Articles: disease.
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Randomized Controlled Trial
Live, Attenuated, Tetravalent Butantan-Dengue Vaccine in Children and Adults.
Butantan-Dengue Vaccine (Butantan-DV) is an investigational, single-dose, live, attenuated, tetravalent vaccine against dengue disease, but data on its overall efficacy are needed. ⋯ A single dose of Butantan-DV prevented symptomatic DENV-1 and DENV-2, regardless of dengue serostatus at baseline, through 2 years of follow-up. (Funded by Instituto Butantan and others; DEN-03-IB ClinicalTrials.gov number, NCT02406729, and WHO ICTRP number, U1111-1168-8679.).
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Sleep-disordered breathing has a relatively high prevalence, which varies from 3-7% in males and from 2-5% in females in the adult population. Studies published in the literature have shown that sleep apnea is closely related to an increased risk of developing various pathologies, among which arterial hypertension stands out. The prevalence of hypertension in patients suffering from obstructive sleep apnea (OSA) ranges from 35-80% and appears to be related to OSA severity. ⋯ The primary objective of this narrative review is to provide an update on what are the main contributing comorbidities to the development of a hypertensive state in patients suffering from OSA, an independent risk factor for diurnal hypertension, implicated as a risk factor for the first stroke, recurrent stroke, and post-stroke mortality. There are a lot of factors that contribute to developing a hypertensive state in OSA patients, some more decisive, others less. More evidence from longitudinal studies is needed on the impact of OSA on cardiovascular risk in females, on the causal link between OSA and arterial hypertension or metabolic diseases, like diabetes and glucose intolerance, and the effect of different kinds of OSA treatment.
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Mayo Clinic proceedings · Feb 2024
ReviewClinical Trials for Special Populations: Children, Older Adults, and Rare Diseases.
Research cannot maximize population health unless it improves health for all members of the public, including special populations such as children, older adults, and people living with rare diseases. Each of these categories require special considerations when planning and performing clinical trials, and common threads of ethical conduct of research in vulnerable populations appear throughout. In this review, definitions of each of the three categories of special population (children, older adults, and rare diseases) are discussed in terms of US research regulations, the unique challenges to conducting clinical trials for these special populations, critical ethical issues, and opportunities for innovative ways to design and operationalize clinical trials in special populations. Additional critical attention is focused on factors that influence the generalizability of study results to reduce health disparities, as well as the importance of community engagement and advocacy groups that can help to educate potential trial participants of the benefits of clinical trial participation.
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Review
Right ventricle: current knowledge of echocardiographic evaluation of this "forgotten" chamber.
In the past the right ventricle (RV) has been traditionally regarded as a simple conduit between the venous system and the pulmonary circulation and it has aroused little interest in both clinical and echocardiographic cardiologists to such an extent that it has been defined as the "forgotten chamber." Subsequently it was clearly shown that the right heart (RH) plays an important physiologic role in cardiac activity, and that congenital or acquired alterations in its structure and function have an important prognostic value. Aim of this review is to shed the light on the echocardiographic approach to this cardiac chamber. ⋯ However, RV may now be evaluated quantitatively and qualitatively in many ways, and some new methods can partially overcome some of the limits imposed by its complex anatomy, thereby yielding a quantitative evaluation. Furthermore, due to the wide range of pathologies which may involve the RV a disease-oriented approach should be considered in the echocardiographic investigation of right heart disease.