1,721,026 research outputs found
Moving forward from statistical to clinical considerations regarding complete revascularization
No full textThis commentary refers to ‘Conclusions of complete revascularization meta-analysis are challenged by state-of-the-art methods’ by A. Jobs et al., 2020;41:2223–2224
Beta-blockers and COPD: how can harmony be restored in a marriage in crisis?
No full textThis editorial refers to ‘Association of beta-blocker use with survival and pulmonary function in patients with chronic obstructive pulmonary and cardiovascular disease: a systematic review and meta-analysis
What are the recommendations for adding novel oral anticoagulants to P2Y12-receptor inhibitors, with or without aspirin?
No full textThe clotting cascade and platelets interplay in thrombus formation during acute coronary syndromes. Accordingly, the combination of anticoagulants and antiplatelets could be an interesting approach to minimize ischemic complications in the acute and chronic phases of acute coronary syndromes. Currently, there are no data supporting the combination of new P2 Y12-receptor inhibitors (ticagrelor and prasug-rel) and non-vitamin K antagonist oral anticoagulants in the long-term treatment after an acute coro-nary syndrome. An intriguing option could be the association of ticagrelor and non-vitamin K antagonist oral anticoagulants, without aspirin, but future studies are clearly required
Frailty in patients admitted to hospital for acute coronary syndrome: when, how and why?
No full textFrailty is an issue of paramount importance for cardiologists, because of the aging of patients admitted to hospital for acute coronary syndrome (ACS) and the straight relationship between aging and frailty. Several tools have been provided in this setting, in order to objectively assess frailty status, but important questions are still unsolved. There are conflicting data about a unique definition of frailty in subjects with cardiovascular diseases, the timing to perform a frailty evaluation in the context of an acute myocardial infarction, the mean to assess frailty in these patients and the usefulness of the information derived from the frailty assessment. Frailty results from the analysis of several items and a multidomain evaluation including laboratory values, clinical data and physical performance assessment is required for a comprehensive frailty assessment. However, regardless of the frailty tool, the prevalence of frailty in older ACS patients is high and it could add important information to the decision-making process about invasive strategy, the multivessel disease management, dual antiplatelet therapy and secondary prevention programs. The present overview tries to summarize the current knowledge about the definition and prevalence of frailty in older adults admitted to hospital for ACS, suggesting how frailty assessment may improve the management of older ACS patients
The New ESC Guidelines for the Diagnosis and Management of Chronic Coronary Syndromes: the Good and the Not So Good
No full textDuring the annual meeting in Paris, the European Society of Cardiology released the new guidelines for the diagnosis and management of chronic coronary syndromes that will replace the 2013 guidelines on stable coronary artery disease. We intend to provide a brief commentary on what, in our opinion, is good and what is not as good. Our careful analysis shows that the 2019 guidelines contain a number of positive innovations, including a new definition, a central role of non-invasive testing for myocardial ischaemia, the most contemporary prevalence of the disease, the fact that medical therapy remains paramount despite the important advances in revascularisation and many other good issues as well as some limitations. The section on medical therapy of chronic coronary syndromes patients shows some inconsistency between text and the suggested scheme as well as contradictions with recommendations of regulatory agencies. It is not immediate to appreciate what is good and what is not so good in guidelines, which are often read in a hurry. We have provided a short commentary for the readers who usually concentrate more on the figures and flowcharts rather than on the text
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
Intranasal Fentanyl for Acute Pain Management in Children, Adults and Elderly Patients in the Prehospital Emergency Service and in the Emergency Department: A Systematic Review
No full textThis systematic review examined the efficacy and safety of intranasal fentanyl (INF) for acute pain treatment in children, adults, and the elderly in prehospital emergency services (PHES) and emergency departments (ED). ClinicalTrials.gov, LILACS, PubMed, SCOPUS, EMBASE, Google Scholar and Cochrane databases were consulted until 31 December 2022. A total of 23 studies were included: 18 in children (1 PHES, 17 ED), 5 in adults (1 PHES, 4 ED) and 1 in older people (1 PHES subgroup analysis). In children, INF was effective in both settings and as effective as the comparator drugs, with no differences in adverse events (AEs); one randomised controlled trial (RCT) showed that INF was more effective than the comparator drugs. In adults, one study demonstrated the efficacy of INF in the PHES setting, one study demonstrated the efficacy of INF in the ED setting, two RCTs showed INF to be less effective than the comparator drugs and one RCT showed INF to be as effective as the comparator, with no difference in AEs reported. In older people, one study showed effective pain relief and no AEs. In summary, INF appears to be effective and safe in children and adults in PHES and ED. More high-quality studies are needed, especially in PHES and older people
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
One-year outcome of elderly patients with endocarditis: a retrospective observational study
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