1,720,969 research outputs found
Acute-phase reactants in acute myocardial infarction: impact on 5-years prognosis
No full textBackground. Acute-phase reactants have recently been shown to have a short-term and possibly long-term prognostic value in acute coronary syndromes. The aim of the present study was to retrospectively verify whether serum levels of inflammation markers can predict the occurrence of early and late cardiac events after myocardial infarction. Methods. We reevaluated 58 consecutive patients (43 men and 15 women, mean age 66 ± 12 years) admitted to our Center during 1993 with a first myocardial infarction. Patients with non-cardiac causes of inflammation were excluded, as well as patients with a left ventricular ejection fraction < 40%. From the first blood sample obtained at admission, we evaluated C-reactive protein (CRP) and α1-acid glycoprotein (α1-AGP) serum levels, the erythrocyte sedimentation rate (ESR), fibrinogen levels, and the white blood cell (WBC) count. We also evaluated the highest level of serum cardiac markers. Follow-up data were collected for 55 patients in June 1999. Results. Five in-hospital and 13 delayed cardiac deaths occurred. The mean follow-up of current survivors was 5.9 ± 0.4 years. Patients in whom cardiac death occurred had significantly higher CRP (7.4 ± 4.1 vs 3.0 ± 2.4 mg/dl, p < 0.001) and α1-AGP levels (160 ± 38 vs 113 ± 24 mg/dl, p < 0.001), ESR (63 ± 30 vs 37 ± 25 mm/hour, p < 0.001), and WBC count (13 727 ± 3853 vs 10 936 ± 3358/mm3, p = 0.004). At multivariate analysis, higher α1-AGP (p < 0.001) and CRP serum levels (p = 0.02) were independent predictors of cardiac death. Patients in whom cardiac events occurred during follow-up showed higher CRP (5.7 ± 3.7 vs 1.6 ± 1.5 mg/dl, p < 0.001) and α1-AGP levels (140 ± 36 vs 101 ± 23 mg/dl, p < 0.001) and ESR (50 ± 30 vs 34 ± 26 mm/hour, p = 0.06). Higher α1-AGP (p < 0.001) and CRP serum levels (p = 0.03) were independent predictors of the occurrence of cardiac events. Conclusions. The present study shows that CRP and α1-AGP have an independent prognostic value in patients presenting with a first, uncomplicated myocardial infarction. Assays of these markers may help to better stratify patients hospitalized for acute coronary syndromes
Cardiopulmonary exercise testing in patients with 21mm St. Jude Medical aortic prosthesis
No full textBackground and aim of the study: Small-sized prostheses may be associated with high transprosthetic gradients, particularly in patients with a body surface area (BSA) >1.70m2, affecting left ventricular mass regression, symptom improvement and long-term survival. However, the influence of such gradients on exercise tolerance has not been clearly defined. The study aim was to verify the utility of cardiopulmonary exercise testing (CPX) in detecting patient-prosthesis mismatch, and to identify the Clinical and echocardiographic data that predict exercise tolerance at CPX in patients with a 21mm St. Jude Medical (SJM) aortic prosthesis. Methods: Twenty patients (one male, 19 females; mean age 66 ± 9 years) with a 21 mm SJM prosthesis were evaluated by means of 2D echocardiography and CPX at 36 ± 10 months after operation. Patients were divided into groups on the basis of a BSA of <1.70 m2 (group 1, n = 12) or >1.70 m2 (group 2, n = 8). Results: At echocardiography, left ventricular mass reduction was 16 ± 10% versus 9 ± 6% in groups 1 and 2, respectively, mean gradient (MG) was 15 ± 6 versus 17 ± 4 mmHg (p = NS), effective orifice area index (EOAi) 0.86 ± 0.10 versus 0.79 ± 0.09 cm2/m2 (p = 0.05). At CPX, group 2 patients showed a significantly lower exercise duration (p = 0.02), maximum workload (p = 0.02), peak O2 uptake (p = 0.01), anaerobic threshold (AT) (p = 0.03), ventilatory equivalent for CO2 at AT (p = 0.007), and O2 cost of work (p = 0.03). Group 1 patients showed a ventilatory origin for their effort dyspnea, while group 2 patients showed a significant circulatory component. At multivariate analysis, BSA, age, EOAi and MG were independent predictors of CPX results. Conclusions: In patients with a 21 mm aortic SJM prosthesis and a BSA > 1.70m2, CPX allows detection of patient-prosthesis mismatch, in terms of impaired exercise tolerance due to circulatory causes. CPX results can be anticipated on the basis of the patient's BSA, age, EOAi and MG. In these patients, technical solutions allowing implantation of a larger prosthesis should be considered whenever an active lifestyle is anticipated after aortic valve replacement
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
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