Objective In cross-sectional studies, TSH levels within the reference range have been positively associated with blood pressure and adverse serum lipid levels. In a prospective study, we aimed to find out if differences in TSH within the reference range are associated with future levels of blood pressure and lipids.Design Prospective ...

During the closing phase of the phonation cycle the true vocal-folds (TVF) have a convergent-divergent shape. The negative pressures generated by the flow through the glottal passage are producing closing forces acting on the TVFs towards the center of the larynx. Intra-glottal pressures can affect both vocal-fold vibration and voice ...

Since voice production is the precondition for speech and, therefore, verbal communication, people suffering from voice disorders are limited in their everyday life. Physiological voice disorders, like vocal fold nodules are understood to result from increased contact pressure of the vocal folds during vibration. Thus, measurement of arising contact pressure ...

The acoustic effects of the supraglottic laryngeal structures (SGSs), including the false vocal folds (FVFs) laryngeal ventricle, and the epiglottis were investigated in an excised canine larynx model with and without these anatomical structures. The purpose of this study was to better understand the acoustic contributions of these structures to ...

Mechanical stresses on the vocal folds surface during high pitch or amplitude phonation have been postulated to cause vocal fold damage. Models for the quantitative estimate of the contact pressure may be valuable for prevention and treatment. The objective of this study was to non-invasively estimate the contact pressure for ...

Background: Recent data from a population-based study in children and adolescents suggests that serum thyroid-stimulating hormone levels (TSH) are associated with arterial blood pressure and hypertension. These results are in agreement with some, but not all population-based studies in adults. Discrepancies in results might be explained by drug intake, different ...

BACKGROUND: Postoperative sore throat (POST) is a common complaint after general anesthesia, especially following thyroidectomy. MATERIALS AND METHODS: We examined the effect of adjusting the endotracheal tube cuff pressure during thyroidectomy on the incidence of airway complications. Ninety patients scheduled for elective thyroidectomy were randomized into two groups: control (group ...

We studied the influence of demographic characteristics, comorbidity, and type and duration of surgery and anesthesia on the occurrence of intraoperative hypertension (IOHTA). Logistic regression analyses were used in order to determine the predictors of occurrence of IOHTA. More than 60% of our patients had IOHTA. Multivariate analysis showed that ...

The unique role of pressure in protein folding studies is emphasized. The variable-pressure NMR experiments carried out under equilibrium conditions gives unique opportunities to explore the energy landscape for protein folding. Intermediate conformers that may appear transiently in the kinetic folding experiments may be stably trapped under pressure, allowing examination ...

Thyroid hormone exerts broad effects on the adult heart, however little is known regarding the role of thyroid hormone on regulating cardiac growth early in development and in response to pathophysiological conditions. To address this issue, we determined the effects of fetal thyroidectomy on cardiac growth and growth related gene ...

BACKGROUND: Increased intraocular pressure (IOP) during surgery can result in serious ophthalmic complications. We hypothesized that carbon dioxide (CO(2)) insufflation of the neck during endoscopic thyroidectomy would constrict the jugular veins mechanically, causing elevated venous pressure and thus elevated IOP. We compared IOP changes at each step of open thyroidectomy ...

A major assumption of previously published PIV measurements in excised larynges, is that the vortices seen directly above the glottal exit during closing are due to the flow separation vortices (FSV) that formed in the glottis. This assumption needed experimental validation. In addition, the pressures associated with the vortices above ...

We investigated whether genetic variations of the beta-2 adrenergic receptor (ADRB2) modulate the haemodynamic response following spinal anaesthesia for caesarean delivery. We focused on the effects of haplotypes formed by combinations of the Arg16Gly and Gln27Glu polymorphisms. Clinical data from 143 healthy parturients were collected. Only the ArgGln haplotype appeared ...

Objective  To assess oxygenation, ventilation-perfusion (V/Q) matching and plasma endothelin (ET-1) concentrations in healthy horses recovering from isoflurane anaesthesia administered with or without pulse-delivered inhaled nitric oxide (iNO). Study Design  Prospective experimental trial. Animals  Healthy adult Standardbred horses. Methods  Horses were anaesthetized with isoflurane in oxygen and placed in lateral ...

BACKGROUND: While surveys about anaesthesia practice appear regularly in the anaesthesia literature, they are usually bound to one country. We compared the approach to specific airway management issues among anaesthesiologists from three different European countries. METHODS A questionnaire was distributed during the main session of three anaesthesia meetings in Austria(A), ...

BACKGROUND: Hypotension and nausea occur frequently during spinal anaesthesia for caesarean section. The aim of this evaluation was to assess systolic arterial pressure control with our routine prophylactic intravenous phenylephrine infusion regimen. We audited a local standard for an incidence of hypotension of ⩽25% during the first 15min of anaesthesia. ...

Objective  To compare isoflurane and sevoflurane in lambs undergoing prolonged anaesthesia for spinal surgery. Study design  Prospective randomised clinical study. Animals  Eighteen Scottish blackface lambs 3-6 weeks of age and weighing 10-17 kg. Methods  After intramuscular medetomidine, anaesthesia was induced and maintained with either isoflurane (group I) or sevoflurane (group S) ...

A treatment challenge for patients with sacral pressure ulcers is balancing the need for adequate surgical debridement with appropriate anaesthesia management. We are functioning under the hypothesis that regional anaesthesia has advantages over general anaesthesia. We describe our regional anaesthesia protocol for perioperative and postoperative management.

We compared the ability of automated non-invasive intermittent oscillometric blood pressure monitoring with a new device, CNAP(TM) (continuous non-invasive arterial pressure) to provide a new blood pressure reading in each 1-min interval between spinal anaesthesia and delivery during caesarean section. We also compared the accuracy of continuous non-invasive arterial pressure ...

Lowering blood pressure by pharmacologic intervention reduces the incidence of cardiovascular events. Nevertheless, despite the widespread availability of effective antihypertensive medications, the vast majority of hypertensive patients worldwide continue to have inadequate blood pressure control. The development of new antihypertensive drugs could contribute to improving the hypertension control rate, and ...

Medical management of cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH) includes hypertensive, hypervolemic, and hemodilution ("triple-H") therapy. However, there is little information regarding the indications and guidance used to initiate and adjust triple-H therapy. A 43-item questionnaire was e-mailed to 375 members of the Neurocritical Care Society. Questions were designed ...

Serotonin (5-hydroxytryptamine [5-HT]) was named for its isolation from blood serum (sero-) and ability to contract smooth muscle (-tonin). Thus, its relationship with the cardiovascular system began with its discovery. This review will focus on the effects of 5-HT and its receptors in the vasculature, with a focus on their ...

Choking under pressure in sport has been explained by either explicit attention to skill execution (self-focus theories), or attention to performance worries (distraction theories). The aim of the present study was to find out which focus of attention occurs most often when expert athletes perform under pressure. Two retrospective methods ...

Following the recent Ongoing Telmistartan Alone and in Combination With Ramipril Global Endpoint Trial (ONTARGET) finding of adverse renal outcomes, dual renin-angiotensin blockade has fallen out of favour, despite antihypertensive and antiproteinuric efficacy. However, in high-risk severe hypertension, not studied in ONTARGET, whether combination treatment should be withheld or withdrawn ...

Methods DATA SOURCES: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and references in review articles were searched. The authors also attempted to identify the grey literature by contacting trialists. STUDY SELECTION: Randomized controlled trials that enrolled patients with hypertensive emergencies in which a selected antihypertensive agent was compared with ...

It is still debated whether there are differences among the various antihypertensive strategies in heart failure prevention. We performed a network meta-analysis of recent trials in hypertension aimed at investigating this issue. Randomized, controlled trials published from 1997 through 2009 in peer-reviewed journals indexed in the PubMed and EMBASE databases ...

Aliskiren is a novel antihypertensive agent and the first direct renin inhibitor (DRI) in clinical use. Several clinical trials have compared DRI with angiotensin receptor blockers (ARBs) in the management of essential hypertension. However, systematic comparison of efficacy and safety between DRIs and ARBs is still lacking. We reviewed randomized ...

The rate of control of hypertension remains suboptimal despite widespread educational programs and an increasing number of novel medications. The combination of drugs with different mechanisms of action has become an alternative to improve blood pressure reduction and control, enhance adherence to the treatment and reduce adverse events. Telmisartan and ...

Hypertension is a major independent risk factor for kidney disease and for faster renal function loss. Choice of antihypertensive strategies with highest nephroprotective effect is crucial to prevent or reverse progression to end stage renal disease (ESRD). The present review focuses on the role of hypertension in the progression of ...

Resistant hypertension is defined as blood pressure uncontrolled to guideline levels despite the use of ≥3 antihypertensive medications. When evaluating patients with resistant hypertension, it is important to consider issues such as blood pressure measurement technique, lifestyle, other comorbid conditions and medications, and the white coat effect. To this point, ...

Hypertension and prehypertension are major public health challenges. Prevention and control of prehypertension through lifestyle changes and the treatment of hypertension to goal blood pressure (BP) are important objectives. In most patients, 2 or more medications with complementary mechanisms of action should be used in combination. Referral for evaluation of ...

In 2009 the European Society of Hypertension (ESH) has developed a document updating the recommendations for the diagnosis and treatment of hypertension issued in 2007. The main elements of novelty refer to the assessment of organ damage, the blood pressure thresholds for treatment initiation as well as the blood pressure ...

Central arterial systolic blood pressure is a very important factor in the pathophysiology of cardiovascular diseases. Central arterial pressure is a better predictor of cardiovascular risk than peripheral brachial blood pressure. Measurement of central blood pressure is useful for a diagnosis of spurious systolic hypertension in young people. Antihypertensive drugs ...

The aim of this issue of Expert Opinion on Pharmacotherapy is to present the most important and controversial problems in hypertension and nephrology. To this end, the most important points of the current (2009) recommendations of the European Society of Hypertension (ESH) are discussed, including aspects related to the treatment ...

Hypertension, the leading cause of mortality and the third largest cause of disability, is poorly controlled worldwide. The failure to control hypertension takes an unacceptable toll on patients and their families. In addition to the personal cost, to the individual patient, uncontrolled hypertension creates huge, avoidable economic burdens when viewed ...

OPINION STATEMENT: Hypertensive intracerebral hemorrhage remains an entity in search of definitive treatment. It requires management in a specialized unit, where hypertension, hyperglycemia, seizures, and elevated intracranial pressure can be expertly managed. However, the exact target range of hypertensive therapy is uncertain. Extraventricular drainage and surgery for cerebellar hemorrhage can ...

Resistant hypertension, namely the hypertensive state characterized by the inability of multiple antihypertensive drug interventions to lower blood pressure to goal levels, represents a condition frequently detected in clinical practice. Its main features are represented by its heterogeneous etiology as well as its very high cardiovascular risk. This latter peculiarity ...

Despite extensive clinical research, still there is some uncertainty regarding management of hypertension, in particular initial and goal blood pressure levels and selection of optimal pharmacotherapy, as well as concomitant medications, to reduce other risk factors. An overview of recent findings from major clinical trials in hypertension (until July 2010), ...

A significant proportion of patients with hypertension will need three or more antihypertensive agents to achieve blood pressure goals, particularly those at higher risk. On the other hand, fixed combinations provide an extra beneficial effect, as they improve medication adherence and, secondarily, the attainment of blood pressure goals during follow-up. ...

Spontaneous intracerebral hemorrhage (sICH) is defined as bleeding within the brain parenchyma, and occurs twice as commonly as subarachnoid hemorrhage, but is equally as deadly. Risk factors for sICH include hypertension, advanced age, leukoaraiosis, prior ICH, renal failure, use of anticoagulant drugs, and cerebral amyloid angiopathy. When a patient is ...

Malignant hypertension (MHT) is the most severe form of hypertension which is clinically defined as the presence of high blood pressure in association with bilateral retinal haemorrhages and/or exudates, with or without papilloedema. The aim of this review article is to discuss whether MHT is a problem which is truly ...

Hypertension is a very common modifiable risk factor for cardiovascular morbidity and mortality. Patients with hypertension represent a diverse group. In addition to those with primary hypertension, there are patients whose hypertension is attributable to secondary causes, those with resistant hypertension, and patients who present with a hypertensive crisis. Secondary ...

The combined use of angiotensin converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) poses a dilemma to clinicians. On the one hand, indirect evidence from compelling, but still surrogate outcome measures such as blood pressure and proteinuria suggest some merits of this combination. On the other hand, the outcome ...

To review the pharmacology, pharmacokinetics, pharmacodynamics, efficacy data, and adverse effects of spironolactone in the treatment of resistant hypertension. A literature search was conducted using MEDLINE (1966-July 2010), International Pharmaceutical Abstracts (1970-July 2010), and Cochrane database (2009) for the key words spironolactone or resistant hypertension. References cited in the articles ...

Low-dose antihypertensive drugs in combination are prescribed frequently in clinical practice. Combination treatment is superior to monotherapy with higher doses of each drug in terms of blood pressure reduction and side effects. However, it is unclear whether combination treatment provides additional prognostic benefit beyond the blood pressure lowering effects. We ...

Chronic kidney disease is a major public health problem worldwide: it is estimated that in the general population, 1 person in 10 has some degree of renal damage. Adequate blood pressure control represents the mainstay of treatment, to delay deterioration of renal function and prevent cardiovascular complications. Current evidence supports ...

Improvements in the diagnosis and treatment of hypertension have been documented in Canada following implementation of a national program to improve hypertension management. To determine whether there are regional variations in not treating diagnosed hypertension with drugs in Canada. Using data from the Canadian Community Health Survey (CCHS) cycle 3.1 ...

Hypertension is a major public health problem and a key risk factor of cardiovascular diseases. Increased physical activity has been recommended as an important lifestyle modification for the prevention and control of hypertension. However the optimal characteristics for a physical activity programme remain open to debate. Walking is recommended by ...

Despite the known health risks of hypertension, many hypertensive patients still have uncontrolled blood pressure. Clinical inertia, the tendency of physicians not to intensify treatment, is a common barrier in controlling chronic diseases. This trial is aimed at determining the impact of activating patients to ask providers to make changes ...

Medication nonadherence is common and results in preventable disease complications. This study assessed the effectiveness of a multifactorial intervention to improve both medication adherence and blood pressure control and to reduce cardiovascular events. In this multicenter, cluster-randomized trial, physicians from hospital-based hypertension clinics and primary care centers across Spain were ...