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1. The Emergency Surgery Frailty Index (EmSFI): development and internal validation of a novel simple bedside risk score for elderly patients undergoing emergency surgery

Author

Costa, Bersigotti, Gianluca, Massa, Laura, Lepre, Giulia, Fransvea, Luca, Lucarini, Pietro, Crucitti A, Mercantini, Alessio, Balducci, Paolo, Sganga, Genoveffa, Agresta, Gabriele, Alemanno, F., Anania, G., Antropoli, G., Argenio, M., Atzeni, G., Avenia, J., Azzinnaro, N., Baldazzi, A., Balducci, G., Barbera, G., Bellanova, G., Bergamini, G., Bersigotti, C., Bianchi, L., Bombardini, P. P., Borzellino, C., Bozzo, G., Brachini, S., Buonanno, G., Canini, G. M., Cardella, T., Carrara, S., Cassini, G., Castriconi, D., Ceccarelli, M., Celi, G., Ceresoli, D., Chiarugi, M., Cillara, M., Cimino, N., Cobuccio, F., Cocorullo, L., Colangelo, G., Costa, E., Crucitti, Antonio, Dalla&nbsp, Caneva, A., De&nbsp, Luca, P, de&nbsp, Manzoni Garberini, M., Nisco, A., Prizio, C., Sol, M., Dibella, A., Falcioni, A., Falco, T., Farina, N., Finotti, C., Fontana, E., Francioni, T., Fransvea, G., Frezza, P., Garbarino, B., Garulli, G., Genna, G., Giannessi, M., Gioffrè, S., Giordano, A., Gozzo, A., Grimaldi, D., Gulotta, S., Iacopini, G., Iarussi, V., Laracca, T., Laterza, G., Leonardi, E., Lepre, A., Lorenzon, L., Luridiana, L., Malagnino, G., Mar, A., Marini, G., Marzaioli, P., Massa, R., Mecarelli, G., Mercantini, V., Mingoli, P., Nigri, A., Occhionorelli, G., Paderno, S., Palini, N., Paradies, G. M., Paroli, D., Perrone, M., Petrucciani, F., Petruzzelli, N., Pezzolla, L., Piazza, A., Piazza, D., Piccoli, V., Pisanu, M., Podda, A., Poillucci, M., Porfidia, G., Rossi, R., Ruscelli, G., Spagnoli, P., Sulis, A., Tartaglia, R., Tranà, D., Travaglino, C., Tomaiuolo, A., Valeri, P., Vasquez, A., Zago, G., Zanoni, M., null, E., Null, Crucitti (ORCID:0000-0003-3496-4185), Costa, Bersigotti, Gianluca, Massa, Laura, Lepre, Giulia, Fransvea, Luca, Lucarini, Pietro, Crucitti A, Mercantini, Alessio, Balducci, Paolo, Sganga, Genoveffa, Agresta, Gabriele, Alemanno, F., Anania, G., Antropoli, G., Argenio, M., Atzeni, G., Avenia, J., Azzinnaro, N., Baldazzi, A., Balducci, G., Barbera, G., Bellanova, G., Bergamini, G., Bersigotti, C., Bianchi, L., Bombardini, P. P., Borzellino, C., Bozzo, G., Brachini, S., Buonanno, G., Canini, G. M., Cardella, T., Carrara, S., Cassini, G., Castriconi, D., Ceccarelli, M., Celi, G., Ceresoli, D., Chiarugi, M., Cillara, M., Cimino, N., Cobuccio, F., Cocorullo, L., Colangelo, G., Costa, E., Crucitti, Antonio, Dalla&nbsp, Caneva, A., De&nbsp, Luca, P, de&nbsp, Manzoni Garberini, M., Nisco, A., Prizio, C., Sol, M., Dibella, A., Falcioni, A., Falco, T., Farina, N., Finotti, C., Fontana, E., Francioni, T., Fransvea, G., Frezza, P., Garbarino, B., Garulli, G., Genna, G., Giannessi, M., Gioffrè, S., Giordano, A., Gozzo, A., Grimaldi, D., Gulotta, S., Iacopini, G., Iarussi, V., Laracca, T., Laterza, G., Leonardi, E., Lepre, A., Lorenzon, L., Luridiana, L., Malagnino, G., Mar, A., Marini, G., Marzaioli, P., Massa, R., Mecarelli, G., Mercantini, V., Mingoli, P., Nigri, A., Occhionorelli, G., Paderno, S., Palini, N., Paradies, G. M., Paroli, D., Perrone, M., Petrucciani, F., Petruzzelli, N., Pezzolla, L., Piazza, A., Piazza, D., Piccoli, V., Pisanu, M., Podda, A., Poillucci, M., Porfidia, G., Rossi, R., Ruscelli, G., Spagnoli, P., Sulis, A., Tartaglia, R., Tranà, D., Travaglino, C., Tomaiuolo, A., Valeri, P., Vasquez, A., Zago, G., Zanoni, M., null, E., Null, and Crucitti (ORCID:0000-0003-3496-4185)

Abstract

Background Frailty assessment has acquired an increasing importance in recent years and it has been demonstrated that this vulnerable profile predisposes elderly patients to a worse outcome after surgery. Therefore, it becomes paramount to perform an accurate stratification of surgical risk in elderly undergoing emergency surgery. Study design 1024 patients older than 65 years who required urgent surgical procedures were prospectively recruited from 38 Italian centers participating to the multicentric FRAILESEL (Frailty and Emergency Surgery in the Elderly) study, between December 2016 and May 2017. A univariate analysis was carried out, with the purpose of developing a frailty index in emergency surgery called "EmSFI". Receiver operating characteristic curve analysis was then performed to test the accuracy of our predictive score. Results 784 elderly patients were consecutively enrolled, constituting the development set and results were validated considering further 240 consecutive patients undergoing colorectal surgical procedures. A logistic regression analysis was performed identifying different EmSFI risk classes. The model exhibited good accuracy as regard to mortality for both the development set (AUC = 0.731 [95% CI 0.654-0.772]; HL test chi(2) = 6.780; p = 0.238) and the validation set (AUC = 0.762 [95% CI 0.682-0.842]; HL test chi(2) = 7.238; p = 0.299). As concern morbidity, our model showed a moderate accuracy in the development group, whereas a poor discrimination ability was observed in the validation cohort. Conclusions The validated EmSFI represents a reliable and time-sparing tool, despite its discriminative value decreased regarding complications. Thus, further studies are needed to investigate specifically surgical settings, validating the EmSFI prognostic role in assessing the procedure-related morbidity risk.

Published
2020

2. Adherence issues related to sublingual immunotherapy as perceived by allergists

Author

Scurati, S., Frati, F., Passalacqua, G., Puccinelli, P., Hilaire, C., Incorvaia, C., D Avino, G., Comi, R., Lo Schiavo, M., Pezzuto, F., Montera, C., Pio, A., Teresa Ielpo, M., Cellini, F., Vicentini, L., Pecorari, R., Aresu, T., Capra, L., Benedictis, E., Bombi, C., Zauli, D., Vanzi, A., Alberto Paltrinieri, C., Bondioli, A., Paletta, I., Ventura, D., Mei, F., Paolini, F., Colangelo, C., Cavallucci, E., Cucinelli, F., Tinari, R., Ermini, G., Beltrami, V., Novembre, E., Begliomini, C., Marchese, E., Solito, E., Ammannati, V., Molino, G., Galli, E., Baldassini, M., Di Michele, L., Calvani, M., Gidaro, M., Venuti, A., Li Bianchi, E., Benassi, F., Pocobelli, D., Zangari, P., Rocco, M. G., Lo Vecchio, A., Pingitore, G., Grimaldi, O., Schiavino, D., Perrone, N., Antonietta Frieri, M., Di Rienzo, V., Tripodi, S., Scarpa, A., Tomsic, M., Bonaguro, R., Enrico Senna, G., Sirena, A., Turatello, F., Crescioli, S., Favero, E., Billeri, L., Chieco Bianchi, F., Gemignani, C., Zanforlin, M., Angiola Crivellaro, M., Hendrick, B., Maltauro, A., Masieri, S., Elisabetta Conte, M., Fama, M., Pozzan, M., Bonadonna, P., Casanova, S., Vallerani, E., Schiappoli, M., Borghesan, F., Giro, G., Casotto, S., Berardino, L., Zanoni, G., Ariano, R., Aquilina, R., Pellegrino, R., Marsico, P., Del Giudice, A., Narzisi, G., Tomaselli, V., Fornaca, G., Favro, M., Loperfido, B., Gallo, C., Buffoni, S., Gani, F., Raviolo, P., Faggionato, S., Truffelli, T., Vivalda, L., Albano, M., Enzo Rossi, R., Lattuada, G., Bona, F., Quaglio, L., Chiesa, A., Trapani, M., Seminara, R., Cucchi, B., Oderda, S., Borio, G., Galeasso, G., Garbaccio, P., Marco, A., Marengo, F., Cadario, G., Manzoni, S., Vinay, C., Curcio, A., Silvestri, A., Peduto, A., Riario-Sforza, G. G., Maria Forgnone, A., Barocelli, P., Tartaglia, N., Feyles, G., Giacone, A., Ricca, V., Guida, G., Nebiolo, F., Bommarito, L., Heffler, E., Vietti, F., Galimberti, M., Savi, E., Pappacoda, A., Bottero, P., Porcu, S., Felice, G., Berra, D., Francesca Spina, M., Pravettoni, V., Calamari, A. M., Varin, E., Iemoli, E., Lietti, D., Ghiglioni, D., Alessandro Fiocchi, Tosi, A., Poppa, M., Caviglia, A., Restuccia, M., Russello, M., Alciato, P., Manzotti, G., Ranghino, E., Luraschi, G., Rapetti, A., Rivolta, F., Allegri, F., Terracciano, L., Agostinis, F., Paolo Piras, P., Ronchi, G., Gaspardini, G., Caria, V., Tolu, F., Fantasia, D., Carta, P., Moraschini, A., Quilleri, R., Santelli, A., Prandini, P., Del Giudice, G., Apollonio, A., Bonazza, L., Teresa Franzini, M., Branchi, S., Zanca, M., Rinaldi, S., Catelli, L., Zanoletti, T., Cosentino, C., Della Torre, F., Cremonte, L., Musazzi, D., Suli, C., Rivolta, L., Ottolenghi, A., Marino, G., Sterza, G., Sambugaro, R., Orlandini, A., Minale, P., Voltolini, S., Bignardi, D., Omodeo, P., Tiri, A., Milani, S., Ronchi, B., Licardi, G., Bruni, P., Scibilia, J., Schroeder, J., Crosti, F., Maltagliati, A., Alesina, M. R., Mosca, M., Leone, G., Napolitano, G., Di Gruttola, G., Scala, G., Mascio, S., Valente, A., Marchetiello, I., Catello, R., Gazulli, A., Del Prete, A., Varricchio, A. M., Carbone, A., Forestieri, A., Stillitano, M., Leonetti, L., Tirroni, E., Castellano, F., Abbagnara, F., Romano, F., Levanti, C., Cilia, M., Longo, R., Ferrari, A., Merenda, R., Di Ponti, A., Guercio, E., Surace, L., Ammendola, G., Tansella, F., Peccarisi, L., Stragapede, L., Minenna, M., Granato, M., Fuiano, N., Pannofino, A., Ciuffreda, S., Giannotta, A., Morero, G., D Oronzio, L., Taddeo, G., Nettis, E., Cinquepalmi, G., Lamanna, C., Mastrandrea, F., Minelli, M., Salamino, F., Muratore, L., Latorre, F., Quarta, C., Ventura, M., D Ippolito, G., Giannoccaro, F., Dambra, P., Pinto, L., Triggiani, M., Munno, G., Manfredi, G., Lonero, G., Damiano, V., Errico, G., Di Leo, E., Manzari, F., Spagna, V., Arsieni, A., Matarrese, A., Mazzarella, G., Scarcia, G., Scarano, R., Ferrannini, A., Pastore, A., Maionchi, P., Filannino, L., Tria, M., Giuliano, G., Damiani, E., Scichilone, N., Marchese, M., Lucania, A., Marino, M., Strazzeri, L., Tumminello, S., Vitale, G. I., Gulotta, S., Gragotto, G., Zambito, M., Greco, D., Valenti, G., Licitra, G., Cannata, E., Filpi, R., Contraffatto, M., Sichili, S., Randazzo, S., Scarantino, G., Lo Porto, B., Pavone, F., Di Bartolo, C., Paternò, A., Rapisarda, F., Laudani, E., Leonardi, S., Padua, V., Cabibbo, G., Marino Guzzardi, G., Deluca, F., Agozzino, C., Pettinato, R., Ghini, M., Scurati S., Frati F., Passalacqua G., Puccinelli P., Hilaire C., Incorvaia C., D'Avino G., Comi R., Lo Schiavo M., Pezzuto F., Montera C., Pio A., Teresa Ielpo M., Cellini F., Vicentini L., Pecorari R., Aresu T., Capra L., De Benedictis E., Bombi C., Zauli D., Vanzi A., Alberto Paltrinieri C., Bondioli A., Paletta I., Ventura D., Mei F., Paolini F., Colangelo C., Cavallucci E., Cucinelli F., Tinari R., Ermini G., Beltrami V., Novembre E., Begliomini C., Marchese E., Solito E., Ammannati V., Molino G., Galli E., Baldassini M., Di Michele L., Calvani M., Gidaro M., Venuti A., Li Bianchi E., Benassi F., Pocobelli D., Zangari P., De Rocco M.G., Lo Vecchio A., Pingitore G., Grimaldi O., Schiavino D., Perrone N., Antonietta Frieri M., Di Rienzo V., Tripodi S., Scarpa A., Tomsic M., Bonaguro R., Enrico Senna G., Sirena A., Turatello F., Crescioli S., Favero E., Billeri L., Chieco Bianchi F., Gemignani C., Zanforlin M., Angiola Crivellaro M., Hendrick B., Maltauro A., Masieri S., Elisabetta Conte M., Fama M., Pozzan M., Bonadonna P., Casanova S., Vallerani E., Schiappoli M., Borghesan F., Giro G., Casotto S., Berardino L., Zanoni G., Ariano R., Aquilina R., Pellegrino R., Marsico P., Del Giudice A., Narzisi G., Tomaselli V., Fornaca G., Favro M., Loperfido B., Gallo C., Buffoni S., Gani F., Raviolo P., Faggionato S., Truffelli T., Vivalda L., Albano M., Enzo Rossi R., Lattuada G., Bona F., Quaglio L., Chiesa A., Trapani M., Seminara R., Cucchi B., Oderda S., Borio G., Galeasso G., Garbaccio P., De Marco A., Marengo F., Cadario G., Manzoni S., Vinay C., Curcio A., Silvestri A., Peduto A., Riario-Sforza G.G., Maria Forgnone A., Barocelli P., Tartaglia N., Feyles G., Giacone A., Ricca V., Guida G., Nebiolo F., Bommarito L., Heffler E., Vietti F., Galimberti M., Savi E., Pappacoda A., Bottero P., Porcu S., Felice G., Berra D., Francesca Spina M., Pravettoni V., Calamari A.M., Varin E., Iemoli E., Lietti D., Ghiglioni D., Fiocchi A., Tosi A., Poppa M., Caviglia A., Restuccia M., Russello M., Alciato P., Manzotti G., Ranghino E., Luraschi G., Rapetti A., Rivolta F., Allegri F., Terracciano L., Agostinis F., Paolo Piras P., Ronchi G., Gaspardini G., Caria V., Tolu F., Fantasia D., Carta P., Moraschini A., Quilleri R., Santelli A., Prandini P., Del Giudice G., Apollonio A., Bonazza L., Teresa Franzini M., Branchi S., Zanca M., Rinaldi S., Catelli L., Zanoletti T., Cosentino C., Della Torre F., Cremonte L., Musazzi D., Suli C., Rivolta L., Ottolenghi A., Marino G., Sterza G., Sambugaro R., Orlandini A., Minale P., Voltolini S., Bignardi D., Omodeo P., Tiri A., Milani S., Ronchi B., Licardi G., Bruni P., Scibilia J., Schroeder J., Crosti F., Maltagliati A., Alesina M.R., Mosca M., Leone G., Napolitano G., Di Gruttola G., Scala G., Mascio S., Valente A., Marchetiello I., Catello R., Gazulli A., Del Prete A., Varricchio A.M., Carbone A., Forestieri A., Stillitano M., Leonetti L., Tirroni E., Castellano F., Abbagnara F., Romano F., Levanti C., Cilia M., Longo R., Ferrari A., Merenda R., Di Ponti A., Guercio E., Surace L., Ammendola G., Tansella F., Peccarisi L., Stragapede L., Minenna M., Granato M., Fuiano N., Pannofino A., Ciuffreda S., Giannotta A., Morero G., D'Oronzio L., Taddeo G., Nettis E., Cinquepalmi G., Lamanna C., Mastrandrea F., Minelli M., Salamino F., Muratore L., Latorre F., Quarta C., Ventura M., D'Ippolito G., Giannoccaro F., Dambra P., Pinto L., Triggiani M., Munno G., Manfredi G., Lonero G., Damiano V., Errico G., Di Leo E., Manzari F., Spagna V., Arsieni A., Matarrese A., Mazzarella G., Scarcia G., Scarano R., Ferrannini A., Pastore A., Maionchi P., Filannino L., Tria M., Giuliano G., Damiani E., Scichilone N., Marchese M., Lucania A., Marino M., Strazzeri L., Tumminello S., Vitale G.I., Gulotta S., Gragotto G., Zambito M., Greco D., Valenti G., Licitra G., Cannata E., Filpi R., Contraffatto M., Sichili S., Randazzo S., Scarantino G., Lo Porto B., Pavone F., Di Bartolo C., Paterno A., Rapisarda F., Laudani E., Leonardi S., Padua V., Cabibbo G., Marino Guzzardi G., Deluca F., Agozzino C., Pettinato R., Ghini M., Scurati S, Frati F, Passalacqua G, Puccinelli P, Hilaire C, Incorvaia I, D'Avino G, Comi R, Lo Schiavio M, Pezzuto F, Montera C, Pio A, Ielpo MT, Cellini F, Vicentini L, Pecorari R, Aresu T, Capra L, De Benedictis E, Bombi C, Zauli D, and et al

Subjects
medicine.medical_specialty, Pathology, genetic structures, efficacy, Alternative medicine, Medicine (miscellaneous), Adherence, Cost, Efficacy, Side effects, Sublingual immunotherapy, Settore MED/10 - Malattie Dell'Apparato Respiratorio, sublingual immunotherapy, ALLERGEN, cost, medicine, Subcutaneous immunotherapy, Sublingual immunotherapy, adherence, Clinical efficacy, Intensive care medicine, Pharmacology, Toxicology and Pharmaceutics (miscellaneous), sublingual immunoterapy, Original Research, Asthma, AEROALLERGENS, side effects, business.industry, Health Policy, medicine.disease, Slit, eye diseases, Clinical trial, Patient Preference and Adherence, immunotherapy, sense organs, Allergists, ADHERENCE TO TREATMENT, business, Social Sciences (miscellaneous)
Abstract

Silvia Scurati1, Franco Frati1, Gianni Passalacqua2, Paola Puccinelli1, Cecile Hilaire1, Cristoforo Incorvaia3, Italian Study Group on SLIT Compliance 1Scientific and Medical Department, Stallergenes, Milan, Italy; 2Allergy and Respiratory Diseases, Department of Internal Medicine, Genoa; 3Allergy/Pulmonary Rehabilitation, ICP Hospital, Milan, ItalyObjectives: Sublingual immunotherapy (SLIT) is a viable alternative to subcutaneous immunotherapy to treat allergic rhinitis and asthma, and is widely used in clinical practice in many European countries. The clinical efficacy of SLIT has been established in a number of clinical trials and meta-analyses. However, because SLIT is self-administered by patients without medical supervision, the degree of patient adherence with treatment is still a concern. The objective of this study was to evaluate the perception by allergists of issues related to SLIT adherence.Methods: We performed a questionnaire-based survey of 296 Italian allergists, based on the adherence issues known from previous studies. The perception of importance of each item was assessed by a VAS scale ranging from 0 to 10.Results: Patient perception of clinical efficacy was considered the most important factor (ranked 1 by 54% of allergists), followed by the possibility of reimbursement (ranked 1 by 34%), and by the absence of side effects (ranked 1 by 21%). Patient education, regular follow-up, and ease of use of SLIT were ranked first by less than 20% of allergists.Conclusion: These findings indicate that clinical efficacy, cost, and side effects are perceived as the major issues influencing patient adherence to SLIT, and that further improvement of adherence is likely to be achieved by improving the patient information provided by prescribers.Keywords: adherence, sublingual immunotherapy, efficacy, cost, side effects

Published
2010

3. Burnout among behavioral health providers in integrated care settings.

Author

Zubatsky M, Runyan C, Gulotta S, Knight JR, and Pettinelli JD

Subjects
Adaptation, Psychological, Adult, Behavioral Medicine statistics & numerical data, Burnout, Professional psychology, Delivery of Health Care, Integrated statistics & numerical data, Female, Health Personnel statistics & numerical data, Humans, Job Satisfaction, Male, Middle Aged, Resilience, Psychological, Surveys and Questionnaires, Behavioral Medicine standards, Burnout, Professional etiology, Delivery of Health Care, Integrated standards, Health Personnel psychology
Abstract

Introduction: Burnout in health care, especially among physicians, is a growing concern. It is now well accepted that physician burnout leads to increased depersonalization of patients, lower personal accomplishment, employee turnover, and worse patient outcomes. What is not known, however, is to what extent behavioral health providers (BHPs) in medical settings experience burnout and its associated sequela., Method: Participants ( n = 230) from a variety of practice settings and levels of integrated care completed practice and burnout questions via an online survey. Practice-related questions and a modified version of the Maslach Burnout Inventory was administered to BHPs who work in different levels of collaboration with other medical providers., Results: Overall, BHPs who work primarily in fully integrated care settings reported higher rates of personal accomplishment in their everyday job (B = 1.49; 95% confidence interval [CI] = 0.40, 2.58). Additionally, those who have worked more than 10 years in these types of settings reported both higher personal accomplishment (B = 1.58; 95% CI = 0.68, 2.49) and lower rates of depersonalization (B = -1.32; 95% CI = -2.28, -0.36)., Discussion: In contrast to high rates of burnout among many clinicians in the United States, this is the first study to document relatively low rates of reported burnout among integrated care BHPs. The relationships between lower burnout, working in a fully integrated care practice, and experience as a BHP is important to understand when creating and sustaining team-based primary care jobs. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Published
2020
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4. Analysis of intraoperative coronary angiography in aortocoronary bypass grafts.

Author

Kaplitt MJ, Frantz SL, Beil AR Jr, Stein HL, and Gulotta SJ

Subjects
Angina Pectoris diagnostic imaging, Angina Pectoris surgery, Blood Flow Velocity, Blood Pressure, Coronary Circulation, Electromagnetic Phenomena, Fluoroscopy, Humans, Angiocardiography classification, Coronary Angiography, Coronary Artery Bypass
Published
1974

5. Management of preinfarction angina. Evaluation and comparison of medical versus surgical therapy in 43 patients.

Author

Berk G, Kaplitt M, Padmanabhan V, Frantz S, Morrison J, and Gulotta SJ

Subjects
Aged, Angina Pectoris etiology, Angina Pectoris surgery, Angiography, Cardiac Catheterization, Coronary Disease complications, Coronary Disease surgery, Coronary Disease therapy, Evaluation Studies as Topic, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Risk, Saphenous Vein transplantation, Transplantation, Autologous, Angina Pectoris therapy
Abstract

Short-term results of aggressive surgical management were compared with results of medical management in forty-three patients with preinfarction angina admitted to the coronary-care unit (CCU) over an 18 month period. These patients were selected from 1,609 consecutive admissions to the CCU because they met strict criteria for preinfarction angina: severe chest pain at rest, ST-segment elevation or depression during pain which subsided rapidly after cessation of pain, and normal serum enzymes (CPK, SGOT, and LDH). Twenty-three patients had coronary angiography, done with operating room and pump standby. One patient, who had total occlusion of the left main coronary artery, died during the study. Twenty-one of the remaining patients were considered surgical candidates, and were treated immediately after angiography with 1 to 3 vein bypass grafts. There was one late postoperative death and, of the 20 survivors, 2 had ECG evidence of acute myocardial infarction and one had mild angina at time of discharge. In contrast, of the 21 patients treated medically, 13 sustained acute MI, resulting in 8 instances of congestive heart failure and 4 cases of ventricular fibrillation. Four patients died in cardiogenic shock. With the use of rigid criteria, a small subgroup of patients with variant angina at high risk of developing AMI has been identified and categorized as having preinfarction angina. Our experience suggests that aggressive surgery immediately following coronary angiography offers a lower incidence of MI, morbidity, and death than does medical management.

Published
1976

6. The syndrome of systolic click, murmur, and mitral valve prolapse--a cardiomyopathy?

Author

Gulotta SJ, Gulco L, Padmanabhan V, and Miller S

Subjects
Adolescent, Adult, Angiography, Cardiac Catheterization, Cardiomegaly complications, Coronary Angiography, Electrocardiography, Endocarditis, Subacute Bacterial complications, Female, Heart Block complications, Heart Valve Diseases diagnosis, Heart Ventricles, Humans, Male, Middle Aged, Myocardial Infarction complications, Angina Pectoris etiology, Arrhythmias, Cardiac etiology, Heart Valve Diseases complications, Mitral Valve, Phonocardiography
Published
1974
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8. Transvenous cardiac pacing. Technics for optimal electrode positioning and prevention of coronary sinus placement.

Author

Gulotta SJ

Subjects
Aged, Coronary Angiography, Electrocardiography, Female, Fluoroscopy, Humans, Male, Microelectrodes, Cardiac Catheterization instrumentation, Cardiac Pacing, Artificial methods, Coronary Vessels anatomy & histology, Coronary Vessels physiology
Abstract

Optimal electrode position for long-term transvenous cardiac pacing is in the apex of the right ventricle. Intracardiac electrograms, surface electrocardiograms, frontal fluoroscopy, lateral roentgenograms, and pacing threshold levels were studied in two groups of patients: One group was comprised of five patients with permanent pacemakers who had inadvertent malplacement of the pacing catheter, and the second group was composed of six patients undergoing temporary pacing from selected sites within the coronary venous system. The results of this study indicate that the appearance of a characteristic right ventricular endocardial complex recorded from the catheter tip is the most reliable guide to proper electrode placement. Low threshold levels, good position demonstrated roentgenographically, and typical surface electrocardiographic patterns of left bundle-branch block were all noted during intentional and following inadvertent malpositioning of the electrode within the coronary venous system and do not, therefore, guarantee proper positioning. A successful routine for pacemaker insertion has been established which includes fluoroscopy, lateral roentgenograms, intracardiac and surface electrocardiograms, and threshold analysis. Satisfaction of all these tests appears to insure proper electrode positioning.

Published
1970
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10. Coexistent idiopathic hypertrophic subaortic stenosis and coronary arterial disease.

Author

Gulotta SJ, Hamby RI, Aronson AL, and Ewing K

Subjects
Age Factors, Aged, Angina Pectoris drug therapy, Angiocardiography, Arteries, Blood Pressure drug effects, Cardiac Catheterization, Cardiomyopathy, Hypertrophic diagnosis, Cineangiography, Coronary Disease diagnosis, Coronary Vessels surgery, Female, Heart Ventricles physiopathology, Humans, Isoproterenol pharmacology, Male, Middle Aged, Nitroglycerin pharmacology, Papillary Muscles physiopathology, Propranolol therapeutic use, Cardiomyopathy, Hypertrophic complications, Coronary Disease complications
Published
1972
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