1,721,006 research outputs found
Management of patients with poly-vascular disease: Priorities for revascularization procedures
No full textMultisite artery disease (MSAD) affects 15% to 30% of patients with clinically manifest atherosclerosis, and has a relevant negative impact on prognosis. However, studies specifically focused on MSAD are very few, and available evidence is scarce. Importantly, patients with MSAD require an integrated management, possibly by a "Vascular Team" composed of the different specialists involved in the treatment of atherosclerosis. A multi-disciplinary, patient-centered approach is mandatory to deal with the variety of clinical scenarios and comorbidities found in MSAD patients. The risk/benefit ratio for multi-site arterial revascularization should always be carefully assessed in MSAD patients, taking into account the additional risks of interventions in this subset of patients. Many therapeutic options have been proposed for multisite revascularization, but little evidence is currently available to support specific recommendations. Percutaneous revascularization of the different arterial districts, when feasible, appears promising because of the lower operative morbidity and mortality. © 2012 Bentham Science Publishers
I risultati dell’angioplastica coronarica sono uguali nell’uomo e nella donna? [Does percutaneous coronary intervention in women provide the same results as in men?].
No full textIschemic heart disease shows gender differences, both in terms of clinical characteristics and pathophysiological mechanisms. It is still debated whether these characteristics influence the diagnostic and therapeutic approach and the outcomes in female patients treated with percutaneous coronary intervention. Percutaneous coronary intervention in women has been shown to be feasible, safe and effective as it is in men throughout the whole clinical spectrum of ischemic syndromes. There is a solid scientific evidence of a different diagnostic and therapeutic approach to women suffering from ischemic heart disease compared to men, with a tendency to undertreat female patients, despite the worst risk profile at presentation. Women, in fact, less frequently undergo coronary angiography and receive antiplatelet, antithrombotic or anti-ischemic drugs. They experience more bleedings than men after administration of glycoprotein IIb/IIIa inhibitors. Gender differences, therefore, affect more the clinical than the interventional approach. At least in part, this is due to the fact that current guidelines are based on a male model of diagnostics. It would be desirable to analyze cohorts of patients in whom the percentage of individuals of both sexes will be equally represented, or rather, exclusively female cohorts in order to formulate more targeted diagnostic and therapeutic indications
Azoospermia
No full textAzoospermia is defined as the complete absence of sperm in the ejaculate even after centrifugation. With a prevalence of 1 % among the general male population and 10-15 % among infertile men, it can be classified in two large groups: Obstructive and non-obstructive azoospermia (OA and NOA). The first is caused by an obstruction in the seminal tract (epididymis, vas, ejaculatory ducts), and the latter is due to impaired sperm production by the testis because of congenital maldevelopment and genetic, hormonal and acquired conditions. Diagnostic workup of azoospermia includes personal and familiar history, clinical evaluation, hormonal and semen biochemical assessment, scrotal and distal seminal tract transrectal ultrasounds and invasive investigations such as testicular fine needle aspiration, open biopsy and, in selected cases, vasography. OA can be treated by surgical recanalization of the seminal tract or sperm retrieval for ART. NOA treatment is represented by sperm retrieval for ART. Only the rare cases of hypogonadotropic hypogonadism might benefit from a medical treatment. MicroTESE has recently been proposed as an optimal method for sperm retrieval in NOA, and we describe a novel stepwise approach of this technique to reduce invasivity
A very rare congenital abnormality: double right coronary artery. A case report
No full textThe incidence of coronary artery anomalies is about 0.6-1.3% in angiographic studies of the adult population. Double right coronary artery is one of the rarest abnormalities reported in the literature. We report a case of a double right coronary artery originating from a single orifice in a woman who underwent coronary angiography for a pathological transprosthetic aortic gradient. J Cardiovasc Med 10:643-645 (C) 2009 Italian Federation of Cardiology
Are coronary angioplasty results equal in men and women?
No full textIschemic heart disease shows gender differences, both in terms of clinical characteristics and pathophysiological mechanisms. It is still debated whether these characteristics influence the diagnostic and therapeutic approach and the outcomes in female patients treated with percutaneous coronary intervention. Percutaneous coronary intervention in women has been shown to be feasible, safe and effective as it is in men throughout the whole clinical spectrum of ischemic syndromes. There is a solid scientific evidence of a different diagnostic and therapeutic approach to women suffering from ischemic heart disease compared to men, with a tendency to undertreat female patients, despite the worst risk profile at presentation. Women, in fact, less frequently undergo coronary angiography and receive antiplatelet, antithrombotic or anti-ischemic drugs. They experience more bleedings than men after administration of glycoprotein IIb/IIIa inhibitors. Gender differences, therefore, affect more the clinical than the interventional approach. At least in part, this is due to the fact that current guidelines are based on a male model of diagnostics. It would be desirable to analyze cohorts of patients in whom the percentage of individuals of both sexes will be equally represented, or rather, exclusively female cohorts in order to formulate more targeted diagnostic and therapeutic indications. © 2012 Il Pensiero Scientifico Editore
Current state of symptomatic aortic valve stenosis in the elderly patient.
No full textBACKGROUND: There have been few reports regarding treatment selection and prognosis of symptomatic aortic valve stenosis (AS) in the elderly in Japan.
METHODS AND RESULTS: Sixty-one patients hospitalized between January 2000 and December 2007 for symptomatic severe AS were investigated. The average observation period was 27 months. Thirty-seven patients (61%) were diagnosed with AS for the first time on hospitalization. Thirty-six patients had onset of symptoms within 1 month before admission. Thirty-six patients received aortic valve replacement (group S) and 25 received medical therapy (group M). The patients in group M were older than those in group S (84.1 ± 5.3 years vs. 74.2 ± 4.6 years, P<0.001). Maximum flow velocity measured by echocardiography was lower in group M (4.5 ± 0.3 m/s vs. 4.9 ± 0.5 m/s, P<0 .01), but there was no difference in valve area between the 2 groups (0.62 ± 0.19 cm2 vs. 0.57 ± 0.15 cm2, P=0.12). One-year mortality rate derived from the Kaplan-Meier curve was higher in group M than group S (53.1% vs. 6.4%, respectively). On multivariate analysis, the only independent favorable prognostic factor was aortic valve replacement (HR: 0.02, 95%CI: 0.01-0.15, P<0.01).
CONCLUSIONS: Medical therapy is often selected for treatment of symptomatic AS in the elderly, but the prognosis is very poor. Symptomatic severe aortic stenosis should be treated surgically, or with transcatheter aortic valve implantation in cases with high surgical risk
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
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
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