Annals of medicine
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To evaluate the effect of body weight (BW) on safety and efficacy of direct oral anticoagulants (DOACs). ⋯ Results of our meta-analysis suggested that DOACs might be a safe and effective therapeutic option for the treatment of acute VTE even in the patients with extreme body weights. However, other studies with larger study populations are warranted to confirm our findings.
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Idiopathic pulmonary fibrosis (IPF) is the most common and lethal form of idiopathic interstitial pneumonia. The disease, which occurs primarily in middle-aged and older adults, is thought to arise following an aberrant reparative response to alveolar epithelial cell injury characterized by secretion of excessive amounts of extracellular matrix components, resulting in scarring of the lung, architectural distortion, and irreversible loss of function. A complex interplay between environmental and host factors is thought to contribute to the development of the disease, although the cause of IPF remains elusive and its pathogenesis incompletely understood. ⋯ This massive effort of the medical and industry community has led to the identification of two compounds (pirfenidone and nintedanib) able to reduce functional decline and disease progression. These promising results notwithstanding, IPF remains a major cause of morbidity and mortality and a largely unmet medical need. A real cure for this devastating disease has yet to emerge and will likely consist of a combination of drugs targeting the plethora of pathways potentially involved in disease pathogenesis.
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Randomized Controlled Trial
The effects of canrenone on inflammatory markers in patients with metabolic syndrome.
To evaluate the effects of canrenone compared to placebo on blood pressure control, some non-conventional biomarkers in cardiovascular stratification, and on metalloproteinases in patients affected by metabolic syndrome. ⋯ Canrenone seems to be effective in reducing blood pressure in patients with metabolic syndrome. Moreover, canrenone seems also to improve MPO, Lp(a), and metalloproteinases in these patients.
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The GRADE method (Grading of Recommendations, Assessment, Development, and Evaluation) provides a tool for rating the quality of evidence for systematic reviews and clinical guidelines. This article aims to analyse conceptually how well grounded the GRADE method is, and to suggest improvements. The eight criteria for rating the quality of evidence as proposed by GRADE are here analysed in terms of each criterion's potential to provide valid information for grading evidence. ⋯ It is concluded that three GRADE criteria have an appropriate conceptual basis to be used as indicators of confidence in research evidence in systematic reviews: internal validity of a study, consistency of the findings, and publication bias. In network meta-analyses, the indirectness of evidence may also be considered. It is here proposed that the grade for the internal validity of a study could in some instances justifiably decrease the overall grade by three grades (e.g. from high to very low) instead of the up to two grade decrease, as suggested by the GRADE method.
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Overweight and obesity in childhood have been linked to an increased risk of adult mortality, but evidence is still scarce. ⋯ An increasing BMI in early life may shorten the lifespan of maturing cohorts as they age, particularly among women.