Articles: treatment.
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Cirrhotic cardiomyopathy (CCM) is a diagnostic entity defined as cardiac dysfunction (diastolic and/or systolic) in patients with liver cirrhosis, in the absence of overt cardiac disorder. Pathogenically, CCM stems from a combination of systemic and local hepatic factors that, through hemodynamic and neurohormonal changes, affect the balance of cardiac function and lead to its remodeling. Vascular changes in cirrhosis, mostly driven by portal hypertension, splanchnic vasodilatation, and increased cardiac output alongside maladaptively upregulated feedback systems, lead to fluid accumulation, venostasis, and cardiac dysfunction. ⋯ However, our group still advocates them as essential tools in optimizing the neurohumoral pathologic axis that perpetuates CCM. Other targeted therapies with direct anti-inflammatory and antioxidative effects still lack sufficient evidence for wide approval. This is not only a review but also a comprehensive distillation of the insights from practicing clinical hepatologists and other specialties engaged in advanced approaches to treating liver disease and its sequelae.
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Mayo Clinic proceedings · Dec 2024
ReviewHypertension Management in Women With a Multidisciplinary Approach.
Current clinical practice guidelines were established by several organizations to guide the diagnosis and treatment of hypertension in men and women in a similar manner despite data demonstrating differences in underlying mechanisms. Few publications have provided a contemporary and comprehensive review focused on characteristics of hypertension that are unique to women across their life spectrum. ⋯ Here, we discuss potential factors contributing to hypertension in women, differences related to effects of lifestyle modifications and drug therapy between men and women, the impact of sleep, and the importance of recognizing disparities in socioeconomic conditions and access to care. This review outlines several opportunities for future studies to fill gaps in knowledge to achieve optimal control of hypertension in women using a multidisciplinary approach, particularly related to sex-specific treatment approaches while considering socioeconomic conditions and life stages from premenopause through the transition to menopause.
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Treatment with so-called psychedelic drugs, including psilocybin, lysergic acid diethylamide (LSD), and others, is among the most promising recent developments in psychiatry. This review focuses on psilocybin, a substance found in all mushrooms of the genus Psilocybe, because the largest amount of available evidence relates to this drug. ⋯ Treatment with psilocybin differs fundamentally from classic psychopharmacotherapy. Its potentially transdiagnostic, rapid, and sustainable efficacy and its positive effect on further dimensions of mental health beyond the patient's symptoms and psychopathology imply that it may have disease-modifying and salutogenic mechanisms of action. Psychotherapy accompanied by the administration of psychedelic drugs may turn out to be the first disease-modifying treatment in the history of psychiatry.
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Background and Objectives: The history of facial fillers is very broad, ranging from the use of various materials to modern technologies. Although procedures are considered safe, complications such as skin inflammation, infection, necrosis, or swelling may occur. It is crucial for specialists to be adequately prepared, inform patients how to prepare for corrective procedures, adhere to high safety standards, and continually educate. ⋯ A total of 7719 injection site reactions were classified as mild or temporary, such as swelling (n = 1184), sensitivity (n = 1145), pain (n = 1064), bleeding (n = 969), hardening/stiffness (n = 888), nodules/irregularities (n = 849), and erythema (redness) (n = 785). Conclusions: Facial wrinkle correction procedures are generally safe and effective and the results can last from 6 to 24 months, depending on the dermal filler material and its components used. The most common complications after dermal filler injection usually resolve spontaneously, but if they persist, various pharmacological treatment methods can be used according to the condition, and surgical intervention is generally not required.
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Extracranial carotid artery aneurysms (ECAAs) are extraordinarily rare, representing approximately 0.4%-4% of all extracranial artery aneurysms. As medical technology has advanced, new approaches for ECAAs treatment can be performed. Nevertheless, there is currently no consensus on the best therapeutic approach due to the information scarcity. ⋯ ECAAs are a rare clinical condition. However, a great percentage of patients could present with ischemic symptoms. Similarly, cardiovascular risk factors present as the most prevalent comorbid conditions associated with these vascular aberrancies. With this systematic review, we seek to provide insight into extracranial carotid aneurysms, identifying areas of opportunity in both the diagnosis and management of this pathology and the standardization of clinical reporting and case classification. These findings underscore the need for future research to improve the understanding and approach to this complex clinical condition.