1,721,007 research outputs found
From gene mutations to biomechanical abnormalities and electrophysiological remodeling in hypertrophic cardiomyopathy: exploring the translational approach.
Full text linkAbnormal balance of inward and outward ion currents in HCM ventricular cardiomyocytes determines a reduced lusitropic response to beta-adrenergic stimulation, due to insufficient APD and Ca2+ transient shortening. In HCM patients, this translates into exercise-induced QTc prolongation, TQ shortening and impaired diastolic reserve, contributing to reduced exercise tolerance. MYBPC3-related HCM showed increased long-term prevalence of systolic dysfunction compared to MHY7, in spite of similar outcome. This trend was subtended by an age-related decline in contractile performance in vitro in MYBC3 but not in MHY7 samples. Such observations suggest different pathophysiology of clinical progression in the two subsets and may prove relevant for understanding of genotype-phenotype correlations in HC
«Mantenne liberi i Romani col soggiogarli»: il discorso sull’eloquenza di Cicerone nelle Instabilità del 1641
No full textIl saggio riflette sulla rifunzionalizzazione politica delle "Instabilità dell'ingegno" di Anton Giulio Brignole Sale tra l'edizione del 1635 e l'edizione del 1641 nel contesto sociale e letterario dell'Accademia degli Addormentati di Genova
Dall’epica al romanzo, una tappa seicentesca tra Tasso e Manzoni: La Rosalinda di Bernardo Morando
No full textIl saggio individua alcuni precisi nuclei narrativi e interessi tematici di origine tassiana i quali, rintracciati con precisi riscontri testuali nella Rosalinda e nei Promessi sposi, suggeriscono un percorso possibile di quel processo che ha visto lentamente la tradizione epico-cavalleresca e del poema eroico trasformarsi nelle forme moderne del romanzo. Processo che appunto nel Seicento affonda le sue origini e in cui si può riconoscere, ancor prima che nel riformato romanzo manzoniano, il funzionamento del modello epico tassiano. Il saggio non intende infatti affrontare la questione di individuare la precisa identità dell’Anonimo manzoniano, ma solo suggerire la possibilità di aggiungere una tessera al mosaico della ricostruzione di una genealogia letteraria del romanzo italiano. In particolare, l’analisi mostra come la trasformazione di quell’interesse già tassiano a indagare gli scenari interiori, porti Manzoni, in sintonia con quanto avviene nella cultura seicentesca, a proporre un personaggio nuovo, modello avvicinabile di etica e di fede
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Diagnostic utility of contemporary echo and BNP assessment in patients with acute heart failure during early hospitalization
No full textBackground The use of B-type natriuretic peptide (BNP) and echocardiography in acute heart failure (AHF) diagnosis is poorly employed in the Emergency Department. The aim of the present study is to evaluate relation among BNP levels systolic and diastolic dysfunction during early phases of AHF hospitalization. Methods We performed contemporary echocardiographic and BNP assessment in 310 patients with AHF within 12 h since hospital admission. We studied the correlation among BNP and degree of diastolic dysfunction evaluated by pulsed Doppler transmitral flow and Tissue Doppler flow. Finally we investigated the relation among BNP and the right systolic longitudinal ventricular function (TAPSE) and the systolic pulmonary arterial pressure (PAPs). Results BNP levels were 1417 ± 1126, 1081 ± 955, 894 ± 901 pg/mL, for patients with EF ≤ 25%, EF 25-40% and EF 40-50% (p = 0.005), respectively. BNP levels linearly correlate with the degree of diastolic dysfunction: 582 ± 406 pg/mL in altered relaxation pattern, 712 ± 557 pg/mL in pseudonormal pattern and 1694 ± 805 in restrictive filling pattern (p < 0.001 for all patterns). BNP levels were significantly increased in patients with right systolic ventricular dysfunction (TAPSE < 18 mm; p = 0.006) and in patients with PAPs ≥ 40 mmHg (p = 0.001). ROC curve and logistic regression analysis highlighted the power of BNP to detect severe systolic dysfunction, right ventricular (RV) overload and dysfunction and diastolic dysfunction patterns. Conclusions BNP levels correlate linearly with LV systolic dysfunction as well as with impaired degree of diastolic dysfunction. Significant PAP increase is a further factor influencing BNP elevation in patients with AHF during early hospitalization phase
Loop Diuretics Strategies in Acute Heart Failure: From Clinical Trials to Practical Application
No full textAlthough loop diuretics are the most commonly used drugs for the treatment of acute heart failure (AHF), their short and long-term effects are relatively unknown. The use of loop diuretics is essential in the management of HF, particularly during episodes of acute decompensation, therefore more than 90% of patients admitted with HF receive this drug. The administration of intravenous loop diuretics to patients with heart failure and congestion typically results in the improvement of dyspnea, pulmonary congestion and in the reduction of Left Ventricular (LV) filling pressures. However, little is known about its appropriate dose, timing and modality administration in patients with AHF: several side effects may result from the administration of high diuretics dose, including worsening kidney function, diuretic resistance and sympathetic overdrive. Furthermore, there is no specific strategy that shows a clear benefit in HF outcome in relation to continuous versus intermittent administration modalities. Current data based on small and heterogeneous studies did not demonstrate a clear risk benefit ratio and larger prospective trials need to be completed in order to be able to provide definitive recommendations in the future. Since every patient represents a single entity and may have different responses to the same treatment, the best clinical approach should take into account physical examination, neuro-hormonal overdrive and kidney functional status. Due to these reasons, treatment with loop diuretics should be specifically customized for each patient, until multicenter blinded trials will provide satisfactory answers regarding optimal dosing, modality administration and precise targets
The assessment, interpretation and implementation of lung ultrasound examinations in Heart Failure: Current evidence and gaps in knowledge
No full textLung ultrasound (LUS) is a simple, fast and non-invasive tool for pulmonary congestion assessment with higher accuracy for the detection of acute heart failure (HF) compared to clinical examination and chest radiography. The integrated assessment with other ultrasound and echocardiographic parameters can lead to a better systemic and pulmonary congestion characterization. Additionally, the combination of echocardiographic and pulmonary features can identify patients at higher risk for adverse outcomes, potentially facilitating both acute and chronic HF management and prognostic stratification. However, the optimal utilization of LUS needs to be better defined both in terms of imaging method and B-line thresholds which may differ based on the clinical scenario and, potentially, the HF phenotype. Despite the extensive potential role of LUS in a wide range of HF scenarios, clinicians may be unaware of the correct technique and exam interpretation. Specifically, the interpretation of LUS findings is influenced by several factors, such as imaging protocol, type of ultrasound transducer, patient positioning, and presence of concomitant pulmonary diseases. The aim of this review is to provide a practical overview of LUS in patients with known or suspected HF with the goal of providing a practical guide for clinicians and nurses in various clinical settings
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