A new device to seal large coronary aneurysms: a case report

<p>Abstract</p> <p>Introduction</p> <p>Coronary artery aneurysm is an uncommon disease. It is defined as a coronary artery dilatation, exceeding the diameter of the normal adjacent segment or the diameter of the patient's largest coronary vessel by 1.5 to 2 times. Coronary artery aneurysms are typically diagnosed by coronary angiography. The prognosis of coronary artery aneurysm is not well known and the management is challenging.</p> <p>Case presentation</p> <p>A 68-year-old Italian-Caucasian man presented to our hospital with angina. Coronary angiography revealed a large coronary aneurysm of the right coronary artery, which was successfully treated by the percutaneous implantation of an MGuard™stent.</p> <p>Conclusion</p> <p>This case report provides evidence that coronary artery aneurysms, even if very large, can be safely treated by MGuard™stent implantation. We strongly emphasize the high flexibility and good deliverability of this device, which leads to the complete exclusion of the aneurysm mediated by the process of endothelization of its thin mesh sleeves.</p

Follow-up of internal mammary artery stent with 64-slice CT

We present a case of 81-year-old woman complaining chest pain after minimal efforts who underwent multiple coronary artery bypass grafts (CABGs) during the last 15 years. A significant in-stent re-stenosis was found at ostium of left internal mammary artery (LIMA). A non-invasive CT coronary angiography (CT-CA) was performed after 6-month follow-up. CT-CA is a reliable non-invasive technique for the follow-up of stents in coronary artery bypass grafts

Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

BACKGROUND: Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes. METHODS: We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization. RESULTS: During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. CONCLUSIONS: Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .)

Verso una didattica inclusiva: il ruolo dell' Educazione Fisica

L\u2019educazione fisica puo\u2019 contribuire in modo significativo alla integrazione e alla inclusione di tutti i bambini. Infatti, attraverso le situazioni di movimento educativamente orientate ricrea occasioni privilegiate di comunicazione, relazione e collaborazione tra tutti i soggetti che vi partecipano, nel rispetto di tutte le possibili differenze di genere, di provenienza e di abilit\ue0. Questo contributo si pone l\u2019obiettivo di far riflettere l\u2019educatore su due percorsi didattici lungo i quali l\u2019inclusione viene spontaneamente facilitata: il primo si sviluppa attraverso la scoperta delle differenti situazioni comunicative verbali e non verbali mentre il secondo privilegia l\u2019utilizzo delle situazioni indotte dalle attivit\ue0 e dai giochi di movimento cooperativi e di socializzazione. La scuola del domani dovr\ue0 valorizzare queste opportunit\ue0 da ricreare non solo nelle ore curricolari di educazione fisica, ma anche nei momenti di pausa e negli spazi informali (ambiente naturale, corridoi, palestre) che consentono l\u2019attuazione di una didattica incorporata come valida alternativa e integrazione alla classica didattica statica che solitamente avviene nelle aule. Per concludere vengono infine proposti alcuni spunti operativi utili all\u2019integrazione degli alunni disabili durante le ore di attivit\ue0 ludico-motorio-sportiva.Physical education (PE) might significantly contribute to the promotion of the phenomena of integration and inclusion among children. In fact, through educationally-oriented movement experiences, PE recreates privileged opportunities for communication, relationship and collaboration among participants, while respecting all the gender differences, backgrounds and abilities. This contribution aims at encouraging the educator to reflect on two different didactic approaches which tend to facilitate the inclusion spontaneously: the first is based on the progressive discovery of different verbal and non-verbal communicative situations, while the latter privileges the adoption of situations induced by cooperative and social movement activities and games. In the school of the future particular care should be given to reward these opportunities not merely in the curricular PE hours but also during daily breaks and in informal spaces (e.g. courtyards, corridors, gymnasiums), which might allow the implementation of an embodied didactics as a valid alternative and/or support to the classic static didactics, usually adopted in classrooms. Lastly, some helpful cues to promote the integration of disabled pupils in leisure-motor sport activities are also included in this contribute

RE response to: "Entacapone, Parkinson's disease, "functional adrenergic denervation", and Takotsubo syndrome"

About Parkinson disease and Tako Tsubo syndrom

Clinical applications of cardiac CT

During the past few years, cardiac CT (CCT) has acquired an increasingly important role as a non-invasive imaging method that allows assessment of coronary heart disease from both the morphological and the functional standpoint. It is quickly becoming a primary clinical tool for the evaluation and follow-up of various conditions related to the heart and great vessels and is providing valuable insight into the natural history of atherosclerosis. The rapid advances in CCT technology, the advent of new clinical applications, and the acquisition of data on prognostic value are just some of the reasons for the publication of this new edition of "Clinical Applications of Cardiac CT", little more than 3 years after the first edition appeared. The text has been extensively revised and updated to reflect current knowledge and practice, and the structure and layout of the educational content have also been improved. The imaging targets, semeiology, technique, and clinical application of CCT are all covered in detail, and in addition relevant information is provided on epidemiology, clinical assessment, and the role of other diagnostic modalities. This book will prove an invaluable tool for radiologists and cardiologists alike.During the past few years, cardiac CT (CCT) has acquired an increasingly important role as a noninvasive imaging method that allows assessment of coronary heart disease from both the morphological and the functional standpoint. It is quickly becoming a primary clinical tool for the evaluation and follow-up of various conditions related to the heart and great vessels and is providing valuable insights into the natural history of atherosclerosis. The rapid advances in CCT technology, the advent of new clinical applications, and the acquisition of data on prognostic value are just some of the reasons for the publication of this new edition of Clinical Applications of Cardiac CT, little more than 3 years after the first edition appeared. The text has been extensively revised and updated to reflect current knowledge and practice, and the structure and layout of the educational content have also been improved. The imaging targets, semeiology, technique, and clinical applications of CCT are all covered in detail, and in addition relevant information is provided on epidemiology, clinical assessment, and the role of other diagnostic modalities. This book will prove an invaluable tool for radiologists and cardiologists alike