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61.
Vasilios G. Athyros Niki Katsiki Konstantinos Tziomalos Thomas D. Gossios Eleni Theocharidou Eygenia Gkaliagkousi Panagiotis Anagnostis Efstathios D. Pagourelias Asterios Karagiannis Dimitri P. Mikhailidis for the GREACE Study Collaborative Group 《Archives of Medical Science》2013,9(3):418-426
Introduction
The effect of cardiovascular disease (CVD) prevention measures aimed at elderly patients requires further evidence. We investigated the effect of statin treatment (targeted to achieve guideline goals) on CVD outcomes in different age groups to determine whether statins are more beneficial in the elderly.Material and methods
The primary endpoint of this post hoc analysis of the GREek Atorvastatin and Coronary-heart-disease Evaluation (GREACE) study (n = 1,600 patients with established coronary heart disease (CHD), mean follow-up 3 years) was the absolute and relative CVD event (a composite of death, myocardial infarction, revascularization, unstable angina, heart failure and stroke) risk reduction in age quartiles (each n = 200). Patients on “structured care” with atorvastatin (n = 800) followed up by the university clinic and treated to lipid goal were compared with the corresponding quartiles on “usual care” (n = 800) followed up by specialists or general practitioners of the patient''s choice outside the hospital.Results
In the elderly (mean age 69 ±4 and 70 ±3 years in the “structured” and “usual care”, respectively) the absolute CVD event reduction between “structured” and “usual care” was 16.5% (p < 0.0001), while in the younger patients (mean age 51 ±3 years and 52 ±3 years in the “structured” and “usual care”, respectively) this was 8.5% (p = 0.016); relative risk reduction (RRR) 60% (p < 0.0001) vs. 42% respectively (p = 0.001). The elderly had higher rates of chronic kidney disease and higher uric acid levels, plus an increased prevalence of diabetes, metabolic syndrome and non-alcoholic fatty liver disease. These factors might contribute to the increased CVD risk in older patients.Conclusions
All age groups benefited from statin treatment, but the elderly on “structured care” had a greater absolute and relative CVD risk reduction than the younger patients when compared with the corresponding patients assigned to “usual care”. These findings suggest that we should not deprive older patients of CVD prevention treatment and lipid target achievement. 相似文献62.
63.
64.
Bimpis A Papalois A Tsakiris S Zarros A Kalafatakis K Botis J Stolakis V Zissis KM Liapi C 《Metabolic brain disease》2012,27(2):221-225
Spontaneous intracerebral hemorrhage (ICH) accounts for 10–15% of all strokes. Despite high incidence, morbidity and mortality,
the precise pathophysiology of spontaneous ICH is not fully understood, while there is little data concerning the mechanisms
that follow the primary insult of the hematoma formation. The cholinergic system, apart from its colossal importance as a
neurotransmission system, seems to also play an important role in brain injury recovery. It has been recently suggested that
the brain possesses a cholinergic anti-inflammatory pathway that counteracts the inflammatory responses after ICH, thereby
limiting damage to the brain itself. We, herein, report the findings of our study concerning the role of acetylcholinesterase
(AChE; a crucial membrane-bound enzyme involved in cholinergic neurotransmission) in a porcine model of spontaneous ICH, with
a focus on the first 4 and 24 h following the lesion’s induction, in combination with a study of the effectiveness of the
lazaroid antioxidant U-74389G administration. Our study demonstrates the activation of AChE activity following U-74389G administration.
The lazaroid U-74389G seems to be an established neuroprotectant and this is the first report of its supporting role in the
enhancement of cholinergic response to the induction of ICH. 相似文献
65.
66.
Voskaridou E Ladis V Kattamis A Hassapopoulou E Economou M Kourakli A Maragkos K Kontogianni K Lafioniatis S Vrettou E Koutsouka F Papadakis A Mihos A Eftihiadis E Farmaki K Papageorgiou O Tapaki G Maili P Theohari M Drosou M Kartasis Z Aggelaki M Basileiadi A Adamopoulos I Lafiatis I Galanopoulos A Xanthopoulidis G Dimitriadou E Mprimi A Stamatopoulou M Haile ED Tsironi M Anastasiadis A Kalmanti M Papadopoulou M Panori E Dimoxenou P Tsirka A Georgakopoulos D Drandrakis P Dionisopoulou D 《Annals of hematology》2012,91(9):1451-1458
Haemoglobinopathies are the most common hereditary disorders in Greece. Although there is a successful national prevention program, established 35 years ago, there is lack of an official registry and collection of epidemiological data for haemoglobinopathies. This paper reports the results of the first National Registry for Haemoglobinopathies in Greece (NRHG), recently organized by the Greek Society of Haematology. NRHG records all patients affected by thalassaemia major (TM), thalassaemia intermedia (TI), "H" Haemoglobinopathy (HH) and sickle cell disease (SCD). Moreover, data about the annual rate of new affected births along with deaths, between 2000 and 2010, are reported. A total of 4,506 patients are registered all over the country while the number of affected newborns was significantly decreased during the last 3 years. Main causes for still having affected births are: (1) lack of medical care due to financial reasons or low educational level; (2) unawareness of time limitations for prenatal diagnosis (PD); due either to obstetricians' malpractice or to delayed demand of medical care of couples at risk; and (3) religious, social or bioethical reasons. Cardiac and liver disorders consist main causes for deaths while life expectancy of patients lengthened after 2005 (p < 0.01). The NRHG of patients affected by haemoglobinopathies in Greece provides useful data about the haemoglobinopathies in the Greek population and confirms the efficacy of the National Thalassaemia Prevention Program on impressively decreasing the incidence of TM and sickle cell syndromes. 相似文献
67.
68.
Antonis Fanouriakis Eleni Krasoudaki Michail Tzanakakis Dimitrios T. Boumpas 《Modern rheumatology / the Japan Rheumatism Association》2012,22(6):803-813
The treatment of lupus nephritis has seen significant advances during the past decade mainly due to the publication of well-designed randomized clinical trials (RCTs). The choice of treatment is guided by the histopathologic classification but is also influenced by demographic, clinical, and laboratory characteristics that allow for the identification of patients at risk for more aggressive disease. For the induction arm, low-dose cyclophosphamide regimens and mycophenolate mofetil have been validated as alternatives to the established National Institutes of Health regimen of high-dose cyclophosphamide; for the maintenance phase, azathioprine and mycophenolate compete for treatment of first choice. Rituximab is efficacious in real-life clinical practice but ineffective in clinical trials. The role of recently approved belimumab in lupus nephritis eagerly awaits further documentation. Aggressive management of comorbid conditions, such as hypertension and dyslipidemia, is of utmost importance. Here, we review the latest advances in lupus nephritis therapy with a focus on recent RCTs as well as new biologic agents under development. Furthermore, we propose a therapeutic algorithm in an effort to facilitate clinical decision-making in this gradually changing landscape. Upcoming European and American recommendations should provide further clarification. 相似文献
69.
Christa?Kasang Albrecht?Ulmer Norbert?Donhauser Barbara?Schmidt August?Stich Hartwig?Klinker Samuel?Kalluvya Eleni?Koutsilieri Axel?Rethwilm Carsten?SchellerEmail author 《BMC infectious diseases》2012,12(1):14
Background
HIV-associated general immune activation is a strong predictor for HIV disease progression, suggesting that chronic immune activation may drive HIV pathogenesis. Consequently, immunomodulating agents may decelerate HIV disease progression. 相似文献70.
Mermigkis C Bouloukaki I Mermigkis D Kallergis E Mavroudi E Varouchakis G Tzortzaki E Siafakas N Schiza SE 《Sleep & breathing》2012,16(3):813-819