Update on the Organizational Aspects of Echocardiography in Italy (From Operator Training to the Report: 2007-2019): A Consensus Document by the "Società Italiana di Ecocardiografia e CardioVascular Imaging" Accreditation Area and Board 2017-2019.

In 2007, Società Italiana di Ecocardiografia e CardioVascular Imaging (SIECVI) already SIEC, published the document on the organization of echocardiography in Italy. In the years following the technological evolution, cultural and health factors have changed "the way, we do echo" as a tool for the different clinical pathways. The SIECVI Accreditation Area and Board 2017-2019 considered necessary to review and update the document in the light of innovation in the application of ultrasound for the heart disease assessment.

Educational pathway, competence, indication and quality process of the new classification of echocardiography according to the appropriateness of use and application.

In continuation of a previous publication, the present study will take into account for each application and profile the clinical use, the minimal data settings, the echo data findings, the indications, the quality process, the accreditation requirements, educational tailored pathway contents and modalities. The aim of the present document was to define the main applications of echocardiography and to tailor for each application-derived profile, according with the previous definitions, requirements that clearly identify the indication, objective, clinical situation in which echocardiography is used, educational pathway and training, quality process and accreditation.

[Application of guidelines in clinical practice: a multicenter analysis of the treatment of membranous glomerulonephritis in Piedmont, Italy].

The treatment of membranous glomerulonephritis (MGN) is controversial, especially in cases of no response to first-line treatment or multiple relapses. The Clinical Nephrology Group of Piedmont carried out a multicenter analysis of the treatment of patients affected by MGN in 15 nephrology units in Piedmont. The first treatment is usually started after a waiting period of 3-6 months in case of proteinuria in the nephrotic range but normal or slightly impaired renal function.

Modeling of multiple valued gene regulatory networks.

In silico modeling of Gene Regulatory Networks has gained a lot of attention recently as it gives a very powerful tool to experimental biologists to gather the knowledge gained from different biological experiments and understand the dynamics of the overall system. One of the key dynamics that is often interesting is the steady states of the networks which biologically corresponds to the cellular states. In our previous paper, we gave an efficient method called GenYsis to compute these steady states in Boolean representation of Gene Regulatory Network.

Percutaneous treatment of non-functioning arteriovenous fistulas.

Aim: To show our results in the percutaneous treatment of non-functioning arteriovenous fistulas of patients undergoing haemodialysis and to discuss the results of the literature.

Methods: Thirty-four patients with 37 non-functioning arteriovenous fistulas (29 native, 8 grafts) underwent percutaneous angioplasty. Restoration of vessel lumen and function at the following dialysis were considered as successful outcome.

The descending branch of lateral femoral circumflex artery in arterial CABG: early and midterm results.

Background: Different arterial conduits have been used for coronary artery bypass grafting (CABG), avoiding remote cardiac events associated with graft failure and improving the quality and expectancy of life in patients with coronary artery disease. The goal of this study was to evaluate the early and midterm results of total arterial CABG with the descending branch of the lateral femoral circumflex artery (DLFCA).

Methods: Between February 1997 and December 2001, 147 patients underwent arterial CABG using the DLFCA at our department.

Effect of transdermal nitroglycerin or N-acetylcysteine, or both, in the long-term treatment of unstable angina pectoris.

Objectives: This study was designed to evaluate whether the addition of transdermal nitroglycerin or oral N-acetylcysteine, or both, to conventional medical therapy improves the natural history of unstable angina pectoris.

Background: Transdermal nitroglycerin is widely used to treat angina pectoris, but the development of tolerance is a major problem that may reduce its clinical efficacy. It has been suggested that the addition of N-acetylcysteine to nitroglycerin reverses the development of tolerance, potentiates the hemodynamic response to nitroglycerin and may improve in-hospital prognosis in unstable angina.

Thrombin activity and early outcome in unstable angina pectoris.

Background: The blood coagulation system is frequently activated in the acute phase of unstable angina, but it is unknown whether the augmented function of the hemostatic mechanism may serve as a marker of increased risk for an early unfavorable outcome.

Methods And Results: Plasma concentrations and 24-hour urinary excretion of fibrinopeptide A were prospectively determined in 150 patients with unstable angina. All patients underwent 24-hour Holter monitoring, during which time urine was collected; at the end of this period, a blood sample was taken and coronary arteriography was performed.

[Treatment with erythropoietin and iron requirements in dialyzed patients].

The use of erythropoietin in dialysed patients leads to the gradual depletion of the body's iron reserves. It is important to assay iron blood levels in both patients receiving Epo therapy and those undergoing dialysis without this treatment. The most common method used is to assay ferritinemia, transferrinemia and the transferrin saturation levels.

[Vascular access for hemodialysis. Our experience in 20 years].

A personal series arterio-venous fistulas from the last 20 years is examined. The authors have tried to verify the correctness of their present proctocol which is based on the abolition of those fistulas applied to the anatomic tabac. In fact in some cases they have caused problems of flow, but in other cases they have lasted much longer than any other kind of fistulas.

Fibrinopeptide A excretion in urine: a marker of the cumulative thrombin activity in stable versus unstable angina patients.

Plasma levels and 24-hour urine excretion of fibrinopeptide A were measured in a consecutive series of 179 patients with angina pectoris. Sixty-four patients had stable angina and 115 patients had unstable angina. Urine was collected over 24 hours the day before coronary arteriography, and blood samples were taken at the end of urine collection.

[Erythropoietin treatment in Piedmont and Valle d'Aosta].

The paper reports a study carried out in the Dialysis Centres of Piedmont and the Aosta Valley on the use of erythropoietin in the treatment of anemia in patients undergoing regular dialysis. The efficacy of the drug and collateral and/or undesirable effects were evaluated. It was found that the drug was efficacious in 99.

Usefulness of the hyperventilation test in stable exertional angina pectoris in selecting medical therapy.

To assess the prevalence of abnormal coronary vasoconstriction in stable exertional angina and to evaluate whether the presence of increased coronary tone may have therapeutic implications, we studied 83 consecutive patients with typical exertional angina, positive response to exercise stress testing and documented coronary artery disease. Abnormal coronary vasoconstriction was induced by a hyperventilation test in 16 patients (group I) while the remaining 67 had a negative response (group II). No differences were observed between the 2 groups with regard to clinical, exercise and angiographic data.

Significance of hyperventilation-induced ST segment depression in patients with coronary artery disease.

To investigate the significance of hyperventilation-induced ST segment depression, 329 consecutive patients with angina and documented coronary artery disease who underwent hyperventilation and exercise tests during pharmacologic washout were studied. The hyperventilation test induced ST segment depression in 79 patients. In 36 of these 79 patients, the electrocardiographic changes occurred early during overbreathing (Group I), whereas in 26 they occurred late during recovery (Group II).