Hip Fracture Surgery in Severe Aortic Stenosis: A Study of Factors Affecting Mortality.

Background: In elderly patients with hip fracture, the prevalence of severe aortic stenosis (valve area <1 cm) is close to 5%. Few studies have evaluated the prognostic role of aortic stenosis in hip fracture surgery and none has considered the effects of the postoperative setting (intensive care unit vs general ward) on clinical outcome.

Purpose: The aim of the present study was to evaluate the factors affecting mortality in patients with severe aortic stenosis undergoing surgery for hip fracture.

Independent, Differential Effects of Delirium on Disability and Mortality Risk After Hip Fracture.

Objectives: To assess the independent effect of delirium on mortality and disability after 1 year of follow-up, in consecutive older patients with hip fracture hospitalized for surgical repair.

Design: This is a prospective observational study.

Setting And Participants: Patients aged older than 65 years consecutively admitted for hip fracture to the Trauma and Orthopedics Centre of a third-level hospital, between March and October 2014.

Management of ongoing direct anticoagulant treatment in patients with hip fracture.

Aim of the present study was to investigate the effects of ongoing treatment with DOACs on time from trauma to surgery and on in-hospital clinical outcomes (blood losses, need for transfusion, mortality) in patients with hip fracture. Moreover we evaluated the adherence to current guidelines regarding the time from last drug intake and surgery. In this observational retrospective study clinical records of patients admitted for hip fracture from January 2016 to January 2019 were reviewed.

Takotsubo Syndrome: Is this a Common Occurrence in Elderly Females after Hip Fracture?

Background: The prevalence of Takotsubo syndrome in hip fracture is not known.

Methods: Hip fracture patients were evaluated in a multidisciplinary unit. Patients with ECG abnormalities and increased troponin I values at the time of hospital admission were included in the study Follow-up was clinical at 30 days and by telephonic interview at one year.

Postoperative atrial fibrillation is related to a worse outcome in patients undergoing surgery for hip fracture.

Few information exist about incidence and prognostic significance of postoperative atrial fibrillation (POAF) in patients undergoing hip fracture surgery. In the period comprised between January 2012 and December 2016, we evaluated 3129 patients referred for hip fracture. At hospital admission 277 were in permanent atrial fibrillation and were excluded from the study.

Effect of the Nano-Ca(OH) Addition on the Portland Clinker Cooking Efficiency.

A new technology was tested to improve the cooking efficiency of the raw mixture for Portland clinker production by the use of nano-Ca(OH). A decrease in the free lime concentration after the firing of approximately 35% and 55% in the nano-added clinkers burned at 1350 °C and 1450 °C, respectively, with respect to the standard Portland clinkers was observed. Moreover, in the nano-added clinkers, a slight decrease in alite (C3S), of approximately 2-4 wt%, and increase in belite (C2S), of approximately 5-6 wt%, were observed.

Outcome in elderly patients with aortic stenosis undergoing hip fracture surgery. Results may suggest a different postoperative strategy?

Background: Five to ten percent of patients with hip fracture have severe aortic valve stenosis (AS). The aim of the present investigation was to evaluate the impact of AS on early and long-term outcome after surgery for hip fracture.

Methods: 145 patients with AS and 283 consecutive patients without AS (control group) aged >70 years referred to Azienda Ospadaliera Universitaria (AOU) Careggi for hip fracture were included in the study.

Diagnostic accuracy of emergency Doppler echocardiography for identification of acute left ventricular heart failure in patients with acute dyspnea: comparison with Boston criteria and N-terminal prohormone brain natriuretic peptide.

Objectives: Echocardiography is a fundamental tool in the diagnosis of acute left ventricular heart failure (aLVHF). However, a consultative exam is not routinely available in every emergency department (ED). The authors investigated the diagnostic performance of emergency Doppler echocardiography (EDecho) performed by emergency physicians (EPs) for the diagnosis of aLVHF in patients with acute dyspnea.

Prognostic value of ECG among patients with acute pulmonary embolism and normal blood pressure.

Objective: To investigate the prognostic value of electrocardiography (ECG) alone or in combination with echocardiography in patients with acute pulmonary embolism and normal blood pressure.

Methods: Consecutive adult patients presenting to the emergency department at Azienda Ospedaliero-Universitaria Careggi with the first episode of pulmonary embolism were included. Patients with systolic blood pressure less than 100 mm Hg were excluded.

Use of biomarkers in triage of patients with suspected stroke.

Background: The absence of a rapidly available and sensitive diagnostic test represents an important limitation in the triage of patients with suspected stroke.

Objectives: The aim of the present study was to investigate the triage accuracy of a novel test that measures blood-borne biomarkers (triage stroke panel, TSP) and to compare its accuracy with that of the Cincinnati Prehospital Stroke Scale (CPSS).

Methods: Consecutive patients with suspected stroke presenting to the Emergency Departments of three Italian hospitals underwent triage by a trained nurse according to the CPSS and had blood drawn for TSP testing.

Association of persistent right ventricular dysfunction at hospital discharge after acute pulmonary embolism with recurrent thromboembolic events.

Background: In patients with acute pulmonary embolism, right ventricular dysfunction (RVD) on hospital admission is a predictor of adverse short-term clinical outcome. The aim of this study was to evaluate the prognostic value of RVD persistence at hospital discharge with regard to the likelihood of recurrent venous thromboembolism (VTE).

Methods: Echocardiography was used to assess RVD on admission and before hospital discharge in 301 consecutive patients with the first episode of acute pulmonary embolism occurring from January 1998 through July 2004.

Release of preformed Ang II from myocytes mediates angiotensinogen and ET-1 gene overexpression in vivo via AT1 receptor.

Unlabelled: The role of angiotensin II in pressure overload is still debated because notwithstanding its effects on myocyte contractility angiotensin II is not an obligatory factor for the development of hypertrophy. To define the role of angiotensin II in acute pressure overload we studied the effects of AT1 blockade (valsartan 80mg per day) on myocardial contractility, cardiac growth factor gene expression, and myocardial hypertrophy in aortic banded (60mmHg) pigs. Acute pressure overload caused an abrupt reduction of myocardial contractility, measured by the end-systolic stiffness constant, and a sharp increase in end-systolic stress which rapidly normalized (within 12h) in the placebo group.

ET(B) receptor in renal medulla is enhanced by local sodium during low salt intake.

Renal endothelin-1 participates in sodium and water handling, and its urinary excretion is increased in sodium-retentive states. We compared the cortical and medullary renal expression of prepro-endothelin-1, endothelin-converting enzyme-1, and endothelin type A and type B receptors in patients who underwent nephrectomy after normal (108 mmol/d NaCl; n=6) or low (20 mmol/d NaCl; n=6) sodium diet and investigated whether sodium exerts a direct role on endothelin receptor binding in vitro. With normal sodium diet prepro-endothelin-1 mRNA was 3-fold higher in renal medulla than in cortex (P<0.