European journal of internal medicine
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Eur. J. Intern. Med. · Jun 2019
Review Meta AnalysisSystematic review and meta-analysis of randomised controlled clinical trial evidence refutes relationship between pharmacotherapy with angiotensin-receptor blockers and an increased risk of cancer.
The potential influence of angiotensin-receptor blockers (ARBs) on carcinogenesis is a much-debated topic. Both observational, as well as preclinical studies in rodent carcinogenic assays, suggest a major role of the Renin-Angiotensin-Aldosterone-System (RAAS) in cancer development. Therefore, a systematic review and meta-analysis with available study data on ARBs and carcinogenicity in general as primary outcome were conducted. Secondary outcomes were defined as tumour-specific mortality rates and the frequency of new cases of specific tumour types with particular emphasis on lung, breast, and prostate cancer. ⋯ The results of our meta-analysis focusing only on high evidence levels and study designs (RCTs) did not reveal any relationship between pharmacotherapy with an ARB and an increased risk for cancer in general.
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Eur. J. Intern. Med. · Jun 2019
Observational StudyProfiling the hospital-dependent patient in a large academic hospital: Observational study.
In older patients with acute illness, a condition of "hospital-dependence" may arise: patients get adapted to the hospital care and, once discharged, may experience health status decline, requiring repeated readmissions despite appropriate treatments. ⋯ Hospital-dependent patients had severe multimorbidity, but exhibited an unexpectedly low prevalence of frailty/disability at baseline, though increasing across admissions. Trends of frailty and multimorbidity are paramount for profiling the hospital-dependence risk.
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Eur. J. Intern. Med. · Jun 2019
ReviewHigh-flow nasal cannula oxygenation utilization in respiratory failure.
High flow nasal cannula (HFNC) represents a new oxygenation system to be used in the treatment of respiratory emergencies. During HFNC therapy, the active humidification and air heating system allow the patient to tolerate higher flows by favouring physiologic mucociliary clearance and improving fluidity of respiratory secretions. ⋯ Several clinical trials in acute respiratory failure patients have suggested lower rate of invasive mechanical ventilation, improved comfort and enhanced survival by early HFNC utilization in comparison with conventional oxygen therapy (COT) or non-invasive ventilation (NIV). This review aims to summarize the main evidences on the use of HFNC in the acute setting and its major indications.
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Eur. J. Intern. Med. · Jun 2019
Observational StudySignificant and constant increase in hospitalization due to heart failure in Spain over 15 year period.
To examine trends in the incidence, characteristics, and in-hospital outcomes of heart failure (HF) hospitalizations from 2001 to 2015 in Spain. ⋯ This research shows an increase of hospitalizations due to HF in Spain, particularly in patients with HF as a secondary diagnosis. Advance age and comorbidity in acute HF has increased in the recent years. However, IHM is decreasing while readmissions remain stable.