380 research outputs found
A sharp estimate for the Hilbert transform along finite order lacunary sets of directions
No full textLet be a nonnegative integer and be a lacunary set of directions of order . We show that the norms, , of the maximal directional Hilbert transform in the plane are comparable to . For vector fields with range in a lacunary set of of order and generated using suitable combinations of truncations of Lipschitz functions, we prove that the truncated Hilbert transform along the vector field , is -bounded for all . These results extend previous bounds of the first author with Demeter, and of Guo and Thiele.20 pages, 2 figures. Submitted. Changes: clarified the definition of D-lacunary set and streamlined the notatio
Supplemental_Material - Current Use and Impact on 30-Day Mortality of Pulmonary Artery Catheter in Cardiogenic Shock Patients: Results From the CardShock Study
No full textSupplemental_Material for Current Use and Impact on 30-Day Mortality of Pulmonary Artery Catheter in Cardiogenic Shock Patients: Results From the CardShock Study by Alessandro Sionis, Mercedes Rivas-Lasarte, Alexandre Mebazaa, Tuukka Tarvasmäki, Jordi Sans-Roselló, Heli Tolppanen, Marjut Varpula, Raija Jurkko, Marek Banaszewski, Jose Silva-Cardoso, Valentina Carubelli, Matias Greve Lindholm, John Parissis, Jindrich Spinar, Johan Lassus, Veli-Pekka Harjola, and Josep Masip in Journal of Intensive Care Medicine</p
Cardiac biomarkers predict 1-year mortality in elderly patients undergoing hip fracture surgery
No full textThis prospective study included 152 elderly patients (mean age, 80 years; range, 72-88 years) with a hip fracture treated surgically. Comorbidities were evaluated, and B-type natriuretic peptide was measured at baseline and at postoperative days 4 and 5 in addition to troponin I. Major cardiac events were recorded, and 1-year mortality was assessed. Comorbidity models with the important multivariate predictors of 1-year mortality were analyzed. Overall, 9 patients (6%) experienced major cardiac events postoperatively during their hospitalization. Three patients (2%) died postoperatively, at days 5, 7, and 10, from autopsy-confirmed myocardial infarction. Three patients (2%) experienced a nonfatal myocardial infarction, and 3 patients (2%) experienced acute heart failure. At 1-year follow-up, 37 patients (24%) had died. Age older than 80 years (P=.000), renal failure (P=.016), cardiovascular disease (P=.003), respiratory disease (P=.010), Parkinson disease (P=.024), and dementia (P=.000) were univariate predictors of 1-year mortality. However, in the multivariate model, only age older than 80 years (P=.000) and dementia (P=.024) were important predictors of 1-year mortality. In all comorbidity models, age older than 80 years and dementia were important predictors of 1-year mortality. Postoperative increase in B-type natriuretic peptide was the most important predictor of 1-year mortality. Receiver operating characteristic curve analysis showed a threshold of 90 ng/mL of preoperative B-type natriuretic peptide (area under the curve=0.773, 95% confidence interval, 0.691-0.855, P<.001) had 82% sensitivity and 62% specificity to predict 1-year mortality. Similarly, a threshold of 190 ng/mL of postoperative B-type natriuretic peptide (area under the curve=0.753, 95% confidence interval, 0.662-0.844, P<.001) had 70% sensitivity and 77% specificity to predict the study endpoint
Forty years literature review of primary lung lymphoma
No full textAbstract There are several unresolved issues through out the literature regarding the entity of primary lung lymphoma. Extensive literature review of this uncommon pathology is carried out. By taking into consideration the reported experience, the author discuss the classification, clinical features, histological differential diagnosis, prognostic criteria, therapeutic management and outcome of primary lung parenchyma lymphocytic infiltrates.</p
Cost-effectiveness of eplerenone in NYHA class II chronic heart failure patients with reduced LVEF: an analysis for Greece
No full textKostas Athanasakis,1 Aikaterini Bilitou,2 Dawn Lee,3 Eleftheria Karampli,1 Apostolos Karavidas,4 John Parissis,5 Georgia Sykara,2 John Kyriopoulos1 1Department of Health Economics, National School of Public Health, Athens, Greece; 2Pfizer Hellas, Athens, Greece; 3BresMed, Sheffield, UK; 4Department of Cardiology, G. Gennimatas Hospital, Athens, Greece; 5Heart Failure Unit, Department of Cardiology, Athens University Hospital Attikon, National and Kapodistrian University of Athens, Athens, Greece Objectives: The aim of the study was to evaluate the cost-effectiveness (CE) of treatment with eplerenone versus standard care in adult patients with New York Heart Association class II chronic heart failure and reduced left ventricular ejection fraction from the perspective of the Greek national health care payer. Methods: A discrete-event model simulating the clinical course and respective outcomes of eplerenone as an add-on to standard therapy versus standard therapy alone based on the pivotal Eplerenone in Mild Patients Hospitalization and SurvIval Study in Heart Failure (EMPHASIS-HF) trial was locally adapted for the Greek setting. Data on medications followed the resource use from eplerenone in mild patients hospitalization and survival study in heart failure and were estimated on a lifetime basis (or until discontinuation). Cost calculations were based on year 2014, event costs (cardiovascular hospitalizations, adverse events, and devices) were sourced from published diagnosis-related groups. A 3% discount rate was applied. In order to test the robustness of the model projections, a range of deterministic and probabilistic sensitivity analyses were carried out. Results: Over a patient’s lifetime, the addition of eplerenone to standard care compared to standard care alone led to an incremental gain of 1.33 quality-adjusted life-years (QALYs) (6.53 vs 5.20 QALYs, respectively) as well as an increase in the cost of treatment by €2,160; these outcomes produced an incremental CE ratio of €1,624/QALY for the Greek setting. On the basis of probabilistic sensitivity analysis, there was a 100% likelihood of eplerenone being cost-effective versus standard care at a threshold of €3,500/QALY. Conclusion: This analysis indicates that eplerenone may be a cost-effective option versus standard care accompanied by additional clinical benefits and an added incremental cost at an acceptable, if not low, CE ratio. The results are consistent with the previously published studies on the CE of eplerenone as an add-on therapy to standard care, such as those regarding the health care settings of Spain, the UK, and Australia. Keywords: heart failure, eplerenone, cost-effectiveness, EMPHASIS-HF, Greec
Detection of mutations in the RAS oncogenes and the oncosuppressor gene P53 in cardiac myxomas using polymerase chain reaction technique
No full textWE INVESTIGATED 20 CARDIAC MYXOMAS, 2 RHABDOMYOMAS AND 1 CARDIAC LEIOMYOSARCOMA FOR THE EXISTENCE OF RAS GENE MUTATIONS, RAS P21 AND P53 OVEREXPRESSION AND MICROSATELLITE INSTABILITY USING PCR-RFLP ANALYSIS, IMMUNOHISTOCHEMICAL METHOD AND PCR TECHNIQUE RESPECTIVELY. GENETIC ANALYSIS REVEALED THE PRESENCE OF APOINT MUTATION AT CODON 12 OF H-RAS IN PRIMARY CARDIAC LEIOMYOSARCOMATISSUE AS WELL AS THE EXISTENCE OF MICROSATELLITE INSTABILITY IN A SIGNIFICANT PERCENTAGE (64%) OF CARDIAC MYXOMAS. THESE RESULTS SUGGEST THAT PARTICULAR GENETICALTERATIONS ARE IMPLICATED IN THE PATHOGENESIS OF THESE RARE CARDIAC TUMORS.ΜΕ ΣΚΟΠΟ ΤΗΝ ΑΝΙΧΝΕΥΣΗ ΓΕΝΕΤΙΚΩΝ ΑΛΛΟΙΩΣΕΩΝ ΣΕ ΠΡΩΤΟΠΑΘΕΙΣ ΚΑΡΔΙΑΚΟΥΣ ΟΓΚΟΥΣ, ΜΕΛΕΤΗΣΑΜΕ 20 ΚΑΡΔΙΑΚΑ ΜΥΞΩΜΑΤΑ, 2 ΚΑΡΔΙΑΚΑ ΡΑΒΔΟΜΥΩΜΑΤΑ ΚΑΙ ΕΝΑ ΚΑΡΔΙΑΚΟ ΛΕΙΟΜΥΟΣΑΡΚΩΜΑ ΓΙΑ ΤΗΝ ΥΠΑΡΞΗ: Α) ΜΕΤΑΛΛΑΞΕΩΝ ΣΤΑ ΓΟΝΙΔΙΑ RAS ΜΕ ΤΗΝ ΤΕΧΝΙΚΗ ΤΗΣPCR-RFLP, Β) ΥΠΕΡΕΚΦΡΑΣΗΣ ΤΩΝ ΠΡΩΤΕΙΝΩΝ RAS P21 ΚΑΙ P53 ΜΕ ΤΗΝ ΑΝΟΣΟΙΣΤΟΧΗΜΙΚΗΜΕΘΟΔΟ, Γ) ΑΣΤΑΘΕΙΑΣ ΤΟΥ ΜΙΚΡΟΔΟΡΥΦΟΡΙΚΟΥ DNA ΜΕ ΤΗΝ PCR ΜΕΘΟΔΟ ΚΑΙ 30 ΜΙΚΡΟΔΟΡΥΦΟΡΙΚΟΥΣ ΔΕΙΚΤΕΣ. Η ΓΕΝΕΤΙΚΗ ΑΝΑΛΥΣΗ ΔΕΝ ΑΝΕΔΕΙΞΕ ΠΟΣΟΤΙΚΕΣ ΑΛΛΟΙΩΣΕΙΣ ΤΩΝ ΠΡΩΤΕΙΝΩΝ RAS P21 ΚΑΙ P53 ΟΥΤΕ ΚΑΙ ΔΟΜΙΚΕΣ ΑΛΛΟΙΩΣΕΙΣ ΤΩΝ ΓΟΝΙΔΙΩΝ RAS ΕΚΤΟΣ ΤΟ ΠΡΩΤΟΠΑΘΕΣ ΚΑΡΔΙΑΚΟ ΛΕΙΟΜΥΟΣΑΡΚΩΜΑ (ΜΕΤΑΛΛΑΞΗ Η RAS). ΑΝΤΙΘΕΤΑ ΑΝΙΧΝΕΥΘΗΚΕ ΑΣΤΑΘΕΙΑ ΤΟΥ ΜΙΚΡΟΔΟΡΥΦΟΡΙΚΟΥ DNA ΣΕ ΣΗΜΑΝΤΙΚΟ ΠΟΣΟΣΤΟ ΚΑΡΔΙΑΚΩΝ ΜΥΞΩΜΑΤΩΝ (64%) ΓΕΓΟΝΟΣ ΠΟΥ ΣΥΝΗΓΟΡΕΙ ΓΙΑ ΤΗΝ ΕΜΠΛΟΚΗ ΤΟΥ ΦΑΙΝΟΜΕΝΟΥ ΣΤΗΝ ΠΑΘΟΓΕΝΕΙΑ ΤΩΝ ΣΥΓΚΕΚΡΙΜΕΝΩΝ ΟΓΚΩΝ
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