Medicina clinica
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Genicular artery embolization emerges as an innovative technique described for the treatment of refractory pain in patients with knee osteoarthritis. This review summarizes the available data on the efficacy of genicular artery embolization in patients with knee osteoarthritis (OA) and refractory pain as an alternative treatment or associated with pharmacological treatment. ⋯ Genicular artery embolization is a possible and potentially very effective alternative in the treatment of chronic refractory pain in patients with knee OA, without serious complications. All studies conclude in favor of embolization of the genicular arteries in the treatment of chronic refractory pain in patients with knee OA.
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Review
Paradigm shift in monogenic autoinflammatory diseases and systemic vasculitis: The VEXAS syndrome.
VEXAS syndrome was described by the end of 2020 as an autoinflammatory disease caused by post-zygotic variants in the UBA1 gene. VEXAS syndrome occurs in adult males with recurrent fever, arthralgia/arthritis, ear/nose chondritis, neutrophilic dermatosis, lung inflammation, venous thrombosis, and different types of vasculitis. Common laboratory changes include raised acute phase reactants and macrocytic anemia. ⋯ Azacitidine has been associated with a good response, especially in patients with accompanying myelodysplastic syndrome. Allogeneic hematopoietic stem cell transplantation appears to be the only curative therapy by now. VEXAS syndrome has become a paradigm shift in the diagnosis and treatment of autoinflammatory diseases and systemic vasculitis.
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SARS-CoV-2 is currently causing a persistent COVID-19 pandemic, which poses a risk of causing long-term cardiovascular sequels in the population. The viral mechanism of cell infection through the angiotensin 2 converter enzyme receptor and the limited antiviral innate immune response are the suspected causes for a more frequent cardiovascular damage in SARS-CoV-2 infection. Knowledge of the appearance during acute infection of other cardiac conditions beyond the classical myocarditis and pericarditis, the long-term cardiac manifestations (persistent COVID-19), and the increased incidence of myocarditis and pericarditis after vaccination is of special interest in order to offer our patients best practices based on current scientific evidence.
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Meta Analysis
Efficacy of exercise in patients with atrial fibrillation: Systematic review and meta-analysis.
The benefits of exercise in atrial fibrillation (AF) are not clear yet. The aim was to assess the effects of exercise on functional capacity, quality of life, symptoms and adverse events in AF patients. ⋯ Exercise has a beneficial role as an adjuvant treatment of AF.
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Non-alcoholic steatohepatitis belongs to the spectrum of metabolic-associated fatty liver diseases characterized by steatosis linked to obesity, diabetes, metabolic syndrome, dyslipidemia and immune-mediated disorders. The main features of MAFLD include high prevalence, heterogeneity, complexity and dynamic disease. Pruritus and asthenia are the main clinical manifestation that impact on quality of life and patient-reported outcomes. ⋯ Therapeutic options included life-style intervention. Mediterranean hypocaloric Diet to lose weight, exercise to fight sarcopenia and alcohol abstinence. In non-responders, drug-therapy focusing on obesity, diabetes and fibrosis using sequentially or combined to promote steatosis, inflammation and fibrosis regression.