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Factors of Social Distancing Amongst Southerly Africans Coming from A dozen Times To the COVID-19 Lockdown: A new Corner Sofa Study.
For other indicators of sleep quality and other population groups, the results are equivocal. Most of the available studies were conducted in special population groups and were inadequately designed; whilst clinical trials were of short duration and small sample sizes. Therefore, further well-designed clinical trials are required before further definitive conclusions can be made.
high glycemic index meals likely improve sleep onset latency in young males. For other indicators of sleep quality and other population groups, the results are equivocal. Most of the available studies were conducted in special population groups and were inadequately designed; whilst clinical trials were of short duration and small sample sizes. Therefore, further well-designed clinical trials are required before further definitive conclusions can be made.
The SARS-CoV-2 lockdown resulted in deep changes of lifestyles, promoting in many people the onset of psychological symptoms generally associated with drug and alcohol abuse. The aim was to assess the variation of alcohol drinking habits in a sample of Italian citizens during lockdown and to identify the psychosocial factors surrounding it.

An online anonymous questionnaire was created and submitted from 9th April 2020 to 28th April 2020. Questions were related to personal psychosocial details and alcohol drinking habits during the lockdown, including Alcohol Use Disorders Identification Test (AUDIT C) questions.

On a total of 1234 surveys the increase of both anxiety and fear was largely detected (63% and 61% respectively). The 18% increased alcohol consumption during the lockdown and it showed a significant correlation with anxiety and fear experienced (both p<0.001). The relative risk for 7 to 9 and more than 10 drinks per day consumption were directly linked to these symptoms (p<0.001). The most involved categories of participants showed this harmful association were self-employed workers and participants who live alone, subject aged 30-50 with high level of instruction or students and not occupied people in the age range 18-19 (all p<0.001). Additionally, the subset of the study population that showed low alcohol consumption before the lockdown has demonstrated the worsening of alcohol assumption during the quarantine (p<0.0001).

Several psychosocial factors are involved in determining the increase of alcohol consumption during lockdown and need the healthcare support to avoid awful impact on human life.
Several psychosocial factors are involved in determining the increase of alcohol consumption during lockdown and need the healthcare support to avoid awful impact on human life.The atherosclerotic cardiovascular disease (ASCVD) represents the leading cause of death and disability in the elderly. The study of atherosclerosis and the strategies to control ASCVD are evolving. All strategies emphasize the need to lower LDL cholesterol (LDL-C) through an appropriate lifestyle and the use of lipid-lowering drugs, mainly statins. Available evidence coming from clinical trials is useful to inform clinical choices but the older people are poorly represented in those trials. Thus evidence supporting the benefit of statin therapy for primary and secondary prevention of fatal and nonfatal ASCVD events in adults aged 75 years and older are limited. The pharmacological therapy of dyslipidemia is recommended by guidelines provided by international expert panels in adults, while in the elderly it is still a matter of debate. Statins are generally well tolerated drugs but their use in the elderly, especially in fragile ones or with multi-pathology that take many other drugs, requires a careful evaluation of the risk-benefit ratio and a shared decision-making process between doctor and patient.
Echocardiographic evaluation of left ventricular ejection fraction (LVEF) provides important information regarding both myocardial function and prognosis. This parameter presents various limitations and does not allow early detection of myocardial dysfunction. LVEF may be related to hemodynamic load, geometric assumptions, to image quality, and it does not reflect myocardial contractility. It has been hypothesized that Speckle tracking echocardiography (STE) may allow overcoming such limits.

STE through the measurement of strain and strain rate, which detect myocardial deformation, allows earlier identification of myocardial dysfunction in different settings both in presence of systolic and diastolic dysfunction, helps to predict left ventricular remodelling after acute myocardial infarction (AMI), and helps to decide the timing of surgery in asymptomatic severe valvular heart disease which is still a problematic issue. Increasingly interest regards the role of STE for the assessment of cardiomyopathies, myocarditis, and pulmonary hypertension.

STE may be applied to the evaluation of systolic and diastolic dysfunction. STE is useful in all conditions in which cardiac dysfunction is not still overt, but a subclinical involvement is undoubtedly present such as in presence of cardiovascular risk factors and in cardio-oncology at earlier stages. It has been confirmed its role in predicting left ventricular remodelling after AMI which represents an important prognostic datum and in deciding the timing of surgery in asymptomatic valvular diseases.

STE is an important tool to detect myocardial impairment even at earlier stages. 3DSTE and layer-specific strain represent promising fields of clinical application of STE.
STE is an important tool to detect myocardial impairment even at earlier stages. 3DSTE and layer-specific strain represent promising fields of clinical application of STE.
Fenofibrate (FF) has been suggested as a second-line therapy for primary biliary cholangitis (PBC) with suboptimal response to ursodeoxycholic acid (UDCA). But its long-term effect is unclear.

From a retrospective cohort (n=838), we enrolled 106 UDCA-refractory PBC patients, among them 62 received UDCA monotherapy (UDCA group) and 44 received FF combined with UDCA (UDCA+FF group). Changes of liver biochemistries and prognosis after treatment were determined. In addition, sequential liver biopsies were used to assess the effect of FF on histological parameters.

We found adding FF could significantly reduce serum levels of ALP, but for patients with pre-treatment ALP≥1.67 upper limit of normal (ULN), the significant decline of serum ALP was only observed in the UDCA+FF group after 1 year of therapy. The mean GLOBE score and the liver transplant-free survival predicted by GLOBE score were both improved significantly in patients receiving UDCA+FF after 1 year of therapy. The liver-related death or liver transplant calculated using UK-PBC risk score was significantly reduced in patients receiving UDCA+FF after 1 year of therapy. Although there was no marked difference in the final histological analysis after 3 years of therapy, patients receiving UDCA+FF had improvements or stabilization in fibrosis (85.7%), and bile duct loss (78.6%) were more than that of patients receiving UDCA (70.6% and 76.5%, respectively).

Adding FF improves GLOBE and UK-PBC scores, and is also associated with the improvements or stabilization of disease features, including fibrosis and ductular injury.
Adding FF improves GLOBE and UK-PBC scores, and is also associated with the improvements or stabilization of disease features, including fibrosis and ductular injury.
The adrenaline autoinjector (AAi) is universally recommended as the first-line treatment for anaphylactic reactions occurring outside the medical setting. The quantification of its acquisition may help estimate the prevalence of patients at risk of anaphylaxis with an indication for AAi.
Evaluation of the global and regional frequency of AAi purchases in Mainland Portugal between 2003-2017 and calculate the inherent costs in 2017.
AAi acquisition distribution analysis along this period. The population was divided in two age groups according to the adrenaline dosage.
A total of 10,993 AAi units of 0.15mg/0.3mL and 28,619 of 0.3mg/0.3mL were acquired in these 15 years, with an annual average of 733 and 1908 units, respectively. https://www.selleckchem.com/products/epacadostat-incb024360.html In cumulative values terms, Lisbon showed the highest number of AAI acquired and higher prevalence per region/100,000 inhabitants in both groups. In 2017, the annual cost for each age group was 64,202.71 € 187,447.70 € for patients and € 37,706.35 / 110,113.30 € for the Nationumber of AAI acquired and higher prevalence per region/100,000 inhabitants in both groups. In 2017, the annual cost for each age group was 64,202.71 € 187,447.70 € for patients and € 37,706.35 / 110,113.30 € for the National Health System. Conclusions. In the last 15 years, there was a progressive increase in AAi acquisition. We estimate a rate of anaphylaxis occurrence in Portugal according to AAi aquisition of 0.165%.
To estimate the prevalence of self-reported adverse reactions (AdR) to subcutaneous airborne allergen immunotherapy (SCIT) and to describe factors associated with its occurrence.
Real-life, observational, descriptive study of all patients treated with SCIT at a Portuguese allergy unit between 03/2017 and 06/2019, and who answered ≥1 time to a pre-SCIT evaluation questionnaire assessing the occurrence of local and/or systemic AdR in the previous administration.
939 questionnaires from 231 patients (42% female, 35% with asthma) were included. Most (60%) SCIT preparations had multiple allergens with concentration adjusted to prevent dilution (MA-NoDil), 26% were single allergen with standard concentration (SA-SC), 10% single allergen with higher than standard concentration (SA-HC), and 4% mixtures without concentration adjustment (MA-Dil). SCIT-related AdR were self-reported in 313 (33%) administrations, 97% at the injection site and 11% grade 1 systemic symptoms. In a multivariable model, being a femala) were included. Most (60%) SCIT preparations had multiple allergens with concentration adjusted to prevent dilution (MA-NoDil), 26% were single allergen with standard concentration (SA-SC), 10% single allergen with higher than standard concentration (SA-HC), and 4% mixtures without concentration adjustment (MA-Dil). SCIT-related AdR were self-reported in 313 (33%) administrations, 97% at the injection site and 11% grade 1 systemic symptoms. In a multivariable model, being a female and having asthma were associated with higher risk of AdR. MA-NoDil SCIT presented a lower risk of AdR compared to SA-SC SCIT. Conclusions. SCIT-related AdR were self-reported in 1/3 of the administrations, most at the injection site. The risk of AdR was higher in females and in patients with asthma. The lower risk of adverse reactions observed in SCIT preparations with multiple allergens with no dilutional effect should be further explored in future, targeted studies.
Although allergic diseases have become increasingly prevalent in the elderly, there are few data on this population. Through a retrospective analysis of the electronic medical records of patients aged 65 years and above followed in our Immunoallergology Unit, we aimed to characterize the immunoallergic diseases of the elderly. The most common disorders were respiratory diseases (n = 185; 50%), mucocutaneous diseases (n = 113; 31%), drug allergy (n = 31; 8%), food allergy (n = 9; 2%), and anaphylaxis (n = 9; 2%). Use of specific immunotherapy was residual (n = 2; 1%). There was an association between anaphylaxis and both, drug (p = 0.004) and food (p = 0.013) allergies. Non-allergic rhinitis and bronchial asthma were more frequent in females, and ACE inhibitors/ARB induced-angioedema in males. Recognizing the characteristics of immunoallergic diseases in the elderly and the specificities of this age group is paramount in providing these patients with the best possible care.
Although allergic diseases have become increasingly prevalent in the elderly, there are few data on this population.
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