Medicina clinica
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Numerous prospective studies establish that elevated asleep blood pressure (BP) constitutes a significant cardiovascular disease (CVD) risk factor, irrespective of daytime office BP measurements or awake and 24h BP measurements. Moreover, except for a small number of studies with flawed methodology, multiple clinical trials of high consistency document significantly better BP-lowering efficacy of hypertension medication and their combinations when ingested at bedtime compared to upon awakening as is customary. Additionally, recent trials conclude bedtime hypertension chronotherapy markedly reduces CVD risk not only in the general population, but also in more vulnerable patients of advanced age, with kidney disease, diabetes, or resistant hypertension. Collectively, these results call for a new definition of true arterial hypertension and its proper diagnosis and management.
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Prevalence of neurological involvement in Behçet's disease (BD) varies between studies and is associated with high morbimortality. Neurological involvement is classified as parenchymal and non-parenchymal involvement (vascular involvement). Treatment of neurological involvement consists of immunosuppressants. Evidence regarding presentation and outcomes in neuro-Behçet's (NB) is scarce. ⋯ The prevalence of NB in patients with BD was higher than previously described. Fever and pseudofolliculitis were more frequently associated with NB, with low mortality during follow-up.
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Letter Case Reports
Long-term outcomes after percutaneous atrial septal deffects closure.
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Osteogenesis imperfecta (OI) is a heterogeneous genetic disease manifesting as bone fragility and fractures. ⋯ The COL1A1 gene is the most frequently affected. OI patients should receive multidisciplinary management and bisphosphonates can improve their quality of life.