1,721,012 research outputs found
Candesartan plus hydrochlorothiazide fixed combination vs previous monotherapy plus diuretic in poorly controlled essential hypertensive patients
No full textOBJECTIVE: To assess efficacy and tolerability of candesartan cilexetil (CC) plus hydrochlorothiazide (HCTZ) fixed combination vs previous monotherapy (PM) plus HCTZ in hypertension. DESIGN AND METHODS: After 2-4 weeks of run in, 409 outpatients (diastolic blood pressure, DBP >90 and or =90 mmHg or SBP > 180 mmHg). RESULTS: Automatic oscillometric (Omron 705 CP) DBP and SBP were similarly reduced by CC + HCTZ and PM + HCTZ after 4 (12/15 and 10/13 mmHg) and 8 weeks (13/20 and 12/18 mmHg) in the intention-to-treat (ITT, n = 398) population. HCTZ dose was doubled in 18.1 and 31.2% of patients in the CC + HCTZ and PM + HCTZ group, respectively (p < 0.05). Rate of normalized patients (DBP <90 and/or SBP < 140 mmHg) after 8 weeks of treatment was greater (p < 0.05) under CC + HCTZ (82.0 vs 72.6% vs PM + HCTZ). Pulse pressure was comparably reduced by CC + HCTZ and PM + HCTZ, at 4 (3 mmHg for both) and 8 weeks (7 and 6 mmHg, respectively). Heart rate was unchanged. Results of per-protocol analysis (n = 316) did not differ from those of ITT analysis. Rate of adverse events was low and comparable between groups. CONCLUSIONS: CC plus HCTZ fixed combination is an effective and safe alternative to other antihypertensive drugs, given either as monotherapy or in combination when they do not satisfactorily control patient's blood pressure
Awareness, treatment, and control of major cardiovascular risk factors in a small-scale Italian community : results of a screening campaign
Full text linkIntroduction: Hypertension, hypercholesterolemia, and diabetes are the main causes of cardiovascular diseases in developed countries. However, these conditions are still poorly recognized and treated.
Objective: This study aimed at estimating the prevalence, awareness, treatment, and control rates of major cardiovascular risk factors in an unselected sample of individuals of a small community located in northern Italy.
Methods: We screened 344 sequential subjects in this study. Data collection included family and clinical history, anthropometric data, blood pressure, blood glucose, and serum cholesterol values. Individual cardiovascular risk profiles were assessed by risk charts of the Progetto Cuore.
Results: Based on personal history and/or measured values, 78.2% of subjects had hypercholesterolemia (total cholesterol levels > 190 mg/dL), 61.0% had central obesity (waist circumference ≥ 94 cm for men and ≥80 cm for women), 51.2% had arterial hypertension (blood pressure ≥ 140/90 mmHg), 8.1% had diabetes (blood glucose ≥ 126 mg/dL), 22.7% had impaired fasting glucose (blood glucose 100–125 mg/dL), and 35.5% were overweight (body mass index 25–29 kg/m2). Alcohol drinkers and smokers accounted for 46.2% and 22.4% of subjects, respectively. Awareness of hypertension, hypercholesterolemia, and diabetes was poor, and control of these risk factors, except for diabetes, was even worse. Prevalence of high blood pressure, high serum cholesterol, overweight, and obesity significantly increased with aging. Hypercholesterolemia and obesity were significantly more common in women, while overweight and diabetes in men. In 15.4% of participants, the risk of a major cardiovascular event in the next 10 years was either high or very high.
Conclusion: In a small community in a wealthy region of Italy, the prevalence of major cardiovascular risk factors is high, while awareness, treatment, and control are poor. Such a result highlights the importance of screening campaigns as a strategy to improve early diagnosis and access to treatment, and thus effective prevention of cardiovascular diseases in the general population
Vascular risk factors in glaucoma : The results of a National Survey
No full textBackground The role of vascular risk factors in glaucoma is still being debated. To assess the importance of vascular risk factors in patients with primary open-angle glaucoma (POAG), data from the medical history of 2,879 POAG patients and 973 age-matched controls were collected and analyzed.
Methods Design: observational survey. Setting: 35 Italian academic centers. Study population: POAG patients and age-matched controls. In order to reduce bias consecutive patients were included. Observation procedures: data concerning vascular risk factors were collected for all patients with a detailed questionnaire. A complete ophthal- mological examination with assessment of intraocular pressure (IOP), visual field, optic disc, and systemic blood pressure was performed. Main outcome measures: the ESH- ESC (European Society of Hypertension-European Society of Cardiology) guidelines were used to calculate the level of cardiovascular risk. Crude and adjusted estimates of the odds ratios (OR) were calculated for all cardiovascular risk factors in POAG and controls.
Results The study included 2,879 POAG patients and 973 controls. POAG cases had a significantly higher systolic and diastolic blood pressure (p = 0.001) and systolic perfusion pressure (p = 0.02) as compared with controls. Also mean IOP was significantly higher in the POAG group (p = 0.01), while diastolic perfusion pressure was not significantly different in the two groups. Myopia was more prevalent in the POAG group (23 vs 18%, p = 0.005) as well as a positive family history for glaucoma (26 vs 12%, p= 0.004). POAG patients tended to have a higher cardiovas- cular risk than controls: 63% of glaucoma cases vs 55% of controls (OR: 1.38, p = 0.005) had a “high” or “very high” cardiovascular risk.
Conclusions The level of cardiovascular risk was signifi- cantly higher in glaucoma patients than in controls
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
Efficacy of the clonidine transdermal therapeutic system (CTTS) compared to enalapril in an elderly population with isolated systolic hypertension
No full textObjective: to assess the efficacy and safety of the clonidine transdermal therapeutic system (CTTS) vs enalapril (E) in elderly patients with isolated systolic hypertension (ISH) from their clinical (C) and 24-hour ambulatory (A) blood pressure (BP) values.
Methods: this was an Italian, multicenter, open label, randomized study. After 2-week wash-out period, 90 elderly patients (mean age±SD: 69±6 years) with ISH (systolic blood pressure, SBP 175±12 mmHg; diastolic blood pressure, DBP 86±6 mmHg) were randomized to 2 weeks of treatment with CTTS1 once a week (0.1 mg/day) or E 10 mg once a day. In non-responders (SBP >150 mmHg during treatment or a <20 mmHg reduction from baseline), the dose of CTTS and E was doubled after two further weeks, and a combination of CTTS 1-2 and E 10-20 mg was started if the patients were still non-responders after the next 2 weeks. The treatment was then continued unchanged for 3 months. At the end of the wash-out and the treatment periods, BP was measured with a semiautomatic device in the doctor's office (CBP) and over 24 hours by ambulatory blood pressure monitoring (ABPM).
Results: clinical SBP was similarly reduced (32±17, 34±15 and 31±17 mmHg) for CTTS (n=38), E (n=41), and CTTS+E (n=11) respectively. The reduction in 24-hour SBP was similar between CTTS (16±9 mmHg; n=31) and E (19±15 mmHg; n=37), while it was slightly, although not statistically significant, greater for CTTS +E (23±9 mmHg; n=10). Similar results were observed for the daytime and nighttime sub-periods and for each hour of the recording. The two single treatments and their combination did not significantly affect C DBP, A DBP and heart rate. The CTTS was well tolerated and skin reactions were the only adverse events seldom observed (five patients).
Conclusions: CTTS is an effective antihypertensive drug in elderly patients with ISH. It reduces SBP over the 24 hours and does not affect DBP and HR
Lo “smoothness index” è superiore al rapporto valle/picco nell’indicare una riduzione omogenea della pressione arteriosa nelle 24 ore e nel predire la regressione del danno d’organo indotte dalla terapia antiipertensiva
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