Marco Pugliese - Academia.edu (original) (raw)
Papers by Marco Pugliese
BACKGROUND Although anticoagulation with unfractionated heparin (UFH) is commonly used during int... more BACKGROUND Although anticoagulation with unfractionated heparin (UFH) is commonly used during intra-aortic balloon pump (IABP) counterpulsation to prevent thromboembolic events, no data or guidelines exist to support this strategy, especially in the setting of acute myocardial infarction (AMI). This study sought to compare the short-term outcome of UFH vs fondaparinux in AMI patients who underwent successful percutaneous coronary intervention (PCI) and IABP insertion. METHODS The anticoagulation therapy of revascularised AMI patients who received IABP counterpulsation and admitted to a tertiary hospital in the last decade was retrospectively evaluated. The primary outcome was the occurrence of all-cause mortality, stroke or transient ischaemic attack, reinfarction, unplanned revascularisation, major or minor limb ischaemia, and any bleeding at 1 month. Propensity score matching was performed to compare the primary outcome between UFH and fondaparinux. RESULTS Of 1,355 AMI survivors ...
European Journal of Clinical Pharmacology, 2021
AIM There is no specific evidence on the antithrombotic management of survivors of out-of-hospita... more AIM There is no specific evidence on the antithrombotic management of survivors of out-of-hospital cardiac arrest (OHCA) due to acute myocardial infarction (AMI). We sought to compare the short-term outcome of unfractioned heparin (UFH) vs fondaparinux in OHCA survivors due to AMI admitted in our Institution in the last decade. METHODS We performed a retrospective cohort study on survivors of OHCA due to AMI managed with UFH or fondaparinux during the hospitalization. The primary outcome was the occurrence of any bleeding, all-cause mortality, cerebrovascular accidents, re-MI, and unplanned revascularization at 1 month. A propensity-score matching was performed to compare the outcome between UFH and fondaparinux. RESULTS Out of 2083 AMI patients undergoing successful PCI, OHCA was present in 94 (4.5%): 41 (43.6%) treated with UFH and 53 (56.4%) with fondaparinux. At clinical follow-up, the incidence of the primary outcome was 65.9% in UFH and 35.8% in fondaparinux group (p = 0.007). More than half of the events included in the primary outcome were related to bleeding complications. In the matched cohort of 56 patients, the primary outcome occurred in 46.4% and 25.0% (p = 0.16), while bleeding was present in 32.1% and 7.1% (p = 0.04), in the UFH and fondaparinux group, respectively. CONCLUSIONS The present analysis suggests that fondaparinux is safer than UFH in the management of OHCA due to AMI by reducing early bleeding complications at one month.
Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology
Journal of Cardiovascular Medicine, 2006
To compare the efficacy and safety of transoesophageal (TOC) vs. transthoracic (TTC) electrical c... more To compare the efficacy and safety of transoesophageal (TOC) vs. transthoracic (TTC) electrical cardioversion, both with biphasic shocks, for sinus rhythm (SR) restoration in patients with persistent atrial fibrillation (AF). We randomised 210 patients (151 male, 59 female, mean age 66 +/- 9 years) with persistent AF into two groups: group 1 (n = 104) undergoing TOC with a step-up protocol of 30, 50, 70 and 100 J, and group 2 (n = 106) undergoing TTC with a step-up protocol of 70, 100, 120 and 150 J. The two groups were homogeneous as for clinical and instrumental characteristics, except for left ventricular ejection fraction (50.5 +/- 10% in group 1 vs. 53 +/- 8% in group 2, P < 0.05) and thoracic impedance (63 +/- 8 Omega in group 1 vs. 66 +/- 6 Omega in group 2, P < 0.005). SR was restored in 98 (94%) group 1 patients vs. 99 (93%) group 2 patients (P = NS). First shock was effective in 48 (46%) group 1 patients vs. 54 (51%) group 2 patients (P = NS). Mean delivered energy was 50.4 +/- 23.6 and 95.1 +/- 29.6 J; mean effective energy was 47.3 +/- 20.7 and 91.2 +/- 26.6 J in group 1 and group 2, respectively. Cross-over to the highest energy level was never effective. TOC tolerability was optimal (mean discomfort score 1.2 on a 1-4 grading scale). Markers of myocardial necrosis did not increase and no procedure-related complications occurred. On logistic regression analysis, the most predictive variables of unsuccessful cardioversion were AF duration (P = 0.0001) and low left atrial appendage emptying velocity (P = 0.02). Both TOC and TTC with biphasic shocks are effective and safe for SR restoration in patients with persistent AF; however, the considerably lower levels of delivered and effective energies for SR restoration allow TOC to be performed during mild sedation with optimal tolerability, thus avoiding general anaesthesia.
European Journal of Echocardiography, 2005
European Journal of Heart Failure Supplements, 2003
Aim: Depression is a relatively common condition among pts with heart failure (HF) and is associa... more Aim: Depression is a relatively common condition among pts with heart failure (HF) and is associated with a poor outcome. Betablocker (BB) treatment has been demonstrated by several trials to reduce mortality, however, few data are available on BB safety in the elderly and these pts are usually underprescribed BB because their perceived side effects. Aim of this observational study was to prospectively assess the impact of Carvedilol (C) treatment to depressive symptoms and cognitive function in very elderly HF pts. Methods: Fifty-three consecutive pts aged >70 yrs (mean 78.3±6.6, range 70-94, 41.5% women, mean NYHA class 2.7±0.7) with stable HF and systolic dysfunction (mean EF% 29.9±8) were prospectively studied in a specialized HF clinic. Depressive symptoms were assessed by means of the 15-item Geriatric Depression Scale (GDS). We defined clinically relevant a score≥6. Emotional status was also assessed by means of the Emotional Dimension score of the Minnesota LHFQ (MED). Cognitive status and functional capability in activities of daily living (ADL) were assessed by means of Folstein MMSE (MMSE) and Katz ADL scale. Results: At baseline, contraindications to C were present in 20 pts (37,7%, Conventional Treatment (ConvT)). In the remaining 33 (62.3%) C was started (CT) using standard uptitration schedule. No significant differences were found between the 2 groups in age, gender, BMI, NYHA class, EF%, ischemic etiology, atrial fibrillation, serum sodium and creatinine, comorbidity, drug treatment. A GDS >/=6 was present in 41.9% of pts. No baseline differences were found in mean GDS (6.87±5.1 vs 4.86±2.8*), MMSE (23±5.5 vs 27.1±2.6*), ADL (5.88±1.0 vs 6.69±0.55*), and MED (10.2±7.4 vs 7.7±5.9*) scores (*=pns). At a mean 206±47 days f-up, 28(68.3%) of the 43 surviving pts were still on CT (mean dose 15.3±8 mg). C was discontinued in 1 pt because of worsening HF (tolerability 97%). Considering only survived pts, no significant differences were found between the 2 groups in GDS, MMSE, ADL and MED scores either at baseline or f-up and GDS≥6 was present in 34% of CT pts at baseline and 33.3% at f-up (p=ns). F-up HR and SBP were 68.5±10 b/m and 123±22 mmHg in CT pts vs 78.6±26 and 130±20 in ConvT pts (p=0.095 and p=ns). NYHA class was 2.1±0.57 vs 3.0±0,63 (p<0,0001). Conclusions: This study suggests that: 1) depression is common in elderly HF pts; 2) Carvedilol does not worsen depressive symptoms and does not adversely affect cognitive and functional status; 3) Carvedilol is well tolerated in eligible elderly pts when treatment is carefully monitored.
ICST Transactions on Ubiquitous Environments, 2015
Neurobiology of Disease, Oct 31, 2004
Microglial cells involved in the pathogenesis of many neurodegenerative diseases acquire the feat... more Microglial cells involved in the pathogenesis of many neurodegenerative diseases acquire the features of cytotoxic and phagocytic cells in response to certain pathogens and inflammatory signals. K ATP channels are energy sensors of ATP availability that link the cell's metabolic state to its membrane excitability. In pancreatic beta cells, they promote glucose-dependent insulin secretion, and in neurones, hyperpolarization that protects against hypoxic damage. This study analyses activated microglia in an in vivo rat neurodegenerative model based on acute hippocampal glutamate receptor overactivation and in postmortem samples from patients with Alzheimer's disease. We demonstrate that in activated microglia the K ATP channel components SUR-1 or SUR-2 are present together with glucokinase. Our results indicate that, according to glucose availability, these channels may modify microglia membrane potential. The functional relevance of these channels is seen as a new mechanism modulating the effects of external signals on microglia. D 2004 Elsevier Inc. All rights reserved.
The International Journal of Cardiovascular Imaging
Tissue Doppler imaging (TDI) has evolved to become a useful non invasive method that can compleme... more Tissue Doppler imaging (TDI) has evolved to become a useful non invasive method that can complement other echocardiographic techniques in the assessment of left ventricular function in different clinical conditions. Spectral pulsed TDI can provide measurements of regional systolic and diastolic myocardial velocities and is particularly useful in detecting abnormalities of left ventricular systolic and diastolic function. We investigated the presence of systo-diastolic dysfunction in patients (pts) with hypertension compared with pts affected by hypertensive cardiomyopathy and normal control subjects. We evaluated 214 pts with traditional echocardiography and TDI: 69 normal control subjects (Group A); 145 pts with hypertension, divided according to base echocardiographic evaluation in 74 with no evidence of hypertensive cardiomyopathy (diastolic dysfunction and ventricular hypertrophy, Group B), and 71 with evidence of hypertensive cardiomyopathy (Group C). Pts groups were matched fo...
The International Journal of Cardiovascular Imaging
Tissue Doppler imaging (TDI) has evolved to become a useful non invasive method that can compleme... more Tissue Doppler imaging (TDI) has evolved to become a useful non invasive method that can complement other echocardiographic techniques in the assessment of left ventricular function in different clinical conditions. Spectral pulsed TDI can provide measurements of regional systolic and diastolic myocardial velocities and is particularly useful in detecting abnormalities of left ventricular systolic and diastolic function. We investigated the presence of systo-diastolic dysfunction in patients (pts) with hypertension compared with pts affected by hypertensive cardiomyopathy and normal control subjects. We evaluated 214 pts with traditional echocardiography and TDI: 69 normal control subjects (Group A); 145 pts with hypertension, divided according to base echocardiographic evaluation in 74 with no evidence of hypertensive cardiomyopathy (diastolic dysfunction and ventricular hypertrophy, Group B), and 71 with evidence of hypertensive cardiomyopathy (Group C). Pts groups were matched fo...
Progress in neuro-psychopharmacology & biological psychiatry, 2005
Diagnosis of dementia of the Alzheimer's type depends on clinical criteria and exclusion of o... more Diagnosis of dementia of the Alzheimer's type depends on clinical criteria and exclusion of other disorders because, at this time, a validated biological marker, aside from histological brain examination, remains to be established. The canine counterpart of senile dementia of the Alzheimer type (ccSDAT) is considered a promising model for examining behavioral, cellular and molecular processes involved in early phases of human brain aging and Alzheimer disease (AD). In order to investigate the first events taking place in canine cognitive dysfunction, in this paper we established a new and rapid behavioral test that finely discriminates the degrees of cognitive impairment. Cerebrospinal fluid (CSF) analysis was performed to determine the relationship between each disease stage and modification of cerebral energy metabolism. Our results demonstrate a parallel increase of lactate, pyruvate and potassium concentrations in the severe cognitive deficit. These differences are discussed...
IEEE GLOBECOM 1998 (Cat. NO. 98CH36250), 1998
CSCW applications often require broadband network infrastructures able to support multipoint-to-m... more CSCW applications often require broadband network infrastructures able to support multipoint-to-multipoint configurations. Current B-ISDN signalling standards only provide unidirectional multicast communication. Following the principle of re-using as much as possible existing standardised protocols, multipoint-to-multipoint capability can be achieved as a mesh of correlated point-to-multipoint connections introducing some new control functionality. Control functionality foresees the invocation of suited remote operations through
Minerva cardioangiologica, 2000
It has been assessed whether echocardiographic harmonic imaging improves the detection of atrial ... more It has been assessed whether echocardiographic harmonic imaging improves the detection of atrial septal aneurysm (ASA) compared with fundamental imaging. We studied consecutively, using fundamental and harmonic imaging, 550 patients (with or without cardiopathy; 300 females and 250 males) in an outpatients' department (age 23-76 years, mean 50 years). We used a multifrequency transthoracic probe transmitting at 2 Mhz and receiving at 4 Mhz. The ASA was classified in three types according to Hanley et al. Type 1A, protruding into the right atrium without oscillation; Type 1B protruding into the right atrium with oscillation, and Type 2, protruding into the left atrium with oscillation. We compared atrial septal aneurysm definition in fundamental and harmonic mode, and assessed the interobserver agreement in the diagnosis of ASA. The echocardiographic images were recorded on magneto-optical disk and analysed by two blinded observer. With Pearson test we assessed the interobserver ...
BioMed Research International, 2015
Brain injury triggers a progressive inflammatory response supported by a dynamic astroglia-microg... more Brain injury triggers a progressive inflammatory response supported by a dynamic astroglia-microglia interplay. We investigated the progressive chronic features of the astroglia-microglia cross talk in the perspective of neuronal effects in a rat model of hippocampal excitotoxic injury. N-Methyl-D-aspartate (NMDA) injection triggered a process characterized within 38 days by atrophy, neuronal loss, and fast astroglia-mediated S100B increase. Microglia reaction varied with the lesion progression. It presented a peak of tumor necrosis factor-(TNF-) secretion at one day after the lesion, and a transient YM1 secretion within the first three days. Microglial glucocorticoid receptor expression increased up to day 5, before returning progressively to sham values. To further investigate the astroglia role in the microglia reaction, we performed concomitant transient astroglia ablation with L--aminoadipate and NMDA-induced lesion. We observed a striking maintenance of neuronal death associated with enhanced microglial reaction and proliferation, increased YM1 concentration, and decreased TNF-secretion and glucocorticoid receptor expression. S100B reactivity only increased after astroglia recovery. Our results argue for an initial neuroprotective microglial reaction, with a direct astroglial control of the microglial cytotoxic response. We propose the recovery of the astroglia-microglia cross talk as a tissue priority conducted to ensure a proper cellular coordination that retails brain damage.
This demo deals with the cryptographic aspect of security applied to the WSN domain. In particula... more This demo deals with the cryptographic aspect of security applied to the WSN domain. In particular, it shows in action a novel cryptographic scheme compliant to security requirements of real-world WSN applications (i.e. with very limited system resources). The proposed scheme exploits benefits from both symmetric and asymmetric ones where the keys, for each communicating node pairs, can be generated only if such nodes have been authenticated with respect to the network topology.
La Clinica terapeutica
In evolution of hypertension's treatment it may no be sufficient to lower blood pressure to a... more In evolution of hypertension's treatment it may no be sufficient to lower blood pressure to achieve beneficial effects in long term outcomes. Several goals of antihypertensive treatment remain unrealized. There is so great interest for new drugs that may protect target organs and improve outcomes. The angiotensin II, the major effector of the renin-angiotensin-aldosterone system, causes a variety of potentially noxious cardiovascular effects which are specially mediated by AT1 subtype receptors. AT1 receptor blockers (losartan, candesartan, irbesartan, valsartan) are available drugs in the angiotensin-II-antagonist class. This paper examine the peculiar features of this new class of drugs.
European Journal of Echocardiography, 1999
European Journal of Echocardiography, 1999
2013 9th International Wireless Communications and Mobile Computing Conference (IWCMC), 2013
ABSTRACT This paper deals with the design and implementation of security mechanisms in networked ... more ABSTRACT This paper deals with the design and implementation of security mechanisms in networked embedded systems (e.g. Wireless Sensor Networks (WSN)), without the support of external “resource unconstrained” facilities. While most literature contributions propose to put intelligence (that is usually more consuming both in computational resources and in memory as well) outside the WSN, we have already reported in some previous works that, under certain limitations, a WSN can operate as a functionally “autonomous entity” not only for sensing operations. This paper provides a global overview of the related research project and then reports on recent design upgrades to what we denote as the “Secure Platform”, i.e. the SW platform over WSN that is able to support a wide range of applications in non-standard environment such as monitoring of critical infrastructures, data acquisition in hazardous environments under standard security conditions. The work presented here is a partial achievement of the internal project WINSOME (WIreless sensor Network-based Secure system fOr structural integrity Monitoring and AlErting) at our Centre DEWS, whose target is to develop a cross-layer secure framework for advanced monitoring and alerting applications.
BACKGROUND Although anticoagulation with unfractionated heparin (UFH) is commonly used during int... more BACKGROUND Although anticoagulation with unfractionated heparin (UFH) is commonly used during intra-aortic balloon pump (IABP) counterpulsation to prevent thromboembolic events, no data or guidelines exist to support this strategy, especially in the setting of acute myocardial infarction (AMI). This study sought to compare the short-term outcome of UFH vs fondaparinux in AMI patients who underwent successful percutaneous coronary intervention (PCI) and IABP insertion. METHODS The anticoagulation therapy of revascularised AMI patients who received IABP counterpulsation and admitted to a tertiary hospital in the last decade was retrospectively evaluated. The primary outcome was the occurrence of all-cause mortality, stroke or transient ischaemic attack, reinfarction, unplanned revascularisation, major or minor limb ischaemia, and any bleeding at 1 month. Propensity score matching was performed to compare the primary outcome between UFH and fondaparinux. RESULTS Of 1,355 AMI survivors ...
European Journal of Clinical Pharmacology, 2021
AIM There is no specific evidence on the antithrombotic management of survivors of out-of-hospita... more AIM There is no specific evidence on the antithrombotic management of survivors of out-of-hospital cardiac arrest (OHCA) due to acute myocardial infarction (AMI). We sought to compare the short-term outcome of unfractioned heparin (UFH) vs fondaparinux in OHCA survivors due to AMI admitted in our Institution in the last decade. METHODS We performed a retrospective cohort study on survivors of OHCA due to AMI managed with UFH or fondaparinux during the hospitalization. The primary outcome was the occurrence of any bleeding, all-cause mortality, cerebrovascular accidents, re-MI, and unplanned revascularization at 1 month. A propensity-score matching was performed to compare the outcome between UFH and fondaparinux. RESULTS Out of 2083 AMI patients undergoing successful PCI, OHCA was present in 94 (4.5%): 41 (43.6%) treated with UFH and 53 (56.4%) with fondaparinux. At clinical follow-up, the incidence of the primary outcome was 65.9% in UFH and 35.8% in fondaparinux group (p = 0.007). More than half of the events included in the primary outcome were related to bleeding complications. In the matched cohort of 56 patients, the primary outcome occurred in 46.4% and 25.0% (p = 0.16), while bleeding was present in 32.1% and 7.1% (p = 0.04), in the UFH and fondaparinux group, respectively. CONCLUSIONS The present analysis suggests that fondaparinux is safer than UFH in the management of OHCA due to AMI by reducing early bleeding complications at one month.
Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology
Journal of Cardiovascular Medicine, 2006
To compare the efficacy and safety of transoesophageal (TOC) vs. transthoracic (TTC) electrical c... more To compare the efficacy and safety of transoesophageal (TOC) vs. transthoracic (TTC) electrical cardioversion, both with biphasic shocks, for sinus rhythm (SR) restoration in patients with persistent atrial fibrillation (AF). We randomised 210 patients (151 male, 59 female, mean age 66 +/- 9 years) with persistent AF into two groups: group 1 (n = 104) undergoing TOC with a step-up protocol of 30, 50, 70 and 100 J, and group 2 (n = 106) undergoing TTC with a step-up protocol of 70, 100, 120 and 150 J. The two groups were homogeneous as for clinical and instrumental characteristics, except for left ventricular ejection fraction (50.5 +/- 10% in group 1 vs. 53 +/- 8% in group 2, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) and thoracic impedance (63 +/- 8 Omega in group 1 vs. 66 +/- 6 Omega in group 2, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.005). SR was restored in 98 (94%) group 1 patients vs. 99 (93%) group 2 patients (P = NS). First shock was effective in 48 (46%) group 1 patients vs. 54 (51%) group 2 patients (P = NS). Mean delivered energy was 50.4 +/- 23.6 and 95.1 +/- 29.6 J; mean effective energy was 47.3 +/- 20.7 and 91.2 +/- 26.6 J in group 1 and group 2, respectively. Cross-over to the highest energy level was never effective. TOC tolerability was optimal (mean discomfort score 1.2 on a 1-4 grading scale). Markers of myocardial necrosis did not increase and no procedure-related complications occurred. On logistic regression analysis, the most predictive variables of unsuccessful cardioversion were AF duration (P = 0.0001) and low left atrial appendage emptying velocity (P = 0.02). Both TOC and TTC with biphasic shocks are effective and safe for SR restoration in patients with persistent AF; however, the considerably lower levels of delivered and effective energies for SR restoration allow TOC to be performed during mild sedation with optimal tolerability, thus avoiding general anaesthesia.
European Journal of Echocardiography, 2005
European Journal of Heart Failure Supplements, 2003
Aim: Depression is a relatively common condition among pts with heart failure (HF) and is associa... more Aim: Depression is a relatively common condition among pts with heart failure (HF) and is associated with a poor outcome. Betablocker (BB) treatment has been demonstrated by several trials to reduce mortality, however, few data are available on BB safety in the elderly and these pts are usually underprescribed BB because their perceived side effects. Aim of this observational study was to prospectively assess the impact of Carvedilol (C) treatment to depressive symptoms and cognitive function in very elderly HF pts. Methods: Fifty-three consecutive pts aged >70 yrs (mean 78.3±6.6, range 70-94, 41.5% women, mean NYHA class 2.7±0.7) with stable HF and systolic dysfunction (mean EF% 29.9±8) were prospectively studied in a specialized HF clinic. Depressive symptoms were assessed by means of the 15-item Geriatric Depression Scale (GDS). We defined clinically relevant a score≥6. Emotional status was also assessed by means of the Emotional Dimension score of the Minnesota LHFQ (MED). Cognitive status and functional capability in activities of daily living (ADL) were assessed by means of Folstein MMSE (MMSE) and Katz ADL scale. Results: At baseline, contraindications to C were present in 20 pts (37,7%, Conventional Treatment (ConvT)). In the remaining 33 (62.3%) C was started (CT) using standard uptitration schedule. No significant differences were found between the 2 groups in age, gender, BMI, NYHA class, EF%, ischemic etiology, atrial fibrillation, serum sodium and creatinine, comorbidity, drug treatment. A GDS >/=6 was present in 41.9% of pts. No baseline differences were found in mean GDS (6.87±5.1 vs 4.86±2.8*), MMSE (23±5.5 vs 27.1±2.6*), ADL (5.88±1.0 vs 6.69±0.55*), and MED (10.2±7.4 vs 7.7±5.9*) scores (*=pns). At a mean 206±47 days f-up, 28(68.3%) of the 43 surviving pts were still on CT (mean dose 15.3±8 mg). C was discontinued in 1 pt because of worsening HF (tolerability 97%). Considering only survived pts, no significant differences were found between the 2 groups in GDS, MMSE, ADL and MED scores either at baseline or f-up and GDS≥6 was present in 34% of CT pts at baseline and 33.3% at f-up (p=ns). F-up HR and SBP were 68.5±10 b/m and 123±22 mmHg in CT pts vs 78.6±26 and 130±20 in ConvT pts (p=0.095 and p=ns). NYHA class was 2.1±0.57 vs 3.0±0,63 (p<0,0001). Conclusions: This study suggests that: 1) depression is common in elderly HF pts; 2) Carvedilol does not worsen depressive symptoms and does not adversely affect cognitive and functional status; 3) Carvedilol is well tolerated in eligible elderly pts when treatment is carefully monitored.
ICST Transactions on Ubiquitous Environments, 2015
Neurobiology of Disease, Oct 31, 2004
Microglial cells involved in the pathogenesis of many neurodegenerative diseases acquire the feat... more Microglial cells involved in the pathogenesis of many neurodegenerative diseases acquire the features of cytotoxic and phagocytic cells in response to certain pathogens and inflammatory signals. K ATP channels are energy sensors of ATP availability that link the cell's metabolic state to its membrane excitability. In pancreatic beta cells, they promote glucose-dependent insulin secretion, and in neurones, hyperpolarization that protects against hypoxic damage. This study analyses activated microglia in an in vivo rat neurodegenerative model based on acute hippocampal glutamate receptor overactivation and in postmortem samples from patients with Alzheimer's disease. We demonstrate that in activated microglia the K ATP channel components SUR-1 or SUR-2 are present together with glucokinase. Our results indicate that, according to glucose availability, these channels may modify microglia membrane potential. The functional relevance of these channels is seen as a new mechanism modulating the effects of external signals on microglia. D 2004 Elsevier Inc. All rights reserved.
The International Journal of Cardiovascular Imaging
Tissue Doppler imaging (TDI) has evolved to become a useful non invasive method that can compleme... more Tissue Doppler imaging (TDI) has evolved to become a useful non invasive method that can complement other echocardiographic techniques in the assessment of left ventricular function in different clinical conditions. Spectral pulsed TDI can provide measurements of regional systolic and diastolic myocardial velocities and is particularly useful in detecting abnormalities of left ventricular systolic and diastolic function. We investigated the presence of systo-diastolic dysfunction in patients (pts) with hypertension compared with pts affected by hypertensive cardiomyopathy and normal control subjects. We evaluated 214 pts with traditional echocardiography and TDI: 69 normal control subjects (Group A); 145 pts with hypertension, divided according to base echocardiographic evaluation in 74 with no evidence of hypertensive cardiomyopathy (diastolic dysfunction and ventricular hypertrophy, Group B), and 71 with evidence of hypertensive cardiomyopathy (Group C). Pts groups were matched fo...
The International Journal of Cardiovascular Imaging
Tissue Doppler imaging (TDI) has evolved to become a useful non invasive method that can compleme... more Tissue Doppler imaging (TDI) has evolved to become a useful non invasive method that can complement other echocardiographic techniques in the assessment of left ventricular function in different clinical conditions. Spectral pulsed TDI can provide measurements of regional systolic and diastolic myocardial velocities and is particularly useful in detecting abnormalities of left ventricular systolic and diastolic function. We investigated the presence of systo-diastolic dysfunction in patients (pts) with hypertension compared with pts affected by hypertensive cardiomyopathy and normal control subjects. We evaluated 214 pts with traditional echocardiography and TDI: 69 normal control subjects (Group A); 145 pts with hypertension, divided according to base echocardiographic evaluation in 74 with no evidence of hypertensive cardiomyopathy (diastolic dysfunction and ventricular hypertrophy, Group B), and 71 with evidence of hypertensive cardiomyopathy (Group C). Pts groups were matched fo...
Progress in neuro-psychopharmacology & biological psychiatry, 2005
Diagnosis of dementia of the Alzheimer's type depends on clinical criteria and exclusion of o... more Diagnosis of dementia of the Alzheimer's type depends on clinical criteria and exclusion of other disorders because, at this time, a validated biological marker, aside from histological brain examination, remains to be established. The canine counterpart of senile dementia of the Alzheimer type (ccSDAT) is considered a promising model for examining behavioral, cellular and molecular processes involved in early phases of human brain aging and Alzheimer disease (AD). In order to investigate the first events taking place in canine cognitive dysfunction, in this paper we established a new and rapid behavioral test that finely discriminates the degrees of cognitive impairment. Cerebrospinal fluid (CSF) analysis was performed to determine the relationship between each disease stage and modification of cerebral energy metabolism. Our results demonstrate a parallel increase of lactate, pyruvate and potassium concentrations in the severe cognitive deficit. These differences are discussed...
IEEE GLOBECOM 1998 (Cat. NO. 98CH36250), 1998
CSCW applications often require broadband network infrastructures able to support multipoint-to-m... more CSCW applications often require broadband network infrastructures able to support multipoint-to-multipoint configurations. Current B-ISDN signalling standards only provide unidirectional multicast communication. Following the principle of re-using as much as possible existing standardised protocols, multipoint-to-multipoint capability can be achieved as a mesh of correlated point-to-multipoint connections introducing some new control functionality. Control functionality foresees the invocation of suited remote operations through
Minerva cardioangiologica, 2000
It has been assessed whether echocardiographic harmonic imaging improves the detection of atrial ... more It has been assessed whether echocardiographic harmonic imaging improves the detection of atrial septal aneurysm (ASA) compared with fundamental imaging. We studied consecutively, using fundamental and harmonic imaging, 550 patients (with or without cardiopathy; 300 females and 250 males) in an outpatients' department (age 23-76 years, mean 50 years). We used a multifrequency transthoracic probe transmitting at 2 Mhz and receiving at 4 Mhz. The ASA was classified in three types according to Hanley et al. Type 1A, protruding into the right atrium without oscillation; Type 1B protruding into the right atrium with oscillation, and Type 2, protruding into the left atrium with oscillation. We compared atrial septal aneurysm definition in fundamental and harmonic mode, and assessed the interobserver agreement in the diagnosis of ASA. The echocardiographic images were recorded on magneto-optical disk and analysed by two blinded observer. With Pearson test we assessed the interobserver ...
BioMed Research International, 2015
Brain injury triggers a progressive inflammatory response supported by a dynamic astroglia-microg... more Brain injury triggers a progressive inflammatory response supported by a dynamic astroglia-microglia interplay. We investigated the progressive chronic features of the astroglia-microglia cross talk in the perspective of neuronal effects in a rat model of hippocampal excitotoxic injury. N-Methyl-D-aspartate (NMDA) injection triggered a process characterized within 38 days by atrophy, neuronal loss, and fast astroglia-mediated S100B increase. Microglia reaction varied with the lesion progression. It presented a peak of tumor necrosis factor-(TNF-) secretion at one day after the lesion, and a transient YM1 secretion within the first three days. Microglial glucocorticoid receptor expression increased up to day 5, before returning progressively to sham values. To further investigate the astroglia role in the microglia reaction, we performed concomitant transient astroglia ablation with L--aminoadipate and NMDA-induced lesion. We observed a striking maintenance of neuronal death associated with enhanced microglial reaction and proliferation, increased YM1 concentration, and decreased TNF-secretion and glucocorticoid receptor expression. S100B reactivity only increased after astroglia recovery. Our results argue for an initial neuroprotective microglial reaction, with a direct astroglial control of the microglial cytotoxic response. We propose the recovery of the astroglia-microglia cross talk as a tissue priority conducted to ensure a proper cellular coordination that retails brain damage.
This demo deals with the cryptographic aspect of security applied to the WSN domain. In particula... more This demo deals with the cryptographic aspect of security applied to the WSN domain. In particular, it shows in action a novel cryptographic scheme compliant to security requirements of real-world WSN applications (i.e. with very limited system resources). The proposed scheme exploits benefits from both symmetric and asymmetric ones where the keys, for each communicating node pairs, can be generated only if such nodes have been authenticated with respect to the network topology.
La Clinica terapeutica
In evolution of hypertension's treatment it may no be sufficient to lower blood pressure to a... more In evolution of hypertension's treatment it may no be sufficient to lower blood pressure to achieve beneficial effects in long term outcomes. Several goals of antihypertensive treatment remain unrealized. There is so great interest for new drugs that may protect target organs and improve outcomes. The angiotensin II, the major effector of the renin-angiotensin-aldosterone system, causes a variety of potentially noxious cardiovascular effects which are specially mediated by AT1 subtype receptors. AT1 receptor blockers (losartan, candesartan, irbesartan, valsartan) are available drugs in the angiotensin-II-antagonist class. This paper examine the peculiar features of this new class of drugs.
European Journal of Echocardiography, 1999
European Journal of Echocardiography, 1999
2013 9th International Wireless Communications and Mobile Computing Conference (IWCMC), 2013
ABSTRACT This paper deals with the design and implementation of security mechanisms in networked ... more ABSTRACT This paper deals with the design and implementation of security mechanisms in networked embedded systems (e.g. Wireless Sensor Networks (WSN)), without the support of external “resource unconstrained” facilities. While most literature contributions propose to put intelligence (that is usually more consuming both in computational resources and in memory as well) outside the WSN, we have already reported in some previous works that, under certain limitations, a WSN can operate as a functionally “autonomous entity” not only for sensing operations. This paper provides a global overview of the related research project and then reports on recent design upgrades to what we denote as the “Secure Platform”, i.e. the SW platform over WSN that is able to support a wide range of applications in non-standard environment such as monitoring of critical infrastructures, data acquisition in hazardous environments under standard security conditions. The work presented here is a partial achievement of the internal project WINSOME (WIreless sensor Network-based Secure system fOr structural integrity Monitoring and AlErting) at our Centre DEWS, whose target is to develop a cross-layer secure framework for advanced monitoring and alerting applications.