Minerva medica
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Over recent years, managing hypertension in older people has gained increasing attention, with reference to very old, frailer individuals. In these patients, hypertension treatment may be challenging due to a higher risk of hypotension-related adverse events which commonly overlaps with a higher cardiovascular risk. Additionally, frailer older adults rarely satisfy inclusion criteria of randomized clinical trials, which determines a substantial lack of scientific data. ⋯ Consequently, "one size does not fit all" and personalized treatment strategies are needed, customized to individuals' frailty and functional status. Similar to other cardiovascular diseases, hypertension management in older people should be characterized by a geriatric approach based on biological rather than chronological age and a geriatric comprehensive evaluation including frailty assessment is required to provide the most appropriate treatment, tailored to patients' prognosis and health care goals. The aim of this review was to illustrate the importance of a patient-centered geriatric approach to hypertension management in older people with the final purpose to promote a wider implementation of frailty assessment in routine practice.
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A meta-analysis was carried out to systematically evaluate the effects of liraglutide on waist circumference, BMI, weight, insulin resistance (IR), Follicle-Stimulating Hormone (FSH), and Luteinizing hormone (LH) levels in obese women with polycystic ovarian syndromes (PCOS). ⋯ For women with PCOS, BMI, weight, and waist circumference were significantly decreased after 12~24 weeks of treatment with liraglutide monotherapy and add-on therapy. Insulin resistance might be improved with the use of liraglutide. Nevertheless, large scale randomized control trials should be carried out to elucidate the long-term outcome in improving the insulin sensitivity of liraglutide treatment.
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Review Case Reports
Beyond the lung involvement in COVID-19 patients. A review.
Since COVID-19 spread all over the world becoming a pandemic illness, researchers have better characterized route of virus transmissibility and clinical signs and symptoms of the disease. Since viral transmission occurs through the droplets emitted during coughing or sneezing, the lungs are primarily affected. ⋯ This review focuses on extra pulmonary involvement underlying atypical presentation of COVID-19. There is a great body of evidence concerning several human organ abnormalities associated to the SARS-CoV-2, enough to consider COVID-19 as a multisystemic and polyhedral disease.
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Lung cancer (LC) and chronic obstructive pulmonary disease (COPD) represent leading causes of morbidity and mortality worldwide. Common risk factors lead to an increased inflammatory response, enhances oxidative stress, and changes in lung microenvironment contributing to fine-tuned interaction between these respiratory disorders. ⋯ Better understanding LC and COPD coexistence may impact on clinical scenario influencing therapeutic approach. In this review, we describe the basis of this network and how the complex interplay between these respiratory disorders affects the clinical decision-making process.
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Cancer therapy-related cardiac dysfunction (CTRCD) is a critical problem with an impact on both oncological and cardiovascular prognosis, especially when it prevents patients from receiving cancer treatment. However, there are very limited data on the efficacy of sacubitril/valsartan in the prevention and treatment of cardiotoxicity. This systematic review aimed to evaluate the potential benefit of sacubitril/valsartan in patients with CTRCD. ⋯ All clinical studies have demonstrated that used Sac/Val in human showed a significant increase in LVEF, and when reported, a reduction in left ventricular volume and NT-proBNP (or BNP). Randomized clinical trials are needed to confirm this hypothesis.