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991.
992.
The risk of increasing blood pressure on the incidence of cardiovascular disease starts at 115/75 mmHg and roughly doubles for every 10 years increase in age, 20 mmHg increase in systolic blood pressure, 10 mmHg increase in diastolic blood pressure, or in the presence of comorbidities, such as diabetes or any evidence of cardiovascular disease. To lower blood pressure in patients with normal blood pressure and diabetes, or heart failure, or with any evidence of atherosclerotic disease in the coronary, cerebral and peripheral territories, reduces the incidence of major cardiovascular events by 18 to 42%. The diagnosis of hypertension in patients with these conditions is therefore irrelevant. The drugs that have mainly been tested in such conditions are the angiotensin-converting enzyme inhibitors, but their efficacy probably derives from their blood pressure-lowering effect, instead of a primary antiatherosclerotic effect.  相似文献   
993.
The association between uric acid (UA) and pre-eclampsia has been known for years, but the prognostic value of UA has been debated. This article will review recent evidences, evaluating UA as a prognostic factor for pre-eclampsia, both in the general population and in women with gestational hypertension, and as a predictor of disease severity and adverse maternal–fetal outcome. Finally, studies investigating UA as a putative pathogenic factor for pre-eclampsia are briefly mentioned.  相似文献   
994.
A suboptimal intrauterine environment has a number of deleterious effects on fetal development and postpartum health outcomes. Epidemiological studies on several human populations have linked socioeconomic status and low birth weight to an increased incidence of diseases such as hypertension, diabetes, obesity and cardiovascular disease. A growing number of experimental studies in a variety of animal models demonstrate that maternal stressors, such as nutrition and reduced uterine perfusion, affect the intrauterine milieu and result in increased blood pressure in offspring. Several mechanisms appear to contribute to hypertension, including vascular dysfunction and increased peripheral resistance, altered cardio–renal structure and alterations in cardio–renal function. Although many studies have characterized models of developmentally generated hypertension, few have begun to seek therapeutic modalities to ameliorate its incidence. This review discusses recent work that refines hypotheses linking a suboptimal intrauterine environment to cardiovascular and renal phenotypes that have increased susceptibility to cardiovascular disease and hypertension.  相似文献   
995.
Antibiotic lock therapy (ALT) – instillation of high concentrations of anti-microbial agent with or without anti-coagulant into the lumen of central venous catheters – is considered a valid conservative treatment for catheter-related bloodstream infection (CRBSI) in patients highly dependent on maintaining the catheter. Results from randomized controlled studies have indicated that the effectiveness of ALT is moderate, but recent findings from experimental studies and observational case series point to considerable efficacy and safety of this therapy, which is usually associated with concomitant systemic treatment. In this article, the current knowledge about ALT for patients with CRBSI is reviewed and discussed, with emphasis on existing controversies and the results obtained according to the various uses of the catheters and the etiologies of infection.  相似文献   
996.
It is estimated that over 300,000 people with Chagas disease are living in the USA, with more than 30,000 cases of Chagas cardiomyopathy expected per year. The epidemiology of Chagas disease in Central and South America differs from that of the USA, where particular attention must focus on blood bank screening, organ donation and vertical transmission. It is essential that healthcare practitioners have heightened awareness of Chagas disease in the differential diagnosis of certain patients and are aware of recommendations for the management of these patients in the USA. Ongoing attention must focus on trials that determine whether all patients will benefit from treatment as well as studies of new agents for therapy.  相似文献   
997.
998.
ABSTRACT.?

In my last Internet-related article, I speculated that social networking would be the coming wave in the effort to share knowledge among experts in various disciplines. At the time I did not know that a palliative care site on the World Wide Web (WWW), palliativedrugs.com, already provided the infrastructure for sharing expert knowledge in the field. The Web site is an excellent traditional formulary but it is primarily devoted to “unlicensed” (“off-label”) use of medications in palliative care, something we in the specialty often do with little to support our interventions except shared knowledge and experience. There is nothing fancy about this Web site. In a good way, its format is a throwback to Web sites of the 1990s. In only the loosest sense can one describe it as “multimedia.” Yet, it provides the perfect forum for expert knowledge and is a “must see” resource. Its existing content is voluminous and reliable, filtered and reviewed by renowned clinicians and educators in the field. Although its origin and structure were not specifically designed for social or professional networking, the Web site's format makes it a natural way for practitioners around the world to contribute to an ever-growing body of expertise in palliative care.  相似文献   
999.
Palliative Care     
Palliative care is the care of patients whose disease is incurable and whose life expectancy is limited to weeks or months. This commentary describes the development of modern palliative care, some of the elements and underlying philosophical constructs of such care, and calls for expansion and improvement in end of life care throughout the world.  相似文献   
1000.
A chart review of the most recent home visits from nursing, social work, and clergy to 37 home hospice patients indicated that all but two psychosocial and spiritual issues examined were addressed by hospice staff on home visits. Spirituality and, secondly, death anxiety were the most frequently discussed variables. Clergy addressed more spiritual issues than the other two professions, and social work addressed more psychosocial issues than the other two professions. These findings underscore the important roles that clergy and social work play on the hospice team, and imply that hospice should make a renewed commitment to psychosocial and spiritual care. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: getinfo@haworth.com]  相似文献   
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