Publications by authors named "Porto I"

Background: The vitamin D pathway contributes to the microbicidal activity of macrophages against infection. In addition to induction of this pathway, interferon-gamma (IFNγ), interleukin (IL)-15, and IL32γ are part of a network of pro-inflammatory cytokines. The aim of this study was to evaluate single-nucleotide polymorphisms (SNPs) in the components of the vitamin D pathway and associated cytokine genes that could be related to resistance or susceptibility to American tegumentary leishmaniasis (ATL).

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Vitamin D is increasingly recognized for its role in cardiovascular health beyond its well-established effects on bone metabolism. This review synthesizes findings from observational studies, interventional trials, and meta-analyses to clarify the mechanisms through which vitamin D impacts cardiovascular health, including its influence on vascular function, inflammation, and metabolic pathways. Additionally, this review emphasizes the importance of a personalized approach to vitamin D supplementation, integrating individual cardiovascular risk profiles, baseline vitamin D levels, and comorbid conditions, such as hypertension and diabetes.

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Article Synopsis
  • The study evaluates various techniques for guiding percutaneous coronary intervention (PCI) to determine which yields the best patient outcomes.
  • It analyzes data from 39 randomized trials involving over 29,000 patients, highlighting that intravascular imaging (like OCT and IVUS) and physiology-guided strategies (like FFR) significantly reduce cardiac death compared to traditional coronary angiography (CA).
  • Overall, the results suggest that OCT is the most effective guidance method, leading to lower rates of myocardial infarction, stent thrombosis, and all-cause mortality compared to CA.
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Functional mitral regurgitation (MR) is associated with increased cardiovascular morbidity and mortality and over the past decade, the diagnosis of atrial functional mitral regurgitation (aFMR) has been increasingly observed in the elderly, especially in those with atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF). Annular enlargement, perturbations of annular contraction, and atriogenic leaflet tethering distinguish the pathophysiology of aFMR from the one of ventricular origin. However, no consensus provides recommendations regarding the differential diagnosis and the subsequent management of aFMR.

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Nearly 35 years after its initial publication in 1989, the Italian Society of Sports Cardiology and the Italian Federation of Sports Medicine (FMSI), in collaboration with other leading Italian Cardiological Scientific Associations (ANCE - National Association of Outpatient Cardiology, ANMCO - National Association of Inpatient Cardiology, SIC - Italian Society of Cardiology), proudly present the 2023 version of the Cardiological Guidelines for Competitive Sports Eligibility. This publication is an update of the previous guidelines, offering a comprehensive and detailed guide for the participation of athletes with heart disease in sports. This edition incorporates the latest advances in cardiology and sports medicine, providing current information and recommendations.

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This proof-of-concept study aimed to assess the diagnostic potential of gas chromatography-mass spectrometry (GC-MS) in profiling volatile organic compounds (VOCs) from exhaled breath as a diagnostic tool for the chronic coronary syndrome (CCS). Exhaled air was collected from patients undergoing invasive coronary angiography (ICA), with all samples obtained prior to ICA. Post hoc, patients were divided into groups based on coronary lesion severity and indications for revascularization.

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Water treeing and water droplets are observed within adhesive layers and on the hybridized surface after bonding sound dentin using single-bottle etch-and-rinse adhesives, indicating permeability of the hybrid layer to water. The aim of this study was to assess the efficacy of dentin sealing by adhesives containing propolis by quantifying the area of water transudation from dentinal tubules after dentin hybridization. Brazilian red propolis was added to experimental adhesive and Single Bond (3M/ESPE) adhesive; experimental adhesive and Single Bond without propolis were used as controls.

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Article Synopsis
  • Current guidelines recommend keeping LDL-C levels below 55 mg/100 ml for patients with acute coronary syndromes (ACS), but many patients struggle to reach this target due to poor medication adherence.
  • A study analyzed 963 ACS patients, using the Morisky Medication Adherence Scale to categorize them into high adherence (HA) and low adherence (LA) groups, finding that 28.7% had low adherence.
  • The results showed that HA patients were significantly more likely to achieve the LDL-C target compared to LA patients, indicating that adherence to lipid-lowering therapy plays a crucial role in reaching cholesterol goals.
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  • Risk stratification for patients with drug-induced type-1 Brugada syndrome is difficult, and the usefulness of electrophysiological studies (EPS) is unclear.
  • A systematic literature search categorized patients into three groups based on EPS results: positive, negative, and no EPS conducted.
  • The study found no significant differences in the rates of arrhythmia events among these groups over an average follow-up of 5.1 years, suggesting EPS may not enhance long-term prognosis in these patients.
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Dyslipidemia is one of the most important risk factors for the development of atherosclerotic disease and its control, through well-proven therapies, allows an optimal risk management over time. LDL-cholesterol targets are well defined by international guidelines and based on individual cardiovascular risk. As guidelines evolve, also laboratory reports need to do the same, including lipid reference values by cardiovascular risk classes, to avoid misunderstandings and inappropriate lipid-lowering therapy withdrawal.

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  • * A retrospective analysis was conducted on 811 patients from the DIAMOND study, which included a total of 1281 patients diagnosed in Italy between 2016-2021, focusing on characteristics leading to their diagnosis and calculating their respective scores.
  • * Findings showed that only 1% of patients had early diagnoses, with significant differences in prognostic variable distribution based on diagnostic pathways, and both NAC and Columbia scores were linked to all-cause mortality.
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  • * Researchers reviewed data from 1,071 patients and found that factors like age over 75, acute coronary syndrome, and femoral access are significant predictors of bleeding risks classified as BARC 2-5 within 48 hours post-PCI.
  • * They developed a new risk score, the "ICARUS score," which effectively predicts high bleeding risk and outperforms existing scoring systems in terms of accuracy and reliability.
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  • * Treatment for obstructive CAD focuses on reducing heart events and symptoms, while INOCA requires addressing functional changes in coronary circulation.
  • * A precise diagnosis in patients with INOCA is vital for personalized treatment, and the paper emphasizes combining coronary revascularization, medication, and lifestyle changes for effective angina management.
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Cardiogenic shock with acute hemodynamic decompensation may be one of the most serious risks in patients affected by ventricular tachycardia (VT). Its proper identification may have important implications in terms of pharmacological management, as might procedural planning in case of patients undergoing catheter ablation. We describe a case series of patients with provisional strategies for circulatory support in VT ablation, including the use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) and vascular accesses in the electrophysiology lab but no initial ECMO activation due to an estimated intermediate pre-procedural risk from the case-series population.

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  • Primary percutaneous coronary intervention (PCI) is the preferred method for treating acute ST-elevation myocardial infarction (STEMI), helping to restore blood flow in blocked arteries.
  • Some patients, however, suffer from a 'no-reflow' phenomenon, where blood flow remains compromised despite the artery being opened, usually due to microvascular obstruction from thrombus or plaque.
  • There is no clear consensus on preventing or treating no-reflow, and while various medications are used, they only improve blood flow for certain patients; a new idea involving low-dose fibrinolysis during PCI shows promise for enhancing recovery.
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  • The study investigates the effects of red blood cell (RBC) transfusion on short-term mortality in patients undergoing transapical transcatheter aortic valve implantation (TA-TAVI), where bleeding is common.
  • Out of 11,265 TAVI participants, 548 had TA-TAVI, with 209 receiving RBC transfusions, and the study found a significant association between transfusion and increased 30-day mortality.
  • The research concluded that RBC transfusion independently predicts higher short-term mortality in TA-TAVI patients, regardless of other factors like major bleeding and kidney injury.
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Based on a wealth of evidence, aspirin is one of the cornerstones of secondary prevention of cardiovascular disease. However, despite several studies showing efficacy also in primary prevention, an unopposed excess risk of bleeding leading to a very thin safety margin is evident in subjects without a clear acute cardiovascular event. Overall, the variability in recommendations from different scientific societies for aspirin use in primary prevention is a classic example of failure of simple risk stratification models based on competing risks (atherothrombosis vs.

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Ischemia with non-obstructive coronary arteries (INOCA) is an increasingly recognized entity. It encompasses different pathophysiological subtypes (i.e.

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Introduction: Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial infarction (AMI), which primarily affects young women without traditional cardiovascular risk factors, often presenting as sudden cardiac death. This study aims to investigate the prevalence, characteristics, predictors, and outcomes of cardiac arrest in SCAD patients.

Methods: The DISCO IT/SPA registry, an international retrospective multicenter study, enrolled 375 SCAD patients from 26 centers in Italy and Spain.

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Background: The prognostic impact of catheter ablation (CA) of atrial fibrillation (AF) in hypertrophic cardiomyopathy (HCM) patients has not yet been satisfactorily elucidated.

Objectives: The aim of the study was to assess the impact of CA of AF on clinical outcomes in a large cohort of HCM patients.

Methods: In this retrospective multicenter study, 555 HCM patients with AF were enrolled, 140 undergoing CA and 415 receiving medical therapy.

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Assessment tools for depression and anxiety usually inquire about the frequency of symptoms. However, evidence suggests that different question framings might trigger different responses. Our aim is to test if asking about symptom's context, ability, duration, and botherment adds validity to Patient Health Questionnaire-9, General Anxiety Disorder-7, and Patient-Related Outcome Measurement Information Systems depression and anxiety.

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: To date, data regarding the characteristics and management of obstructive, stable coronary artery disease (CAD) encountered in patients undergoing transcatheter aortic valve implantation (TAVI) are sparse. The aim of the study was to analyze granular details, treatment, and outcomes of patients undergoing TAVI with obstructive, stable CAD from real-world practice. : REVASC-TAVI (Management of myocardial REVASCularization in patients undergoing Transcatheter Aortic Valve Implantation with coronary artery disease) is an investigator-initiated, multicenter registry, which collected data from patients undergoing TAVI with obstructive stable CAD found during the pre-TAVI work-up.

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Article Synopsis
  • The study compares the use of Impella pumps and VA-ECMO in treating patients with cardiogenic shock, focusing on clinical outcomes, resource use, and quality of life.
  • Conducted across 17 clinical centers in Italy, the research involves both prospective data collection for Impella patients and retrospective data matching for VA-ECMO patients to assess cost-effectiveness and budget impact.
  • As of May 2024, most centers have received ethical approval for the study, with plans to publish results in peer-reviewed journals for wider dissemination.
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