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A 25-year-long journey into interventional cardiology: looking back, and rushing forward. 长达 25 年的介入心脏病学之旅:回顾过去,砥砺前行。
Pub Date : 2024-08-01 Epub Date: 2024-06-13 DOI: 10.23736/S0026-4806.24.09236-X
Nicola Corcione, Paolo Ferraro, Alberto Morello, Michele Cimmino, Michele Albanese, Raffaella Avellino, Sara Turino, Michele Polimeno, Stefano Messina, Gennaro Maresca, Salvatore Giordano, Giuseppe Biondi-Zoccai, Martino Pepe, Arturo Giordano

Cardiovascular disease remains decade after decade a leading cause of mortality, morbidity and resource use globally as well as locally. We have had the opportunity of being involved in several iterative breakthroughs in invasive cardiovascular procedures, ranging from the advent of coronary stents to transcatheter mitral valve repair. Building up such extensive clinical and research experience, we hereby present 25 years of cardiovascular interventions at Pineta Grande Hospital and Casa di Salute S. Lucia, respectively in Castel Volturno, and S. Giuseppe Vesuviano, both in the Italian Campania region, where the same team of interventional cardiologists has managed to adopt and master several cardiovascular innovations for the benefit of thousands of patients. Our experience showcases the evolution of invasive cardiology, especially in diagnostic and therapeutic practices. Key highlights include advancements in coronary procedures, with the introduction of bare-metal stents, drug-eluting stents and drug-coated balloons, despite the setback of bioresorbable vascular scaffolds, as well as transcatheter aortic valve implantation and innovative approaches to mitral regurgitation. Furthermore, this overview scrutinizes procedural challenges, patient outcomes, and quality of life improvements, providing a rich tapestry of clinical experiences and research insights. It serves as a testament to the dynamic nature of interventional cardiology, offering a forward-looking perspective on future trends and technologies. We hope that this overview will prove an informative and insightful read for those seeking to understand the intricate journey of invasive cardiovascular care over the past decades and its trajectory into the future.

十年过去了,心血管疾病仍然是全球和本地死亡、发病和资源使用的主要原因。从冠状动脉支架的出现到经导管二尖瓣修复术,我们有幸参与了有创心血管手术的多次迭代突破。凭借丰富的临床和研究经验,我们在此介绍分别位于意大利坎帕尼亚大区Castel Volturno的Pineta Grande医院和Casa di Salute S. Lucia医院25年来的心血管介入治疗经验,在这两家医院里,同一个介入心脏病专家团队成功采用并掌握了多项心血管创新技术,造福了成千上万的患者。我们的经验展示了介入心脏病学的发展,尤其是在诊断和治疗实践方面。主要亮点包括冠状动脉手术方面的进步,包括裸金属支架、药物洗脱支架和药物涂层球囊的引入,尽管生物可吸收血管支架遭遇挫折,以及经导管主动脉瓣植入术和治疗二尖瓣反流的创新方法。此外,本综述还仔细研究了手术挑战、患者疗效和生活质量的改善,提供了丰富的临床经验和研究见解。它证明了介入心脏病学的动态性质,为未来趋势和技术提供了前瞻性视角。我们希望,对于那些希望了解心血管介入治疗在过去几十年中的复杂历程及其未来发展轨迹的人来说,本综述将是一本信息丰富、见解深刻的读物。
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引用次数: 0
Male infertility: the role of lifestyle and environmental factors. 男性不育:生活方式和环境因素的作用。
Pub Date : 2024-08-01 Epub Date: 2024-07-04 DOI: 10.23736/S0026-4806.24.09461-8
Anna Perri, Sabrina Bossio
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引用次数: 0
Reappraisal of Pidotimod: an immunomodulatory agent with 30-year evidence. 重新评估匹多莫德:一种经过 30 年验证的免疫调节药物。
Pub Date : 2024-08-01 Epub Date: 2024-07-17 DOI: 10.23736/S0026-4806.24.09391-1
Gian L Marseglia, Matteo Gelardi, Pierachille Santus, Giorgio Ciprandi

Pidotimod (3-L-pyroglutamyl-L-thiaziolidine-4-carboxylic acid) is a synthetic dipeptide with immunomodulatory properties that is indicated for use in adults and children over 3 years of age with documented cell-mediated immunodepression during respiratory and urinary tract infections. Infections are associated with an immune response that helps fight pathogens. In this scenario, inflammatory events occur to improve the antimicrobial reaction. However, defective immunity and/or sustained inflammation may adversely affect the course of the infection. Thus, modulating immune function could be a valuable option in managing patients with infections. The multifaceted mechanism of action of Pidotimod enables it to modulate innate and adaptive immunity. Extensive evidence about Pidotimod, accumulated over the last 30 years, has provided much data on the prevention of recurrent respiratory infections in susceptible children and respiratory exacerbations in patients with chronic bronchitis. Recent studies provide interesting information on how Pidotimod affects the metabolomic profiles of patients with bronchiectasis, clinical and immunological outcomes of elderly patients with pneumonia, clinical and cellular changes in patients with allergic rhinitis and asthma, and beneficial effects on cytokines and humoral immunity in human immunodeficiency virus (HIV) patients. Preliminary experience suggests that Pidotimod can shorten the duration of COVID-19 infection and reduce clinical severity by modulating the immune response, as well as prevent vaccination-related adverse events. In conclusion, the immunomodulatory properties of Pidotimod indicate that it may be a valuable option in managing patients with respiratory infections and other immune-mediated disorders, including allergy, chronic obstructive pulmonary disease, and asthma.

匹多莫德(3-L-焦谷氨酰-L-噻唑烷-4-羧酸)是一种具有免疫调节特性的合成二肽,适用于在呼吸道和泌尿道感染期间有细胞介导的免疫抑制记录的成人和 3 岁以上儿童。感染与有助于对抗病原体的免疫反应有关。在这种情况下,炎症事件的发生可改善抗菌反应。然而,免疫缺陷和/或持续炎症可能会对感染过程产生不利影响。因此,调节免疫功能可能是治疗感染患者的一个重要选择。匹多莫德的多重作用机制使其能够调节先天性免疫和适应性免疫。在过去 30 年中积累的有关匹多莫德的大量证据,为预防易感儿童反复呼吸道感染和慢性支气管炎患者呼吸道恶化提供了大量数据。最近的研究提供了关于匹多莫德如何影响支气管扩张症患者代谢组谱、老年肺炎患者的临床和免疫学结果、过敏性鼻炎和哮喘患者的临床和细胞变化以及对人类免疫缺陷病毒(HIV)患者的细胞因子和体液免疫的有益影响的有趣信息。初步经验表明,匹多莫德可通过调节免疫反应缩短 COVID-19 感染的持续时间并降低临床严重程度,还能预防与疫苗接种相关的不良反应。总之,匹多莫德的免疫调节特性表明,它可能是治疗呼吸道感染和其他免疫介导疾病(包括过敏、慢性阻塞性肺病和哮喘)患者的重要选择。
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引用次数: 0
Efficacy of epidural anesthesia in labor pain management: a prospective observational study. 硬膜外麻醉在分娩镇痛中的疗效:一项前瞻性观察研究。
Pub Date : 2024-08-01 Epub Date: 2024-03-26 DOI: 10.23736/S0026-4806.24.09189-4
Jiaolian Wang, Juyan Sun, Mengdie Chen
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引用次数: 0
Multicenter observational study on the efficacy of selective Janus Kinase-1 inhibitor upatacitinib in rheumatoid arthritis. 选择性 Janus 激酶-1 抑制剂 upatacitinib 对类风湿性关节炎疗效的多中心观察性研究。
Pub Date : 2024-08-01 DOI: 10.23736/S0026-4806.24.09409-6
Alberto Lo Gullo, Simone Parisi, Andrea Becciolini, Marino Paroli, Elena Bravi, Romina Andracco, Valeria Nucera, Francesca Ometto, Federica Lumetti, Antonella Farina, Patrizia Del Medico, Matteo Colina, Viviana Ravagnani, Palma Scolieri, Maddalena Larosa, Marta Priora, Elisa Visalli, Olga Addimanda, Rosetta Vitetta, Alessandro Volpe, Alessandra Bezzi, Francesco Girelli, Aldo Biagio Molica Colella, Rosalba Caccavale, Eleonora DI Donato, Giuditta Adorni, Daniele Santilli, Gianluca Lucchini, Eugenio Arrigoni, Ilaria Platè, Natalia Mansueto, Aurora Ianniello, Enrico Fusaro, Maria Chiara Ditto, Vincenzo Bruzzese, Dario Camellino, Gerolamo Bianchi, Francesca Serale, Rosario Foti, Giorgio Amato, Francesco DE Lucia, Ylenia Dal Bosco, Roberta Foti, Massimo Reta, Alessia Fiorenza, Guido Rovera, Antonio Marchetta, Maria C Focherini, Fabio Mascella, Simone Bernardi, Gilda Sandri, Dilia Giuggioli, Carlo Salvarani, Maria Ilenia DE Andres, Veronica Franchina, Francesco Molica Colella, Giulio Ferrero, Alarico Ariani

Background: Upadacitinib (UPA) is a selective, reversible Janus kinase inhibitor (JAKi) approved for the treatment of RA. However, there is still no solid evidence on the long-term efficacy of UPA in treated patients. The purpose of this study was to determine the efficacy of UPA to obtain remission or low disease activity (LDA) in a series of UPA patients in patients with RA after 6 and 12 months of treatment in a real-world setting.

Methods: A series of 111 consecutive patients treated with UPA in 23 rheumatology centers were enrolled. Personal history, treatment history and disease activity at baseline, after 6 and 12 months were recorded. Intention-to-treat (ITT) and per-protocol (PP) analyses assessed achievement of remission or LDA or defined as DAS28 <2.6 and ≤3.2, respectively. Logistic regression analysis examined the role of several independent factors on the reduction of disease activity after 6 months of treatment.

Results: Of the initial group of 111 subjects at baseline, 86 and 29 participants completed clinical assessments at 6 and 12 months. According to ITT analysis, the rates of remission and LDA were 18% and 18% at 6 months and 31.5% and 12.5% at 12 months, respectively. PP analysis showed higher rates of remission and LDA at 6 (23.3% and 19.8%) and 12 months (55.2% and 20.7%). Results of multivariate logistic regression analysis indicated that a low DAS28 score (P=0.045) was the only predictor of achieving remission at 6 months. None of the baseline factors predicted remission/LDA at 6 months.

Conclusions: RA patients treated with UPA achieved a significant rate of disease remission or LDA in a real-world setting. The 6-month response was found to depend only on the baseline value of DAS28, while it was not influenced by other factors such as disease duration, line of treatment or concomitant therapy with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) or corticosteroids.

背景:乌达替尼(UPA)是一种选择性、可逆性 Janus 激酶抑制剂(JAKi),已被批准用于治疗 RA。然而,目前仍无确凿证据表明 UPA 对接受治疗的患者具有长期疗效。本研究的目的是在现实世界中确定一系列UPA患者在治疗6个月和12个月后获得缓解或低疾病活动性(LDA)的疗效:方法:在23个风湿病中心连续收治了111名接受UPA治疗的患者。记录了个人病史、治疗史以及基线、6个月和12个月后的疾病活动情况。意向治疗(ITT)和按方案(PP)分析评估了缓解或LDA(定义为DAS28)的实现情况:在最初的 111 名基线受试者中,分别有 86 人和 29 人完成了 6 个月和 12 个月的临床评估。根据 ITT 分析,6 个月时的缓解率和 LDA 率分别为 18% 和 18%,12 个月时分别为 31.5% 和 12.5%。PP分析显示,6个月和12个月的缓解率和LDA率较高(分别为23.3%和19.8%),分别为55.2%和20.7%。多变量逻辑回归分析结果表明,DAS28得分低(P=0.045)是预测6个月缓解率的唯一因素。没有一个基线因素能预测6个月后的缓解/LDA:结论:在真实世界环境中,接受UPA治疗的RA患者获得了显著的疾病缓解率或LDA。结论:在真实世界环境中,接受UPA治疗的RA患者的疾病缓解率或LDA显著提高,6个月的反应仅取决于DAS28的基线值,而不受其他因素的影响,如病程、治疗方案或同时接受传统合成改善病情抗风湿药(csDMARDs)或皮质类固醇的治疗。
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引用次数: 0
Hydrogen sulfide affects aortic vasodilation in rats by mediating PI3K-Akt signaling pathway. 硫化氢通过介导 PI3K-Akt 信号通路影响大鼠主动脉血管扩张
Pub Date : 2024-08-01 Epub Date: 2024-01-15 DOI: 10.23736/S0026-4806.23.08955-3
Jingyi Sun, Jiajie Mei, Jingsi Zhang, Yu Lou, Shasha Jiang, Yang Li, Xiaodan Fu
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引用次数: 0
Enhanced bioavailability of cannabidiol via solubilization in edible oil blends. 通过在混合食用油中增溶提高大麻二酚的生物利用率。
Pub Date : 2024-08-01 Epub Date: 2024-07-11 DOI: 10.23736/S0026-4806.24.09470-9
Francesco DI Pierro, Fazle Rabbani, Ayesha Kanwal, Areaba Shafiq, Hina Khokhar, Roohi Nigar, Amjad Khan, Alexander Bertuccioli, Massimiliano Cazzaniga, Luigina Guasti, Nicola Zerbinati
{"title":"Enhanced bioavailability of cannabidiol via solubilization in edible oil blends.","authors":"Francesco DI Pierro, Fazle Rabbani, Ayesha Kanwal, Areaba Shafiq, Hina Khokhar, Roohi Nigar, Amjad Khan, Alexander Bertuccioli, Massimiliano Cazzaniga, Luigina Guasti, Nicola Zerbinati","doi":"10.23736/S0026-4806.24.09470-9","DOIUrl":"10.23736/S0026-4806.24.09470-9","url":null,"abstract":"","PeriodicalId":94143,"journal":{"name":"Minerva medica","volume":" ","pages":"523-525"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Application and handling of positive biological indicators in pressure steam sterilization. 压力蒸汽灭菌中阳性生物指标的应用和处理。
Pub Date : 2024-08-01 Epub Date: 2024-02-07 DOI: 10.23736/S0026-4806.24.09183-3
Yajuan Wang, Yeyuan Chu, Jianli Fan, Chunfeng He, Minxia Gu, Xijuan Yang
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引用次数: 0
Interplay between gender and pollution on the prognosis of resuscitated out-of-hospital cardiac arrest. 性别和污染对院外心脏骤停抢救预后的影响。
Pub Date : 2024-08-01 Epub Date: 2024-07-17 DOI: 10.23736/S0026-4806.24.09438-2
Janusz Sielski, Małgorzata Jóźwiak, Karol Kaziród-Wolski, Magdalena Wolska, Giovanni Chiariello, Carlo Gaudio, Giuseppe Biondi-Zoccai, Francesco Versaci, Zbigniew Siudak

Background: Differences between men and women in prognosis after sudden pre-hospital out-of-hospital cardiac arrest (OHCA) have been described in many studies, but the interplay between gender and pollution have not been characterized in detail. We aimed at appraising the interplay between gender and pollution on the prognosis of OHCA.

Methods: Details on patients with OHCA in whom return of spontaneous circulation was obtained and transferred to a large teaching hospital were obtained from the medical charts of the ambulance service and the Polish National Health Fund. Matching pollutant concentrations (PM 2.5, PM10, As, Ni, Cd, Pb) were obtained from the Polish National Environmental Protection Inspectorate.

Results: Details on 948 resuscitated OHCA, 325 (34.3%) of them in women, and occurring between 2018 and 2021, were retrieved. Notably, OHCA in women was associated with significantly higher daily concentrations of PM10 (23.37 [17.09, 37.04] vs. 21.92 [16.32, 29.98] μg/m3, P=0.023) and PM2.5 (16.83 [11.87, 28.24] vs. 15.27 [11.64, 22.72] μg/m3, P=0.026), as well as heightened concentrations of Cd, daily (0.32 [0.19, 0.44] vs. 0.27 [0.17, 0.40] ng/m3, P=0.027) and over 30 days (0.34 [0.20, 0.44] vs. 0.29 [0.18, 0.43] ng/m3, P=0.027). Concurrently, OHCA in females was associated with lower daily temperatures on the day of the incident (8.40 [0.20, 15.40] vs. 9.90 [1.40, 15.90] °C, P=0.042). Despite these differences, survival at 30 days and 12 months was similar in women and men (both P>0.05).

Conclusions: OHCA events with successful resuscitation in women occurred in concomitance with higher daily contaminant levels, yet short-term and long-term prognosis was similar in men and women. The interplay between gender and air pollution on OHCA outcomes requires further population-based studies.

背景:许多研究都描述了院前院外心脏骤停(OHCA)后男性和女性预后的差异,但性别和污染之间的相互作用尚未得到详细描述。我们旨在评估性别和污染对 OHCA 预后的相互影响:方法:我们从救护车服务和波兰国家卫生基金的病历中获得了自发循环恢复并转入一家大型教学医院的 OHCA 患者的详细资料。匹配的污染物浓度(PM2.5、PM10、砷、镍、镉、铅)来自波兰国家环境保护监察局:检索了 948 例抢救成功的 OHCA 的详细信息,其中 325 例(34.3%)为女性,发生在 2018 年至 2021 年期间。值得注意的是,女性 OHCA 与 PM10(23.37 [17.09, 37.04] vs. 21.92 [16.32, 29.98] μg/m3,P=0.023)和 PM2.5(16.83 [11.87, 28.24] vs. 15.27 [11.64,22.72] μg/m3,P=0.026),以及镉浓度升高,每日(0.32 [0.19,0.44] vs. 0.27 [0.17,0.40] ng/m3,P=0.027)和 30 天(0.34 [0.20,0.44] vs. 0.29 [0.18,0.43] ng/m3,P=0.027)。同时,女性发生 OHCA 与事发当天较低的日气温有关(8.40 [0.20, 15.40] vs. 9.90 [1.40, 15.90] °C,P=0.042)。尽管存在这些差异,但女性和男性在30天和12个月后的存活率相似(P均大于0.05):结论:女性抢救成功的 OHCA 事件与较高的日污染物水平同时发生,但男性和女性的短期和长期预后相似。性别和空气污染对 OHCA 结果的相互影响需要进一步的人群研究。
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引用次数: 0
Analysis of angiotensin II type 1 receptor and osteoprotegerin gene polymorphism on the risk of cardiovascular mortality risk and progressivity of chronic kidney disease. 血管紧张素 II 1 型受体和骨保护蛋白基因多态性对心血管死亡风险和慢性肾脏病进展风险的影响分析。
Pub Date : 2024-08-01 DOI: 10.23736/S0026-4806.24.09435-7
Hendri Susilo, Budi S Pikir, Nathanael J Tjipta, Mochamad Y Alsagaff, Mochammad Thaha, Satriyo D Suryantoro, Citrawati Dk Wungu, Mochamad Amin, Derren D Rampengan, Roy N Ramadhan, Platon Papageorgiou, Ryan Gauci, Rebeka Tóthová

Background: Chronic kidney disease (CKD) is a significant global public health issue with increased risk of atherosclerotic cardiovascular disease (ASCVD) and cardiovascular mortality. Single nucleotide polymorphisms (SNPs) on angiotensin II type 1 receptor (AT1R) A1166C and osteoprotegerin (OPG) C950T gene have received significant attention as a genetic risk factor for cardiovascular disease and CKD.

Methods: This was a cross-sectional study involving 75 adults with CKD recruited from Nephrology Outpatient Clinics of Universitas Airlangga Hospital, Surabaya, Indonesia. Demographic data was obtained from interviews and medical records. The "CKD Patch" application was used to asses ASCVD and cardiovascular mortality risk scores. Statistical analysis was performed by using SPSS version 26.

Results: We detected four different AT1R gene polymorphisms (A1166C, A1160C, G1170T, and G1181C) and two OPG gene polymorphisms (T950C and G1181C) in Indonesian CKD patients. A1160C and G1181C polymorphisms were novel SNPs, newly discovered in this research. No significant association was found between AT1R SNPs and kidney prognostic markers or ASCVD risk/mortality risk scores. However, for OPG C950T we found that TT genotype had a significantly higher ACR than TC or CC genotype (P=0.032). As for OPG G1181C, we found that GG genotype had a higher serum creatinine and albumin to creatinine ratio compared to GC and CC genotypes (P=0.004 and 0.029, respectively). Genotype GC for OPG G1181C was also shown to be protective for having better kidney markers and lowest cardiovascular mortality risk compared to GG and CC genotypes (P=0.018 and 0.032, respectively).

Conclusions: Increased ASCVD risk and mortality risk score was not found on individuals with AT1R gene SNPs. However, for OPG gene polymorphism, C950T and G1181C were associated with kidney progression and cardiovascular mortality.

背景:慢性肾脏病(CKD)是一个重要的全球性公共卫生问题,它增加了动脉粥样硬化性心血管疾病(ASCVD)和心血管死亡的风险。血管紧张素 II 1 型受体(AT1R)A1166C 和骨保护蛋白(OPG)C950T 基因上的单核苷酸多态性(SNPs)作为心血管疾病和 CKD 的遗传风险因素受到了广泛关注:这是一项横断面研究,从印度尼西亚泗水 Universitas Airlangga 医院肾脏病门诊部招募了 75 名患有慢性肾脏病的成年人。人口统计学数据来自访谈和医疗记录。使用 "CKD Patch "应用软件来评估ASCVD和心血管死亡风险评分。统计分析采用 SPSS 26 版本:结果:我们在印尼的 CKD 患者中发现了四种不同的 AT1R 基因多态性(A1166C、A1160C、G1170T 和 G1181C)和两种 OPG 基因多态性(T950C 和 G1181C)。A1160C和G1181C多态性是本研究新发现的新型SNPs。在 AT1R SNP 与肾脏预后指标或 ASCVD 风险/死亡风险评分之间没有发现明显的关联。然而,我们发现 OPG C950T 的 TT 基因型的 ACR 明显高于 TC 或 CC 基因型(P=0.032)。至于 OPG G1181C,我们发现与 GC 和 CC 基因型相比,GG 基因型的血清肌酐和白蛋白肌酐比值更高(P=0.004 和 0.029)。与 GG 和 CC 基因型相比,OPG G1181C 的 GC 基因型对肾脏指标和最低心血管死亡风险也有保护作用(P=0.018 和 0.032):结论:在具有 AT1R 基因 SNP 的个体中,并未发现 ASCVD 风险和死亡风险评分增加的现象。结论:未发现AT1R基因多态性会增加ASCVD风险和死亡率风险评分,但OPG基因多态性中,C950T和G1181C与肾脏恶化和心血管疾病死亡率有关。
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引用次数: 0
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Minerva medica
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