant within one month of cooling treatment. The patient has a known hypersensitivity or contraindication to buspirone hydrochloride or Meperidine (Demerol) and/or has been treated with a monoamine oxidase inhibitor in the past 14 days. Patient has a known history of severe hepatic or renal (...) presentation to the clinical site. Contraindications to hypothermia, such as patients with known hematologic dyscrasias which affect thrombosis (e.g., cryoglobulinemia, sickle cell disease, serum cold agglutinins) or vasospastic disorders (such as Raynaud's or thromboangitis obliterans). The patient has a known hypersensitivity or contraindication to aspirin, heparin, or sensitivity to contrast media, which cannot be adequately pre-medicated. The patient has a known history of bleeding diathesis

2017 Clinical Trials

338. Targeted OXYgen Therapy in Critical Illness

The patient is expected to receive mechanical ventilation for > 24 hours Exclusion Criteria: Admission following surgery (elective or unplanned) Those patients expected to die within 24 hours of admission to ICU * Pregnant females Admission post-cardiac arrest Admission post trauma (including traumatic brain injury) Known sickle cell trait or disease Ongoing significant haemorrhage or profound anaemia Severe peripheral vascular disease Severe pulmonary hypertension Other medical conditions where mild (...) care unit is feasible and whether this affects specific blood biomarker levels. Investigators in this area of expertise currently lack the information necessary to determine how much oxygen should be given to adult critically ill patients on a mechanical ventilator to assist their breathing in order to achieve the best clinical outcomes i.e. minimal morbidity and mortality. Excessive oxygen administration (both its concentration and duration) and hyperoxaemia (an excessively high blood oxygen level

2017 Clinical Trials

339. Measurement of Renal Functional Reserve Change In Patients With SRC Before and After Laparoscopic Deroofing

hospitalization or oral steroid therapy Inadequate intravenous access Severe anemia (Hct <21%) Acute kidney injury (rise in creatinine to ≥1.5 times the previous baseline or by ≥ 0.3 mg/dL on most recent labs prior to enrollment) History of contrast-induced nephropathy Hyperthyroidism Pheochromocytoma Sickle cell disease Urinary retention or incontinence Status post organ transplant Pregnancy or active breast feeding Cognitive impairment with inability to give consent Institutionalized status Contacts (...) acids supplementation Not Applicable Detailed Description: Simple renal cysts (SRC) are the most frequent type of cystic renal disease. The prevalence rate of SRCs is about 10% and increases with age. Hypertension and decreased renal functions have been reported to occur more commonly among these patients with SRC and there are no clear guidelines for managing asymptomatic SRCs.Renal functional reserve (RFR) describes the capacity of the intact nephron mass to increase glomerular filtration rate(GFR

2017 Clinical Trials

340. Nintedanib in Lung Transplant Recipients With Bronchiolitis Obliterans Syndrome Grade 1-2

) Planned major surgery during the trial participation History of thrombotic event (including stroke and transient ischemic attack) within 6 months of visit 1 Second-degree or third-degree atrioventricular (AV) block on electrocardiogram (ECG) per investigator judgement at visit 1 i) Hypotension (systolic blood pressure [SBP] < 90 mm Hg or diastolic blood pressure [DBP] < 50 mm Hg) (symptomatic orthostatic hypotension) at visit 1; ii) Uncontrolled systemic hypertension (SBP > 160 mmHg; DBP > 100 mmHg (...) ) at visit 1 Known penile deformities or conditions (e.g., sickle cell anemia, multiple myeloma, leukemia) that may predispose to priapism Retinitis pigmentosa, or History of vision loss, or History of nonarteritic ischemic optic neuropathy Treatment with pirfenidone, during the trial participation Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided

2017 Clinical Trials

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