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The Journal of Pharmacology and... Jun 2024
Topics: Humans; Hypertrophy, Left Ventricular; Blood Pressure; Antihypertensive Agents; Hypertension
PubMed: 38906565
DOI: 10.1124/jpet.123.002093 -
The Medical Letter on Drugs and... Jun 2024
Topics: Humans; Hypertension; Antihypertensive Agents; Drug Interactions
PubMed: 38905532
DOI: 10.58347/tml.2024.1704b -
The Medical Letter on Drugs and... Jun 2024
Topics: Humans; Mydriasis; Phentolamine; Ophthalmic Solutions; Mydriatics; Administration, Ophthalmic
PubMed: 38905525
DOI: 10.58347/tml.2024.1705c -
Indian Journal of Ophthalmology Jul 2024
Comparative Study
Topics: Humans; Intravitreal Injections; Administration, Oral; Rifampin; Central Serous Chorioretinopathy; Vascular Endothelial Growth Factor A; Propranolol; Angiogenesis Inhibitors; Adrenergic beta-Antagonists
PubMed: 38905466
DOI: 10.4103/IJO.IJO_2774_23 -
Molecular Biology Reports Jun 2024Acute leukemias (ALs) are the most common cancers in pediatric population. There are two types of ALs: acute lymphoblastic leukemia (ALL) and acute myeloid leukemia... (Review)
Review
Acute leukemias (ALs) are the most common cancers in pediatric population. There are two types of ALs: acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Some studies suggest that the Renin Angiotensin System (RAS) has a role in ALs. RAS signaling modulates, directly and indirectly, cellular activity in different cancers, affecting tumor cells and angiogenesis. Our review aimed to summarize the role of RAS in ALs and to explore future perspectives for the treatment of these hematological malignancies by modulating RAS molecules. The database including Pubmed, Scopus, Cochrane Library, and Scielo were searched to find articles about RAS molecules in ALL and in pediatric patients. The search terms were "RAS", "Acute Leukemia", "ALL", "Angiotensin-(1-7)", "Pediatric", "Cancer", "Angiotensin II", "AML". In the bone marrow, RAS has been found to play a key role in blood cell formation, affecting several processes including apoptosis, cell proliferation, mobilization, intracellular signaling, angiogenesis, fibrosis, and inflammation. Local tissue RAS modulates tumor growth and metastasis through autocrine and paracrine actions. RAS mainly acts via two molecules, Angiotensin II (Ang II) and Angiotensin (1-7) [Ang-(1-7)]. While Ang II promotes tumor cell growth and stimulates angiogenesis, Ang-(1-7) inhibits the proliferation of neoplastic cells and the angiogenesis, suggesting a potential therapeutic role of this molecule in ALL. The interaction between ALs and RAS reveals a complex network of molecules that can affect the hematopoiesis and the development of hematological cancers. Understanding these interactions could pave the way for innovative therapeutic approaches targeting RAS components.
Topics: Humans; Renin-Angiotensin System; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Angiotensin II; Leukemia, Myeloid, Acute; Signal Transduction; Angiotensin I; Neovascularization, Pathologic; Animals; Peptide Fragments
PubMed: 38904729
DOI: 10.1007/s11033-024-09659-3 -
Translational Vision Science &... Jun 2024To develop machine learning (ML) and deep learning (DL) models to predict glaucoma surgical outcomes, including postoperative intraocular pressure, use of ocular...
PURPOSE
To develop machine learning (ML) and deep learning (DL) models to predict glaucoma surgical outcomes, including postoperative intraocular pressure, use of ocular antihypertensive medications, and need for repeat surgery.
METHODS
We identified glaucoma surgeries performed at Stanford from 2013-2024, with two or more postoperative visits with intraocular pressure (IOP) measurement. Patient features were identified from the electronic health record (EHR), including demographics, prior diagnosis and procedure codes, medications and eye exam findings. Classical ML and DL models were developed to predict which glaucoma surgeries would result in surgical failure, defined as (1) IOP not reduced by more than 20% of preoperative baseline on two consecutive postoperative visits, (2) increased classes of glaucoma medications, and (3) need for additional glaucoma surgery or revision of original surgery.
RESULTS
A total of 2398 glaucoma surgeries of 1571 patients were included, of which 1677 surgeries met failure criteria. Random forest performed best for prediction of overall surgical failure, with accuracy of 75.5% and area under the receiver operator curve (AUROC) of 76.7%, similar to the deep learning model (accuracy 75.5%, AUROC 76.6%). Across all models, prediction performance was better for IOP outcomes (AUROC 86%) than need for an additional surgery (AUROC 76%) or need for additional glaucoma medication (AUC 70%).
CONCLUSIONS
ML and DL algorithms can predict glaucoma surgery outcomes using structured data inputs from EHRs.
TRANSLATIONAL RELEVANCE
Models that predict outcomes of glaucoma surgery may one day provide the basis for clinical decision support tools supporting surgeons in personalizing glaucoma treatment plans.
Topics: Humans; Glaucoma; Electronic Health Records; Female; Male; Intraocular Pressure; Machine Learning; Aged; Middle Aged; Neural Networks, Computer; Deep Learning; ROC Curve; Antihypertensive Agents; Treatment Outcome; Retrospective Studies
PubMed: 38904612
DOI: 10.1167/tvst.13.6.15 -
Ugeskrift For Laeger Jun 2024Ongoing monitoring and targeted treatment are important to ensure the best blood-pressure control and thus prevent cardiovascular risks. In this review, we evaluate the... (Review)
Review
Ongoing monitoring and targeted treatment are important to ensure the best blood-pressure control and thus prevent cardiovascular risks. In this review, we evaluate the findings of four clinical studies investigating the effects of morning versus bedtime dosing of antihypertensives. In three out of four studies, overwhelming results were found favouring bedtime dosing. The same studies have been criticized for mechanistic implausible results and multiple study biases. No harmful effects were reported in relation to bedtime dosing. Thus, antihypertensives can be taken as it is most convenient for the patient.
Topics: Humans; Antihypertensive Agents; Hypertension; Drug Administration Schedule; Drug Chronotherapy; Blood Pressure
PubMed: 38903038
DOI: 10.61409/V11230700 -
BMC Medicine Jun 2024The 2018/2023 ESC/ESH Guidelines underlined a gap how baseline cardiovascular disease (CVD) risk predicted blood pressure (BP) lowering benefits. Further, 2017 ACC/AHA...
BACKGROUND
The 2018/2023 ESC/ESH Guidelines underlined a gap how baseline cardiovascular disease (CVD) risk predicted blood pressure (BP) lowering benefits. Further, 2017 ACC/AHA Guideline and 2021 WHO Guideline recommended implementation studies about intensive BP control. Now, to bridge these guideline gaps, we conducted a post hoc analysis to validate whether the baseline CVD risk influences the effectiveness of the intensive BP control strategy, which was designed by China Rural Hypertension Control Project (CRHCP).
METHODS
This is a post hoc analysis of CRHCP, among which participants were enrolled except those having CVD history, over 80 years old, or missing data. Subjects were stratified into quartiles by baseline estimated CVD risk and then grouped into intervention and usual care group according to original assignment in CRHCP. Participants in the intervention group received an integrated, multi-faceted treatment strategy, executed by trained non-physician community health-care providers, aiming to achieve a BP target of < 130/80 mmHg. Cox proportional-hazards models were used to estimate the hazard ratios of outcomes for intervention in each quartile, while interaction effect between intervention and estimated CVD risk quartiles was additionally assessed. The primary outcome comprised myocardial infarction, stroke, hospitalization for heart failure, or CVD deaths.
RESULTS
Significant lower rates of primary outcomes for intervention group compared with usual care for each estimated CVD risk quartile were reported. The hazard ratios (95% confidence interval) in the four quartiles (from Q1 to Q4) were 0.59 (0.40, 0.87), 0.54 (0.40, 0.72), 0.72 (0.57, 0.91) and 0.65 (0.53, 0.80), respectively (all Ps < 0.01). There's no significant difference of hazard ratios by intervention across risk quartiles (P for interaction = 0.370). Only the relative risk of hypotension, not symptomatic hypotension, was elevated in the intervention group among upper three quartiles.
CONCLUSIONS
Intensive BP lowering strategy designed by CRHCP group was effective and safe in preventing cardiovascular events independent of baseline CVD risk.
TRIAL REGISTRATION
The trial is registered with ClinicalTrials.gov, NCT03527719.
Topics: Humans; Male; Female; China; Hypertension; Middle Aged; Aged; Cardiovascular Diseases; Blood Pressure; Rural Population; Antihypertensive Agents; Treatment Outcome; Heart Disease Risk Factors
PubMed: 38902731
DOI: 10.1186/s12916-024-03494-w -
The British Journal of General Practice... Jun 2024Hypertensive disorders of pregnancy (HDP) affect approximately 10-15% of pregnancies and pre-eclampsia affects 3-5% of pregnancies. Women with previous pre-eclampsia or... (Review)
Review
What interventions are effective in reducing development of hypertension and other cardiovascular complications in women who have had hypertensive disorders of pregnancy? A systematic review.
BACKGROUND
Hypertensive disorders of pregnancy (HDP) affect approximately 10-15% of pregnancies and pre-eclampsia affects 3-5% of pregnancies. Women with previous pre-eclampsia or HDP are at increased risk of hypertension (2 to 5 times) and major cardiovascular disease (1.5 to 3 times). There is little guidance on how to reduce this risk.
AIM
To establish if there are interventions in women with previous HDP or pre-eclampsia that reduce the risk of developing adverse cardiovascular outcomes.
METHOD
A protocol was submitted to PROSPERO; inclusion and exclusion criteria were determined and a search strategy implemented. Primary outcomes were: development of hypertension or change in blood pressure and development of other cardiovascular complications. Records and full texts were screened independently by two reviewers. The Cochrane Risk of Bias tool was used for quality assessment.
RESULTS
3593 articles were screened. Nine articles were included. There were seven randomised-controlled trials and two quasi-experimental studies. One study trialled antihypertensive use, two studies looked at blood pressure monitoring and six studies focused on lifestyle interventions. Three trials reported significant reductions in diastolic blood pressure in the experimental group. No studies looked at the optimal time of intervention or the impact of interventions on the development of other long-term cardiovascular complications. Five studies reported participant feedback. The majority of studies were of low quality.
CONCLUSION
Further research needs to explore potential interventions and optimal timing of interventions to reduce cardiovascular risk. Women also need to be consulted about their preferences for discussions about cardiovascular risk and potential interventions.
Topics: Humans; Female; Pregnancy; Hypertension, Pregnancy-Induced; Antihypertensive Agents; Cardiovascular Diseases; Pre-Eclampsia; Hypertension; Blood Pressure
PubMed: 38902046
DOI: 10.3399/bjgp24X738069 -
Journal of Neuroimmune Pharmacology :... Jun 2024Traumatic brain injury (TBI) is a leading cause of mortality and morbidity amongst trauma patients. Its treatment is focused on minimizing progression to secondary... (Review)
Review
Traumatic brain injury (TBI) is a leading cause of mortality and morbidity amongst trauma patients. Its treatment is focused on minimizing progression to secondary injury. Administration of propranolol for TBI maydecrease mortality and improve functional outcomes. However, it is our sense that its use has not been universally adopted due to low certainty evidence. The literature was reviewed to explore the mechanism of propranolol as a therapeutic intervention in TBI to guide future clinical investigations. Medline, Embase, and Scopus were searched for studies that investigated the effect of propranolol on TBI in animal models from inception until June 6, 2023. All routes of administration for propranolol were included and the following outcomes were evaluated: cognitive functions, physiological and immunological responses. Screening and data extraction were done independently and in duplicate. The risk of bias for each individual study was assessed using the SYCLE's risk of bias tool for animal studies. Three hundred twenty-three citations were identified and 14 studies met our eligibility criteria. The data suggests that propranolol may improve post-TBI cognitive and motor function by increasing cerebral perfusion, reducing neural injury, cell death, leukocyte mobilization and p-tau accumulation in animal models. Propranolol may also attenuate TBI-induced immunodeficiency and provide cardioprotective effects by mitigating damage to the myocardium caused by oxidative stress. This systematic review demonstrates that propranolol may be therapeutic in TBI by improving cognitive and motor function while regulating T lymphocyte response and levels of myocardial reactive oxygen species. Oral or intravenous injection of propranolol following TBI is associated with improved cerebral perfusion, reduced neuroinflammation, reduced immunodeficiency, and cardio-neuroprotection in preclinical studies.
Topics: Propranolol; Animals; Brain Injuries, Traumatic; Neuroprotective Agents; Humans; Disease Models, Animal; Drug Evaluation, Preclinical; Adrenergic beta-Antagonists
PubMed: 38900343
DOI: 10.1007/s11481-024-10121-1