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Partridge DG, Sori A, Green DJ, Simpson R, Poller B, Raza M, Kaur H, Jessop H, Colton B, Nield A, Evans CM, Lee A. Universal use of surgical masks is tolerated and prevents respiratory viral infection in stem cell transplant recipients. J Hosp Infect 2021; 119:182-186. [PMID: 34543704 PMCID: PMC8447542 DOI: 10.1016/j.jhin.2021.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 12/14/2022]
Abstract
Prevention of respiratory viral infection in stem cell transplant patients is important due to its high risk of adverse outcome. This single-centre, mixed methods study, conducted before the severe acute respiratory syndrome coronavirus-2 pandemic, explored the barriers and facilitators to a policy of universal mask use by visitors and healthcare workers, and examined the impact of the first year of introduction of the policy on respiratory viral infection rates compared with preceding years, adjusted for overall incidence. Education around universal mask use was highlighted as being particularly important in policy implementation. A significant decrease in respiratory viral infection was observed following introduction.
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Affiliation(s)
- D G Partridge
- Department of Microbiology, Sheffield Teaching Hospitals Foundation NHS Trust, Sheffield, UK; Florey Institute for Host-Pathogen Interaction, University of Sheffield, Sheffield, UK.
| | - A Sori
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - D J Green
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - R Simpson
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - B Poller
- Department of Laboratory Medicine, NHS Lothian, Edinburgh, UK
| | - M Raza
- Department of Virology, Sheffield Teaching Hospitals Foundation NHS Trust, Sheffield, UK
| | - H Kaur
- Department of Haematology, Sheffield Teaching Hospitals Foundation NHS Trust, Sheffield, UK
| | - H Jessop
- Department of Haematology, Sheffield Teaching Hospitals Foundation NHS Trust, Sheffield, UK
| | - B Colton
- Department of Haematology, Sheffield Teaching Hospitals Foundation NHS Trust, Sheffield, UK
| | - A Nield
- Department of Haematology, Sheffield Teaching Hospitals Foundation NHS Trust, Sheffield, UK
| | - C M Evans
- Florey Institute for Host-Pathogen Interaction, University of Sheffield, Sheffield, UK; Department of Virology, Sheffield Teaching Hospitals Foundation NHS Trust, Sheffield, UK
| | - A Lee
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Di Filippo C, Caniato F, Cappelli F, Mattesini A, Meucci F, Sori A, Stolcova M, Agostini C, Bernardo P, Di Mario C. Discontinuation of both cangrelor and ticagrelor because of severe dyspnea during primary angioplasty. J Cardiovasc Med (Hagerstown) 2021; 22:317-319. [PMID: 33633048 DOI: 10.2459/jcm.0000000000001042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Chiara Di Filippo
- Heart Lung and Vessels Department, Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy
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Agostini C, Stolcova M, Bernardo P, Cappelli F, Sori A, Mattesini A, Meucci F, Sorini Dini C, Cianchi G, Peris A, Di Mario C, Valente S. [Tips and tricks for using extracorporeal life support devices in the intensive cardiac care unit]. G Ital Cardiol (Rome) 2019; 19:14S-22S. [PMID: 29989607 DOI: 10.1714/2939.29546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In patients with severe cardiac dysfunction refractory to conventional therapies, extracorporeal membrane oxygenation used in veno-arterious modality can provide temporary circulatory assistance (extracorporeal life support, ECLS). Since it is an invasive and complex technique, its use is potentially burdened by severe complications, thus requiring careful nursing and medical care during intensive cardiac care unit stay. The use of ECLS requires specific skills such as knowledge of protective mechanical invasive ventilation, specific echocardiographic evaluation, accurate monitoring of hemodynamics and laboratory tests. A patient on ECLS is at high risk of thrombotic and hemorrhagic complications that could be fatal, hence specific pro- and anti-hemostatic therapy is needed. Moreover, the knowledge of some peculiar aspects of ECLS system and management can help doctors to avoid several complications such as limb ischemia, left ventricular overload and regional perfusion discrepancy. In conclusion, careful management by adequately trained personnel is required.
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Affiliation(s)
- Cecilia Agostini
- SOD Interventistica Cardiologica Strutturale, Azienda Ospedaliero-Universitaria Careggi, Firenze
| | - Miroslava Stolcova
- SOD Interventistica Cardiologica Strutturale, Azienda Ospedaliero-Universitaria Careggi, Firenze
| | - Pasquale Bernardo
- SOD Interventistica Cardiologica Strutturale, Azienda Ospedaliero-Universitaria Careggi, Firenze
| | - Francesco Cappelli
- SOD Interventistica Cardiologica Strutturale, Azienda Ospedaliero-Universitaria Careggi, Firenze
| | - Andrea Sori
- SOD Interventistica Cardiologica Strutturale, Azienda Ospedaliero-Universitaria Careggi, Firenze
| | - Alessio Mattesini
- SOD Interventistica Cardiologica Strutturale, Azienda Ospedaliero-Universitaria Careggi, Firenze
| | - Francesco Meucci
- SOD Interventistica Cardiologica Strutturale, Azienda Ospedaliero-Universitaria Careggi, Firenze
| | | | - Giovanni Cianchi
- SOD Cure Intensive del Trauma e delle Gravi Insufficienze d'Organo, Azienda Ospedaliero-Universitaria Careggi, Firenze
| | - Adriano Peris
- SOD Cure Intensive del Trauma e delle Gravi Insufficienze d'Organo, Azienda Ospedaliero-Universitaria Careggi, Firenze
| | - Carlo Di Mario
- SOD Interventistica Cardiologica Strutturale, Azienda Ospedaliero-Universitaria Careggi, Firenze
| | - Serafina Valente
- SOD Interventistica Cardiologica Strutturale, Azienda Ospedaliero-Universitaria Careggi, Firenze
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Tommasi E, Lazzeri C, Bernardo P, Sori A, Chiostri M, Gensini GF, Valente S. Cooling techniques in mild hypothermia after cardiac arrest. J Cardiovasc Med (Hagerstown) 2017; 18:459-466. [DOI: 10.2459/jcm.0000000000000130] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Lazzeri C, Sori A, Bernardo P, Chiostri M, Tommasi E, Zucchini M, Romano SM, Gensini GF, Valente S. Cardiovascular effects of mild hypothermia in post-cardiac arrest patients by beat-to-beat monitoring. A single centre pilot study. Acute Card Care 2014; 16:67-73. [PMID: 24654656 DOI: 10.3109/17482941.2014.889310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Data on the hemodynamic and cardiovascular effects of hypothermia in patients with cardiac arrest are scarce. The aim of this study was to evaluate the hemodynamic changes induced by hypothermia by means of Most Care(®) (pressure recording analytical method, PRAM methodology), a beat-to-beat hemodynamic monitoring method. METHODS We enrolled 20 patients with cardiac arrest (CA) consecutively admitted to our intensive cardiac care unit and treated with mild hypothermia (TH). RESULTS While non-survivors showed no changes in haemodynamic variables throughout the study period, survivors exhibited a significant increase in systemic vascular resistance indexed during hypothermia and a trend towards lower values of heart rate and higher levels of mean arterial pressure. CONCLUSIONS According to our data, PRAM methodology proved to be a feasible and clinically useful tool in CA patients treated with TH since it provides continuous beat-to-beat haemodynamic monitoring that is based on assessment of several haemodynamic variables. Moreover, we observed that survivors showed a different haemodynamic behaviour during hypothermia in respect to patients who died. However, further studies, performed in larger cohorts, are needed to better elucidate the haemodynamic effects of hypothermia in CA patients by means of PRAM methodology.
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Affiliation(s)
- Chiara Lazzeri
- Intensive Cardiac Coronary Unit, Heart and Vessel Department, Azienda Ospedaliero-Universitaria Careggi , Florence , Italy
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Di Bari M, Balzi D, Fracchia S, Barchielli A, Orso F, Sori A, Spini S, Carrabba N, Santoro GM, Gensini GF, Marchionni N. Decreased usage and increased effectiveness of percutaneous coronary intervention in complex older patients with acute coronary syndromes. Heart 2014; 100:1537-42. [DOI: 10.1136/heartjnl-2013-305445] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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Lazzeri C, Gensini GF, Sori A, Bernardo P, Chiostri M, Tommasi E, Grossi F, Valente S. Dynamic behaviour of lactate values during mild hypothermia in patients with cardiac arrest. Eur Heart J Acute Cardiovasc Care 2013; 3:176-82. [PMID: 24337917 DOI: 10.1177/2048872613514014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND METHODS The present investigation was aimed at assessing the dynamic behaviour of lactate values during hypothermia in 33 patients with cardiac arrest. RESULTS Fifteen patients died during intensive care stay (15/33, 45.5%). When compared to survivors, they were older (survivors 50.7 ± 14.7 vs. non-survivors 70.1 ± 10.4 years, p<0.001) and exhibited a significantly higher APACHE score (survivors 21.9 ± 3.9 vs. non-survivors 27.5 ± 4.6, p<0.001). A higher incidence of non-shockable rhythms was observed in non-survivors (p=0.026) who showed a longer collapse-recovery of spontaneous circulation time (p=0.01). During hypothermia, lactate values showed a progressive and significant decrease despite no significant change in mean arterial pressure and central venous pressure (i.e. independently of blood pressure values and volaemia). Lactate values when measured during hypothermia were related to in-intensive cardiac care unit (in-ICCU) death. CONCLUSION In our series, lactate values measured during hypothermia hold a prognostic role in these patients since they are related to in-ICCU death.
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Affiliation(s)
- Chiara Lazzeri
- Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
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Lazzeri C, Sori A, Bernardo P, Picariello C, Gensini GF, Valente S. In-hospital refractory cardiac arrest treated with extracorporeal membrane oxygenation: A tertiary single center experience. ACTA ACUST UNITED AC 2013; 15:47-51. [DOI: 10.3109/17482941.2013.796385] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Lazzeri C, Bernardo P, Sori A, Innocenti L, Stefano P, Peris A, Gensini GF, Valente S. Venous-arterial extracorporeal membrane oxygenation for refractory cardiac arrest: a clinical challenge. Eur Heart J Acute Cardiovasc Care 2013; 2:118-26. [PMID: 24222820 PMCID: PMC3821811 DOI: 10.1177/2048872613484687] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Accepted: 03/07/2013] [Indexed: 11/15/2022]
Abstract
Guidelines stated that extracorporeal membrane oxygenation (ECMO) may improve outcomes after refractory cardiac arrest (CA) in cases of cardiogenic shock and witnessed arrest, where there is an underlying circulatory disease amenable to immediate corrective intervention. Due to the lack of randomized trials, available data are supported by small series and observational studies, being therefore characterized by heterogeneity and controversial results. In clinical practice, using ECMO involves quite a challenging medical decision in a setting where the patient is extremely vulnerable and completely dependent on the medical team's judgment. The present review focuses on examining existing evidence concerning inclusion and exclusion criteria, and outcomes (in-hospital and long-term mortality rates and neurological recovery) in studies performed in patients with refractory CA treated with ECMO. Discrepancies can be related to heterogeneity in study population, to differences in local health system organization in respect of the management of patients with CA, as well as to the fact that most investigations are retrospective. In the real world, patient selection occurs individually within each center based on their previous experience and expertise with a specific patient population and disease spectrum. Available evidence strongly suggests that in CA patients, ECMO is a highly costly intervention and optimal utilization requires a dedicated local health-care organization and expertise in the field (both for the technical implementation of the device and for the intensive care management of these patients). A careful selection of patients guarantees optimal utilization of resources and a better outcome.
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Affiliation(s)
- Chiara Lazzeri
- Intensive Cardiac Coronary Unit, Ospedaliero-Universitaria Careggi, Italy
| | - Pasquale Bernardo
- Intensive Cardiac Coronary Unit, Ospedaliero-Universitaria Careggi, Italy
| | - Andrea Sori
- Intensive Cardiac Coronary Unit, Ospedaliero-Universitaria Careggi, Italy
| | - Lisa Innocenti
- Intensive Cardiac Coronary Unit, Ospedaliero-Universitaria Careggi, Italy
| | | | - Adriano Peris
- Emergency Intensive Care Unit, Ospedaliero-Universitaria Careggi, Italy
| | - Gian F Gensini
- Intensive Cardiac Coronary Unit, Ospedaliero-Universitaria Careggi, Italy
| | - Serafina Valente
- Intensive Cardiac Coronary Unit, Ospedaliero-Universitaria Careggi, Italy
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Lazzeri C, Bernardo P, Sori A, Innocenti L, Passantino S, Chiostri M, Gensini GF, Valente S. Renal replacement therapy in patients with refractory cardiac arrest undergoing extracorporeal membrane oxygenation. Resuscitation 2013; 84:e121-2. [PMID: 23692982 DOI: 10.1016/j.resuscitation.2013.05.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 05/04/2013] [Accepted: 05/09/2013] [Indexed: 10/26/2022]
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Valente S, Lazzeri C, Bernardo P, Sori A, Chiostri M, Innocenti L, Stefano P, Peris A, Gensini GF. Bleeding events in refractory cardiac arrest treated with extracorporeal membrane oxygenation--a single centre experience. Resuscitation 2013; 84:e119. [PMID: 23643781 DOI: 10.1016/j.resuscitation.2013.04.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 04/05/2013] [Indexed: 11/25/2022]
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Lazzeri C, Sori A, Picariello C, Chiostri M, Gensini GF, Valente S. Nonthyroidal illness syndrome in ST-elevation myocardial infarction treated with mechanical revascularization. Int J Cardiol 2012; 158:103-4. [PMID: 22560494 DOI: 10.1016/j.ijcard.2012.03.100] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2012] [Accepted: 03/08/2012] [Indexed: 01/17/2023]
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Valente S, Lazzeri C, Chiostri M, Sori A, Giglioli C, Gensini GF. Prior and new onset anemia in ST-elevation myocardial infarction: a different prognostic role? Intern Emerg Med 2011; 6:329-36. [PMID: 21140239 DOI: 10.1007/s11739-010-0494-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2010] [Accepted: 11/17/2010] [Indexed: 02/07/2023]
Abstract
The present investigation, performed in 1,122 consecutive STEMI patients treated with primary coronary intervention, was aimed at evaluating: (1) the prevalence of prior anemia and its prognostic significance in the short term; and (2) the prevalence of new anemia and its impact in the short term. The prevalence of prior anemia was 27.4%. Patients with a prior anemia were older and exhibited a higher incidence of chronic diseases and comorbidities. They showed a higher intra-hospital mortality rate (p < 0.001), a higher incidence of PCI failure (p < 0.001) and major bleedings (p < 0.001). Prior anemia was an independent predictor for intra-hospital mortality (OR 2.12; 95% CI 1.21-3.70, p = 0.009). Patients with a new anemia account for 46.8% of our series, and showed a higher early mortality rate and incidence of major bleedings in respect to those who maintained normal Hb values (p < 0.05 and <0.05, respectively). our data strengthens the prognostic role of Hb values in STEMI patients submitted to primary PCI, since the presence of prior anemia identified a subset of patients, characterized by advanced age, higher comorbidities and serious coronary artery disease, at higher risk for intra ICCU mortality and complications. Moreover, the development of anemia during an ICCU stay is common, and is associated with a higher mortality rate and incidence of complications in respect to patients who maintain normal Hb values.
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Affiliation(s)
- Serafina Valente
- Heart and Vessel Department, Intensive Cardiac Care Unit, Azienda Ospedaliero-Universitaria Careggi, Viale Morgagni 85, 50134, Florence, Italy.
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Lazzeri C, Chiostri M, Sori A, Valente S, Gensini GF. Postprocedural hyperglycemia in ST elevation myocardial infarction submitted to percutaneous coronary intervention: a prognostic indicator and a marker of metabolic derangement. J Cardiovasc Med (Hagerstown) 2010; 11:7-13. [PMID: 19829142 DOI: 10.2459/jcm.0b013e32832d83b3] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Hyperglycemia in acute coronary syndrome is associated with an increased risk of death in patients without previously known diabetes but the prognostic role of postrevascularization hyperglycemia in these patients is so far incompletely elucidated. MATERIALS AND METHODS In 175 consecutive patients without previously known diabetes and with ST elevation myocardial infarction treated with primary angioplasty, we evaluated the relation between acute and chronic glucose dysmetabolism and early and late mortality and the relation between hyperglycemia and extension of myocardial damage [creatine phosphokinase-MB (CPK-MB), troponin I levels, ejection fraction], inflammation (leukocyte count, erythrocyte sedimentation rate, C-reactive protein) and prognostic biohumoral markers [N-terminal brain natriuretic peptide (NT-proBNP) and lactic acid]. RESULTS Highest glucose levels were associated with higher Killip class, lower ejection fraction and increased values of CPK, CPK-MB, troponin I, proBNP, lactic acid, leukocytes and insulin. At multivariate logistic regression analysis, the following variables were independent predictors of intraintensive cardiac care unit mortality: postprocedural glycemia [odds ratio (OR) 8.79; 95% confidence interval (CI) 1.41-54.94; P = 0.020] and troponin I (OR 1.003; 95% CI 1.0004-1.006; P = 0.023) when adjusted for insulinemia [OR 0.98; 95% CI 0.92-1.06; P = not significant (NS)], HbA1c (OR 0.51; 95% CI 0.11-2.37; P = NS), ST elevation myocardial infarction location (OR 1.27; 95% CI 0.44-3.66; P = NS) and creatininemia (OR 1.48; 95% CI 0.90-2.45; P = NS). CONCLUSION In ST elevation myocardial infarction patients without previously known diabetes submitted to percutaneous coronary intervention, glucose serum levels measured after mechanical revascularization were independent predictors of in-hospital mortality.
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Affiliation(s)
- Chiara Lazzeri
- Department of Heart and Vessel Disease, Intensive Cardiac Care Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
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Valente S, Lazzeri C, Chiostri M, Giglioli C, Sori A, Tigli S, Gensini GF. NT-proBNP on admission for early risk stratification in STEMI patients submitted to PCI. Relation with extension of STEMI and inflammatory markers. Int J Cardiol 2009; 132:84-9. [DOI: 10.1016/j.ijcard.2007.10.045] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2007] [Revised: 07/20/2007] [Accepted: 10/27/2007] [Indexed: 10/22/2022]
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Valente S, Lazzeri C, Chiostri M, Sori A, Giglioli C, Salvadori C, Gensini GF. Time of onset and outcome of cardiogenic shock in acute coronary syndromes. J Cardiovasc Med (Hagerstown) 2008; 9:1235-40. [DOI: 10.2459/jcm.0b013e3283168a27] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Lazzeri C, Valente S, Chiostri M, Sori A, Bernardo P, Gensini GF. Uric acid in the acute phase of ST elevation myocardial infarction submitted to primary PCI: its prognostic role and relation with inflammatory markers: a single center experience. Int J Cardiol 2008; 138:206-9. [PMID: 18684529 DOI: 10.1016/j.ijcard.2008.06.024] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2008] [Accepted: 06/07/2008] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND METHODS Scarce data are available on the prognostic role of uric acid (UA ) in patients with ST elevation myocardial infarction (STEMI). We aimed at assessing the relation between uric acid, measured on Intensive Cardiac Care Unit (ICCU) admission, and mortality at short term follow-up in 466 consecutive STEMI patients submitted to percutaneous coronary intervention (PCI), as well as its relation with inflammatory markers (C-reactive protein, CRP-fibrinogen, erythrocyte sedimentation rate ESR). RESULTS Higher UA were detectable in the 21.5%.. In-hospital mortality was higher in patients with elevated UA (p<0.01 O.R. (95% C.I.): 3.9 (1.5-10.2)). At backward stepwise regression analysis UA resulted an independent predictor for in-hospital mortality (OR 1.82, 95%CI 1.15-2.86; p=0.01). CONCLUSION Our data strongly suggest that in the acute phase of STEMI patients submitted to PCI, uric acid holds a prognostic role for in-hospital mortality.
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Valente S, Lazzeri C, Sori A, Giglioli C, Bernardo P, Gensini GF. The recent evolution of coronary care units into intensive cardiac care units: the experience of a tertiary center in Florence. J Cardiovasc Med (Hagerstown) 2007; 8:181-7. [PMID: 17312435 DOI: 10.2459/jcm.0b013e32801261e3] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To evaluate the evolution of intensive cardiac care units (ICCUs) in the third millenium by assessing the activity and the workload of our ICCU which is a Hub center, from 1 January 2004 to 30 June 2005. METHODS Among the 1397 patients consecutively admitted to our ICCU, 40.5% came from Spokes. Patients with ST elevation myocardial infarction comprised 29.5% of the entire population: all of them were admitted to ICCU after mechanical reperfusion. RESULTS The incidences of ventricular fibrillation (1%) and complete AV block (0.6%) are low in our patients. The most frequent complications were acute renal failure requiring renal replacement therapy (4.4%) and vascular and hemorrhagic complications (4.3%). CONCLUSIONS Our ICCU is a post-reperfusion unit for treating complications of therapy and older and more complex patients who require more intensive care. This is why the cardiac intensivists also need to be skilled in general intensive care. In the Integrated Cardiac Network (Hub-and-Spoke model), ICCUs play a crucial role in the management of all cardiac emergencies, and in maintaining a continuous and strict interplay with Spokes, they have a prominent and unique role in the selection and early treatment of acute cardiac patients and their follow-up.
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Affiliation(s)
- Serafina Valente
- Intensive Cardiac Care Unit, Heart and Vessel Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
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Christakos S, Malkowitz L, Sori A, Sperduto A, Feldman SC. Calcium binding protein in squid brain: biochemical similarity to the 28,000-Mr vitamin D-dependent calcium binding protein (calbindin-D28k). J Neurochem 1987; 49:1427-37. [PMID: 3312496 DOI: 10.1111/j.1471-4159.1987.tb01010.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A calcium binding protein that is biochemically similar to vertebrate 28,000-Mr vitamin D-dependent calcium binding protein (calbindin-D28k) has been purified from squid brain. Squid brain calbindin was found to have an isoelectric point of 5.0, was heat stable up to 60 degrees C, and showed increased electrophoretic mobility in the presence of chelator. Amino acid analysis revealed a high content of glutamic and aspartic acids and a low level of methionine, histidine, and tyrosine, a finding similar but not identical to the composition of vertebrate calbindin-D28k. The molecular weight of the squid protein, determined by Ferguson plot analysis of data obtained from sodium dodecyl sulfate-gel electrophoresis, was calculated to be 25,700, as compared with 27,800 for rat renal calbindin. Immunocytochemical analysis demonstrated immunoreactive protein in a selected population of neurons and fibers in several areas of the molluscan nervous system. This study represents the first purification from an invertebrate of a calcium binding protein that is biochemically similar to vitamin D-dependent calcium binding protein. These results demonstrate that calbindin, although not identical in vertebrates and cephalopods, may be phylogenetically conserved in structure. The restricted distribution of immunoreactive calbindin in both the cephalopod and mammalian brain suggests that the function of neuronal calbindin may also be conserved in evolution.
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Affiliation(s)
- S Christakos
- Department of Biochemistry, University of Medicine and Dentistry of New Jersey, Newark 07103
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Christakos S, Sori A, Greenstein SM, Murphy TF. Sucrose density gradient analysis of 1,25-dihydroxyvitamin D3 binding in human breast tumors. J Clin Endocrinol Metab 1983; 56:686-91. [PMID: 6300161 DOI: 10.1210/jcem-56-4-686] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Buscaino GA, Sori A, Campanella G. [Study of dopamine and noradrenaline in the brains of three patients with Parkinson's disease who died in the course of treatment with L-dopa]. Rev Neurol (Paris) 1972; 127:301-2. [PMID: 4666634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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