Risultati per: Nuovo test per distinguere tra infezioni virali e batteriche

Circulation, Volume 150, Issue Suppl_1, Page A4143506-A4143506, November 12, 2024. Background:Anatomic burden of coronary artery disease (CAD) has been considered a consistent prognostic marker. Inflammation also increases the cardiovascular risk and plays a significant role in the evolution of atherosclerosis. The progression of CAD impacts the responses to exercise, reducing functional capacity. Despite this knowledge, the specific interplay between inflammation and atherosclerotic burden in influencing submaximal exercise capacity, particularly oxygen uptake (VO2) kinetics, remains underexplored in CAD. This study aims to investigate how these factors correlate with VO2on-kinetics in the Six-minute Walk Test (6MWT) in patients with CAD.METHODS:Patients with obstructive CAD, confirmed by coronary angiography, underwent a 6MWT using a mobile telemetric cardiopulmonary monitoring to assess functional capacity and the VO2on-kinetics through the mean response time corrected by work (wMRT). Inflammatory markers were analyzed by dosage of high-sensitivity C-reactive protein, interferon-gama, tumor necrosis factor alpha and interleukins (IL), IL-6, IL-8 and IL-10. Coronary atherosclerotic burden was evaluated by the Grading Scale for Anatomic Burden of Disease from COURAGE Trial. Correlation analyses were performed according to the symmetric distribution of data, using Pearson’s (r) or Spearman’s rank correlation coefficients(rs).RESULTS:A total of thirty-four patients aged between 60.3±8.0 years were enrolled, presenting body mass index of 26.0±3.7kg/cm2, left ventricular ejection fraction of 0.50±0.14, walking distance of 443±66m, VO2at steady-state (VO2SS) of 896±240ml/min and wMRT of 1.64×10-3± 1.00×10-3min2/ml. Although correlated with distance and VO2SS(r=-0.472;p=0.002 and r=-0.434;p=0.015, respectively), atherosclerotic burden was not associated with wMRT (p=0.17). High-sensitivity C-reactive protein and IL-8 were negatively associated with both distance and VO2SS(rs=-0.428;p=0.001/ rs=-0.543;p=0.001 and rs=-0.438;p=0.014/ rs=-0.407;p=0.019) and positively correlated with wMRT (rs=0.412;p=0.022/ rs=0.505;p=0.003).CONCLUSION:In contrast to anatomic burden, inflammatory markers were associated with both walking intensity and VO2kinetics. Therefore, inflammation may be more crucial to exercise response mechanisms than coronary stenosis, suggesting a paradigm shift in our understanding of clinical repercussions of obstructive CAD. Actions able to attenuate the inflammatory profile may improve exercise capacity and prognosis.

Circulation, Volume 150, Issue Suppl_1, Page A4146883-A4146883, November 12, 2024. Introduction:Peripheral arterial disease (PAD) is caused by a lack of blood flow to the musculature relative to its metabolism which results in pain. PAD impacts up to 20% of patients around the world. PAD involves macrovascular and microvascular dysfunction. Near-infrared spectroscopy (NIRS) measures muscle oxygenation levels and assesses microvascular function. The standard of care for diagnosing PAD is the ankle-brachial index (ABI), which assesses macrovascular disease, and the 6-minute walk test (6MWT), which measures gait speed and claudication. NIRS has the potential to monitor progression of PAD.Hypothesis:NIRS measurement of muscle oxygenation, during a standard test of vascular occlusion and post-occlusive hyperemia, the vascular occlusion test (VOT), is predictive of PAD severity as determined by ABI and 6MWT.Methods:We studied 24 patients diagnosed with PAD. The mean age of the patients was 71.3 years, including 54% (n=13) males and 46% (n=11) females. The VOT consisted of rest, occlusion, and reperfusion phases each lasting 5 min (15 min total). Muscle oxygen saturation levels were recorded at 2 hertz. For every patient, 6 features were extracted from the VOT data using computational methods. The VOT features from 15 patients were used to train function-fitting neural network models to predict ABI and 6MWT Continuous Distance. The models were then used to predict ABI and 6MWT Continuous Distance from the VOT features of 9 test patients not used in the training,Results:For patients in the test set, the ABI and 6MWT Continuous Distance predicted by the models differed from the actual measurements by 14%±13% and 15%±17%, respectively (Figure 1). For patients in the training set, the ABI and 6MWT Continuous Distance predicted by the models differed from the actual measurements by 0±0% and 12%±11%, respectively (Figure 1).Conclusion:The VOT has the potential to predict the ABI and 6MWT Continuous Distance of patients diagnosed with PAD, suggesting that the VOT can be automated and used to monitor the severity of PAD. With more data from both healthy patients and PAD patients, and improvement of the model, we anticipate that the VOT will complement ABI and 6MWT in the diagnosis and monitoring of PAD.

Circulation, Volume 150, Issue Suppl_1, Page A4142557-A4142557, November 12, 2024. Background:In Central Asia, hypertension accounts for 14.5% of all maternal deathsThe problem of assessing endothelial dysfunction in women with hypertensive disorders during pregnancy are one of the early predictors of cardiovascular events.Objective:to determine the relationship between endothelial dysfunction and levels of nitric oxide (NO) concentration and flow-mediated vasodilatation (FMD) in overweight pregnant women with CHT.Methods:The study included 55 pregnant women of the I-II gestation period, divided into 2 groups. First group (n=34) included healthy pregnant women (healthy group). Second group (n=24) consisted of pregnant women with chronic hypertension/CHT. A physical examination was performed, heart rate was assessed, blood pressure was measured according to Korotkov method, body mass index (BMI) was calculated. Endothelial function was analyzed using a flow-mediated dilation (FMD) test by using ultrasound system Simens Acuson X700 and the level of nitric oxide (NO) concentration. NO level, which was determined by amount the main stable metabolites NO2 – and NO3 – were assessed by P.P. Golikov method. Results are presented as mean±SD. Statistical processing was carried out using the Statistica 13.0 program. P < 0.05 was considered statistically significant.Results:It was revealed that there was no significant difference in the age of women (27±3.4 in 1 group vs 29±4.5 in 2 group, P = 0.0658) and number of pregnancies between groups (3.3±1.2 in 1 group vs 3.2±1.6 in 2 group, P = 0.7920). The average level of blood pressure in the group with CHT amounted to systolic blood pressure (SBP) of 153.83±16.43 mmHg. vs 102.72±10.42 mmHg in group 1 (P

Circulation, Volume 150, Issue Suppl_1, Page A4118724-A4118724, November 12, 2024. Background:The New York Heart Association (NYHA) classification is a subjective tool that is commonly used in clinical practice to assess symptoms and functional capacity of patients with heart failure (HF). Correct assignment of NYHA is essential to facilitate evidence-based management.Research Question:What is the validity of the CLASS-HF Guide compared to the 6-minute walk test (6MWT)?Purpose:To examine the validity of the new investigator-developed CLASS-HF guide to assist in appropriate assignment of NYHA Class relative to the 6MWT.Methods:A multi-site, cross-sectional study in three cardiology clinical sites (two specializing in HF) recruited 103 patients in various classes and stages of HF. Providers assigned patients their NYHA Classification using the CLASS-HF guide. Patients then performed the 6MWT with test staff blinded to the assigned NYHA class. Exertion, dyspnea, and walk distance were captured post-test. The validity of the guide-assisted classification was then examined for convergent validity with 6MWT outcomes. Data analysis was performed with correlations, ANOVA, and multivariable regression.Results:Of the 103 total participants, 65.1% were male, 18.4% were non-White, with an average age of 66.0 ± 15.5 years old. A little less than one-third (30.1%) had HFpEF (LVEF ≥ 50%). Provider-assigned NYHA Class was 22.3% I, 38.8% II, 35.0% III and 3.9% IV. The average distance walked during the 6MWT by class was: 367.1 ± 85.6 m for I, 343.7 ± 104.7 m for II, 261.6 ± 73.9 m for III, and 184.6 ± 114.0 m for IV. Convergent validity of NYHA class with Borg exertion (Spearman’sr= .546,p< .001) and dyspnea (r= .504,p< .001) was strong. A statistically significant inverse correlation was found between NYHA assigned class and meters walked during the 6MWT (r= -.469,p< .001), with significant mean differences (ANOVAF(3,99) = 10.72,p< .001) in distance walked for: NYHA Class I vs. III (md= 105.5 m), I vs. IV (md= 182.6 m), II vs. III (md= 82.1 m), II vs. IV (md= 159.2 m). Increasing NYHA class remained significantly associated with lower 6MWT distance (F(3,90)=5.22,p= .002) in multivariable regression (Adj.R-squared= .575) controlling for age, sex, race/ethnicity, diagnosis, site, Borg exertion and dyspnea, and 6MWT stopping/pausing.Conclusion:Validity evidence was found for NYHA class assignment after use of the CLASS-HF guide with respect to 6MWT distance and post-test perceived exertion and dyspnea.

Circulation, Volume 150, Issue Suppl_1, Page A4145321-A4145321, November 12, 2024. Introduction:Pulmonary dysfunction is a risk factor for increased mortality in patients with acute coronary syndromes (ACS). The purpose of this study was to investigate the association between thrombogenicity and pulmonary function test abnormalities in patients with ACS.Methods:We included ACS patients who underwent successful percutaneous coronary intervention (PCI). Pulmonary function was assessed by spirometry based on the forced expiratory volume in one second (FEV1%pred) after PCI. Thrombogenicity was evaluated with the thromboelastography and conventional hemostatic measures.Results:Among 323 patients, 90 patients (28.8%) had pulmonary dysfunction (moderate or severe spirometric abnormality, FEV1%pred

Oncologi, disagio psicologico per il 64% portatori di geni Brca

Il 13 novembre giornata dedicata a salute e prevenzione giovani

The TS POC CC had a promising sensitivity for diagnosis of participants with active NCC lesions within a community-based setting. Accuracy for NCC at any stage was limited for all tests (TS POC, rT24H-EITB and antigen ELISA). With further development the TS POC CC may enable a better detection and faster referral of NCC patients who may benefit from antiparasitic treatment.

‘Positivo 30 mila nuove assunzioni tra medici e infermieri’

Ma graduatoria dopo il primo semestre sulla base dell’esito degli esami

Gonorrea aumenta del 50%, sifilide del 20%; cala l’uso del preservativo

Introduction
Crohn’s disease and ulcerative colitis are chronic inflammatory bowel diseases (IBD) with a relapsing-remitting nature. With adequate non-invasive prediction of mucosal inflammation, endoscopies can be prevented and treatment optimised earlier for better disease control. We aim to validate and recalibrate commonly used patient-reported symptom scores combined with a faecal calprotectin (FC) home test as non-invasive diagnostic tool for remote monitoring of IBD, both in daily practice and in a strict trial setting. Endoscopy will be used as the gold standard.

Methods and analysis
In this multicentre prospective validation study, adult IBD patients are asked to fill out questionnaires regarding disease activity (Monitor IBD At Home, mobile Health Index, Manitoba IBD Index, IBD control and patient-HBI/patient-Simple Clinical Colitis Activity Index), perform a FC home test and collect a stool sample for routine laboratory FC measurement, before the start of the bowel preparation for the ileocolonoscopy. Endoscopic disease activity will be scored according to the simplified endoscopic score for Crohn’s disease (CD) for CD patients or Ulcerative Colitis Endoscopic Index for Severity and Mayo Endoscopic Subscore for ulcerative colitis patients. The main study outcome is the diagnostic test accuracy of the various patient-reported scores to assess mucosal inflammation in combination with a FC home test.

Ethics and dissemination
This study is approved by the Medical Research Ethics Committee of azM/UM in Maastricht dated 03 March 2021 (METC 20–085) and is monitored by the Clinical Trial Centre Maastricht according to Good Clinical Practice guidelines. Written informed consent will be obtained from all patients. Study results will be published in international peer-reviewed medical journals.

Trial registration number
NCT05886322