Search Results for: Polmonite acquisita in comunità (CAP)

La pneumologa Dagmar Rinnenburger: “L’aspirazione per evitare infezione da ingestione”

Nessun tumore al cervello o infezione da polmonite batterica

La patologia del Papa

Nuova palazzina a fianco “C. Urbani”, lavori per 9 milioni euro

Fabi, possibile un potenziamento delle Case della Comunità

To the Editor We read with great interest the recent review on community-acquired pneumonia (CAP) by Dr Vaughn and colleagues. Although the thoroughness of the article is commendable, it is necessary to address the brief and somewhat dismissive mention of lung ultrasonography in diagnosing CAP. The assertion that “the utility of ultrasonography for diagnosing CAP is unclear” does not adequately reflect the advancements and growing body of evidence supporting the clinical value of this tool.

In Reply We appreciate the questions raised by Dr Di Bella and colleagues in their Letter to the Editor regarding the use of lung ultrasonography for diagnosing CAP.

This JAMA Patient Page describes community-acquired pneumonia (CAP) and its risk factors, symptoms, diagnosis, treatment, and prevention measures.

Circulation, Ahead of Print. BACKGROUND:Patients with acute myocardial infarction and angiographically obstructive non-culprit lesions are at high risk for recurrent major adverse cardiac events (MACEs). However, it remains largely unknown whether events are due to stenosis severity or due to the underlying high-risk lesion morphology.METHODS:Between January 2017 and December 2021, 1312 patients with acute myocardial infarction underwent optical coherence tomography of all the 3 main epicardial arteries after successful percutaneous coronary intervention. Patients and lesions were categorized according to the presence or absence of (1) 1 or more non-culprit angiographic obstructive stenoses with a visual diameter stenosis of ≥50% and (2) 1 or more lesions with an underlying high-risk morphology defined as an optical coherence tomography thin-cap fibroatheroma (TCFA). Patients were followed for up to 5 years (median 4.1 [interquartile range: 3.0–5.0] years). MACEs comprised cardiac death, non-fatal myocardial infarction, and unplanned coronary revascularization.RESULTS:Overall, 492 patients had at least 1 obstructive non-culprit lesion, 352 had a single lesion, and 140 had multiple obstructive non-culprit lesions. The presence and number of angiographic obstructive non-culprit lesions correlated with the proportion and number of optical coherence tomography–derived TCFAs. At the lesion level, the prevalence of TCFA was twice as high in obstructive lesions compared with nonobstructive lesions. Patients with obstructive non-culprit lesions had an increased risk of overall MACEs (17.7% versus 12.8%; hazard ratio, 1.39 [95% CI, 1.02–1.91]) and non-culprit lesion–related MACEs (8.7% versus 3.9%; HR, 2.13 [95% CI, 1.26–3.59). Results were similar when patients were categorized on the basis of the underlying TCFA. A proportionally higher rate of overall and non-culprit lesion–related MACEs was observed as the number of obstructive stenoses or TCFAs in non-culprit segments increased. The lesion-specific HRs for obstructive lesion and TCFA were 2.03 (95% CI, 1.06–3.89) and 2.39 (95% CI, 1.29–4.43), respectively. Optical coherence tomography–derived TCFA, but not angiographic obstructive stenosis, was independently predictive of recurrent MACEs in both patient-level and lesion-level multivariable models in which these 2 characteristics were introduced simultaneously.CONCLUSIONS:The long-term prognostic implications of the presence and extent of angiographic obstructive non-culprit lesions in patients with acute myocardial infarction are primarily due to their correlation with the underlying high-risk morphology, which confers an increased risk of recurrent MACEs.

Stroke, Volume 56, Issue Suppl_1, Page AWP156-AWP156, February 1, 2025. Introduction:Inter-hospital transfer of stroke patients with large vessel occlusion (LVO) safely and timely from primary stroke centers to comprehensive stroke centers is needed to improve outcomes. In this study we aim at comparing use of simple 911 ambulance stat transfer with contracted ambulance pickup (CAP) used for interhospital transfer of stroke and its effect on Door In Door Out time (DIDO).Methods:Data were retrospectively abstracted for patients with an LVO from 10/2020 to 04/2024. Median DIDO times were calculated for patients who were transferred using AMR 911 vs CAP. Statistical analysis was performed using R.Results:There were total of 412 patients with acute ischemic stroke who were found to have LVO. 272 (66%) of patients were transferred using contracted ambulance pickup (CAP) while 140(34%) were transferred using 911 ambulance. There were no significant differences in baseline demographics between the CAP and 911 ambulance groups (Table1). DIDO (AMR911: median 74.50 min (IQR 57.7-96) vs CAP: 105.50 (85-133.2), p< 0.001 was significantly faster for 911 AMR cases compared to CAP cases. (graph1).Conclusions:Utilizing the widely available 911 stat ambulance process for stroke patients eligible for mechanical thrombectomy reduced DIDO time significantly, which may contribute to improved functional outcome.

Stroke, Volume 56, Issue Suppl_1, Page ATP219-ATP219, February 1, 2025. Introduction:A calcified nodule (CN) is defined as a lesion with fibrous cap disruption and luminal thrombus associated with eruptive, dense, calcific nodules. CNs have been reported as an important cause of acute coronary syndrome, including sudden coronary death. However, few reports have discussed CNs in the context of carotid artery stenosis. This study aimed to evaluate the prevalence and distribution of CNs in carotid arteries using carotid endarterectomy (CEA) specimens in correlation with clinical symptoms.Methods:We included 508 consecutive patients with moderate to severe (50–95%) carotid artery stenosis who underwent CEA between April 2008 and March 2023. We performed pathological analysis of plaque characteristics in carotid arteries and compared with patient characteristics.Results:Of the 508 specimens, 462 (90.9%) were from male patients and mean degree of stenosis was 73.8±16.4%. Fourteen CNs (2.8%) were identified. Seventy-eight calcified plaques (10.4%) defined as the presence of nodular or sheet calcifications were also identified. The number of women was significantly higher in CN group (9/14: 64.3%) than in non-CN group (37/494: 7.5%;P

Oggi sottoscrizione documento, traguardo concreto e simbolico

Oggi sottoscrizione documento, traguardo concreto e simbolico

Mi chiamo Federica Aimeri, sono un medico di medicina generale che lavora in un piccolo paese di campagna del nord Italia, in provincia di Cuneo. Sono anche una lettrice del…

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