RESUMO
This article investigates the conceptual connection between argumentation and explanation in the law and provides a formal account of it. To do so, the methods used are conceptual analysis from legal theory and formal argumentation from AI. The contribution and results are twofold. On the one hand, we offer a critical reconstruction of the concept of legal argument, justification, and explanation of decision-making as it has been elaborated in legal theory and, above all, in AI and law. On the other hand, we propose some definitions of explanation in the context of formal legal argumentation, showing a connection between formal justification and explanation. We also investigate the notion of stable normative explanation developed elsewhere in Defeasible Logic and extend some complexity results. Our contribution is thus mainly conceptual, and it is meant to show how notions of explanation from literature on explainable AI and legal theory can be modeled in an argumentation framework with structured arguments.
Assuntos
Infarto do Miocárdio sem Supradesnível do Segmento ST/complicações , Edema Pulmonar/etiologia , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio sem Supradesnível do Segmento ST/diagnóstico por imagem , Pneumonia/diagnóstico por imagem , Edema Pulmonar/diagnóstico por imagemAssuntos
Infarto do Miocárdio/diagnóstico , Volume Sistólico/fisiologia , Cardiomiopatia de Takotsubo/diagnóstico , Troponina I/sangue , Idoso , Diagnóstico Diferencial , Eletrocardiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/sangue , Infarto do Miocárdio/fisiopatologia , Cardiomiopatia de Takotsubo/sangue , Cardiomiopatia de Takotsubo/fisiopatologiaAssuntos
Angina Pectoris Variante/etiologia , Angioplastia Coronária com Balão/efeitos adversos , Angioplastia Coronária com Balão/instrumentação , Estenose Coronária/terapia , Vasoespasmo Coronário/etiologia , Stents Farmacológicos , Angina Pectoris Variante/diagnóstico , Angina Pectoris Variante/tratamento farmacológico , Fármacos Cardiovasculares/administração & dosagem , Angiografia Coronária , Estenose Coronária/diagnóstico , Vasoespasmo Coronário/diagnóstico , Vasoespasmo Coronário/tratamento farmacológico , Everolimo , Humanos , Masculino , Pessoa de Meia-Idade , Desenho de Prótese , Sirolimo/administração & dosagem , Sirolimo/análogos & derivados , Fatores de Tempo , Resultado do Tratamento , Vasodilatadores/uso terapêuticoAssuntos
Displasia Arritmogênica Ventricular Direita/terapia , Morte Súbita Cardíaca/prevenção & controle , Desfibriladores Implantáveis , Adulto , Displasia Arritmogênica Ventricular Direita/epidemiologia , Morte Súbita Cardíaca/epidemiologia , Feminino , Seguimentos , Humanos , Masculino , Morbidade/tendências , Prognóstico , Sicília/epidemiologia , Taxa de Sobrevida/tendências , Fatores de Tempo , Resultado do TratamentoAssuntos
Ponte de Artéria Coronária , Doença da Artéria Coronariana/diagnóstico , Tomada de Decisões , Stents Farmacológicos , Trombose/diagnóstico , Ponte de Artéria Coronária/estatística & dados numéricos , Doença da Artéria Coronariana/terapia , Stents Farmacológicos/estatística & dados numéricos , Feminino , Humanos , Pessoa de Meia-Idade , Trombose/terapiaRESUMO
AIMS: Different studies have shown a correlation between aldosterone, atherosclerosis and ischemia in the past decade. Evidence exists for the relationship between high levels of aldosterone and augmented risk of cardiovascular diseases, such as hypertension, cardiac failure, coronary artery disease and stroke. The objective of this study was to determine the prognostic role of aldosterone in patients with myocardial infarction. METHODS: The study population included 96 consecutive patients admitted to our department for ST-elevated and non-ST-elevated myocardial infarction from June 2009 to March 2012. Plasma aldosterone levels were measured at admission to hospital in all patients. A 2-year prospective follow-up was performed, and fatal events and non-fatal events, such as reinfarction, congestive heart failure and arrhythmias, were recorded. RESULTS: Aldosterone levels at admission were associated with incidence of congestive heart failure (Pâ=â0.02), ventricular arrhythmias (Pâ=â0.01) and all complications (Pâ=â0.003) after 1-month follow-up. Moreover, high aldosterone levels gave important information in the medium term (24â±â6 months). Specifically, aldosterone was a predictive variable of reinfarction (Pâ<â0.0001), congestive heart failure (Pâ<â0.0001) and adverse events (Pâ=â0.0002). The logistic regression analysis confirmed these results and showed that aldosterone may be predictive of adverse events at medium-term follow-up (odds ratio 1.1, 95% confidence interval 1.03-1.15, Pâ=â0.02). CONCLUSION: These data show a strong and significant correlation between plasma aldosterone levels at admission for myocardial infarction and fatal and nonfatal adverse events. Aldosterone appears to be a main marker of adverse clinical outcome, in accordance with the literature. These data suggest the need to identify whether antialdosteronic drug treatment, applied acutely in patients with aldosterone elevation, can influence favorably the prognosis of patients with myocardial infarction.
Assuntos
Síndrome Coronariana Aguda/sangue , Aldosterona/sangue , Infarto do Miocárdio/sangue , Síndrome Coronariana Aguda/complicações , Síndrome Coronariana Aguda/mortalidade , Idoso , Idoso de 80 Anos ou mais , Arritmias Cardíacas/sangue , Arritmias Cardíacas/etiologia , Arritmias Cardíacas/mortalidade , Biomarcadores/sangue , Distribuição de Qui-Quadrado , Feminino , Seguimentos , Insuficiência Cardíaca/sangue , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/mortalidade , Hospitais Universitários , Humanos , Incidência , Itália/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/etiologia , Infarto do Miocárdio/mortalidade , Razão de Chances , Admissão do Paciente , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Recidiva , Medição de Risco , Fatores de Risco , Fatores de Tempo , Regulação para CimaRESUMO
Pulmonary embolism is a rare clinical onset of chronic myeloproliferative diseases. Early diagnosis is very important because medical therapy reduces both mortality and morbility. We describe a case of pulmonary embolism as clinical onset of an unknown myeloproliferative disorder. On the basis of our experience is very important early diagnosis and therapy to reduce incidence of later major thrombotic complications.
Assuntos
Policitemia Vera/complicações , Embolia Pulmonar/complicações , Humanos , Masculino , Pessoa de Meia-IdadeAssuntos
Infarto do Miocárdio/diagnóstico por imagem , Infarto do Miocárdio/etiologia , Adolescente , Feminino , Humanos , Hipertensão/complicações , Hipertensão/diagnóstico por imagem , Hipertensão/genética , Infarto do Miocárdio/genética , Radiografia , Fatores de Risco , Fumar/efeitos adversos , Fumar/genéticaRESUMO
The increased survival after acute myocardial infarction induced an increase in heart failure with left ventricular systolic dysfunction. Early detection and treatment of asymptomatic left ventricular systolic dysfunction give the chance to improve outcomes and to reduce costs due to the management of patients with overt heart failure.
RESUMO
Takotsubo cardiomyopaty is a recently described syndrome characterized by transient left ventricular dysfunction, mimicking an acute coronary syndrome and usually precipitated by a physical or emotional stress. We report the first case of Takotsubo cardiomyopathy after acute diarrhea in a man. It may be argued that severe diarrhea in predisposed individuals may cause an acute stress resulting in increased sympathetic activity leading to this syndrome. Probably the relationship between the adrenergic system and the heart is more complex than general thought and the stimuli which favor an autonomic imbalance and precipitate the syndrome are very disparate in clinical practice.
Assuntos
Diarreia/complicações , Cardiomiopatia de Takotsubo/etiologia , Síndrome Coronariana Aguda/diagnóstico , Doença Aguda , Idoso , Diagnóstico Diferencial , Ecocardiografia , Eletrocardiografia , Humanos , Masculino , Cardiomiopatia de Takotsubo/diagnóstico , Cardiomiopatia de Takotsubo/diagnóstico por imagemRESUMO
This is the case of a young man suffering from schizophrenia and treated with clozapine. He developed acute heart failure associated with pericardial effusion and midventricular dyskinesia with severe systolic dysfunction and left ventricular dilatation at echocardiogram, readily resolved after the suspension of clozapine therapy. The segmental wall motion abnormalities observed at echocardiogram in this case are peculiar and have never been described before. The possible cardiotoxic effects of clozapine have been reported previously in the literature. Because of its serious potential side effects this drug is not considered the first choice for treatment of schizophrenia. Before beginning treatment, patients should undergo a cardiac evaluation, and they should also be periodically followed up with echocardiograms.
Assuntos
Antipsicóticos/efeitos adversos , Clozapina/efeitos adversos , Miocardite/induzido quimicamente , Esquizofrenia/tratamento farmacológico , Disfunção Ventricular/induzido quimicamente , Doença Aguda , Insuficiência Cardíaca/induzido quimicamente , Humanos , Masculino , Contração Miocárdica/efeitos dos fármacos , Miocardite/diagnóstico por imagem , Miocardite/fisiopatologia , Derrame Pericárdico/induzido quimicamente , Ultrassonografia , Disfunção Ventricular/diagnóstico por imagem , Disfunção Ventricular/fisiopatologia , Função Ventricular Esquerda/efeitos dos fármacos , Função Ventricular Direita/efeitos dos fármacos , Adulto JovemRESUMO
A 71 year-old man with a history of previous anterior myocardial infarction, triple coronary artery bypass graft and left ventricular (LV) aneurysmectomy was admitted to the cardiology unit for chest pain. Physical examination showed a pulsing mass in the left chest wall. Cardiac multislice computed tomography showed a rare case of LV pseudoaneurysm (6.3 x 6 x 10 cm) communicating by a fistulous trait (1 cm) with the left anterior chest wall (C7-C8), creating a subfascial mass (7.1 x 3.6 cm).
Assuntos
Falso Aneurisma/diagnóstico , Fístula/diagnóstico , Aneurisma Cardíaco/diagnóstico , Idoso , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/cirurgia , Procedimentos Cirúrgicos Cardíacos , Fístula/diagnóstico por imagem , Fístula/cirurgia , Aneurisma Cardíaco/diagnóstico por imagem , Aneurisma Cardíaco/cirurgia , Ventrículos do Coração/diagnóstico por imagem , Humanos , Masculino , Tomografia Computadorizada por Raios XRESUMO
The aim of the present study was to reevaluate the indications to electrophysiological study after the observation of various clinical trials such as MADIT, AVID and MUSTT. In this perspective, the guidelines of 1995 surely appear to be outdated. The present paper concludes that the indications which still appear acceptable are those which support catheter ablation, those regarding syncope of unexplained origin and, until the conclusions of MADIT-II are universally accepted, the indication included in the MADIT study.