Search results for "Signs"

2019

OBJECTIVE With a combination of different sympathetic tests, we aimed to elucidate whether impairment of sympathetic function in Parkinson's disease (PD) is the consequence of a central or peripheral efferent dysfunction. METHODS Thirty-five patients with early-to-intermediate PD (median age: 63 years; IQR: 57-67 years; disease duration 1-9 years, 15 women) and 20 age- and sex-matched healthy controls (median age: 64.5 years; IQR: 58-68 years; 10 women) were recruited. Autonomic testing was performed in two subgroups and included the assessment of resting cardiovascular parameters, postprandial hypotension (PPH), orthostatic hypotension (OH), and vasoconstriction induced by intradermal micr…

Hypovitaminosis D and orthostatic hypotension: A systematic review and meta-analysis

2016

Objectives: Orthostatic hypotension is a common condition among older adults and is associated with a range of deleterious outcomes. Recently, interest has developed in hypovitaminosis D (defined as low 25 hydroxiyVitamin D levels) as a potential risk factor for orthostatic hypotension. We conducted a systematic review and meta-analysis examining the association of orthostatic hypotension between study participants with and without hypovitaminosis D, including the adjustment of potential confounders (age, sex, BMI, renal function, comorbidities, seasonality, use of antihypertensive medications, and supplementation with cholecalciferol). Methods: A systematic literature search of major elect…

EPA-0666 – Long-term maintenance of efficacy of extended-release guanfacine hydrochloride (GXR) in children and adolescents with attention-deficit/hy…

2014

Introduction GXR, a selective α2A-adrenergic agonist, is a non-stimulant ADHD treatment approved in the USA for children and adolescents, and in Canada for children. Objectives To evaluate long-term maintenance of efficacy of GXR in children and adolescents with ADHD who respond to an initial open-label, short-term trial. Aims To determine if there is a higher rate of treatment failure for placebo vs GXR during the double-blind randomised-withdrawal phase (RWP) (NCT01081145). Methods Patients (6–17 years) meeting DSM-IV-TR criteria for ADHD, baseline ADHD Rating Scale-IV (ADHD-RS-IV) ≥32 and Clinical Global Impressions-Severity (CGI-S) ratings ≥4 were enrolled. Following 7-week dose optimiz…

Goals of Care in Emergency Abdominal Surgery in the Elderly and Frail Patient

2021

Elderly and frail patients are often those at highest risk during surgical procedures both in terms of intraoperative complications and postoperative outcome. It is clear that the best therapeutic result in the elderly and frail patient can be obtained through multidisciplinary management of the problem. In the management of elderly and frail patients undergoing to emergency surgery, we can make a series of considerations that guide our decision-making process. First, correct diagnosis can be difficult because of the impaired cognitive and physical status of the patient or other clinical conditions and medications that mask signs and symptoms. Second, the choice of the treatment to be carri…

Load progression criteria in exercise programmes in lower limb tendinopathy: a systematic review

2020

ObjectiveThe objective of this study is to summarise and analyse the current literature about what progression criteria are applied in loading exercise programmes in lower limb tendinopathies and their evidence and effectiveness.DesignSystematic review.MethodsPubMed, Embase, Scopus and PEDrowere searched from inception to 24 September 2020. The inclusion criteria were randomised controlled trials that included patients with midportion Achilles, patellar or gluteal tendinopathy; assessed function, pain or performance; included at least one group where progressive physical exercise was administered as monotherapy; included at least a control group. We excluded studies that included subjects w…

2019

Objective: In two independent study arms, we determine the effects of strength training (ST) and high-intensity interval training (HIIT) overload on cardiac autonomic modulation by measuring heart rate (HR) and vagal heart rate variability (HRV). Methods: In the study, 37 well-trained athletes (ST: 7 female, 12 male; HIIT: 9 female, 9 male) were subjected to orthostatic tests (HR and HRV recordings) each day during a 4-day baseline period, a 6-day overload microcycle, and a 4-day recovery period. Discipline-specific performance was assessed before and 1 and 4 days after training. Results: Following ST overload, supine HR, and vagal HRV (Ln RMSSD) were clearly increased and decreased (small …

Safety of agalsidase alfa in patients with Fabry disease under 7 years

2011

Aim:  To evaluate the safety and explore the efficacy of enzyme replacement therapy (ERT) for Fabry disease with agalsidase alfa in young children enrolled in the Fabry Outcome Survey (FOS). Methods:  This retrospective chart review identified eight children (mean age = 5.0 ± 1.6 [mean ± SD]) in FOS who began treatment with agalsidase alfa (0.2 mg/kg, i.v., every other week) when <7 years old. Vital signs and adverse events were monitored throughout the study period. Glomerular filtration rate (GFR) was estimated, and left ventricular mass indexed to height2.7 (LVMi) was assessed with echocardiography. Patients received 1.2–6.7 years of treatment (mean = 4.2 years). Results:  Infusion react…

Chambered warm moist air eyelid warming devices – a review

2021

Background Eyelid warming is an important treatment for meibomian gland dysfunction (MGD). Specialized chambered devices, using warm moist air have been developed. Purpose To critically evaluate the literature on the safety and efficacy of chambered warm moist air devices in MGD treatment and pinpoint areas of future research. Methods PubMed and Embase were searched on 06 June 2021. The search term was ‘(warm OR heat OR steam OR goggle OR spectacle OR moist air) AND (meibomian OR MGD OR blepharitis OR eyelid OR dry eye OR DED)’. All relevant articles with available English full text were included. Results Eighteen articles assessing the application of chambered warm moist air eyelid warming…

Orthostatic Hypotension and Complications

2020

Orthostatic hypotension prevalence exponentially increases with age, and an early detection of it can prevent the severe complications it may lead to. Among those, we mention (orthostatic) syncope and falls, cardiovascular diseases, and neurological diseases. Increased blood pressure variability related to standing which can provoke brain hypoperfusion and ischemia, higher arterial stiffness, and activated systematic inflammation, which have both been strongly involved in the pathogenesis of atherosclerosis, finally leading to CVD.

Topical 5'-methylthioadenosine in the treatment of symptomatic chronic venous insufficiency, haemorrhoids and superficial phlebitis. A double-blind p…

1992

500 patients entered a randomised double-blind placebo-controlled trial designed to evaluate the efficacy and tolerability of topical 5′-methylthioadenosine (MTA) 0.5% in relieving the major signs and symptoms related to chronic venous insufficiency, superficial phlebitis and first and second degree haemorrhoids.