1,356,454 research outputs found
Spotlight Issue "Electrophysiology and cardiac device therapy: why and how to approach health economics?" Volume 13 Supplement 2 May 2011 of EP Europace
No full textThis is a special issue of EP-Europace, with G Boriani as Guest Editor. It is the result of an initiative of the Committee on Health Economics and Outcome Research of EHRA, chaired by G Boriani. EHRA is the acronym of European Heart Rhythm Association, a branch of the European Society of Cardiology and it is the leader association on Electrophysiology and Arrhthmia science in Europe. This issue covers a wide spectrum of topics, starting from an overview of economic evaluations, and then focusing on the disease burden and emerging costs of atrial fibrillation and heart failure, two growing epidemics in western countries. The emerging role of European registries, a cornerstone of outcome research and policy making is also highlighted, as well as the important contribution of patient associations in promoting and supporting the access to evidence-based therapies. The applications of economic evaluations to a series of treatments that carry a high up-front cost, such as cardioverter defibrillators, devices for CRT, and atrial fibrillation ablation procedures are discussed in articles co-authored by both electrophysiologists and health economists. Remote monitoring, a new option for improving both patient care and the organization of device clinics, is also discussed. Finally, the application of health economics in policy making, the need for an appropriate approach to treatment with medical devices, taking into consideration the differences with pharmacological treatments, and the possibility to base decision making on a multidisciplinary approach, such as health technology assessment, are debated. In this complex scenario, the heterogeneity of reimbursement practices and the need for a refinement of DRG (diagnosis-related groups) systems and for new strategies to sustain and enhance those effective technological innovations that may be beneficial for specific patient populations are also highlighted.
The issue includes 13 articles in 65 pages
Caratteri geografici e antropici degli insediamenti. Il paesaggio agrario e le infrastrutture territoriali nella loro evoluzione storica
No full textPubblicazione del Museo Civico di Lentate sul Seveso, Lentate sul Seveso (MI
L’insediamento di villa e i caratteri dei giardini nel territorio lentatese
No full textPubblicazione del Museo Civico di Lentate sul Seveso, Lentate sul Seveso (MI
Aclees visayus Meregalli & Boriani & Taddei & Hsu & Tseng & Mouttet 2020
No full textAclees visayus (Heller, 1929) Aclees visayus. Philippines: Mindanao, Surigao del Sur, Barobo, I.2019, 1 ♂, local collector leg.Published as part of Meregalli, Massimo, Boriani, Marco, Taddei, Andrea, Hsu, Chen-Fu, Tseng, Wei-Zhe & Mouttet, Raphaëlle, 2020, A new species of Aclees from Taiwan with notes on other species of the genus (Coleoptera: Curculionidae: Molytinae), pp. 1-26 in Zootaxa 4868 (1) on page 19, DOI: 10.11646/zootaxa.4868.1.1, http://zenodo.org/record/442856
Propafenone in the treatment of cardiac arrhythmias. A risk-benefit appraisal
No full textPropafenone is a potent antiarrhythmic agent effective in either supraventricular or ventricular tachyarrhythmias. For proper utilisation, some important pharmacological aspects must be considered, such as nonlinear pharmacokinetics, inability in some patients (poor debrisoquine metabolisers) to oxidise the drug in the liver, existence of at least one active metabolite (5-hydroxy-propafenone) and ability to exert a slight beta-blocking activity. Like all the other antiarrhythmic drugs, propafenone may be associated with adverse effects and may exert proarrhythmic effects. For this reason, its usage must be based on a careful analysis of the risk-benefit ratio, by considering the patient's profile as well as the characteristics of the arrhythmia and its prognostic significance. Propafenone appears to be very effective, and has a favourable risk-benefit profile in the treatment of all supra-ventricular arrhythmias. Particularly, it is effective in converting atrial fibrillation to sinus rhythm and in preventing atrial fibrillation recurrences, and is very effective in the pharmacological control of the arrhythmias of the Wolff-Parkinson-White syndrome. Propafenone is also effective in suppressing ventricular premature complexes and nonsustained ventricular tachycardias. However, because of potential proarrhythmic effects, its use in these arrhythmias must be considered after a careful analysis of the risk-benefit profile, which could be favourable in some patients, but less favourable in others (e.g. patients with coronary artery disease and ventricular dysfunction). In malignant ventricular arrhythmias, further studies are needed to define the limitations of antiarrhythmic drugs in comparison with non-pharmacological treatments, mainly cardioverter/defibrillators. At present, like the other class I antiarrhythmic agents, propafenone does not seem to be a first choice prophylactic agent for malignant ventricular arrhythmias, although more data from controlled studies are needed
Directory of Armenian and Assyrian Churches in the villages of the Salmas and Khoy Counties
No full textThe directory gives a detailed account of 23 churches surveyed in the counties of Salmas, Khoy and Urmia, chosen from the 29 visited from 2016 to 2018 because they still retain a recognisable architectural conformation that characterised them, although many of them are now in a state of ruin. For each of them a sheet has been drawn up detailing the period of construction, the planimetric layout, the description and the state of conservation, defining the main problems but also the possibilities for reuse and enhancement. Where possible, the current state is compared with that found in the 1970s during the missions of Adriano Alpago Novello (1976, 1977)
Foglio 056 Sondrio. Note illustrative della Carta Geologica d'Italia alla scala 1:50.000
No full textLetter by Boriani et al regarding article, "Death without prior appropriate implantable cardioverter-defibrillator therapy: a competing risk study".
No full textDRUGS, SURGERY, CARDIOVERTER DEFIBRILLATOR - A DECISION BASED ON THE CLINICAL PROBLEM
No full textThese three therapeutic options are the basis of sudden cardiac death prevention: antiarrhythmic drugs, surgery, and automatic implantable cardioverter defibrillator. Each of these treatments has specific favorable and unfavorable indications. Antiarrhythmic drugs are mainly limited by the low therapeutic profile, proarrhythmic effects, complex pharmacokinetics and pharmacodynamics, possible negative inotropic effects, and the possible change of the organic substratum. Arrhythmia surgery may be limited by the need of a highly trained center, by a relatively high perioperative mortality (up to 15%), and by limited electrophysiological and clinical indications. The implantable cardioverter defibrillator is an expensive tool with a theoretically wide range of clinical indications, with already proven efficacy in converting ventricular fibrillation to sinus rhythm but with unproven efficacy on prolonging survival because of a lack of controlled trials (which, we must admit, is also true for drugs and surgery). The results of the ongoing multicenter trials on this item will clarify this clinical point. The choice among these different therapeutic options is mainly based on hemodynamic status (ejection fraction), feasibility of a surgical treatment, and the electrophysiological characteristics of the ventricular arrhythmia
Foreword. Toward protection, conservation and reuse of architectural and landscape heritage
No full textThe book is about the history of Protection and Restoration in Iran, and particularly in Iranian Western Azerbaijan. A substantial part of the volume is dedicated to illustrating how the territory of the cities of Khoy and Salmas has been described in the reports of Western travelers. Finally, several essays are dedicated to the study of the Armenian and Assyrian churches still present in this area, evaluating the problems of their protection and conservation
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