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Aim: To assess the impact to their short-term prognosis of the system time delay to primary percutaneous coronary intervention (pPCI) in patients with STEMI. Methods: Retrospective analysis of documentation of 340 patients with STEMI and primary PCI in the Prešov Cardiocentre in 2014. Short-term prognosis in patients was studied in three indicators: in-hospital mortality, in-hospital cardiac decompensation and systolic left ventricular function judged by echocardiography during hospitalisation. Chí-quadrat tests (χ2) and Fisher exact test, analyses of variance or Mann-Whitneyho U test were calculated to test association between variables. Results: According to the latest guidelines laid down by the European Society of Cardiology (ESC) and by the Slovak Society of Cardiology (SKS), the system delay (refers to time delay from first medical contact to primary PCI) should be less than 120 minutes. A longer system delay had significant negative impact on short-term prognosis of patients including their in-hospital mortality (3.9% vs 10%, p=0.028) and in-hospital signs of acute heart failure (21.3% vs 39.1%, p=0.001). The impact of longer system delay on left ventricular systolic function was statistically not significant. The time delay in cardiocentre was acceptable since the median of door-to-balloon (D2B) interval was only 25 minutes (±13.4). There was no significant difference in short-term prognosis between study groups with D2B within 30 minutes in comparison to the group with D2B over 30 minutes as to mortality, heart failure and ejection fraction. Conclusion: Longer system delay for primary PCI (over 120 minutes) has a significant negative impact on short-term prognosis patients including their in-hospital mortality and in-hospital appearance of acute heart failure. The most important subperiod responsible for time delay was the "FMC-to-door" interval. [ABSTRACT FROM AUTHOR]

Diuretics are an essential and regular part of the treatment of symptomatic heart failure patients regardless of left ventricular systolic function. The objective of diuretic administration is to remove the congestion which is not only the dominating cause of the symptoms and signs of heart failure but also an important factor of adverse remodeling and progression of myocardial dysfunction. Patients with persistent or recurrent symptoms of congestion have a poor prognosis. On the other hand a higher mortality was observed in the patients with high doses of diuretics. A principle of safe and effective diuretic therapy is to maintain the optivolemic state using the lowest possible doses. The practical implementation of this principle is difficult because of the low sensitivity and specificity of the clinical examination for the detection and quantification of congestion, and also because of the unconstant diuretic response for the same dose of drug. The dosage of diuretics should therefore be flexible, with regular monitoring of electrolytes and renal function, particularly after the change of doses of diuretics, ACE inhibitors and aldosterone receptor antagonists. The review article is devoted to the mechanism of the action, hemodynamic and metabolic effects of diuretics in general, and their individual classes. The authors discuss the views and evidence on the effect of diuretics on the survival of patients with heart failure and perspectives for optimizing their use. [ABSTRACT FROM AUTHOR]

This work describes finding of 23 dead specimens of European rhinoceros beetle (Oryctes nasicornis) that emerged from a stump in the center of Olomouc city. The stump was situated on an unsheltered place which, in a combination with extremely hot and dry weather, apparently caused mortality of these beetles. [ABSTRACT FROM AUTHOR]

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L'anemia è una frequente complicanza dell'insufficienza renale cronica (IRC), per il cui trattamento gli strumenti principali sono gli agenti stimolanti l'eritropoiesi (ESA) e la supplementazione marziale. La terapia marziale per via endovenosa è stata ultimamente oggetto di regolamentazione (e limitazione) da parte delle agenzie del farmaco europea e italiana, in quanto associata a gravi (anche se rari) eventi avversi. Una recente analisi di dati provenienti dallo studio Dialysis Outcomes and Practice Patterns Study (DOPPS) ha mostrato un'associazione tra elevata supplementazione marziale per via endovenosa (superiore a 300 mg/mese) e aumentata mortalità, nei pazienti con valori di emoglobina superiori a 10 g/dL. Le nuove molecole disponibili in commercio dovrebbero presentare un migliore profilo di sicurezza e vantaggi legati alla possibilità di somministrare elevate dosi di ferro in un'unica occasione. La possibilità di fornire supplementazione marziale attraverso il dialisato e con l'assunzione di nuovi chelanti del fosforo dimostra il grande fervore scientifico che oggi caratterizza questo importante ambito clinico, anche per i nostri pazienti con IRC.

L'associazione tra un'attività sportiva regolare (fitness) e la mortalità è ormai una definitiva certezza nella letteratura scientifica. Obiettivo di questa revisione è di approfondire le evidenze scientifiche esistenti circa l'associazione tra la consuetudine dì fitness e la tendenza a sviluppare patologie croniche non fatali renali e cardiache. Se, infatti, è assodato che la capacità funzionale cardio-respiratoria di un soggetto adulto è, in qualche misura, in funzione dell'attività fisica svolta nel corso della vita, si può postulare che un ragionamento analogo valga anche per la funzione renale? (Cardionephrology)

Numerose evidenze cliniche e di laboratorio suggeriscono una relazione stretta tra le alterazioni del metabolismo minerale (oggi chiamate Chronic Kidney Disease Mineral Bone Disorders, CKD-MBD) e i marker di danno cardiovascolare e di malattia ossea nell'insufficienza renale cronica. Anche se i meccanismi non sono stati ancora completamente chiariti, si ritiene che l'associazione con la malattia cardiovascolare, in particolare con le calcificazioni vascolari, rappresenti una valida spiegazione dell'incremento del rischio di morte o di progressione verso l'insufficienza renale cronica terminale associata alle alterazioni del metabolismo minerale. In questo articolo si vogliono riassumere le evidenze scientifiche che suggeriscono il legame tra metabolismo del fosforo, danno d'organo e sopravvivenza nell'insufficienza renale cronica.

BACKGROUND: Problem gambling is associated with a high prevalence of psychiatric comorbidity and suicidality, which substantially contributes to the mortality of problem gamblers. AIMS: To explore the mortality rate of problem gamblers and contribution of suicides to its structure. METHODS: A database-linkage retrospective cohort mortality study of persons hospitalised in psychiatric facilities with diagnosis of pathological gambling (dg. F63.0 according to ICD-10) in the CR in 1994-2011 was performed. The National Register of Hospitalisations and the Death Information System were data sources. The Indirect standardisation was performed and the Standardised Mortality Ratio (SMR) was computed. The mortality structure in the sample was compared with that of the general population in the 1994-2011 after adjusting for gender and age. RESULTS: There were 7,704 individuals in the cohort, of whom 7,215 (93.7%) were males and 489 (6.3%) females, with the mean age of 33.2 years, (males 32.7, females 40.5). The total person- time of observation was 64,370 person-years. In total, 547 persons died (516 males, 31 females). The mean annual crude mortality rate was 8.50/1,000 persons (8.44 in the males, 9.63 in the females). The central estimate of SMR was approximately 2 over the years, slightly higher in females. External causes of death predominated in the crude mortality structure of the hospitalised gamblers (44.6%), most of whom were suicides (26.7% of all the deaths). The adjusted (for gender and age) proportion of suicides was 3.4 times higher than in the general population. CONCLUSION: Suicidality represents a considerable part of clinical picture of gambling disorder and significantly determines mortality of disordered gamblers. Attention should be paid to the risk of suicides in disordered gamblers in treatment. [ABSTRACT FROM AUTHOR]

Copyright of Monaldi Archives for Chest Disease is the property of PAGEPress and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: To obtain information about the progress and results of treatment of aortic dissection in the present. Methods: We performed a retrospective analysis of 38 patients with aortic dissection who were hospitalized in our department for the last 10 years, from 2003 until the end of 2012. Results: There were 22 patients with type A aortic dissection according to the Stanford classification, with type B dissections 16. The age in both groups was similar 65 or 66 years, males predominated over women. Arterial hypertension clearly dominated of the risk factors in both groups. In one case we recorded an iatrogenic cause. Our patients most often presented with chest pain, in the second group with backache and stomachache as well. Precordial murmur was dominated in physical finding in the first group, while most patients in the second group had no physical findings. Pulse deficits were a rare find. The computed tomography was the most used diagnostic method. Level of D-dimer was high on average, but we recorded low values in patients with symptoms lasting longer than 24 hours. Complications associated with aortic dissection were more common in the first group. 18 patients of 38 died (47%). There were 22 patients who underwent surgery or interventional procedures with 30-day mortality 32%, which was at the time a downward trend. Conclusion: Aortic dissection is currently associated with an acceptable operating decreasing mortality. The predominant clinical sign is sudden pain. The preferred diagnostic method is CT aortography. The recommended biochemical marker is plasma levels of D-dimer with a cutoff value of > 500 ng/ml. A negative value does not exclude aortic dissection. [ABSTRACT FROM AUTHOR]

The renin-angiotensin-aldosterone system (RAAS), essential for the regulation of blood pressure, cardiovascular and renal function, is a key therapeutic target in hypertension. A series of the latest metaanalyses from large hypertension trials has shown that RAAS inhibitors significantly reduce relative risk for all-cause and cardiovascular mortality. Separately, angiotensin-converting enzyme (ACE) inhibitors produce a significant reduction in relative risk for all-cause mortality and a trend toward a significant reduction in cardiovascular mortality, whereas angiotensin II receptor blockers (ARBs) have no effect. All meta-analyses almost consistently have found that, while ACE inhibitors prevent coronary events with reductions in cardiovascular morbidity and all-cause mortality, ARBs are, at best, efficient only for the prevention of stroke. These results provide proof of clear differences in the cardioprotection afforded by these two antihypertensive classes. The evidence from meta-analyses suggests that in hypertension ACE inhibitors should be considered ahead of ARBs, and ARBs restricted to patients intolerant of ACE inhibitors. [ABSTRACT FROM AUTHOR]

Oggigiorno, è opinione comune che, rispetto all'emodialisi standard (HD), l'emodiafiltrazione on-line (HDF) possa consentire migliori risultati in termini di tolleranza intradialitica, stato nutrizionale, mantenimento della funzione renale residua, responsività all'eritropoietina e controllo della fosforemia. Tuttavia, finora, gli studi controllati non sono stati in grado di dimostrare la superiorità dell'HDF nel ridurre la morbilità e la mortalità. Due recenti studi prospettici, randomizzati e controllati, il “Convective Transport Study” (CONTRAST) e il “Comparison of Post-dilution Online Haemodiafiltration and Haemodialysis” (TURKISH OL-HDF STUDY), hanno confrontato la sopravvivenza e gli eventi cardiovascolari in HDF e in HD. Benché fossero studi ampi e appositamente disegnati per valutare questo importante outcome, non è stato possibile trovare differenze significative tra i due trattamenti (HDF vs HD low-flux nel CONTRAST e HDF vs HD high-flux nel TURKISH STUDY). In analisi post-hoc, entrambi gli studi hanno mostrato come alti volumi convettivi fossero associati a una migliore prognosi, anche se questi risultati devono essere considerati solo “generatori di ipotesi” e necessitano di essere testati in adeguati trial. I risultati derivanti dallo studio spagnolo e francese, non ancora pubblicati, ci aiuteranno a comprendere meglio l'importanza dell'HDF nella pratica clinica quotidiana.

Il calciomimetico Cinacalcet è ormai in uso da alcuni anni per il trattamento dell'iperparatiroidismo secondario (IPTS) nei pazienti dializzati, permettendo una buona riduzione dei livelli di paratormone. Nell'ottica di valutare un suo possibile effetto benefico nel migliorare la prognosi cardio-vascolare dei pazienti dializzati, è stato condotto lo studio randomizzato “Evaluation of Cinacalcet Hydrochloride Therapy to Lower Cardiovascular Events” (EVOLVE). Sono stati randomizzati a ricevere Cinacalcet o placebo 3883 pazienti dializzati affetti da iperparatiroidismo secondario moderato-severo, valutando come end-point compositi primari la mortalità e gli episodi di infarto mio-cardico, l'ospedalizzazione per angina instabile, lo scompenso cardiaco ed eventi vascolari periferici. Nell'analisi “intention-to-treat”, a causa di una bassa potenza statistica, non sono state rilevate differenze significative tra i due bracci dello studio, a fronte di una più elevata incidenza di ipocalcemia, nausea e vomito nei soggetti in terapia con il calciomimetico. I dati dello studio EVOLVE hanno sicuramente deluso la comunità nefrologica, che si sarebbe aspettata dei risultati positivi. La mancanza di risultati conclusivi e i costi elevati suggeriscono un uso giudizioso del Cinacalcet. Non di meno, anche se mancano dati conclusivi su “hard end-point”, ci sembra poco saggio negare strategie terapeutiche che includano il Cinacalcet ai pazienti con severo IPTS con elevati livelli di PTH (PTH >800 pg/mL) refrattari alla terapia standard e/o ipercalcemia e/o calcifilassi e/o elevato rischio chirurgico alla paratiroidectomia.

This article is a comparative analysis of two "chronicles" of contemporary monasteries of women: the Poor Clares of Santa Maria di Monteluce in Perugia and the Dominican Nuns of Santa Caterina in Pistoia. It attempts to make the best use of the chronicles' demographic data covering the 16th -- 18th centuries, especially with respect to trends in the mortality rate of religious women, the causes of death, and the frequency of taking the veil and professing vows. Finally, it is a question of proposing a methodology that can generate glimmers of interest in historical-religious demography with respect to the health status of communities and the development within each religious family from one generation to the next. [ABSTRACT FROM AUTHOR]

Nel presente lavoro viene riportato il risultato del rilevamento degli spiaggiamenti e dei rinvenimenti in mare di Cetacei avvenuti negli anni 2006 - 2011 lungo le coste della Campania. I dati sono stati raccolti in base ad una collaborazione scientifica tra l’Università degli Studi di Napoli Federico II, l’Istituto Zooprofilattico Sperimentale del Mezzogiorno, il Centro Studi Cetacei e il Centro Studi Ecosistemi Marini, collaborazione, che nel 2008 è stata ratificata da un protocollo di intesa finalizzato agli interventi sui Cetacei spiaggiati lungo le coste della Campania. Nel 2009 la Giunta Regionale della Campania, su richiesta del Settore Veterinario dell’Assessorato alla Sanità, ha decretato la “Costituzione di un Comitato di Coordinamento per l’attuazione del protocollo di intesa per gli interventi in caso di Cetacei e tartarughe spiaggiate” formato dai rappresentanti dei citati enti, delle AA.SS.LL. costiere, della Direzione Marittima di Napoli e dell’A.R.P.A.C. al fine di approvare le linee guida relative alla procedura operativa da adottarsi in caso di intervento per il recupero di carcasse di Cetacei spiaggiati. In totale sono stati raccolti i dati riguardanti 73 esemplari di almeno 6 specie, così suddivisi: 1 Balaenoptera acutorostrata; 4 Balaenoptera physalus; 2 Grampus griseus; 1 Delphinus delphis; 9 Tursiops truncatus; 40 Stenella coeruleoalba; 10 Delfinidi indeterminati e 6 Cetacei indeterminati. Si riporta anche il primo caso di mal rossino diagnosticato in un esemplare di Stenella striata mai segnalato prima per le coste dell’Italia continentale.

Copyright of Remedia is the property of Medical Tribune CZ, s.r.o. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article presents a case study of the population of Gela, Italy which depicted excess mortality and morbidity risks due to emissions from local petrochemical plant. Standardized Mortality Ratios (SMRs) for specific causes were calculated by using the mortality rates. Hospitalization risks were conducted by job and residence subcohorts. The article discusses the need of thorough investigations into the occupational and environmental sources of exposure in the area.

Copyright of La Medicina del Lavoro is the property of Mattioli 1885 SpA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of La Medicina del Lavoro is the property of Mattioli 1885 SpA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Obesity is associated with low inflammatory activity and is a risk factor for severe cardiovascular and metabolic diseases. The occurrence of cardiovascular diseases in rheumatoid arthritis is two times higher than in the general population. Rheumatoid arthritis is associated with an unfavourable metabolic condition - chronic inflammation, and lack of exercise causes loss of muscle mass and increased accumulation of adipose tissue. This condition is referred to as rheumatoid cachexia or sarcopenic obesity and occurs in individuals with increased or mainly with normal body mass index. Obesity in rheumatoid arthritis affects many aspects. It can be a potential risk factor for seronegative subset of the disease. Obese patients with rheumatoid arthritis tend to have more active disease course and worse quality of life. On the other hand, there is some evidence that obese patients with rheumatoid arthritis have less joint erosions, and slower structural progression. The higher incidence of cardiovascular disease and increased mortality in rheumatoid arthritis are probably not directly dependent on the body mass index, but rather dependent on the inflammatory activity of the disease. On the contrary, very thin patients appear to be the more vulnerable group. The aim of this review is to summarize the relationship between obesity, the severity of rheumatoid arthritis and cardiovascular risk profile in the context of new knowledge on the role of adipokines in the pathogenesis of metabolic and inflammatory diseases. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to determine the levels of TFF1 in paediatric patients with SIRS or a septic condition compared with healthy population levels. The second goal was to compare the levels of TFF1 within the individual septic conditions and the impact of this protein levels on mortality. Design: Prospective observational study. Setting: Department of Anaesthesiology and Intensive Care Medicine, University Hospital. Materials and methods: The study included 57 children aged 0-19 years (30 boys and 27 girls), hospitalized from June 2009 to March 2011, with expected or proven SIRS and a septic condition. The degree of severity was evaluated according to PELOD Score. Blood tests to determine TFF factor levels were taken throughout the period when the patients were meeting the SIRS or sepsis criteria. The control samples were obtained by collecting serum TFF levels from patients undergoing elective surgery. Results:TFF1 levels in patients with SIRS or any septic condition were higher than in the control group. TFF1 cut-off for the first day was 2.44 ng/ml, AUC 0.668, p = 0.002, for the third day 1.82 ng/ml, AUC 0.733, p < 0.001 and for the fifth day 1.33 ng/ml, AUC 0.749, p < 0.001. TFF1 levels in patients with septic shock/MODS were higher than in other groups (p =0.038), but without apparent dynamics of this protein within five days. Patients who were hospitalized for more than 10 days had significantly higher levels of TFF1, p = 0.032. Conclusion: We demonstrated increased expression of protein Trefoil factor 1 during sepsis in the paediatric population. [ABSTRACT FROM AUTHOR]

Muggia is a town situated between Trieste and Koper in the upper Adriatic. It belonged to the Venetian Republic of San Marco and then, after the Napoleonic Wars, it came under the rule of the Austro-Hungarian Empire. Originally a small fishing village, it experienced industrial and demographic growth with the development of its shipyards, and in this it followed, albeit on a smaller scale, the fate of the nearby city of Trieste. Imperial regulations mandated that parish priests were to serve as civil registrars and that all death records (liber mortuorum) were to report the cause of each death, as communicated by the physician. This article examines the causes of death in the town of Muggia over a fairly homogenous period of time, up to the end of World War I. The main causes of death during this time include infectious diseases, both acute (see the town's contribution to the last cholera epidemic in 1886) and chronic (bronchopulmonary diseases and tuberculosis appear as a constant cause of death over the years). There was the usual high rate of child mortality, as well as workplace accidents or at any rate violent deaths, and a broad range of poorly delineated chronic conditions of diverse origin (neoplastic, malnutritional), which accounted for all those deaths whose definition was no longer of medical concern. [ABSTRACT FROM AUTHOR]

Prostate cancer is one of the most common malignancies in the world; more and more men are being diagnosed with prostate cancer worldwide. According to epidemiological studies, prostate cancer will become the most common male cancer by 2010, with 900,000 cases per year. Nevertheless, although the constant increase in incidence, knowledge about the aetiology and risk factors of this tumour is still poor. Several important issues could foster the understanding and prevention of this disease, such as the variation in incidence of prostate cancer between ethnic populations, studies on migrants, dietary and genetic factors. Here we provide an update on epidemiology and risk factors of prostate cancer. [ABSTRACT FROM AUTHOR]