Risultati per: Nota 13 AIFA - Guida pratica

Il 2022 per l’epilessia potrebbe essere l’anno della svolta: a maggio l’Organizzazione Mondiale della Sanità dovrà ratificare il primo documento ufficiale sulla gestione dell’epilessia e di altri disturbi neurologici

Stroke, Volume 53, Issue Suppl_1, Page A13-A13, February 1, 2022. Background:The study of plaque enhancement using high resolution vessel wall imaging can provide useful prognostic data. However, this analysis is hindered by plaque sampling and methodological constrains. We developed a new method to quantify plaque enhancement with 3D map analysis.Methods:Ultra-high resolution (7 Tesla) vessel wall imaging was performed on 41 patients with history of symptomatic atherosclerotic disease. Culprit and non-culprit plaques were analyzed. 3D reconstructions of culprit (N=41) and non-culprit plaques (N=14) was performed on T1 and T1+Gd images. Using an in-house code, orthogonal probes were extended from the lumen of the vessel into the arterial wall (Figure). In this way, the entire wall was sampled with multiple spokes. These values were then normalized to the corpus callosum (CC) to obtain a signal intensity ratio (SIratio). Dynamic contrast uptake was quantified as the change in mean SI of the plaque after contrast administration.Results:Forty one culprit and 14 non-culprit plaques (N=55) were analyzed. Culprit plaques enhanced with gadolinium (Gd) more significantly (SIplaque= 0.76 ± 0.28) than non-culprit plaques (SIplaque=0.58 ± 0.14) (p=0.05). In addition, culprit plaques displayed more contrast uptake (ΔSIplaque=0.33±0.25) than non-culprit plaques (ΔSIplaque=0.19 ± 0.08,p=0.01).Conclusion:3D analysis of plaque enhancement with ultra-high resolution MRI is a promising technique that may be used as a biomarker of culprit intracranial atherosclerotic plaques. In addition, quantifying the dynamic plaque contrast uptake may provide more insight into the biology of these lesions.Figure. Magnified 7T coronal view of a basilar artery plaque pre (A) and post administration of Gd (B). 3D analysis of the dynamic uptake of Gd in T1 (C) and T1 + Gd (D). This plaque had a of 0.49 = highly enhancing.

Risultati positivi dalla Nota che amplia agli mmg la prescrizione di anticoagulanti orali diretti per i soli pazienti con fibrillazione atriale non valvolare. Un percorso che coinvolge sempre di più il territorio e la medicina generale nella presa in carico di pazienti cronici.

La novità della Nota Aifa 99: aspetti positivi e criticità. Le considerazioni del coordinatore Simg area pneumologia Franco Lombardo, del presidente Simg Claudio Cricelli, del responsabile area politica del farmaco Fimmg Roberto Venesia e del pneumologo dell’ospedale Sacco Pierachille Santus.