ABSTRACT
BACKGROUND: Comorbidity indexes were designed in order to measure how the disease burden of a patient is related to different clinical outcomes such as mortality, especially in older and intensively treated people. Charlson's Comorbidity Index (CCI) is the most widely used rating system, based on diagnoses, but when this information is not available therapy-based comorbidity indices (TBCI) are an alternative: among them, Drug Derived Complexity Index (DDCI), Medicines Comorbidity Index (MCI), and Chronic Disease Score (CDS) are available. AIMS: This study assessed the predictive power for 1-year mortality of these comorbidity indices and polypharmacy. METHODS: Survival analysis and Receiver Operating Characteristic (ROC) analysis were conducted on three Italian cohorts: 2,389 nursing home residents (Korian), 4,765 and 633 older adults admitted acutely to geriatric or internal medicine wards (REPOSI and ELICADHE). RESULTS: Cox's regression indicated that the highest levels of the CCI are associated with an increment of 1-year mortality risk as compared to null score for all the three samples. DDCI and excessive polypharmacy gave similar results but MCI and CDS were not always statistically significant. The predictive power with the ROC curve of each comorbidity index was poor and similar in all settings. CONCLUSION: On the whole, comorbidity indices did not perform well in our three settings, although the highest level of each index was associated with higher mortality.
Subject(s)
Hospitalization , Polypharmacy , Aged , Chronic Disease , Comorbidity , Humans , Italy/epidemiologyABSTRACT
The effect of habitual cocoa consumption on arterial stiffness and wave reflection indexes, as well as on peripheral and central blood pressure, was assessed in 198 healthy subjects. In conclusion, higher cocoa intake was an independent determinant of low arterial stiffness and wave reflection indexes and was also independently associated with significantly lower central (aortic) pulse pressure.
Subject(s)
Aortic Diseases/physiopathology , Beverages , Blood Pressure , Cacao , Feeding Behavior , Adolescent , Adult , Biomarkers/blood , Blood Flow Velocity , Carotid Artery, Common/physiopathology , Cross-Sectional Studies , Female , Femoral Artery/physiopathology , Heart Rate , Humans , Male , Middle Aged , Multivariate Analysis , Observer Variation , Surveys and QuestionnairesABSTRACT
The alpha-adrenolytic activity of 1-methyl-10-methoxydihydrolysergol 2-(3,5-dimethyl)pyrrolcarboxylate (XV, formula II) is, both in vitro and parenterally, quite similar to that of dihydroergotamine. By oral route the new compound is more active, and longer lasting than dihydroergotamine.
Subject(s)
Ergolines/chemical synthesis , Nicergoline/chemical synthesis , Sympatholytics/chemical synthesis , Administration, Oral , Animals , Delayed-Action Preparations , Dihydroergotamine/pharmacology , Guinea Pigs , Injections, Intravenous , Male , Nicergoline/administration & dosage , Nicergoline/analogs & derivatives , Receptors, Adrenergic, alpha/drug effects , Structure-Activity RelationshipABSTRACT
The synthesis and the pharmacological activities of 24 analogues of the alpha-adrenergic blocking drug, nicergoline (I b), are reported. The majority of the new compounds were found to be less active than (I b): the structure-activity relationships are presented and discussed.
