Search Our Scientific Publications & Authors

JAMA 2021 May;325(17):1765-1778

Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas.

Importance: Nearly 10 million US adults experience stable angina, which occurs when myocardial oxygen supply does not meet demand, resulting in myocardial ischemia. Stable angina is associated with an average annual risk of 3% to 4% for myocardial infarction or death. Diagnostic tests and medical therapies for stable angina have evolved over the last decade with a better understanding of the optimal use of coronary revascularization. Read More

Allergol Immunopathol (Madr) 2021 1;49(3):17-20. Epub 2021 May 1.

Allergy Unit, Pediatrics Area, Department of Life Sciences and Public Health, Policlinico Gemelli Universitary Foundation IRCCS, Catholic University of Sacred Heart, Rome, Italy;

Functional constipation (FC) is one of the most common disorders in childhood and has a negative impact on the quality of life of children. Scientific evidence regarding a causal relationship between FC and cow's milk allergy is controversial, as it is also reported by the latest European Society for Paediatric Gastroenterology, Hepatology and Nutrition-North American Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN-NASPGHAN) recommendations. In the case of FC, routine allergometric tests are not recommended and the cows' milk-free diet is only proposed in the case of laxative-resistant constipation and only following the advice of an expert. Read More

Case Rep Cardiol 2021 11;2021:6633085. Epub 2021 Apr 11.

Department of Cardiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan 610072, China.

A 32-year-old female with systemic lupus erythematosus (SLE) for more than 7 years, and long-term treatment with cyclophosphamide, cyclosporine, methotrexate, and tacrolimus, later found to be combined with hypertrophic cardiomyopathy (HCM) for one year. The patient denied a family history of cardiomyopathy and sudden cardiac death (SCD). Echocardiography suggested that uneven thickening of the left ventricle (LV), mainly in the lower middle segment. Read More

Front Psychol 2021 16;12:652543. Epub 2021 Apr 16.

Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy.

A large number of studies, including single case and case series studies, have shown that patients with different types of frontotemporal dementia (FTD) are characterized by the emergence of artistic abilities. This led to the hypothesis of enhanced creative thinking skills as a function of these pathological conditions. However, in the last years, it has been argued that these brain pathologies lead only to an augmented "drive to produce" rather than to the emergence of creativity. Read More

Pharmaceuticals (Basel) 2021 Apr 23;14(5). Epub 2021 Apr 23.

Department of Experimental and Clinical Medicine, Division of Rheumatology, University of Firenze, 50121 Florence, Italy.

Systemic sclerosis (SSc) is an autoimmune disease, characterized by the presence of generalized vasculopathy and tissue fibrosis. Collagen vascular disorder in SSc is due to fibroblast and endothelial cell dysfunctions. This leads to collagen overproduction, vascular impairment and immune system abnormalities and, in the last stage, multi-organ damage. Read More

Cancers (Basel) 2021 Apr 22;13(9). Epub 2021 Apr 22.

Division of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.

Intraductal papillary mucinous neoplasms (IPMN) are common but difficult to manage since accurate tools for diagnosing malignancy are unavailable. This study tests the diagnostic value of the main pancreatic duct (MPD) diameter for detecting IPMN malignancy using a meta-analysis of published data of resected IPMNs. Collected from a comprehensive literature search, the articles included in this analysis must report malignancy cases (high-grade dysplasia (HGD) and invasive carcinoma (IC)) and MPD diameter so that two MPD cut-offs could be created. Read More

PLoS One 2021 28;16(4):e0250708. Epub 2021 Apr 28.

Pan American Health Organization, Incident Management Systems for COVID-19, Washington, Columbia, United States of America.

Background: Coronavirus disease (COVID-19) is the pandemic caused by SARS-CoV-2 that has caused more than 2.2 million deaths worldwide. We summarize the reported pathologic findings on biopsy and autopsy in patients with severe/fatal COVID-19 and documented the presence and/or effect of SARS-CoV-2 in all organs. Read More

Chimia (Aarau) 2021 Apr;75(4):291-295

Department of Chemistry, University of Basel, Klingelbergstrasse 80, CH-4056 Basel, Switzerland;, Email:

We review our recent experimental results on the non-destructive quantum-state detection and spectroscopy of single trapped molecules. At the heart of our scheme, a single atomic ion is used to probe the state of a single molecular ion without destroying the molecule or even perturbing its quantum state. This method opens up perspectives for new research directions in precision spectroscopy, for the development of new frequency standards, for tests of fundamental physical concepts and for the precise study of chemical reactions and molecular collisions with full control over the molecular quantum state. Read More

J Intensive Care 2021 Apr 26;9(1):36. Epub 2021 Apr 26.

Respiratory Research Unit, Department of Respiratory Medicine, Waikato Hospital, Pembroke Street, Hamilton, 3204, New Zealand.

Background: Acute respiratory distress syndrome (ARDS) is a leading cause of morbidity and mortality in the intensive care unit. Biochemical markers of cardiac dysfunction are associated with high mortality in many respiratory conditions. The aim of this systematic review is to examine the link between elevated biomarkers of cardiac dysfunction in ARDS and mortality. Read More

ASAIO J 2021 05;67(5):496-502

Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, West Virginia.

The role of extracorporeal membrane oxygenation (ECMO) in the management of severely ill patients with coronavirus disease 2019 (COVID-19) continues to evolve. The purpose of this study is to review a multi-institutional clinical experience in 100 consecutive patients, at 20 hospitals, with confirmed COVID-19 supported with ECMO. This analysis includes our first 100 patients with complete data who had confirmed COVID-19 and were supported with ECMO. Read More

NPJ Genom Med 2021 Apr 22;6(1):29. Epub 2021 Apr 22.

Rady Children's Institute for Genomic Medicine, San Diego, CA, USA.

Congenital heart disease (CHD) is the most common congenital anomaly and a major cause of infant morbidity and mortality. While morbidity and mortality are highest in infants with underlying genetic conditions, molecular diagnoses are ascertained in only ~20% of cases using widely adopted genetic tests. Furthermore, cost of care for children and adults with CHD has increased dramatically. Read More

Int J Sports Physiol Perform 2021 Apr 21:1-11. Epub 2021 Apr 21.

Postexercise recovery is a fundamental component for continuous performance enhancement. Due to physiological and morphological changes in aging and alterations in performance capacity, athletes of different ages may recover at different rates from physical exercise. Differences in body composition, physiological function, and exercise performance between men and women may also have a direct influence on restoration processes. Read More

Rev Port Cardiol 2021 May 18;40(5):383-388. Epub 2021 Apr 18.

Serviço de Cardiologia, Hospital Professor Doutor Fernando da Fonseca, EPE, Amadora, Portugal.

The authors describe a case of a patient admitted to the emergency department with diabetic ketoacidosis. Although there were no symptoms attributable to the cardiovascular system, lab tests revealed elevated troponin I and natriuretic peptides, coupled with repolarization abnormalities on the ECG. The transthoracic echocardiogram (TTE) showed a non-dilated left ventricle with severe left ventricular systolic dysfunction due to diffuse hypokinesia, and a concomitant diagnosis of profile L heart failure was proposed. Read More

Panminerva Med 2021 Apr 20. Epub 2021 Apr 20.

IRCCS Policlinico S. Orsola-Malpighi University Hospital, Bologna, Italy -

Introduction: The Brisighella Heart Study (BHS) is a long-term, prospective, population-based longitudinal study on 2939 randomly selected residents of the town of Brisighella, Emilia-Romagna, Italy.

Evidence Acquisition: At the enrollment time in 1972 no participant had any cardiovascular disease, 1491 participants were men and 1448 women, and the age span was 14 to 84 years.

Evidence Synthesis: The observational phase of the study contributed to the evidence of a strong pathophysiological association between hypercholesterolemia and hypertension. Read More

Sci Rep 2021 04 19;11(1):8449. Epub 2021 Apr 19.

Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, 1000, Manila, Philippines.

Although most patients recover from COVID-19, it has been linked to cardiac, pulmonary, and neurologic complications. Despite not having formal criteria for its diagnosis, COVID-19 associated cardiomyopathy has been observed in several studies through biomarkers and imaging. This study aims to estimate the proportion of COVID-19 patients with cardiac abnormalities and to determine the association between the cardiac abnormalities in COVID-19 patients and disease severity and mortality. Read More

Eur J Breast Health 2021 Apr 31;17(2):145-149. Epub 2021 Mar 31.

Research Institute of Senology, Acıbadem Maslak Hospital, İstanbul, Turkey.

Objective: In this study, we aimed to review the heart and left coronary artery doses over the years in patients who received breast cancer radiotherapy (RT).

Materials And Methods: A total of 436 breast cancer patients of 2 RT centers treated between the years 2010 and 2018 were included. The mean heart doses (HeartDmean-HDM) and left coronary artery mean doses (LDM) were analyzed using nonparametric tests. Read More

Rev Mal Respir 2021 Apr 15. Epub 2021 Apr 15.

Association pour la prévention de la pollution atmosphérique - A.P.P.A., Aix-Marseille université, Marseille, France; Hôtel technologique, 45, rue Joliot-Curie, 13013 Marseille, France. Electronic address:

Introduction: "Anti-pollution" masks are a form of personal protective equipment intended to ensure filtration of ambient particulate air pollution.

State Of The Art: Although according to tests performed in the lab, their filtration power is high, the filtering efficiency of these masks in real conditions of use, that is to say, during physical effort, is generally lower than that established in the laboratory and this information is rarely available on commercial products on sale. Clinical studies, which are rarely double-blind, demonstrate a lower incidence of symptoms and a somewhat better cardiac performance when exercise is performed while wearing a mask. Read More

Am J Med 2021 Apr 14. Epub 2021 Apr 14.

Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee. Electronic address:

Coronary artery disease is a leading cause of morbidity and mortality worldwide. Non-invasive imaging tests play a significant role in diagnosing coronary artery disease, as well as risk stratification and guidance for revascularization. Myocardial perfusion imaging, including single photon emission computed tomography and positron emission tomography, has been widely employed. Read More

Hamostaseologie 2021 Apr 15. Epub 2021 Apr 15.

Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria.

Extracorporeal circuits including renal replacement therapy, extracorporeal membrane oxygenation, and ventricular assist devices are increasingly used in critically ill patients. The need for anticoagulation to provide circuit patency and avoid thrombosis remains a challenging task for treating physicians. In the presence of overall low scientific evidence concerning the optimal anticoagulants, monitoring tests, and therapeutic target ranges, recommendations are largely expert opinions and most centers use individual "in-house" anticoagulation protocols. Read More

Cochrane Database Syst Rev 2021 Apr 15;4:CD013346. Epub 2021 Apr 15.

Dipartimento di Scienze Biomediche e Cliniche "L. Sacco", Università degli Studi di Milano, Milan, Italy.

Background: Hepatocellular carcinoma (HCC) occurs mostly in people with chronic liver disease and ranks sixth in terms of global instances of cancer, and fourth in terms of cancer deaths for men. Despite that abdominal ultrasound (US) is used as an initial test to exclude the presence of focal liver lesions and serum alpha-foetoprotein (AFP) measurement may raise suspicion of HCC occurrence, further testing to confirm diagnosis as well as staging of HCC is required. Current guidelines recommend surveillance programme using US, with or without AFP, to detect HCC in high-risk populations despite the lack of clear benefits on overall survival. Read More

Pediatr Emerg Care 2021 Apr 9. Epub 2021 Apr 9.

From the *Department of Pediatrics, Massachusetts General Hospital for Children †Department of Medicine, Massachusetts General Hospital, Boston MA.

Objectives: To review the presentation, management, and outcomes of pediatric pulmonary embolism (PE) patients treated at a single institution over 10 years to determine whether laboratory findings and clinical presentation predict disease severity.

Methods: We performed a retrospective chart review of patients treated for PE in a 14-bed pediatric intensive care unit from January 1, 2008, to December 31, 2018. Associations between clot burden and disease severity, clinical risk factors (body mass index, recent hospitalization, estrogen use), clinical presentation (heart rate, oxygen saturation), and laboratory values (white blood cell count, D-Dimer, troponin, proBNP) were performed using Student t test, χ tests, and 1-way analysis of variance. Read More

J Thorac Dis 2021 Mar;13(3):1833-1850

Division of Cardiovascular Surgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada.

Unruptured sinus of Valsalva aneurysms (SVAs) are rare cardiac lesions that arise due to congenital or acquired etiologies. They could be asymptomatic or cause various clinical manifestations as a consequence of their mass effect on the coronary arteries, heart valves, and other adjacent structures. While the factors predicting SVA rupture are not fully understood, ruptured SVAs carry a high complication and mortality rate, highlighting the need for early recognition and management of unruptured SVAs. Read More

JMIR Mhealth Uhealth 2021 Apr 9;9(4):e26167. Epub 2021 Apr 9.

Department of Family Medicine, Taipei Medical University Hospital, Taipei City, Taiwan.

Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia worldwide. Early diagnosis of AF is crucial for preventing AF-related morbidity, mortality, and economic burden, yet the detection of the disease remains challenging. The 12-lead electrocardiogram (ECG) is the gold standard for the diagnosis of AF. Read More

J Am Coll Cardiol 2021 Apr;77(14):1813-1822

Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.

The prevalence of cardiovascular disease (CVD) in pregnancy, both diagnosed and previously unknown, is rising, and CVD is a leading cause of maternal morbidity and mortality. Historically, women of child-bearing potential have been underrepresented in research, leading to lasting knowledge gaps in the cardiovascular care of pregnant and lactating women. Despite these limitations, clinicians should be familiar with the safety of frequently used diagnostic and therapeutic interventions to adequately care for this at-risk population. Read More

J Diabetes Metab Disord 2021 Mar 31:1-12. Epub 2021 Mar 31.

Mankar College, Mankar, West Bengal India.

Background: The coronavirus disease 2019 (COVID-19) patients with diabetes mellitus (DM) are at high risk of fatal outcomes. This meta-analysis quantifies the prevalence of mortality among (1) diabetic and (2) non-diabetic, and (3) the prevalence of DM, in hospitalized COVID-19 patients.

Methods: Published studies were retrieved from four electronic databases (PubMed, Embase, Scopus, and medRxiv) and appraised critically utilizing the National Heart, Lung, and Blood Institute's tool. Read More

Chest 2021 Apr 2. Epub 2021 Apr 2.

Research and Early Development, Respiratory, Inflammation, and Autoimmune (RIA), BioPharmaceuticals R&D, AstraZeneca, Boston, MA, USA.

Identification of pathological changes in early and mild obstructive lung disease has revealed the importance of the small airways and their contribution to symptoms. Indeed, significant small airways dysfunction has been found before any overt airway obstruction is detectable by conventional spirometry techniques. However, most therapies for the treatment of obstructive lung disease target the physiological changes and associated symptoms that result from chronic lung disease, rather than directly targeting the specific underlying causes of airflow disruption or the drivers of disease progression. Read More

JAMA Intern Med 2021 Apr 5. Epub 2021 Apr 5.

Division of General Internal Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.

Importance: Accurate diagnosis is essential to proper patient care.

Objective: To explore practitioner understanding of diagnostic reasoning.

Design, Setting, And Participants: In this survey study, 723 practitioners at outpatient clinics in 8 US states were asked to estimate the probability of disease for 4 scenarios common in primary care (pneumonia, cardiac ischemia, breast cancer screening, and urinary tract infection) and the association of positive and negative test results with disease probability from June 1, 2018, to November 26, 2019. Read More

Fac Rev 2021 24;10:31. Epub 2021 Mar 24.

Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.

Amyloidosis is a disorder characterized by misfolded precursor proteins that form depositions of fibrillar aggregates with an abnormal cross-beta-sheet conformation, known as amyloid, in the extracellular space of several tissues. Although there are more than 30 known amyloidogenic proteins, both hereditary and non-hereditary, cardiac amyloidosis (CA) typically arises from either misfolded transthyretin (ATTR amyloidosis) or immunoglobulin light-chain aggregation (AL amyloidosis). Its prevalence is more common than previously thought, especially among patients with heart failure and preserved ejection fraction (HFpEF) and aortic stenosis. Read More