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101.
Luca Masotti Grazia Panigada Giancarlo Landini Filippo Pieralli Francesco Corradi Salvatore Lenti Rino Migliacci Stefano Arrigucci Anna Frullini Maria Chiara Bertieri Stefano Tatini Alberto Fortini Irene Cascinelli Nicola Mumoli Stefano Giuntoli Alessandro De Palma Veronica De Crescenzo Michele Piacentini Giancarlo Tintori Alba Dainelli Giuseppa Levantino Plinio Fabiani Filippo Risaliti Roberta Mastriforti Michele Voglino Valentina Carli Simone Meini 《Journal of thrombosis and thrombolysis》2016,41(4):606-612
Prognostic stratification of acute pulmonary embolism (PE) remains a challenge in clinical practice. Simplified PESI (sPESI) score is a practical validated score aimed to stratify 30-day mortality risk in acute PE. Whether prognostic value of sPESI score differs according to sex has not been previously investigated. Therefore the aim of our study was to provide information about it. Data records of 452 patients, 180 males (39.8 %) and 272 females (60.2 %) discharged for acute PE from Internal Medicine wards of Tuscany (Italy) were analysed. sPESI was retrospectively calculated. Variables enclosed in sPESI score, all cause in-hospital mortality and overall bleedings were compared between sexes. Moreover, predictive ability of sPESI score as prognosticator of all cause in-hospital mortality was tested and compared between sexes. sPESI score 0 (low risk) was found in 17.7 % of males and 13.6 % of females (p = 0.2323). We didn’t find significant difference in sPESI scoring distribution. Age ≥80 years (51.4 vs. 33.8 %, p = 0.0003) and heart rate ≥110 bpm (23.5 vs. 14.4 %, p = 0.0219) were found significantly more prevalent in females, whereas active cancer (23.8 vs. 39.4 %, p = 0.0004) and cardio-respiratory diseases (19.8 vs. 27.7 %, p = 0.0416) were in males. All cause in-hospital mortality was 0 % in both genders for sPESI score 0, whereas it was 5.4 % in females and 13.6 % in males with sPESI score 1–2 (p = 0.0208) and 22 % in females and 19.3 % in males with sPESI score ≥3 (p = 0.7776). Overall bleedings were significantly more frequent in females compared with males (4.77 vs. 0.55 %, p = 0.0189). In females overall bleedings ranged from 2.7 % in sPESI score 0 to 6 % in sPESI score ≥3. Predictive ability of sPESI score as prognosticator of all cause in-hospital mortality was higher in females compared to males (AUC 0.72 vs. 0.67, respectively). In real life different co-morbidity burdens in females compared to males. Females seems to be at lower risk of all cause in-hospital mortality for sPESI score ≤2 but at higher risk of bleeding, irrespective from sPESI scoring. Predictive ability of sPESI score seems better in females. 相似文献
102.
Filippo Rossi Marco Santoro Giuseppe Perale 《Journal of tissue engineering and regenerative medicine》2015,9(10):1093-1119
Although bone has a high potential to regenerate itself after damage and injury, the efficacious repair of large bone defects resulting from resection, trauma or non‐union fractures still requires the implantation of bone grafts. Materials science, in conjunction with biotechnology, can satisfy these needs by developing artificial bones, synthetic substitutes and organ implants. In particular, recent advances in polymer science have provided several innovations, underlying the increasing importance of macromolecules in this field. To address the increasing need for improved bone substitutes, tissue engineering seeks to create synthetic, three‐dimensional scaffolds made from polymeric materials, incorporating stem cells and growth factors, to induce new bone tissue formation. Polymeric materials have shown a great affinity for cell transplantation and differentiation and, moreover, their structure can be tuned in order to maintain an adequate mechanical resistance and contemporarily be fully bioresorbable. This review emphasizes recent progress in polymer science that allows relaible polymeric scaffolds to be synthesized for stem cell growth in bone regeneration. Copyright © 2013 John Wiley & Sons, Ltd. 相似文献
103.
We report a complex case of percutaneous intervention on a right coronary artery with calcific stenoses and a large coronary aneurysm with long longitudinal diameter, which was successfully performed using a polytetrafluoroethylene-covered self-expandable stent (Symbiot; Boston Scientific; Natick, MA). The use of this new device may enhance the anatomic indications for percutaneous interventions on coronary aneurysms. 相似文献
104.
Giuseppe Gargiulo Sara Ariotti Pascal Vranckx Sergio Leonardi Enrico Frigoli Nestor Ciociano Carlo Tumscitz Francesco Tomassini Paolo Calabrò Stefano Garducci Gabriele Crimi Giuseppe Andò Maurizio Ferrario Ugo Limbruno Bernardo Cortese Paolo Sganzerla Alessandro Lupi Filippo Russo Marco Valgimigli 《JACC: Cardiovascular Interventions》2018,11(1):36-50
Objectives
This study sought to assess whether transradial access (TRA) compared with transfemoral access (TFA) is associated with consistent outcomes in male and female patients with acute coronary syndrome undergoing invasive management.Background
There are limited and contrasting data about sex disparities for the safety and efficacy of TRA versus TFA for coronary intervention.Methods
In the MATRIX (Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX) program, 8,404 patients were randomized to TRA or TFA. The 30-day coprimary outcomes were major adverse cardiovascular and cerebrovascular events (MACCE), defined as death, myocardial infarction, or stroke, and net adverse clinical events (NACE), defined as MACCE or major bleeding.Results
Among 8,404 patients, 2,232 (26.6%) were women and 6,172 (73.4%) were men. MACCE and NACE were not significantly different between men and women after adjustment, but women had higher risk of access site bleeding (male vs. female rate ratio [RR]: 0.64; p = 0.0016), severe bleeding (RR: 0.17; p = 0.0012), and transfusion (RR: 0.56; p = 0.0089). When comparing radial versus femoral, there was no significant interaction for MACCE and NACE stratified by sex (pint = 0.15 and 0.18, respectively), although for both coprimary endpoints the benefit with TRA was relatively greater in women (RR: 0.73; p = 0.019; and RR: 0.73; p = 0.012, respectively). Similarly, there was no significant interaction between male and female patients for the individual endpoints of all-cause death (pint = 0.79), myocardial infarction (pint = 0.25), stroke (pint = 0.18), and Bleeding Academic Research Consortium type 3 or 5 (pint = 0.45).Conclusions
Women showed a higher risk of severe bleeding and access site complications, and radial access was an effective method to reduce these complications as well as composite ischemic and ischemic or bleeding endpoints. 相似文献105.
Rizzello V Bax JJ Schinkel AF Boersma E Bountioukos M Vourvouri EC Crea F Biagini E Elhendy A Roelandt JR Poldermans D 《Coronary artery disease》2004,15(5):269-275
OBJECTIVE: To evaluate the potential of a simple and widely available technique as two-dimensional (2D) echocardiography to identify patients with ischemic cardiomyopathy and low likelihood of functional recovery after coronary revascularization. METHODS: Two-dimensional echocardiography and radionuclide ventriculography (RNV) were performed before coronary revascularization in 94 patients with ischemic cardiomyopathy. Left ventricular ejection fraction (LVEF) was measured by RNV. Regional wall motion abnormalities, wall motion score index, end-diastolic wall thickness (EDWT), left ventricular (LV) volumes and LV sphericity index were assessed in the echocardiographic images. RNV was repeated 9-12 months after revascularization to assess LVEF change; an improvement >or=5% was considered clinically significant. RESULTS: Nine hundred and ninety-nine segments were severely dysfunctional; 149 out of 999 (15%) had an EDWT or=100 ml/ml) and of the end-systolic volume index (>or=80 ml) was present in 32 (34%) and 21 (22%) patients, respectively. A spherical shape of the LV was observed in 35 (37%) patients. LVEF after revascularization increased in 30 out of 94 patients (32%) from 30+/-8% to 39+/-9% (P<0.0001). On multivariate analysis, the EDVI was the only predictor of no recovery in LVEF [odds ratio, 1.06, confidence interval (CI), 1.04-1.1, P<0.0001]. The cut-off value of EDVI >or=90 ml/ml accurately identified patients that virtually never recover. Post-operatively, LVEF increased in three out of 42 (7%, 95% CI 0-15%) patients with EDVI >or=90 ml/ml as compared to 27 out of 52 (52%) patients with EDVI<90 ml/ml (P<0.0001). CONCLUSIONS: In patients with ischemic cardiomyopathy and severe LV enlargement, improvement of LVEF after revascularization is unlikely to occur. Conversely, in patients with relatively preserved LV size, a higher likelihood of functional recovery may be anticipated. 相似文献
106.
107.
Enrico Cecchi Massimo Imazio Franco Pomari Ivano Dal Conte Costantina Preziosi Filippo Lipani Rita Trinchero 《Italian heart journal》2005,6(12):972-976
BACKGROUND: HIV infection is one of the leading causes of acquired heart disease. Because of its high diffusion, systematic echocardiographic monitoring has been proposed to exclude cardiovascular involvement in these patients. The aim of this study was to evaluate an alternative clinical approach by which echocardiographic screening is limited to patients with a clinical suspicion of heart disease. METHODS: We studied 2030 consecutive HIV-infected patients admitted to a tertiary referral hospital (group A). History, physical examination, ECG, and chest X-ray were used to screen HIV-infected patients for cardiovascular involvement. Selected patients were extensively studied, first of all by echocardiography. Cardiovascular and non-cardiovascular deaths were recorded: RESULTS: Cardiovascular involvement was clinically suspected in 201 patients (9.9%; group B). Among them a higher extracardiac mortality was found in presence of pericardial disease (odds ratio [OR] 4.27, 95% confidence interval [CI] 2.01-9.09), while a higher cardiovascular mortality was recorded for patients with cardiomyopathy or myocarditis (OR 2.72, 95% CI 1.09-6.81), and right ventricular dysfunction and/or pulmonary hypertension (OR 4.67, 95% CI 1.44-15.2). Compared with group A, patients in group B had a significantly increased cardiac death rate (0.114 vs 0.018, p < 0.001). A positive echocardiogram slightly increased this rate (from 0.114 to 0.164, p = NS), whereas a negative echocardiogram significantly decreased the cardiac death rate (0.015 vs 0.164, p = 0.004). CONCLUSIONS: Clinical selection of HIV-infected patients with suspected cardiovascular involvement may help identify patients with higher frequency of cardiovascular involvement. Among these patients, echocardiography may be a useful screening tool in those at high risk for cardiovascular death. 相似文献
108.
109.
Ultrastructural Evidence of Serous Gland Polymorphism in the Skin of the Tungara Frog Engystomops pustulosus (Anura Leptodactylidae) 下载免费PDF全文
Giovanni Delfino Filippo Giachi Cecilia Malentacchi Daniele Nosi 《Anatomical record (Hoboken, N.J. : 2007)》2015,298(9):1659-1667
Three types of serous products were detected in the syncytial cutaneous glands of the leptodactylid tungara frog, Engystomops pustulosus: type Ia, granules with wide halos and variable density cores; type Ib, high density granules without halos; and type II, vesicles containing a finely dispersed product. Ultrastructural evidence revealed that these products were manufactured by different serous gland types and excluded that they represented different steps in the secretory cycle of a single gland type. Indeed, secretory maturation affecting the products released by the Golgi apparatus proceeded through different mechanisms: confluence (vesicles), interactions between syncytium and secretory product (type Ib granules), and a combination of both processes (type Ia granules). In conclusion, this investigation of secretory maturation was shown to be a suitable approach for the identification of serous gland polymorphism and demonstrated that the tungara frog belongs to the minority of anuran species characterized by this peculiar morpho‐functional trait. Anat Rec, 298:1659–1667, 2015. © 2015 Wiley Periodicals, Inc. 相似文献
110.