Mesothelialymonocytic incidental cardiac excrescence (MICE) is a benign finding made up of a mixt... more Mesothelialymonocytic incidental cardiac excrescence (MICE) is a benign finding made up of a mixture of cuboidal mesothelial cells, histiocytes and fibrine and is mainly found incidentally during open heart surgery, commonly after cardiac catheterization. Clinical importance of this lesion has been emphasized because of its potential confusion with malignancies, especially with metastatic carcinoma. We report a case of an asymptomatic 72-year-old man with incidental finding of a pericardial effusion and a small mass attached to the left appendage.
Aims The aim of this registry was to evaluate the additional prognostic value of a composite card... more Aims The aim of this registry was to evaluate the additional prognostic value of a composite cardiac magnetic resonance (CMR)-based risk score over standard-of-care (SOC) evaluation in a large cohort of consecutive unselected non-ischaemic cardiomyopathy (NICM) patients. Methods and results In the DERIVATE registry (www.clinicaltrials.gov/registration: RCT#NCT03352648), 1000 (derivation cohort) and 508 (validation cohort) NICM patients with chronic heart failure (HF) and left ventricular ejection fraction <50% were included. All-cause mortality and major adverse arrhythmic cardiac events (MAACE) were the primary and secondary endpoints, respectively. During a median follow-up of 959 days, all-cause mortality and MAACE occurred in 72 (7%) and 93 (9%) patients, respectively. Age and >3 segments with midwall fibrosis on late gadolinium enhancement (LGE) were the only independent predictors of all-cause mortality (HR: 1.036, 95% CI: 1.0117–1.056, P < 0.001 and HR: 2.077, 95% CI...
A synthetic myocardial extracellular volume fraction (sECV) can be obtained without blood hematoc... more A synthetic myocardial extracellular volume fraction (sECV) can be obtained without blood hematocrit (Hct) by using the linear relationship between Hct and the longitudinal relaxation time of blood. Concerns have been raised about the widespread clinical application of this approach.
Grapevine 'Pinot gris' virus (GPGV) is a newly emergent virus associated with the appearance of g... more Grapevine 'Pinot gris' virus (GPGV) is a newly emergent virus associated with the appearance of grapevine leaf mottling and deformation disease (GLMD). The worldwide spreading of this virus, and sometimes of the associated disease, that has occurred in the last years, requests further epidemiological studies to verify the progress of natural infection in the field. In the present paper, GPGV infection and spatiotemporal spreading of GLMD, investigated in two vineyards with high disease occurrence, confirmed an elevated presence of the virus in vineyards of Northeastern Italy, and revealed an increasing of symptomatic plants over the time. At the same time, the progress of natural infection was monitored after the placement of new grafted plants near the symptomatic grapevines in the infected vineyards. After three years, 76 % of the plantlets that were initially GP-GV-free became GPGV-infected, giving an evidence of the fast transmission of GPGV in the field. Only 14 % of the plantlets, all collocated inside a patch with diseased plants, showed typical GLMD-symptoms. Interestingly, some plantlets, which were already GPGV-infected with the "asymptomatic" GPGV variant before planting in the field, did not become infected with the "symptomatic" viral wild variant after three years and never showed GLMD symptoms.
Objective: To describe the characteristics, the management and the outcome of a consecutive serie... more Objective: To describe the characteristics, the management and the outcome of a consecutive series of patients with diabetic foot lesions (DF) and no-option critical limb ischemia (CLI) treated with a multidimensional, interdisciplinary approach in a dedicated center. Research Design and Methods: The prospective database of the Diabetic Foot Unit of the Maria Cecilia Hospital (Cotignola, Italy) collects medical history, risk factors, chemistry values, angiographic data, characteristic of foot lesions, medical and surgical therapies of all patients admitted with a diagnosis of DF and CLI. All patients were followed-up for at least 1 year and/ or total recovery. The primary endpoint was 1-year amputation-free survival (AFS), secondary endpoints were limb salvage and survival. Results: Between October 2014 and October 2017, 1024 patients with DF and CLI were admitted to the center. Eighty-four of them (8.2%) fulfilled the criteria for no-option CLI. At 1 year, AFS, limb salvage, and survival rates were 34%, 34%, and 83%, respectively. Lesions located proximal to the Lisfranc joint were associated with major amputation (HR 2.1 [1.2-3.6]). One-year survival of patients treated with minor procedures was significantly higher compared to patients treated with major amputation (96% vs 76%, log-rank p = 0.019). Major amputation was independently associated with mortality (HR 7.83 [1.02-59.89]). Conclusions: The application of dedicated and standardized strategies permitted limb salvage in one-third of patients with no-option CLI. Patients with stable lesions limited to the forefoot and without ischaemic pain had a greater probability to successfully receive conservative treatments. Limb salvage was associated with subsequent higher one-year survival.
Accurate quantification of left ventricular (LV) volumes [end-diastolic volume (EDV) and end-syst... more Accurate quantification of left ventricular (LV) volumes [end-diastolic volume (EDV) and end-systolic volume (ESV)] and ejection fraction (EF) is of critical importance. The development of real-time three-dimensional echocardiography (RT3DE) has shown better correlation than two-dimensional (2D) echocardiography with magnetic resonance imaging (MRI) measurements. The aim of our study was to assess the accuracy of RT3DE and 64-slice computed tomography (CT) in the evaluation of LV volumes and function using MRI as the reference standard in a real-world population with various types of heart disease with different chamber geometry. The study population consisted of 66 patients referred for cardiac MRI for various pathologies. All patients underwent cardiac MRI, and RT3DE and 64 slices CT were then performed on a subsequent day. The study population was then divided into 5 clinical groups depending on the underlying heart disease. RT3DE volumes correlated well with MRI values (R (2) values: 0.90 for EDV and 0.94 for ESV). RT3DE measurements of EF correlated well with MRI values (R (2)Â =Â 0.86). RT3DE measurements resulted in slightly underestimated values of both EDV and ESV, as reflected by biases of -9.18 and -4.50Â mL, respectively. Comparison of RT3DE and MRI in various types of cardiomyopathies showed no statistical difference between different LV geometrical patterns. These results confirm that RT3DE has good accuracy in everyday clinical practice and can be of clinical utility in all types of cardiomyopathy independently of LV geometric pattern, LV diameter or wall thickness, taking into account a slight underestimation of LV volumes and EF compared to MRI.
Mesothelialymonocytic incidental cardiac excrescence (MICE) is a benign finding made up of a mixt... more Mesothelialymonocytic incidental cardiac excrescence (MICE) is a benign finding made up of a mixture of cuboidal mesothelial cells, histiocytes and fibrine and is mainly found incidentally during open heart surgery, commonly after cardiac catheterization. Clinical importance of this lesion has been emphasized because of its potential confusion with malignancies, especially with metastatic carcinoma. We report a case of an asymptomatic 72-year-old man with incidental finding of a pericardial effusion and a small mass attached to the left appendage.
Aims: Periprosthetic aortic regurgitation after TAVI is relatively common, but may have relevant ... more Aims: Periprosthetic aortic regurgitation after TAVI is relatively common, but may have relevant clinical consequences. The aim of our study is to evaluate the role of subvalvular calcifications in the generation of paravalvular aortic regurgitation. Methods: A total of 43 consecutive patients who underwent TAVI with CoreValve. Two and three dimensional transesophageal echocardiography was performed during the procedure. The presence and the distribution of aortic valve calcifications were evaluated from three dimensional dataset. The distribution of sub valvular calcifications (calcium nodules located below the aortic annulus line) was described referring to the corresponding aortic cusp. The presence of post-procedural aortic regurgitation was evaluated at the end of the device implantation and graded as 0=absent, 1=mild, 2= moderate and 3=severe. Regurgitation jets localizations were than described referring to the corresponding aortic cusp. Patients were divided into 4 groups ba...
Cardiovascular prevention has been developed in the last eight years producing an ever increasing... more Cardiovascular prevention has been developed in the last eight years producing an ever increasing amount of data requiring frequent updating. Studies using angiography to determine change in coronary obstruction have indicated progression, stabilization, or regression of coronary lesions associated with changes in plasma lipids and lipoproteins. Moreover, the guidelines on arterial hypertension published in 2007 listed the risk factors affecting prognosis but even by 2009 an update modified not only the list of risks, but even the philosophy behind the thought process which introduced as essential element in the prognosis of hypertension the ascertained existence of a damaged organ. Thus, the documentation of atherosclerotic vascular disease (plaques) and the quantification of its extension in the arterial tree became a determinant in the definition of cardiovascular risk. Magnetic Resonance (MRI) and coronary computed tomography (coro CT) applied to the heart and large vessels are ...
A young man presented with recurrent ischemic stroke under antiplatelet therapy. A patent foramen... more A young man presented with recurrent ischemic stroke under antiplatelet therapy. A patent foramen ovale (PFO) was diagnosed by transesophageal echocardiography (TEE) and the patient was referred to our institution for percutaneous closure. An echogenic mass in the right atrium was detected during the intraprocedural TEE. The interventional team decided to perform transcatheter closure of PFO under fluoroscopy and TEE guide, without complications. Subsequent cardiac magnetic resonance (CMR) imaging confirmed an encapsulated and hyperintense mass located in the roof of the right atrium. The signal intensity pattern and the absence of gadolinium contrast uptake allowed a confident diagnosis of lipoma. Cardiac lipoma accounts for about 10% of primary cardiac tumors and frequently rises from the epicardial fat tissue. Echocardiographic images can remain equivocal about the nature of the mass and CMR offers a substantial contribution to a correct diagnosis. The tumor usually appears encapsulated and asymptomatic, but dyspnea, atrial and ventricular arrhythmias and, rarely, peripheral embolization have been reported. To our knowledge, this is the second case reported on paradoxical embolization associated with right atrial lipoma. Although the relationship of cardiac lipoma with stroke is not well defined, the potential proembolic significance of this lesion cannot be excluded, especially when a PFO coexists.
Interactive CardioVascular and Thoracic Surgery, 2008
Mesothelialymonocytic incidental cardiac excrescence (MICE) is a benign finding made up of a mixt... more Mesothelialymonocytic incidental cardiac excrescence (MICE) is a benign finding made up of a mixture of cuboidal mesothelial cells, histiocytes and fibrine and is mainly found incidentally during open heart surgery, commonly after cardiac catheterization. Clinical importance of this lesion has been emphasized because of its potential confusion with malignancies, especially with metastatic carcinoma. We report a case of an asymptomatic 72-year-old man with incidental finding of a pericardial effusion and a small mass attached to the left appendage.
Mesothelialymonocytic incidental cardiac excrescence (MICE) is a benign finding made up of a mixt... more Mesothelialymonocytic incidental cardiac excrescence (MICE) is a benign finding made up of a mixture of cuboidal mesothelial cells, histiocytes and fibrine and is mainly found incidentally during open heart surgery, commonly after cardiac catheterization. Clinical importance of this lesion has been emphasized because of its potential confusion with malignancies, especially with metastatic carcinoma. We report a case of an asymptomatic
Journal of the American Society of Echocardiography, 2008
The ability to collectively toss a common coin among n parties in the presence of faults is an im... more The ability to collectively toss a common coin among n parties in the presence of faults is an important primitive in the arsenal of randomized distributed protocols. In the case of dishonest majority, it was shown to be impossible to achieve less than 1 r bias in O(r) rounds (Cleve STOC '86). In the case of honest majority, in contrast, unconditionally secure O(1)-round protocols for generating common perfectly unbiased coins follow from general completeness theorems on multiparty secure protocols in the perfectly secure channels model (e.g., BGW, CCD STOC '88). However, in the multi-party protocols with faulty minority, parties need to generate and hold local secret values which are assumed to be perfectly hidden from malicious parties: an assumption which is crucial to proving the resulting common coin is unbiased. This assumption unfortunately does not seem to hold in practice, as attackers can launch side-channel attacks on the local state of honest parties and leak information on their secrets. In this work, we present an O(1)-round protocol for collectively generating an unbiased common coin, in the presence of leakage on the local state of the honest parties. We tolerate t ≤ ( 1 3 -)n computationally-unbounded Byzantine faults and in addition a Ω(1)-fraction leakage on each (honest) party's secret state. Our results hold in the memory leakage model (of Akavia, Goldwasser, Vaikuntanathan '08) adapted to the distributed setting. Another contribution of our work is a tool we use to achieve collective coin flipping -leakageresilient verifiable secret sharing. Informally, this is a variant of ordinary VSS in which secrecy guarantees are maintained even if information is leaked on individual shares of the secret.
Increased heart rate is associated with high blood pressure and metabolic disturbances that lead ... more Increased heart rate is associated with high blood pressure and metabolic disturbances that lead to hypertension, atherosclerosis and increased cardiovascular morbidity and mortality. In this respect, elevated heart rate can be considered a marker of risk. Whole body temperature and energy needs are controlled by heart activity, and the 'language' employed by the heart could be considered its rate, which, via the intensity and frequency of shear stress, it uses to regulate endothelial function and vascular tone. A close link between body temperature, metabolism and heart rate has been observed, and so heart rate may determine metabolic demand and 'control' the duration of life. In mammals, the calculated number of heart beats in a lifetime is remarkably constant, despite a 40-fold difference in life expectancy. According to this view, a reduction in heart rate would increase life expectancy also in humans. The heart produces and utilizes approximately 30 kg adenosine triphosphate each day, and slowing its rate by 10 beats/min would result in a saving of about 5 kg in a day. Considering that heart rate is a major determinant of oxygen consumption and metabolic demand, heart rate reduction would be expected to diminish cardiac workload. Clinical studies with beta-blockers have already shown a reduction in mortality and improvement in outcome as a result of reduction in heart rate.
During the past 50 years there have been vast improvements in the treatment of chronic heart fail... more During the past 50 years there have been vast improvements in the treatment of chronic heart failure (CHF). CHF was initially considered to be a cardio-renal problem -an acute disorder leading to volume expansion and oedema. Diuretics and digitalis were the only available treatments. Subsequently, CHF was considered to be the result of both myocardial dysfunction and increased tone in the pulmonary and peripheral circulations. The presence of peripheral vasoconstriction suggested that circulatory failure was an important component of the disease, and vasodilators were added to therapy. In the more recent past, experimental and clinical studies have demonstrated that CHF is also characterized by increased neurohormonal activation. This has led to the use of angiotensin-converting enzyme inhibitors, beta-blockers and spirouolactone in CHF. Increased neurohormonal activity is now recognized as one of the major pathophysiological factors that contribute to the progression of CHF. Activation of neurohormonal mechanisms is only compensatory in the short term; chronic activation produces detrimental changes in the myocardkma, kidneys and peripheral vasculature. This article provides an overview of the key neurohormonal systems that are activated in CHF. (Eur Heart J Supplements 2002; 4 (Suppl D): D3-Dll)
properties and configurations have to be considered. Gradient magnetic fields can cause induced v... more properties and configurations have to be considered. Gradient magnetic fields can cause induced voltages but contribute negligibly to temperature increases. Results: Detailed standardisation of MR test methods have begun on the part of the American Society of Testing and Materials (ASTM, USA). Results are basic standardized test methods for magnetic force, torque, RF heating and image artifacts. For international standardisation latest research results should be summarized and codified. In first European and international standards for vascular devices, MR safety is primarily considered only. Standardised test methods are still missing. Conclusion: International (ISO) MR safety standardisation is required to minimise patient risk and therefore support device manufacturers and physicians.
Mesothelialymonocytic incidental cardiac excrescence (MICE) is a benign finding made up of a mixt... more Mesothelialymonocytic incidental cardiac excrescence (MICE) is a benign finding made up of a mixture of cuboidal mesothelial cells, histiocytes and fibrine and is mainly found incidentally during open heart surgery, commonly after cardiac catheterization. Clinical importance of this lesion has been emphasized because of its potential confusion with malignancies, especially with metastatic carcinoma. We report a case of an asymptomatic 72-year-old man with incidental finding of a pericardial effusion and a small mass attached to the left appendage.
Aims The aim of this registry was to evaluate the additional prognostic value of a composite card... more Aims The aim of this registry was to evaluate the additional prognostic value of a composite cardiac magnetic resonance (CMR)-based risk score over standard-of-care (SOC) evaluation in a large cohort of consecutive unselected non-ischaemic cardiomyopathy (NICM) patients. Methods and results In the DERIVATE registry (www.clinicaltrials.gov/registration: RCT#NCT03352648), 1000 (derivation cohort) and 508 (validation cohort) NICM patients with chronic heart failure (HF) and left ventricular ejection fraction <50% were included. All-cause mortality and major adverse arrhythmic cardiac events (MAACE) were the primary and secondary endpoints, respectively. During a median follow-up of 959 days, all-cause mortality and MAACE occurred in 72 (7%) and 93 (9%) patients, respectively. Age and >3 segments with midwall fibrosis on late gadolinium enhancement (LGE) were the only independent predictors of all-cause mortality (HR: 1.036, 95% CI: 1.0117–1.056, P < 0.001 and HR: 2.077, 95% CI...
A synthetic myocardial extracellular volume fraction (sECV) can be obtained without blood hematoc... more A synthetic myocardial extracellular volume fraction (sECV) can be obtained without blood hematocrit (Hct) by using the linear relationship between Hct and the longitudinal relaxation time of blood. Concerns have been raised about the widespread clinical application of this approach.
Grapevine 'Pinot gris' virus (GPGV) is a newly emergent virus associated with the appearance of g... more Grapevine 'Pinot gris' virus (GPGV) is a newly emergent virus associated with the appearance of grapevine leaf mottling and deformation disease (GLMD). The worldwide spreading of this virus, and sometimes of the associated disease, that has occurred in the last years, requests further epidemiological studies to verify the progress of natural infection in the field. In the present paper, GPGV infection and spatiotemporal spreading of GLMD, investigated in two vineyards with high disease occurrence, confirmed an elevated presence of the virus in vineyards of Northeastern Italy, and revealed an increasing of symptomatic plants over the time. At the same time, the progress of natural infection was monitored after the placement of new grafted plants near the symptomatic grapevines in the infected vineyards. After three years, 76 % of the plantlets that were initially GP-GV-free became GPGV-infected, giving an evidence of the fast transmission of GPGV in the field. Only 14 % of the plantlets, all collocated inside a patch with diseased plants, showed typical GLMD-symptoms. Interestingly, some plantlets, which were already GPGV-infected with the "asymptomatic" GPGV variant before planting in the field, did not become infected with the "symptomatic" viral wild variant after three years and never showed GLMD symptoms.
Objective: To describe the characteristics, the management and the outcome of a consecutive serie... more Objective: To describe the characteristics, the management and the outcome of a consecutive series of patients with diabetic foot lesions (DF) and no-option critical limb ischemia (CLI) treated with a multidimensional, interdisciplinary approach in a dedicated center. Research Design and Methods: The prospective database of the Diabetic Foot Unit of the Maria Cecilia Hospital (Cotignola, Italy) collects medical history, risk factors, chemistry values, angiographic data, characteristic of foot lesions, medical and surgical therapies of all patients admitted with a diagnosis of DF and CLI. All patients were followed-up for at least 1 year and/ or total recovery. The primary endpoint was 1-year amputation-free survival (AFS), secondary endpoints were limb salvage and survival. Results: Between October 2014 and October 2017, 1024 patients with DF and CLI were admitted to the center. Eighty-four of them (8.2%) fulfilled the criteria for no-option CLI. At 1 year, AFS, limb salvage, and survival rates were 34%, 34%, and 83%, respectively. Lesions located proximal to the Lisfranc joint were associated with major amputation (HR 2.1 [1.2-3.6]). One-year survival of patients treated with minor procedures was significantly higher compared to patients treated with major amputation (96% vs 76%, log-rank p = 0.019). Major amputation was independently associated with mortality (HR 7.83 [1.02-59.89]). Conclusions: The application of dedicated and standardized strategies permitted limb salvage in one-third of patients with no-option CLI. Patients with stable lesions limited to the forefoot and without ischaemic pain had a greater probability to successfully receive conservative treatments. Limb salvage was associated with subsequent higher one-year survival.
Accurate quantification of left ventricular (LV) volumes [end-diastolic volume (EDV) and end-syst... more Accurate quantification of left ventricular (LV) volumes [end-diastolic volume (EDV) and end-systolic volume (ESV)] and ejection fraction (EF) is of critical importance. The development of real-time three-dimensional echocardiography (RT3DE) has shown better correlation than two-dimensional (2D) echocardiography with magnetic resonance imaging (MRI) measurements. The aim of our study was to assess the accuracy of RT3DE and 64-slice computed tomography (CT) in the evaluation of LV volumes and function using MRI as the reference standard in a real-world population with various types of heart disease with different chamber geometry. The study population consisted of 66 patients referred for cardiac MRI for various pathologies. All patients underwent cardiac MRI, and RT3DE and 64 slices CT were then performed on a subsequent day. The study population was then divided into 5 clinical groups depending on the underlying heart disease. RT3DE volumes correlated well with MRI values (R (2) values: 0.90 for EDV and 0.94 for ESV). RT3DE measurements of EF correlated well with MRI values (R (2)Â =Â 0.86). RT3DE measurements resulted in slightly underestimated values of both EDV and ESV, as reflected by biases of -9.18 and -4.50Â mL, respectively. Comparison of RT3DE and MRI in various types of cardiomyopathies showed no statistical difference between different LV geometrical patterns. These results confirm that RT3DE has good accuracy in everyday clinical practice and can be of clinical utility in all types of cardiomyopathy independently of LV geometric pattern, LV diameter or wall thickness, taking into account a slight underestimation of LV volumes and EF compared to MRI.
Mesothelialymonocytic incidental cardiac excrescence (MICE) is a benign finding made up of a mixt... more Mesothelialymonocytic incidental cardiac excrescence (MICE) is a benign finding made up of a mixture of cuboidal mesothelial cells, histiocytes and fibrine and is mainly found incidentally during open heart surgery, commonly after cardiac catheterization. Clinical importance of this lesion has been emphasized because of its potential confusion with malignancies, especially with metastatic carcinoma. We report a case of an asymptomatic 72-year-old man with incidental finding of a pericardial effusion and a small mass attached to the left appendage.
Aims: Periprosthetic aortic regurgitation after TAVI is relatively common, but may have relevant ... more Aims: Periprosthetic aortic regurgitation after TAVI is relatively common, but may have relevant clinical consequences. The aim of our study is to evaluate the role of subvalvular calcifications in the generation of paravalvular aortic regurgitation. Methods: A total of 43 consecutive patients who underwent TAVI with CoreValve. Two and three dimensional transesophageal echocardiography was performed during the procedure. The presence and the distribution of aortic valve calcifications were evaluated from three dimensional dataset. The distribution of sub valvular calcifications (calcium nodules located below the aortic annulus line) was described referring to the corresponding aortic cusp. The presence of post-procedural aortic regurgitation was evaluated at the end of the device implantation and graded as 0=absent, 1=mild, 2= moderate and 3=severe. Regurgitation jets localizations were than described referring to the corresponding aortic cusp. Patients were divided into 4 groups ba...
Cardiovascular prevention has been developed in the last eight years producing an ever increasing... more Cardiovascular prevention has been developed in the last eight years producing an ever increasing amount of data requiring frequent updating. Studies using angiography to determine change in coronary obstruction have indicated progression, stabilization, or regression of coronary lesions associated with changes in plasma lipids and lipoproteins. Moreover, the guidelines on arterial hypertension published in 2007 listed the risk factors affecting prognosis but even by 2009 an update modified not only the list of risks, but even the philosophy behind the thought process which introduced as essential element in the prognosis of hypertension the ascertained existence of a damaged organ. Thus, the documentation of atherosclerotic vascular disease (plaques) and the quantification of its extension in the arterial tree became a determinant in the definition of cardiovascular risk. Magnetic Resonance (MRI) and coronary computed tomography (coro CT) applied to the heart and large vessels are ...
A young man presented with recurrent ischemic stroke under antiplatelet therapy. A patent foramen... more A young man presented with recurrent ischemic stroke under antiplatelet therapy. A patent foramen ovale (PFO) was diagnosed by transesophageal echocardiography (TEE) and the patient was referred to our institution for percutaneous closure. An echogenic mass in the right atrium was detected during the intraprocedural TEE. The interventional team decided to perform transcatheter closure of PFO under fluoroscopy and TEE guide, without complications. Subsequent cardiac magnetic resonance (CMR) imaging confirmed an encapsulated and hyperintense mass located in the roof of the right atrium. The signal intensity pattern and the absence of gadolinium contrast uptake allowed a confident diagnosis of lipoma. Cardiac lipoma accounts for about 10% of primary cardiac tumors and frequently rises from the epicardial fat tissue. Echocardiographic images can remain equivocal about the nature of the mass and CMR offers a substantial contribution to a correct diagnosis. The tumor usually appears encapsulated and asymptomatic, but dyspnea, atrial and ventricular arrhythmias and, rarely, peripheral embolization have been reported. To our knowledge, this is the second case reported on paradoxical embolization associated with right atrial lipoma. Although the relationship of cardiac lipoma with stroke is not well defined, the potential proembolic significance of this lesion cannot be excluded, especially when a PFO coexists.
Interactive CardioVascular and Thoracic Surgery, 2008
Mesothelialymonocytic incidental cardiac excrescence (MICE) is a benign finding made up of a mixt... more Mesothelialymonocytic incidental cardiac excrescence (MICE) is a benign finding made up of a mixture of cuboidal mesothelial cells, histiocytes and fibrine and is mainly found incidentally during open heart surgery, commonly after cardiac catheterization. Clinical importance of this lesion has been emphasized because of its potential confusion with malignancies, especially with metastatic carcinoma. We report a case of an asymptomatic 72-year-old man with incidental finding of a pericardial effusion and a small mass attached to the left appendage.
Mesothelialymonocytic incidental cardiac excrescence (MICE) is a benign finding made up of a mixt... more Mesothelialymonocytic incidental cardiac excrescence (MICE) is a benign finding made up of a mixture of cuboidal mesothelial cells, histiocytes and fibrine and is mainly found incidentally during open heart surgery, commonly after cardiac catheterization. Clinical importance of this lesion has been emphasized because of its potential confusion with malignancies, especially with metastatic carcinoma. We report a case of an asymptomatic
Journal of the American Society of Echocardiography, 2008
The ability to collectively toss a common coin among n parties in the presence of faults is an im... more The ability to collectively toss a common coin among n parties in the presence of faults is an important primitive in the arsenal of randomized distributed protocols. In the case of dishonest majority, it was shown to be impossible to achieve less than 1 r bias in O(r) rounds (Cleve STOC '86). In the case of honest majority, in contrast, unconditionally secure O(1)-round protocols for generating common perfectly unbiased coins follow from general completeness theorems on multiparty secure protocols in the perfectly secure channels model (e.g., BGW, CCD STOC '88). However, in the multi-party protocols with faulty minority, parties need to generate and hold local secret values which are assumed to be perfectly hidden from malicious parties: an assumption which is crucial to proving the resulting common coin is unbiased. This assumption unfortunately does not seem to hold in practice, as attackers can launch side-channel attacks on the local state of honest parties and leak information on their secrets. In this work, we present an O(1)-round protocol for collectively generating an unbiased common coin, in the presence of leakage on the local state of the honest parties. We tolerate t ≤ ( 1 3 -)n computationally-unbounded Byzantine faults and in addition a Ω(1)-fraction leakage on each (honest) party's secret state. Our results hold in the memory leakage model (of Akavia, Goldwasser, Vaikuntanathan '08) adapted to the distributed setting. Another contribution of our work is a tool we use to achieve collective coin flipping -leakageresilient verifiable secret sharing. Informally, this is a variant of ordinary VSS in which secrecy guarantees are maintained even if information is leaked on individual shares of the secret.
Increased heart rate is associated with high blood pressure and metabolic disturbances that lead ... more Increased heart rate is associated with high blood pressure and metabolic disturbances that lead to hypertension, atherosclerosis and increased cardiovascular morbidity and mortality. In this respect, elevated heart rate can be considered a marker of risk. Whole body temperature and energy needs are controlled by heart activity, and the 'language' employed by the heart could be considered its rate, which, via the intensity and frequency of shear stress, it uses to regulate endothelial function and vascular tone. A close link between body temperature, metabolism and heart rate has been observed, and so heart rate may determine metabolic demand and 'control' the duration of life. In mammals, the calculated number of heart beats in a lifetime is remarkably constant, despite a 40-fold difference in life expectancy. According to this view, a reduction in heart rate would increase life expectancy also in humans. The heart produces and utilizes approximately 30 kg adenosine triphosphate each day, and slowing its rate by 10 beats/min would result in a saving of about 5 kg in a day. Considering that heart rate is a major determinant of oxygen consumption and metabolic demand, heart rate reduction would be expected to diminish cardiac workload. Clinical studies with beta-blockers have already shown a reduction in mortality and improvement in outcome as a result of reduction in heart rate.
During the past 50 years there have been vast improvements in the treatment of chronic heart fail... more During the past 50 years there have been vast improvements in the treatment of chronic heart failure (CHF). CHF was initially considered to be a cardio-renal problem -an acute disorder leading to volume expansion and oedema. Diuretics and digitalis were the only available treatments. Subsequently, CHF was considered to be the result of both myocardial dysfunction and increased tone in the pulmonary and peripheral circulations. The presence of peripheral vasoconstriction suggested that circulatory failure was an important component of the disease, and vasodilators were added to therapy. In the more recent past, experimental and clinical studies have demonstrated that CHF is also characterized by increased neurohormonal activation. This has led to the use of angiotensin-converting enzyme inhibitors, beta-blockers and spirouolactone in CHF. Increased neurohormonal activity is now recognized as one of the major pathophysiological factors that contribute to the progression of CHF. Activation of neurohormonal mechanisms is only compensatory in the short term; chronic activation produces detrimental changes in the myocardkma, kidneys and peripheral vasculature. This article provides an overview of the key neurohormonal systems that are activated in CHF. (Eur Heart J Supplements 2002; 4 (Suppl D): D3-Dll)
properties and configurations have to be considered. Gradient magnetic fields can cause induced v... more properties and configurations have to be considered. Gradient magnetic fields can cause induced voltages but contribute negligibly to temperature increases. Results: Detailed standardisation of MR test methods have begun on the part of the American Society of Testing and Materials (ASTM, USA). Results are basic standardized test methods for magnetic force, torque, RF heating and image artifacts. For international standardisation latest research results should be summarized and codified. In first European and international standards for vascular devices, MR safety is primarily considered only. Standardised test methods are still missing. Conclusion: International (ISO) MR safety standardisation is required to minimise patient risk and therefore support device manufacturers and physicians.
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Papers by Stefano Censi