Institution
Catholic University of the Sacred Heart
Education•Milan, Lombardia, Italy•
About: Catholic University of the Sacred Heart is a education organization based out in Milan, Lombardia, Italy. It is known for research contribution in the topics: Population & Health care. The organization has 13592 authors who have published 31048 publications receiving 853961 citations.
Topics: Population, Health care, Cancer, Myocardial infarction, Transplantation
Papers published on a yearly basis
Papers
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TL;DR: Non-compliance or withdrawal of aspirin treatment has ominous prognostic implication in subjects with or at moderate-to-high risk for CAD and aspirin discontinuation in such patients should be advocated only when bleeding risk clearly overwhelms that of atherothrombotic events.
Abstract: Aims The role of aspirin in patients with coronary artery disease (CAD) is well established, yet patients happen to discontinue aspirin according to physician’s advice or unsupervised. We thus undertook a systematic review to appraise the hazards inherent to aspirin withdrawal or non-compliance in subjects at risk for or with CAD. Methods and results Electronic databases were systematically searched (updated January 2006). Study designs, patient characteristics, and outcomes were abstracted. Pooled estimates for odds ratios (OR) were computed according to random-effect methods. From the 612 screened studies, six were selected (50 279 patients). One study (31 750 patients) focused on adherence to aspirin therapy in the secondary prevention of CAD, two studies (2594) on aspirin discontinuation in acute CAD, two studies (13 706) on adherence to aspirin therapy before or shortly after coronary artery bypass grafting, and another (2229) on aspirin discontinuation among patients undergoing drug-eluting stenting. Overall, aspirin non-adherence/withdrawal was associated with three-fold higher risk of major adverse cardiac events (OR ¼ 3.14 [1.75–5.61], P ¼ 0.0001). This risk was magnified in patients with intracoronary stents, as discontinuation of antiplatelet treatment was associated with an even higher risk of adverse events (OR ¼ 89.78 [29.90–269.60]). Conclusion Non-compliance or withdrawal of aspirin treatment has ominous prognostic implication in subjects with or at moderate-to-high risk for CAD. Aspirin discontinuation in such patients should be advocated only when bleeding risk clearly overwhelms that of atherothrombotic events.
677 citations
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TL;DR: An updated approach to the diagnosis of idiopathic pulmonary fibrosis is provided, based on a systematic search of the medical literature and the expert opinion of members of the Fleischner Society.
676 citations
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Hammersmith Hospital1, Cancer Research UK2, Imperial College London3, University College London4, Royal North Shore Hospital5, Flinders University6, Monash University7, Ain Shams University8, French Institute of Health and Medical Research9, Charité10, University of Oldenburg11, Magna Græcia University12, Catholic University of the Sacred Heart13, University of Verona14, Tokyo Medical University15, Aichi Medical University16, King Abdulaziz Medical City17, Seoul National University Hospital18, Keimyung University19, University of Ulsan20, Inje University21, Universidad Francisco de Vitoria22, University of Amsterdam23, VU University Amsterdam24, Istanbul University25, University of Florence26, Conquest Hospital27, University of Exeter28, Anglia Ruskin University29, Emory University30, United States Department of Veterans Affairs31, University of Washington32, Stony Brook University33, Canterbury Christ Church University34, Duke University35, Hospital Clínico San Carlos36, Complutense University of Madrid37
TL;DR: Coronary revascularization guided by iFR was noninferior to revascularizations guided by FFR with respect to the risk of major adverse cardiac events at 1 year.
Abstract: BackgroundCoronary revascularization guided by fractional flow reserve (FFR) is associated with better patient outcomes after the procedure than revascularization guided by angiography alone. It is unknown whether the instantaneous wave-free ratio (iFR), an alternative measure that does not require the administration of adenosine, will offer benefits similar to those of FFR. MethodsWe randomly assigned 2492 patients with coronary artery disease, in a 1:1 ratio, to undergo either iFR-guided or FFR-guided coronary revascularization. The primary end point was the 1-year risk of major adverse cardiac events, which were a composite of death from any cause, nonfatal myocardial infarction, or unplanned revascularization. The trial was designed to show the noninferiority of iFR to FFR, with a margin of 3.4 percentage points for the difference in risk. ResultsAt 1 year, the primary end point had occurred in 78 of 1148 patients (6.8%) in the iFR group and in 83 of 1182 patients (7.0%) in the FFR group (difference i...
672 citations
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Duke University1, University at Buffalo2, University of Miami3, Catholic University of the Sacred Heart4, University of Bergen5, Autonomous University of Barcelona6, Northwestern University7, University of Erlangen-Nuremberg8, University of Tübingen9, Kyushu University10, University of Western Ontario11, University of Oxford12, University of California, Davis13, Leiden University14, Harvard University15
TL;DR: An international formal consensus of MG experts intended to be a guide for clinicians caring for patients with MG worldwide is developed.
Abstract: Objective: To develop formal consensus-based guidance for the management of myasthenia gravis (MG). Methods: In October 2013, the Myasthenia Gravis Foundation of America appointed a Task Force to develop treatment guidance for MG, and a panel of 15 international experts was convened. The RAND/UCLA appropriateness methodology was used to develop consensus guidance statements. Definitions were developed for goals of treatment, minimal manifestations, remission, ocular MG, impending crisis, crisis, and refractory MG. An in-person panel meeting then determined 7 treatment topics to be addressed. Initial guidance statements were developed from literature summaries. Three rounds of anonymous e-mail votes were used to attain consensus on guidance statements modified on the basis of panel input. Results: Guidance statements were developed for symptomatic and immunosuppressive treatments, IV immunoglobulin and plasma exchange, management of impending and manifest myasthenic crisis, thymectomy, juvenile MG, MG associated with antibodies to muscle-specific tyrosine kinase, and MG in pregnancy. Conclusion: This is an international formal consensus of MG experts intended to be a guide for clinicians caring for patients with MG worldwide.
664 citations
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TL;DR: In hypoxemic ARF, NPPV can be successful in selected populations, but when patients have a higher severity score, an older age, ARDS or pneumonia, or fail to improve after 1 h of treatment, the risk of failure is higher.
Abstract: Context: In patients with hypoxemic acute respiratory failure (ARF), randomized studies have shown noninvasive positive pressure ventilation (NPPV) to be associated with lower rates of endotracheal intubation. In these patients, predictors of NPPV failure are not well characterized. Objective: To investigate variables predictive of NPPV failure in patients with hypoxemic ARF. Design: Prospective, multicenter cohort study. Setting: Eight Intensive Care Units (ICU) in Europe and USA. Patients: Of 5,847 patients admitted between October 1996 and December 1998, 2,770 met criteria for hypoxemic ARF. Of these, 2,416 were already intubated and 354 were eligible for the study. Results: NPPV failed in 30% (108/354) of patients. The highest intubation rate was observed in patients with ARDS (51%) or community-acquired pneumonia (50%). The lowest intubation rate was observed in patients with cardiogenic pulmonary edema (10%) and pulmonary contusion (18%). Multivariate analysis identified age >40 years (OR 1.72, 95% CI 0.92–3.23), a simplified acute physiologic score (SAPS II) ≥35 (OR 1.81, 95% CI 1.07–3.06), the presence of ARDS or community-acquired pneumonia (OR 3.75, 95% CI 2.25–6.24), and a PaO2:FiO2 ≤146 after 1 h of NPPV (OR 2.51, 95% CI 1.45–4.35) as factors independently associated with failure of NPPV. Patients requiring intubation had a longer duration of ICU stay (P<0.001), higher rates of ventilator-associated pneumonia and septic complications (P<0.001), and a higher ICU mortality (P<0.001). Conclusions: In hypoxemic ARF, NPPV can be successful in selected populations. When patients have a higher severity score, an older age, ARDS or pneumonia, or fail to improve after 1 h of treatment, the risk of failure is higher.
661 citations
Authors
Showing all 13795 results
Name | H-index | Papers | Citations |
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Peter J. Barnes | 194 | 1530 | 166618 |
Cornelia M. van Duijn | 183 | 1030 | 146009 |
Dennis R. Burton | 164 | 683 | 90959 |
Paolo Boffetta | 148 | 1455 | 93876 |
Massimo Antonelli | 130 | 1272 | 79319 |
David B. Audretsch | 126 | 671 | 72456 |
Piero Anversa | 115 | 412 | 60220 |
Marco Pahor | 112 | 476 | 46549 |
David L. Paterson | 111 | 739 | 68485 |
Alfonso Caramazza | 108 | 451 | 39280 |
Anthony A. Amato | 105 | 911 | 57881 |
Stefano Pileri | 100 | 635 | 43369 |
Giovanni Gasbarrini | 98 | 894 | 36395 |
Giampaolo Merlini | 96 | 684 | 40324 |
Silvio Donato | 96 | 860 | 41166 |