1,721,241 research outputs found

    Updates on NSAIDs in patients with and without coronary artery disease: Pitfalls, interactions and cardiovascular outcomes

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    NSAIDs are used worldwide by more than 30 million people everyday, given their anti-inflammatory, analgesic and antipyretic effects. NSAIDs are approved for several common adult diseases, including acute and chronic musculoskeletal or inflammatory disease, osteoarthritis, rheumatoid arthritis and other arthritic conditions, as well as for children with juvenile idiopathic arthritis. Importantly, the population commonly taking NSAIDs is that of older individuals who also represent the population with the highest risk for cardiovascular (CV) and gastrointestinal adverse effects. In recent years, a growing body of evidence regarding potential risks from chronic use of NSAIDs has emerged. The aim of this review is to update the available data concerning chronic use of NSAIDs in patients with and without CV disease by analyzing the mechanisms of action, the interference of specific NSAIDs with the established CV protective role of low-dose aspirin, and the potential increased risk of myocardial infarction, stroke, hypertension, heart failure and atrial fibrillation

    Three-dimensional angle assessment and plaque distribution classification in left main disease: Impact of geometry on outcome

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    Bifurcation geometry and plaque distribution in a diseased left main artery (LM) have the potential to drive operators' decisions regarding treatment strategies, techniques, and material selection. The three-dimensional (3D) geometry of the LM bifurcation typically results in specific patterns of plaque distribution. Plaque distribution may, in turn, significantly affect the procedural and long-term clinical and angiographic outcomes of LM percutaneous coronary intervention. Each LM bifurcation must be treated according to its unique anatomic and pathologic characteristics. Novel classification schemes of plaque distribution and 3D assessment may be valuable aids to obtaining a working picture of the bifurcation geometry

    State of the art: Duration of dual antiplatelet therapy after percutaneous coronary intervention and coronary stent implantation - Past, present and future perspectives

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    Evidence from studies published more than 10 years ago suggested that patients receiving first-generation drug-eluting stents (DES) needed dual antiplatelet therapy (DAPT) for at least 12 months. Current evidence from randomised controlled trials (RCT) reported within the past five years suggests that patients with stable ischaemic heart disease who receive newer-generation DES need DAPT for a minimum of three to six months. Patients who undergo stenting for an acute coronary syndrome benefit from DAPT for at least 12 months, but a Bayesian network meta-analysis confirms that extending DAPT beyond 12 months confers a trade-off between reduced ischaemic events and increased bleeding. However, the network meta-analysis finds no credible increase in all-cause mortality if DAPT is lengthened from three to six months to 12 months (posterior median odds ratio [OR] 0.98; 95% Bayesian credible interval [BCI]: 0.73-1.43), from 12 months to 18-48 months (OR 0.87; 95% BCI: 0.64-1.17), or from three to six months to 18-48 months (OR 0.86; 95% BCI: 0.63-1.21). Future investigation should focus on identifying scoring systems that have excellent discrimination and calibration. Although predictive models should be incorporated into systems of care, most decisions about DAPT duration will be based on clinical judgement and patient preference

    Going Beyond Counting First Authors in Author Co-citation Analysis

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    The 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

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    “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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