Long-term prognosis of diabetic patients with critical limb ischemia: a population-based cohort study.

Objective: To evaluate the long-term prognosis of critical limb ischemia (CLI) in diabetic patients.

Research Design And Methods: A total of 564 consecutive diabetic patients were hospitalized for CLI from January 1999 to December 2003; 554 were followed until December 2007.

Results: The mean follow-up was 5.

[Inflammation and endothelial dysfunction in patients with chronic heart failure].

Background: In chronic heart failure (CHF), endothelial dysfunction (ED) is a consequence of an imbalance of vascular tone regulating substances. The relationship between ED and inflammation has not been fully investigated.

Aim: To assess the association between inflammation and ED in CHF.

[Predictors of acute coronary syndrome without ST segment elevation and risk stratification in the chest pain unit].

Background: Nearly 10% of patients with an actual acute coronary syndrome (ACS) are discharged with an inadequate diagnosis.

Aim: To select clinical and laboratory predictors to identify patients with a high likelihood of ACS in the Chest Pain Unit.

Material And Methods: Prospective evaluation of patients consulting in a Chest Pain Unit of a University Hospital.

Cytomegalovirus infection via mother's milk: could distinct virus strains determine different disease patterns in preterm twins?

We describe a case of cytomegalovirus infection via the mother's milk in preterm twins who showed a different disease pattern. Molecular analyses to genotype the viral genome disclosed a mixed population of virus strains in the milk. These isolates were differentially transmitted to each of the twins and this may be responsible of the different patterns of disease.

Pleiotropic effects of atorvastatin in heart failure: role in oxidative stress, inflammation, endothelial function, and exercise capacity.

Background: Increased oxidative stress, a common feature in chronic heart failure, has been associated with inflammation, endothelial dysfunction, and extracellular matrix degradation. Statins have known anti-inflammatory and anti-oxidant effects; however, their role in chronic heart failure is still controversial.

Methods: This was a prospective study of 38 patients with stable systolic chronic heart failure.

Exploring language barriers to Evidence-based Health Care (EBHC) in post-graduate medical students: a randomised trial.

Background: Understanding the written English language might be a barrier when teaching Evidence-based Health Care (EBHC) to Spanish-speaking physicians.

Aim: To quantify the magnitude of this potential barrier.

Method: Cochrane Review abstracts in English or in Spanish were randomly distributed among first-year residents at the Pontificia Universidad Catolica of Chile.

New advances in the diagnosis of congenital cytomegalovirus infection.

Although the diagnosis of congenital CMV infection is still complex, important goals have been achieved in recent years, among which are: the availability of more reliable IgM tests for screening pregnant women whose pre-pregnancy serological status for CMV is unknown, tests to determine the avidity index of anti-CMV IgG, allowing the diagnosis of a primary CMV infection and innovative and traditional virological tests to detect the virus in amniotic fluid. When a woman is found to be IgM-positive, further diagnostic evaluation focused on determining whether this is due to a primary infection should be carried out. Maternal primary infections that were difficult to determine until a few years ago unless documented by seroconversions can now be readily diagnosed from the presence of low/moderate avidity anti-CMV antibody which persists for approximately 18-20 weeks after primary infection.

[Chest pain unit: first experience in Chile].

Background: In large series, nearly 60% of admissions for suspected acute coronary syndrome (ACS) had a non-coronary etiology of the pain. However, short term mortality of non recognized ACS patients, mistakenly discharged from the emergency room is at least twice greater than the expected if they would had been admitted. The concept of a chest pain unit (CPU) is a methodological approach developed to address these issues.

Solution structure of YaeO, a Rho-specific inhibitor of transcription termination.

Rho-dependent transcription termination is an essential process for the regulation of bacterial gene expression. Thus far, only two Rho-specific inhibitors of bacterial transcription termination have been described, the psu protein from the satellite bacteriophage P4 and YaeO from Escherichia coli. Here, we report the solution structure of YaeO, the first of a Rho-specific inhibitor of transcription termination.

Cytomegalovirus (CMV)-encoded UL144 (truncated tumor necrosis factor receptor) and outcome of congenital CMV infection.

Background: Cytomegalovirus (CMV) is the most common congenital infection in humans. The effect of viral strains on the outcome of congenital CMV is debated. We evaluated whether UL144 polymorphisms in amniotic fluid from CMV-infected Italian women were associated with terminations of pregnancy, subsequent disease in their offspring, or viral load.

Early and five-year amputation and survival rate of diabetic patients with critical limb ischemia: data of a cohort study of 564 patients.

Objective: To evaluate the early and late major amputation and survival rates and related risk factors in diabetic patients with critical limb ischemia (CLI).

Design: Retrospective study.

Methods: Revascularization feasibility, major amputation, survival rate and related risk factors were recorded in 564 diabetic patients consecutively hospitalized for CLI from 1999 to 2003 and followed until June 2005.

Neonatal cytomegalovirus blood load and risk of sequelae in symptomatic and asymptomatic congenitally infected newborns.

Objective: Human cytomegalovirus (CMV) is a ubiquitous human-specific DNA virus and is the main cause of congenital virus infection in developed countries leading to psychomotor impairment and deafness. Diagnostic techniques for CMV detection have greatly improved during recent years with the advent of sophisticated serological and virological methods. The aim of the present study was to assess the diagnostic and prognostic value of detection and quantification of virus in neonatal blood samples of symptomatic and asymptomatic newborns with CMV congenital infection.

Monitoring for human cytomegalovirus infection in solid organ transplant recipients through antigenemia and glycoprotein N (gN) variants: evidence of correlation and potential prognostic value of gN genotypes.

Human cytomegalovirus (HCMV) ORF UL73 encodes the envelope glycoprotein gpUL73-gN, which shows seven genotypes (gN-1, gN-2, gN-3a, gN-3b, gN-4a, gN-4b, gN-4c). The goal of this study was to determine retrospectively the distribution of gN variants in solid organ transplant recipients with HCMV infection and to establish an association with parameters important for monitoring post-transplantation clinical course during a follow-up of up to 2 years. Peripheral blood leukocytes from 40 solid organ transplant recipients were analysed for pp65-antigen by immunofluorescence and gN genotyped by sequencing or RFLP analysis.

Peripheral angioplasty as the first-choice revascularization procedure in diabetic patients with critical limb ischemia: prospective study of 993 consecutive patients hospitalized and followed between 1999 and 2003.

Objective: To evaluate the effectiveness of peripheral angioplasty (PTA) as the first-choice revascularisation procedure in diabetic patients with critical limb ischemia (CLI).

Design: Prospective study.

Methods: PTA was employed as first choice revascularisation in a consecutive series of diabetic patients hospitalized for CLI between January 1999 and December 2003.

Early complications in endovascular treatment of abdominal aortic aneurysm.

Objective: The incidence of perioperative complications during endovascular repair of abdominal aortic aneurysm (EVAR) is reported in limited series. The aim of this study is to evaluate a multi-center survey of unexpected intraprocedural critical events of EVAR.

Methods: A questionnaire relative to intraprocedural complications during EVAR was sent to major vascular surgery divisions in Italy.

[Critical appraisal: Subcutaneous adjusted-dose unfractionated heparin vs fixed-dose low-molecular-weight heparin in the initial treatment of venous thromboembolism. Prandoni P, Carnovali M, Marchiori A, Galilei investigators. Arch Intern Med 2004; 164: 1077-83].

Background: Few reports have addressed the value of unfractionated heparin (UFH) or low-molecular-weight heparin in treating the fill spectrum of patients with venous thromboembolism (VTE), including recurrent VTE and pulmonary embolism.

Methods: In an open, multicenter clinical trial, 720 consecutive patients with acute symptomatic VTE, including 119 noncritically ill patients (16.5%) with pulmonary embolism and 102 (14.

[The approach to the infradiaphragmatic and adrenal aorta].

The progressive selection of the patient reserved to open surgery is determined by the preference of the endovascular option on the treatment of abdominal aortic aneurysm. This fact probably will cause a reduction of the number of cases singularly approachable by the infrarenal way while will prevail the need of control and clamping of the infradiaphragmatic and adrenal aorta. The approach to the infradiaphragmatic and adrenal aorta introduces technical and physiopathologic problems related to the hold interconnection between the vessel and the surrounding structures, particularly those visceral.

Congenital cytomegalovirus infection: recent advances in the diagnosis of maternal infection.

In most European countries, pregnant women are tested for cytomegalovirus (CMV) during the first trimester of pregnancy. Within the last 5 years, European laboratories have made significant progress in solving diagnostic problems linked to infection in pregnancy. With advances in CMV serology, the presence of anti-CMV immunoglobulin (Ig)M detected by a screening test such as enzyme immunoassay, can be confirmed by blot, identifying pregnant women undergoing an active or recent infection.

Hydroxymethyl-glutaryl coenzyme a reductase inhibition limits cytomegalovirus infection in human endothelial cells.

Background: Statins exert anti-inflammatory effects independently of cholesterol-lowering properties. Cytomegalovirus (CMV) infection appears to be implicated in the pathophysiology of atherosclerosis by inducing inflammatory modifications in endothelial cells, especially in immunosuppressed patients. We investigated whether the activity of statins can inhibit replication of CMV in human endothelial cells.

Vascular anastomoses in dichorionic diamniotic-fused placentas.

A case of fetal twin-to-twin cytomegalovirus infection through a dichorionic diamniotic (DiDi)-fused placenta prompted our search for possible vascular anastomoses in this type of placenta. This case and three additional DiDi-fused placentas were studied with gross (macro) sections and a three-dimensional (3D) stereomicroscopic technique. Two twins were dizygotic (they differed in gender and blood groups) and the other two were probably monozygotic.

Congenital cytomegalovirus infection in twin pregnancies: viral load in the amniotic fluid and pregnancy outcome.

Human cytomegalovirus (CMV) is the most common cause of viral intrauterine infection and fetal damage largely attributable to maternal primary infection. Most cases of congenital CMV infection in twins reported in the literature involved only 1 twin. We assessed the validity of polymerase chain reaction (PCR) and quantitative PCR on amniotic fluid (AF), at 21 to 22 weeks' gestation and at least 6 to 8 weeks after seroconversion, to predict the outcome of newborns in twin pregnancies.

Congenital infection with human herpesvirus 6 variant B associated with neonatal seizures and poor neurological outcome.

Human herpesvirus 6 (HHV 6) has neurotropic and neuroinvasive properties. The virus has been found in the cerebrospinal fluid of many children with aseptic meningoencephalitis. Intrauterine transmission has been documented by HHV 6 DNA detection in cord blood specimens of apparently healthy newborns and in fetuses following spontaneous abortions.

Horizontal in utero acquisition of cytomegalovirus infection in a twin pregnancy.

It is generally accepted that viral infections can be transmitted horizontally by direct or indirect contact with virus-excreting persons, and some viral infections can be transmitted vertically, either prenatally or perinatally, from mother to child. This report presents data strongly supporting a prenatal horizontal acquisition of human cytomegalovirus infection in a twin pregnancy.