1,721,117 research outputs found
Re-appraisal of cardiovascular risk prediction in healthy older people: Have you ever considered the added value of patient-perception of health status?
No full textA commentary of the manuscript:
Phyo AZZ, Ryan J, Gonzalez-Chica DA, Stocks NP, Reid CM, Tonkin AM, Woods RL,
Nelson MR, Murray AM, Gasevic D, Freak-Poli R; ASPREE Investigator Group.
Health-related quality of life and incident cardiovascular disease events in
community-dwelling older people: A prospective cohort study. Int J Cardiol. 2021
Sep 15;339:170-178
Personalized medicine: women in heart failure clinical trials, a must!
No full textWe read with great interest the paper by Merrill et al. (1) reporting that spironolactone is associated with a reduction in all-cause mortality in women but not in
Letters to the Editor JACC: HEART FAILURE VOL. 7, NO. 8, 2019 AUGUST 2019:731 – 4 732 Author's Personal Copy men with heart failure with preserved ejection fraction, enrolled in the TOPCAT (Aldosterone Antagonist Therapy for Adults With Heart Failure and Preserved Systolic Function) trial (2). The authors should be congratulated for exploring differences in clinical response to drugs between men and women. Their analyses highlight the importance of stratified
randomization by sex and sample sizes large enough to make conclusions in both men and women.
The random assignment of treatment is an essential feature of randomized clinical trials (RCT) that maximizes comparability between treatment groups.
Subgroup analyses are often performed to estimate the effect of the drug based on specific characteristics, such as patient sex. However, subgroup analyses
have limitations including not adjusting for covariates. Because randomization is not usually stratified by sex, women and men, despite being randomized to
treatment, may not have comparable clinical characteristics. In fact, in stratifying by sex, Merrill et al. (1) uncovered how women and men had a significantly
different clinical profile. Women were older, with fewer comorbidities (i.e., coronary artery disease and atrial fibrillation), but with higher blood pressure and
body mass index. Such imbalances between women and men highlight the need for randomization stratified by sex
The Internal Medicine and Assessment of Gender Differences in Europe (IMAGINE): The new European Federation of Internal Medicine initiative on sex and gender medicine
No full textMarital status and cardiovascular disease: can a soulmate prevent a “broken heart?"
No full textDuring the last century, the management of cardiovascular disease (CVD) in women and men has focused on a persistent, yet suboptimal, fight against traditional cardiovascular risk factors, primarly hypertension, diabetes, dyslipidemia, and smoking. Despite prevention campaigns and the availability of more effective therapies, CVD persists as the number one cause of mortality and morbidities, suggesting that the current knowledge of determinants of cardiovascular health is still far from comprehensively understood. The gap between the expected and the observed poses challenges for both cardiovascular scientists and clinicians who struggle to foster innovative approaches aimed at improving the well-being of individuals with CVD. Psycho-cultural-social factors, which are associated with the gender of individuals, are rarely measured as determinants of health outcomes. Neverthless, they have been proven to play an upstream role in mediating worse CV clinical outcomes
Cardiovascular Pathophysiology, Epidemiology, and Treatment Considerations of Coronavirus Disease 2019 (COVID-19): A Review
No full textThe coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is rapidly evolving, with important cardiovascular considerations. The presence of underlying cardiovascular risk factors and established cardiovascular disease (CVD) may affect the severity and clinical management of patients with COVID-19. We conducted a review of the literature to summarize the cardiovascular pathophysiology, risk factors, clinical presentations, and treatment considerations of COVID-19 patients with underlying CVD. Angiotensin-converting enzyme 2 (ACE2) has been identified as a functional receptor for the SARS-CoV-2 virus, and it is associated with the cardiovascular system. Hypertension, diabetes, and CVD are the most common comorbidities in COVID-19 patients, and these factors have been associated with the progression and severity of COVID-19. However, elderly populations, who develop more-severe COVID-19 complications, are naturally exposed to these comorbidities, underscoring the possible confounding of age. Observational data support international cardiovascular societies’ recommendations to not discontinue ACE inhibitor/angiotensin-receptor blocker therapy in patients with guideline indications for fear of the increased risk of SARS-CoV-2 infection, severe disease, or death. In addition to the cardiotoxicity of experimental antivirals and potential interactions of experimental therapies with cardiovascular drugs, several strategies for cardiovascular protection have been recommended in COVID-19 patients with underlying CVD. Troponin elevation is associated with increased risk of in-hospital mortality and adverse outcomes in patients with COVID-19. Cardiovascular care teams should have a high index of suspicion for fulminant myocarditis-like presentations being SARS-CoV-2 positive, and remain vigilant for cardiovascular complications in COVID-19 patients
Impact of Sex and Gender on the Efficacy of Antiplatelet Therapy: The Female Perspective
No full text
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
Anticoagulant therapy in patients with liver cirrhosis and portal vein thrombosis: insights for the clinician
Full text linkPortal vein thrombosis (PVT) is a frequent complication in the natural history of patients with liver cirrhosis (LC). The prevalence of PVT in LC is highly variable, ranging from 0.6% to 25% according to different reports. The impact of PVT on the natural history of LC is unclear, but it seems to negatively affect the prognosis of patients undergoing liver transplantation (LT) by increasing post-LT mortality and delaying waiting time. The antithrombotic treatment of PVT is still challenging as PVT may often remain asymptomatic and incidentally diagnosed, and a spontaneous partial/total regression of PVT is observed in an important proportion of patients, even in the absence of anticoagulation. Recent evidence suggested that the anticoagulant treatment for PVT may favorably affect both ischemic and bleeding outcomes in LC patients. Anticoagulant therapies so far available include unfractioned heparin, low molecular weight heparins (LMWHs) and fondaparinux for acute treatment, and LMWHs and vitamin K antagonists (VKAs) for long-term treatment. No robust data currently support the use of direct oral anticoagulants (DOACs) in patients with LC and PVT, as the safety and efficacy of DOACs in this setting is still unclear. This review summarizes current evidence for the evaluation and management of patients with LC and PVT
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
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