The authors' reply

We appreciate Dr West's comments on our paper1; he has given us the opportunity to clarify some points that seem unresolved

Multivessel revascularisation in ST-elevation myocardial infarction: Too early to change the guidelines

Multivessel revascularisation in ST-elevation myocardial infarction: too early to change the guideline

Treatment of Common Femoral Artery Lesions Involving the Superficial and Profunda Femoral Artery Bifurcation: Is the Snow Too Melted to Plow With New Endovascular Devices?

Surgical endarterectomy for common femoral artery bifurcation obstructive atherosclerotic disease repre- sents the "gold standard" therapy, with excellent long-term results and minimal complications. On the other hand, recent advances in endovascular therapy have led to a safer and similar effective results, with a potential reduction in hospital stays, quicker recovery to normal functional status, good short- and long-term clinical outcomes, and consequent lower morbidity and mortality. Percutaneous directional atherectomy and intravascular lithotripsy are game-changer medical devices for the treatment of peripheral arterial disease related to complex and severely calcific atherosclerotic plaque encroaching the common femoral artery bifurcation segment. The application of these devices, technical execution, and clinical experience is reported in two exemplary cases

Relazione tecnica sistema di comunicazione multiprotocollo con FTDI UM232H

In this paper a system that allows a computer or an embedded system to easily communicate with devices which implement the usual standard communication protocols is proposed. The system consists of a hardware device and a software application. The hardware component is based on the FTDI FT232H chip, a single channel USB to serial/parallel port converter which can be configured in a variety of industrial standard serial or parallel interfaces. The software application manages the hardware component and provides a user friendly graphical user interface which allows the customers to choose the desired protocol, to configure some protocol and message parameters, and to communicate with their devices. Therefore, the system can be used without knowing programming languages and/or protocol characteristics

Clinical and anatomical variables associated in the literature to limb graft occlusion after endovascular aneurysm repair compared to the experience of a tertiary referral center

Introduction: Limb graft occlusion (LGO) is the third reason for hospital readmission after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm. We reviewed the clinical features, incidence, anatomical and devices related predictive factors for LGO after EVAR, and compared them with our experience. Evidence acquisition: EVAR between 2010-2017 were included. Patients with LGO (LGO group) were matched for age and type of endograft with the rest of the entire cohort without LGO (control group). Clinical, anatomical, operative, outcome, and follow-up data were collected. Evidence synthesis: Two hundred seventy-six EVAR, (30 aorto-uniliac), 276 patients. The incidence of LGO was 2.5% (seven limbs, seven patients) at 27±24.6 days. Symptomatic patients were successfully treated. No mortality, limb loss, critical limb ischemia or residual claudication due to LGO was observed. Fifty patients resulted from the matching. Among the predictive factors of LGO between the two groups, significant differences were observed in graft limb oversizing ≥15% (57.1% vs. 8%, P=0.005), or kinking (42.9% vs. 2%, P=0.01), and diameter of the aortic bifurcation <20 mm (71.4% vs. 20%, P=0.01). Logistic regression analysis showed that these three variables increased the risk of LGO (P=0.003, P=0.006, and P=0.01, respectively). Conclusions: The strongest predictive factors of LGO issued from our review were: extension in the external iliac artery, or small diameter; tortuous, angled, and calcific iliac axis; excessive oversizing of the limb graft, or kinking; use of old generation devices; EVAR performed outside the instructions for use. Limb graft oversizing >15%, or kinking, and aortic bifurcation <20 mm appear to be independent predictive factors of LGO

Acute myocardial infarction with occlusion of all three main epicardial coronary arteries: When Mother Nature takes care more than physicians

Double-arterial coronary stent thrombosis in acute myocardial infarction (AMI) is an infrequent but severe complication, especially when the third main coronary artery is chronically occluded. The conus artery (CA) can serve as a major source of collateral when the left anterior descendent coronary artery (LAD) becomes obstructed. We report a case of a 48-year-old man presenting with AMI due to a very late double-arterial stent thrombosis (ST) following drug-eluting stent implantation and a chronic occlusion of LAD collateralized by a large anomalous CA, which provided for the entire vascularization of the coronary tree. © 2010 Springer

Hot-Carrier Degradation in Power LDMOS: Selective LOCOS-Versus STI-Based Architecture

In this paper, we present an analysis of the degradation induced by hot-carrier stress in new generation power lateral double-diffused MOS (LDMOS) transistors. Two architectures with the same nominal voltage and comparable performance featuring a selective LOCOS and a shallow-trench isolation are investigated by means of constant voltage stress measurements and TCAD simulations. In particular, the on-resistance degradation in linear regime is experimentally extracted and numerically reproduced under different stress conditions. A similar amount of degradation has been reached by the two architectures, although different physical mechanisms contribute to the creation of the interface states. By using a recently developed physics-based degradation model, it has been possible to distinguish the damage due to collisions of single high-energetic electrons (single-particle events) and the contribution of colder electrons impinging on the silicon/oxide interface (multiple-particle events). A clear dominance of the single-electron collisions has been found in the case of LOCOS structure, whereas the multiple-particle effect plays a clear role in STI-based device at larger gate-voltage stress

Epidemiology, patient profile, and health care resource use for hepatitis C in Italy

The objectives of this study were to estimate the prevalence of Hepatitis C among six Italian Local Health Units (LHUs), to describe patient and antiviral drug characteristics, and to estimate the health care consumption rates and related costs for the management of patients affected by hepatitis C virus (HCV) infection by using data from routine clinical practice

Numerical Simulation and Experimental Characterization of Emitter Wrap through Solar Cells with Deep Grooved Base Contact (EWT-DGB)

Abstract In this work we present an Emitter Wrap Through cell with Deep Grooved Base contact (EWT-DGB), designed for both 1-sun and concentrating applications. The proposed approach, which consists in a deep grooved hole array composed by holes of two alternating doping type, allows both a reduction of the cell series resistance and an increase in collection efficiency also by using relatively thick substrates with low lifetime. The measured experimental data including dark J-V characteristics, figures of merit (FOMs) under illumination and external quantum efficiency (EQE) are compared to the results of 3-D drift-diffusion TCAD numerical simulations. Moreover, the impact of the hole spacing and of process-dependent physical parameters (interface defects) on FOMs is investigated by means of simulations

Elexacaftor-Tezacaftor-Ivacaftor corrects monocyte microbicidal deficiency in cystic fibrosis

Question. Cystic Fibrosis (CF), which is caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR), is characterized by chronic bacterial lung infection and inflammation. In CF, monocytes and monocyte-derived macrophages have been shown to display defective phagocytosis and antimicrobial activity against relevant lung pathogens, including Pseudomonas aeruginosa. Thus, we addressed the effect of the CFTR triple modulator therapy, Elexacaftor/Tezacaftor/Ivacaftor (ETI), on the activity of CF monocytes against P. aeruginosa. Materials/patients and Methods Monocytes from people with CF (PWCF) before and after 1 and 6 months of ETI therapy were isolated from blood and infected with P. aeruginosa to assess phagocytic activity and intracellular bacterial killing. The oxidative burst and IL-6 secretion were also determined. Monocytes from healthy controls were also included. Results and answer to the question Longitudinal analysis of the clinical parameters confirmed an improvement of lung function and lung microbiology by ETI. Both the phagocytic and microbicidal deficiencies of the CF monocytes also improved significantly, although not completely. Furthermore, we measured an exuberant oxidative burst in CF monocytes before therapy, which was reduced considerably by ETI. This led to an improvement of the ROS-dependent bactericidal activity. Inflammatory response to bacterial stimuli was also lowered compared to pre-therapy. PWCF on ETI therapy, in a real-life setting, in addition to clinical recovery, showed significant improvement in monocyte activity against P. aeruginosa, which may have contributed to the overall effect of ETI on pulmonary disease. This also suggests that CF monocyte dysfunctions may be specifically targeted to ameliorate lung function in CF