NSW trainer Pat Murphy in intensive care amid multiple health issues - The Australian

Parminder K. Judge, PhD, explains why eGFR and electrolytes should be monitored when diuretics are added to reach intensive BP targets in patients with CKD In written comments to Pharmacy Times, Parminder K. Judge, PhD, MBChB, MRCP, associate professor at Oxford Population Health and honorary consultant nephrologist at Oxford University Hospitals, discussed monitoring patients with chronic kidney disease (CKD) whose blood pressure (BP) treatment is intensified. Judge is the corresponding author of a JAMA Cardiology meta-analysis that Pharmacy Times previously reported found that intensive BP control cuts cardiovascular (CV) risk regardless of CKD status.1,2The meta-analysis of 27 trials found that intensive BP lowering did not increase kidney failure but did increase sustained declines in estimated glomerular filtration rate (eGFR), which the authors suggested may reflect hemodynamic responses to added diuretic therapy.1,2Building on those findings, Judge said decisions to target a systolic BP below 120 mm Hg should be personalized, as that target would not be appropriate for all patients with CKD.

A common liver disease affecting nearly 30% of adults worldwide is far more complex than previously understood. Researchers at Mayo Clinic have identified five biologically distinct forms of the condition, each associated with different risks of serious health complications, including heart disease, liver failure, cancer, and the need for a liver transplant. The findings, published in Nature Communications, come from a collaboration between Mayo Clinic and Virginia Tech. Scientists discovered that metabolic dysfunction-associated steatotic liver disease, or MASLD, can develop through several different biological pathways. Some are closely connected to obesity and diabetes, while others appear to be driven by inherited genetic differences.

IntroductionHypertension is a major global health concern and a leading cause of morbidity and mortality [1]. It is estimated that more than 19 million annual deaths are attributed to cardiovascular disease (CVD) worldwide [2]. In Japan, high blood pressure (BP) has been consistently identified as a strong risk factor for the national burden of CVD, in terms of notable incidence, mortality, direct/indirect healthcare costs, and quality-adjusted life years (QALYs) associated with this condition [3, 4]. Although age-specific mean BP declined in Japan over recent decades [5], hypertension remains a critical public health issue, particularly because of the rapid aging population. The proportion of individuals aged ≥65 years is projected to reach approximately 35% by 2040 in Japan [6], highlighting a potentially higher future burden of hypertension in this country. While the prevalence of hypertension increases with age, population aging may offset the benefits of declining BP levels in each age group. As a result, the future burden of hypertension in Japan remains uncertain.

Granulomatosis with polyangiitis (GPA) is a systemic necrotizing granulomatous vasculitis classically involving the upper and lower respiratory tracts and kidneys. Timely diagnosis requires a high index of suspicion for the presenting symptoms. Otolaryngologic manifestations are commonly reported but most often involve the nasal and paranasal sinuses. Sensorineural hearing loss (SNHL) as the sole initial manifestation of GPA is uncommon and may contribute to diagnostic delay. We report a case of a 67-year-old male who presented with rapidly progressive bilateral SNHL that preceded pulmonary and renal manifestations by several months, during which the patient was treated for otitis externa and Eustachian tube dysfunction without improvement. Development of pulmonary symptoms prompted additional workup, which demonstrated markedly elevated cytoplasmic anti-neutrophil cytoplasmic antibody (c-ANCA) and proteinase 3-anti-neutrophil cytoplasmic antibody (PR3-ANCA), raising concern for GPA. Histopathology then confirmed the diagnosis. The patient was treated with high-dose corticosteroids and rituximab with serologic remission; however, his hearing loss was largely irreversible. This case