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Browsing by Author "Gnoni, Martin"
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Item Potential role of intermittent fasting on decreasing cardiovascular disease in human immunodeficiency virus patients receiving antiretroviral therapy(Baishideng Publishing Group, 2021-11-20) Gnoni, Martin; Beas, Renato; Raghuram, Anupama; Díaz-Pardavé, Celeste; Riva-Moscoso, Adrian; Príncipe-Meneses, Fortunato S.; Vásquez-Garagatti, Raúl; Medicine, School of MedicineCardiovascular disease (CVD) has become one of the commonest causes of comorbidity and mortality among People living with human immunodeficiency virus (HIV) (PLWH) on antiretroviral therapy (ART). Nearly 50% of PLWH are likely to have an increased risk of developing CVD, including coronary heart disease, cerebrovascular disease, peripheral artery disease and aortic atherosclerosis. Aside from the common risk factors, HIV infection itself and side effects of antiretroviral therapy contribute to the pathophysiology of this entity. Potential non-pharmacological therapies are currently being tested worldwide for this purpose, including eating patterns such as Intermittent fasting (IF). IF is a widespread practice gaining high level of interest in the scientific community due to its potential benefits such as improvement in serum lipids and lipoproteins, blood pressure (BP), platelet-derived growth factor AB, systemic inflammation, and carotid artery intima-media thickness among others cardiovascular benefits. This review will focus on exploring the potential role of intermittent fasting as a non-pharmacological and cost-effective strategy in decreasing the burden of cardiovascular diseases among HIV patients on ART due to its intrinsic properties improving the main cardiovascular risk factors and modulating inflammatory pathways related to endothelial dysfunction, lipid peroxidation and aging. Intermittent fasting regimens need to be tested in clinical trials as an important, cost-effective, and revolutionary coadjutant of ART in the fight against the increased prevalence of cardiovascular disease in PLWH.Item Treatment of Community-Acquired Pneumonia in Immunocompromised Adults(Elsevier, 2020-06) Ramirez, Julio A.; Musher, Daniel M.; Evans, Scott E.; Dela Cruz, Charles; Crothers, Kristina A.; Hage, Chadi A.; Aliberti, Stefano; Anzueto, Antonio; Arancibia, Francisco; Arnold, Forest; Azoulay, Elie; Blasi, Francesco; Bordon, Jose; Burdette, Steven; Cao, Bin; Cavallazzi, Rodrigo; Chalmers, James; Charles, Patrick; Chastre, Jean; Claessens, Yann-Erick; Dean, Nathan; Duval, Xavier; Fartoukh, Muriel; Feldman, Charles; File, Thomas; Froes, Filipe; Furmanek, Stephen; Gnoni, Martin; Lopardo, Gustavo; Luna, Carlos; Maruyama, Takaya; Menendez, Rosario; Metersky, Mark; Mildvan, Donna; Mortensen, Eric; Niederman, Michael S.; Pletz, Mathias; Rello, Jordi; Restrepo, Marcos I.; Shindo, Yuichiro; Torres, Antoni; Waterer, Grant; Webb, Brandon; Welte, Tobias; Witzenrath, Martin; Wunderink, Richard; Medicine, School of MedicineBackground Community-acquired pneumonia (CAP) guidelines have improved the treatment and outcomes of patients with CAP, primarily by standardization of initial empirical therapy. But current society-published guidelines exclude immunocompromised patients. Research Question There is no consensus regarding the initial treatment of immunocompromised patients with suspected CAP. Study Design and Methods This consensus document was created by a multidisciplinary panel of 45 physicians with experience in the treatment of CAP in immunocompromised patients. The Delphi survey methodology was used to reach consensus. Results The panel focused on 21 questions addressing initial management strategies. The panel achieved consensus in defining the population, site of care, likely pathogens, microbiologic workup, general principles of empirical therapy, and empirical therapy for specific pathogens. Interpretation This document offers general suggestions for the initial treatment of the immunocompromised patient who arrives at the hospital with pneumonia.