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A Patient With Parenteral Nutrition-Dependent Short Bowel Syndrome and Cardiovascular Disease With 4-Year Exposure to Teduglutide.
Compher, C, Levinson, KB, Cambor, CL, Stoner, N, Boullata, JI, Piarulli, A, Kinosian, B
JPEN. Journal of parenteral and enteral nutrition. 2016;(5):725-9
Abstract
Clinical trials of the glucagon-like peptide 2 analogue teduglutide resulted in approval of the drug by the Food and Drug Administration in 2012 as a treatment for parenteral nutrition-dependent short bowel syndrome in adults. This report presents the case study of a man with short bowel syndrome caused by portal vein thrombosis who had 4 years exposure to the drug at the time of his death due to cardiovascular disease.
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2.
An unusual cause of susceptibility artifact in magnetic resonance imaging.
Cook, SC, Shull, J, Pickworth-Pierce, K, Farra, Y, Simonetti, OP, Raman, SV
Journal of magnetic resonance imaging : JMRI. 2006;(5):1148-50
Abstract
Magnetic susceptibility artifact has been documented with various implants and devices, which require appropriate identification with screening of patients prior to subjecting them to magnetic resonance examination. We performed cardiovascular magnetic resonance (CMR) examination of the aorta in a 24-year-old woman in the setting of repaired aortic coarctation, and found magnetic susceptibility artifact arising from the stomach in the absence of known susceptibility artifact-producing material in this region. Further history revealed that she had ingested a prenatal vitamin prior to imaging, prompting experimental analyses that led us to conclude that iron-containing vitamins may be a source of magnetic susceptibility artifact.
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3.
Digoxin in the management of cardiovascular disorders.
Gheorghiade, M, Adams, KF, Colucci, WS
Circulation. 2004;(24):2959-64
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4.
[Chronic inflammation and cardiovascular risk in hemodialysis].
Pertosa, G, Simone, S, Soccio, M, Marrone, D, Grandaliano, G
Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia. 2003;(6):631-40
Abstract
Cardiovascular disease (CVD) remains the main cause of morbidity and mortality in patients with end-stage renal disease (ESRD). Traditional risk factors are common in ESRD patients, but they alone may not be sufficient to account for the high prevalence of CVD in this population. Recent clinical evidence demonstrates that chronic inflammation, a non traditional risk factor which is commonly observed in ESRD patients, may be associated with the presence of poor nutritional parameters and progressive atherosclerotic CVD. Based on these observations, the presence in ESRD patients of a syndrome consisting in malnutrition, signs of systemic chronic inflammation and atherosclerosis (MIA syndrome) has recently been suggested. A central role in this syndrome is played by the proinflammatory cytokines generated in response to factors such as chronic renal failure and infectious-inflammatory co-morbid disease. It is now clear that the immune response, both innate and adaptive, is the main cause of inflammation characterising atherosclerosis. As there is as yet no recognized, or even proposed, treatment for ESRD patients with chronic inflammation, it would be of obvious interest to study the long-term effect of various inflammatory treatment strategies on the nutritional and cardiovascular status as well as the outcome in these patients.
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5.
Adverse metabolic and cardiovascular risk following treatment of acute lymphoblastic leukaemia in childhood; two case reports and a literature review.
Amin, P, Shah, S, Walker, D, Page, SR
Diabetic medicine : a journal of the British Diabetic Association. 2001;(10):849-53
Abstract
We report two patients who survived childhood acute lymphoblastic leukaemia (ALL) following treatment with chemotherapy, total body irradiation (TBI) and bone marrow transplantation (BMT). The first case presented with an acute cerebral infarction at 23 years of age and was found to have non-ketotic diabetes and gross mixed hyperlipidaemia; the second presented with non-ketotic diabetes, hypertension, proteinuria and dyslipidaemia at age 16 years. The association of glucose intolerance with other vascular risk factors in young adult survivors of BMT was recently highlighted in a follow-up study of 23 survivors of BMT [1], but none presented with such gross mixed hyperlipidaemia. The improving survival rates of childhood malignancy over the last two decades will present adult physicians with patients who have accelerated vascular risk at a young age who will require early treatment to modify it.
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6.
Applying evidence-based medicine to current practice: a round table panel discussion.
McInnes, GT, Mancia, G, Sever, PS, Poulter, NR
Journal of human hypertension. 2000;:S17-22
Abstract
Over the past decade, an expanding body of epidemiological and clinical trial data has been collated, culminating in the development of guidelines designed to help physicians make decisions about intervention and the intensity of treatment, based on objective assessments of the overall level of risk for cardiovascular disease. However, guidelines are not prescriptive and allow physicians leeway in interpretation. Thus, it is of clinical interest to explore some of the issues that may influence the use of these guidelines in clinical practice. This paper summarises a round table panel discussion that highlighted the usefulness of current guidelines, but also demonstrated that these guidelines, and the evaluation of cardiovascular risk, need to be used with care and always interpreted in the light of sound clinical judgement.
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7.
Cardiovascular fibrosis, hydrocephalus, ophthalmoplegia, and visceral involvement in an American child with Gaucher disease.
Stone, DL, Tayebi, N, Coble, C, Ginns, EI, Sidransky, E
Journal of medical genetics. 2000;(11):E40
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8.
The clinical implications of insulin resistance.
Peters, AL
The American journal of managed care. 2000;(13 Suppl):S668-74; discussion S675-81
Abstract
Insulin resistance is a prime risk factor associated with atherosclerosis and thrombosis. Other risk factors include dyslipidemia, obesity, and hypertension. The constellation of those factors, which is known as the cardiovascular dysmetabolic syndrome, increases the risk of macrovascular disease. Insulin resistance may contribute directly to cardiovascular disease and may also act as a precursor of diabetes, which is also associated with an increased risk of macrovascular disease. Insulin resistance can be difficult to assess clinically, but it is invariably present in patients with type 2 diabetes, impaired fasting glucose, or impaired glucose tolerance. Treatment of insulin resistance includes diet, exercise, smoking cessation, strict control of hypertension, aggressive treatment of lipid abnormalities, and keeping the hemoglobin A1c level below 7%. New oral agents improve glycemic control for those with diabetes or insulin resistance, but their role in reducing the risk of macrovascular disease is undetermined.