[Thiazide- or thiazide-like diuretics should be used in the treatment of patients with hypertension? Particularities of the situation in Hungary]
VÁLYI Péter
VÁLYI Péter
Szöveg nagyítása:
[Diuretics have remained the cornerstone of the antihypertensive treatment since their widespreading in the 1960s. According to the 2018 ESC/ESH Guidelines for the management of arterial hypertension, in the absence of evidence from direct comparator trials and recognizing that many of the approved single-pill combinations are based on hydrochlorothiazide, this drug and thiazide-like indapamide can be considered suitable antihypertensive agents. In the 2018 Hungarian guidelines indapamide is named as the most efficacious diuretic in the treatment of patients with hypertension. The aim of the publication is redefining thiazide- and thiazide-like diuretic use in the treatment of hypertensive patients, with particular attention to presently available hydrochlorothiazide and indapamide, and their combination drugs in Hungary.]
Lege Artis Medicinae
[The occurrence of specific forms of mood disorders is significantly higher among eminent creative persons, thus the talent and creative skills show some connections or may have common roots with mood swings. This phenomenon can be observed among composers as well. Our paper briefly summarizes several aspects of Gaetano Donizetti’s life (1797-1848), and some characteristic features of his operas. After his musical studies and initial successes Donizetti was hired by the opera impresario Domenico Barbaja who pressed him under contract to write operas in a considerable number. Donizetti’s personal tragedy was that his wife and three children have died young. He composed more than 70 operas, wrote the librettos for some of them, had drawing skills, and a sense for theatre Gesamtkunst. His composing technique was incredibly fast, partly due to the external pressure (especially by the impresario Barbaja). Beside the feverish speed (hypomania) he suffered of episodes with genuine fever, headache, and nausea. From 1845 onward full apathy, depression (occurred already earlier), and paralysis (progressiva?) developed hindering any creative power and meaningful interpersonal contact, so he was admitted to a closed mental facility. His illness was considered syphilis, but prevailing bipolar mood disorder may strongly be presumed today which is supported by early emerging creativity and hypomanic signs, transient mood swings, the composing technique, his multimodal talent, the abundance of his works (output of 3-4 operas a year), the vein (mood) streaming from the operas (’maddening scenes’ alongside lax and sparkling characters) and by certain circumstances (he was able to write opera buffas during his greatest personal tragedies). To all these components there can certainly be added an exogenous environmental pressure factor: Domenico Barbaja, the ’prince’ (and taskmaster) of opera impresarios. ]
Lege Artis Medicinae
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Lege Artis Medicinae
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Lege Artis Medicinae
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Lege Artis Medicinae
[Care of PAD (peripherial arterial disease) is one of the most negligent area of cardiovascular diseases: on one hand patients suffering from PAD are the most uncared, less educated and health-minded population (it’s enough to keep in mind the high rate of smoking and alcohol-abuse among them) in addition the number of angiologists is insufficient for the treatment of PAD. Although detection of PAD would be easy as a widely applicable, cheap screening method, the ankle-brachial index is available which is an obligatory screening investigation in general care. Therapeutic options are better and better since cilostazol was launched we have an evidence-based treatment which can solve the symptoms, slower the progression which is strongly recommended (IA recommendation) in both American and Hungarian guidelines. Cilostazol, a PDE3-inhibitor has complex pharmacological effect but contraindicated in several clinical conditions as pentoxiphylline is not totally excluded from the therapeutic arsenal of PAD. The place of antiplatelet agents is well-defined in the most recent European guidelines in the treatment of PAD. The jumping development of interventional radiology beyond medical therapy contributed a lot to prevent limb amputations in the case of early detection of PAD. ]
Journal of Nursing Theory and Practice
[The high blood pressure disease is one of the primary risk factors for the development of other cardiovascular diseases. The aim of the present study was to assess the medication habits, sleep quality, and quality of life of patients aged 45 and older living with hypertension.
Our study was a quantitative descriptive cross-sectional survey conducted in 2022 in the form of an online questionnaire among patients aged 45 and older suffering from hypertension (n=143). The data collection tools included the Morisky Medication Adherence Scale (8 items), the Pittsburgh Sleep Quality Index, EQ-5D-5L, and a self-designed questionnaire.
Lower age was associated with higher levels of medication adherence (R=-0.36; p=0.024). Patients who regularly visited their general practitioner showed more consistent medication intake (p=0.048). Adequate sleep quality positively influenced the quality of life (p<0.001).
Regular visits to the general practitioner not only facilitate medication adherence but also provide an excellent opportunity for patient education and health promotion. Therefore, it has paramount importance to draw the attention of hypertensive patients to the role of regular check-ups with their general practitioner, which can contribute to the prevention of complications arising from hypertension.]
Clinical Neuroscience
Posterior reversible encephalopathy syndrome (PRES) is characterized by vasogenic edema, usually reversible, with the prominent involvement of the parietal and occipital lobes. The exact etiopathogenesis leading to PRES is unknown. Because signs of eclampsia and preeclampsia in neuroimaging often overlap and manifest as PRES, we aimed to evaluate whether demographic, clinical, and laboratory parameters predict PRES in patients with preeclampsia or eclampsia.
Hypertension and nephrology
[Hypertension and hyperlipidemia frequently coexist, and their interaction amplifies overall atherosclerotic cardiovascular disease risk. We aimed to investigate lipid abnormalities and their associations with body mass index (BMI) in a large adult hypertensive patient population with the help of data mining.]
Hypertension and nephrology
[Biological drugs-combined chemotherapy represents a real breakthrough in the effective treatment of locally advanced and metastatic cancer patients. One of the most common and clinically significant side effects of angiogenesis inhibition is the development of high blood pressure. The purpose of this review is to analyze the relationship between inhibitors of the vascular endothelial growth factor signaling pathway and hypertension. We review incidence of VEGF/VEGFR inhibitors induced hypertension, mechanisms of its development, importance of blood pressure values regular monitoring, possible treatment strategies, and effectiveness of prophylactic antihypertensive treatment. We compare the results of clinical studies to clarify the prognostic and predictive significance of blood pressure elevation during antiangiogenic treatment. Further research into the relationship between biological treatment and hypertension may lead to more effective treatment with longer survival and better quality of life in advanced cancer patients.]
Hypertension and nephrology
[Increased sympathetic nervous system activity can be found in all forms of hypertension, but the degree of this may differ depending on the individual accompanying diseases.]
Risk factors of posterior reversible encephalopathy syndrome in patients with preeclampsia or eclampsia: A retrospective review
The effect of anesthetic blockade of greater occipital nerve during the withdrawal period of the medication overuse headache treatment
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Factors influencing the level of stigma in Parkinson’s disease in western Turkey3.
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Neuropathic pain and mood disorders in earthquake survivors with peripheral nerve injuries4.
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COMMENTS
1 comments
István Barna (SE. Belgyógyászati és Onkológiai Klinika)
SEPTEMBER 03, 2022
16:42