The American journal of medicine
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Multicenter Study
Systolic blood pressure reduction and risk of acute renal injury in patients with intracerebral hemorrhage.
Aggressive systolic blood pressure reduction may precipitate acute renal injury because of underlying hypertensive nephropathy in patients with intracerebral hemorrhage. The study's objective was to determine the rate and determinants of acute renal injury during acute hospitalization among subjects with intracerebral hemorrhage using a post hoc analysis of a multicenter prospective study. ⋯ Although acute renal injury is infrequent and mild among subjects with intracerebral hemorrhage undergoing systolic blood pressure reduction, a trend in association between systolic blood pressure reduction and renal impairment was observed in this small study. Therefore, it is important to carefully monitor the renal function when administering treatment to reduce systolic blood pressure in patients with intracerebral hemorrhage.
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We hypothesized that women with early- and mid-adult life obesity, as well as high mid-adult life waist-to-hip ratios, and high weight gain during adulthood, experience a greater incidence of gout. ⋯ In a large cohort of black and white women, obesity in early- and mid-adulthood, and weight gain during this interval, were each independent risk factors for incident gout in women.
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There has been a worldwide resurgence of bedbug infestations. Bites by these insects may cause mild or severe cutaneous reactions, and anaphylaxis has been reported. Little is known about the most severe cutaneous reactions, termed bullous or complex reactions. ⋯ Historically, bedbug bite reactions have been considered to be of minor medical significance. However, the findings presented here demonstrate that the not-uncommon bullous reactions to bedbug bites reflect the presence of a local, highly destructive, cutaneous vasculitis. The histologic features of these reactions resemble those occurring in the Churg-Strauss syndrome. Therefore, efforts to prevent further bites and monitor for evidence of systemic vasculitis should be made in patients with bullous reactions to bedbug bites. Topical treatment with high potency corticosteroids may be useful in the treatment of bullous reactions.
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The objective of this study was to estimate the latest prevalence of major comorbidities associated with gout and hyperuricemia in the US based on a recent, nationally representative sample of US men and women. ⋯ These findings from the latest nationally representative data highlight remarkable prevalences and population estimates of comorbidities of gout and hyperuricemia in the US. Appropriate preventive and management measures of these comorbidities should be implemented in gout management, with a preference to strategies that can improve gout and comorbidities together.
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The task of improving patient and caregiver satisfaction in the management of myelodysplastic syndromes (MDS) poses many challenges for physicians and patient care teams. Advances in the understanding of MDS biology have resulted in the approval of 3 agents for the treatment of MDS by the US Food and Drug Administration (FDA) in the past decade. ⋯ Interestingly, a survey performed in patients with MDS suggests that patient understanding of treatment goals and prognosis is often limited, with a third of patients reporting that prognosis was not discussed with their physician. Efforts to improve patient awareness of their disease severity and establishing clear treatment goals are crucial for setting up an individualized treatment plan and ensuring optimal patient and caregiver satisfaction.