The Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colonproctologia) guidelines for the management of acute and chronic hemorrhoidal disease.

The aim of these evidence-based guidelines is to present a consensus position from members of the Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colon-Proctologia, SIUCP) on the diagnosis and management of hemorrhoidal disease, with the goal of guiding physicians in the choice of the best treatment option. A panel of experts was charged by the Board of the SIUCP to develop key questions on the main topics related to the management of hemorrhoidal disease and to perform an accurate and comprehensive literature search on each topic, in order to provide evidence-based answers to the questions and to summarize them in statements. All the clinical questions were discussed by the expert panel in multiple rounds through the Delphi approach and, for each statement, a consensus among the experts was reached.

The Italian Unitary Society of Colon-proctology (SIUCP: Società Italiana Unitaria di Colonproctologia) guidelines for the management of anal fissure.

Introduction: The aim of these evidence-based guidelines is to present a consensus position from members of the Italian Unitary Society of Colon-Proctology (SIUCP: Società Italiana Unitaria di Colon-Proctologia) on the diagnosis and management of anal fissure, with the purpose to guide every physician in the choice of the best treatment option, according with the available literature.

Methods: A panel of experts was designed and charged by the Board of the SIUCP to develop key-questions on the main topics covering the management of anal fissure and to performe an accurate search on each topic in different databanks, in order to provide evidence-based answers to the questions and to summarize them in statements. All the clinical questions were discussed by the expert panel in different rounds through the Delphi approach and, for each statement, a consensus among the experts was reached.

Multi-imaging evaluation and long-term outcome of a patient with chest pain and an anomalous right coronary artery arising from pulmonary artery: a case report.

Background: Anomalous right coronary artery from pulmonary artery (ARCAPA) is a rare coronary anomaly. Adult patients usually present with few symptoms due to extensive collateral network from left coronary artery, with little/absent symptoms. Few data exist regarding surgical vs.

Breakthrough healthcare technologies in the COVID-19 era: a unique opportunity for cardiovascular practitioners and patients.

Introduction: The Coronavirus disease 2019 (COVID-19) pandemic, caused by symptomatic severe acute respiratory syndrome-Coronavirus-2 (SARS-CoV-2) infection, has wreaked havoc globally, challenging the healthcare, economical, technological and social status quo of developing but also developed countries. For instance, the COVID-19 scare has reduced timely hospital admissions for ST-elevation myocardial infarction in Europe and the USA, causing unnecessary deaths and disabilities. While the emergency is still ongoing, enough efforts have been put to study and tackle this condition such that a comprehensive perspective and synthesis on the potential role of breakthrough healthcare technologies is possible.

Myocardial perfusion imaging in patients with unprotected left main disease.

Background: The management of patients with unprotected left main (LM) coronary artery disease remains challenging, with recent data casting a shadow of doubt on the safety of percutaneous coronary intervention. We aimed at describing the features of patients undergoing myocardial perfusion imaging (MPI) subsequently found to have LM disease.

Methods: We queried our institutional database for subjects without prior revascularization or myocardial infarction (MI), who had undergone MPI followed by invasive coronary angiography within 6 months, comparing those with evidence of angiographically significant LM disease (i.

Oral antiplatelet therapy in the elderly undergoing percutaneous coronary intervention: an umbrella review.

Percutaneous coronary intervention has become a mainstay in the management of coronary artery disease. While initially advanced age was considered a relative contraindication to invasive management of coronary artery disease, current cardiovascular practice stands solidly on an early invasive approach for elderly patients, typically based on radial access and drug-eluting stent implantation. Since the advent of coronary stents, oral antiplatelet therapy has proved crucial to maximize the benefits and minimize the risks of stenting, and this holds even truer in older patients rather than in younger ones.

Comparative analysis between myocardial perfusion reserve and maximal ischemia score at single photon emission computed tomography with new-generation cadmium-zinc-telluride cameras.

Background: Whether estimates of myocardial perfusion reserve (MPR) stemming from new-generation cadmium-zinc-telluride (CZT) cameras are accurate remains unclear.

Methods: We queried our institutional database for patients undergoing MPR with CZT cameras. The primary goal was appraising the incremental diagnostic yield of MPR on top or at odds of maximal ischemia score (MIS).

Hybrid anatomo-functional imaging of coronary artery disease: Beneficial irrespective of its core components.

Coronary artery disease (CAD) is the most common and important cause of ischemic heart disease, with major implications on global morbidity and mortality. Non-invasive testing is crucial in the diagnostic and prognostic work-up of patients with or at risk of CAD, and also to guide decision making in terms of pharmacologic and revascularization therapy. The traditional paradigm is to view anatomic (i.

Umbrella review and multivariate meta-analysis of diagnostic test accuracy studies on hybrid non-invasive imaging for coronary artery disease.

Background: The diagnosis of coronary artery disease (CAD) remains challenging. It is uncertain whether hybrid imaging can improve diagnostic accuracy for CAD.

Methods: This is a systematic review and multivariate meta-analysis.

Impact of specific coronary lesions on regional ischemia at single photon emission computed tomography.

Aims: Prior studies using stress myocardial perfusion imaging (MPI), which examined the association between obstructive epicardial coronary disease and presence of myocardial ischemia did not provide a detailed assessment on a regional level. We examined this relationship in a large population of patients in whom the coronary anatomy was defined by invasive coronary angiography.

Methods: We retrospectively extracted details on individuals undergoing MPI with single photon emission computed tomography (SPECT) who had coronary angiography within 12 months.

Prognostic accuracy of myocardial perfusion imaging in octogenarians.

Background: Myocardial perfusion imaging (MPI) has an established role in the work-up of coronary artery disease (CAD), but its comparative accuracy is debated in elderly patients. We examined a large administrative database to appraise the performance of MPI in octogenarians.

Methods: Our institutional database was queried for patients undergoing MPI without recent coronary revascularization or myocardial infarction (MI).

Temporal Trends in the Prevalence, Severity, and Localization of Myocardial Ischemia and Necrosis at Myocardial Perfusion Imaging After Myocardial Infarction.

The definition, presentation, and management of myocardial infarction (MI) have changed substantially in the last decade. Whether these changes have impacted on the presence, severity, and localization of necrosis at myocardial perfusion imaging (MPI) has not been appraised to date. Subjects undergoing MPI and reporting a history of clinical MI were shortlisted.

Diagnostic Accuracy of Myocardial Perfusion Imaging With CZT Technology: Systemic Review and Meta-Analysis of Comparison With Invasive Coronary Angiography.

Objectives: This study sought to summarize the evidence on stress myocardial perfusion imaging (MPI) using cadmium-zinc-telluride (CZT) technology for the diagnosis of obstructive coronary artery disease (CAD). The CZT cameras are newly introduced, and comparative data with the conventional Anger technology (Anger-MPI) are lacking.

Background: The diagnostic accuracy of Anger-MPI for detection of angiographically significant CAD is well established; however, less evidence is available on the diagnostic accuracy of CZT-MPI.

Impact of coronary revascularization on the clinical and scintigraphic outlook of patients with myocardial ischemia.

Aims: The impact of coronary revascularization on outcomes and ischemic burden among patients with objective proof of ischemia is not yet established. We appraised the impact of revascularization on outcomes and residual ischemia in patients with objective evidence of ischemia at myocardial perfusion scintigraphy (MPS).

Methods: We queried our database for stable patients with myocardial ischemia at MPS, excluding those with prior myocardial infarction, systolic dysfunction, or cardiomyopathy.

Assessment of the fate of myocardial necrosis by serial myocardial perfusion imaging.

Background: Myocardial necrosis after myocardial infarction (MI) is common; extent and severity are however variable. The pattern is recognized by myocardial perfusion imaging (MPI) as fixed perfusion defects (FPD). The fate of such FPD is not well appraised.

Comparative safety and effectiveness of coronary computed tomography: Systematic review and meta-analysis including 11 randomized controlled trials and 19,957 patients.

Background/objectives: The clinical approach to suspected or established coronary artery disease (CAD) has been revolutionized in the last few decades by coronary computed tomography (coroCT). Yet, uncertainty persists on its comparative diagnostic and clinical effectiveness. We conducted a systematic review on randomized controlled trials (RCTs) of coroCT.