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To compare 7-year survival and freedom from reoperation, as well as early clinical and hemodynamic outcomes, after surgical aortic valve replacement (SAVR) with mechanical or bioprosthetic valves in patients aged 50-70 years.

single-center retrospective cohort study including adults aged 50-70 years who underwent SAVR in 2012 with a mechanical or bioprosthetic valve. Median follow-up was 7 years. Univariable analyses were performed using Kaplan-Meier curves and Log-Rank tests for survival and freedom from reoperation analyses. Multivariable time-to-event analyses were conducted using Cox Regression.

Of a total of 193 patients, 76 (39.4%) received mechanical valves and 117 (60.6%) received bioprosthetic valves. A trend for better survival was found for mechanical prostheses when adjusting for EuroSCORE II (HR 0.35; 95%CI 0.12-1.02, p=0.054), but using a backward stepwise Cox regression prosthesis type was not retained by the model as an independent predictor of survival. Moreover, mechanical prostheses showed trends for higher freedom from reoperation (100% vs. 95.5%, Log-Rank, p=0.076), higher median EuroSCORE II (2.52% vs. 1.95%, p=0.06) and early mortality (7.9% vs. 2.6%, p=0.086). However, after adjusting for EuroSCORE II, there was no significant difference in early mortality (OR 2.3, 95%CI 0.5-10.5, p=0.272). Regarding hemodynamic performance at follow-up echocardiogram, there were no differences other than left ventricular mass regression, which was not as pronounced in the mechanical group (-12% vs. -21%, p=0.002).

Mechanical and bioprosthetic aortic valves prostheses showed similar mid-term survival in the 50-70 age group. Further prospective and larger studies are needed to provide evidence-based recommendations on this topic.
Mechanical and bioprosthetic aortic valves prostheses showed similar mid-term survival in the 50-70 age group. Further prospective and larger studies are needed to provide evidence-based recommendations on this topic.This review will focus on whole-body functional imaging applied to lung cancer disease and patient management. Lung cancer needs to be avoided… (but if not well succeeded), suspected, screened, histologically confirmed, anatomically inventoried, prognostically staged, molecularly characterized, genetically studied and finally, therapeutically managed. Functional imaging using 18F-fluoro-deoxy-glucose (FDG) is a non-invasive method that is widely used in oncologic disease, mainly for clinical staging and re-staging, with impact on therapy planning. For lung cancer, the functional imaging with FDG-PET/CT is used for clinical staging and also to provide information on a pre-diagnostic phase, to categorize lung nodules according to the metabolic risk of malignancy. Clinicians need to be aware of the different possibilities of the functional imaging information, to provide the better use of it. This review will focus on data from the different medical fields that are considered important to informed decision making when asking for functional imaging in the daily clinical routine of a lung cancer patient.
An asymptomatic carotid stenosis (CS) is defined as a stable atherosclerotic luminal narrowing in patients with no history of ipsilateral cerebral or ocular ischemic events in the past six months. The bifurcation of the common carotid artery makes this area vulnerable to atherosclerosis due to the features of haemodynamic flow. The exact prevalence of asymptomatic patients with CS remains unknown and opinions on the treatment of these patients are controversial.

The authors aimed to review the evidence on the management of the asymptomatic CS and describe its clinical characteristics, diagnosis and treatment management.

A comprehensive review of the literature was carried out to collate data from relevant studies concerning patients with extracranial moderate to severe asymptomatic carotid stenosis. The data used was identified by a search using PubMed and Google Scholar with the keywords / MESH terms "carotid stenosis", in combination with the term "asymptomatic". For this study, the authors focused on publications in the past two decades, using English publications.

A few studies have addressed the prevalence, natural course and/or prognostic impact of asymptomatic CS in patients under medical treatment or undergoing vascular surgery procedures. selleck chemical The prevalence of asymptomatic CS ranged from 0.3% to 4.5% in women and 0.5% to 5.7% in men - The risk of stroke/TIA in these patients was reported between 2% to 5% annually with a downward trend across time to 0.5% with current best medical therapy.

A great proportion of patients with asymptomatic CS should be submitted to conservative management with best medical therapy. However, selective surgical management should be considered if high risk features are present.
A great proportion of patients with asymptomatic CS should be submitted to conservative management with best medical therapy. However, selective surgical management should be considered if high risk features are present.Neural dynamics can shape human experience, including pain. Pain has been linked to dynamic functional connectivity within and across brain regions of the dynamic pain connectome (consisting of the ascending nociceptive pathway (Asc), descending antinociceptive pathway (Desc), salience network (SN), and the default mode network (DMN)), and also shows sex differences. These linkages are based on fMRI-derived slow hemodynamics. Here, we utilized the fine temporal resolution of magnetoencephalography (MEG) to measure resting state functional coupling (FCp) related to individual pain perception and pain interference in 50 healthy individuals (26 women, 24 men). We found that pain sensitivity and pain interference were linked to within- and cross-network broadband FCp across the Asc and SN. We also identified sex differences in these relationships (a) women exhibited greater within-network static FCp, whereas men had greater dynamic FCp within the dynamic pain connectome; (b) relationship between pain sensitivity and pain interference with FCp in women was commonly found in theta, whereas in men, these relationships were predominantly in the beta and low gamma bands. These findings indicate that dynamic interactions of brain networks underlying pain involve fast brain communication in men but slower communication in women.
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