Comparing the Prognostic Value of Stress Myocardial Perfusion Imaging by Conventional and Cadmium-Zinc Telluride Single-Photon Emission Computed Tomography through a Machine Learning Approach.

We compared the prognostic value of myocardial perfusion imaging (MPI) by conventional- (C-) single-photon emission computed tomography (SPECT) and cadmium-zinc-telluride- (CZT-) SPECT in a cohort of patients with suspected or known coronary artery disease (CAD) using machine learning (ML) algorithms. A total of 453 consecutive patients underwent stress MPI by both C-SPECT and CZT-SPECT. The outcome was a composite end point of all-cause death, cardiac death, nonfatal myocardial infarction, or coronary revascularization procedures whichever occurred first.

Autonomic disorders and myocardial 123I-metaiodobenzylguanidine scintigraphy in Huntington's disease.

Background: Huntington's disease (HD) patients often present with abnormal modulation of blood pressure and heart rate. We investigated whether cardiac autonomic innervation assessed by 123I-metaiodobenzylguanidine (MIBG) imaging is impaired in HD patients, in comparison with controls (Ctrl).

Methods: Fifteen patients (6 F and 9 M) were assessed by the motor section of the Unified HD Rating Scale, the Total Function Capacity, and the scale for outcomes in Parkinson's disease-autonomic (SCOPA-AUT) questionnaire.

A machine learning-based approach to directly compare the diagnostic accuracy of myocardial perfusion imaging by conventional and cadmium-zinc telluride SPECT.

Background: We evaluated the performance of conventional (C) single-photon emission computed tomography (SPECT) and cadmium-zinc-telluride (CZT)-SPECT in a large cohort of patients with suspected or known coronary artery disease (CAD) and compared the diagnostic accuracy of the two systems using machine learning (ML) algorithms.

Methods And Results: A total of 517 consecutive patients underwent stress myocardial perfusion imaging (MPI) by both C-SPECT and CZT-SPECT. In the overall population, an excellent correlation between stress MPI data and left ventricular (LV) functional parameters measured by C-SPECT and by CZT-SPECT was observed (all P < .

Quantification of myocardial perfusion reserve by CZT-SPECT: A head to head comparison with Rubidium PET imaging.

Background: We measured myocardial blood flow (MBF) and perfusion reserve (MPR) by dynamic CZT-SPECT and Rb-PET in patients with suspected or known coronary artery disease (CAD) and compared the accuracy of the two methods in predicting obstructive CAD.

Methods: Twenty-five patients with available coronary angiography data underwent Tc-sestamibi CZT-SPECT and Rb-PET cardiac imaging. Stress and rest MBF and MPR were calculated by both methods and compared.

Relationship between heart rate response and cardiac innervation in patients with suspected or known coronary artery disease.

Background: Chronotropic response to pharmacological stress test is blunted in patients with autonomic neuropathy. The relationship between heart rate (HR) changes during pharmacological stress test and cardiac autonomic dysfunction has not been fully investigated. We assessed the potential interplay between HR response (HRR) and myocardial innervation in patients with suspected or known coronary artery disease (CAD).

Outcome of Patients With Differentiated Thyroid Cancer Treated With 131-Iodine on the Basis of a Detectable Serum Thyroglobulin Level After Initial Treatment.

In patients with differentiated thyroid cancer (DTC) and raising serum thyroglobulin (Tg) after total or near-total thyroidectomy and I remnant ablation an empiric I therapy may be considered. However, outcome data after empiric therapy in did not show a clear evidence of improved survival. We assessed the efficacy of such empiric I therapy in patients with DTC and evaluated the long-term outcome.

Added prognostic value of left ventricular shape by gated SPECT imaging in patients with suspected coronary artery disease and normal myocardial perfusion.

Background: Left ventricular (LV) remodeling is associated with adverse cardiovascular events. We evaluated the added prognostic value of LV shape index (SI) assessed by gated single-photon emission tomography (SPECT) in patients without known coronary artery disease (CAD).

Methods And Results: We studied 674 patients with normal myocardial perfusion and normal LV ejection fraction (EF) on stress gated SPECT imaging.

[[Bioethical interpretation of intensive care] ].

The bioethical interpretation concerns both those receiving intensive care (IC) and the nature of the treatment itself. The principle of autonomy expressed in the doctor-patient relationship is achieved through the use of informed consent and may also be used in the unique context of patients in IC. Organ-function replacement treatment raises the ethical question of the definition and management of the limit to treatment.

Cerebral hemodynamic response to CO2 after severe head injury: clinical and prognostic implications.

Objective: To study the cerebrovascular reactivity to CO2 after severe head injury to establish the clinical and prognostic relevance of CO2 reactivity.

Methods: Cerebrovascular reactivity to CO2 was studied in 20 patients with severe head injuries at 3.0+/-1.

Reliability in diagnosis of brain death.

Objective: To compare some of the confirmatory investigations of brain death with clinical criteria in order to achieve the most sensitive and accurate diagnosis of brain death.

Design: All patients with isolated brain lesions and Glasgow Coma Scale (GCS) = 3 were subjected to neurological examination after ruling out hypothermia, metabolic disorders and drug intoxications and diagnosed as clinically brain-dead when the brainstem reflexes were absent and the apnea test positive.

Patients: 15 patients with clinical diagnosis of brain death entered this study.

Intermediate intensive units: definition, legislation and need in Italy.

This paper deals with the definition of intensive care medicine and the organization of different levels of care; intermediate and high level. The organization, facilities and personnel for intermediate care are discussed. The available public data on the organization of intensive medicine and modifications planned by the Legislator are considered.

Cardiac cachexia: preoperative and postoperative nutrition management.

The present study examined the hemodynamic and metabolic effects of nutrition support in patients with malnutrition secondary to severe mitral valve disease and congestive heart failure. Pulmonary artery pressure measurements, echocardiographic studies, gas exchange measurements, immune function tests, and clinical evaluations were made on hospitalized patients 2 weeks before and 3 weeks after surgery for valve replacement or annuloplasty. All patients received a total daily energy intake of 20 to 30 kcal/kg, four of the patients preoperatively as a combination of oral food plus parenteral nutrition and these four patients plus two additional patients as only parenteral nutrition in the early postoperative period.

[Energy expenditure during a pregnancy complicated by post-traumatic coma: analysis of 2 clinical cases].

Objective: To analyze the measured resting energy expenditure, the clinical evolution and the nutritional therapy of two pregnant women complicated by post-traumatic coma and sepsis.

Design: Clinical study.

Setting: The ICU of Neurosurgery in Regional Hospital in Italy.

Acute renal failure in the patient undergoing cardiac operation. Prevalence, mortality rate, and main risk factors.

A total of 775 consecutive patients who survived the first 24 hours after cardiac operation were prospectively studied to assess the prevalence, mortality rate, and main risk factors for development of new acute renal failure. Normal renal function before operation (serum creatinine level less than 1.5 mg/dl) was registered in 734 (94.

[Gastric pH changes during and after extracorporeal circulation. What is its clinical meaning?].

Objective: To determine the relationship between gastric pH (pHm) and several other indices of blood perfusion in patients undergoing cardiopulmonary bypass (CPB). To evaluate the importance of pHm as a prognostic index for elective cardiac surgery.

Design: Prospectives study.

The effects of prolonged cardiopulmonary bypass on cell-mediated immunity.

Studies of T-cell subsets (CD3+, CD4+, CD8+, CD8+ CD57+ cells), lymphocyte response to concanavalin A (Con A), phytohaemoagglutinin (PHA) and the alterations of white cell membranes shown by scanning electronic microscope (SEM) in 51 patients who underwent cardiac operation were performed. Out of these 51 unselected patients, for 16, duration of CPB was < or = 110 min (group A), while for the other 35 (group B) it was prolonged (> 110 minutes). Although variations of the lymphocyte subset observed between groups A and B were slightly significant (p < 0.

Effects of a continuous diltiazem infusion on renal function during cardiac surgery.

Thirty-five male patients undergoing coronary artery surgery were studied to investigate renal function during a continuous infusion of the calcium channel blocker diltiazem. All patients had preoperative renal function within normal limits (serum creatinine below 0.133 mmol/L) and were randomly divided into three groups: Control (C), Diltiazem 1 (D1), and Diltiazem 2 (D2).

Total parenteral nutrition in patients with intra-aortic balloon counterpulsation.

The effects of total parenteral nutrition (TPN) were studied in nine of 19 patients with intra-aortic balloon pumping TPN (c. 27 kcal/kg/day) was begun 3 hours after the start of pumping. The non-protein caloric source was composed of hypertonic dextrose and fat emulsion (60% and 40%).

[Treatment and outcome of prospective organ donors in neurosurgical intensive therapy. Analysis of a 3-year period].

Strict guidelines for selection, monitoring and treatment of Potential Organ Donors (POD) in Neurosurgical Intensive Care Units (ICUs) are mandatory since patients with Acute Brain Injuries (ABI) are more frequently admitted on these specialized ICUs. We report the guidelines accepted in the Neurosurgical ICU of Treviso City Hospital (TVH) and the results obtained in the last three years (1988-1990). All patients with unfavourable neurological outcome were considered POD if absolute or relative contraindications to organ procurement were absent.

Assessing brain function in post-traumatic coma by means of bit-mapped SEPs, BAEPs, CT, SPET and clinical scores. Prognostic implications.

Sixty-eight severely head injured comatose patients were studied. Bit-colour-mapped SEPs to median nerve stimulation, BAEPs, CT and SPET regional values and ICP were assessed in relation to clinical information in evaluating cerebral function. All these variables were related to a 1-year outcome.