Mechanical power is associated with cardiac output and pulmonary blood flow in an experimental acute respiratory distress syndrome in pigs.

Background: Despite being essential in patients with acute respiratory distress syndrome (ARDS), mechanical ventilation (MV) may cause lung injury and hemodynamic instability. Mechanical power (MP) may describe the net injurious effects of MV, but whether it reflects the hemodynamic effects of MV is currently unclear. We hypothesized that MP is also associated with cardiac output (CO) and pulmonary blood flow (PBF).

Automatic Lung Segmentation and Quantification of Aeration in Computed Tomography of the Chest Using 3D Transfer Learning.

Background: Identification of lung parenchyma on computer tomographic (CT) scans in the research setting is done semi-automatically and requires cumbersome manual correction. This is especially true in pathological conditions, hindering the clinical application of aeration compartment (AC) analysis. Deep learning based algorithms have lately been shown to be reliable and time-efficient in segmenting pathologic lungs.

Mechanical Power Correlates With Lung Inflammation Assessed by Positron-Emission Tomography in Experimental Acute Lung Injury in Pigs.

Mechanical ventilation (MV) may initiate or worsen lung injury, so-called ventilator-induced lung injury (VILI). Although different mechanisms of VILI have been identified, research mainly focused on single ventilator parameters. The mechanical power (MP) summarizes the potentially damaging effects of different parameters in one single variable and has been shown to be associated with lung damage.

Effects of Different Levels of Variability and Pressure Support Ventilation on Lung Function in Patients With Mild-Moderate Acute Respiratory Distress Syndrome.

Variable pressure support ventilation (vPSV) is an assisted ventilation mode that varies the level of pressure support on a breath-by-breath basis to restore the physiological variability of breathing activity. We aimed to compare the effects of vPSV at different levels of variability and pressure support (Δ ) in patients with acute respiratory distress syndrome (ARDS). This study was a crossover randomized clinical trial.

Computed tomography assessment of PEEP-induced alveolar recruitment in patients with severe COVID-19 pneumonia.

Background: There is a paucity of data concerning the optimal ventilator management in patients with COVID-19 pneumonia; particularly, the optimal levels of positive-end expiratory pressure (PEEP) are unknown. We aimed to investigate the effects of two levels of PEEP on alveolar recruitment in critically ill patients with severe COVID-19 pneumonia.

Methods: A single-center cohort study was conducted in a 39-bed intensive care unit at a university-affiliated hospital in Genoa, Italy.

[Defense mechanisms as outcome measure in short-term psychotherapy related to symptoms, severity and overall functioning: a preliminary study].

Unlabelled: The assessment of defense mechanisms in psychotherapy is currently one of the most used ways to evaluate the effectiveness of psychotherapy. In literature there are few reports on defense mechanisms changes by short-term treatments.

Aim: To determine whether the defense mechanisms are changed after twelve sessions of short-term psychotherapy related to psychopathological symptoms, severity and overall functioning.

["Subjective time" as diagnostic marker in cognitive-systems oriented psychotherapy].

After examining the notion of time among philosophical and psychological theories and some recent evidences, we propose a concept of time, relating to its objective/subjective difference, from a cognitive-systems process oriented approach, which is a multidisciplinary and evolutionary approach for diagnosis, practice and steps of psychotherapy.

Coronary rotational atherectomy in current practice: acute and mid-term results in high- and low-volume centers.

We conducted a prospective observational study to evaluate the indications, technique, in-hospital and 9-month results of consecutive patients treated with rotational atherectomy (RA) in 12 centers during 1 year, as well as their relationship with volume of RA activity. The study included 345 lesions in 289 patients treated (4.4% +/- 2.

Immediate and late results of coronary angioplasty in patients with severe left ventricular dysfunction.

Background: Severe coronary artery disease in patients with a markedly depressed left ventricular function is associated with a poor prognosis. Even though coronary angioplasty (PTCA) has been offered as an alternative to bypass surgery, the role of PTCA in the treatment of patients with severe left ventricular dysfunction has not been well defined. The aim of the present study was to evaluate the immediate and long-term results in patients with severe left ventricular dysfunction < or = 35% who underwent PTCA.

Iatrogenic aortic dissection during coronary intervention.

Iatrogenic acute dissection of the ascending aorta following coronary angiography and percutaneous intervention is rare. Localized aortic dissections have been treated by sealing the entry with a coronary stent. Extensive dissections may require a surgical intervention.

Intracoronary beta-radiation for the treatment of patients at very high risk for recurrence of in-stent restenosis: a single center experience.

Background: Intracoronary brachytherapy has significantly reduced the recurrence of in-stent restenosis. The aim of this study was to evaluate the feasibility, safety and efficacy of intracoronary beta-radiation in patients at very high risk for recurrence of in-stent restenosis.

Methods: We analyzed 42 patients with 50 lesions submitted to catheter-based beta-radiation (Beta-Cath System, Novoste Corporation, Norcross, GA, USA) for in-stent restenosis.

Elective stenting in small coronary arteries: results of the Italian prospective multicenter registry MICROSCOPE.

Background: The role of stent implantation in small coronary arteries is still controversial. The MICROSCOPE study (Ministenting in small coronary arteries, a prospective evaluation) is a multicenter registry addressed to prospectively evaluate the immediate and mid-term clinical and angiographic results of elective stenting of lesions located in coronary arteries with an angiographic reference diameter < or = 2.75 mm.

"Hybrid" percutaneous and surgical coronary revascularization: selection criteria from a single-center experience.

Background: The association of minimally invasive direct coronary artery bypass (MIDCAB) to percutaneous transluminal coronary angioplasty (PTCA) of large arteries with focal lesions can be an alternative therapeutic method for patients with multivessel coronary artery disease. We reviewed our experience regarding 42 patients treated at our Institute.

Methods: MIDCAB and PTCA of the circumflex or right coronary arteries > 3 mm were performed in 42 patients from September 1997 to December 1999.

Percutaneous transluminal coronary revascularization in women: higher risk of dissection and need for stenting.

Background: Even though success rates of percutaneous transluminal coronary angioplasty (PTCA) are influenced by gender, women are at higher risk for adverse procedural events. Plaque dissection has been demonstrated to cause more adverse cardiac events during PTCA in the female gender than the male, but it is not clear how much it could influence stent implantation and procedural complications in the stent era. This study sought to evaluate whether the prevalence of dissection is equal in men and women with similar vessel size, which factors are associated with the risk of this complication and whether stenting has modified the immediate outcome.

Italian BiodivYsio open registry (BiodivYsio PC-coated stent): study of clinical outcomes of the implant of a PC-coated coronary stent.

Unlabelled: Rapid technological developments have made new materials available for percutaneous coronary intervention procedures. The coronary stent in particular has undergone progressive structural improvements leading to the recent availability of a third generation of stents, namely, coated stents. The rapid evolution of the stent has often made its evaluation problematical, since trials are frequently confined to small groups of patients in single centers.

[Percutaneous coronary angioplasty in the elderly: a report of 2 cases in patients over 90].

Percutaneous transluminal coronary angioplasty is a validated method for coronary revascularization over coronary surgery in elderly patients. We describe two cases in patients in their nineties. Case n.

"Hybrid" and combined percutaneous and surgical intervention to treat selected cardiac patients: a new strategy.

The term "hybrid revascularization" describes the combined use of minimally-invasive surgery without cardiopulmonary bypass and percutaneous coronary revascularization in selected cases. The theoretical advantage of a less invasive surgical intervention must be weighted against the need for additional percutaneous procedures, with their own risks and limitations. We describe our initial experience with hybrid revascularization at the Istituto Clinico Humanitas in Milan.

Clinical feasibility of 0.018-inch intravascular ultrasound imaging device.

Objectives: Intravascular ultrasound imaging (IVUS) is limited by the size of the imaging catheter. To facilitate imaging before and during interventions, a 30-MHz ultrasonic imaging device was developed that is the same dimension as a 0.018-inch guide wire.

Intracoronary stent implantation in native coronary arteries and saphenous vein grafts: a consecutive experience with six types of stents without prolonged anticoagulation.

Objective: To analyze the results of implantation of six different intracoronary stents without the use of prolonged anticoagulation.

Material And Methods: Between Mar. 30, 1993, and Jun.

High pressure assisted coronary stent implantation accomplished without intravascular ultrasound guidance and subsequent anticoagulation.

Objectives: The purpose of this study was to determine the efficacy of treatment with antiplatelet therapy and no anticoagulation after high pressure assisted coronary stent implantation performed without intravascular ultrasound (IVUS) guidance.

Background: Previous studies have shown that during IVUS-guided Palmaz-Schatz coronary stenting, it is safe to withhold anticoagulation when stent expansion has been optimized by high pressure balloon dilation.

Methods: Patients that had successful coronary stenting without IVUS guidance were treated with ticlopidine, 500 mg/day, and aspirin, 325 mg/day, for 1 month and then received only aspirin, 325 mg/day, indefinitely.

Successful closure of a coronary vessel rupture with a vein graft stent: case report.

We report a successfully percutaneous closure of a brisk coronary artery rupture with a custom-made "vein graft stent," a Palmaz-Schatz stent covered with a vein graft. This method is an elegant and effective alternative to the traditional surgical approach and should be considered whenever technically and clinically feasible.

[The evaluation of the acute recoil of the Palmaz-Schatz stent using echography. A case report].

Intravascular ultrasound, performed using a 0.018 in guide wire with a 30 MHz ultrasound transducer, allows to study the acute recoil of Palmaz-Schatz stent. This case showed that the acute recoil of the Palmaz-Schatz stent occurs immediately after stent implantation.

Acute recoil of Palmaz-Schatz stent: a rare cause of suboptimal stent implantation--report of two cases with intravascular ultrasound findings.

It is generally believed that the Palmaz-Schatz stent maintains a strong radial force, preventing stent recoil. However, the capacity to prevent recoil is largely governed by the hardness or resistance of the lesion. We report two cases of "acute Palmaz-Schatz stent recoil," documented by intravascular ultrasound, and suggest a novel treatment of this unusual problem.

Implantation of the peripheral Wallstent for diffuse lesions in coronary arteries and vein grafts.

The Wallstent (Schneider, Bulach, Switzerland) is available in different lengths without much compromise in flexibility and radial support compared to some other stents. We treated 24 patients (26 vessels) with diffuse coronary lesions or vein graft lesions with intravascular ultrasound-guided peripheral Wallstent implantation. Average balloon pressure during stent optimization was 16.