1,721,012 research outputs found
Response to letter to the editor regarding article "Macrophage migration inhibitory factor (MIF) is associated with degree of collateralization in patients with totally occluded coronary arteries"
No full textNo abstract availabl
Pathophysiology and mechanisms of Acute Coronary Syndromes: atherothrombosis, immune-inflammation, and beyond
No full textIntroduction: The pathophysiology of atherosclerosis and its acute complications, such as the Acute Coronary Syndromes (ACS), is continuously under investigation. Immunity and inflammation seem to play a pivotal role in promoting formation and grow of atherosclerotic plaques. At the same time, plaque rupture followed by both platelets' activation and coagulation cascade induction lead to intracoronary thrombus formation. Although these phenomena might be considered responsible of about 90% of ACS, in up to 5-10% of acute syndromes, a non-obstructive coronary artery disease (MINOCA) might be documented. This paper gives an overview on atherothrombosis and immuno-inflammation processes involved in ACS pathophysiology, also emphasizing the pathological mechanisms potentially involved in MINOCA. Areas covered: The relationship between immuno-inflammation and atherothrombosis is continuously updated by recent findings. At the same time, pathophysiology of MINOCA still remains a partially unexplored field, stimulating the research of potential links between these two aspects of ACS pathophysiology. Expert opinion: Pathophysiology of ACS has been extensively investigated; however, several gray areas still remain. MINOCA represents one of these areas. At the same time, many aspects of immune-inflammation processes are still unknown. Thus, research should be continued to shed a brighter light on both these sides of "ACS" moon
FFR prediction model based on conventional quantitative coronary angiography and the amount of myocardium subtended by an intermediate coronary artery stenosis
No full textBackground Coronary angiography has poor predictive value for functionally significant coronary artery stenosis. The Fractional Flow Reserve (FFR) currently represents the gold standard to define the ischemic potential of epicardial stenosis and, recently, the instantaneous wave-free ratio (iFR), has also been introduced as alternative to the FFR, but it still remains an invasive procedure. We aimed this study in order to evaluate the accuracy of the “Angiography-DeriveD hEmoDynamic index” (ADDED index) to predict the FFR as compared with the iFR. Methods and results Consecutive patients with at least one equivocal stenosis in one major coronary artery were enrolled. Both the FFR and iFR were measured. The amount of jeopardized myocardium was evaluated using the Duke Jeopardy Score (DJS). Two-dimensional quantitative coronary angiography (QCA) was used to assess the angiographic features of the coronary stenosis and both the reference vessel diameter (RVD) and minimal lumen diameter (MLD) were calculated. The ADDED index was defined as the ratio between DJS and MLD. We evaluated 100 intermediate coronary artery stenoses in 83 patients. Both FFR and iFR inversely correlated with the ADDED index (respectively, r2 = 0.59, p < 0.001 and r2 = 0.61, p < 0.001). This latter also showed high accuracy in predicting the FFR value (ROC analysis: 0.94[0.90–0.99], p < 0.001) as well as the iFR (0.91[0.86–0.97], p < 0.001, difference: 0.03 SD 0.04, p = 0.52). Conclusions The ADDED index, taking into account both the MLD and DJS, showed high accuracy to predict FFR and it might be used to detect functionally significant coronary artery stenosis
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
True double bifurcation lesions: new application of the self-expandable Axxess stent and review of literature with dedicated bifurcation devices
No full textVery late bioresorbable scaffold thrombosis and reoccurrence of dissection two years later chronic total occlusion recanalization of the left anterior descending artery
No full textWe describe the case of a patient presenting with ST-segment elevation myocardial infarction due to very late scaffold thrombosis. The patient was already admitted for an elective percutaneous recanalization of a chronically occluded left anterior descending artery (LAD). The procedure was performed according the sub-intimal tracking and re-entry (STAR) technique with 4 bioresorbable vascular scaffolds implantation. However, even though the coronary flow was preserved at the end of the procedure, the dissected segment was only partially sealed at the distal segment of the LAD. After 18 mo of regular assumption, dual antiplatelet therapy was discontinued for 10 mo before his presentation at the emergency room. This is the first reported case of a very late scaffold thrombosis after coronary chronic total occlusion (CTO) recanalization performed according to the STAR technique. This case raises concerns about the risk of very late scaffold thrombosis after complex CTO revascularization
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
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Effetti dell’accesso vascolare arterioso, in procedure endovascolari, sulla funzione endoteliale digitale periferica. Dott. Luigi
No full textIntroduzione: Scopo di questo studio è stato quello di verificare se, in pazienti sottoposti a cateterismo cardiaco, la funzione del microcircolo digitale, post procedurale, fosse ridotta nei pazienti sottoposti ad accesso radiale rispetto a quelli sottoposti ad accesso femorale. Inoltre, è stata ricercata l’eventuale stretta correlazione tra disfunzione microvascolare periferica e quella miocardica, e valutato il ruolo predittivo dell’Endoscore nell’identificazione dei pazienti affetti da malattia aterosclerotica coronarica.
Metodi e Risultati: Sono stati arruolati 38 pazienti (19 con accesso radiale e 19 con accesso femorale), la cui funzione endoteliale digitale è stata studiata in tre diverse occasioni: a) prima dello studio angiografico coronarico (Baseline), b) 24 ore dopo accesso vascolare (24h post procedura) e c) a 30 giorni di follow up (Follow Up). Dopo accesso radiale, a 24 ore dalla procedura, sia i valori di Endoscore che quelli di RHI erano significativamente ridotti rispetto ai valori di base (Endoscore: 0.26 + 0.19 vs 0.41 + 0.28, p = 0.02; RHI: 1.72 + 0.35 vs 1.94 + 0.39, p = 0.02), a differenza di quanto osservato nel gruppo di pazienti con accesso femorale (Endoscore: 0.46 + 0.39 vs 0.44 + 0.34, p = 0.76; RHI: 2.06 + 0.70 vs 2.07 + 0.67 p = 0.94). Tale disfunzione microvascolare, molto più evidente nei pazienti che, di base, presentavano una normale funzione, migliora spontaneamente dopo 30 giorni, ed è dipendente dalle variabili procedurali e dal processo infiammatorio loco-regionale determinato dall’accesso percutaneo. Inoltre, mentre il solo RHI è significativamente inversamente correlato con l’Indice di Resistenza Miocardica (IMR), entrambi lo sono con lo score di Bogaty, che valuta l’estensione della malattia aterosclerotica coronarica.
Conclusioni: L’accesso radiale riduce significativamente la funzione microvascolare periferica. Tale danno è strettamente dipendente dal tipo di materiale impiegato e dai tempi procedurali e
migliora spontaneamente dopo 30 giorni. Inoltre, la stretta correlazione tra gli indici di disfunzione del microcircolo periferico e l’indice di resistenza miocardica e l’estensione della malattia aterosclerotica coronarica, incoraggia lo studio della funzione microvascolare periferica, anche nella pratica clinica, nella stratificazione del rischio cardiovascolare
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