1,721,055 research outputs found
European consensus on standard and guidelines for global and regional ventricular function from echocardiography: Overview and choice of parameters to assess myocardial contractility
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Imaging in the diagnosis of acute aortic dissection: Report on time-benefit and risk-benefit
No full textAcute aortic dissection is a dramatic event in which the outcome is strongly influenced by the time necessary for the diagnosis. Surgically untreated type A aortic dissection has a mortality rate ranging from 60% within the first hours to 90% within 3 months; type B, medically treated dissection, has a survival rate of 80% within the first year. For both types a rapid diagnosis is of extreme importance in experience and the technologic advances of each hospital. Standard chest X-ray can be useful especially if it shows an enlargement of the mediastinum, which guides to the second step in diagnostic testing which is, depending on the setting, echocardiography or computed tomography, and rarely angiography. Standard echocardiography has a very low sensitivity and a moderate specificity. Transesophageal echocardiography can give information about: intimal flap entry (color flow Doppler), extension of the dissection (up to the supradiaphragmatic level), distinction between true and false lumen, left ventricular function and presence of aortic regurgitation. Computed tomography is more accurate in detecting the total extension of the side branch involvement. Aortic angiography, still widely requested by the majority of cardiovascular surgeons, represents a higher risk procedure although giving important information similar to those already mentioned. Magnetic resonance imaging offers the best imaging by multiplane approach but cannot be performed in critically ill patients. In terms of risk-benefit and time-benefit the best diagnostic sequence in the unstable patient should consist in: chest X-ray, transesophageal echocardiography acid/or computed tomography scan. Aortic angiography may be avoided and the surgeon must become familiar to all new imaging techniques
Diabetes mellitus and cardiovascular complications: pathophysiological peculiarities and therapeutic implications
No full textDiabetes mellitus is a chronic illness frequently associated with cardiovascular complications. The cardiologist must therefore play an important role in the management of diabetic patients, aware of the different natural history of the insulin-dependent and non-insulin-dependent forms, as well as of the pathophysiological peculiarities of the disease which requires particular diagnosis and therapy. Unfortunately, treatments which have proved to be most effective are still underused. Cardiovascular complications in diabetic patients are aggravated by higher morbidity and mortality rates than in the general population. In an attempt to prevent major cardiovascular events, the cardiologist must identify those patients at greater risk, particularly those with asymptomatic coronary heart disease
Gender Medicine in Italy: The Point of View of Maria Grazia Modena: The Story, Limits, and Plans: My Personal Story
No full textGender medicine (GM) in Italy was born with the association I have been part of since the 90s Tailored Health for Women created by Dr. Elvira Reale and eight women doctors. We started research on risk factors for illness in women’s daily lives with Ministries of Pair Opportunity and Health, summarizing important documents in the history of GM in Italy. We had little success initially since (1) both ministers were changed and the successors were not interested in GM; (2) we were considered feminists and our congresses attended by few, all women! Each of us continued research in their own field, meeting every year with growing enthusiasm. The biggest limits for GM development in Italy are the excessive fragmentation of often self-referential associations/working groups, absence of GM in the core curriculum of medical school and of a gender-based law for health care. Finally I report of my personal story, an example of “gender related storm.”
The occurrence of drug-induced side effects in women and men with arterial hypertension and comorbidities
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