Risultati per: Tumore prostata, test della saliva piu’ attendibile del PSA

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 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 A4140642-A4140642, November 12, 2024. Background:The diagnosis of VVS largely relies on clinical history and simple diagnostic tools (e.g., electrocardiogram) to rule out dangerous differential diagnoses. However, using the head-up tilt test (HUTT) has become controversial among clinicians. This retrospective study aims to evaluate whether the prodromal symptoms experienced during HUTT are consistent with those experienced during spontaneous syncope.Methods:This study utilized data from the HUTT registry at the Syncope Unit of the tertiary Heart Center, focusing on adults aged 18 and older diagnosed with VVS. Diagnoses were based on clinical histories, physical examinations, and the latest syncope guidelines. Out of 1914 patients with HUTT results, 764 patients with positive tests were analyzed for mutual prodromal symptoms during HUTT and spontaneous syncope.Results:The McNemar test revealed significant differences for several symptoms, including palpitation (X2 = 30.59, P < 0.001), nausea (X2 = 16.13, P < 0.001), chest pain (X2 = 24.32, P < 0.001), abdominal discomfort (X2 = 22.33, P < 0.001), flushing (X2 = 10.87, P < 0.001), and aura (X2 = 19.86, P < 0.001), indicating discrepancies in the occurrence of these symptoms. Cohen's Kappa values ranged from 0.06 to 0.32, signifying slight to fair agreement. Specifically, diaphoresis (k = 0.32), palpitation (k = 0.27), and vertigo (k = 0.25) demonstrated fair agreement, whereas nausea, aura, chest pain, abdominal discomfort, and flushing exhibited slight agreement. Among the 640 patients who experienced prodrome during spontaneous syncope, 110 (17.19%) had no symptoms. Conversely, among the 123 patients who did not experience prodrome, 96 (78.05%) experienced at least one symptom during the tilt test (Figure).Conclusion:The assessment of prodromal symptoms during HUTT compared to spontaneous syncope showed significant differences for several symptoms and overall low levels of agreement. Also, tilt cannot differentiate patients with or without prodrome during their spontaneous spells.

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

Aiom, terapia ormonale salvavita. Soluzioni smart per ricordarla

In Italia 37mila persone con cancro metastatico della mammella

Il 13 novembre giornata dedicata a salute e prevenzione giovani

Presentato alla Camera il policy brief di Europa Donna Italia

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.

L’incidenza alta tra chi vive entro 500 metri da vie trafficate

Equipe di Ginecologia costretta ad un intervento a cielo aperto

Ricerca del Cro di Aviano pubblicata sul Journal of Pathology