Acute profound abciximab induced thrombocytopenia: a correct management of a methodological error

Thrombocytopenia is a rare complication of glycoprotein IIb/IIIa treatment. We report a case of an acute profound abciximab induced thrombocytopenia and its successful management. The patient, presenting with unstable angina, underwent percutaneous coronary intervention with implantation of three drug eluting stents without receiving a clopidogrel loading dose according to guidelines. The rapid drop in the platelet count after abciximab elastomeric pump infusion was treated with drug discontinuation and platelet transfusion. The high risk of stent thrombosis was avoided by a timely readministration of the dual antiplatelet treatment

On the morphology of the abrasive wear on ploughshares by means of 3D scanning

During tillage, soil engaging tools are exposed to very critical working conditions due to soil friction. This produces an abrasive wear which needs to be monitored in order to avoid high costs for machine maintenance and fuel consumption and a deterioration of tillage quality. A commonly used method for wear diagnosis is the evaluation of the mass loss and volume change after a prolonged component usage. The instruments generally used for the assessment of these two quantities give only general and punctual information about the wear. Modern three-dimensional scanning technologies allow for creating a numerical model of the worn component and thereby extracting knowledge of the wear pattern. In this paper, the wear pattern of four ploughshares of a semi-mounted plough were analysed and compared. Each ploughshare was scanned by means of a structured blue-light 3D scanner before and after a prolonged field usage. From the scans, the cutting edge profile, described with three parameters, and the blade profile were calculated. The wear pattern and the volume losses were numerically calculated through Hausdorff's method and deviation analysis. Results of the experiments showed that cutting edge profile parameter of ploughshares could differ significantly from each other. Moreover, even if the wear pattern was very similar in shape for all the ploughshares, a large variability in volume losses was observed between the ploughshares. The adopted methodology permits to easily evaluate the wear pattern of tillage tools

ST-elevation myocardial infarction in the COVID-19 era

The worldwide pandemic caused by the novel acute respiratory syndrome coronavirus 2 (SARS-CoV2) has resulted in a new and lethal disease termed coronavirus disease 2019 (COVID-19). The risk of adverse outcomes in patients with COVID-19 is strongly associated with advanced age, comorbidities, and pre-existing cardiovascular risk factors. Moreover, the patient experienced a delay in clinical presentation reducing numbers of daily calls for primary PCI. We aimed at formally appraise the daily incidence and corresponding symptom-to-reperfusion time in patients with AMI at our institution between March 1 and March 19, 2020, comparing the findings with the same period in 2019. Our data showed that the COVID-19 scare is associated with fewer STEMIs and NSTEMIs, as well as calls to the STEMI networks and increase in symptom-to-balloon times

The pressure/volume relationship during dobutamine stress echocardiography in transplanted heart: comparison with quality of life and coronary anatomy

Abstract Background Cardiac allograft vasculopathy (CAV) is a major late complication in cardiac transplant recipients and has a relevant impact on outcome of these patients. Aims of this study: to compare, in cardiac transplant recipients patients, the diagnostic value of pressure/volume relationship (ESPVR) during dobutamine stress echocardiography (DSE) for coronary artery disease, assessed by Multislice Computed Tomography (MSCT), and by coronary angiography (CA). We also analyzed any possible relationship between ESPVR and the Health Related Quality of Life of the patients (HRQoL), evaluated by SF–36 questionnaire. Methods 25 consecutive patients underwent DSE within 24 hours after MSCT coronary angiogram and then they underwent CA. The HRQoL questionnaire was administered to the patients in the settings of DSE. They were followed-up for 6 months. Results DSE has a sensitivity in detecting CAV of 67%, specificity of 95%, positive predictive value of 67% and negative predictive value of 95%; DSE with ESPVR has a sensitivity of 100%, specificity of 95%, positive predictive value of 75%, negative predictive value of 100%; MSCT has a sensitivity of 100%; specificity of 82%; positive predictive value of 43%; negative predictive value of 100%. Htx recipients with a flat-biphasic ESPVR, although asymptomatic, perceived a worst HRQoL compared with the up-sloping ESPVR population, and this is statistically significant for the general health (p 0.0004), the vitality (p 0.0013) and the mental health (p 0.021) SF-36 subscale. Conclusions Evaluation with DSE and ESPVR is accurate in the clinical control of heart transplant recipients reserving invasive evaluation only for patients with abnormal contractility indexes.</p

Neural correlate of Internet use in patients undergoing psychological treatment for Internet addiction

Background: The new version of Diagnostic and Statistical Manual of Mental Disorders (DSM-5th) proposed the Internet Gaming Disorder for the diagnosis of Internet addiction (IA) considering the neurobiological evidence of the craving. Aims: The aim was to test the neural correlate in response to the Internet cue in patients with IA. Methods: Sixteen males with IA diagnosis (clinical group) and 14 healthy male (control group) were recruited for an experimental visual task composed of Internet images and emotional images. During the visual presentation of Internet cue, electroencefalographic data were recorded using Net Station 4.5.1 with a 256-channels HydroCel Geodesic Sensor Net. Eventrelated potential (ERP) components and low-resolution electromagnetic tomography (sLoreta) were analysed. Results: sLoreta analyses showed that patients from the clinical group presented a higher primary somatosensorial cortex and lower paralimbic, temporal and orbito-frontal activation in response to both Internet and emotional images compared to those of the control group. Conclusions: These results suggest that clinically recognized pathological use of Internet could be linked to dissociative symptoms

Renal arteries denervation with second generation systems: a remedy for resistant hypertension?

Initial studies on renal denervation (RDN) for the treatment of non-controlled arterial hypertension (HTN) through radiofrequency ablation of renal arteries demonstrated that RDN is an effective therapeutic strategy to reduce arterial blood pressure (BP). Nonetheless, the first randomized study, SYMPLICITY-HTN-3, failed to demonstrate a clear benefit for RND over the control group. Technologic evolution, with the introduction of new second generation multi-electrode devices, allowed deep energy delivery along the full circumference of the vessel. Two recent randomized studies involving patients assuming (SPYRAL HTN-ON MED) or not (SPYRAL HTN-OFF MED) antihypertensive pharmacologic treatment, demonstrated the efficacy and safety of RDN using second generation systems for radiofrequency ablation. Another recent randomized study demonstrated that RDN with ultrasounds (RADIANCE-HTN SOLO) of the main renal arteries led to a significant BP reduction compared to the control group. These studies have once again raised the interest of the scientific community towards attempting to define the appropriate role of RDN in the treatment of hypertension. Nonetheless, larger and longer clinical trials will be necessary to draw further conclusions

Perclose Proglide™ for vascular closure

In the past 20&nbsp;years, numerous percutaneous vascular closure devices have been tested and compared with manual compression and to surgical cut-down. The suture-mediated closure device Perclose ProGlide™ system (Abbott Vascular, CA, USA) emerged as a safe and effective alternative for many procedures requiring either small or large bore vascular accesses. In this review, we will discuss the characteristics of this vascular closure device and the main studies that proved its potential to reduce vascular complications, time to deambulation, time to discharge and patient discomfort