Hypertension and nephrology

[Strategies for increasing physical activity in chronic kidney insufficiency. Why to train in CKD?]

APOR Péter

DECEMBER 10, 2017

Hypertension and nephrology - 2017;21(06)

[Chronic kidney patients are prone to lose their muscles, strength, their physical functioning and parallel to this the life expectancies are diminish. Physical training is a natural way to delaying these devastating processes in every grade of the illness. Centre-based or home, ambulant or dialysis-bound forms of programs are published – some of that recent information are summarized in this paper.]

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Hypertension and nephrology

[A Letter to Our Readers]

KÉKES Ede

Hypertension and nephrology

[Novelties in treatment of hypertension in pregnancy]

ALFÖLDI Sándor

[Hypertensive disorders represent the most common and dangerous medical disorder in pregnancy. Furthermore, its prevalence is rising. According the recent studies the initiation of antihypertensive treatment should be withhold in mild chronic hypertension (140-159/90-109 mmHg) in pregnancy, excepting associated subclinical hypertensive organ damage or hypertensive complications because of risk of compromising uteroplacental perfusion and fatal circulation. In preeclampsia, however, early antihypertensive treatment is necessary for the prevention of maternal cerebrovascular events.]

Hypertension and nephrology

[From healthcare accross health affair to „whole-ness” affair ]

VÁLYI Péter

[The present healthcare system is mainly disease-centered. There is an increased need in a health model, that considerates the human being, his or her health, health status, their effects on every day life activities, on filling of his or her social tasks, takes into account the influential role of physical, social, economical factors and personal characteristics as well. A such of kind health model should be developed, that considerates the whole human being, the completness of his or her health affairs, and simultaneously is a part of a „whole-ness” affair-, human-centered system, taking into account physical, social, economical and political factors at the same time.]

Hypertension and nephrology

[Sudden Death Risk Score (Scoring System) for Hypertensive Patients]

KÉKES Ede

Hypertension and nephrology

[Gout, hyperuricaemia and cardiovascular risk - Effects of allopurinol]

KÉKES Ede

[Hyperuricemia has an increasing clinical relevance due to its pathomechanism and its presence and adverse effects on cardiovascular, metabolic and renal diseases today. Its presence is a world phenomenon and in our country, we have seen increasing incidence rates during the screening surveys in recent years. Convincing evidence suggests that the high uric acid values in cardiovascular and renal diseases is an independent risk factor for CV mortality and their clinical manifestations. Experimental and clinical evidences indicates that in addition to gout, all high uric acid levels should be considered to initiate the XO inhibitor allopurinol treatment. Recently, in some diseases, in the treatment of the underlying disease (especially elderly hypertension, ischemic heart disease, chronic heart failure, chronic kidney failure) is also considered as an adjunct therapy.]

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We aimed to investigate the association between fluoxetine use and the survival of hospitalised coronavirus disease (COVID-19) pneumonia patients. This retrospective case-control study used data extracted from the medical records of adult patients hospitalised with moderate or severe COVID-19 pneumonia at the Uzsoki Teaching Hospital of the Semmelweis University in Budapest, Hungary between 17 March and 22 April 2021. As a part of standard medical treatment, patients received anti-COVID-19 therapies as favipiravir, remdesivir, baricitinib or a combination of these drugs; and 110 of them received 20 mg fluoxetine capsules once daily as an adjuvant medication. Multivariable logistic regression was used to evaluate the association between fluoxetine use and mortality. For excluding a fluoxetine-selection bias potentially influencing our results, we compared baseline prognostic markers in the two groups treated versus not treated with fluoxetine. Out of the 269 participants, 205 (76.2%) survived and 64 (23.8%) died between days 2 and 28 after hospitalisation. Greater age (OR [95% CI] 1.08 [1.05–1.11], p<0.001), radiographic severity based on chest X-ray (OR [95% CI] 2.03 [1.27–3.25], p=0.003) and higher score of shortened National Early Warning Score (sNEWS) (OR [95% CI] 1.20 [1.01-1.43], p=0.04) were associated with higher mortality. Fluoxetine use was associated with an important (70%) decrease of mortality (OR [95% CI] 0.33 [0.16–0.68], p=0.002) compared to the non-fluoxetine group. Age, gender, LDH, CRP, and D-dimer levels, sNEWS, Chest X-ray score did not show statistical difference between the fluoxetine and non-fluoxetine groups supporting the reliability of our finding. Provisional to confirmation in randomised controlled studies, fluoxetine may be a potent treatment increasing the survival for COVID-19 pneumonia.

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