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WOS: 000405571400002, PubMed ID: 28560717, Organ injury and impairment are commonly observed in patients with acute heart failure (AHF), and congestion is an essential pathophysiological mechanism of impaired organ function. Congestion is the predominant clinical profile in most patients with AHF; a smaller proportion presents with peripheral hypoperfusion or cardiogenic shock. Hypoperfusion further deteriorates organ function. The injury and dysfunction of target organs (i.e. heart, lungs, kidneys, liver, intestine, brain) in the setting of AHF are associated with increased risk for mortality. Improvement in organ function after decongestive therapies has been associated with a lower risk for post-discharge mortality. Thus, the prevention and correction of organ dysfunction represent a therapeutic target of interest in AHF and should be evaluated in clinical trials. Treatment strategies that specifically prevent, reduce or reverse organ dysfunction remain to be identified and evaluated to determine if such interventions impact mortality, morbidity and patient-centred outcomes. This paper reflects current understanding among experts of the presentation and management of organ impairment in AHF and suggests priorities for future research to advance the field., Heart Failure Association of the European Society of Cardiology, This work was supported by the Heart Failure Association of the European Society of Cardiology.

WOS: 000373160000002, PubMed ID: 26995592, Acute right ventricular (RV) failure is a complex clinical syndrome that results from many causes. Research efforts have disproportionately focused on the failing left ventricle, but recently the need has been recognized to achieve a more comprehensive understanding of RV anatomy, physiology, and pathophysiology, and of management approaches. Right ventricular mechanics and function are altered in the setting of either pressure overload or volume overload. Failure may also result from a primary reduction of myocardial contractility owing to ischaemia, cardiomyopathy, or arrhythmia. Dysfunction leads to impaired RV filling and increased right atrial pressures. As dysfunction progresses to overt RV failure, the RV chamber becomes more spherical and tricuspid regurgitation is aggravated, a cascade leading to increasing venous congestion. Ventricular interdependence results in impaired left ventricular filling, a decrease in left ventricular stroke volume, and ultimately low cardiac output and cardiogenic shock. Identification and treatment of the underlying cause of RV failure, such as acute pulmonary embolism, acute respiratory distress syndrome, acute decompensation of chronic pulmonary hypertension, RV infarction, or arrhythmia, is the primary management strategy. Judicious fluid management, use of inotropes and vasopressors, assist devices, and a strategy focusing on RV protection for mechanical ventilation if required all play a role in the clinical care of these patients. Future research should aim to address the remaining areas of uncertainty which result from the complexity of RV haemodynamics and lack of conclusive evidence regarding RV-specific treatment approaches.

This paper describes the diagnostic criteria for vestibular paroxysmia (VP) as defined by the Classification Committee of the Barany Society. The diagnosis of VP is mainly based on the patient history and requires: A) at least ten attacks of spontaneous spinning or non-spinning vertigo; B) duration less than 1 minute; C) stereotyped phenomenology in a particular patient; D) response to a treatment with carbamazepine/oxcarbazepine; and F) not better accounted for by another diagnosis. Probable VP is defined as follows: A) at least five attacks of spinning or non-spinning vertigo; B) duration less than 5 minutes; C) spontaneous occurrence or provoked by certain head-movements; D) stereotyped phenomenology in a particular patient; E) not better accounted for by another diagnosis.Ephaptic discharges in the proximal part of the 8th cranial nerve, which is covered by oligodendrocytes, are the assumed mechanism. Important differential diagnoses are Meniere's disease, vestibular migraine, benign paroxysmal positional vertigo, epileptic vestibular aura, paroxysmal brainstem attacks (in multiple sclerosis or after brainstem stroke), superior canal dehiscence syndrome, perilymph fistula, transient ischemic attacks and panic attacks. Current areas of uncertainty in the diagnosis of VP are: a) MRI findings of vascular compression which are not diagnostic of the disease or predictive for the affected side because they are also observed in about 30% of healthy asymptomatic subjects; and b) response to treatment with carbamazepine/ oxcarbazepine supports the diagnosis but there are so far no randomized controlled trials for treatment of VP.

Gilead Sciences Chronic infection with hepatitis C virus (HCV) is a leading indicator for liver disease. New treatment options are becoming available, and there is a need to characterize the epidemiology and disease burden of HCV. Data for prevalence, viremia, genotype, diagnosis and treatment were obtained through literature searches and expert consensus for 16 countries. for some countries, data from centralized registries were used to estimate diagnosis and treatment rates. Data for the number of liver transplants and the proportion attributable to HCV were obtained from centralized databases. Viremic prevalence estimates varied widely between countries, ranging from 0.3% in Austria, England and Germany to 8.5% in Egypt. the largest viremic populations were in Egypt, with 6358000 cases in 2008 and Brazil with 2106000 cases in 2007. the age distribution of cases differed between countries. in most countries, prevalence rates were higher among males, reflecting higher rates of injection drug use. Diagnosis, treatment and transplant levels also differed considerably between countries. Reliable estimates characterizing HCV-infected populations are critical for addressing HCV-related morbidity and mortality. There is a need to quantify the burden of chronic HCV infection at the national level. Arud Ctr Addict Med, CH-8005 Zurich, Switzerland Univ Leipzig, D-04109 Leipzig, Germany Odense Univ Hosp, Dept Infect Dis, DK-5000 Odense, Denmark Univ Libre Brussels, Erasme Univ Hosp, Brussels, Belgium Univ Fed Rio de Janeiro, Dept Gastroenterol, Rio de Janeiro, Brazil Hop Henri Mondor, Dept Sante Publ, F-94010 Creteil, France Hosp Santa Maria, Ctr Hosp Lisboa Norte, Dept Gastroenterol, Lisbon, Portugal Univ Toronto, Toronto Gen Hosp, Univ Hlth Network, Toronto, ON M5G 1L7, Canada Nottingham Univ Hosp NHS Trust, Nottingham, England Biomed Res Unit, Nottingham, England Inst Clin & Expt Med, Dept Hepatogastroenterol, Prague, Czech Republic Ege Univ, Izmir, Turkey Ankara Univ, TR-06100 Ankara, Turkey Osped Cantonale, Dept Gastroenterol, Bellinzona, Switzerland Univ Montreal, Dept Med, Liver Unit, Montreal, PQ H3C 3J7, Canada Adv Tech Hlth Serv Res TAISS, Madrid, Spain Hosp Valle de Hebron, CIBERehd, Barcelona, Spain Hosp Santo Antonio Capuchos, Dept Gastroenterol, Ctr Hosp Lisboa Cent, Lisbon, Portugal Hosp Puerta Hierro, Madrid, Spain Univ Fed Rio Grande do Sul, Hosp Clin, Porto Alegre, RS, Brazil Region Hosp Hovedstaden, Region Hovedstaden, Denmark Univ Fed Rio de Janeiro, Dept Clin Med, Rio de Janeiro, Brazil Hannover Med Sch, Dept Gastroenterol Hepatol & Endocrinol, Hannover, Germany German Liver Fdn, Hannover, Germany Univ Plymouth, Peninsula Schools Med & Dent, Plymouth PL4 8AA, Devon, England Univ New S Wales, Kirby Inst, Sydney, NSW, Australia Cairo Univ, Cairo, Egypt Orebro Univ Hosp, Dept Infect Dis, Orebro, Sweden Univ Orebro, Sch Hlth & Med Sci, SE-70182 Orebro, Sweden Ain Shams Univ, Cairo, Egypt Dokuz Eylul Univ, Izmir, Turkey Ctr Dis Anal CDA, Louisville, CO USA Karolinska Inst, Infect Dis Unit, Dept Med Huddinge, Stockholm, Sweden Exigo Consultores, Alhos Vedros, Portugal Universidade Federal de São Paulo, Div Gastroenterol, São Paulo, Brazil Universidade Federal de São Paulo, Div Infect Dis, São Paulo, Brazil Hosp Carlos III, CIBERehd, Madrid, Spain Univ Copenhagen, Copenhagen, Denmark Direccao Geral Saude, Lisbon, Portugal Univ Estadual Campinas, Fac Ciencias Med, UNICAMP,Dept Clin Med, Grp Estudo Hepatites,Disciplina Doencas Infeccios, São Paulo, Brazil Wilhelminenspital Stadt Wien, Dept Internal Med 4, Vienna, Austria Univ São Paulo, Sch Med, Div Gastroenterol & Hepatol, São Paulo, Brazil Hop Henri Mondor, Serv Hepatogastroenterol, F-94010 Creteil, France Med Univ Vienna, Dept Internal Med 3, Div Gastroenterol & Hepatol, Vienna, Austria Masaryk Univ, Univ Hosp Brno, Clin Infect Dis, Brno, Czech Republic Ankara Univ, Dept Gastroenterol, Sch Med, TR-06100 Ankara, Turkey Univ Manitoba, Dept Internal Med, Sect Hepatol, Winnipeg, MB, Canada Hlth Sci Ctr, Viral Hepatitis Invest Unit, Winnipeg, MB, Canada European Liver Patients Assoc, St Truiden, Belgium Istanbul Univ, Istanbul, Turkey Univ British Columbia, British Columbia Ctr Dis Control, Vancouver, BC V5Z 1M9, Canada Aalborg Univ Hosp, Dept Med Gastroenterol, Aalborg, Denmark Aalborg Univ Hosp, Sect Mol Diagnost, Aalborg, Denmark Katholieke Univ Leuven, Univ Hosp Leuven, Louvain, Belgium Univ Western Ontario, Div Gastroenterol, London, ON, Canada Univ Dusseldorf, Dusseldorf, Germany Univ São Paulo, Sch Med, São Paulo, Brazil Univ Zurich Hosp, Swiss HPB Hepatopancreatobiliary Ctr, CH-8091 Zurich, Switzerland Univ Zurich Hosp, Dept Gastroenterol & Hepatol, CH-8091 Zurich, Switzerland Univ Calgary, Liver Unit, Div Gastroenterol & Hepatol, Calgary, AB, Canada Univ Hosp, Div Gastroenterol & Hepatol, Geneva, Switzerland Univ Hosp, Div Clin Pathol, Geneva, Switzerland Natl Inst Publ Hlth, Natl Reference Lab Hepatitis, Prague, Czech Republic Univ Southhampton, Southampton, England Dalhousie Univ, Dept Med, Halifax, NS, Canada Dalhousie Univ, Dept Surg, Halifax, NS B3H 4H2, Canada Capital Dist Hlth Author, Serv Hepatol, Queen Elizabeth II Hlth Sci Ctr, Halifax, NS, Canada Univ British Columbia, Dept Gastroenterol, Vancouver, BC V5Z 1M9, Canada Assembleia Republ, Lisbon, Portugal Alfred Hosp, Melbourne, Vic, Australia Monash Univ, Melbourne, Vic 3004, Australia UCL, UCL Inst Liver & Digest Hlth, Div Med, London, England Ctr Hosp Porto, Dept Infect Dis, Oporto, Portugal JW Goethe Univ Hosp, Frankfurt, Germany Cantonal Hosp St Gallen, Div Gastroenterol & Hepatol, St Gallen, Switzerland Egyptian Liver Res Inst & Hosp ELRIAH, Dakahliah, Egypt Monash Hlth, Melbourne, Vic, Australia Catholic Univ Louvain, Clin Univ St Luc, Brussels, Belgium Med Univ Graz, Dept Internal Med, Div Gastroenterol & Hepatol, Graz, Austria St Vincents Hosp, Dept Gastroenterol, Melbourne, Vic, Australia Univ Melbourne, Melbourne, Vic, Australia Charles Univ Prague, Dept Internal Med, Fac Med 1, Prague, Czech Republic Cent Mil Hosp, Prague, Czech Republic Deutsch Leberhilfe eV, Cologne, Germany Ghent Univ Hosp, Ghent, Belgium Univ Ghent, B-9000 Ghent, Belgium Hasselt Univ, Dept Hlth Econ & Patient Safety, Diepenbeek, Belgium Med Univ Innsbruck, A-6020 Innsbruck, Austria Natl Liver Inst, Menoufia, Egypt Copenhagen Univ Hosp, Hvidovre, Denmark Univ New S Wales, St George Hosp Clin Sch Med, Sydney, NSW, Australia Univ New S Wales, Sch Med Sci, Sydney, NSW, Australia Univ Antwerp, B-2020 Antwerp, Belgium Karolinska Inst, Dept Med Huddinge, Stockholm, Sweden Karolinska Univ Hosp, Dept Gastroenterol & Hepatol Infect Dis, Stockholm, Sweden Universidade Federal de São Paulo, Div Gastroenterol, São Paulo, Brazil Universidade Federal de São Paulo, Div Infect Dis, São Paulo, Brazil Web of Science

Gilead Sciences The number of hepatitis C virus (HCV) infections is projected to decline while those with advanced liver disease will increase. A modeling approach was used to forecast two treatment scenarios: (i) the impact of increased treatment efficacy while keeping the number of treated patients constant and (ii) increasing efficacy and treatment rate. This analysis suggests that successful diagnosis and treatment of a small proportion of patients can contribute significantly to the reduction of disease burden in the countries studied. the largest reduction in HCV-related morbidity and mortality occurs when increased treatment is combined with higher efficacy therapies, generally in combination with increased diagnosis. With a treatment rate of approximately 10%, this analysis suggests it is possible to achieve elimination of HCV (defined as a >90% decline in total infections by 2030). However, for most countries presented, this will require a 3-5 fold increase in diagnosis and/or treatment. Thus, building the public health and clinical provider capacity for improved diagnosis and treatment will be critical. Hannover Med Sch, Dept Gastroenterol Hepatol & Endocrinol, D-30625 Hannover, Germany German Liver Fdn, Hannover, Germany Orebro Univ Hosp, Dept Infect Dis, Orebro, Sweden Univ Orebro, Sch Hlth & Med Sci, SE-70182 Orebro, Sweden Hosp Valle de Hebron, CIBERehd, Barcelona, Spain UCL, Div Med, UCL Inst Liver & Digest Hlth, London, England Inst Clin & Expt Med, Dept Hepatogastroenterol, Prague, Czech Republic Cairo Univ, Cairo, Egypt Ankara Univ, TR-06100 Ankara, Turkey Ghent Univ Hosp, Ghent, Belgium Wilhelminenspital Stadt Wien, Dept Internal Med 4, Vienna, Austria Ege Univ, Izmir, Turkey Karolinska Inst, Dept Med Huddinge, Stockholm, Sweden Karolinska Univ Hosp, Dept Gastroenterol & Hepatol Infect Dis, Stockholm, Sweden Univ Leipzig, D-04109 Leipzig, Germany Osped Cantonale, Dept Gastroenterol, Bellinzona, Switzerland Univ Montreal, Dept Med, Liver Unit, Montreal, PQ H3C 3J7, Canada Adv Tech Hlth Serv Res TAISS, Madrid, Spain Fed Univ State Rio de Janeiro, Dept Gastroenterol, Rio de Janeiro, Brazil Arud Ctr Addict Med, Zurich, Switzerland Hosp Santo Antonio Capuchos, Ctr Hosp Lisboa Cent, Dept Gastroenterol, Lisbon, Portugal Hosp Puerta Hierro, Madrid, Spain Univ Fed Rio Grande do Sul, Hosp Clin, Porto Alegre, RS, Brazil Odense Univ Hosp, Dept Infect Dis, DK-5000 Odense, Denmark Region Hosp Hovedstaden, Region Hovedstaden, Denmark Univ Fed Rio de Janeiro, Dept Clin Med, Rio de Janeiro, Brazil Univ Plymouth, Peninsula Sch Med & Dent, Plymouth PL4 8AA, Devon, England Univ New S Wales, Kirby Inst, Sydney, NSW, Australia Ain Shams Univ, Cairo, Egypt Dokuz Eylul Univ, Izmir, Turkey Ctr Dis Anal CDA, Louisville, CO USA Karolinska Inst, Dept Med Huddinge, Karolinska Univ Hosp, Infect Dis Unit, Stockholm, Sweden Exigo Consultores, Alhos Vedros, Portugal Universidade Federal de São Paulo, Div Gastroenterol, São Paulo, Brazil Universidade Federal de São Paulo, Div Infect Dis, São Paulo, Brazil Hosp Carlos III, CIBERehd, Madrid, Spain Univ Copenhagen, Copenhagen, Denmark Direccao Geral Saude, Lisbon, Portugal Univ Estadual Campinas, Fac Ciencias Med, Disciplina Doencas Infecciosas, Grp Estudo Hepatites,Dept Clin Med, São Paulo, Brazil Univ São Paulo, Sch Med, Div Gastroenterol & Hepatol, São Paulo, Brazil Hop Henri Mondor, Serv Hepatogastroenterol, F-94010 Creteil, France Med Univ Vienna, Div Gastroenterol & Hepatol, Dept Internal Med 3, Vienna, Austria Masaryk Univ, Clin Infect Dis, Univ Hosp Brno, Brno, Czech Republic Ankara Univ, Dept Gastroenterol, Sch Med, TR-06100 Ankara, Turkey Univ Manitoba, Dept Internal Med, Sect Hepatol, Winnipeg, MB, Canada Hlth Sci Ctr, Viral Hepatitis Invest Unit, Winnipeg, MB, Canada European Liver Patients Assoc, St Truiden, Belgium Istanbul Univ, Istanbul, Turkey Univ British Columbia, British Columbia Ctr Dis Control, Vancouver, BC V5Z 1M9, Canada Aalborg Univ Hosp, Dept Med Gastroenterol, Aalborg, Denmark Aalborg Univ Hosp, Sect Mol Diagnost, Aalborg, Denmark Katholieke Univ Leuven, Univ Hosp Leuven, Louvain, Belgium Univ Western Ontario, Div Gastroenterol, London, ON, Canada Univ Dusseldorf, Dusseldorf, Germany Univ São Paulo, Sch Med, São Paulo, Brazil Univ Libre Brussels, Erasme Univ Hosp, Brussels, Belgium Univ Zurich Hosp, Swiss HPB Hepatopancreatobiliary Ctr, CH-8091 Zurich, Switzerland Univ Zurich Hosp, Dept Gastroenterol & Hepatol, CH-8091 Zurich, Switzerland Univ Calgary, Div Gastroenterol & Hepatol, Liver Unit, Calgary, AB, Canada Natl Inst Publ Hlth, Natl Reference Lab Hepatitis, Prague, Czech Republic Univ Southhampton, Southampton, England Dalhousie Univ & Hepatol Serv, Queen Elizabeth II Hlth Sci Ctr, Capital Dist Hlth Author, Dept Med, Halifax, NS, Canada Dalhousie Univ & Hepatol Serv, Queen Elizabeth II Hlth Sci Ctr, Capital Dist Hlth Author, Dept Surg, Halifax, NS, Canada Univ British Columbia, Dept Gastroenterol, Vancouver, BC V5Z 1M9, Canada Assembleia Republ, Lisbon, Portugal Alfred Hosp, Melbourne, Vic, Australia Monash Univ, Melbourne, Vic 3004, Australia Hop Henri Mondor, Dept Sante Publ, F-94010 Creteil, France Nottingham Univ Hosp NHS Trust, Nottingham, England Biomed Res Unit, Nottingham, England Ctr Hosp Porto, Dept Infect Dis, Oporto, Portugal JW Goethe Univ Hosp, Frankfurt, Germany Cantonal Hosp St Gallen, Div Gastroenterol & Hepatol, St Gallen, Switzerland Univ Toronto, Toronto Gen Hosp, Univ Hlth Network, Toronto, ON M5G 1L7, Canada Egyptian Liver Res Inst & Hosp ELRIAH, Dakahliah, Egypt Catholic Univ Louvain, Clin Univ St Luc, Brussels, Belgium Med Univ Graz, Div Gastroenterol & Hepatol, Dept Internal Med, Graz, Austria St Vincents Hosp, Dept Gastroenterol, Melbourne, Vic, Australia Univ Melbourne, Melbourne, Vic, Australia Charles Univ Prague, Dept Internal Med, Fac Med 1, Prague, Czech Republic Cent Mil Hosp, Prague, Czech Republic Univ Antwerp, B-2020 Antwerp, Belgium Deutsch Leberhilfe eV, Cologne, Germany Univ Ghent, Dept Hlth Econ & Patient Safety, B-9000 Ghent, Belgium Hasselt Univ, Diepenbeek, Belgium Med Univ Innsbruck, A-6020 Innsbruck, Austria Natl Liver Inst, Menoufia, Egypt Copenhagen Univ Hosp, Hvidovre, Denmark Univ New S Wales, St George Hosp Clin Sch Med, Sydney, NSW, Australia Univ New S Wales, Sch Med Sci, Sydney, NSW, Australia Univ Hosp, Div Gastroenterol & Hepatol, Geneva, Switzerland Univ Hosp, Div Clin Pathol, Geneva, Switzerland Monash Hlth, Melbourne, Vic, Australia Division of Gastroenterology, Federal University of São Paulo, São Paulo, Brazil Division of Infectious Disease, Federal University of São Paulo, São Paulo, Brazil Web of Science

Gilead Sciences The disease burden of hepatitis C virus (HCV) is expected to increase as the infected population ages. A modelling approach was used to estimate the total number of viremic infections, diagnosed, treated and new infections in 2013. in addition, the model was used to estimate the change in the total number of HCV infections, the disease progression and mortality in 2013-2030. Finally, expert panel consensus was used to capture current treatment practices in each country. Using today's treatment paradigm, the total number of HCV infections is projected to decline or remain flat in all countries studied. However, in the same time period, the number of individuals with late-stage liver disease is projected to increase. This study concluded that the current treatment rate and efficacy are not sufficient to manage the disease burden of HCV. Thus, alternative strategies are required to keep the number of HCV individuals with advanced liver disease and liver-related deaths from increasing. Ctr Dis Anal, Louisville, CO 80027 USA Natl Liver Inst, Menoufia, Egypt JW Goethe Univ Hosp, Frankfurt, Germany Univ Calgary, Liver Unit, Div Gastroenterol & Hepatol, Calgary, AB, Canada Ankara Univ, Dept Gastroenterol, Sch Med, TR-06100 Ankara, Turkey Hosp Santo Antonio Capuchos, Dept Gastroenterol, Ctr Hosp Lisboa Cent, Lisbon, Portugal Med Univ Innsbruck, A-6020 Innsbruck, Austria Univ São Paulo, Sch Med, São Paulo, Brazil Hop Henri Mondor, Serv Hepatogastroenterol, F-94010 Creteil, France Adv Tech Hlth Serv Res TAISS, Madrid, Spain Ege Univ, Izmir, Turkey Karolinska Inst, Dept Med Huddinge, Stockholm, Sweden Karolinska Univ Hosp, Dept Gastroenterol & Hepatol Infect Dis, Stockholm, Sweden Ankara Univ, TR-06100 Ankara, Turkey Univ Leipzig, D-04109 Leipzig, Germany Osped Cantonale, Dept Gastroenterol, Bellinzona, Switzerland Univ Montreal, Dept Med, Liver Unit, Montreal, PQ H3C 3J7, Canada Fed Univ State Rio de Janeiro, Dept Gastroenterol, Rio de Janeiro, Brazil Arud Ctr Addict Med, Zurich, Switzerland Hosp Valle de Hebron, CIBERehd, Barcelona, Spain Hosp Puerta Hierro, Madrid, Spain Univ Fed Rio Grande do Sul, Hosp Clin, Porto Alegre, RS, Brazil Odense Univ Hosp, Dept Infect Dis, DK-5000 Odense, Denmark Reg Hosp Hovedstaden, Copenhagen, Denmark Univ Fed Rio de Janeiro, Dept Clin Med, Rio de Janeiro, Brazil Univ Plymouth, Peninsula Sch Med & Dent, Plymouth PL4 8AA, Devon, England Univ New S Wales, Kirby Inst, Sydney, NSW, Australia Cairo Univ, Cairo, Egypt Orebro Univ Hosp, Dept Infect Dis, Orebro, Sweden Univ Orebro, Sch Hlth & Med Sci, SE-70182 Orebro, Sweden Ain Shams Univ, Cairo, Egypt Dokuz Eylul Univ, Izmir, Turkey Karolinska Inst, Karolinska Univ Hosp, Dept Med Huddinge, Infect Dis Unit, Stockholm, Sweden Exigo Consultores, Alhos Vedros, Portugal Universidade Federal de São Paulo, Div Gastroenterol, São Paulo, Brazil Universidade Federal de São Paulo, Div Infect Dis, São Paulo, Brazil Inst Clin & Expt Med, Dept Hepatogastroenterol, Prague, Czech Republic Hosp Carlos III, CIBERehd, Madrid, Spain Univ Copenhagen, Copenhagen, Denmark Direccao Geral Saude, Lisbon, Portugal Univ Estadual Campinas, Disciplina Doencas Infecciosas, Dept Clin Med, Grp Estudo Hepatites,Fac Ciencias Med,UNICAMP, São Paulo, Brazil Wilhelminenspital Stadt Wien, Dept Internal Med 4, Vienna, Austria Univ São Paulo, Sch Med, Div Gastroenterol & Hepatol, São Paulo, Brazil Med Univ Vienna, Div Gastroenterol & Hepatol, Dept Internal Med 3, Vienna, Austria Masaryk Univ, Univ Hosp Brno, Clin Infect Dis, Brno, Czech Republic Univ Manitoba, Dept Internal Med, Sect Hepatol, Winnipeg, MB, Canada Hlth Sci Ctr, Viral Hepatitis Invest Unit, Winnipeg, MB, Canada European Liver Patients Assoc, St Truiden, Belgium Istanbul Univ, Istanbul, Turkey Univ British Columbia, British Columbia Ctr Dis Control, Vancouver, BC V5Z 1M9, Canada Aalborg Univ Hosp, Dept Med Gastroenterol, Aalborg, Denmark Aalborg Univ Hosp, Sect Mol Diagnost, Aalborg, Denmark Katholieke Univ Leuven, Univ Hosp Leuven, Louvain, Belgium Hosp Santa Maria, Dept Gastroenterol, Ctr Hosp Lisboa Norte, Lisbon, Portugal Univ Western Ontario, Div Gastroenterol, London, ON, Canada Univ Dusseldorf, Dusseldorf, Germany Univ Libre Brussels, Erasme Univ Hosp, Brussels, Belgium Univ Hosp, Div Gastroenterol & Hepatol, Geneva, Switzerland Univ Hosp, Div Clin Pathol, Geneva, Switzerland Natl Inst Publ Hlth, Natl Reference Lab Hepatitis, Prague, Czech Republic Univ Southhampton, Southampton, England Dalhousie Univ & Hepatol Serv, Capital Dist Hlth Author, Queen Elizabeth II Hlth Sci Ctr, Dept Med, Halifax, NS, Canada Dalhousie Univ & Hepatol Serv, Capital Dist Hlth Author, Queen Elizabeth II Hlth Sci Ctr, Dept Surg, Halifax, NS, Canada Univ British Columbia, Dept Gastroenterol, Vancouver, BC V5Z 1M9, Canada Assembleia Republ, Lisbon, Portugal Alfred Hosp, Melbourne, Vic, Australia Monash Univ, Melbourne, Vic 3004, Australia UCL, Div Med, UCL Inst Liver & Digest Hlth, London, England Hop Henri Mondor, Dept Sante Publ, F-94010 Creteil, France Nottingham Univ Hosp NHS Trust, Nottingham, England Biomed Res Unit, Nottingham, England Ctr Hosp Porto, Dept Infect Dis, Oporto, Portugal Cantonal Hosp St Gallen, Div Gastroenterol & Hepatol, St Gallen, Switzerland Univ Toronto, Toronto Gen Hosp, Univ Hlth Network, Toronto, ON M5G 1L7, Canada Egyptian Liver Res Inst & Hosp, Dakahliah, Egypt Monash Hlth, Melbourne, Vic, Australia Catholic Univ Louvain, Clin Univ St Luc, Brussels, Belgium Med Univ Graz, Div Gastroenterol & Hepatol, Dept Internal Med, Graz, Austria St Vincents Hosp, Dept Gastroenterol, Melbourne, Vic, Australia Univ Melbourne, Melbourne, Vic, Australia Charles Univ Prague, Dept Internal Med, Fac Med 1, Prague, Czech Republic Cent Mil Hosp, Prague, Czech Republic Univ Antwerp, B-2020 Antwerp, Belgium Deutsch Leberhilfe eV, Cologne, Germany Ghent Univ Hosp, Ghent, Belgium Univ Ghent, Belgium Hasselt Univ, Dept Hlth Econ & Patient Safety, Diepenbeek, Belgium Hannover Med Sch, Dept Gastroenterol Hepatol & Endocrinol, Hannover, Germany Copenhagen Univ Hosp, Hvidovre, Denmark Univ New S Wales, St George Hosp Clin Sch Med, Sydney, NSW, Australia Univ New S Wales, Sch Med Sci, Sydney, NSW, Australia Univ Zurich Hosp, Swiss HPB Hepatopancreatobiliary Ctr, CH-8091 Zurich, Switzerland Univ Zurich Hosp, Dept Gastroenterol & Hepatol, CH-8091 Zurich, Switzerland Universidade Federal de São Paulo, Div Gastroenterol, São Paulo, Brazil Universidade Federal de São Paulo, Div Infect Dis, São Paulo, Brazil Web of Science

WOS: 000332489101355, …

Stallergenes ALK-Abello European Academy of Allergy and Clinical Immunology (EAACI) MSD Novartis Nycomed/Takeda PHADIA/Thermo Fischer 3M AstraZeneca GlaxoSmithKline Merck Frosst Altair Amgen Asmacure Boehringer-Ingelheim Genentech Pharmaxis Schering Wyeth Ache Brazilian Research Council Fundacao de Amparo a Pesquisa da Bahia Fundacao Ciencia e Tecnologia Sociedade Portuguesa de Alergologia e Immunologia Clinica Abdi Ibrahim OrionPharma Nasonebs Merck McNeal Chiesi Nycomed Air Liquid Healthcare Mundipharma Almirall Kyorin Teva UK National Health Service Aerocrine AKL Ltd PREDICTA Swiss National Science Foundation MeDALL Global Allergy and Asthma European Network (GA 2LEN) Christine Kuthe Center for Allergy Research and Education Faes Farma Bial Johnson Johnson Sanofi HAD treasurer Innovative Medicine Initiative (EU) Helse Sor-Ost RHF (Southern and Eastern Norway Regional Health Authority) MEDA Alcon ISTA Thermo-Fisher Airsonett Medical Research Council Moulton Charitable Trust AB Science Canadian Institutes for Health Research AllerGen NCE Merck/Schering-Plough Circassia University Hospital Medical School of Universidad Autonoma de Nuevo Leon, Mexico Children's Research Foundation (Ireland) Danone Food Standards Agency (United Kingdom) European Union (EU) DTG Netherlands Asthma Foundation Merck-Sharp-Dohme, Mexico Allerquim Mexico Abbott Apotex HRA MedImmune Schering-Plough Proctor Gamble Sunovion (Sepracor) Phadia Servier CSC JohnsonJohnson Oxygen Plus New Medics European Respiratory Society Societe de Pneumologie de Langue Francaise Asthma Ministry of Health, Welfare, and Labor Altana Takeda UCB Uriach advisory board NAPP Royal College of GPs Clinical Champion in Allergy Agency for Healthcare Research and Quality (AHRQ) AnseII Bayer Schering OST Fujisawa IHAL Henkel Allergic rhinitis (AR) and asthma represent global health problems for all age groups. Asthma and rhinitis frequently coexist in the same subjects. Allergic Rhinitis and its Impact on Asthma (ARIA) was initiated during a World Health Organization workshop in 1999 (published in 2001). ARIA has reclassified ARas mild/moderate-severe and intermittent/persistent. This classification closely reflects patients' needs and underlines the close relationship between rhinitis and asthma. Patients, clinicians, and other health care professionals are confronted with various treatment choices for the management of AR. This contributes to considerable variation in clinical practice, and worldwide, patients, clinicians, and other health care professionals are faced with uncertainty about the relative merits and downsides of the various treatment options. in its 2010 Revision, ARIA developed clinical practice guidelines for the management of AR and asthma comorbidities based on the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) system. ARIA is disseminated and implemented in more than 50 countries of the world. Ten years after the publication of the ARIAWorld Health Organization workshop report, it is important to make a summary of its achievements and identify the still unmet clinical, research, and implementation needs to strengthen the 2011 European Union Priority on allergy and asthma in children. (J Allergy Clin Immunol 2012;130:1049-62.) Kryolan Leti MSO Procter and Gamble Sanofi-Aventis Scientific Advisory Board for the German Society for Allergy and Clinical Immunology German Federal Ministry of Consumer Protection European Centre for Allergy Research Foundation (ECARF) Hop Arnaud Villeneuve, Dept Resp Dis, Univ Hosp, Montpellier, France INSERM, U1018, CESP Ctr Res Epidemiol & Populat Hlth, Resp & Environm Epidemiol Team, Villejuif, France McMaster Univ, Dept Clin Epidemiol & Biostat & Med, Hamilton, ON, Canada Med Univ Warsaw, Dept Prevent Environm Hazards & Allergol, Warsaw, Poland Univ Hosp Montpellier, Hop Arnaud Villeneuve, INSERM, U657, Montpellier, France Catholic Univ, Fac Med, Res Ctr Resp Med CIMER, Cordoba, Argentina Univ Genoa, Sch Specializat, Genoa, Italy Univ Ghent, Dept Otorhinolaryngol, Upper Airways Res Lab, B-9000 Ghent, Belgium CNR, Inst Translat Pharmacol, Rome, Italy Univ Naples 2, Naples, Italy Univ Laval, Inst Univ Cardiol & Pneumol Quebec, Quebec City, PQ, Canada Univ Genoa, Dept Internal Med, DIMI, I-16126 Genoa, Italy Creighton Univ, Dept Med, Div Allergy & Immunol, Omaha, NE 68178 USA Univ Fed Bahia, ProAR Nucleo Excelencia Asma, Salvador, BA, Brazil CNPq, Salvador, BA, Brazil Univ Amsterdam, Dept Otorhinolaryngol, NL-1012 WX Amsterdam, Netherlands Univ Amsterdam, Acad Med Ctr, Dept Otorhinolaryngol, NL-1105 AZ Amsterdam, Netherlands Univ Porto, Sch Med, Dept Hlth Informat & Decis Sci, P-4100 Oporto, Portugal Univ Porto, Sch Med, CINTESIS, P-4100 Oporto, Portugal Hosp S Joao & Inst, Dept Allergy, Oporto, Portugal Hosp CUF Porto, Oporto, Portugal Erasmus MC, Dept Internal Med, Sect Allergol, Rotterdam, Netherlands Univ Washington, Sch Med, Seattle, WA USA Helsinki Univ Hosp, Dept Allergy, Skin & Allergy Hosp, Helsinki, Finland GARD ARIA Coordinator, Geneva, Switzerland Med Univ Lodz, Dept Internal Med Asthma & Allergy, Barlicki Univ Hosp, Lodz, Poland Univ S Florida, Coll Med, Dept Internal Med, Div Allergy & Immunol, Tampa, FL 33612 USA James A Haley Vet Hosp, Tampa, FL USA Univ Oslo, Oslo Univ Hosp, Dept Paediat, Oslo, Norway CIBERES, IDIBAPS, Hosp Clin, Rhinol Unit,ENT Dept, Barcelona, Spain CIBERES, IDIBAPS, Hosp Clin, Smell Clin,ENT Dept, Barcelona, Spain Univ Chicago, Dept Otolaryngol Head & Neck Surg, Chicago, IL 60637 USA Alfred Hosp, Dept Allergy Immunol & Resp Med, Melbourne, Vic, Australia Monash Univ, Melbourne, Vic 3004, Australia Teikyo Univ, Sch Med, Dept Med, Div Resp Med & Allergol, Tokyo 173, Japan EFA European Federat Allergy & Airways Dis Patien, Brussels, Belgium Univ Athens, Dept Allergy, Pediat Clin 2, Athens, Greece Nippon Med Sch, Bunkyo Ku, Tokyo 113, Japan Univ Aberdeen, Dept Primary Care Resp Med, Aberdeen, Scotland Woodbrook Med Ctr, Loughborough, Leics, England Univ Edinburgh, Edinburgh, Midlothian, Scotland Univ Manitoba, Fac Med, Winnipeg, MB, Canada NIAID, Bethesda, MD 20892 USA Univ N Carolina, Sch Pharm, Chapel Hill, NC USA Celal Bayar Univ, Sch Med, Dept Pulmonol, Manisa, Turkey Allergy & Asthma Inst, Islamabad, 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Barranquilla, Colombia IRCCS San Raffaele Pisana, Rome, Italy Univ Cattolica Sacro Cuore, Dept Thorac Surg, Rome, Italy Leiden Univ, Med Ctr, Dept Publ Hlth & Primary Care, Leiden, Netherlands Capital Inst Pediat, Asthma Clin, Natl Cooperat Grp Pediat Res Asthma, Beijing, Peoples R China Capital Inst Pediat, Educ Ctr, Beijing, Peoples R China Ctr Asthma Res & Educ, Beijing, Peoples R China Hop Arnaud Villeneuve, Univ Hosp, Allergy Unit, Montpellier, France Univ Hosp, Dept Allergol, Sch Med CEU San Pablo Madrid, Madrid, Spain Georgian Natl Univ, AIETI Med Sch, SEU Clin, Med Ctr, Tbilisi, Rep of Georgia Univ Genoa, Dept Internal Med, IRCCS Azienda Osped Univ San Martino, I-16126 Genoa, Italy Univ Montpellier I, Primary Care Dept, Montpellier, France Nova SE Univ, Coll Osteopath Med, Davie, FL USA Univ Manchester, Manchester, Lancs, England Aarhus Univ Hosp, Dept Resp Dis, DK-8000 Aarhus, Denmark Tech Univ Munich, Dept Dermatol & Allergy Biederstein, Munich, Germany TUM, Div Environm Dermatol, Munich, Germany TUM, Allergy Helmholtz Ctr, Munich, Germany Univ Hosp Strasbourg, Chest Dis Dept, Div Pulmonol Asthma & Allergol, Strasbourg, France Univ Med & Pharm Iuliu Hatieganu, Dept Allergy, Med Clin 3, Romanian Soc Allergy & Clin Immunol, Cluj Napoca, Romania McMaster Univ, AllerGen NCE, Dept Med, Hamilton, ON, Canada McMaster Univ, AllerGen NCE, Michael G DeGroote Sch Med, Div Clin Immunol & Allergy,Fac Hlth Sci, Hamilton, ON, Canada Univ Versailles St Quentin, Hop Foch, UPRES EA 220, Suresnes, France Ctr Hosp Reg Annecy, Serv Pneumol, Annecy, France Univ Ss Cyril & Methodius, Univ Clin Pulmonol & Allergy, Skopje, Macedonia Georgia Hlth Sci Univ, Augusta, GA USA Ctr Hosp Univ Beni Messous, Serv Pneumoallergol, Algiers, Algeria Vilnius Univ, Fac Med, Collaborating Ctr GA2LEN, Vilnius, Lithuania Univ London Imperial Coll Sci Technol & Med, Natl Heart & Lung Inst, London, England Wake Forest Univ, Bowman Gray Sch Med, Winston Salem, NC USA Ain Shams Univ, Childrens Hosp, Pediat Allergy & Immunol Unit, Cairo, Egypt Egyptian Soc Pediat Allergy & Immunol, Cairo, Egypt Soc Marocaine Malad Resp, Casablanca, Morocco Ctr Resp Dis & Allergy, Casablanca, Morocco Vilnius Univ, Fac Med, Vilnius, Lithuania Univ Milan, Sch Med, Melloni Hosp, Milan, Italy Educ Hlth, Warwick, England Dokkyo Med Univ, Mibu, Tochigi, Japan WHO, Country Off Georgia, Tbilisi, Rep of Georgia Clin Ricardo Palma, Lima, Peru Univ Nuevo Leon UANL, Hosp Univ, Fac Med, Monterrey, Mexico Ctr Allergy & Immunol, Tbilisi, Rep of Georgia Clin Hosp Univ Chile, Dept Med, Immunol & Allergol Div, Santiago, Chile Univ Hosp Leuven, Dept Otorhinolaryngol Head & Neck Surg, Louvain, Belgium Cent Reg Denmark, Ctr Publ Hlth & Qual Improvement, Aarhus, Denmark Allergy Ctr Vienna W, Vienna, Austria Natl Univ Ireland Univ Coll Cork, Dept Paediat & Child Hlth, Cork, Ireland Univ Southampton, Fac Med, Southampton SO9 5NH, Hants, England Univ Paris 11, Serv Pneumol, Hop Antoine Beclere, AP HP,INSERM,U999, Clamart, France Salvador Univ, Sch Med, Dept Immunol, Buenos Aires, DF, Argentina Univ St Andrews, St Andrews, Fife, Scotland Univ Paris, APHP, Ctr Asthme & Allergies, Grp Hosp Trousseau La Roche Guyon, F-75252 Paris, France Hacettepe Univ, Sch Med, Pediat Allergy & Asthma Unit, Ankara, Turkey George Washington Univ, Sch Med, Washington, DC USA Inst Asthma & Allergy, Chevy Chase, MD USA Hacettepe Univ Hosp, Dept Chest Dis, Adult Allergy Unit, Ankara, Turkey Charite, Inst Social Med Epidemiol & Hlth Econ, D-13353 Berlin, Germany McMaster Univ, Hamilton, ON, Canada Hotel Dieu France, Serv Pneumol & Reanimat Med, Beirut, Lebanon Univ St Joseph, Fac Med, Beirut, Lebanon Natl Med Ctr, Seoul, South Korea Seoul Natl Univ, Seoul, South Korea Korea Asthma Allergy Fdn, Seoul, South Korea Ctr Hosp Univ, Serv Malad Resp, Abidjan, Cote Ivoire Univ Groningen, Univ Med Ctr Groningen, GRIAC Res Inst, Beatrix Childrens Hosp,Dept Pediat Pulmonol & Ped, Groningen, Netherlands Med Univ Lodz, Dept Immunol Rheumatol & Allergy, Lodz, Poland Karolinska Inst, Dept Clin Sci & Educ, Stockholm, Sweden Karolinska Inst, Sachs Childrens Hosp, Stockholm, Sweden Vilnius Univ, Ctr Pulmonol & Allergol, Vilnius, Lithuania Vilnius Univ Hosp Santariskiu Klinikos, Vilnius, Lithuania Hosp Med Sur, Dept Allergy, Mexico City, DF, Mexico Univ Med & Pharm, Thanh Pho Ho Chi Minh, Vietnam Hop Sacre Coeur Montreal, Montreal, PQ, Canada Univ Montreal, Montreal, PQ, Canada Guangzhou Med Univ, Affiliated Hosp 1, State Key Lab Resp Dis, Guangzhou, Guangdong, Peoples R China Univ Tennessee, Coll Med, Memphis, TN USA Univ Dundee, Ninewells Hosp, Asthma & Allergy Res Grp, Dundee, Scotland Dubai Hlth Author, Sharjah, U Arab Emirates Univ Sharjah, Sharjah, U Arab Emirates Univ Mississippi, Med Ctr, Div Clin Immunol & Allergy, Jackson, MS 39216 USA Univ Arizona, Coll Med, Arizona Resp Ctr, Tucson, AZ USA Univ Arizona, Inst BIO5, Tucson, AZ USA Shahid Beheshti Univ Med Sci, NRITLD, Tehran, Iran Shahid Beheshti Univ Med Sci, Chron Resp Dis Res Ctr, Tehran, Iran Charite, Dept Dermatol & Allergy, D-13353 Berlin, Germany Maputo Cent Hosp, Dept Peadiat, Maputo, Mozambique Eduardo Mondlane Univ, Fac Med, Maputo, Mozambique Childrens Hosp La Fe, Unit Pediat Allergy & Pneumol, Valencia, Spain Karolinska Inst, Inst Environm Med, S-10401 Stockholm, Sweden Karolinska Univ Hosp, Astrid Lindgren Childrens Hosp, Stockholm, Sweden Univ Calif San Diego, Allergy & Asthma Med Grp, San Diego, CA 92103 USA Univ Calif San Diego, Res Ctr, San Diego, CA 92103 USA IMSS, Dept Allergy & Clin Immunol, Ctr Med Nacl Siglo 21, Mexico City, DF, Mexico Univ Aachen, Dept Dermatol, Aachen, Germany Inst Pneumol Marius Nasta, Bucharest, Romania Tishreen Univ, Sch Med, Dept Internal Med, WHO EMRO Collaborating Ctr Training & Res Chron R, Latakia, Syria CUF Descobertas Hosp, Immunoallergy Dept, Lisbon, Portugal Univ Padua, Dept Pediat, Food Allergy Referral Ctr Veneto Reg, Padua, Italy Mustapha Hosp, Algiers, Algeria Sci Ctr Childrens Hlth RAMS, Moscow, Russia Hosp Hospitaller Bros Buda, Budapest, Hungary Charite, Allergie Ctr Charite ECARF, Dept Dermatol Venerol & Allergy, D-13353 Berlin, Germany German Red Cross Hosp Westend, Berlin, Germany Jagiellonian Univ, Sch Med, Dept Pulmonol, Krakow, Poland Kinshasa Univ, ENT Dept, Kinshasa, Zaire Chiba Univ Hosp, Dept Otorhinolaryngol, Chiba, Japan Nippon Med Sch, Dept Otolaryngol, Bunkyo Ku, Tokyo 113, Japan Ctr Hosp Univ Pediat Charles de Gaulle, Ouagadougou, Burkina Faso Marmara Univ, Div Pediat Allergy & Immunol, Istanbul, Turkey Mem Hlth Grp, Istanbul, Turkey Charles Univ Prague, Fac Med Plzen, Dept Immunol & Allergol, Prague, Czech Republic MESSERLI Res Inst, Vienna, Austria Med Univ Vienna, Univ Vet Med Vienna, Vienna, Austria Univ Vienna, Vienna, Austria Ajou Univ, Sch Med, Suwon 441749, South Korea NICE, Paris, France Soc Pneumol Langue Francaise, Paris, France Krankenhaus Hietzing, Karl Landsteiner Inst Expt & Clin Pneumol, Dept Pulm Med, Vienna, Austria Alexanders Univ Hosp, Clin Allergy & Asthma, Sofia, Bulgaria Univ Groningen, Univ Med Ctr Groningen, GRIAC Res Inst, Dept Pulmonol, Groningen, Netherlands Univ Cape Town, Lung Inst, ZA-7925 Cape Town, South Africa Groote Schuur Hosp, ZA-7925 Cape Town, South Africa Leiden Univ, Dept Pulmonol, Med Ctr, Leiden, Netherlands Grosshansdorf Clin, Grosshansdorf, Germany Hop Prive Athis Mons, Serv Pneumol, Athis Mons, France Helsinki Univ Hosp, Dept Dermatol, Skin & Allergy Hosp, Helsinki, Finland Tech Univ Munich, CKCARE, Dept Dermatol Allergy Biederstein, Munich, Germany Univ Wisconsin, Sch Med & Publ Hlth, Madison, WI USA Med Univ Silesia, Dept & Clin Internal Dis Allergol & Clin Immunol, Katowice, Poland Complesso Integrato Columbus, Allergy Unit, Rome, Italy IRCCS Oasi Maria SS, Troina, Italy Son Pisa Primary Care Ctr, IB Salut Balear Hlth Serv, Int Primary Care Resp Grp, Palma de Mallorca, Spain Hosp Luz, Immunoallergy Dept, Lisbon, Portugal Univ Missouri, Kansas City Sch Med, Kansas City, MO 64110 USA Childrens Mercy Hosp, Kansas City, MO USA Emek Med Ctr, Afula, Israel Technion Israel Inst Technol, Rappaport Fac Med, Haifa, Israel Ctr Med Docente La Trinidad, Dept Allergy & Clin Immunol, Caracas, Venezuela UCL, Royal Natl TNE Hosp, London, England Univ Zurich Hosp, Dept Dermatol, Allergy Unit, CH-8091 Zurich, Switzerland Univ Edinburgh, Sch Med, Ctr Populat Hlth Sci, Allergy & Resp Res Grp, Edinburgh, Midlothian, Scotland Universidade Federal de São Paulo, Dept Pediat, Div Allergy Clin Immunol & Rheumatol, São Paulo, Brazil Natl Ctr Cardiol & Internal Med, Bishkek, Kyrgyzstan Ctr ACI Immunoflow, Czech Initiat Asthma, Prague, Czech Republic GAAPP, Vienna, Austria Ctr Res Environm Epidemiol CREAL, Barcelona, Spain Pontificia Univ Catolica RGS, Sch Med, Porto Alegre, RS, Brazil Univ Nevada, Sch Med, Reno, NV 89557 USA Hosp Mar, Municipal Inst Med Res IMIM, Barcelona, Spain CIBER Epidemiol & Salud Publ CIBERESP, Barcelona, Spain Univ Pompeu Fabra UPF, Barcelona, Spain Jagiellonian Univ, Coll Med, Krakow, Poland Coimbra Univ Hosp, Immunoallergy Dept, Coimbra, Portugal Childrens Hosp Philadelphia, Ctr Appl Genom, Philadelphia, PA 19104 USA Finnish Inst Occupat Hlth, Helsinki, Finland Univ Laval, Fac Med, Dept Obstet & Gynecol, Laval, PQ, Canada Med Univ Vienna, Christian Doppler Lab Allergy Res, Div Immunopathol, Dept Pathophysiol & Allergy Res,Ctr Pathophysiol, Vienna, Austria Hosp Clin Barcelona, Dept Pneumol, Allergy Unit, Immunoallergia Resp Clin, Barcelona, Spain IDIBAPS, Barcelona, Spain CIBERES, Barcelona, Spain Univ Paris 13, Bobigny, France Avicenne Hosp, AP HP, Bobigny, France Vilnius Univ, Fac Med, Dept Paediat, Vilnius, Lithuania Lithuanian Natl Council Childs Hlth, Vilnius, Lithuania Terveystalo Turku, Allergy Clin, Turku, Finland Univ Turku, Dept Lung Dis & Clin Immunol, Turku, Finland Univ Ghent, Dept Otorhinolaryngol, B-9000 Ghent, Belgium Catholic Univ Louvain, Univ Hosp Mt Godinne, Yvoir, Belgium Radboud Univ Nijmegen, Med Ctr, Dept Primary & Community Care, NL-6525 ED Nijmegen, Netherlands Siriraj Hosp, Fac Med, Dept Pediat, Bangkok, Thailand CNR, IBIM, Palermo, Italy Clin Physiol IFC, Pisa, Italy Natl Univ Singapore, Yong Loo Lin Sch Med, Singapore 117595, Singapore Floridsdorf Allergy Ctr FAZ, Vienna, Austria Med Univ Vienna, Dept Dermatol, DIAID, Vienna, Austria Bradford Teaching Hosp Fdn Trust, Bradford Inst Hlth Res, Bradford, W Yorkshire, England Olmsted Med Ctr, Dept Res, Rochester, MN USA Univ Minnesota, Dept Family & Community Hlth, Rochester, MN USA Harvard Univ, Sch Publ Hlth, Cyprus Int Inst Environm & Publ Hlth Assoc, Limassol, Cyprus Cyprus Univ Technol, Limassol, Cyprus Univ Cape Town, Red Cross War Mem Childrens Hosp, Dept Paediat & Child Hlth, ZA-7925 Cape Town, South Africa Catholic Univ Cordoba, Sch Med, Dept Otorhinolaryngol, Cordoba, Argentina Guangzhou Med Univ, Guangzhou Inst Resp Dis, Guangzhou, Guangdong, Peoples R China Guangzhou Med Univ, State Key Lab Resp Dis, Guangzhou, Guangdong, Peoples R China Univ Clin Resp & Allerg Dis, Golnik, Slovenia Charite, Network Excellence, Global Allergy & Asthma European Network GA2LEN, D-13353 Berlin, Germany Universidade Federal de São Paulo, Dept Pediat, Div Allergy Clin Immunol & Rheumatol, São Paulo, Brazil Web of Science

WOS: 000307827100011, PubMed ID: 21784540, The molecular background of the Ca2+-sensitizing effect of levosimendan relates to its specific interaction with the Ca2+-sensor troponin C molecule in the cardiac myofilaments. Over the years, significant preclinical and clinical evidence has accumulated and revealed a variety of beneficial pleiotropic effects of levosimendan and of its long-lived metabolite, OR-1896. First of all, activation of ATP-sensitive sarcolemmal K+ channels of smooth muscle cells appears as a powerful vasodilator mechanism. Additionally, activation of ATP-sensitive K+ channels in the mitochondria potentially extends the range of cellular actions towards the modulation of mitochondrial ATP production and implicates a pharmacological mechanism for cardioprotection. Finally, it has become evident, that levosimendan possesses an isoform-selective phosphodiesterase-inhibitory effect. Interpretation of the complex mechanism of levosimendan action requires that all potential pharmacological interactions are analyzed carefully in the framework of the currently available evidence. These data indicate that the cardiovascular effects of levosimendan are exerted via more than an isolated drug-receptor interaction, and involve favorable energetic and neurohormonal changes that are unique in comparison to other types of inodilators. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

WOS: 000296318900014, PubMed ID: 22024466, Aims Loop diuretics are recommended to treat congestion in heart failure (HF), despite limited quality evidence. High-dose (HD) loop diuretics seem to worsen outcomes in chronic HF, though; data for acute HF are scarce, with equivocal results. Methods and results The ALARM-HF study recorded in-hospital HF therapy in 4953 patients from nine countries. A post-hoc analysis was performed to determine if there was an interaction between intravenous (iv) bolus diuretic dosing and outcomes. Patients were classified as receiving high-or low-dose iv furosemide if their total initial 24 h dose was above (HD) or below [low dose (LD)] 1 mg/kg. Propensity scoring, matching an extensive list of variables, was performed. High-dose and LD patients were matched by propensity scores and outcomes determined. We identified 2460 LD and 848 HD patients, with overall in-hospital mortality of 9 and 13% (P = 0.002), respectively. After propensity matching, there were 506 patients in each subgroup, with the matched LD and HD cohorts having similar mortality (13 vs. 15%; P = 0.4). We further investigated in which subgroups of patients HD diuretics influenced mortality. Before matching, HD diuretics were associated with a greater risk of in-hospital death in some subgroups, including patients aged >80 years, those with an acute coronary syndrome, or with a left ventricular ejection fraction, ALARM-HF survey; Department of Biostatistics and Clinical Epidemiology; INSERM [U717]; St-Louis Hospital, France; Abbott; Alere; BAS; Brahms; EKR; Nanosphere; Medicines Company; Orion Pharma, Abbott funded the ALARM-HF survey; data were acquired by IMS. Analyses were performed independently of the funding source by the Department of Biostatistics and Clinical Epidemiology, INSERM U717, St-Louis Hospital, France.; J.P. has received honoraria as a speaker or advisor from Orion Pharma Finland and Abbott USA. W.F.P. has received research grants from Abbott, Alere, BAS, Brahms, EKR, Nanosphere, and the Medicines Company; is a consultant for Abbott, Alere, Beckman Coulter, Electroclore, and The Medicines Company, serves on the speakers bureau of Abbott and Alere and has ownership interests in Comprehensive Research Associates LLC, Vital Sensors and Emergencies in Medicine LLC. A.M. has received lecture fees from Orion Pharma.

WOS: 000289305700010, PubMed ID: 21210078, Purpose: We performed a survey on acute heart failure (AHF) in nine countries in four continents. We aimed to describe characteristics and management of AHF among various countries, to compare patients with de novo AHF versus patients with a pre-existing episode of AHF, and to describe subpopulations hospitalized in intensive care unit (ICU) versus cardiac care unit (CCU) versus ward. Methods and results: Data from 4,953 patients with AHF were collected via questionnaire from 666 hospitals. Clinical presentation included decompensated congestive HF (38.6%), pulmonary oedema (36.7%) and cardiogenic shock (11.7%). Patients with de novo episode of AHF (36.2%) were younger, had less comorbidities and lower blood pressure despite greater left ventricular ejection fraction (LVEF) and were more often admitted to ICU. Overall, intravenous (IV) diuretics were given in 89.7%, vasodilators in 41.1%, and inotropic agents (dobutamine, dopamine, adrenaline, noradrenaline and levosimendan) in 39% of cases. Overall hospital death rate was 12%, the majority due to cardiogenic shock (43%). More patients with de novo AHF (14.2%) than patients with a pre-existing episode of AHF (10.8%) (p = 0.0007) died. There was graded mortality in ICU, CCU and ward patients with mortality in ICU patients being the highest (17.8%) (p < 0.0001). Conclusions: Our data demonstrated the existence of different subgroups based on de novo or pre-existing episode(s) of AHF and the site of hospitalization. Recognition of these subgroups might improve management and outcome by defining specific therapeutic requirements., TUBITAK (Turkey); Abbott, All coauthors would like to thank Patrick Cepon, Helen Smith, Ches Manly and Melinda Swan for their support. MB Yilmaz received a grant from TUBITAK (Turkey).; Abbott funded the ALARM-HF survey; data were acquired by IMS. Analyses were performed by Departement de Biostatistique et Informatique Medicale, Hopital Saint-Louis, APHP; Universite Paris 7; INSERM - UMR-S 717, Paris France by RP and EG. AM, JP, FVB, JFD and FF received honorarium from Abbott for lectures and/or consulting.

WOS: 000291117200007, PubMed ID: 21586217, Objective: To obtain experiences and expert opinion on treatment of SSc patients with TNF-alpha antagonists. Methods: An investigation was carried out among the EUSTAR centres into their expertise on use of TNF-alpha antagonists. Assessment forms on the frequency of TNF-alpha inhibitor use were distributed to EULAR Scleroderma Trials and Research Group (EUSTAR) centres. Afterwards, a three round Delphi exercise was performed to obtain expert consensus on the use of TNF-alpha inhibitors in SSc. Results: Seventy-nine centres returned information on use of TNF-alpha antagonists in SSc patients. A total of 65 patients were treated with TNF-alpha inhibitors in 14 different centres. Forty-eight of the 65 patients treated with TNF-alpha inhibitors improved. Improvement was mainly seen in patients with arthritis, whereas the effects on fibrosis varied. In the first round of the subsequent Delphi approach, 71 out of 79 experts stated that they would use TNF-alpha antagonists in SSc. Arthritis was suggested as an indication for TNF alpha antagonists by 75% of the experts. However; after the third stage of the Delphi exercise, the acceptance for the off-label use of TNF-alpha antagonists decreased and 59% recommended that TNF-alpha antagonists should not be used or only used in clinical trials in SSc patients, while 38% of the experts suggested the use of TNF-alpha antagonists for arthritis associated with SSc. Conclusions: Most of the experts do not recommend the routine use of TNF-alpha antagonists in systemic sclerosis. Arthritis might be a potential indication in SSc, although controlled clinical trials with TNF-alpha antagonists are needed before general recommendations can be given., Novartis; Bayer Schering Pharma; Cell Gen Therapeutics; NicOx; Array BioPharma; Bristol-Myers Squibb; Ergonex Pharma GmbH; Actelion Pharmaceuticals; Pfizer; GlaxoSmithKline; Merck; Amgen; Abbott; Roche; EUSTAR/EULAR; Sanofi-Aventis; United BioSource Corporation; Medac; Biovitrium; Active Biotech; Ergonex, Dr Jorg Distler has served as a consultant for Actelion Pharmaceuticals, Pfizer, and GlaxoSmithKline; has received grant support from Novartis, Bayer Schering Pharma, Cell Gen Therapeutics, NicOx, Array BioPharma, Bristol-Myers Squibb, and Ergonex Pharma GmbH; has received payment for development of educational presentations (including service on speakers' bureaus) from Actelion Pharmaceuticals, Pfizer, GlaxoSmithKline, and Bayer Schering Pharma.; Dr F. lannone has received speaker's and consultancy fees from Merck.; Dr Riemekasten has been invited for a meeting by Humira-People (Amgen) and has received speaker's fees and support for travel costs riembursed by Amgen.; Dr M.F. Seidel has received research grants from Pfizer and Abbott.; Dr J. van Laar has received speaker's and consultancy fees and research grants from Roche.; Dr U. Muller-Ladner has received research grants from EUSTAR/EULAR.; Dr Oliver Distler has a consultancy relationship and/or has received research funding from Actelion Pharmaceuticals, Pfizer, Ergonex Pharma GmbH, Bristol-Myers Squibb, Sanofi-Aventis, United BioSource Corporation, Medac, Biovitrium, Novartis and Active Biotech in the area of potential treatments of scleroderma and its complications. He has received lecture honoraria from Actelion Pharmaceuticals, Pfizer and Ergonex.