Pub Date : 2024-04-01DOI: 10.23736/S0026-4806.24.09200-0
F. Numeroso, Luca Bottaro, Ali Younes, Andrea Ungar, A. Cabassi
BACKGROUND Hypotensive susceptibility in hypertensive patients could facilitate orthostatic hypotension, syncope and fall. The aim of this study was to identify incidence, clinical form, complications and risk factors for non-cardiac syncope in a cohort of hypertensive patients. METHODS This is an observational, case-controlled, retrospective study carried out on 168 patients, evaluated at the Hypertension Center of the University Hospital of Parma (Italy). Based on the presence of episodes of syncope during the six months prior to enrolment, we identified cases and controls and then we compared them to personal data, comorbidities, current drug regimens, presence of orthostatic hypotension, office and ambulatory blood pressure monitoring (ABPM) blood pressure (BP) values. RESULTS In patients with previous syncopal episodes (29.8% of total), we more frequently found female gender, comorbidities associated with autonomic dysfunction, diuretics and non-CV drugs potentially associated with hypotension in their current drug regimen, orthostatic hypotension and lower office and ABPM BP values. CONCLUSIONS To identify hypertensive patients at higher risk for syncope and falls, physicians should focus on comorbidities and current drug regimens, systematically perform an active standing test to identify orthostatic hypotension, employ ABPM to compare BP values with the pre-established target and highlight systolic BP drops and abnormalities suggesting concomitant autonomic dysfunction. The modulation of antihypertensive therapy is an effective tool to counteract the risk of non-cardiac syncope, with possible trauma or other negative influences.
{"title":"Incidence and risk factors for non-cardiac syncope in a cohort of patients addressing an accredited Arterial Hypertension Center: the Innocent Study.","authors":"F. Numeroso, Luca Bottaro, Ali Younes, Andrea Ungar, A. Cabassi","doi":"10.23736/S0026-4806.24.09200-0","DOIUrl":"https://doi.org/10.23736/S0026-4806.24.09200-0","url":null,"abstract":"BACKGROUND\u0000Hypotensive susceptibility in hypertensive patients could facilitate orthostatic hypotension, syncope and fall. The aim of this study was to identify incidence, clinical form, complications and risk factors for non-cardiac syncope in a cohort of hypertensive patients.\u0000\u0000\u0000METHODS\u0000This is an observational, case-controlled, retrospective study carried out on 168 patients, evaluated at the Hypertension Center of the University Hospital of Parma (Italy). Based on the presence of episodes of syncope during the six months prior to enrolment, we identified cases and controls and then we compared them to personal data, comorbidities, current drug regimens, presence of orthostatic hypotension, office and ambulatory blood pressure monitoring (ABPM) blood pressure (BP) values.\u0000\u0000\u0000RESULTS\u0000In patients with previous syncopal episodes (29.8% of total), we more frequently found female gender, comorbidities associated with autonomic dysfunction, diuretics and non-CV drugs potentially associated with hypotension in their current drug regimen, orthostatic hypotension and lower office and ABPM BP values.\u0000\u0000\u0000CONCLUSIONS\u0000To identify hypertensive patients at higher risk for syncope and falls, physicians should focus on comorbidities and current drug regimens, systematically perform an active standing test to identify orthostatic hypotension, employ ABPM to compare BP values with the pre-established target and highlight systolic BP drops and abnormalities suggesting concomitant autonomic dysfunction. The modulation of antihypertensive therapy is an effective tool to counteract the risk of non-cardiac syncope, with possible trauma or other negative influences.","PeriodicalId":18671,"journal":{"name":"Minerva medica","volume":"107 ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140758877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01Epub Date: 2023-07-24DOI: 10.23736/S0026-4806.23.08788-8
Shujun Zhao, Xiao Sun, Rui Xu, Yaqin Wang, Muchen Zhang, Yuchen Sun, Yan Zhang
{"title":"Clinical efficacy and mechanism exploration of Tianma Gouteng decoction in improving gestational hypertension by regulating IL-6, NF-kB, and AngII.","authors":"Shujun Zhao, Xiao Sun, Rui Xu, Yaqin Wang, Muchen Zhang, Yuchen Sun, Yan Zhang","doi":"10.23736/S0026-4806.23.08788-8","DOIUrl":"10.23736/S0026-4806.23.08788-8","url":null,"abstract":"","PeriodicalId":18671,"journal":{"name":"Minerva medica","volume":" ","pages":"97-100"},"PeriodicalIF":4.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9849835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Clinical study on the efficacy of self-designed elimination soup in the accumulation of qi stagnation and blood stasis based on transient elasticity of liver and spleen.","authors":"Xinfeng Huang, Lina Xu, Yurong Li, Mingyue Song, Dongwang Zhan","doi":"10.23736/S0026-4806.23.08787-6","DOIUrl":"10.23736/S0026-4806.23.08787-6","url":null,"abstract":"","PeriodicalId":18671,"journal":{"name":"Minerva medica","volume":" ","pages":"100-102"},"PeriodicalIF":4.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9764326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01Epub Date: 2021-02-22DOI: 10.23736/S0026-4806.21.07171-8
Alessandro DI Marco Berardino, Federica Sambuco, Francesco Travaglino, Antonina Re, Emanuele Gilardi
{"title":"Blood gas analysis changes and body position in patients with pneumonia due to SARS-CoV-2.","authors":"Alessandro DI Marco Berardino, Federica Sambuco, Francesco Travaglino, Antonina Re, Emanuele Gilardi","doi":"10.23736/S0026-4806.21.07171-8","DOIUrl":"10.23736/S0026-4806.21.07171-8","url":null,"abstract":"","PeriodicalId":18671,"journal":{"name":"Minerva medica","volume":" ","pages":"85-86"},"PeriodicalIF":4.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25398478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Application of fiberoptic bronchoscopy assisted local injection of budesonide in improving the prognosis of severe pneumonia.","authors":"Linjuan Tian, Yunping Wu, Dong Wang, Wei Liu, Yongding Wei, Zhihe Zhou, Dongyue Zhang","doi":"10.23736/S0026-4806.21.07609-6","DOIUrl":"10.23736/S0026-4806.21.07609-6","url":null,"abstract":"","PeriodicalId":18671,"journal":{"name":"Minerva medica","volume":" ","pages":"88-89"},"PeriodicalIF":4.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39046711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01Epub Date: 2023-05-19DOI: 10.23736/S0026-4806.23.08538-5
Yuki Kotani, Giovanni Landoni, Tommaso Scquizzato, Nadia Mohamed, Martina Baiardo Redaelli, Rosaria Sofia, Stefano Fresilli, Alberto Zangrillo, Maria L Azzolini
Introduction: Antiandrogen therapy can reduce the expression of transmembrane protease 2, which is essential for severe acute respiratory syndrome coronavirus-2 to enter the host cells. Prior trials suggested the efficacy of antiandrogen agents in patients with COVID-19. We investigated whether antiandrogen agents reduce mortality compared to placebo or usual care.
Evidence acquisition: We searched for randomized controlled trials comparing antiandrogen agents with placebo or usual care alone in adults with COVID-19 in PubMed, EMBASE, the Cochrane Library, the reference lists of retrieved articles, and publications by manufacturers of antiandrogen agents. The primary outcome was mortality at the longest follow-up available. The secondary outcomes included clinical worsening, the need for invasive mechanical ventilation, admission to the intensive care unit, hospitalization, and thrombotic events. We registered this systematic review and meta-analysis in PROSPERO International Prospective Register of Systematic Reviews (CRD42022338099).
Evidence synthesis: We included 13 randomized controlled trials enrolling 1934 COVID-19 patients. We found that antiandrogen agents reduced mortality at the longest follow-up available (91/1021 [8.9%] vs. 245/913 [27%]; risk ratio =0.40; 95% confidence interval, 0.25-0.65; P=0.0002; I2=54%). Antiandrogen therapy also reduced clinical worsening (127/1016 [13%] vs. 298/911 [33%]; risk ratio =0.44; 95% confidence interval, 0.27-0.71; P=0.0007; I2=70%) and hospitalization (97/160 [4.4%] vs. 24/165 [15%]; risk ratio =0.24; 95% confidence interval, 0.10-0.58; P=0.002; I2=44%). There was no significant difference in the other outcomes between the two treatment groups.
Conclusions: Antiandrogen therapy reduced mortality and clinical worsening in adult patients with COVID-19.
简介抗雄激素疗法可减少跨膜蛋白酶2的表达，而跨膜蛋白酶2是严重急性呼吸系统综合征冠状病毒-2进入宿主细胞的必要条件。之前的试验表明，抗雄激素药物对COVID-19患者有疗效。我们研究了与安慰剂或常规护理相比，抗雄激素药物是否能降低死亡率：我们在 PubMed、EMBASE、Cochrane 图书馆、检索到的文章的参考文献列表以及抗雄激素药物制造商的出版物中搜索了抗雄激素药物与安慰剂或单纯常规治疗对 COVID-19 成人患者的随机对照试验。主要结果是最长随访时间内的死亡率。次要结果包括临床恶化、有创机械通气需求、入住重症监护室、住院和血栓事件。我们在 PROSPERO 国际前瞻性系统综述注册中心（CRD42022338099）注册了这项系统综述和荟萃分析：我们纳入了13项随机对照试验，共招募了1934名COVID-19患者。我们发现，抗雄激素药物可降低最长随访时间内的死亡率（91/1021 [8.9%] vs. 245/913 [27%]；风险比 =0.40；95% 置信区间，0.25-0.65；P=0.0002；I2=54%）。抗雄激素治疗也减少了临床恶化（127/1016 [13%] vs. 298/911 [33%]；风险比 =0.44；95% 置信区间，0.27-0.71；P=0.0007；I2=70%）和住院（97/160 [4.4%] vs. 24/165 [15%]；风险比 =0.24；95% 置信区间，0.10-0.58；P=0.002；I2=44%）。结论：抗雄激素治疗可降低死亡率和并发症：抗雄激素治疗降低了COVID-19成年患者的死亡率和临床恶化程度。
{"title":"Antiandrogen agents in COVID-19: a meta-analysis of randomized trials.","authors":"Yuki Kotani, Giovanni Landoni, Tommaso Scquizzato, Nadia Mohamed, Martina Baiardo Redaelli, Rosaria Sofia, Stefano Fresilli, Alberto Zangrillo, Maria L Azzolini","doi":"10.23736/S0026-4806.23.08538-5","DOIUrl":"10.23736/S0026-4806.23.08538-5","url":null,"abstract":"<p><strong>Introduction: </strong>Antiandrogen therapy can reduce the expression of transmembrane protease 2, which is essential for severe acute respiratory syndrome coronavirus-2 to enter the host cells. Prior trials suggested the efficacy of antiandrogen agents in patients with COVID-19. We investigated whether antiandrogen agents reduce mortality compared to placebo or usual care.</p><p><strong>Evidence acquisition: </strong>We searched for randomized controlled trials comparing antiandrogen agents with placebo or usual care alone in adults with COVID-19 in PubMed, EMBASE, the Cochrane Library, the reference lists of retrieved articles, and publications by manufacturers of antiandrogen agents. The primary outcome was mortality at the longest follow-up available. The secondary outcomes included clinical worsening, the need for invasive mechanical ventilation, admission to the intensive care unit, hospitalization, and thrombotic events. We registered this systematic review and meta-analysis in PROSPERO International Prospective Register of Systematic Reviews (CRD42022338099).</p><p><strong>Evidence synthesis: </strong>We included 13 randomized controlled trials enrolling 1934 COVID-19 patients. We found that antiandrogen agents reduced mortality at the longest follow-up available (91/1021 [8.9%] vs. 245/913 [27%]; risk ratio =0.40; 95% confidence interval, 0.25-0.65; P=0.0002; I<sup>2</sup>=54%). Antiandrogen therapy also reduced clinical worsening (127/1016 [13%] vs. 298/911 [33%]; risk ratio =0.44; 95% confidence interval, 0.27-0.71; P=0.0007; I<sup>2</sup>=70%) and hospitalization (97/160 [4.4%] vs. 24/165 [15%]; risk ratio =0.24; 95% confidence interval, 0.10-0.58; P=0.002; I<sup>2</sup>=44%). There was no significant difference in the other outcomes between the two treatment groups.</p><p><strong>Conclusions: </strong>Antiandrogen therapy reduced mortality and clinical worsening in adult patients with COVID-19.</p>","PeriodicalId":18671,"journal":{"name":"Minerva medica","volume":" ","pages":"37-44"},"PeriodicalIF":4.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9480688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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