1,721,017 research outputs found
Fisiopatologia, clinica e indagini cardiovascolari - Medicina di genere in cardiologia
No full textLe malattie cardiovascolari continuano a rappresentare la principale causa di morte e disabilità. Questo libro, dedicato a tale tema cruciale della medicina, è stato pensato per offrire uno strumento innovativo e agile a studenti di medicina, medici e specialisti, cardiologi e non, interessati ad approfondire tutti i temi principali pertinenti. La novità dell’opera rientra precisamente nella geometria dei capitoli, tutti scritti da esperti riconosciuti della materia. In particolare, il lettore vi troverà sempre all’inizio di ogni contributo un caso clinico pertinente all’argomento, quindi una sintesi del tema fisiopatologico o clinico specifico, e infine uno studio scientifico commentato, tale da metterne in luce, oltre ai risultati, uno o più aspetti metodologici di rilievo. La sezione centrale si avvicina per forma e contenuti ad altri testi di cardiologia, ma l’abbinamento caso clinico - sintesi del tema - studio scientifico costituisce una novità sostanziale
Early Percutaneous Coronary Intervention: Risks and Outcomes in Patients With Cancer
No full textBackground: Patients with malignancies may have high pro-thrombotic status as well as a high risk of hemorrhagic events either due to the tumor or its treatment.For this reason, these patients have always been excluded from randomized clinical trials on percutaneous coronary intervention (PCI).
Aim: To investigate the safety of PCI in patients with malignancies admitted for an AMI.
Methods and Results: Retrospective analysis on an international European ACS registry. Primary endpoint: 30-day mortality. Secondary endpoint: periprocedural complications. There were 273 patients (35% women) with AMI and malignancies. Colon (19%), prostate (14%), breast (13%), lung (8%) and blood (8%) malignancies were the most frequent type of cancer. Women and men had similar age (68 ±11.5 vs 69.1 ±11.5, p=ns). STEMI was in 56% of patients (with no significant gender difference: 51% men vs 65% women, p=0.09). PCI was performed in 64% of patients (with primary PCI in 75% of STEMI). The rate of complications during cardiac catheterization and intervention was 6.5% (2.1% distal embolization, 2.1% no-reflow, 0.7% acute closure, 0.7% dissection, 0.7% perforation, none major bleeding). Nobody among patients that had cardiac catheterization and intervention complications died during hospital stay. In-hospital mortality was 5.9%. The group of patients treated with PCI had a significantly lower rate of death then that of those treated non invasively (1.7% vs 13.1%, p<0.00001). Factors associated with lower probability to receive cardiac catheterization were older age (OR 0.94, 95% CI 0.92-0.97) and absence of typical chest pain at admission (OR: 0.38; 95%CI:0.18-0.81), but the type of malignancy and gender were not. On multivariable model, age (OR 1.1, 95%CI 1.03-1.17) and PCI (OR 0.16 95%CI, 0.04-0.59) were independently associated with the risk of death for ACS (increased and decreased risk, respectively).
Conclusion: These preliminary data from the real world support the safety use of PCI in patients with malignancies and ACS, which have always been excluded from randomized clinical trial
Persisting Chest Pain in Nonobstructive Coronary Artery Disease
No full texthest pain is the most common symptom of coronary artery disease (CAD) prompting subjects to seek attention from physicians. Angina is an important predictor of outcomes and to a large extent determines health-related quality of life (HRQoL) even in the overall apparently health population. Furthermore, physical disability caused by angina has an impact on prognosis as well as on HRQoL. Early reports have demonstrated the value of supplementing the clinical presentation of angina with angiographic information. Angiography does not miss significant life-threatening disease. The severity and the extent of obstructive coronary lesions demonstrated by angiography are powerful predictors of death. Clinical presentation is also a strong predictor of mortality, as type and severity of chest pain act indirectly as predictors because of their association with the severity of the coronary 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
"DE NOVO" HEART FAILURE: A MECHANISM UNDERSCORING SEX DIFFERENCES IN OUTCOMES AFTER ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION
No full textBackground: ST-Segment Elevation Myocardial Infarction (STEMI) complicated by symptoms of acute heart failure (HF) is associated with excess mortality. Yet the relative contribution of sex to the development of acute HF and its related outcomes remains controversial. We aimed to compare the incidence and outcomes of patients with HF during index admission for STEMI according to sex and prior HF status: pre-existing diagnosis of HF, as assessed by past medical history, or no prior HF.
Methods: Cohort study using a population-based registry consisting of 8,409 STEMI patients with acute HF status recorded at baseline. Adjusted 30-day mortality and HF rates at index admission were estimated using inverse probability of weighting and logistic regression models. HF was defined as Killip class 2 or higher and classified according to prior medical history as acute “de novo” or decompensated HF.
Results: A total of 2,526 women and 5,883 men had HF status recorded at baseline and were included in the analysis. Of these patients, 2,403 (95.1%) women and 5,664 (96.3%) men have never experienced HF before index admission. After adjustment for baseline clinical covariates, the incidence of “de novo” HF was significantly higher for women than for men (29.4% vs 21.9 %, OR 1.23; 95%CI 1.10-1.38). For “de novo” HF presentations women have higher 30-day mortality than men (9.5% vs 6.2%: OR 1.58; 95%CI 1.33-1.88). After adjusting for potential confounders, a history of pre-existing HF was strongly associated with increased risk of acute decompensated HF at index admission (OR 3.89; 95%CI, 3.02-5.01). Nevertheless, when women and men presented with acute decompensated HF their outcomes are equally negative with a 30-day mortality of 11.3% vs 12.9%, respectively (OR 0.86; 95%CI 0.43-1.70).
Conclusion: Female sex has differing effects among patients with STEMI according to prior medical history of HF. It worsens outcomes in patients with acute “de novo” HF but has neutral effects in those with acute decompensated HF. “De novo” HF is a key feature to explain mortality difference between sexes
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
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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