416 research outputs found

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    A 2018 Overview of Diuretic Resistance in Heart Failure

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    Heart failure is a disease with high direct and indirect costs. Current treatment includes drugs that alter disease progression and drugs that to improve symptoms. Loop diuretics are the cornerstone of congestion relief for acute management, as well as for chronic stabilization. In heart failure patients, maximal diuretic response is reduced by many individual factors. Diuretic resistance is defined as failure to achieve effective congestion relief despite appropriate or escalating diuretic doses. Its causes include impaired delivery of the diuretic to its luminal site of action, neurohormonal activation, tubular compensatory adaptation and drug interactions. Several strategies can be employed to aid decongestion of patients with impaired diuretic response. These include salt restriction, a higher effective single dose or higher dose frequency of loop diuretics, continuous infusion of diuretics and/or sequential nephron blockade through a synergistic combination of two or more diuretics from different classes. Ultrafiltration has also been found to be another effective and safe therapeutic option and should be considered in patients with refractory diuretic resistance. Overall, there is a lack of high-quality clinical data to guide the choice of treatment strategy and therapy should be tailored on a case-by-case basis.info:eu-repo/semantics/publishedVersio

    COVID-19 and lockdown, as lived and felt by university students

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    © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).In the last 2 years, the COVID-19 pandemic has spread all over the world, forcing the closure of universities, among other unusual measures in recent history. (1) Background: This work is based on the study HOUSE-ULisbon, a survey carried out during the second confinement (March-May 2021) in Portugal with the collaboration of all the Faculties of the University of Lisbon (UL). The present work aims to explore gender differences in how first-year college students experienced and felt COVID-19 and the second confinement. (2) Methods: A questionnaire was carried out. In total, 976 university students (19.66 years (SD = 4.033); Min = 17 and Max = 65) from the first year of the UL were included, of which 69.5% (n = 678) were female, and 30.5% were male (n = 298). SPSS v. 26 was used for quantitative data and MAXQDA 2020 for qualitative data. (3) Results: Overall, students reported various symptoms of physical and mental discomfort (especially females). Statistically significant differences were found in the problems that could arise from the pandemic, such as the prevalence of higher anxiety and worries by females, and online gaming by males. In coping strategies, differences were found in leisure and family relationships, with greater difficulty on the female side. Social interaction was perceived as difficult or very difficult by both genders. As strategies for future pandemics, they highlighted a concerted effort between the government and media in the transmission of messages to the population, facilitating information, knowledge and adoption of protective behaviors. (4) Conclusions: These results are important data for activating or maintaining resources and services for first-year university students, who in some university institutions were supported during the pandemic by psychological, material (e.g., computers, internet), and financial support measures, which are now diminished or extinct. The impacts on their lives will certainly not be extinguished post-pandemic, and health, education, and public policy measures should be prioritized for this group. These results are important data for activating resources and services for students, informing health and education professionals, and supporting public policies.Ana Cerqueira—Foundation for Science and Technology (FCT) PhD Grant (SFRH/BD/148403/2019); Fábio Botelho Guedes—Foundation for Science and Technology (FCT) PhD Grant (SFRH/BD/148299/2019).info:eu-repo/semantics/publishedVersio
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