colleagues for their interest in our recent meta-analysis describing the limitations of healthcare-associated pneumonia (HCAP) as a tool to identify patients at risk of antibiotic-resistant pathogens [1]. Salvatore et al have made a number of criticisms with respect to the search strat

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Background: PJieumatoid arthritis (RA) is a systemic disease involving many organ systems and is frequently accompanied by cardiac alterations. However, there is considerable disagreement concerning the cardiac abnormalities found in patients with RA. The purpose of our investigation was to determine, by a non-invasive method such as echocardiography, the nature and extent of cardiac involvement in RA patients with no symptoms of cardiac disease, in comparison with a control sample. Methods: We selected 35 patients affected by rheumatoid arthritis (five men, 30 women), aged 51 ± 11 years. No patient had either symptoms of cardiac disease or extra cardiac complaint. As a control group we studied 52 volunteers, aged 51 ± 12 years, randomly selected among a larger group of subjects with no symptoms, signs andlor clinical findings of extra cardiac diseases. All were in sinus rhythm and without any cardiac symptom. Standard two-dimensional, M-mode and Doppler echocardiographic examination was carried out on each subject. Results: In RA patients we found a higher prevalence of several abnormalities. We found no statistically significant differences between the groups of RA patients based on the stage and duration of disease. We found no correlation between cardiac abnormalities and inflammatory indices or drug therapy.

Endothelial nitric oxide synthase gene polymorphisms and cardiovascular damage in hypertensive subjects: an Italian case-control study

and other meteorological variables on hospital admissions for angina pectoris

Background and Aims: Plasma levels of NT-pro-BNP, a natriuretic peptide precursor, are raised in the presence of fluid retention of cardiac origin and can be used as markers of cardiac dysfunction. Recent studies showed high levels of NT pro BNP in patients with cirrhosis. We assessed NT pro-BNP and other parameters of cardiac dysfunction in patients with cirrhosis, with or without ascites, in order to determine whether the behaviour of NT pro BNP is linked to the stage of liver disease or to secondary cardiac dysfunction. Methods: Fifty eight consecutive hospitalized patients mostly with viral or NAFLD-related cirrhosis were studied. All underwent abdominal ultrasound and upper GI endoscopy. Cardiac morpho-functional changes were evaluated by echocardiography and NT-pro-BNP plasma levels determined upon admission. Twenty-eight hypertensive patients, without evidence of liver disease served as controls. Results: Fifty eight cirrhotic patients (72 % men) with a median age of 62 years (11 % with mild arterial hypertension and 31 % with type 2 diabetes) had a normal renal function (mean creatinine 0.9 mg/dl, range 0.7–1.06). As compared to controls, cirrhotic patients had higher NT pro-BNP plasma levels (365.26365.2 vs 70.8670.6 pg/ml; p,0.001). Left atrial volume (LAV) (61.8626.3 vs 43.5614.1 ml; p = 0.001), and left ventricular ejection fraction (62.766.9 vs. 65.564%,; p = 0.05) were also altered in cirrhotic patients that in controls. Patients with F2-F3 oesophageal varices as compared to F0/F1,

Metabolic syndrome (MetS) represents a combination of cardio-metabolic risk factors, including visceral obesity, glucose intolerance or type 2 diabetes, elevated triglycerides, reduced HDL cholesterol, and hypertension. MetS is rapidly increasing and prevalent worldwide as a consequence of the “epidemic ” obesity, with a considerable impact on the global incidence of cardiovascular disease and type 2 diabetes. At present, some authors are disappointed on the role of insulin resistance as unifying factor in the occurrence of all the MetS components, whereas the role of visceral obesity is increasing. This review summarizes and critically evaluates the clinical and scientific evidence supporting the existence of MetS as a “fatal consequence of visceral obesity”. In view of this, the effects of some adipocytokines and other proinflammatory factors produced by fat accumulation on the occurrence of the MetS have been also emphasized. Accordingly, the “hypoadiponectinemia ” has been proposed as the most interesting new hypothesis to explain the pathophysiology of MetS.

community- or hospital-acquired. Although only limited data are available, health care–associated pneumonia has been recently pro-posed as a new category of respiratory infection. “Health care– associated pneumonia ” refers to pneumonia in patients who have recently been hospitalized, had hemodialysis, or received intra-venous chemotherapy or reside in a nursing home or long-term care facility. Objective: To ascertain the epidemiology and outcome of commu-nity-acquired, health care–associated, and hospital-acquired pneu-monia in adults hospitalized in internal medicine wards. Design: Multicenter, prospective observational study. Setting: 55 hospitals in Italy comprising 1941 beds. Patients: 362 patients hospitalized with pneumonia during two

combined blockade of renin-angiotensin system with ACE inhibitor and angiotensin II type 1 receptor blocker in hypertensive patients: A 24-week randomized controlled double-dummy trial

License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Metabolic syndrome (MetS) represents a combination of cardiometabolic risk factors, including visceral obesity, glucose intolerance or type 2 diabetes, elevated triglycerides, reduced HDL cholesterol, and hypertension. MetS is rapidly increasing in prevalence worldwide as a consequence of the “epidemic ” obesity, with a considerable impact on the global incidence of cardiovascular disease and type 2 diabetes. At present, there is a growing interest on the role of visceral fat accumulation in the occurrence of MetS. In this review, the effects of adipocytokines and other proinflammatory factors produced by fat accumulation on the occurrence of the MetS have been also emphasized. Accordingly, the “hypoadiponectinemia ” has been proposed as the most interesting new hypothesis to explain the pathophysiology of MetS. 1.