European journal of internal medicine
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Eur. J. Intern. Med. · Oct 2020
Multicenter StudyPrevalence and risk factors for pulmonary embolism in patients with suspected acute exacerbation of COPD: a multi-center study.
Pulmonary embolism (PE) prevalence in acute exacerbations of COPD is highly variable. ⋯ PE prevalence is not negligible in this setting. A number of risk factors may help clinicians in identification of patients at increased risk of PE.
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Eur. J. Intern. Med. · Oct 2020
ReviewHyperuricaemia and gout in cardiovascular, metabolic and kidney disease.
During the last century, there has been an increasing prevalence of hyperuricaemia noted in many populations. While uric acid is usually discussed in the context of gout, hyperuricaemia is also associated with hypertension, chronic kidney disease, hypertriglyceridaemia, obesity, atherosclerotic heart disease, metabolic syndrome, and type 2 diabetes. Here we review the connection between hyperuricaemia and cardiovascular, kidney and metabolic diseases. ⋯ Hyperuricaemia is a predictive factor for the development of hypertension, metabolic syndrome, type 2 diabetes, coronary artery disease, left ventricular hypertrophy, atrial fibrillation, myocardial infarction, stroke, heart failure and chronic kidney disease. Treatment with uric acid-lowering therapies has also been found to improve outcomes in patients with hypertension and kidney disease, in some but not all studies. In conclusion, uric acid is emerging as a potentially treatable risk factor for cardiometabolic diseases, and more clinical trials investigating the potential benefit of lowering serum uric acid are recommended in individuals with hyperuricaemia with and without deposition and concomitant hypertension, metabolic syndrome or chronic kidney disease.
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Eur. J. Intern. Med. · Oct 2020
Quality of care after AKI development in the hospital: Consensus from the 22nd Acute Disease Quality Initiative (ADQI) conference.
Acute kidney injury (AKI) is independently associated with increased morbidity and mortality. Quality improvement has been identified as an important goal in the care of patients with AKI. Different settings can be targeted to improve AKI care, broadly classified these include the inpatient and outpatient environments. In this paper, we will emphasize quality indicators associated with the management and secondary prevention of AKI in hospitalized patients to limit the severity, duration, and complications. ⋯ These recommendations identified and outlined an approach to define and evaluate the quality of AKI management in hospitalized patients.
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Eur. J. Intern. Med. · Oct 2020
VAV3 rs7528153 and VAV3-AS1 rs1185222 polymorphisms are associated with an increased risk of developing hypertension.
The aetiology of essential hypertension is complex and involves both environmental and genetic factors. Approximately 30% of the inter-individual variability in blood pressure is genetically determined. It has been shown that numerous vasoconstrictors stimulate RhoA in local populations of vascular SMCs that, in turn, promote localised constriction of arterial blood vessels and elevations in blood pressure. ⋯ The results suggest that T allele of the VAV3 rs7528153 and G allele of the VAV3-AS1 rs11185222 polymorphisms are associated with an increased risk of developing hypertension. We hypothesise that these polymorphisms could modify blood pressure, likely through a modification in the Rho/Rac pathway. Our results suggest that those polymorphisms could be useful genetic markers of susceptibility to suffering hypertension.
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Eur. J. Intern. Med. · Oct 2020
Higher odds and rising trends in arrhythmia among young cannabis users with comorbid depression.
Cannabis (marijuana) use and depression are known to be strongly interconnected. However, amid alarming rates of mental health problems in the United States young population, the risk of arrhythmia among young cannabis users with comorbid depression has never been studied. ⋯ Rampant recreational use of marijuana may increase the risk of arrhythmia by 40% in young cannabis users with depression as compared to non-depressed.