310 research outputs found
Evening versus morning administrations of statins: evening is better.
No full textCircadian rhythms of metabolic functions and cholesterol production are discussed, in order to optimize drug assumption
Oxidative stress in essential hypertension
No full textA major cause for endothelial dysfunction in essential hypertension is decreased availability of nitric oxide (NO). Impairment in NO bioavailability is likely to be the consequence of multiple mechanisms affecting NO synthesis as well as NO breakdown. An alteration in the redox balance in endothelial cells leads to increased superoxide anion production and oxidative stress. This in turn not only exerts negative effects on vascular tone, but is also able to activate important mechanisms (such as platelet activity, leukocyte adhesion, vascular smooth muscle cell proliferation and expression of adhesion molecules) with an established central role in the pathogenesis of hypertensive target organ damage. As a consequence, a drug therapy able to restore NO availability in essential hypertensive patients would probably exert additional benefits, as compared to blood pressure lowering per se, in terms of prevention of target organ damage and improved prognosis of these patients. Unfortunately, as of today only the antagonists of the renin-angiotensin system and the calcium-channel blockers have shown some ability in this respect, whereas no longitudinal intervention study has been undertaken, so far, to prove that the restoration of NO bioavailability through an antihypertensive treatment may confer additional prognostic advantage to essential hypertensive patients
Morning surge in blood pressure as a predictor of silent and clinical cerebrovascular disease in elderly hypertensives
No full textWe read with interest the paper by Kario et al, indicating that an excessive morning surge in blood pressure is a predictor of subsequent stroke in a sample population of elderly Japanese hypertensives. On one hand, the evident diurnal variation in the onset of many acute cardiovascular events, eg, myocardial infarction, angina, cardiac arrest, sudden death, and pulmonary embolism, is closely related to the circadian pattern of blood pressure. On the other, there is no doubt that hypertension plays a key role as a risk factor for cerebrovascular accidents. However, recent studies from our group found that patients with and without hypertension had the same 24-hour pattern of onset of both ischemic and hemorrhagic stroke, characterized by a morning peak. Moreover, other cardiovascular events, eg, acute aortic dissection, show an evident diurnal variation as well. Recent data from the large worldwide population of the International Registry of Acute Aortic Dissection found a significant morning peak quite similar in both hypertensive and normotensive subjects. Taken together, all of these data strengthen the suggestion that the morning surge in blood pressure (irrespective of presence or absence of hypertension) may be crucial in determining the rupture of a critically weakened arterial wall. We agree that the morning surge in blood pressure should be a therapeutic target for preventing unfavorable cardiovascular events in hypertensive patients, and the medications should provide 24-hour efficacy. However, because a morning surge in blood pressure may also be harmful for normotensive subjects, an accurate evaluation of the range of early morning blood pressure might be useful for normotensives as well
Prevent heroin overdose: do not forget circadian rhythms.
No full textThe existence of temporal windows of higher risk of onset of heroin overdose is discussed, in terms of alert and prevention
Buerger’s disease: spinal cord stimulator may represent a useful tool for delaying amputation in young patients
No full textThis is a discussion letter on a previous article published in this Journal
The Monday peak in the onset of ischemic stroke is independent of major risk factors
No full textAvailable evidence suggests that the occurrence of cardiovascular events, for example, myocardial infarction, cardiac arrest, and sudden death, exhibits a peak on Monday compared to other days of the week, and this Monday excess risk in cardiovascular mortality has been estimated with an odds ratio of 1.19. An earlier single-center study confirmed such Monday preference also for onset of ischemic stroke. This retrospectively study, conducted by using the database of the region Emilia-Romagna (RER) of Italy, was aimed to investigate whether the most common risk factors, such as arterial hypertension, diabetes mellitus, and dyslipidemia, could influence the temporal weekly pattern of onset of ischemic stroke or not..
Circadian and seasonal variation of first febrile seizures
No full textTime of occurrence of 188 first febrile seizures (FS) was recorded, both by four 6-hour periods and by hourly intervals. The frequency of events was significantly (P <.001) increased from 6 to 11.59 PM with a peak between 5 and 8 P PM. A seasonal peak was observed in January
Acute cholecystitis as a presentation of metastatic breast carcinoma of the gallbladder: A case report
No full textTHE AUTHORS PRESENT A CASE OF ACUTE CHOLECYSTITIS AS A PRESENTATION OF METASTATIC BREAST CARCINOMA OF THE GALLBLADDE
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