1,354,119 research outputs found
Manuale di Cardiologia, Chirurgia Vascolare e Cardiovascolare (4th edition)
No full textIl cuore è situato nel mediastino medio. Il solco atrioventricolare,
o solco coronario, separa gli atri dai ventricoli. Il solco
interventricolare a sua volta separa tra di loro i due ventricoli. Il
punto in cui il solco interventricolare interseca il solco atrioventricolare
è denominato crux cordis (croce cardiaca)
Cell based therapeutic approach in vascular surgery: application and review
No full textMultipotent stem cells - such as mesenchymal stem/stromal cells and stem cells derived from different sources like vascular wall are intensely studied to try to rapidly translate their discovered features from bench to bedside. Vascular wall resident stem cells recruitment, differentiation, survival, proliferation, growth factor production, and signaling pathways transduced were analyzed. We studied biological properties of vascular resident stem cells and explored the relationship from several factors as Matrix Metalloproteinases (MMPs) and regulations of biological, translational and clinical features of these cells. In this review we described a translational and clinical approach to Adult Vascular Wall Resident Multipotent Vascular Stem Cells (VW-SCs) and reported their involvement in alternative clinical approach as cells based therapy in vascular disease like arterial aneurysms or peripheral arterial obstructive disease
Hemophilia, how will end the story? [Emofilia, come si concluderà la storia?]
No full textHemophilia A (HA) and B (HB) are the most frequent inherited bleeding disorders caused by defects in the F8C and F9 genes that encode coagulation factor VIII and factor IX, respectively. Both HA and HB are X-linked recessive diseases and have an incidence of 1:5000 and 1:30,000 males, respectively. The diagnosis is based on normal prothrombin time, altered activated partial thromboplastin time and reduced activity of factor VIII or factor IX in plasma. Furthermore, laboratory contributes to identify the inhibitor (an immunoglobulin against the factor that some hemophilic patients develop during therapy) and to reveal acquired hemophilia. Carrier females of HA and HB are tipically asymptomatic and can be identified only by molecular analysis; their evaluation is important, as one third of cases of hemophilia is due to novel mutations and in these cases the mother (and consanguineous females) of the proband have no risk to be carrier. Both diseases are due to a myriad of different mutations (mostly private), so that the molecular diagnosis is based on scanning techniques or gene sequencing. Given the number of hemophilic patients that experience severe perinatal complications, high-risk couples usually require prenatal diagnosis. We revise here our experience on 50 prenatal diagnoses of hemophilia. The clinical heterogeneity of hemophilic patients prompted many groups to study prothrombotic gene variants in these subjects to investigate whether such variants modify the clinical expression of disease. Finally, therapy (using recombinant factors) and, in a near future, gene therapy will change the natural history of hemophilic patients
Hemophilia, how will end the story? [Emofilia, come si concluderà la storia?]
No full textHemophilia A (HA) and B (HB) are the most frequent inherited bleeding disorders caused by defects in the F8C and F9 genes that encode coagulation factor VIII and factor IX, respectively. Both HA and HB are X-linked recessive diseases and have an incidence of 1:5000 and 1:30,000 males, respectively. The diagnosis is based on normal prothrombin time, altered activated partial thromboplastin time and reduced activity of factor VIII or factor IX in plasma. Furthermore, laboratory contributes to identify the inhibitor (an immunoglobulin against the factor that some hemophilic patients develop during therapy) and to reveal acquired hemophilia. Carrier females of HA and HB are tipically asymptomatic and can be identified only by molecular analysis; their evaluation is important, as one third of cases of hemophilia is due to novel mutations and in these cases the mother (and consanguineous females) of the proband have no risk to be carrier. Both diseases are due to a myriad of different mutations (mostly private), so that the molecular diagnosis is based on scanning techniques or gene sequencing. Given the number of hemophilic patients that experience severe perinatal complications, high-risk couples usually require prenatal diagnosis. We revise here our experience on 50 prenatal diagnoses of hemophilia. The clinical heterogeneity of hemophilic patients prompted many groups to study prothrombotic gene variants in these subjects to investigate whether such variants modify the clinical expression of disease. Finally, therapy (using recombinant factors) and, in a near future, gene therapy will change the natural history of hemophilic patients
Apixaban in a morbid obese patient with atrial fibrillation: A clinical experience using the plasmatic drug evaluation
No full textWe present the case of a 45-year-old man with atrial fibrillation and morbid obesity (weight 128 kg, height 168 cm, BMI 45.4) who was switched from Warfarin 5 mg once daily to Apixaban 5 mg twice daily because he did not achieve at least 60% of the time in therapeutic range. We performed serial determinations of apixaban plasma concentration (at 2, 6, 12, 24 hrs after intake) showing drug levels within reference range, even when the patient lose weight
Going Beyond Counting First Authors in Author Co-citation Analysis
No full textThe 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
Pain processing in patients with migraine: an event-related fMRI study during trigeminal nociceptive stimulation
No full textWe explored the functional pattern of the pain-processing network in patients with migraine, in the interictal periods, during trigeminal noxious stimulation. Contact heat evoked potential stimulation induced thermal pain and functional magnetic resonance imaging were used to measure whole-brain activation in 16 patients with episodic migraine without aura and 16 age- and gender-matched healthy controls in response to a severe (53°C) noxious, a moderate (51°C) noxious, and a control (41°C) stimulus applied to the maxillary skin. When comparing the fMRI activation over the entire brain, patients with migraine, with respect to healthy controls, showed a significantly greater activation in the perigenual part of anterior cingulate cortex at 51°C and less activation in the bilateral secondary somatosensory cortex at 53°C. A group-by-stimulus interaction analysis revealed a region in the pons showing a divergent response in patients and healthy controls. Correlation analyses demonstrated that the pons activation correlated with higher headache-related disability in patients. Our findings demonstrate increased antinociceptive activity in patients with migraine, which may represent a compensatory reorganization to modulate pain perception at the same intensity of healthy controls
Beyond motor neurons: new insights on amyotrophic lateral sclerosis neurodegeneration provided by advanced MRI tecnique
No full textAim
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease, characterized by the progressive degeneration of upper and lower motor neurons, but does not spare extra-motor areas, causing cognitive and behavioural syndromes.
To better investigate structural and functional abnormalities in ALS, we used resting-state fMRI data combined to VBM analysis and a quantitative DTI approach, by a TBSS analysis, in a population of behaviour impaired ALS patients.
Methods
We investigated 20 ALS patients (10 women and 10 men) ranging from 34 to 80 years (mean age 60.7 ± 11.1) of age, fulfilling the diagnostic criteria for probable or definite ALS, according to the revised El Escorial criteria of the World Federation of Neurology.
The control group comprised 20 healthy controls (10 men, 10 women) aged from 46 to 78 years (mean age 62.1 + 8.5 years) with no history of neurological or psychiatric diseases and without any abnormalities detected on conventional MRI T1 and T2 weighted images.
Magnetic resonance images were acquired on a 3-T GE Medical System scanner equipped with an 8-channel parallel head coil.
Results
The sensori-motor network (SMN) showed significant disease effects, with signal suppression in patients in the primary and the supplementary motor cortices. The same was visible frontally in the right fronto-parietal network, possibly reflecting the patients' frontal dysfunction. Compared with controls, ALS patients had significant clusters of reduced GM density in the left premotor and right fronto-parietal cortex. DTI analysis showed reduced FA values in the body of corpus callosum (CC) and bilaterally in WM tracts from the central CC to primary motor and premotor cortices, also including, with slight prevalence in the left hemisphere, corona radiata, anterior cingulate, superior longitudinal, inferior longitudinal, inferior occipito-frontal and uncinate fasciculi. The DTI pattern of predominantly frontal WM injury clearly reflects the frontal executive dysfunction that characterizes our ALS patients, and is in agreement with the growing body of evidence that degeneration of the frontotemporal lobar type may occur in ALS with a variable range of behavioral and cognitive impairments among patients. In patients a significant decrease of FA compared to controls mainly in the midbody of the CC, where for reduced FA vs increased UMN score a strong significant correlation was also seen. Additionally, for reduced FA vs lower ALS functional rating scale revised (ALSFRS-R), index of patients' disability, a striking trend of correlation was found both in in the WM underneath the left premotor cortex, especially the left paracentral lobule, including also anterior cingulate and superior longitudinal fasciculus. We confirmed the effect of ALS on the SMN network and investigated the possible extramotor involvement in ALS. The correlations between reduction of FA in the body of CC with the UMN score indicate that the WM degeneration in the CC is strictly related to the ALS pyramidal impairment, whilst the correlation between FA and ALSFRS-R in the associative tracts underneath the left premotor cortex might reflect the progressive spread of the disease from motor towards extra-motor areas
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