1,720,956 research outputs found
New onset of type 2 diabetes mellitus during antihypertensive therapy: What evidence?
No full textHypertension is a widely diffused clinical condition in the general population and it is often associated with people who are overweight (i.e. have abdominal adiposity) or obese and with metabolic syndrome. Evidence shows that hypertensive patients are at increased risk of developing type 2 diabetes mellitus (T2DM) since angiotensin II is involved in the pathogenesis of hypertension and insulin resistance, which are both the key components of metabolic syndrome. The preventive effect of renin-angiotensin system (RAS) inhibition on the development of T2DM could reflect the closely linked mechanisms of blood pressure and blood glucose homeostasis. Since hyperglycaemia is a consequence of insulin resistance and β-cell dysfunction, preventing T2DM by RAS inhibition may result from an improvement of β-cell function and/or an enhancement of insulin sensitivity, which are secondary to modifications in microcirculation and changes in ionic status. On the basis of this hypothesis, several trials in treating hypertensive patients have shown a positive effect of drugs inhibiting RAS in reducing the number of hypertensive patients that develop T2DM. We analysed the results of the following clinical studies that found a reduction in the incidence of new-onset T2DM in hypertensive patients using angiotensin II type 1 receptor blockers (ARBs): LIFE (Losartan Intervention For Endpoint reduction in hypertension) [losartan]; SCOPE (Study on COgnition and Prognosis in the Elderly) [candesartan]; ALPINE (Antihypertensive treatment and Lipid Profile In a North of Sweden Efficacy evaluation) [candesartan]; CHARM (Candesartan in Heart failure Assessment of Reduction in Mortality and morbidity) [candesartan]; and VALUE (Valsartan Antihypertensive Long-term Use Evaluation) [valsartan]. Evidence shows that blood pressure reduction, when associated with lifestyle modifications (especially in high-risk patients), is more important than the mechanism of action of the antihypertensive drugs, which is to normalise blood pressure and thus reduce the incidence of cardiovascular events. In this regard, the identification of the potential influence of RAS inhibition in preventing new-onset T2DM in hypertensive subjects is a promising topic for the healthcare system. In the future, data from the ongoing trials, where prevention of diabetes is the primary endpoint, may prove to what extent this class of drugs is actually effective. However, in the previously mentioned clinical trials, the superior effectiveness of ARBs in preventing T2DM is associated with a lower efficacy in preventing cardiovascular events, because of their lesser capacity in lowering blood pressure. Evidence so far suggests the use of ARBs preferably in association with other classes of antihypertensive drugs and under a constant control of blood pressure. In this latter regard, in the recently published ASCOT-BPLA (Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm) study, a combination therapy based on a drug inhibiting RAS (perindopril) and a calcium-channel blocker (amlodipine) significantly reduced the incidence of major cardiovascular events and new onset of diabetes in high-risk hypertensive patients, compared with a combination therapy based on thiazide diuretic and a β-blocker
Fahr's disease detected on a head CT scan in patient with "epileptic syncope" in the Emergency Department.
No full textFahr’s disease is a rare neurological disorder characterized
by diffuse intracranial calcification with a prevalent
involvement of the basal ganglia and dentate nucleus of the
cerebellum.
It has been reported to be an autosomal dominant
inheritance in familial cases, although the causal gene is
still unknown, and sporadic types have been described.
Most cases initially present with a deterioration of motor
function. Later in the development of the disease, other
symptoms and signs occur, especially extrapyramidal
symptoms. We report a case with an unusual presentation
and no extrapyramidal signs:
An 58-year-old woman was brought to the Emergency
Department (ED) because of a sudden loss of consciousness
with seizure and urinary incontinence. She denied
chest or abdominal pain, nausea vomiting or diarrhea.
Upon falling from the seizure, she sustained cranial
trauma (frontal skull). She denied any past medication
history, allergies to medications, chest or abdominal pain,
nausea, vomiting or diarrhea. There was no family history
of mental illness, dementia, or major physical illness
Elevated B-type natriuretic peptide blood levels during hypertensive crisis: A novel diagnostic marker of acute coronary and cerebrovascular events?
No full textObjectives: The objectives of this study were: (i) to assess the role of B-type natriuretic peptide (BNP) in the course of hypertensive crisis; (ii) to evaluate the possible role of BNP in the differential diagnosis between hypertensive emergencies (HE) or urgencies (HU); and (iii) to investigate the relationship between BNP concentration and blood pressure (BP) acute burden with consequent myocardial ischaemia or brain damage. Methods: 57 consecutive patients were admitted to the emergency department for acute elevated BP levels (systolic BP [SBP]/diastolic BP [DBP]: 200.7 ± 24.7/121.2 ± 12.4 mmHg) were enrolled. On the basis of clinical data, patients were subdivided into two groups: (i) 25 patients with HE: SBP/DBP 204.16 ± 29.1/123.3 ± 13.0 mmHg with heart (acute coronary syndrome) or brain involvement; (ii) 32 patients with HU: SBP/DBP 198.1 ± 20.7/120 ± 11.7 mmHg, without any acute or ongoing deterioration of target organs. For each patient, a serum dosage of BNP was performed. Results: In the whole population, no significant relationship was found between BP total burden and BNP level. In HE, BNP concentration (113.22 ± 87 pg/mL) was significantly (p < 0.001) higher than in HU (23.5 ± 21.3 pg/ mL) patients. There was a significant increase (p < 0.01) of BNP blood level in HE patients with acute coronary syndrome (162.02 ± 95.7 pg/mL) compared with those with neurological complications (80.7 ± 65.2 pg/mL). Moreover, in HU patients, there was a significant relationship (r = 0.37; p < 0.05) between BNP levels and pulse pressure. Conclusions: During hypertensive crisis, BNP blood level increase seems to have a role as a diagnostic tool for the screening of hypertensive emergencies due to an acute coronary or brain injury, and the BNP elevation is greater in the presence of myocardial ischaemia than brain damage
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
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