1,721,054 research outputs found
Pulmonary arterial hypertension: sex-specific differences and outcomes
Get PDF: Pulmonary arterial hypertension (PAH) is a progressive and life-threatening vascular disease characterized by increased pulmonary vascular resistance, leading to right ventricular failure and death. It has a higher prevalence in women than men, yet notable sex-based differences influence disease presentation, treatment response, and outcomes. This narrative review explores the distinct sex differences in PAH and their significant impact on prognosis. Data from major PAH clinical trials indicate that nearly 78.4% of participants are women. According to the REVEAL registry, the most common causes of PAH in women are connective tissue disease-associated PAH (CTD-PAH), idiopathic PAH (IPAH), and congenital heart disease-associated PAH (CHD-PAH). Women are often found to have better baseline right ventricular (RV) function and hemodynamics before treatment, as well as more favorable RV adaptation post-therapy. They also demonstrate a stronger response to endothelin receptor antagonists (ERA) and prostacyclins. Most notably, these factors contribute to better survival outcomes in women compared to men. In conclusion, significant sex-based differences exist in PAH, underscoring the need for personalized treatment approaches that consider sex-related factors. Future research should focus on optimizing therapeutic strategies to improve outcomes for both sexes
Insulin resistance: Is it time for primary prevention?
No full textInsulin resistance is a clinical condition characterized by a decrease in sensitivity and responsiveness to the metabolic actions of insulin, so that a given concentration of insulin produces a less-than-expected biological effect. As a result, higher levels of insulin are needed to maintain normal glucose tolerance. Hyperinsulinemia, indeed, is one of the principal characteristics of insulin resistance states. This feature is common in several pathologic conditions, such as type 2 diabetes, obesity, and dyslipidemia, and it is also a prominent component of hypertension, coronary heart disease, and atherosclerosis. The presence of endothelial dysfunction, related to insulin resistance, plays a key role in the development and progression of atherosclerosis in all of these disorders. Insulin resistance represents the earliest detectable abnormality in type 2 diabetes, and is one of the major underlying mechanisms of hypertension and cardiovascular diseases. Its early detection could be of great importance, in order to set a therapeutic attack and to counteract the higher risk of diabetes and cardiovascular diseases
Mechanisms of Cardiovascular Damage Induced by Traditional Chemotherapy
No full textTraditional chemotherapeutics are essential tools in the management of cancer patients. Nevertheless, these drugs are burdened by some degree of cardiovascular toxicity. Anthracycline-induced toxicity has been historically the most studied, but also the use of other drugs can be limited by a certain risk of cardiac and vascular toxicities. Here we acknowledge the main mechanistic insights, and we describe the different aspects of cardiotoxicity of these drugs, highlighting the different cellular compartments and cardiovascular components affected
Molecular Mechanisms of Cardiovascular Damage Induced by Anti-HER-2 Therapies
No full textIn the last two decades, newer biological drugs have been designed in order to “target” specific proteins involved in cancer proliferation and overcome the increased risk of cardiovascular toxicity associated with “broad-spectrum” classic chemotherapeutics. Unfortunately, these proteins are also important for the maintenance of cardiovascular homeostasis. The humanized anti-ErbB2 antibody, trastuzumab, is the prototypical biological drug first introduced in antineoplastic protocols for the treatment of ErbB2+ breast cancer. Indeed, not only is this protein overexpressed in several breast cancers, but also it plays a major role in the cardiovascular system in cell growth, including myocyte growth, and inhibition of apoptosis and can modulate the oxidative damage induced by anthracyclines. Hence, patients treated with trastuzumab developed systolic dysfunction, especially when administered with or shortly after doxorubicin
Pulmonary Hypertension Induced by Anticancer Drugs
No full textPulmonary vascular damage is a rare but possible complication of treatment with chemotherapeutic agents or bone marrow transplantation. The main clinical manifestations involving the pulmonary vessels are the development of pulmonary arterial hypertension or pulmonary veno-occlusive disease. In this chapter we describe the main mechanisms underlying the development of this form of toxicity, the screening algorithm, and its clinical management
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe 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
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