220 research outputs found
Midterm clinical and echocardiographic results and predictors of mitral regurgitation recurrence following restrictive annuloplasty for ischemic cardiomyopathy
No full textObjectiveAlthough mitral restrictive annuloplasty plus coronary artery bypass grafting are considered the best therapeutic strategies for ischemic cardiomyopathy with chronic mitral regurgitation, some recurrences are still reported. We evaluated predictors for late recurrence of ischemic cardiomyopathy with chronic mitral regurgitation.MethodsHospital outcome and serial clinical and echocardiographic (preoperative, discharge, 6 months, end of follow-up) follow-up assessments were recorded for 82 consecutive patients with ischemic cardiomyopathy with chronic mitral regurgitation having coronary artery bypass grafting + mitral restrictive annuloplasty (2 sizes ring downsizing). Recurrent ischemic cardiomyopathy with chronic mitral regurgitation was defined by grade ≥ 2 at echocardiography.ResultsHospital mortality was 4.9%; 17.7 ± 1.7 (standard error) months (range 1–55) survival was 95.5% ± 2.5%. Two-year Kaplan-Meier freedom from reintervention was 94.2% ± 4.2%; from rerevascularization, 87.5% ± 11.7%; from congestive heart failure, 83.8% ± 5.7%; from ischemic cardiomyopathy with chronic mitral regurgitation grade ≥ 2, 46.5% ± 11.2%. Recurrence of ischemic cardiomyopathy with chronic mitral regurgitation gave lower 2-year Kaplan-Meier freedom from death (P = .03) and lower 2-year freedom from congestive heart failure (P = .0001), reintervention (P = .034), and tricuspid insufficiency (P = .0001). Ischemic cardiomyopathy with chronic mitral regurgitation recurrence correlated with worsened New York Heart Association class (P = .0001), left ventricular ejection fraction (P = .024), pulmonary arterial pressures (P = .0001), left ventricular end-diastolic diameter (P = .004), left ventricular end-systolic diameter (P = .014), indexed left ventricular mass (P = .008), and coaptation depth (P = .0001). Independent predictors for recurrent ischemic cardiomyopathy with chronic mitral regurgitation were previous anterior + posterior myocardial infarction (odds ratio 3.70; confidence interval 2.93–5.41; P = .001), preoperative left ventricular end-diastolic diameter ≥ 70 mm (odds ratio 3.91; confidence interval 2.65–5.22; P = .001), and coaptation depth at discharge ≥ 0.5 cm (odds ratio 11.9; confidence interval 5.91–21.34; P = .0001). Preoperative left ventricular end-diastolic diameter ≥ 70 mm correlated with higher congestive heart failure (P = .002), recurrent ischemic cardiomyopathy with chronic mitral regurgitation (P = .0001), worsened New York Heart Association class (P = .0001), and higher diuretics (P = .0001). Coaptation depth < 0.5 cm at discharge accounted for better survival (P = .010), lower incidence of congestive heart failure (P = .0001), lower need for diuretics (P = .0001), and improved New York Heart Association class (P = .0001).ConclusionsFailure of mitral restrictive annuloplasty is responsible for follow-up mortality and congestive heart failure and correlates with absence of cardiac reverse remodeling. Prognosis of patients having mitral restrictive annuloplasty for ischemic cardiomyopathy with chronic mitral regurgitation is good, as long as a low postoperative coaptation depth is achieved. Patients with significant left ventricular dilation should be considered for different surgical strategies
Mid-term echocardiographic results with different rings following restrictive mitral annuloplasty for ischaemic cardiomiopathy
No full textBACKGROUND: Despite restrictive mitral annuloplasty (RMA) being considered effective for chronic ischaemic mitral regurgitation (CIMR), few data exist on mid-term echocardiographic results with different prosthetic rings. Therefore, comparative echocardiographic analysis has been performed.
METHODS: Sixty-four consecutive coronary artery bypass graft surgery (CABG) + RMA (downsizing by two-ring sizes; median size: 26 mm) for CIMR with a follow-up of at least 6 months were prospectively followed-up with serial echocardiograms (preoperative, discharge, 6 months, follow-up ending). Hospital mortality, follow-up clinical and echocardiographic results were analysed and compared between three groups (group A: semi-rigid band, 17 patients; group B: complete symmetric semi-rigid, 22 patients; group C: complete asymmetric semi-rigid, 25 patients).
RESULTS: Hospital mortality was 6.3%; 22.8 +/- 14.7 standard deviation (SD) months (range: 6-55) survival was 96.5 +/- 2.5%; freedom from re-intervention was 94.2 +/- 4.2%, from re-revascularisation 87.5 +/- 11.7%, from > or = grade-2 mitral regurgitation 58.2 +/- 9.8% and from heart failure (CHF) 71.6 +/- 10.5%. Recurrent (> or = grade-2) CIMR resulted in lower freedom-from-CHF (p = 0.0001), worsened New York Heart Association (NYHA) classification (p = 0.0001) and absence of reverse remodelling of the left ventricular end-diastolic diameter (LVEDD; p = 0.004), systolic diameter (LVESD; p = 0.014), indexed mass (LVMi; p = 0.005) and coaptation depth (p = 0.0001). Group A showed significant worse freedom from CHF (group A: 42.8 +/- 19.5% vs group B: 88.9 +/- 10.5% vs group C: 92.3 +/- 7.5%; p = 0.049) and from recurrent CIMR (17.4 +/- 13.8% vs 82.1 +/- 11.7% vs 94.1 +/- 5.7%, respectively; p = 0.0001). Complete rings decreased the hazard of recurrent CIMR (Physio = 0.141; Adams = 0.089). Higher NYHA during follow-up was found in group A (p = 0.002 for group B and p = 0.001 for group C) with a progressive reduction of trans-mitral mean gradient (p = 0.001), and a lower degree of reverse remodelling of LVEDD (p = 0.009 and p = 0.010) and coaptation depth (p = 0.040 and p = 0.002).
CONCLUSIONS: Recurrent CIMR correlates with absent ventricular reverse remodelling. Despite a higher trans-mitral gradient, complete rings achieve better results in the treatment of CIMR
La riforma (ancora in cantiere) della magistratura onoraria e la decisione della Consulta n. 41/2021: la partecipazione degli ausiliari nei collegi d’appello “sarà” costituzionalmente illegittima
No full textTaking into account the outcomes of the sentence no. 41/2021 of Italian Constitutional Court, which declared the incostincency of the legislation that introduced the “auxiliary judges” in the appeal
courts, the Author reflects on the current role of the non professional judges, in a general context of law-making’s and case-law’s interest on the subject. The Author analyzes also the decision-making process adopted by the Court which led to the “manipulation” of the temporal effects of the decision upholding the question of constitutional inconsistency
Marsico G., Valsiner J. (2018). Is there any reason for suffering—for science in psychology? In G. Marsico & J. Valsiner, J. (2018). Beyond the Mind: Cultural Dynamics of the Psyche. (pp. 49-52), Charlotte, N.C. USA: Information Age Publishing;
No full textPart I includes texts about the current state of affairs in psychology, and of the emergence of the new area—cultural psychology—that turns out to be older than psychology itself. The sentiments expressed in these two papers seem to represent the doubts their author has about the future of psychology as a science
Spunti per il dibattito sul Regolamento (UE) 2017/625: armonizzazione normativa e atti delegati
No full textIn this work the Author examines the legislative technique used by the European Parliament in the regulation 625 of 2017 which entrusts the instrument of delegation with the integration of important parts of the same and highlights how this technique removes the European legislator from the aim pursued rationalization and simplification of the global regulatory framework by integrating the rules relating to official controls, currently located in specific sectors, in a single regulatory framework relating to official controls
Il Messale di Gjon Buzuku: la lingua materna nella prassi liturgica albanese
No full textMeshari ‘The Missal’ (1555) is the first known printed book in Albanian. It is a translation from the Latin of the Catholic Missal, made by the ecclesiastical Gjon Buzuku. The only known copy extant is preserved in the Apostolic Library of the Vatican in Rome. It is missing the frontispiece and the first 16 pages, so the title and place of publication of the work are not known. The place the book was printed is thought to be Venice. The Meshari contains texts of prayers, rituals, catechetical texts and the liturgies of the main holidays. All we know about the author is from the book’s colophon written by Buzuku himself in Albanian. In the colophon, he explains the reasons that led him to divulge the Christian doctrine using the language of its land. The time in which The Meshari appeared was of great cultural decay for Albania, a land where frictions have been consumed between Catholicism and Orthodoxy, and where Christian and Muslim civilizations were one against the other. Buzuku offers to the people of Albanian believers to approach the Sacred scriptures through their language. Since the use of Latin was far from the understanding of Albanian people, Buzuku translated the divine Word in order to allow that it was comprehensible to the Albanian Christians
Successful surgical treatment of chronic ischemic mitral regurgitation achieves left ventricular reverse remodeling but does not affect right ventricular function
No full textObjectiveTo evaluate left-sided and right-sided heart echocardiographic results after restrictive mitral annuloplasty in chronic ischemic mitral regurgitation.MethodsLeft atrial diameter, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, left ventricular ejection fraction, left ventricular indexed mass, coaptation depth, transmitral mean gradient, systolic pulmonary arterial pressure, tricuspid annular plane systolic excursion, right ventricular ejection fraction, and tricuspid insufficiency grading were evaluated preoperatively, postoperatively, at 6 months, and at the end of the follow-up period in 64 patients undergoing restrictive mitral annuloplasty and coronary artery bypass grafting. Recurrence of chronic ischemic mitral regurgitation was defined as 2+/4+ grade or greater mitral regurgitation at any time postoperatively.ResultsTwenty-two months of freedom from recurrent chronic ischemic mitral regurgitation was 58.2% ± 9.8%. Recurrent chronic ischemic mitral regurgitation did not lead to reverse remodeling of left atrial diameter, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, and ventricular indexed mass (P = not significant), with increased coaptation depth, parallel to follow-up chronic ischemic mitral regurgitation worsening. Effective restrictive mitral annuloplasty induced reverse remodeling of left ventricular end-diastolic diameter, left ventricular end-systolic diameter, and ventricular indexed mass, improved left ventricular ejection fraction, shortened coaptation depth, and improved mean gradient (P ≤ .014). Recurrent chronic ischemic mitral regurgitation in patients without tricuspid surgery prevented improvements of systolic pulmonary arterial pressure, tricuspid annular plane systolic excursion, right ventricular ejection fraction, worsening New York Heart Association (P = .003), and daily diuretic need (P = .008), whereas effective restrictive mitral annuloplasty progressively improved tricuspid insufficiency grading, systolic pulmonary arterial pressure, right ventricular ejection fraction, tricuspid annular plane systolic excursion, New York Heart Association, and diuretic need (P ≤ .013). Patients undergoing tricuspid annuloplasty did not show any improvement of systolic pulmonary arterial pressure, right ventricular ejection fraction, and tricuspid annular plane systolic excursion regardless of the recurrence of chronic ischemic mitral regurgitation (P = not significant), although effective restrictive mitral annuloplasty improved tricuspid insufficiency grading, New York Heart Association, and daily diuretic need (P ≤ .010).ConclusionEffective restrictive mitral annuloplasty induces reverse left ventricular remodeling. Absence of recurrent chronic ischemic mitral regurgitation improves tricuspid insufficiency grading, systolic pulmonary arterial pressure, right ventricular ejection fraction, tricuspid annular plane systolic excursion, New York Heart Association, and diuretic need in patients who do not undergo tricuspid surgery, but only tricuspid insufficiency grading, New York Heart Association, and daily diuretic need in patients who undergo tricuspid surgery
Andrej Belyj. Sinfonia (2-a, la drammatica). E il tempo scorreva senza sosta...
No full textAndrej Belyj (1913-1914), esordisce nel 1902 con un’opera che inaugura in Russia il genere letterario della sinfonia. Nell’introduzione a Sinfonia (2-a, la drammatica) Belyj spiega che l’opera «ha tre significati: uno musicale, uno satirico e uno ideologico-simbolico». Dal «significato musicale», che porta l’autore a «dividere la sinfonia in parti, le parti in frammenti e i frammenti in versi (frasi musicali)», nasce il genere misto di prosa e poesia di cui Belyj si serve per enfatizzare il contenuto mistico, satirico e grottesco dell’opera, che caratterizzerà poi anche Pietroburgo. Nella Seconda sinfonia}Belyj prende di mira i gruppi di mistici che andavano formandosi all’inizio del Novecento a Mosca e Pietroburgo, citando esplicitamente o raffigurando velatamente personaggi reali del mondo della letteratura, dell’arte e della filosofia, come Vladimir Solov’ev (1853-1900), Dmitrij Merežkovskij (1865-1941) e altri. Motivi strettamente autobiografici vengono così presentati sotto forma di immagini grottesche e iperboliche, alternate a momenti di estremo lirismo. Al «significato musicale» è legata anche la particolare scansione del tempo in cui si dispiega la trama dell’opera, che inizia con il lento trascorrere di un’intera giornata e accelera poi nel passare dei mesi e delle stagioni per ritornare, ciclicamente e drammaticamente, al punto di partenza. Questo procedimento artistico è ben sintetizzato in uno dei leitmotive dell’opera: «E il tempo scorreva senza sosta, e nello scorrere del tempo si rifletteva l’Eternità brumosa». Andrei Bely (1880-1934), poet, novelist, theorist and literary critic of the Russian Symbolist movement, author of the famous novel in rhythmic prose Petersburg (1913-1914), made his literary debut in 1902 with a work introducing in Russia a new literary genre, the symphony. In the introduction to The Dramatic Symphony, Bely explains that the work «has three meanings: a musical meaning, a satirical meaning, and a symbolic ideological meaning». The «musical meaning» inspires the author in splitting the Symphony «into parts, the parts into fragments, and the fragments into verses (musical phrases)», thus creating a new literary genre, which combines prose and poetry, and emphasizes the mystic, satirical and grotesque content of the work. This mix of prose and poetry is also typical of the novel Petersburg. In the Dramatic Symphony Bely was targeting groups of mystics operating in the early 1900’s in Moscow and Saint Petersburg. He openly mentions or covertly alludes to actual protagonists of the literary, artistic and philosophical Russian society: Vladimir Solovyov (1853-1900), Dmitry Merezhkovsky (1865-1941) and others. Strictly autobiographical themes are presented in form of grotesque and hyperbolic images, alternating with moments of great lyrical tension. The «musical meaning» is also linked to the particular conception of time through which the plot of Bely’s Symphony is developed. At the beginning, a whole day passes by very slowly; then time speeds up and the plot goes through several months and seasons. At the end of the work we are back to where we started, like in a dramatic cycle. This method is well summarized in one of the leitmotive of the work: «And the time flowed without stopping, and the passage of time reflected the Eternity misty».</p
Marsico, G., Brandelli Costa, A., (2023). The Journal’s Growth: The Role of the Associate Editors, Trends in Psychology. 10.1007/s43076-023-00296-6
No full textIt is always with great happiness that we announce the growth of our journal. Based
on Springer annual report, since 2020, the journal has doubled the number of articles
accepted for publication. Also, the number of accesses to the full texts of published
articles increased by almost three times. The journal has also seen an increasing
diversity in terms of geographic regions for both the submissions received and
the accesses, with author and readers from all the continents. This is the result of the
collective efforts of our associate editors, along with the Brazilian Society of Psychology and the Springer Team
I piccoli padiglioni universitari progettati da Enrico Mandolesi a Cagliari
No full textBetween 1962 and 1964, Enrico Mandolesi designed three small pavilions for the University of Cagliari: the Great Models Pavilion for the Institute of Construction 377 377 Antonello Sanna, Giuseppina Monni, Emanuela Quaquero I PICCOLI PADIGLIONI UNIVERSITARI PROGETTATI DA ENRICO MANDOLESI A CAGLIARI Science, the Pavilion for the Institute of Hydraulics and the Institute of Genetics. In all cases, the “pictorial” dimension, placing on the same level the warm tones of the clinker and the neutral one of the reinforced concrete, shows the author’s firm belief that all the materials have the same relevance. This is a lesson that Mandolesi learns from Mario Ridolfi, precursor of the Italian realism that abolishes the hierarchy between structural elements and finishes and declares that the creative idea of architecture lies in the precision of details. In the Great Models Pavilion for the Institute of Construction Science he chose to create a new volume connected to preexisting buildings with a small building. The horizontal and vertical windows declare the non-structural nature of the envelope made of bricks. A cultured design approach that uses the paradigm of the Illinois Institute of Technology by Mies van de Rohe. The Institute of Genetics is a building composed of two small volumes articulated on two levels and hinged to an independent stairway with a square plan. In this case, on a formal level, the basic principle is the horizontality that Mandolesi pursues at every level of detail. The author applied a combined solution that includes solid brick walls and a steel structure that connects to the frames of the fixtures. Both cases represent an accurate narration of construction stories that uses the combination of different materials, classic elements and modern solutions, the rough surfaces of reinforced concrete and the smooth ones of brick strips
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