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Interventional treatment in elderly patients with severe aortic valve stenosis and coronary artery disease
Full text linkUniversitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroduction. Aortic stenosis (AS) is a valvular heart disease commonly found in the elderly patients and frequently is associated with coronary artery disease (CAD), sharing multiple risk factors and common pathophysiological mechanisms, such as age, smoking, hypertension, and hyperlipidemia. The prevalence of CAD in patients with severe AS is between 15% and 80% and the impact of coronary involvement on postprocedural outcomes is controversial and incompletely studied. Aim of study. This study aims to compare clinical and hemodynamic outcomes, as well as the rate of major adverse cardiovascular and cerebrovascular events (MACCE) in patients undergoing TAVI with PCI (patients with AS and CAD) versus isolated TAVI (patients with AS). Methods and materials. A retrospective study was performed that included 41 patients older than 70 years with a diagnosis of severe aortic valve stenosis and CAD. Patients were divided into two groups: 32 patients without significant coronary lesions and 9 patients with significant multivessel lesions and Syntax Score <22. In these patients, we aimed to assess the valvular pressure gradient, and aortic valve peak velocity, pre-procedural, post-procedural, 30 days and 1 year post-TAVI. To assess the postprocedural results, the rate of major adverse cardiovascular events (MACCE) is recorded, represented by: cardiovascular mortality, cerebrovascular accident, acute myocardial infarction or myocardial revascularization, readmission due to heart failure. Results. After analyzing the data, it was determined that in group I the proportion of men was 21.87%, compared to 22.2% in group no. II, and the average age was 78.15 ± 4.61 vs 75.66 ± 5.02, p<0,09. The mean values of the maximum transaortic pressure gradient were 93.11 mmHg ± 21.55 in group 1 and 103.07 mmHg ± 20.19, respectively, p<0,156; the mean transaortic pressure gradient 57.52 mmHg ± 15.25 vs 63.98 ± 15.0, p<0,156, and the mean value of the peak velocity through the aortic valve was 4.78 m/s ± 0.56 in group I and 5.05 m/s ± 0.54 in the second group, p<0,142. After the procedure, the average pressure gradient decreased impressively, the average value being 12.59 ± 5.62 mmHg vs 14.78 ± 8.73 mmHg, p< 0.338. The peak velocity of the jet through the aortic valve is 2.36 ± 0.50 m/s vs 2.53 ± 0.83 m/s, p< 0.361. In this study, one case of death associated with the procedure, which represents 3.12%, and 2 cases of stroke, which constituted 6.25%, were documented in group I. At the same time, in both groups 2 cases of readmission due to heart failure were reported. Conclusion. In patients with severe AS and complex CAD, TAVI + PCI was not associated with a higher rate of MACCE after a 12-month follow-up compared with patients with severe AS without CAD and approached by TAVI, probably due to the small study group and short follow-up period. Performing PCI before TAVI in patients with a Syntax score <22 appears to be safe, with no differences in echocardiographic parameters or MACCE compared to the group of patients without coronary lesions. Keywords. Aortic stenosis, transcatheter aortic valve implantation, coronary artery disease. and frequently is associated with coronary artery disease (CAD ), sharing multiple risk factors and common pathophysiological mechanisms, such as age, smoking, hyperten sion, and hyperlipidemia. The prevalence of CAD in patients with severe AS is between 15% and 80% and the impact of coronary involvement on postprocedural outcomes is controversial and incomple tely studied. Aim of study. This study aims to compare clinical and hemodynamic outcomes, as w ell as the rate of major adverse cardiovascular and cerebrovascular events (MACCE) in patients undergoing TAVI with PCI (patients with AS and CAD) versus isolated TAVI (patients with AS). Methods and materials. A retrospective study was performed that included 41 patients older than 70 years with a diagnosis of severe aortic valve stenosis and CAD. Patients were divided into two groups: 32 patients without significant coronary lesions and 9 patients with si gnificant multivessel lesions and Syntax Score <22. In these patients, we aimed to assess the valvular pressure gradient, and aortic valve peak velocity, pre-procedural, post-procedural, 30 days and 1 year post-T AVI. To assess the postprocedural results, the rate of major adverse cardiovascular events (MACCE) is recorded, represented by: cardiovascular mortality, cerebrovascular accident, acute myocardial infarction or myocardial revascularization, readmission due to heart failure. Results. After analyzing the data, it was determined that in group I the pr oportion of men was 21.87%, compared to 22.2% in group no. II, and the average age was 78.15 ± 4.61 vs 75.66 ± 5.02, p<0,09. The mean values of the maximum transaortic pressure gradient were 93.11 mmHg ± 21.55 in group 1 and 103.07 mmHg ± 20.19, respectively, p<0,156; the mean transaortic pressure gradient 57.52 mmHg ± 15.25 vs 63.98 ± 15.0, p<0,156, and the mean value of the peak velocity through the aortic valve was 4.78 m/s ± 0.56 in group I and 5.05 m/s ± 0.54 in the second group, p<0,142. After the procedure, the average pressure gradient decreased impressively, the average val ue being 12.59 ± 5.62 mmHg vs 14.78 ± 8.73 mmHg, p< 0.338. The peak velocity of the jet through the aortic valve is 2.36 ± 0.50 m/s vs 2.53 ± 0.83 m/s, p< 0.361. In this study, one case of death associate d with the procedure, which represents 3.12%, and 2 cases of stroke, which constituted 6.25%, were documente d in group I. At the same time, in both groups 2 cases of readmission due to heart failure were rep orted. Conclusion. In patients with severe AS and complex CAD, TAVI + PCI was not associated with a higher rate of MACCE after a 12-month follow-up compared with patie nts with severe AS without CAD and approached by TAVI, probably due to the small study gro up and short follow-up period. Performing PCI before TAVI in patients with a Syntax score <22 appea rs to be safe, with no differences in echocardiographic parameters or MACCE compared to the group of patient s without coronary lesions
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
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
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
Postoperative evolution and incidence of complications after transcatheter aortic valve implantation in the period 2019-2025
Full text linkUniversitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu”, Chișinău, Republica MoldovaIntroducere. Începând cu anul 2019, în Republica Moldova implantarea transcateter de valvă aortică (TAVI) a devenit o alternativă eficientă pentru tratamentul stenozei aortice (SA) la pacienţii vârstnici, însă în pofida succesului acestei proceduri, complicaţiile peri- şi postprocedurale rămân inevitabile. Scop. Analiza evoluţiei clinice şi a complicaţiilor postoperatorii la pacienţii supuşi TAVI, atât în perioada periprocedurală, cât şi la intervale de 30 de zile, şase luni şi un an postintervenţie. Material şi metode. În studiu au fost incluşi 171 de pacienţi supuşi TAVI în perioada anilor 2019-2025, fiind monitorizată evoluţia lor clinică pe termen scurt şi mediu. Vârsta medie a fost de 76,28 ± 4,842 ani, cu predominanţa femeilor (61,99%). S-au analizat evenimentele adverse cardiovasculare majore (MACE) şi complicaţiile periprocedurale. Rezultate. Periprocedural, 29 pacienţi (16,96%) au prezentat complicaţii, precum: BAV grad III cu implantare de pacemaker (6,43%), complicaţii vasculare (4,68%), embolizare valvulară (1,17%), aritmii ventriculare (1,75%) şi deces procedural (1,17%). La 30 de zile, 10 pacienţi (5,84%) au prezentat reinternare cu insuficienţă cardiacă (IC) (4,09%), tromboză valvulară (0,58%) şi IMA (0,58%). La 6 luni, 6 pacienţi (4,44%) au avut tromboză valvulară (1,48%), reinternare cu IC (1,48%), BAV grad III (0,74%) şi deces non-cardiac (0,74%). La 1 an, 4 pacienţi (3,28%) au prezentat reinternare cu IC, BAV grad III, AVC şi deces non-cardiac (0,82% fiecare). Concluzii. Evaluarea complicaţiilor peri- şi postprocedurale la pacienţii vârstnici evidenţiază, în ultimii ani, o scădere semnificativă a acestora, datorită îmbunătăţirii continue a designului valvei, selecţiei riguroase a pacienţilor şi creşterii experienţei centrului şi operatorilor.Introduction. Starting in 2019, in the Republic of Moldova, transcatheter aortic valve implantation (TAVI) has become an effective alternative for the treatment of aortic stenosis (AS) in elderly patients. However, despite the success of this procedure, peri- and postprocedural complications remain inevitable. Objective. Clinical evolution and postoperative complications in patients undergoing TAVI, assessed during the periprocedural period and at follow-ups of 30 days, 6 months, and 1-year post-procedure. Material and methods. The study included 171 patients who underwent TAVI between 2019 and 2025, with their clinical course monitored over the short and medium term. The mean age was 76.28 ± 4.842 years, with a predominance of female patients (61.99%). Major adverse cardiovascular events (MACE) and periprocedural complications were analyzed. Results. Periprocedurally, 29 patients (16.96%) experienced complications, including third-degree AV block with pacemaker implantation (6.43%), vascular complications (4.68%), valve embolization (1.17%), ventricular arrhythmias (1.75%) and procedure-related death (1.17%). At 30 days, 10 patients (5.84%) had HF readmission (4.09%), valve thrombosis (0.58%) and MI (0.58%). At 6 months, 6 patients (4.44%) showed valve thrombosis (1.48%), HF readmission (1.48%), third-degree AV block (0.74%) and non-cardiac death (0.74%). At 1 year, 4 patients (3.28%) experienced HF readmission, AV block, stroke, and non-cardiac death (0.82% each). Conclusion. The evaluation of peri- and postprocedural complications in elderly patients has shown a significant decrease in recent years, due to the continuous improvement of valve design, rigorous patient selection, and the growing experience of both the center and the operators
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