Publications by authors named "Luca Salvi"
Specialized or secondary metabolites are small molecules of biological origin, often showing potent biological activities with applications in agriculture, engineering and medicine. Usually, the biosynthesis of these natural products is governed by sets of co-regulated and physically clustered genes known as biosynthetic gene clusters (BGCs). To share information about BGCs in a standardized and machine-readable way, the Minimum Information about a Biosynthetic Gene cluster (MIBiG) data standard and repository was initiated in 2015.
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- Quartzite caves on tepuis in the Guyana Shield host unique microbes adapted to silica-rich and acidic conditions, leading to a study of their metabolic activities.
- Researchers isolated 80 microbial strains, many of which exhibited multiple enzymatic functions and antimicrobial properties, including two notable strains producing significant antimicrobial compounds.
- The findings suggest these previously underexplored cave environments could offer valuable microbial strains for biotechnological applications, highlighting their potential for antibiotics and other beneficial compounds.
A patient with history of dilated cardiomyopathy, a cardiac resynchronization therapy defibrillator, and endocardial ablation presented for refractory ventricular tachycardia 3 years after implantation of a Jarvik 2000 left ventricular assist device (Jarvik Heart, Inc., New York, New York). Open-chest epicardial ablation safely and effectively terminated the arrhythmia, without ventricular tachycardia recurrence at 9-month follow-up and in the absence of complications during the hospital stay.
View Article and Find Full Text PDFVasopressor Therapy in Cardiac Surgery-An Experts' Consensus Statement.
J Cardiothorac Vasc Anesth
April 2021
Hemodynamic conditions with reduced systemic vascular resistance commonly are observed in patients undergoing cardiac surgery and may range from moderate reductions in vascular tone, as a side effect of general anesthetics, to a profound vasodilatory syndrome, often referred to as vasoplegic shock. Therapy with vasopressors is an important pillar in the treatment of these conditions. There is limited guidance on the appropriate choice of vasopressors to restore and optimize systemic vascular tone in patients undergoing cardiac surgery.
View Article and Find Full Text PDFDespite the technological advancements in the last 40 years, conditions such as refractory cardiogenic shock and cardiac arrest still present a very high mortality rate in real-world clinical practice. In this light, we have reviewed the techniques, indications, contraindications, and results of the socalled Veno-Arterial Extracorporeal Circulatory Membrane Oxygenation (VA-ECMO) in the adult population to evaluate the current results of this temporary cardio-pulmonary support as salvage and/or bridge therapy in the patient suffering from refractory cardiogenic shock or cardio-circulatory arrest. The results are encouraging, especially in the setting of refractory cardiogenic shock and in-hospital cardiac arrest.
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- The study investigates the use of continuous positive airway pressure (CPAP) in the nonventilated lung during minimally invasive surgical ablation for atrial fibrillation when patients are in the supine position, which poses unique challenges for oxygen delivery.
- Conducted at Centro Cardiologico Monzino in Milan, Italy, the randomized trial involved 22 patients to compare outcomes between those receiving CPAP and those who did not during one-lung ventilation.
- Results indicated that the strategy aimed to improve oxygenation by mitigating intrapulmonary shunting and optimizing ventilation, highlighting the importance of managing respiratory mechanics in this surgical context.
Article Synopsis
- Assessing consciousness after severe brain injuries is difficult, but the study investigates using electroencephalography (EEG) as a low-cost method to evaluate awareness in patients with disorders of consciousness.
- Researchers recorded EEG data from individuals with unresponsive wakefulness syndrome (UWS) and healthy subjects during various motor and mental tasks to analyze brain wave patterns.
- The results indicated that UWS patients showed some brain activity changes when prompted, suggesting that EEG could help in diagnosing consciousness disorders by revealing the brain's response to movement tasks.
Background: Mitral regurgitation (MR) is frequently associated with severe aortic stenosis, but its influence on outcomes after transcatheter aortic valve implantation (TAVI) remains controversial. This study sought to assess the baseline etiology and degree of MR in TAVI population, identify the predictors of MR changes and investigate the clinical and prognostic impact of baseline MR at mid and long-term follow-up.
Methods: We enrolled 572 consecutive patients who underwent TAVI.
Background: Transcatheter aortic valve replacement (TAVR) is nowadays generally accepted as the treatment of choice for high- to intermediate-risk patients with severe aortic stenosis not suitable for the standard surgical replacement. Many vascular accesses have been described for the valve delivery, comprising the common iliac artery as the arterial site of access.
Methods: From September 2008 to June 2014, 440 patients underwent TAVR at our institution.
Article Synopsis
- Acute kidney injury (AKI) is a common and serious complication following cardiac surgery that influences patient outcomes.
- Nephrocheck, a device for early AKI detection, has limitations in interpreting results due to overlapping scores among different RIFLE groups, possibly caused by sample dilution.
- A pilot study involving 68 cardiac surgery patients found that combining AKIRisk scores with evaluations of urine concentration improved the identification of AKI severity.
Background: Nowadays, transvenous lead extraction (TLE) is considered an essential technique in lead management strategy. Since 2011, a multidisciplinary approach was undertaken in our centre involving electrophysiologists, cardiac surgeons and anaesthesiologists to improve cross- unit cooperation and minimize complications and mortality. The present paper reports procedural outcomes and complications of our lead extraction experience.
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- - The study investigates the effectiveness of neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker for predicting acute kidney injury (AKI) in adults after cardiac surgery, finding promising results.
- - Out of 69 patients, 35% experienced AKI post-surgery; NGAL levels showed a good correlation with the severity of AKI and had a sensitivity of 76% and specificity of 59% at a cutoff of 154 ng/mL.
- - Using two consecutive NGAL tests improved diagnostic accuracy, achieving 86% sensitivity and a negative predictive value of 87%, suggesting NGAL could assist in early AKI treatment in ICU settings.
Background: Increasing left ventricular assist device (LVAD) pump speed according to the patient's activity is a fascinating hypothesis. This study analyzed the short-term effects of LVAD speed increase on cardiopulmonary exercise test (CPET) performance, muscle oxygenation (near-infrared spectroscopy), diffusion capacity of the lung for carbon monoxide (Dlco) and nitric oxide (Dlno), and sleep quality.
Methods: We analyzed CPET, Dlco and Dlno, and sleep in 33 patients supported with the Jarvik 2000 (Jarvik Heart Inc.
Article Synopsis
- The contraction of striated muscles relies on myosin II interacting with actin filaments, which is driven by ATP, and this study explores that mechanism using a synthetic nanomachine made of myosin II dimers.
- This nanomachine can perform both isometric and isotonic contractions at low ATP concentrations, with maximum power output measured at 5 aW.
- The findings suggest that efficient muscle contraction occurs when at least 32 myosin heads work together, providing insights into muscle function while minimizing the interference from other cellular components.
Objective: Patients with Disorders of consciousness, are persons with extremely low functioning levels and represent a challenge for health care systems due to their high needs of facilitating environmental factors. Despite a common Italian health care pathway for these patients, no studies have analyzed information on how each region have implemented it in its welfare system correlating data with patients' clinical outcomes.
Materials And Methods: A multicenter observational pilot study was realized.
Long noncoding RNAs (lncRNAs) play a conserved role in regulating gene expression, chromatin dynamics, and cell differentiation. They serve as a platform for RNA interference (RNAi)-mediated heterochromatin formation or DNA methylation in many eukaryotic organisms. We found in that heterochromatin is lost at transcribed regions in the absence of RNA degradation.
View Article and Find Full Text PDFEffects of Maintaining Body Core Temperature on Atrial Fibrillation.
J Cardiothorac Vasc Anesth
June 2016
Perioperative management of antiplatelet therapy in patients with coronary stents undergoing cardiac and non-cardiac surgery: a consensus document from Italian cardiological, surgical and anaesthesiological societies.
EuroIntervention
May 2014
Article Synopsis
- Optimal antiplatelet therapy for patients with coronary stents undergoing surgery is still unclear and debated among healthcare professionals due to the risk of complications like stent thrombosis.
- Current clinical guidelines lack specific recommendations for managing antiplatelet therapy during high-risk surgeries, highlighting the need for better-defined ischaemic and haemorrhagic risk categories.
- A new consensus document offers practical recommendations, suggesting the continuation of aspirin during most surgeries and careful management of dual antiplatelet therapy, including the possible use of short-acting intravenous treatments for high-risk patients.
Article Synopsis
- The study aimed to evaluate the clinical effectiveness and safety of transcatheter aortic valve implantation (TAVI) versus surgical aortic valve replacement (S-AVR) for treating severe aortic stenosis in 187 patients.
- Results showed no significant differences in thirty-day mortality or morbidity between TAVI and S-AVR, although TAVI had advantages in ICU stay and provided better immediate reductions in aortic gradients, valve area, and functional class.
- While survival rates were comparable for the first year, later follow-ups indicated that TAVI patients had higher all-cause and noncardiac mortality, but TAVI was associated with lower morbidity and mortality than traditional surgery in high-risk cases
Article Synopsis
- - A new bulky biarylphosphine ligand (L8) has been created to enhance Pd-catalyzed C-O cross-coupling reactions between aryl halides and phenols under milder conditions.
- - The study found that the size of substituents on specific positions of the ligand's nonphosphine ring has a direct impact on the effectiveness of the catalyst.
- - Notably, larger substituents in the 2', 4', and 6' positions led to a faster reaction rate in the coupling process.
Background: The aim of this study was to test the feasibility of the assessment of right ventricular (RV) volumes and function using real-time three-dimensional (3D) transesophageal echocardiographic (TEE) imaging in patients undergoing cardiac surgery.
Methods: One hundred-fifty surgical patients were enrolled: 65 undergoing mitral valve repair, 10 undergoing mitral valve and tricuspid valve repair, four with congenital heart disease, two undergoing Jarvik implantation, 13 undergoing aortic valve surgical replacement, and 56 undergoing transcatheter aortic valve implantation. Real-time 3D TEE acquisition for RV evaluation was performed before and after the surgical procedure and compared with standard two-dimensional multiplane TEE measurements.