Patients with CRF have higher frequency of aspirin resistance. This might further increase the risk of cardiovascular morbidity and mortality in these patients.
Abstract-Hypertensive crises require immediate therapy, usually by parenteral drug administration.Sublingual nifedipine has been shown to be highly effective. However, the blood pressure fall following nifedipine is frequently associated with side effects.The use of sublingual captopril has recently been indicated in hyper tensive crisis, assuming that by this route, there would be a faster absorption and thus a more rapid effect on blood pressure than with the oral route. To verify this hypothesis, we have compared the hypotensive effects of sublingual nifedipine and sublingual captopril in 52 patients with hypertensive emergencies:25-mg captopril and 1 0-mg nifedipine were administered sublingually to 28 and 24 patients, respec tively. Blood pressures and heart rates were continuously measured up to 240 min postdose.A significant (P<0.001) hypotensive effect of both sublingual captopril and nifedipine therapy occured at 5 min and persisted for 240 min. Heart rates increased with nifedipine, but decreased with captopril.
J Clin Hypertens (Greenwich). 2010;12:714–720. ©2010 Wiley Periodicals, Inc. Aspirin resistance is associated with poor clinical prognosis. The authors investigated aspirin resistance in 200 hypertensive patients (111 men, age: 68.3±11.4 years) by the Ultegra Rapid Platelet Function Assay‐ASA (Accumetrics Inc., San Diego, CA). Aspirin resistance was defined as an aspirin reaction unit ≥550. Aspirin resistance was detected in 42 patients. Aspirin resistance was present in 25.6% of the patients with poor blood pressure control, while in 17.8% of the patients with controlled blood pressure (P=.182). Female gender and creatinine levels were significantly higher (P=.028 and P=.030, respectively), while platelet count was significantly lower (P=.007) in aspirin‐resistant patients. Multivariate analysis revealed that female gender (odds ratio [OR], 2.445; P=.045), creatinine levels (OR, 1.297; P=.015) and platelet count (OR, 0.993; P=.005) were independent predictors of aspirin resistance. The frequency of aspirin resistance is not low in hypertensive patients. Female hypertensive patients, especially, with higher creatinine levels and lower platelet count are at higher risk for aspirin resistance.
These preliminary data indicate that end-diastolic images can significantly reduce artifactual defects in patients with LBBB. The resolution of an LBBB pattern on end-diastolic data would significantly improve the diagnostic role of myocardial perfusion studies in these patients.
SUMMARYA patient was found to have a mobile catheter fragment in the right atrium incidentally during echocardiography. On further investigation, it was learned that the catheter had been inserted 9 years earlier during surgery and had probably been broken during removal. The patient did not experience any symptoms during this period. The catheter was removed percutaneously without any complications using a system similar to the loopsnare catheter. (Jpn Heart J 34: 117-119, 1993.) Key Words: Percutaneous extraction Catheter fragment ANY patients receive intravascular catheters, and infrequently, complications due to their use are seen in clinical practice. Catheter breakage is one of the complications seen, and may be associated with serious consequences in 71% of these patients.4)Since the removal of the catheter usually requires major surgery, there have been attempts to remove intravascular catheters by alternative methods. The first case of nonsurgical removal of an intravascular catheter was described in 1984, and since then, several different techniques have emerged and have been utilized safely.1),6) CASE REPORT A 52-year-old man underwent subtotal gastrectomy, gastrojejunostomy and partial omentectomy for gastric lymphoma in 1982. He received chemotherapy and radiotherapy after the operation. An intravascular catheter was placed durFrom the
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