1,721,063 research outputs found
Managing erectile dysfunction in heart failure.
No full textNowadays, erectile dysfunction (ED) is considered an increasingly important clinical condition in men with heart failure (HF) which might influence the therapeutic approach to these patients. Since there is cogent evidence that ED is a "sentinel marker" of acute cardiovascular events especially in men younger than 65 years old or in those affected by type 2 diabetes mellitus, it deserves an early diagnosis and an appropriate treatment. In NYHA III-IV class HF patients, sexual activity could lead to acute cardiovascular events and this should be taken into account when approaching ED patients. Moreover, it is well known that some classes of drugs, normally employed in the treatment of HF patients (e.g.thiazide diuretics, spironolactone and ß-blockers), might worsen or even contribute to ED development. However, growing evidence suggests that PDF 5 inhibitors (vardenafil, tadalafil and sildenafil) seem to better satisfy the needs of NYHA HF I- II class men suffering from ED. In fact, they show a few side effects, while improving both cardiopulmonary parameters and quality of life. Therefore, the aim of this review is to sum up the most recent evidences regarding the management of ED in men suffering from HF
Neuroimmune activation in chronic heart failure
No full textCardiac hypertrophy/remodeling is a critical condition that if not efficiently contrasted may predispose to fatal heart failure and multiple organ dysfunction as a result of irreversible neuroendocrine, autonomic and immune system imbalances. Indeed, in chronic heart failure (CHF) the over-excitation of sympathetic and/or the breakdown of central parasympathetic tone are believed to be the basis of the persistent immune activation that in part is primed by inflammatory reactions in the Central Nervous System. Moreover, the clinical management of CHF still today requires the identification of molecularly targeted drugs alternative to those considered so far. In this review are focused the possible neuroimmune-mediated pathways involved in CHF and set out the current therapeutic strategies
Thyroid disorders in Chronic Heart Failure: from prognostic set-up to therapeutic management.
No full textThyroid hormones have relevant activity at cardiac and vascular level, by influencing heart rate, myocardial excitability as well as inotropic and lusitropic status, systemic vascular resistance and blood pressure. Moreover, they interact with neuro-hormonal systems such as sympathetic nervous system and renin-angiotensin-aldosterone system thus also indirectly influencing cardiovascular function. Due to these effects, both hypothyroidism and hyperthyroidism, either in their overt or subclinical forms, can have an unfavourable impact in the setting of cardiovascular diseases. The aim of this review is to focus on the prognostic consequences of thyroid disorders in heart failure patients. Moreover, the therapeutical approach and the possible beneficial effects of restoring euthyroidism are reviewed
Osteoporosis in GH deficiency
No full textGH/IGF-1 axis is one of the main regulator of both
bone modeling and remodeling. Therefore, GH deficient
(GHD) patients have a derangment in these processes
leading to impaired linear growth with delayed stature,
reduced peak bone acquisition, reduced bone size, decrease
in bone turnover, low bone mass, osteoporosis and
increased fracture risk in adults. GH replacement therapy
can restore a normal bone linear growth in children and
can improve bone mass, reducing the fractures in GHD
patients, whereas its application in treating osteoporosis
in non-GHD patients is still controversial
Congestive heart failure and thyroid dysfunction: The role of the low T3 syndrome and therapeutic aspects
No full textBackground: Both the morbidity and mortality rates from congestive heart failure (CHF) remain elevated despite the medical and non-medical management of the disease, thus suggesting the existence of residual risk factors such as thyroid dysfunction. Particularly, the 15-30% of patients with CHF, especially those with severe ventricular dysfunction, display the so-called low T3 syndrome (LT3S), which seems to negatively affect the cardiovascular prognosis. Objective: Only a few clinical trials have been carried out to verify both the safety and the efficacy of thyroid replacement in the LT3S, aiming to ameliorate the prognosis of CHF, and most of the results were controversial. Methods: Since the aim of the present review was to briefly overview both the indication and contraindication of triiodothyronine replacement in CHF and LT3S, the authors searched PubMed using the medical subject headings (MeSH) related to the following terms: “congestive heart failure” and “low T3 syndrome” or “euthyroid sick syndrome” or “non-thyroidal sick syndrome”. The research study only focused on the narrative and systematic reviews, randomized clinical trials and meta-analysis studies which were conducted before June 2019. Results: Studies conducted in both animal models and humans provided controversial information about the effectiveness and safety of the T3 replacement for improving ventricular dysfunction, particularly in the long-term. Conclusion: Further clinical trials are needed to better explore the role of LT3S in patients with CHF and its consequent therapeutic strategy in this clinical setting
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
Introduction to the special issue: Relevance of endocrine and metabolic disorders in heart failure: from pathophysiology to therapeutic approach.
Full text linkVariations 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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