Hippokratia
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Chronic Obstructive Pulmonary Disease (COPD) is taking on catastrophic proportions. However, there is still a need for more objective and quantitative methods for its diagnosis and stratification. The present study explores the effectiveness of signal analysis methodologies as the means to increase the effectiveness of spirometry in diagnosing and stratifying COPD. ⋯ (a) It is for the first time that airflow resonances are identified in the sub-audible (<20 Hz) range of the power spectrum of the FEF curve. (b) COPD patients present with FEF curves which have different power spectral characteristics from those of healthy individuals (p<0.01), at frequencies lower than 3.66 Hz. (c) In COPD, in restrictive lung disease and in interstitial fibrosis, the lower resonant frequencies of the spectrum of the FEF curve predominate.
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The myelodysplastic syndromes (MDS) remain challenging to the clinician in terms of diagnosis and management. The diagnosis is essentially one of exclusion in first ruling out other disorders that can also cause peripheral blood/bone marrow cell dysplasia and cytopenias. Recent studies implicate extensive apoptosis as the explanation of the paradoxical observation of marrow hyperplasia, but peripheral blood cytopenia. ⋯ Low-risk patients should be considered for hematopoietic growth factor singly or in combination, while high-risk patients should be offered AML-induction therapy or novel therapeutic agents. Common complications are neutropenias with recurrent infections and red cell transfusion dependence. Future advances upon understanding the molecular details of the MDS clone should ultimately improve the care of patients with MDS.
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To investigate if pepsin is detected, with an activity assay, in the saliva of patients with a clinical diagnosis of laryngopharyngeal reflux (LPR) and can therefore be used as a diagnostic marker of laryngopharyngeal reflux. ⋯ Pepsin was not detected, with an activity assay, in the saliva of patients with a clinical diagnosis of LPR. A concentration method might be more sensitive although saliva and swallowing physiology renders the detection of pepsin in the saliva difficult.
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The ultimate goal of antihypertensive therapy is cardiovascular risk reduction. As lowering blood pressure per se reduces risk for myocardial infarction only by 20%-25%, it is obvious that a better protection is needed. An optimal strategy to reduce risk in hypertensives may include lifestyle modification, promotion of adherence to therapy, early and aggressive target levels achievement by appropriate drug choice. ⋯ This is not simply a co-existence but there is an independent and causal relationship between lipids and hypertension and there is a physiologic rationale and evidence for statins use especially in patients with complicated hypertension or in patients with more than two risk factors. So, whilst blood pressure lowering is undoubtedly beneficial, we have to focus on the global cardiovascular risk. We must go beyond blood pressure and the most effective way to go "beyond BP" is to add a statin.
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Cardiovascular diseases are the most common causes of death among hemodialysis (HD) patients, yet the risk factors for these events have not been well established. Our study objective was to determine predictors of cardiovascular mortality, considering the non-traditional/disease-related and treatment-related/ cardiovascular risk factor in HD patients. ⋯ It can be concluded that, inflammation (elevated CRP) and anaemia (decreased Hb), were identified as significant independent non-traditional, disease-related cardiovascular risk factors that predict cardiovascular mortality in HD patients.