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1.
Sci Total Environ ; 862: 160694, 2023 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-36481154

RESUMO

This work pursues the hydro-geochemical and isotopic characterization of the complex groundwater system of the Gioia Tauro Plain, one of the most important industrialized and agricultural coastal areas of southern Italy. The anthropic pressure exposes the water resources at risk of depletion and quality degradation making the plain groundwater a system of high scientific and social interest. The plain is characterized by a shallow aquifer, mostly recharged by local rains and a deep aquifer apparently less influenced by local precipitation. Both aquifers are mainly Ca-HCO3 waters except for localized sectors where Na-HCO3, Na-Cl and Ca-SO4 waters are present. In deep aquifer, both prolonged interaction with sedimentary rocks, mainly deriving from the erosion of crystalline rocks, and direct cation exchange represent the primary factors controlling the formation of Na-HCO3 waters. Mixing processes between these waters and either connate brine and/or deep thermal waters contribute to the formation of isolated high salinity Na-Cl-rich waters. In shallow aquifer, inputs of N-rich sewage and agriculture-related contaminants, and SOx emissions in proximity of the harbor are responsible of the increasing nitrate and sulphate concentrations, respectively. The Cl/Br and NO3/Cl ratios highlight contamination mainly linked to agricultural activities and contribution of wastewater. Along the northern boundary, the warmest groundwater (Na-Cl[SO4]) were found close to a bend of the main strike-slip fault system, locally favouring the rising of B- and Li-rich deep waters, testifying the influence of geological-structural features on deep water circulation. Despite the high-water demand, a direct marine intrusion is localized in a very restricted area, where we observed an incipient groundwater-seawater mixing (seawater contribution ≤7 %). The qualitative and quantitative conditions of the shallow aquifer still have acceptable levels because of the relatively high recharge inflow. A reliable hydrogeochemical conceptual model, able to explain the compositional variability of the studied waters, is proposed.


Assuntos
Água Subterrânea , Poluentes Químicos da Água , Monitoramento Ambiental , Poluentes Químicos da Água/análise , Água Subterrânea/química , Água , Itália
2.
Sci Total Environ ; 830: 154566, 2022 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-35304151

RESUMO

Crystalline aquifers are layered systems in which the hydrogeological path of waters extends from highly weathered, shallow and porous rocks to poorly weathered, deep and fissured rocks. This varying hydrogeological setting influences the water chemistry in different ways. The paper aims to reconstruct the water-rock interaction process in these various environments starting from a solid reactant represented by an average granite rock and several waters from the shallow aquifer. Afterwards, the water-rock interaction processes occurring in the deep environment are reconstructed, varying the geochemical conditions (primary reactants, secondary mineral phases allowed to precipitate, fO2 and fCO2), with a special focus on fluoride (F-). The evolution from the F-poor, Ca-HCO3 facies to the F-rich, Na-HCO3 water type of high pH was simulated using reaction path modelling. The obtained results show that the theoretical evolution trends well reproduce both shallow and deep water samples providing detailed information on the behavior of fluoride and other relevant constituents (i.e., Na, K, Ca, Mg, SiO2). The performed model represents a flexible and powerful tool for environmental research, applicable in other areas hosting F-rich groundwater.


Assuntos
Água Subterrânea , Poluentes Químicos da Água , Monitoramento Ambiental , Fluoretos/análise , Água Subterrânea/química , Dióxido de Silício , Água , Poluentes Químicos da Água/análise
3.
J Environ Manage ; 301: 113796, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34626951

RESUMO

Arsenic (As) is one of the most investigated elements worldwide due to its negative impact on the natural system. Its geochemical behavior depends on several geogenic processes, which can cause hazardous enrichment into natural waters, even in remote areas, far from anthropogenic sources. In this work the arsenic pollution issue has been addressed by studying water-rock interaction processes and applying reaction path modelling as a tool to understand the rock-to-water release of As and the fate of this natural pollutant in crystalline aquifers. In-depth geochemical characterization of several water samples discharging from crystalline aquifers was performed. The obtained data were used to fix the boundary conditions and validate the modelling outcomes. The performed modelling allowed to reconstruct the water-rock interaction processes which occur (i) in shallow and relatively shallow crystalline aquifers in which no As anomalies were observed and (ii) in As-rich areas, coupling reaction path modelling of granite dissolution with adsorption of dissolved As onto precipitating crystalline and amorphous Fe(III)-oxyhydroxides given the widespread presence of these phases in the studied environment. The results of the geochemical modelling are in agreement with the analytical data and reproduce them satisfactorily. The performed geochemical modelling is of high environmental significance because it is a flexible and powerful tool that correctly defines the water-rock interaction processes occurring in crystalline aquifers, providing valuable data to improve the knowledge on As behavior, not only in the study area, but also in similar geological settings worldwide. Therefore, the present research has broad future perspectives in the environmental field.


Assuntos
Arsênio , Poluentes Ambientais , Água Subterrânea , Poluentes Químicos da Água , Arsênio/análise , Monitoramento Ambiental , Compostos Férricos/análise , Poluentes Químicos da Água/análise
4.
Sci Total Environ ; 806(Pt 1): 150345, 2022 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-34563913

RESUMO

The concept of natural background level (NBL) aims at distinguishing the natural and anthropogenic contributions to concentrations of specific contaminants, as groundwater management and protection tools. This is usually defined as a unique value at a regional scale, even when the hydrogeological and geochemical features of a certain territory are far from homogeneous. The concentration of target contaminants is affected by multiple hydrogeochemical processes. This is the case of arsenic in the Calabria region, where concentrations are definitely variable in groundwater. To overcome the limitation of a traditional approach and to include the intrinsic hydrogeological and geochemical heterogeneity into the definition of the natural contribution to As content in groundwater, an integrated probabilistic approach to the NBL assessment combining aquifer-based preselection criteria and multivariate non-parametric geostatistics was proposed. In detail, different NBL values were selected, based on the aquifer type and/or hydrogeochemical features. Then, these aquifer-based NBL values of arsenic were used in the Probability Kriging method to map the probability of exceedance and to provide contamination risk management tools. This multivariate geostatistical approach that takes advantage of the physico-chemical variables used in the aquifer-based NBL values definition allowed mapping the probability of exceedance of As in a physically-based way. The hydrogeochemical diversity of the study area and all the processes affecting As concentrations in the aquifers have been considered too. As a result, the obtained map was characterized by a short-range and long-range variability due to local hydrogeochemical anomalies and water-rock interaction and/or atmospheric precipitation. By this approach, the NBL exceedance probability maps proved to be less "noisy", because the local hydrogeochemical conditions were filtered, and more capable of pointing out anthropogenic inputs or very anomalous natural contributions, which need to be investigated more in detail and properly managed.


Assuntos
Arsênio , Água Subterrânea , Poluentes Químicos da Água , Arsênio/análise , Monitoramento Ambiental , Itália , Probabilidade , Poluentes Químicos da Água/análise
5.
Rev Sci Instrum ; 92(5): 054504, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-34243263

RESUMO

In the last few decades, much effort has been made for the production of squeezed vacuum states in order to reduce quantum noise in the audio-frequency band. This technique has been implemented in all running gravitational-wave interferometric detectors and helped to improve their sensitivity. While the detectors are acquiring data for astrophysical observations, they must be kept in the operating condition, also called "science mode," that is, a state that requires the highest possible duty-cycle for all the instrumental parts and controls. We report the development of a highly automated setup for the generation of optical squeezed states, where all the required control loops are supervised by a software based on finite state machines; we took special care to grant ease of use, stability of operation, and possibility of auto-recovery. Moreover, the setup has been designed to be compatible with the existing software and hardware infrastructure of the Virgo detector. In this paper, we discuss the optical properties of this squeezing setup, the locking techniques, and the automation algorithms.

6.
Ital J Pediatr ; 46(1): 65, 2020 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-32430001

RESUMO

BACKGROUND: As the quality and quantity of patient-centered care may be perceived differently by recipients and independent observers, assessment of humanization of pediatric care remains an elusive issue. Herein we aim to analyze differences between the degrees of verified existing vs. perceived humanization issues of a pediatric ward. Furthermore, we examine whether there is concurrence between the degrees of humanization perceived by users (parents/visitors) vs. staff members. METHODS: The study was conducted in the pediatric wards of seven medical centers of the Campania region (Italy) categorized as general (n = 4), children's (n = 1), and university (n = 2) hospitals. The degree of existing humanization was assessed by a multidisciplinary focus group for each hospital through a pediatric care-oriented checklist specifically developed to individuate the most critical areas (i.e., those with scores < 2.5). The degree of perceived humanization was assessed through four indicators: well-being, social aspects, safety and security, and health promotion. RESULTS: The focus groups showed that critical areas common to all centers were mainly concerned with welfare, mediation, translation, and interpretation services. Specific critical issues were care and organizational processes oriented to the respect and specificity of the person and care of the relationship with the patient. Perceived humanization questionnaires revealed a lack of recreational facilities and mediation and translation services. As for specific features investigated by both tools, it was found that mediation and interpretation services were lacking in all facilities while patient perceptions and observer ratings for space, comfort, and orientation concurred only in the general hospital evaluations. CONCLUSIONS: Future humanization interventions to ensure child- and family-friendly hospital care call for careful preliminary assessments, tailored to each pediatric ward category, which should consider possible differences between perceived and verified characteristics.


Assuntos
Atitude do Pessoal de Saúde , Serviços de Saúde da Criança/organização & administração , Pais/psicologia , Assistência Centrada no Paciente/organização & administração , Pediatria , Adulto , Criança , Grupos Focais , Humanos , Itália
7.
Chemosphere ; 254: 126696, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32335434

RESUMO

In this work, a geochemical approach was used as strong-scientific tool for pre-selection of suitable remediation systems to treat Cr-contaminated groundwaters. The geochemical characterization allowed to select Nanofiltration (NF) and Reverse Osmosis (RO) as suitable remediation processes, whereas through a new geochemical modeling, the evolution of water chemistry during the water-rock interaction was also studied. The new reaction path modelling was performed re-evaluating the role of Fe as main oxidant in the system and the analytic concentrations of relevant solutes, including Cr(VI), were reproduced. The spring with the highest Cr(VI) content was treated to lower its concentration below the threshold values. A laboratory-scale set-up was used to carry out both NF and RO experiments. The experiments were conducted on different commercial membranes varying the operating pressures. The results showed high Cr(VI) rejections (around 95%) for all tested membranes, leading to Cr(VI) concentrations below the threshold limits. The high flux, obtained already at lower operating pressures, combined with high selectivity towards Cr(VI) makes NF a favorable remediation option.


Assuntos
Cromo/análise , Modelos Químicos , Poluentes Químicos da Água/análise , Purificação da Água , Filtração , Fenômenos Geológicos , Água Subterrânea/química
8.
Neurobiol Dis ; 138: 104791, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32032735

RESUMO

CDKL5 deficiency disorder (CDD) is a rare X-linked neurodevelopmental disorder that is characterised by early-onset seizures, intellectual disability, gross motor impairment, and autistic-like features. CDD is caused by mutations in the cyclin-dependent kinase-like 5 (CDKL5) gene that encodes a serine/threonine kinase with a predominant expression in the brain. Loss of CDKL5 causes neurodevelopmental alterations in vitro and in vivo, including defective dendritic arborisation and spine maturation, which most likely underlie the cognitive defects and autistic features present in humans and mice. Here, we show that treatment with epigallatocathechin-3-gallate (EGCG), the major polyphenol of green tea, can restore defects in dendritic and synaptic development of primary Cdkl5 knockout (KO) neurons. Furthermore, defective synaptic maturation in the hippocampi and cortices of adult Cdkl5-KO mice can be rescued through the intraperitoneal administration of EGCG, which is however not sufficient to normalise behavioural CDKL5-dependent deficits. EGCG is a pleiotropic compound with numerous cellular targets, including the dual-specificity tyrosine-phosphorylation-regulated kinase 1A (DYRK1A) that is selectively inhibited by EGCG. DYRK1A controls dendritic development and spine formation and its deregulation has been implicated in neurodevelopmental and degenerative diseases. Treatment with another DYRK1A inhibitor, harmine, was capable of correcting neuronal CDKL5-dependent defects; moreover, DYRK1A levels were upregulated in primary Cdkl5-KO neurons in concomitance with increased phosphorylation of Tau, a well-accepted DYRK1A substrate. Altogether, our results indicate that DYRK1A deregulation may contribute, at least in part, to the neurodevelopmental alterations caused by CDKL5 deficiency.


Assuntos
Catequina/análogos & derivados , Síndromes Epilépticas/metabolismo , Polifenóis/metabolismo , Espasmos Infantis/metabolismo , Chá/metabolismo , Animais , Encéfalo/metabolismo , Catequina/metabolismo , Hipocampo/metabolismo , Masculino , Camundongos , Camundongos Knockout , Neurônios/metabolismo , Fosforilação , Proteínas Serina-Treonina Quinases/metabolismo , Proteínas Tirosina Quinases/metabolismo
9.
Neuropharmacology ; 164: 107897, 2020 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-31794725

RESUMO

Mutations in the X-linked cyclin-dependent kinase-like 5 (CDKL5) gene are responsible for the onset of CDKL5 Deficiency Disorder (CDD), a neurological pathology characterised by severe infantile seizures, intellectual disability, impairment of gross motor skills, sleep and gastrointestinal disturbances. CDKL5 is a serine/threonine kinase the molecular network of which is not yet fully understood. Loss of CDKL5 both in vitro and in vivo leads to altered neuronal morphology including axon specification and outgrowth, dendritic arborisation and spine morphology suggesting a link between CDKL5 and the regulation of proper cytoskeleton functioning. Recently, we found that CDKL5 regulates the binding of CLIP170 to microtubules (MT). CLIP170 is a MT-plus end tracking protein (+TIP) that associates with MTs when present in its open, active conformation. Here we present evidence suggesting CLIP170 contributes to neuronal CDKL5-dependent defects and that it represents an important novel druggable target for CDD; indeed, CLIP170 is directly targeted by the neuroactive steroid pregnenolone (PREG), which induces the active conformation of the protein thus promoting MT-dynamics. We here show that PREG and a synthetic derivative pregnenolone-methyl-ether (PME) can restore the MT association of CLIP170 and revert morphological and molecular defects in Cdkl5-KO neurons at different stages of maturation. All together, these findings identify CLIP170 as possible novel druggable target for CDKL5 related disorders providing an intriguing prospective for future disease-modifying drug-based therapies.


Assuntos
Síndromes Epilépticas/tratamento farmacológico , Síndromes Epilépticas/genética , Pregnenolona/uso terapêutico , Espasmos Infantis/tratamento farmacológico , Espasmos Infantis/genética , Animais , Axônios/efeitos dos fármacos , Axônios/ultraestrutura , Células COS , Chlorocebus aethiops , Ensaio Cometa , Dendritos/efeitos dos fármacos , Dendritos/ultraestrutura , Proteína 4 Homóloga a Disks-Large/genética , Proteína 4 Homóloga a Disks-Large/metabolismo , Feminino , Cones de Crescimento/efeitos dos fármacos , Masculino , Camundongos , Camundongos Knockout , Microtúbulos/efeitos dos fármacos , Microtúbulos/patologia , Neurônios/patologia , Gravidez
10.
Sci Rep ; 9(1): 1711, 2019 02 08.
Artigo em Inglês | MEDLINE | ID: mdl-30737455

RESUMO

In this work the morphologic features of Pele's hair formed during three different eruptions of Kilauea volcano have been investigated: fountaining from Kilauea Iki's 1959 Episode 1, weak explosive activity from Halemaumau lava lake and littoral explosions at Waikupanaha (2009). Morphological studies were performed by optical, stereo- and scanning electron microscopy. For the first time 3D image analysis was carried out by synchrotron radiation X-ray computed microtomography, which allowed a high-resolution 3D reconstruction of the internal structure of each Pele's hair, highlighting several differences in terms of number density, elongation and shape of the vesicles between the samples from the three eruptions. We identified three main parameters determining these differences: initial size of the magma droplet, ejection velocity and magma viscosity. Pele's hair erupted during the Kilauea Iki's fountaining shows the highest thickness and the least elongated shape of the vesicles, though it is related to fast ejection of a low viscosity magma. We therefore suggest that the size of magma droplets is the main parameter influencing the morphology and inner textures of the Pele's hair. The comparison with Pele's hair of similar eruptions elsewhere demonstrates that there is no univocal correspondence between eruptive style and Pele's hair texture.

11.
Heart Fail Rev ; 23(6): 841-847, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30267205

RESUMO

Elevated left atrial (LA) filling pressures are associated with poor prognosis in patients with heart failure (HF). Recent evidences have shown that, in this setting, the presence of restrictive small atrial defect may protect from an extreme increase in LA pressure and prevent consecutive pulmonary congestion and acute decompensation, without the expense of an unfavourable significant left-to-right shunt. Therefore, decompression of LA by creating a unidirectional but restrictive left-to-right interatrial shunt has been emerging as a new therapeutic strategy in patients suffering from both HF with preserved and reduced ejection fraction. Two dedicated devices (V-Wave and interatrial septal device system-IASD) are currently available to create a restrictive interatrial communication. Several clinical studies have demonstrated the safety of this approach, with encouraging results regarding the improvements in haemodynamic parameters, functional status and quality of life in treated patients. We aim to summarize the present knowledge concerning this novel therapeutic approach for HF, describe the currently available devices and depict their potential future clinical indications.


Assuntos
Pressão Atrial , Cateterismo Cardíaco/métodos , Procedimentos Cirúrgicos Cardíacos/métodos , Átrios do Coração/cirurgia , Insuficiência Cardíaca/cirurgia , Próteses e Implantes , Volume Sistólico/fisiologia , Animais , Insuficiência Cardíaca/fisiopatologia , Humanos
12.
Transl Med UniSa ; 17: 12-18, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30050875

RESUMO

MicroRNAs (microRNAs or miRs) are small, non-coding RNAs that control gene expression by binding to and repressing specific mRNA target and have emered as powerful regulators of many biological processes. Understanding miRNAs-biology and functions may be pivotal to get a better insight into pathophysiological mechanisms responsible for a large number of morbid conditions and may lay the foundations for the development of novel therapeutic interventions. Moreover, besides their intracellular functions, miRs are present in the human circulation in a remarkably stable cell-free form, and their plasmatic levels have been proposed as biomarkers for several pathological conditions. The present review aims to summarize the current evidences with regard to biological role of miRNAs in cardiovascular system and their involvement in the pathogenesis of cardiovascular diseases including atherosclerosis, heart failure and pathological heart and vascular remodelling and to highlight their potential use as novel biomarkers and as therapeutic targets in cardiac and vascular diseases.

13.
Transl Med UniSa ; 17: 19-21, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30050876

RESUMO

Elevated left atrial (LA) pressures are associated with poor prognosis in heart failure (HF). Invasive monitoring of LA-pressures and direct mechanical LA-decompression are associated with functional improvement in patients suffering from HF both with reduced and preserved ejection fraction. We aim to review the current available percutaneously implantable sensors for haemodynamic telemonitoring of LA-pressures (direct LAP sensor device-HeartPOD; right ventricular device-Chronicle; pulmonary artery device-CardioMEMs).

14.
Phys Rev Lett ; 116(23): 231101, 2016 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-27341221

RESUMO

We report the first results of the LISA Pathfinder in-flight experiment. The results demonstrate that two free-falling reference test masses, such as those needed for a space-based gravitational wave observatory like LISA, can be put in free fall with a relative acceleration noise with a square root of the power spectral density of 5.2±0.1 fm s^{-2}/sqrt[Hz], or (0.54±0.01)×10^{-15} g/sqrt[Hz], with g the standard gravity, for frequencies between 0.7 and 20 mHz. This value is lower than the LISA Pathfinder requirement by more than a factor 5 and within a factor 1.25 of the requirement for the LISA mission, and is compatible with Brownian noise from viscous damping due to the residual gas surrounding the test masses. Above 60 mHz the acceleration noise is dominated by interferometer displacement readout noise at a level of (34.8±0.3) fm/sqrt[Hz], about 2 orders of magnitude better than requirements. At f≤0.5 mHz we observe a low-frequency tail that stays below 12 fm s^{-2}/sqrt[Hz] down to 0.1 mHz. This performance would allow for a space-based gravitational wave observatory with a sensitivity close to what was originally foreseen for LISA.

15.
Phys Rev Lett ; 116(5): 051104, 2016 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-26894698

RESUMO

A torsion pendulum with 2 soft degrees of freedom (DOFs), realized by off-axis cascading two torsion fibers, has been built and operated. This instrument helps characterize the geodesic motion of a test mass for LISA Pathfinder or any other free-fall space mission, providing information on cross talk and other effects that cannot be detected when monitoring a single DOF. We show that it is possible to simultaneously measure both the residual force and the residual torque acting on a quasifree test mass. As an example of the investigations that a double pendulum allows, we report the measurement of the force-to-torque cross talk, i.e., the amount of actuation signal, produced by applying a force on the suspended test mass, that leaks into the rotational DOF, detected by measuring the corresponding (unwanted) torque.

16.
Science ; 350(6256): 64-7, 2015 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-26272904

RESUMO

Directly detecting thermal emission from young extrasolar planets allows measurement of their atmospheric compositions and luminosities, which are influenced by their formation mechanisms. Using the Gemini Planet Imager, we discovered a planet orbiting the ~20-million-year-old star 51 Eridani at a projected separation of 13 astronomical units. Near-infrared observations show a spectrum with strong methane and water-vapor absorption. Modeling of the spectra and photometry yields a luminosity (normalized by the luminosity of the Sun) of 1.6 to 4.0 × 10(-6) and an effective temperature of 600 to 750 kelvin. For this age and luminosity, "hot-start" formation models indicate a mass twice that of Jupiter. This planet also has a sufficiently low luminosity to be consistent with the "cold-start" core-accretion process that may have formed Jupiter.

18.
Radiol Med ; 118(5): 752-98, 2013 Aug.
Artigo em Italiano | MEDLINE | ID: mdl-23184241

RESUMO

Cardiac magnetic resonance (CMR) is considered an useful method in the evaluation of many cardiac disorders. Based on our experience and available literature, we wrote a document as a guiding tool in the clinical use of CMR. Synthetically we describe different cardiac disorders and express for each one a classification, I to IV, depending on the significance of diagnostic information expected.


Assuntos
Doenças Cardiovasculares/diagnóstico , Imageamento por Ressonância Magnética/métodos , Meios de Contraste , Humanos , Itália
19.
Radiol Med ; 117(6): 901-38, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22466874

RESUMO

Cardiac computed tomography (CCT) has grown as a useful means in different clinical contexts. Technological development has progressively extended the indications for CCT while reducing the required radiation dose. Even today there is little documentation from the main international scientific societies describing the proper use and clinical indications of CCT; in particular, there are no complete guidelines. This document reflects the position of the Working Group of the Cardiac Radiology Section of the Italian Society of Radiology concerning the indications for CCT.


Assuntos
Doenças Cardiovasculares/diagnóstico por imagem , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Humanos , Itália , Doses de Radiação , Tomografia Computadorizada por Raios X/instrumentação , Tomografia Computadorizada por Raios X/métodos
20.
Radiol Med ; 116(8): 1161-73, 2011 Dec.
Artigo em Inglês, Italiano | MEDLINE | ID: mdl-21892711

RESUMO

PURPOSE: This study assessed the accuracy of computed tomography coronary angiography (CT-CA) for detecting significant coronary artery disease (CAD; ≥50% lumen reduction) in intermediate/high-risk asymptomatic patients. MATERIALS AND METHODS: A total of 183 consecutive asymptomatic individuals (92 men; mean age 54±11 years) with more than one major risk factor (obesity, hypertension, diabetes, hypercholesterolaemia, family history, smoking) and an inconclusive or nonfeasible noninvasive stress test result (stress electrocardiography, stress echocardiography, nuclear stress scintigraphy) underwent CT-CA in an outpatient setting. All patients underwent conventional coronary angiography (CAG) within 4 weeks. Data from CT-CA were compared with CAG regarding the presence of significant CAD (≥50% lumen reduction). RESULTS: Mean calcium score was 177±432, mean heart rate during the CT-CA scan was 58±8 bpm and the prevalence (per-patient) of obstructive CAD was 19%. CT-CA showed single-vessel CAD in 9% of patients, two-vessel CAD in 9% and three-vessel CAD in 0%. Per-patient sensitivity, specificity, positive predictive value and negative predictive value of CT-CA were 100% (90-100), 98% (96-99), 97% (85-99), 100% (97-100), respectively. Positive and negative likelihood ratios were 151 and 0, respectively. CONCLUSIONS: CT-CA is an excellent noninvasive imaging modality for excluding significant CAD in intermediate/ high-risk asymptomatic patients with inconclusive or nonfeasible noninvasive stress test.


Assuntos
Calcinose/diagnóstico por imagem , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Estenose Coronária/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Idoso , Calcinose/epidemiologia , Doença da Artéria Coronariana/epidemiologia , Estenose Coronária/epidemiologia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais/estatística & dados numéricos , Valor Preditivo dos Testes , Prevalência , Medição de Risco , Fatores de Risco , Sensibilidade e Especificidade , Sicília/epidemiologia
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