Eating raw or insufficiently cooked bivalve molluscs contaminated with human noroviruses (NoV) can result in acute cases of gastroenteritis in humans. Manila clams (Ruditapes philippinarum) are particularly prone to exposure to NoVs due to the brackish environment in which they are farmed which is known to be susceptible to human ...

Despite decades of research into the mechanisms of lung inflation and deflation, there is little consensus about whether lung inflation occurs due to the recruitment of new alveoli or by changes in the size and/or shape of alveoli and alveolar ducts. In this study we use in vivo (3)He lung ...

Aim  Quantification of the anorectal reflex function is critical for explaining the physiological control of continence. Reflex external anal sphincter activity increases with rectal distension in a dynamic response. We hypothesized that rectal distension would similarly augment voluntary external anal sphincter function, quantified by measuring the anal maximum squeeze pressure. ...

To determine the phonation threshold pressure (PTP) and phonation threshold flow (PTF) in excised human larynges; determine the effects of posterior glottal width, glottal area, and gender on PTP and PTF; test the hypothesis that hysteresis is present in excised human laryngeal phonation; and compare these results to those from ...

We have developed two fundamental components to manufacture a prosthetic skin: a stretchable pressure sensor formed of piezoelectric elastomer/ferroelectret multilayer sandwiched between stretchable electrodes and stretchable thin-film transistors. The components are prepared and embedded in silicone rubber, a polymer, which mimics the mechanical compliance of human skin. We demonstrate the ...

Hypertension is rare in the young, but its prevalence increases with age. Exercise contributes to the prevention of hypertension in normotensive subjects and to the control of blood pressure in hypertensive patients. The overall cardiovascular risk of the hypertensive patient does depend not only on blood pressure but also on ...

A sharp rise in intracranial pressure (ICP) was noted in a 6-year-old girl with Fontan circulation after surgical removal of a hematoma associated with intracranial hemorrhage. Inhalation of nitric oxide resulted in reduction of central venous pressure (CVP) and precipitous fall in ICP, which was otherwise resistant to conventional therapy. ...

Hypertension is a significant risk factor for cardiovascular morbidity and mortality in people older than 60 years. Isolated systolic hypertension and widened pulse pressure appear to be more important than diastolic hypertension. Very low blood pressure and orthostatic hypotension are associated with increased mortality, and should be checked for at every ...

BACKGROUND: Nasal high flow (NHF) oxygen therapy is associated with an increased mean nasopharyngeal airway pressure in adults. However, the relationship between flow and pressure is not well defined. This prospective study set out to describe the relationship between flow and pressure associated with NHF delivered by the Optiflow(tm) system ...

Antiangiogenic therapy has emerged as an important concept in the treatment of solid tumors. Vascular endothelial growth factor (VEGF) represents an important therapeutic target, as it is the primary mediator of angiogenesis and is induced by multiple tumor-relevant stimuli. Arterial hypertension has been commonly reported in all clinical trials testing ...

BACKGROUND: Intra-arterial (IA) nicardipine is often used to treat cerebral vasospasm associated with subarachnoid hemorrhage (SAH). While hypotension has been noted to be a dose-limiting side effect of intravenous infusions, this has seldom been reported for IA administration. METHODS: We reviewed a consecutive series of patients who received IA nicardipine ...

Abstract Background. Arterial hypertension is commonly associated with hyperuricemia. Several studies have shown that allopurinol reduces arterial blood pressure in animal models and in adolescent patients with newly diagnosed hypertension. Moreover, allopurinol has shown beneficial effects on endothelial function and arterial wave reflection in contrast to uricosuric agents. Antihypertensive drugs ...

Pulmonary arterial hypertension (PAH) is a progressive disease that results in elevation of the pulmonary artery pressure and ultimately development of right ventricular failure. Baseline and periodic invasive hemodynamics via right heart catheterization are generally obtained in order to characterize and follow the extent of hemodynamic derangement, response to therapy, ...

The prevalence of hypertension among all adolescents is approximately 3.5%, with somewhat higher rates of prehypertension. Obesity affects approximately 20% of adolescents in the United States, and the prevalence of hypertension is much higher among obese adolescents compared with nonobese adolescents. As in other populations, the evaluation of elevated blood ...

Aims To evaluate corneal hysteresis (CH) and intraocular pressure (IOP) before and after IOP lowering with prostaglandin analogue (PGA) therapy in medication-naïve eyes. Methods In this retrospective study, we included records from 57 consecutive patients with open angle glaucoma who were initiated on PGA. Patients underwent ocular response analyser measurement ...

Aims The long-term cardioprotective effect of angiotensin receptor blockers (ARBs) is associated with the short-term lowering of its primary target blood pressure, but also with the lowering of albuminuria. Since the individual blood pressure and albuminuria response to an ARB varies between and within an individual, we tested whether the ...

The absolute number of patients with uncontrolled hypertension is growing worldwide. Many factors may be involved, including physician inertia and patient nonadherence. In this context, we reviewed published studies related to the efficacy and efficiency of starting combination antihypertensive treatment versus mono-therapy. The overall evidence supports that initial combination therapy ...

Minority patients with hypertension generally require combination therapy to reach blood pressure (BP) goals. We examined the BP-lowering efficacy and safety of combination aliskiren/amlodipine therapy in self-identified minority patients in the United States with stage 2 hypertension and the impact of adding hydrochlorothiazide (HCTZ) to this combination. In this 8-week ...

Hypertension affects up to 5% of school-aged children and is defined by an average systolic or diastolic blood pressure greater than the 95th percentile for age, sex and height. In prepubertal children a secondary cause for hypertension including renal disease, coarctation of the aorta or endocrine disease should be excluded ...

Hypertension is a highly prevalent disorder in the United States. Of particular concern is resistant hypertension, which by definition is hypertension that cannot be adequately treated by conventional 3-drug regimens. The Rheos Baroreflex Hypertension Therapy System is a new implantable device that can treat patients with hypertension resistant to multidrug ...

Recent technical advances have renewed interest in device-based therapy for the treatment of drug-resistant hypertension. Findings from recent clinical trials regarding the efficacy of electric stimulation of the carotid sinus for the treatment of resistant hypertension are reviewed here. The main goal of this article, however, is to summarize the ...

INTRODUCTION: Research indicates that music can affect heart rate, blood pressure, and skin conductance. Music can stimulate central emotions in the brain and release biochemical materials that change the physiologic state. We sought to compare changes in the electrical function of the heart in response to music. METHOD: Subjects were ...

PURPOSE OF REVIEW: During acute-on-chronic liver failure (ACLF), the marked systemic inflammatory response and rapid deterioration in liver function are associated with a significant deterioration in organ perfusion and an appreciable rise in portal pressure. Indeed, the development of sepsis and multiorgan dysfunction that commonly follows presentation in these patients ...

The development of pulmonary arterial hypertension in the setting of portal hypertension is known as portopulmonary hypertension. Portal hypertension is thought to predispose patients to disturbances in the homeostatic regulation of numerous neurohumoral and vasoactive mediators that induce the development of pulmonary arterial hypertension. Portopulmonary hypertension is pathologically indistinguishable from ...

OBJECTIVE:: Blood pressure, urine albumin-to-creatinine ratio, and estimated glomerular filtration rate (GFR) are highly correlated conditions. The longitudinal effect of exposure to postmenopausal estrogen therapy on these traits studied together has not been reported. METHODS:: This was a cross-sectional study of 1,044 older postmenopausal community-dwelling women from the Rancho Bernardo ...

Diuretics are among the most commonly prescribed cardiovascular (CV) medications. The strength of evidence supporting the effectiveness of diuretics in lowering blood pressure and for preventing major adverse CV events in patients with hypertension varies considerably among diuretic classes and even among agents within the same class. Unfortunately, common prescribing ...

Treatment strategies to improve blood pressure control, reduce end-organ damage, and improve cardiovascular outcomes are more important today than ever before. Most patients will require combination therapy to achieve target blood pressure; early initiation of combination therapy may help patients achieve blood pressure control more rapidly. Low-dose combinations may be ...

A 63-year-old male with a history of cancer, and who had undergone a left pneumonectomy seven years before, presented with deterioration in his general status and recent dyspnea [stage III (New York Heart Association) NYHA]. Imaging revealed a contralateral mediastinal shift and cardiac compression caused by pneumonectomy cavity enlargement and ...

Chronically elevated plasma angiotensin II (AngII) causes a salt-sensitive form of hypertension that is associated with a differential pattern of peripheral sympathetic outflow. This "AngII-salt sympathetic signature" is characterized by a transient reduction in sympathetic nervous system activity (SNA) to the kidneys, no change in SNA to skeletal muscle, and ...

The goal of this study is to develop a focal zone sharpening strategy that produces more precise lesions for pulsed cavitational ultrasound therapy, or histotripsy. Precise and well-confined lesions were produced by locally suppressing cavitation in the periphery of the treatment focus without affecting cavitation in the center. The local ...

The first-line option for lowering intraocular pressure (IOP) is a single hypotensive agent, but patients frequently require additional IOP-lowering agents to reach their target pressures. Disadvantages of this multi-therapy approach include washout effect, inconvenience and poor adherence. Fixed combinations (FCs) combine two or more hypotensive agents in a single bottle, ...

Few would argue with the need for long-term follow-up after endovascular repair of abdominal aortic aneurysms. A small risk of reintervention persists and the challenge remains to identify those patients that will require additional procedures to prevent subsequent complications. The ideal follow-up regimen remains elusive. Up until this point, most ...

Obstructive sleep apnea syndrome (OSAS) is an independent and modifiable risk factor for cardiovascular diseases; however, the pathophysiological mechanisms underlying this association are not yet fully understood. Intermittent hypoxemia, one of the physiological markers of OSAS, is characterized by transient periods of oxygen desaturation followed by reoxygenation. The hypoxia-reoxygenation cycles ...

At least 16 treatment trials have been done in which patients were randomly assigned different blood pressure goals in an attempt to better define specific target pressures. We critically review the data.

Hypertensive emergencies, though uncommon in children, are potentially life threatening. While targeting blood pressure reduction to below the 90th percentile for age, gender and height, mean arterial blood pressure should be gradually lowered by one-fourth of the planned reduction over 8-12 h, a further fourth over the next 8-12 h, and the ...

Patients with stage 2 systolic hypertension require sizable blood pressure (BP) reductions to achieve recommended targets. This randomized double-blind study compared a single-pill combination of the direct renin inhibitor aliskiren and hydrochlorothiazide (aliskiren/HCTZ) with HCTZ monotherapy in older patients (older than 55 years) with systolic BP ≥160 mm Hg and <200 mm Hg. ...

The antihypertensive agents olmesartan medoxomil, amlodipine and hydrochlorothiazide (HCTZ) are now available as a fixed-dose combination tablet (olmesartan medoxomil/amlodipine/HCTZ). In a 12-week, randomized, double-blind, multicentre trial (TRINITY) in adults with moderate to severe hypertension, olmesartan medoxomil + amlodipine + HCTZ triple combination therapy produced significantly greater least squares mean reductions from baseline in seated ...

Acta Ophthalmol. 2011: 89: e57-e63 ABSTRACT.: Aims:  This prospective, multicenter, single-masked study evaluated the additive effect of dorzolamide hydrochloride 2% on the diurnal intraocular pressure (IOP) curve and retinal and retrobulbar hemodynamics in patients with primary open-angle glaucoma (POAG) treated with morning-dosed bimatoprost 0.03%. Methods:  Eighty-nine patients (aged, 60.7 ± 11.8 years, range ...

BACKGROUND: Topical negative pressure (TNP) therapy is increasingly used in open abdomen management. It is not known to what extent this pressure propagates through the dressing to the bowel surface, potentially increasing the risk of bowel fistula formation. The present study in a porcine model was designed to evaluate pressure ...

A 58-year-old woman with a past medical history significant for tobacco use presented with shortness of breath. Physical examination revealed a 30 mm Hg difference in upper-extremity blood pressures (right arm greater than left), elevated jugular venous pressure, and leg edema. A two-dimensional echocardiogram revealed an ejection fraction of 20%. ...

To assess the impact of 2 strategies for initiating therapy in ocular hypertension (OH) on drug use, intraocular pressure (IOP), and blindness caused by glaucoma. Using a simulation model, initiating therapy with timolol (strategy 1) and with latanoprost (strategy 2) was simulated for a hypothetic cohort of ocular hypertension patients ...

Hypertension in chronic renal disease and renovascular disease is often resistant to therapy. Understanding the pathogenic mechanisms responsible for hypertension in these conditions may lead to improved and more targeted therapeutic interventions. Several factors have been implicated in the pathogenesis of hypertension associated with renal disease and/or renal failure. Although ...

Our understanding of the complexities and inter-related pathways of the renin-angiotensin-aldosterone system continues to evolve. Which drugs to use, when, and how, are everyday questions faced by clinicians in the ambulatory setting. Combining these classes, for the purpose of enhancing renin-angiotensin-aldosterone system blockade and incremental blood pressure, nephroprotective, and cardioprotective ...

Despite a broad and efficient pharmacological antihypertensive armamentarium, blood pressure (BP) control is suboptimal and heterogeneous throughout Europe. Recent representative data from Switzerland are limited. The goal of the present survey was therefore to assess the actual control rate of high BP in Switzerland in accordance with current guidelines. The ...

Resistant hypertension is a failure to achieve goal BP (<140/90 mm Hg for the overall population and <130/80 mm Hg for those with diabetes mellitus or chronic kidney disease) in a patient who adheres to maximum tolerated doses of 3 antihypertensive drugs including a diuretic. The kidneys play a critical role in long-term regulation ...

Patients with obstructive sleep apnea (OSA) often have hypertension that is difficult to control. We review the causes of OSA hypertension and evidence supporting specific therapies. Sleep apnea commonly accompanies the metabolic syndrome and renal insuffiency. Apneas stimulate atrial natriuretic peptide release and sympathetic nerve activity, which persists throughout the ...

Portal hypertension (PH) is a severe complication of liver cirrhosis. Measurement of the degree of portal hypertension is usually performed by measuring the hepatic venous pressure gradient (HVPG) which is the difference between the free hepatic venous pressure (FHVP) and the wedged hepatic venous pressure (WHPG). The HVPG accurately reflects ...

The purpose of this report is to review available and emerging antihypertensive treatment options in light of current guidelines and evidence from large clinical trials. The published literature was reviewed for evidence regarding first-line options for antihypertensive agents, including thiazide-type diuretics, as monotherapy or as part of combination therapy. Current ...

AIMS: To investigate whether genetic variation in the renin-angiotensin-aldosterone system (RAAS) and kallikrein-bradykinin pathways is related to hypertension and blood pressure (BP) response to angiotensin-converting enzyme (ACE) inhibitor therapy in stable coronary artery disease (CAD) patients. METHODS AND RESULTS: In 8907 stable CAD patients from the EUROPA trial, 52 haplotype-tagging ...

OBJECTIVES: We hypothesised that sildenafil would improve hemodynamics in children with pulmonary hypertension and attenuate rebound pulmonary hypertension after inhaled nitric oxide withdrawal.Patients and methodsWe undertook an open-label, single-drug study of sildenafil in patients under 5 years of age with either symptomatic or rebound pulmonary hypertension following inhaled nitric oxide ...