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Impact of severe left ventricular dysfunction on mid-term mortality in elderly patients undergoing transcatheter aortic valve implantation

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Journal of Geriatric Cardiology 2016年第4期13卷 290-298页

作者： Giuseppe Ferrante Patrizia Presbitero Paolo Pagnotta Anna Sonia Petronio Nedy Brambilla Federico De Marco Claudia Fiorina Cristina Giannini Fabrizio D'Ascenzo Silvio Klugmann Marco L Rossi Federica Ettori francesco Bedogni Luca Testa Department of Cardiovascular Medicine Humanitas Research Hospital Rozzano Italy Cardiothoracic and Vascular Department Azienda Ospedaliero-Universitaria Pisana Pisa Italy Department of Cardiology IRCCS Pol. S. Donato S. Donato Milanese Milan Italy Department of lnterventional Cardiology Niguarda Ca' Granda Hospital Milan Italy Cardiothoracic Department Spedali Civili di Brescia Brescia Italy Cardiothoracic Department Ospedale Molinette Torino Italy

Background Whether patients with reduced left ventricular function present worse outcome after transcatheter aortic valve implantation （TAVI） is controversial. The aim of this study was to assess the impact of baseline severe impairment of left ventricular ejection fraction （LVEF） on mortality after TAVI. Methods Six-hundred-forty-nine patients with aortic stenosis underwent TAVI with the CoreValve system （92.8%） or the Edwards SAPIEN valve system （7.2%）. Baseline LVEF was measured by the echocardiographic Simpson method. The impact of LVEF 〈 30% on mortality was assessed by Cox regression. Results Patients with LVEF 〈 30% （n = 63）, as compared to those with LVEF 〉 30% （n = 586）, had a higher prevalence of NHYA class 〉 2 （P 〈 0.001） and presented with a higher Euroscore （P 〈 0.001）. Procedural success was similar in both groups （98.4% vs. 97.2%, P = 1）. After a median follow-up of 436 days （25^-75th percentile, 357-737 days）, all-cause mortality [23.8% vs. 23.7%, P = 0.87, hazard ratios （HR）： 0.96, 95% confidence intervals （CI）： 0.56-1.63] and cardiac mortality （19.1% vs. 17.6%, P = 0.89, HR： 1.04, 95% CI： 0.57-1.90） were similar in patients with LVEF 〈 30% as compared to those with LVEF 〉 30%. Thirty-day all-cause mortality was not significantly different between the two groups （11.1% vs. 6.3%, P = 0.14, HR： 1.81, 95% CI： 0.814.06）. Patients with LVEF 〈 30% had a trend toward higher risk of 30-day cardiac mortality （11.1% vs. 5.3%; P = 0.06, HR： 2.16, 95% CI： 0.95-4.90）, which disappeared after multivariable adjustment （P = 0.22）. Conclusions Baseline severe impairment of LVEF is not a predictor of increased short-term and mid-term mortality after TAVI. Selected patients with severe impairment of left ventricular function should not be denied TAVI.

关键词： Left ventricular ejection fraction Mortality Transcatheter aortic valve implantation

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From advanced diagnosis to advanced resection in early neoplastic colorectal lesions:Never-ending and trending topics in the 2020s

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World Journal of Gastrointestinal Surgery 2022年第7期14卷 632-655页

作者： francesco Auriemma Sandro Sferrazza Mario Bianchetti Maria Flavia Savarese Laura Lamonaca Danilo Paduano Nicole Piazza Enrica Giuffrida Lupe Sanchez Mete Alessandra Tucci Sebastian Manuel Milluzzo Chiara Iannelli Alessandro Repici Benedetto Mangiavillano Gastrointestinal Endoscopy Unit Humanitas Mater DominiCastellanza 21053Italy Gastroenterology and Endoscopy Unit Santa Chiara HospitalTrento 38014Italy Digestive Endoscopy Unit San Giuseppe Hospital-MultimedicaMilan 20123Italy Department of Gastroenterology and Gastrointestinal Endoscopy General HospitalSanremo 18038Italy Gastroenterology Unit IRCCS Policlinico San DonatoSan Donato MilaneseDepartment of Biomedical Sciences for HealthUniversity of MilanMilan 20122Italy Gastroenterology and Hepatology Unit A.O.U.Policlinico"G.Giaccone"Palermo 90127Italy Department of Gastroenterology and Digestive Endoscopy IRCCS Regina Elena National Cancer InstituteRome 00144Italy Department of Gastroenterology Molinette HospitalCittàdella salute e della Scienza di TorinoTurin 10126Italy Digestive Endoscopy Unit and Gastroenterology Fondazione PoliambulanzaBrescia 25100Italy Department of Health Sciences Magna Graecia UniversityCatanzaro 88100Italy Digestive Endoscopy Unit and Gastroenterology Humanitas Clinical and Research Center and Humanitas UniversityRozzano 20089Italy Biomedical Science HunimedPieve Emanuele 20090Italy Gastrointestinal Endoscopy Unit Humanitas Mater DominiCastellanzaVarese 21053Italy

Colonoscopy represents the most widespread and effective tool for the prevention and treatment of early stage preneoplastic and neoplastic lesions in the panorama of cancer *** the world there are different approaches to the topic of colorectal cancer prevention and screening:different starting ages(45-50 years);different initial screening tools such as fecal occult blood with immunohistochemical or immune-enzymatic tests;recto-sigmoidoscopy;and *** key aspects of this scenario are composed of a proper bowel preparation that ensures a valid diagnostic examination,experienced endoscopist in detection of preneoplastic and early neoplastic lesions and open-minded to upcoming artificial intelligence-aided examination,knowledge in the field of resection of these lesions(from cold-snaring,through endoscopic mucosal resection and endoscopic submucosal dissection,up to advanced tools),and management of complications.

关键词： Colorectal lesions Colorectal tumor Endoscopic submucosal dissection Endoscopic mucosal resection Cold-endoscopic mucosal resection FTRD® Complications Adverse events Polypectomy

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Follow-up of endovascular aortic aneurysm repair:Preliminary validation of digital tomosynthesis and contrast enhanced ultrasound in detection of medium- to long-term complications

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World Journal of Radiology 2016年第5期8卷 530-536页

作者： Maria Antonietta Mazzei Susanna Guerrini francesco Giuseppe Mazzei Nevada Cioffi Squitieri Dario Notaro Gianmarco de donato Giuseppe Galzerano Palmino Sacco francesco Setacci Luca Volterrani Carlo Setacci Department of Medical Surgical and Neuro SciencesDiagnostic Imaging UnitUniversity of SienaAzienda Ospedaliera Universitaria Senese Diagnostic Imaging Unit Azienda Ospedaliera Universitaria Senese Department of Medical Surgical and Neuro SciencesVascular and Endovascular Surgery UnitUniversity of SienaAzienda Ospedaliera Universitaria Senese Department of General Surgery "P.Valdoni" First School of MedicineUniversity of Rome "La Sapienza"

AIM: To validate the feasibility of digital tomosynthesis of the abdomen(DTA) combined with contrast enhanced ultrasound(CEUS) in assessing complications after endovascular aortic aneurysm repair(EVAR) by using computed tomography angiography(CTA) as the gold ***: For this prospective study we enrolled 163 patients(123 men; mean age, 65.7 years) referred for CTA for EVAR follow-up. CTA, DTA and CEUS were performed at 1 and 12 mo in all patients, with a maximum time interval of 2 ***: Among 163 patients 33 presented complications at CTA. DTA and CTA correlated for the presence of complications in 32/33(96.96%) patients and for the absence of complications in 127/130(97.69%) patients; the sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV) and accuracy of DTA were 97%, 98%, 91%, 99%, and 98%, respectively. CEUS and CTA correlated for the presence of complications in 19/33(57.57%) patients and for the absence of complications in 129/130(99.23%) patients; the sensitivity, specificity, PPV, NPV and accuracy of CEUS were 58%, 99%, 95%, 90%, and 91%, respectively. Sensitivity, specificity and accuracy of combining DTA and CEUS together in detecting EVAR complications were 77%, 98% and 95%, ***: Combining DTA and CEUS in EVAR follow-up has the potential to limit the use of CTA only in doubtful cases.

关键词： Digital tomosynthesis Contrast enhanced ultrasound Endovascular aortic aneurysm repair followup Endovascular aortic replacement

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Safety and feasibility of thullium laser transurethral resection of prostate for the treatment of benign prostatic enlargement in overweight patients

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Asian Journal of Urology 2019年第3期6卷 270-274页

作者： Luca Carmignani Maria Chiara Clementi Claudia Signorini Gloria Motta Sebastiano Nazzani Franco Palmisano Elisa De Lorenzis Michele Catellani Alessandro francesco Mistretta Andrea Conti Valeria Tringali Maria Beatrice Costa Damiano Vizziello Policlinico San donato UrologySan DonatoMilaneseItaly Ospedale Maggiore Policlinico UrologyMilanItaly Istituto Europeo di Oncologia UrologyMilanItaly Ospedale San Giuseppe UrologyMilanItaly

Objective:We aimed to determine safety and feasibility of thulium laser transurethral vapoenucleation of prostate(ThuVEP)for treatment of obese patients affected by benign prostatic hyperplasia(BPH).Methods:We retrospectively analysed data of 452 patients with BPH who underwent ThuVEP from February 2012 to March 2016 in a single *** were divided into three groups according to body mass index(BMI,kg/m^2):Normal weight(18.5≤BMI0.05).There was no statistically significant difference among three groups as for hospital stay and days of catheterization(p>0.05).Conclusion:Our results showed that ThuVEP was safe and feasible even in overweight patients with substantially enlarged prostate.

关键词： Laser Thulium Prostate Overweight

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Fluctuating temperature modifies heat-mortality association around the globe

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The Innovation 2022年第2期3卷 65-72页

作者： Yao Wu Bo Wen Shanshan Li Antonio Gasparrini Shilu Tong Ala Overcenco Ales Urban Alexandra Schneider Alireza Entezari Ana Maria Vicedo-Cabrera Antonella Zanobetti Antonis Analitis Ariana Zeka Aurelio Tobias Barrak Alahmad Ben Armstrong Bertil Forsberg CarmenÍñiguez Caroline Ameling César De la Cruz Valencia ChristoferÅström Danny Houthuijs Do Van Dung Dominic Royé Ene Indermitte Eric Lavigne Fatemeh Mayvaneh Fiorella Acquaotta Francesca de’donato francesco Sera Gabriel Carrasco-Escobar Haidong Kan Hans Orru Ho Kim Iulian-Horia Holobaca Jan Kyselý Joana Madureira Joel Schwartz Klea Katsouyanni Magali Hurtado-Diaz Martina SRagettli Masahiro Hashizume Mathilde Pascal Micheline de Sousa Zanotti Stagliorio Coélho Noah Scovronick Paola Michelozzi Patrick Goodman Paulo Hilario Nascimento Saldiva Rosana Abrutzky Samuel Osorio Tran Ngoc Dang Valentina Colistro Veronika Huber Whanhee Lee Xerxes Seposo Yasushi Honda Michelle L.Bell Yuming Guo Department of Epidemiology and Preventive Medicine School of Public Health and Preventive MedicineMonash UniversityMelbourne 3004Australia Climate Air Quality Research UnitSchool of Public Health and Preventive MedicineMonash UniversityMelbourne 3004Australia Department of Public Health Environments and SocietyLondon School of Hygiene&Tropical MedicineLondon WC1E 7HTUK Centre for Statistical Methodology London School of Hygiene&Tropical MedicineLondon WC1E 7HTUK Centre on Climate Change&Planetary Health London School of Hygiene&Tropical MedicineLondon WC1E 7HTUK Shanghai Children’s Medical Centre Shanghai Jiao Tong UniversityShanghai 200025China School of Public Health Institute of Environment and Human HealthAnhui Medical UniversityHefei 230032China Center for Global Health Nanjing Medical UniversityNanjing 211166China School of Public Health and Social Work Queensland University of TechnologyBrisbane 4000Australia National Agency for Public Health of the Ministry of Health Labour and Social Protection of the Republic of MoldovaChisinau MD-2009Republic of Moldova Institute of Atmospheric Physics Czech Academy of SciencesPrague 14100Czech Republic Faculty of Environmental Sciences Czech University of Life SciencesPrague 16500Czech Republic Institute of Epidemiology Helmholtz Zentrum M€unchen-German Research Center for Environmental HealthNeuherberg 85747Germany Faculty of Geography and Environmental Sciences Hakim Sabzevari UniversitySabzevar ***Iran Institute of Social and Preventive Medicine University of BernBern 3012Switzerland Oeschger Center for Climate Change Research University of BernBern 3012Switzerland Department of Environmental Health Harvard T.H.Chan School of Public HealthHarvard UniversityBostonMA 02115USA Department of Hygiene Epidemiology and Medical StatisticsNational and Kapodistrian University of AthensAthens 11527Greece Institute for Environment Healthand SocietiesBrunel University LondonLondon UB83PNUK Institute of Environmental Assessment and

Studies have investigated the effects of heat and temperature variability(TV)on ***,few assessed whether TV modifies the heat-mortality *** on daily temperature and mortality in the warm season were collected from 717 locations across 36 *** was calculated as the standard deviation of the average of the same and previous days’minimum and maximum temperatures.

关键词： deviation modif heat

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Management of unstable angina in a patient with Haemophilia A

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World Journal of Hematology 2017年第2期6卷 28-31页

作者： Andreina Carbone Tiziana Formisano francesco Natale Maurizio Cappelli Bigazzi donato Tartaglione Enrica Golia Felice Gragnano Mario Crisci Renato Maria Bianchi Raffaele Calabrò Maria Giovanna Russo Paolo Calabrò Chair of Cardiology Second University of NaplesAORN dei ColliMonaldi Hospital

Hemophilia A is an X-linked recessive disorder characterized by a deficiency of coagulation factor Ⅷ(FⅧ) and therefore by a greater risk of bleeding during percutaneous interventional procedures and during the dual antiplatelet therapy(DAPT) in patients with ischemic heart disease. Information regarding safe percutaneous procedures in hemophiliacs is limited. Since the introduction of FVⅧ concentrates, the life expectancy of hemophiliac patients has improved and consequently, the rate of ischemic heart disease in this population is increased. Frequently the replacement therapy can trigger the onset of an acute coronary syndrome. We report a case of a patient with mild Hemophilia A, who presents with unstable angina, treated successfully with coronary angioplasty and drug eluting stent implantation without replacement of FVⅧ, treated with long term DAPT without major bleeding after six months of follow up.

关键词： Hemophilia A Unstable angina Dual antiplatelet therapy Drug eluting stent Coagulation factors replacement therapy

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Efficacy and tolerability of high and low-volume bowel preparation compared:A real-life single-blinded large-population study

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World Journal of Gastrointestinal Endoscopy 2021年第12期13卷 659-672页

作者： Vincenzo Occhipinti Paola Soriani francesco Bagolini Valentina Milani Emanuele Rondonotti Maria Laura Annunziata Flaminia Cavallaro Sara Vavassori Maurizio Vecchi Luca Pastorelli Gian Eugenio Tontini Digestive Endoscopy and Gastroenterology Unit A.Manzoni HospitalASST LeccoLecco 23900Italy Gastroenterology Unit IRCCS Policlinico San DonatoSan Donato Milanese 20097Italy Gastroenterology and Digestive Endoscopy Unit Azienda USL ModenaCarpi HospitalCarpi 41012Italy Scientific Directorate IRCCS Policlinico San DonatoSan Donato Milanese 20097Italy Gastroenterology Unit Ospedale ValduceComo 22100Italy Gastroenterology and Endoscopy Unit Fondazione IRCCS Ca'Granda Ospedale Maggiore PoliclinicoMilan 20122Italy Gastroenterology and Hepatology Unit ASST Santi Paolo e CarloMilan 20142Italy Department of Pathophysiology and Transplantation University of MilanMilan 20122Italy Department of Biomedical Sciences for Health University of MilanMilan 20122Italy

BACKGROUND Low-volume preparations for colonoscopy have shown similar efficacy compared to high-volume ones in randomized controlled trials(RCT).However,most RCTs do not provide data about clinical outcomes including lesions detection ***,real-life comparisons are *** To compare efficacy(both in terms of adequate bowel preparation and detection of colorectal lesions)and tolerability of a high-volume(HV:4 L polyethylene glycol,PEG)and a low-volume(LV:2 L PEG plus bisacodyl)bowel preparation in a real-life *** Consecutive outpatients referred for colonoscopy were prospectively enrolled between 1 December 2014 and 31 December *** could choose either LV or HV preparation,with a day-before schedule for morning colonoscopies and a split-dose for afternoon *** bowel preparation according to Boston Bowel Preparation Scale(BBPS),clinical outcomes including polyp detection rate(PDR),adenoma detection rate(ADR),advanced adenoma detection rate(AADR),sessile/serrated lesion detection rate(SDR)and cancer detection rate and self-reported tolerability of HV and LV were blindly *** Total 2040 patients were enrolled and 1815(mean age 60.6 years,50.2%men)finally *** was chosen by 52%of patients(50.8%of men,54.9%of women).Split-dose schedule was more common with HV(44.7%vs 38.2%,P=0.005).High-definition scopes were used in 33.4%of patients,without difference in the two groups(P=0.605).HV and LV preparations showed similar adequate bowel preparation rates(89.2%vs 86.6%,P=0.098),also considering the two different schedules(HV split-dose 93.8%vs LV split-dose 93.6%,P=1;HV daybefore 85.5%vs LV day-before 82.3%,P=0.182).Mean global BBPS score was higher for HV preparations(7.1±1.7 vs 6.8±1.6,P<0.001).After adjustment for sex,age and indications for colonoscopy,HV preparation resulted higher in PDR[Odds ratio(OR)1.32,95%CI:1.07-1.63,P=0.011]and ADR(OR 1.29,95%CI 1.02–1.63,P=0.038)and comparable to LV in AADR(OR 1.51

关键词： Bowel preparation volume Polyethylene glycol Bisacodyl Colonoscopy Colonic adenomas Tolerability

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Reporting rotator cuff tears on magnetic resonance arthrography using the Snyder's arthroscopic classification

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世界放射学杂志：英文版（电子版） 2017年第3期9卷 126-133页

作者： Alberto Aliprandi Carmelo Messina Paolo Arrigoni Michele Bandirali Giovanni Di Leo Stefano Longo Sandro Magnani Chiara Mattiuz Filippo Randelli Silvana Sdao francesco Sardanelli Luca Maria Sconfienza Pietro Randelli Servizio di Radiologia IRCCS Policlinico San Donato Scuola di Specializzazione in Radiodiagnostica Università degli Studi di Milano Unità Operativa di Ortopedia e Traumatologia Ⅱ IRCCS Policlinico San Donato Dipartimento di Scienze Biomediche per la Salute Università degli Studi di Milano Unità Operativa di Ortopedia e Traumatologia V IRCCS Policlinico San Donato Unità Operativa di Radiologia/Diag-nostica per Immagini con Servizio di Radiologia Interventistica IRCCS Istituto Ortopedico Galeazzi Unità Operativa Complessa I Divisione Istituto Ortopedico Gaetano Pini

AIM To determine diagnostic performance of magnetic resonance arthrography(MRA) in evaluating rotator cuff tears(RCTs) using Snyder's classification for *** One hundred and twenty-six patients(64 males, 62 females; median age 55 years) underwent shoulder MRA and arthroscopy, which represented our reference standard. Surgical arthroscopic reports were reviewed and the reported Snyder's classification was recorded. MRA examinations were evaluated by two independent radiologists(14 and 5 years' experience) using Snyder's classification system, blinded to arthroscopy. Agreement between arthroscopy and MRA on partial-and fullthickness tears was calculated, first regardless of their extent. Then, analysis took into account also the extent of the tear. Interobserver agreement was also calculated the quadratically-weighted Cohen kappa *** On arthroscopy, 71/126 patients(56%) had a fullthickness RCT. The remaining 55/126 patients(44%) had a partial-thickness RCT. Regardless of tear extent, out of 71 patients with arthroscopically-confirmed fullthickness RCTs, 66(93%) were correctly scored by both readers. All 55 patients with arthroscopic diagnosis of partial-thickness RCT were correctly assigned as having a partial-thickness RCT at MRA by both readers. Interobserver reproducibility analysis showed total agreement between the two readers in distinguishing partial-thickness from full-thickness RCTs, regardless of tear extent(k = 1.000). With regard to tear extent, in patients in whom a complete tear was correctly diagnosed, correct tear extent was detected in 61/66 cases(92%); in the remaining 5/66 cases(8%), tear extent was underestimated. Agreement was k = 0.955. Interobserver agreement was total(k = 1.000).CONCLUSION MRA shows high diagnostic accuracy and reproducibility in evaluating RCTs using the Snyder's classification for reporting. Snyder's classification may be adopted for routine reporting of MRA.

关键词： Arthroscopy Magnetic resonance imaging Shoulder Arthrography Supraspinatus tendon Rotator cuff tear

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Relevant incidental findings at abdominal multi-detector contrast-enhanced computed tomography:A collateral screening?

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World Journal of Radiology 2015年第10期7卷 350-356页

作者： Luca Maria Sconfienza Giovanni Mauri Claudia Muzzupappa Alessandro Poloni Michele Bandirali Anastassia Esseridou Stefania Tritella francesco Secchi Giovanni Di Leo francesco Sardanelli Servizio di Radiologia IRCCS Policlinico San Donato Dipartimento di Scienze Biomediche per la Salute Università degli Studi di Milano Scuola di Specia-lizzazione in Radiodiagnostica Università degli Studi di Milano

AIM: To investigate the prevalence of relevant incidental findings(RIFs) detected during routine abdominal contrast-enhanced computed tomography(Ce CT).METHODS: We retrospectively evaluated the reports of a consecutive series of abdominal Ce CT studies performed between January and May 2013. For each report, patients' age and sex, admission as inpatient or outpatient, clinical suspicion as indicated by the requesting physician, availability of a previous abdominal examination, and name of the reporting radiologist were recorded. Based on the clinical suspicion, the presence and features of any RIFs(if needing additional workup) was ***: One thousand forty abdominal Ce CT were performed in 949 patients(528 males, mean age 66 ±14 years). No significant difference was found between inpatients and outpatients age and sex distribution(P > 0.472). RIFs were found in 195/1040(18.8%) Ce CT [inpatients = 108/470(23.0%); outpatients = 87/570(15.2%); P = 0.002]. RIFs were found in 30/440(6.8%) Ce CT with a previous exam and in 165/600(27.5%) without a previous exam(P < 0.001). Radiologists' distribution between inpatients or outpatients was significantly different(P < 0.001). RIFs prevalence increased with aging, except for a peak in 40-49 year group. Most involved organs were kidneys, gallbladder, and ***: A RIF is detected in 1/5 patients undergoing abdominal Ce CT. Risk of overdiagnosis should be taken into account.

关键词： Contrast-enhanced computed tomography Abdomen Inci

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