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Article: Saudi Guidelines on the Diagnosis and Treatment of Pulmonary Hypertension: Biomarkers in pulmonary arterial hypertension.

Minai, Omar A

2014 Volume 9, Issue Suppl 1, Page(s) S92–7

Abstract: The biomarker is an indicaror of a biological or pathological process. Clinical observations, measures or environmental events, or measured laboratory values can all be biomarkers in the appropriate setting. An ideal biomarker reflects the underlying ... ...

Abstract	The biomarker is an indicaror of a biological or pathological process. Clinical observations, measures or environmental events, or measured laboratory values can all be biomarkers in the appropriate setting. An ideal biomarker reflects the underlying biological process, predicts clinical events, is easily obtainable, is reproducible and is not prohibitively expensive. This typically requires validation in longitudinal cohort studies. Biomarkers may help understand the pathological mechanisms responsible for the disease, help as screening tools, predict disease worsening or decline, and determine adequacy of response to therapeutic interventions.
Language	English
Publishing date	2014-07-18
Publishing country	India
Document type	Journal Article
ZDB-ID	2241287-6
ISSN	1998-3557 ; 1817-1737
ISSN (online)	1998-3557
ISSN	1817-1737
DOI	10.4103/1817-1737.134047
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Saudi Guidelines on the Diagnosis and Treatment of Pulmonary Hypertension

Omar A Minai

Annals of Thoracic Medicine, Vol 9, Iss 5, Pp 92-

Biomarkers in pulmonary arterial hypertension

2014 Volume 97

Abstract	The biomarker is an indicaror of a biological or pathological process. Clinical observations, measures or environmental events, or measured laboratory values can all be biomarkers in the appropriate setting. An ideal biomarker reflects the underlying biological process, predicts clinical events, is easily obtainable, is reproducible and is not prohibitively expensive. This typically requires validation in longitudinal cohort studies. Biomarkers may help understand the pathological mechanisms responsible for the disease, help as screening tools, predict disease worsening or decline, and determine adequacy of response to therapeutic interventions.
Keywords	Biomarkers ; brain natriuretic peptide ; heart failure ; pulmonary arterial hypertension ; Saudi association for pulmonary hypertension guidelines ; Diseases of the respiratory system ; RC705-779 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R
Subject code	610
Language	English
Publishing date	2014-01-01T00:00:00Z
Publisher	Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Saudi Guidelines on the Diagnosis and Treatment of Pulmonary Hypertension: Perioperative management in patients with pulmonary hypertension.

Tonelli, Adriano R / Minai, Omar A

Annals of thoracic medicine

2014 Volume 9, Issue Suppl 1, Page(s) S98–S107

Abstract: Patients with pulmonary hypertension (PH) are being encountered more commonly in the perioperative period and this trend is likely to increase as improvements in the recognition, management, and treatment of the disease continue to occur. Management of ... ...

Abstract	Patients with pulmonary hypertension (PH) are being encountered more commonly in the perioperative period and this trend is likely to increase as improvements in the recognition, management, and treatment of the disease continue to occur. Management of these patients is challenging due to their tenuous hemodynamic status. Recent advances in the understanding of the patho-physiology, risk factors, monitoring, and treatment of the disease provide an opportunity to reduce the morbidity and mortality associated with PH in the peri-operative period. Management of these patients requires a multi-disciplinary approach and meticulous care that is best provided in centers with vast experience in PH. In this review, we provide a detailed discussion about oerioperative strategies in PH patients, and give evidence-based recommendations, when applicable.
Language	English
Publishing date	2014-06-12
Publishing country	India
Document type	Journal Article
ZDB-ID	2241287-6
ISSN	1998-3557 ; 1817-1737
ISSN (online)	1998-3557
ISSN	1817-1737
DOI	10.4103/1817-1737.134048
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Article: A 60-year old man presenting with yellow nail syndrome.

Modrykamien, Ariel / Minai, Omar

Respiratory care

2011 Volume 56, Issue 7, Page(s) 1043–1045

MeSH term(s)	Cough/etiology ; Dyspnea/etiology ; Humans ; Lymphedema/etiology ; Lymphedema/therapy ; Male ; Middle Aged ; Pleural Effusion/diagnostic imaging ; Pleural Effusion/etiology ; Pleural Effusion/therapy ; Pleurodesis ; Radiography ; Yellow Nail Syndrome/diagnosis
Language	English
Publishing date	2011-07
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	603252-7
ISSN	0020-1324 ; 0098-9142
ISSN	0020-1324 ; 0098-9142
DOI	10.4187/respcare.00942
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Zs.B 2285: Show issues

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Article ; Online: Six-Minute Walk Test as a Predictor of Diagnosis, Disease Severity, and Clinical Outcomes in Scleroderma-Associated Pulmonary Hypertension: The DIBOSA Study.

Gadre, Abhishek / Ghattas, Christian / Han, Xiaozhen / Wang, Xiaofeng / Minai, Omar / Highland, Kristin B

Lung

2017 Volume 195, Issue 5, Page(s) 529–536

Abstract: Background: Pulmonary hypertension (PH) is a common complication of scleroderma (SSc) and is a leading cause of morbidity and mortality.: Objectives: To explore the utility of the 6MWT in the prediction of SSc-PH and to assess its prognostic ... ...

Abstract	Background: Pulmonary hypertension (PH) is a common complication of scleroderma (SSc) and is a leading cause of morbidity and mortality. Objectives: To explore the utility of the 6MWT in the prediction of SSc-PH and to assess its prognostic implications. Methods: A retrospective review of SSc patients from 2003 to 2013, with 6MWT and echocardiogram (n = 286), was conducted. Presence of PH was defined by right heart catheterization. Patients were randomized into development and validation cohorts. Using regression techniques, we developed a scoring system to predict the presence of SSc-PH and tested it in our validation cohort. Trends of mortality and disease severity were studied for incremental scores. Results: The DIBOSA scoring system includes DIstance walked in 6 min, BOrg dyspnea index, and SAturation of oxygen at 6 min. The DIBOSA score in the development cohort ranged from 0 to 3, resulting in an area of 0.858 (P < 0.0001) under the ROC curve. A score of 0 had a NPV of 100% and a score of 3 had a PPV of 86.58%. The validation cohort had an area under the ROC curve of 0.842. The DIBOSA score correlated with both pulmonary artery pressures and mortality. The 3-year survival rates for DIBOSA scores of 0, 1, 2, and 3 were 100, 100, 87.67, and 66.67%, respectively (HR = 3.92, P < 0.0001). Conclusions: DIBOSA score is a sensitive tool for the prediction of SSc-PH. The DIBOSA score is a direct predictor of mortality in SSc-PH and strongly correlates with pulmonary pressures. 6MWT can be used to predict clinical outcomes in SSc-PH.
MeSH term(s)	Adult ; Aged ; Cardiac Catheterization ; Echocardiography ; Female ; Humans ; Hypertension, Pulmonary/diagnosis ; Hypertension, Pulmonary/diagnostic imaging ; Hypertension, Pulmonary/etiology ; Hypertension, Pulmonary/physiopathology ; Male ; Middle Aged ; Mortality ; ROC Curve ; Regression Analysis ; Retrospective Studies ; Scleroderma, Systemic/complications ; Scleroderma, Systemic/physiopathology ; Severity of Illness Index ; Walk Test
Language	English
Publishing date	2017-06-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	6165-7
ISSN	1432-1750 ; 0341-2040
ISSN (online)	1432-1750
ISSN	0341-2040
DOI	10.1007/s00408-017-0034-1
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Uh II Zs.20: Show issues

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Article ; Online: Impact on survival of warfarin in patients with pulmonary arterial hypertension receiving subcutaneous treprostinil.

Ascha, Mona / Zhou, Xuan / Rao, Youlan / Minai, Omar A / Tonelli, Adriano R

Cardiovascular therapeutics

2017 Volume 35, Issue 5

Abstract: Introduction: Anticoagulation is a common treatment modality in patients with pulmonary arterial hypertension (PAH). Further studies are needed to appropriately assess the risk/benefit ratio of anticoagulation, particularly in PAH patients receiving PAH- ...

Abstract	Introduction: Anticoagulation is a common treatment modality in patients with pulmonary arterial hypertension (PAH). Further studies are needed to appropriately assess the risk/benefit ratio of anticoagulation, particularly in PAH patients receiving PAH-specific therapies. Aims: We use observational long-term data on PAH patients treated with subcutaneous (SQ) treprostinil from a large open-label study. Patients were followed for up to 4 years. The use of warfarin and bleeding events were recorded. Results: At total of 860 patients (age [mean±SD] 46±15 years, 76% female, 83% Caucasian, 49% idiopathic PAH, and 76% New York Heart Association [NYHA] functional class III) were included. All patients received SQ treprostinil (15% also other pulmonary hypertension [PH]-therapies) and 590 (69%) received warfarin during the study. The proportions of women, African American, and idiopathic pulmonary hypertension (IPAH) patients were higher in the group receiving warfarin. A higher proportion of patients with congenital heart disease and portopulmonary hypertension did not receive warfarin. There were no differences in unadjusted long-term survival between PAH patients receiving warfarin or not (log-rank test, P value=.69), even when only considering idiopathic PAH (P=.32). In addition, no difference was found in adjusted long-term survival both in PAH (P=.84) and idiopathic PAH patients (P=.44) based on the use of warfarin. Furthermore, no survival difference based on the use of warfarin were noted between propensity score-matched PAH patients (P=.37). Conclusions: Long-term anticoagulation with warfarin was not associated with any significant effect on survival in PAH or idiopathic PAH patients treated with SQ treprostinil.
MeSH term(s)	Adult ; Anticoagulants/adverse effects ; Anticoagulants/therapeutic use ; Antihypertensive Agents/adverse effects ; Antihypertensive Agents/therapeutic use ; Chi-Square Distribution ; Epoprostenol/adverse effects ; Epoprostenol/analogs & derivatives ; Epoprostenol/therapeutic use ; Familial Primary Pulmonary Hypertension/diagnosis ; Familial Primary Pulmonary Hypertension/drug therapy ; Familial Primary Pulmonary Hypertension/mortality ; Familial Primary Pulmonary Hypertension/physiopathology ; Female ; Hemorrhage/chemically induced ; Humans ; Infusions, Subcutaneous ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Propensity Score ; Proportional Hazards Models ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome ; Warfarin/adverse effects ; Warfarin/therapeutic use
Chemical Substances	Anticoagulants ; Antihypertensive Agents ; Warfarin (5Q7ZVV76EI) ; Epoprostenol (DCR9Z582X0) ; treprostinil (RUM6K67ESG)
Language	English
Publishing date	2017-07-27
Publishing country	England
Document type	Comparative Study ; Journal Article ; Observational Study
ZDB-ID	2428378-2
ISSN	1755-5922 ; 1755-5914
ISSN (online)	1755-5922
ISSN	1755-5914
DOI	10.1111/1755-5922.12281
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Zs.A 2474: Show issues

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Article ; Online: Lung or Heart-Lung Transplant in Pulmonary Arterial Hypertension: What Is the Impact of Systemic Sclerosis?

Gadre, Shruti K / Minai, Omar A / Wang, Xiao-Feng / Zhang, Qi / Budev, Marie / Tonelli, Adriano R

Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation

2017 Volume 15, Issue 6, Page(s) 676–684

Abstract: Objectives: Little is known about recipient characteristics and outcomes of patients with pulmonary arterial hypertension undergoing lung transplant, particularly those with systemic sclerosis-associated disease. Here, we describe the characteristics ... ...

Abstract	Objectives: Little is known about recipient characteristics and outcomes of patients with pulmonary arterial hypertension undergoing lung transplant, particularly those with systemic sclerosis-associated disease. Here, we describe the characteristics and outcomes of patients with pulmonary arterial hypertension undergoing lung transplant, focusing on systemic sclerosis-associated disease. Materials and methods: This retrospective study included pulmonary arterial hypertension patients undergoing lung or heart-lung transplant between July 1992 and August 2013 at a single center. Results: We evaluated 51 patients with pulmonary arterial hypertension (37.3% males; mean age of 45.3 ± 11.9 y). Of 51 patients, 9 (17.6%) had systemic sclerosis-associated pulmonary arterial hypertension. Pulmonary arterial hypertension patients without systemic sclerosis-associated disease had higher mean pulmonary arterial pressure (P = .002), higher pulmonary vascular resistance (P = .008), and were more likely to have severe right ventricular systolic dysfunction (P = .006) than individuals with the disease. Mean hospital stay posttransplant was similar in the 2 groups (42.2 ± 43.3 vs 43.1 ± 19.4 d; P = .20). Higher pretransplant creatinine clearance (P = .0005), forced vital capacity (P = .01), and absence of vasopressor/inotrope use (P = .03) were associated with shorter hospital stay. Mortality for pulmonary arterial hypertension patients with versus without systemic sclerosis-associated disease was 0% versus 13% at 1 year, 29% versus 24% at 2 years, and 86% versus 53% at 5 years. Female sex (hazard ratio, 0.23; 95% confidence interval, 0.08-0.68) and less severe tricuspid regurgitation (hazard ratio, 0.31; 95% confidence interval, 0.11-0.89) were independently associated with long-term survival. Conclusions: Pulmonary arterial hypertension patients with versus without systemic sclerosis-associated disease have comparable short-term and 2-year outcomes after lung or heart-lung transplant. Female sex and less severe tricuspid regurgitation were independently associated with better long-term survival. These outcomes did not vary when adjusted for the year of transplant.
MeSH term(s)	Adult ; Arterial Pressure ; Female ; Heart-Lung Transplantation/adverse effects ; Heart-Lung Transplantation/mortality ; Humans ; Hypertension, Pulmonary/etiology ; Hypertension, Pulmonary/mortality ; Hypertension, Pulmonary/physiopathology ; Hypertension, Pulmonary/surgery ; Length of Stay ; Lung Transplantation/adverse effects ; Lung Transplantation/mortality ; Male ; Middle Aged ; Ohio ; Postoperative Complications/therapy ; Registries ; Retrospective Studies ; Risk Factors ; Scleroderma, Systemic/complications ; Scleroderma, Systemic/mortality ; Scleroderma, Systemic/physiopathology ; Sex Factors ; Time Factors ; Treatment Outcome ; Vascular Resistance ; Ventricular Dysfunction, Right/etiology ; Ventricular Dysfunction, Right/mortality ; Ventricular Dysfunction, Right/physiopathology ; Ventricular Dysfunction, Right/surgery ; Ventricular Function, Right
Language	English
Publishing date	2017-05-22
Publishing country	Turkey
Document type	Journal Article
ZDB-ID	2396778-X
ISSN	2146-8427 ; 1304-0855
ISSN (online)	2146-8427
ISSN	1304-0855
DOI	10.6002/ect.2016.0209
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.A 6632: Show issues

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Article ; Online: Saudi Guidelines on the Diagnosis and Treatment of Pulmonary Hypertension

Adriano R. Tonelli / Omar A. Minai

Annals of Thoracic Medicine, Vol 9, Iss 5, Pp 98-

Perioperative management in patients with pulmonary hypertension

2014 Volume 107

Abstract	Patients with pulmonary hypertension (PH) are being encountered more commonly in the perioperative period and this trend is likely to increase as improvements in the recognition, management, and treatment of the disease continue to occur. Management of these patients is challenging due to their tenuous hemodynamic status. Recent advances in the understanding of the patho-physiology, risk factors, monitoring, and treatment of the disease provide an opportunity to reduce the morbidity and mortality associated with PH in the peri-operative period. Management of these patients requires a multi-disciplinary approach and meticulous care that is best provided in centers with vast experience in PH. In this review, we provide a detailed discussion about oerioperative strategies in PH patients, and give evidence-based recommendations, when applicable.
Keywords	Heart failure ; perioperative management ; pulmonary hypertension ; surgery ; Saudi association for pulmonary hypertension guidelines ; Diseases of the respiratory system ; RC705-779 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R
Subject code	610
Language	English
Publishing date	2014-01-01T00:00:00Z
Publisher	Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Saudi Guidelines on the Diagnosis and Treatment of Pulmonary Hypertension

Adriano R. Tonelli / Omar A. Minai

Annals of Thoracic Medicine, Vol 9, Iss 5, Pp 98-

Perioperative management in patients with pulmonary hypertension

2014 Volume 107

Abstract	Patients with pulmonary hypertension (PH) are being encountered more commonly in the perioperative period and this trend is likely to increase as improvements in the recognition, management, and treatment of the disease continue to occur. Management of these patients is challenging due to their tenuous hemodynamic status. Recent advances in the understanding of the patho-physiology, risk factors, monitoring, and treatment of the disease provide an opportunity to reduce the morbidity and mortality associated with PH in the peri-operative period. Management of these patients requires a multi-disciplinary approach and meticulous care that is best provided in centers with vast experience in PH. In this review, we provide a detailed discussion about oerioperative strategies in PH patients, and give evidence-based recommendations, when applicable.
Keywords	Heart failure ; perioperative management ; pulmonary hypertension ; surgery ; Saudi association for pulmonary hypertension guidelines ; Diseases of the respiratory system ; RC705-779 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R
Subject code	610
Language	English
Publishing date	2014-01-01T00:00:00Z
Publisher	Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Bosentan in systemic sclerosis.

Heresi, Gustavo A / Minai, Omar A

Drugs of today (Barcelona, Spain : 1998)

2008 Volume 44, Issue 6, Page(s) 415–428

Abstract: Systemic sclerosis (SSc) is a relatively rare chronic connective tissue disease characterized by varying degrees of skin fibrosis and visceral organ involvement. Pulmonary compromise, including pulmonary arterial hypertension and interstitial lung ... ...

Abstract	Systemic sclerosis (SSc) is a relatively rare chronic connective tissue disease characterized by varying degrees of skin fibrosis and visceral organ involvement. Pulmonary compromise, including pulmonary arterial hypertension and interstitial lung disease, is currently the leading cause of death in patients with SSc. Digital ulcers are common complications which lead to substantial morbidity and functional limitation. Until recently, treatment options for these complications were quite limited. Endothelin-1 (ET-1) is a peptide that has a role in promoting both vascular injury and the fibrotic process in SSc. Bosentan is a dual endothelin receptor antagonist approved for the treatment of pulmonary arterial hypertension. In patients with pulmonary hypertension secondary to SSc, bosentan therapy prevents deterioration in exercise capacity and may improve survival. No beneficial effect was found in one study in patients with interstitial lung disease and SSc. Bosentan is able to reduce the number of new digital ulcers in patients with either a history of previous ulcers or an active ulcer, without expediting the healing of existing ulcers. Bosentan therapy is contraindicated in pregnancy and causes elevated liver transaminases in up to 14% of patients. Hence, monthly pregnancy tests should be performed and hepatic function should be monitored.
MeSH term(s)	Animals ; Antihypertensive Agents/adverse effects ; Antihypertensive Agents/pharmacology ; Antihypertensive Agents/therapeutic use ; Endothelin Receptor Antagonists ; Humans ; Hypertension, Pulmonary/drug therapy ; Hypertension, Pulmonary/etiology ; Lung Diseases, Interstitial/drug therapy ; Lung Diseases, Interstitial/etiology ; Scleroderma, Systemic/complications ; Scleroderma, Systemic/drug therapy ; Skin Ulcer/drug therapy ; Skin Ulcer/etiology ; Sulfonamides/adverse effects ; Sulfonamides/pharmacology ; Sulfonamides/therapeutic use
Chemical Substances	Antihypertensive Agents ; Endothelin Receptor Antagonists ; Sulfonamides ; bosentan (Q326023R30)
Language	English
Publishing date	2008-06
Publishing country	Spain
Document type	Journal Article ; Review
ISSN	1699-3993
ISSN	1699-3993
DOI	10.1358/dot.2008.44.6.1220138
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