Risultati per: Nuovo test rapido per distinguere le infezioni virali

Circulation, Volume 150, Issue Suppl_1, Page A4140796-A4140796, November 12, 2024. BACKGROUND:Coronary artery spasm (CAS) is a cause of variant angina and is typically diagnosed by intracoronary acetylcholine (ACH) provocation test. Investigations regarding association between the severity of coronary artery stenosis and the minimum responsive dose of ACH required for provocation is limited.METHODS:In this study, 3,915 patients who underwent the acetylcholine (ACH) provocation test and showed CAS between October 2004 and December 2022 were enrolled. Significant CAS was defined as temporary narrowing of ≥70% during the ACH test. Patients were divided into three groups, based on the minimum responsive dose of ACH: A1 group (20ug, n=227), A2 group (50ug, n=1,366) and A3 group (100ug, n=2,322).RESULTS:In patients who were documented with positive intracoronary ACH provocation test, 5.8% responded at the lowest dose (20ug), 34.9% responded at the medium doses (50ug) and 59.3% responded only at the highest dose of ACH (100ug). The baseline characteristics of the patients among the 3 groups were similar, demonstrating no significant difference in the prevalence of hypertension, diabetes mellitus, and dyslipidemia. However, patients who responded at lower dose showed higher proportion of smokers (A1 37.9% vs. A2 35.7% vs. A3 31.0%, p=0.004). A1 group demonstrated the highest proportion of severe stenosis (63.0%), followed by A2 group (60.1%) and A3 group (47.4%) (Figure 1).CONCLUSION:In patients with chest pain with positive intracoronary ACH provocation test, severe stenotic lesions were found to be more frequent and more susceptible in patients who responded at lower doses of ACH.

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

Circulation, Volume 150, Issue Suppl_1, Page A4117646-A4117646, November 12, 2024. Introduction:The HeartMate 3 (HM3) LVAD, was shown to have a higher survival free of hemocompatibility related adverse events (HRAE) compared to its predecessors (HM2, HVAD). Superior HM3 outcomes are attributed to wide blood flow pathways coupled with frictionless movement and intrinsic pulsatility, reducing shear stress and blood stasis. It is unknown if improved hemocompatibility can withstand pump restart after prolonged shutdown. We herein report a case of HM3 pump stoppage without subsequent HRAE.Case Presentation:A 41-year-old male underwent HVAD implant in 2019 for advanced non-ischemic cardiomyopathy. This was exchanged to HM3 for recurrent neurological events despite therapeutic anticoagulation. Ten months after exchange, he awakened one morning to find his LVAD had been off for an unknown period but had not heard any device alarms (85dB if on battery power, 165dB if on wall power). Since he felt well he changed to battery power resulting in immediate pump restart. Log file analysis showed pump stoppage 2 am – 10 am, without preceding low flow alarms or power elevations.Management and Outcomes:In the ER INR was 1.5 (2.8 one week prior) and systemic heparin was started. Evaluation included: 1) CT brain without acute infarcts 2) echocardiogram without intracardiac thrombus 3) CT Angiography with patency of the inflow cannula and outflow graft 4) stable serial LDH measurements. The controller was exchanged, and analysis noted normal function. 1-year later the patient is maintained on warfarin and aspirin 325mg without further HRAE. Given the patient’s neurologic history and pump stoppage event, we did not invoke ARIES trial guidance and thus continued aspirin.Conclusion:Pump stoppage occurs when there is complete battery depletion, disconnection of both power leads, or the percutaneous lead from system controller. Our case is unique in that the duration of pump shutdown was 8 hours and INR subtherapeutic, without HRAE in the background of neurologic events on HVAD support. It has been previously reported that complete outflow graft thrombosis can occur shortly after LVAD decommissioning. The HM3 User Manual recommends restarting the pump immediately if off for a few minutes and using clinical judgment for longer durations due to increased risk for thromboembolic events. Our case adds to the paucity of existing data on improved hemocompatibility of the HM3 during rare circumstances of the ultimate test in hemocompatibility: complete pump shut down.

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

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