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91.
Fabrizio Tomai Achille Gaspardone Marco Papa Patrizio Polisca 《Catheterization and cardiovascular interventions》2002,55(1):97-99
We report a case of acute left ventricular failure after transcatheter closure of a single secundum atrial septal defect in a 68-year-old man with coronary artery disease. Just before the procedure, two coronary lesions had been treated with direct stenting. Transcatheter closure of atrial septal defects should always be deferred in ischemic heart disease patients who need percutaneous myocardial revascularization. 相似文献
92.
Broglio F Prodam F Gottero C Destefanis S Me E Riganti F Giordano R Picu A Balbo M Van der Lely AJ Ghigo E Arvat E 《Clinical endocrinology》2004,60(6):699-704
OBJECTIVE: Acylated ghrelin, a gastric peptide, possesses a potent GH- but also significant ACTH/cortisol-releasing activity mediated by the activation of GH secretagogue receptors (GHS-R) at the hypothalamus-pituitary level. The physiological role of ghrelin in the control of somatotroph and corticotroph function is, however, largely unclear. Glucagon is known to induce a clear increase of GH, ACTH and cortisol levels in humans, at least after intramuscular administration. In fact, glucagon is considered to be a classical alternative to insulin-induced hypoglycaemia (ITT) for the combined evaluation of the function of GH and the hypothalamus-pituitary-adrenal (HPA) axis. We aimed to clarify whether ghrelin mediate the GH and corticotroph responses to intramuscular glucagon or ITT, which has recently been reported able to induce a surprising ghrelin decrease. SUBJECTS: To this aim we enrolled six normal young male subjects [age (mean +/- SD): 29.0 +/- 8.0 years, body mass index (BMI) 21.9 +/- 2.5 kg/m(2)]. DESIGN AND MEASUREMENTS: In all the subjects we studied ghrelin, GH, ACTH, cortisol and glucose levels after glucagon (GLU; 0.017 mg/kg intramuscularly), ITT (0.1 IU/kg insulin intravenously) or saline administration. RESULTS: Saline infusion was not followed by any significant variation in ghrelin, GH and glucose levels while ACTH and cortisol showed the expected spontaneous morning trend toward a decrease. GLU administration increased (P < 0.01) circulating GH, ACTH and cortisol as well as insulin and glucose levels. ITT induced an obvious increase (P < 0.01) of GH, ACTH and cortisol levels. The ITT-induced increases in GH and ACTH, but not cortisol, levels were higher (P < 0.01) than those after GLU. Circulating ghrelin levels were not modified by GLU. On the other hand, ghrelin levels underwent a transient reduction (P < 0.01) after insulin-induced hypoglycaemia. CONCLUSIONS: Ghrelin does not mediate the GH and ACTH responses to glucagon or to the ITT. In fact, ghrelin levels are not modified at all by glucagon and transiently decrease during the ITT. These findings support the assumption that ghrelin does not play a major role in the physiological control of somatotroph and corticotroph function. 相似文献
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BACKGROUND/AIMS: The identification of metabolic and environmental predictors of excess body fat is still far from being achieved. The aim of this study was to evaluate whether respiratory quotient in non-obese women is a predictor of body weight changes after a 6-year follow-up period. METHODS: Forty-three non-obese healthy women participated in the study. Their baseline general characteristics were: age 40.5 +/- 12.8 years; height 159 +/- 7 cm; weight 61.8 +/- 10.1 kg, and body mass index (BMI) 24.4 +/- 3.8 kg/m2. At baseline basal metabolic rate and respiratory quotient were determined by indirect calorimetry, while weight and BMI were recorded at the first observation and after the 3- and 6-year follow-ups. RESULTS: At the first observation basal metabolic rate was 5,360 +/- 713 kJ/day and respiratory quotient 0.850 +/- 0.052. After 6 years, with weight changes equal to 1.4 +/- 4.5 kg, baseline respiratory quotient was a significant predictor (p < 0.05) of changes in body weight or BMI together with baseline BMI. CONCLUSIONS: This follow-up study confirms that a high respiratory quotient (measured on free diet) predisposes to weight gain, especially in women with the highest baseline respiratory quotient (above the 90th percentile of the distribution for this variable). 相似文献
94.
Sergio Raposeiras-Roubín Berenice Caneiro Queija Fabrizio D’Ascenzo Tim Kinnaird Albert Ariza-Solé Sergio Manzano-Fernández Christian Templin Lazar Velicki Ioanna Xanthopoulou Enrico Cerrato Giorgio Quadri Andrea Rognoni Giacome Boccuzzi Andrea Montabone Salma Taha Alessandro Durante Sebastiano Gili Giulia Magnani Emad Abu-Assi 《Revista espa?ola de cardiología》2019,72(3):215-223
Introduction and objectives
The PARIS score allows combined stratification of ischemic and hemorrhagic risk in patients with ischemic heart disease treated with coronary stenting and dual antiplatelet therapy (DAPT). Its usefulness in patients with acute coronary syndrome (ACS) treated with ticagrelor or prasugrel is unknown. We investigated this issue in an international registry.Methods
Retrospective multicenter study with voluntary participation of 11 centers in 6 European countries. We studied 4310 patients with ACS discharged with DAPT with ticagrelor or prasugrel. Ischemic events were defined as stent thrombosis or spontaneous myocardial infarction, and hemorrhagic events as BARC (Bleeding Academic Research Consortium) type 3 or 5 bleeding. Discrimination and calibration were calculated for both PARIS scores (PARISischemic and PARIShemorrhagic). The ischemic-hemorrhagic net benefit was obtained by the difference between the predicted probabilities of ischemic and bleeding events.Results
During a period of 17.2 ± 8.3 months, there were 80 ischemic events (1.9% per year) and 66 bleeding events (1.6% per year). PARISischemic and PARIShemorrhagic scores were associated with a risk of ischemic events (sHR, 1.27; 95%CI, 1.16-1.39) and bleeding events (sHR, 1.14; 95%CI, 1.01-1.30), respectively. The discrimination for ischemic events was modest (C index = 0.64) and was suboptimal for hemorrhagic events (C index = 0.56), whereas calibration was acceptable for both. The ischemic-hemorrhagic net benefit was negative (more hemorrhagic events) in patients at high hemorrhagic risk, and was positive (more ischemic events) in patients at high ischemic risk.Conclusions
In patients with ACS treated with DAPT with ticagrelor or prasugrel, the PARIS model helps to properly evaluate the ischemic-hemorrhagic risk. 相似文献95.
Theodore C. Bailey Maria W. Merritt Fabrizio Tediosi 《American journal of public health》2015,105(4):629-636
It has been suggested that initiatives to eradicate specific communicable diseases need to be informed by eradication investment cases to assess the feasibility, costs, and consequences of eradication compared with elimination or control.A methodological challenge of eradication investment cases is how to account for the ethical importance of the benefits, burdens, and distributions thereof that are salient in people’s experiences of the diseases and related interventions but are not assessed in traditional approaches to health and economic evaluation.We have offered a method of ethical analysis grounded in theories of social justice. We have described the method and its philosophical rationale and illustrated its use in application to eradication investment cases for lymphatic filariasis and onchocerciasis, 2 neglected tropical diseases that are candidates for eradication.The eradication of smallpox was a signature success of global public health in the 20th century, but it is an open and contentious question whether global eradication as opposed to regional elimination or control is warranted for other potentially eradicable infectious diseases.1–4 The box on page 630 provides our definitions of eradication, elimination, and control, as explained by Dowdle.4
Open in a separate windowSource. Dowdle.4Global eradication efforts require vast resource commitments that must be locked in over long time frames, thereby imposing opportunity costs that require justification. For example, donors invested $10.0 billion in the Global Polio Eradication Initiative from 1988 through 2012, and the Global Polio Eradication Initiative’s 2013 to 2018 strategic plan calls for an additional $5.5 billion, totaling $15.5 billion over 30 years.5 The Global Polio Eradication Initiative has prepared an economic case estimating net benefits to date at $27.0 billion and arguing that completion of the eradication initiative would be more cost effective than are available alternatives.6 Ideally, with so much at stake, deliberations about coordinated global approaches to eradicable infectious diseases should be informed by prospective comparative assessment of the feasibility, costs, and consequences of control, elimination, and eradication. The same point of principle applies to other large-scale, long-term, and resource-intensive health programs, substituting the relevant scenarios for comparison.The eradication investment case (EIC) framework is a method for making such assessments to apply them to eradicable infectious diseases.7–11 Although traditional health and economic assessments are core components of EICs, leading architects of the EIC framework contend that EICs should also include “a narrative of the moral value of launching an eradication program” to “capture the value of intangible benefits and ensure consideration of benefits that are difficult to quantify.”9(p143) EICs lacking such ethical analyses may critically overvalue or undervalue eradication scenarios compared with elimination or control by failing to identify ethically important kinds of benefits, burdens, and distributions thereof. The need for such prospective ethical analysis is not unique to assessing disease eradication programs and arguably should be part of assessing and justifying other kinds of health programs.How can EICs account for the ethical importance of the benefits, burdens, and distributions thereof that are salient in people’s experience of particular diseases and disease-related interventions but not assessed in traditional health and economic evaluations? We have proposed a method of ethical analysis grounded in social justice to help EICs respond to this challenge in hopes that it may also prove useful as an approach to prospective ethical assessment for health programs concerned with noneradicable infectious diseases and noninfectious diseases. We have illustrated the proposed method through its application to lymphatic filariasis and onchocerciasis, 2 neglected tropical diseases considered amenable to eradication and for which EICs are currently being assembled.7 相似文献
Definitions of Eradication, Elimination, and Control
Eradication—the permanent reduction to zero of the worldwide incidence of infection caused by a specific agent as a result of deliberate efforts so that intervention measures are no longer needed. |
Elimination—the reduction to zero of the incidence of infection caused by a specific agent in a defined geographical area as a result of deliberate efforts; continued measures to prevent reestablishment of transmission are required. |
Control—the reduction of disease incidence, prevalence, morbidity, or mortality to a locally acceptable level as a result of deliberate efforts; continued intervention measures are required to maintain the reduction. |
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97.
98.
Emanuel Raschi Elisabetta Poluzzi Ariola Koci Francesco Salvo Antoine Pariente Maurizio Biselli Ugo Moretti Nicholas Moore Fabrizio De Ponti 《British journal of clinical pharmacology》2015,80(2):285-293
Aim
We assessed the hepatic safety of novel oral anticoagulants (NOACs) analyzing the publicly available US-FDA adverse event reporting system (FAERS).Methods
We extracted reports of drug-induced liver injury (DILI) associated with NOACs, including acute liver failure (ALF) events. Based on US marketing authorizations, we performed disproportionality analyses, calculating reporting odds ratios (RORs) with 95% confidence interval (CI), also to test for event- and drug-related competition bias, and case-by-case evaluation for concomitant medications.Results
DILI reports represented 3.7% (n = 146) and 1.7% (n = 222) of all reports for rivaroxaban and dabigatran, respectively. No statistically significant association was found for dabigatran, in primary and secondary analyses. Disproportionality signals emerged for rivaroxaban in primary analysis (ALF: n = 25, ROR = 2.08, 95% CI 1.34, 3.08). In a large proportion of DILI reports concomitant hepatotoxic and/or interacting drugs were recorded: 42% and 37% (rivaroxaban and dabigatran, respectively), especially statins, paracetamol and amiodarone. Among ALF reports, fatal outcome occurred in 49% of cases (44% and 51%, rivaroxaban and dabigatran, respectively), whereas rapid onset of the event (<1 week) was detected in 46% of patients (47% and 44%, respectively).Conclusions
The disproportionality signal for rivaroxaban calls for further comparative population-based studies to characterize and quantify the actual DILI risk of NOACs, taking into account drug- and patient-related risk factors. As DILI is unpredictable, our findings strengthen the role of (a) timely pharmacovigilance to detect post-marketing signals of DILI through FAERS and other data sources, (b) clinicians to assess early, on a case-by-case basis, the potential responsibility of NOACs when they diagnose a liver injury. 相似文献99.
Martha Nydia Ballesteros Fabrizio Valenzuela Alma E. Robles Elizabeth Artalejo David Aguilar Catherine J. Andersen Herlindo Valdez Maria Luz Fernandez 《Nutrients》2015,7(5):3449-3463
There is concern that egg intake may increase blood glucose in patients with type 2 diabetes mellitus (T2DM). However, we have previously shown that eggs reduce inflammation in patients at risk for T2DM, including obese subjects and those with metabolic syndrome. Thus, we hypothesized that egg intake would not alter plasma glucose in T2DM patients when compared to oatmeal intake. Our primary endpoints for this clinical intervention were plasma glucose and the inflammatory markers tumor necrosis factor (TNF)-α and interleukin 6 (IL-6). As secondary endpoints, we evaluated additional parameters of glucose metabolism, dyslipidemias, oxidative stress and inflammation. Twenty-nine subjects, 35–65 years with glycosylated hemoglobin (HbA1c) values <9% were recruited and randomly allocated to consume isocaloric breakfasts containing either one egg/day or 40 g of oatmeal with 472 mL of lactose-free milk/day for five weeks. Following a three-week washout period, subjects were assigned to the alternate breakfast. At the end of each period, we measured all primary and secondary endpoints. Subjects completed four-day dietary recalls and one exercise questionnaire for each breakfast period. There were no significant differences in plasma glucose, our primary endpoint, plasma lipids, lipoprotein size or subfraction concentrations, insulin, HbA1c, apolipoprotein B, oxidized LDL or C-reactive protein. However, after adjusting for gender, age and body mass index, aspartate amino-transferase (AST) (p < 0.05) and tumor necrosis factor (TNF)-α (p < 0.01), one of our primary endpoints were significantly reduced during the egg period. These results suggest that compared to an oatmeal-based breakfast, eggs do not have any detrimental effects on lipoprotein or glucose metabolism in T2DM. In contrast, eggs reduce AST and TNF-α in this population characterized by chronic low-grade inflammation. 相似文献
100.