A 71 year-old man with a history of previous anterior myocardial infarction, triple coronary arte... more 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).
International angiology: a journal of the International Union of Angiology
Impaired endothelial function and increased carotid intima-media thickness are key events in the ... more Impaired endothelial function and increased carotid intima-media thickness are key events in the atherosclerotic process and predict future cardiovascular events in subjects with and without coronary artery disease. The purpose of this study was to investigate whether the vasodilator response to increased flow in the brachial artery and the presence of carotid lesions may have a prognostic significance for in-stent restenosis in patients undergoing coronary angioplasty. The study population included 58 patients undergoing percutaneous coronary intervention (PCI) with stenting and at least 10 months of follow-up. All patients underwent ultrasound detection of brachial artery reactivity 30 days after PCI. Flow mediated dilatation (FMD) was investigated after 5 minutes of occlusion of the artery and nitroglycerin mediated dilation (NMD) was investigated after administration of sublingual nitrates. Vascular echography was performed to measure intima media thickness (IMT) of carotid arte...
Italian heart journal. Supplement: official journal of the Italian Federation of Cardiology
The aim of the present study was to reevaluate the indications to electrophysiological study afte... more 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 In this perspective, the guidelines of 1995 surely appear to be outdated.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.
International angiology : a journal of the International Union of Angiology, 2009
The aim of the study was to evaluate the prevalence of carotid atherosclerosis and endothelial dy... more The aim of the study was to evaluate the prevalence of carotid atherosclerosis and endothelial dysfunction in 45 young patients (38 mens and 7 females) with myocardial infarction (MI), age 29-45, mean age 42+/-3 years, to verify its possible role as a marker of coronary atherosclerosis. Vascular echography was performed to verify the presence of carotid atherosclerosis and/or endothelial dysfunction in 45 young patients with MI and in 45 healthy control subjects well matched for age and sex. We observed a normal intima media thickness (IMT) only in 30% of patients with juvenile myocardial infarction (JMI) compared with 66% in the control group (P<0.0001) and 34% of patients showed an increased IMT compared with 24% of healthy subjects (P<0.0001). Compared with control subjects, patients with JMI had lower flow-mediated reactivity of the brachial arteries (P<0.05). There was a negative linear relationship between flow-mediated dilation and IMT (P<0.001). The severity of c...
ABSTRACT The aim of our study was to determine if patients with multifocal atherosclerosis have a... more ABSTRACT The aim of our study was to determine if patients with multifocal atherosclerosis have a worse prognosis than patients with atherosclerosis only in the coronary bed. We studied 45 subjects admitted to intensive coronary care unit of the Division of Cardiology with the diagnosis of acute myocardial infarction (AMI). Traditional cardiovascular risk factors were investigated and laboratory analysis included measurement of plasma lipids, glycemia, fibrinogen and high-sensitivity-C-reactive protein (hs-CRP). Each patient underwent coronary-angiography as well as carotid and peripheral arterial ultrasound examination. A follow-up of 13+/-2 months was performed. We found that the severity of coronary atherosclerosis is significantly associated with the presence of carotid (P&lt;0.05) and peripheral atherosclerosis (P&lt;0.005). Markers of inflammation, hs-CRP (P&lt;0.005) and fibrinogen (P&lt;0.05), were significantly associated with multifocal atherosclerosis. We have shown that an increased number of coronary vessels with atherosclerotic stenosis is associated with a higher value of carotid (P&lt;0.0001) and peripheral intima media thickness (P&lt;0.0001). During 13 months of follow-up the incidence of fatal or non fatal events was 18%. The multivariate analysis showed that the variables independently associated with fatal and non fatal events were: male sex (P&lt;0.001), family history of cardiovascular disease (P&lt;0.005), hypertension (P&lt;0.01), diabetes mellitus (P&lt;0.05), higher levels of total cholesterol (P&lt;0.05), smoking habit (P&lt;0.05), and multifocal atherosclerosis (P&lt;0.05). The ultrasound examination of carotid and peripheral atherosclerotic lesions may be useful in placing patients with AMI in a category of higher risk of cerebrovascular and cardiovascular events. Moreover, the precocious identification of patients at risk can suggest a more aggressive pharmacological treatment and a more accurate follow-up in order to avoid future events.
Type 2 diabetes is associated with an increase in the risk of coronary heart disease, by a factor... more Type 2 diabetes is associated with an increase in the risk of coronary heart disease, by a factor of two to four. The scientific community has suggested that all patients with diabetes could be treated as if they had a prior coronary heart disease. A computer review of 11-year prevalence (from 1991 to 2002) of type 2 diabetes among 3242 patients admitted to the Intensive Coronary Care Unit of the Division of Cardiology of the University Hospital ''Paolo Giaccone'', Palermo, was carried out, with the diagnosis of ST elevation myocardial infarction (STEMI) (51%), non ST elevation myocardial infarction (NSTEMI) (6%) or unstable angina (UA) (43%). Prevalence of type 2 diabetes was 31.5% on the overall population; in particular, a higher prevalence was found among STEMI affected patients (37% of the diabetic patients). The average number of days of an in-hospital stay was of 10.4+/-3.1 for diabetic patients without complications (N.=602) and of 15.9+/-4.4 for diabetic pat...
The clinical and prognostic role of cardiac natriuretic peptides (CNP) in patients with heart fai... more The clinical and prognostic role of cardiac natriuretic peptides (CNP) in patients with heart failure is well known; recently, several studies have evaluated the possibility of using CNP to evaluate their potential prognostic role in patients with acute coronary syndromes (ACS). The aim of this study was to evaluate the short term prognostic value of NT-proBNP in 70 patients admitted for ACS. The authors studied 70 patients with ACS, evaluating, at admission, clinical-anamnestic, instrumental and laboratory characteristics including NT-proBNP plasma levels. Patients were monitored in a 6-month-follow-up to record adverse fatal events and their possible correlation with baseline characteristics. The incidence of adverse events during the follow-up period was 28% (10 patients). In patients with adverse events, the authors observed lower left ventricle ejection fraction (P=0.01), higher prevalence of ST elevation myocardial infarction (P=0.03) and higher NT-proBNP levels (P=0.03), comp...
A non-monotonic logic of institutional agency is defined combining a computationally oriented non... more A non-monotonic logic of institutional agency is defined combining a computationally oriented non- monotonic system (Defeasible Logic) and inten- sional notions of agency.
This paper presents an approach for the specification and implementation of e-contracts for Web m... more This paper presents an approach for the specification and implementation of e-contracts for Web monitoring. This is done in the setting of RuleML. We argue that monitoring contract execution requires also a logical account of deontic concepts and of violations. Accordingly, RuleML is extended to cover these aspects. 1 Background and Motivation Business contracts are mutual agreements between two or
In this paper we propose a temporal extension of Defeasible Logic to model legal modifications, s... more In this paper we propose a temporal extension of Defeasible Logic to model legal modifications, such as abrogation and annulment. Hence, this frame- work overcomes the difficulty, discussed elsewhere (7), of capturing these modi- fication types using belief and base revision.
In this paper we present a Gentzen system for reasoning with contrary- to-duty obligations. The i... more In this paper we present a Gentzen system for reasoning with contrary- to-duty obligations. The intuition behind the system is that a contrary- to-duty is a special kind of normative exception. The logical machinery to formalize this idea is taken from substructural logics and it is based on the definition of a new non-classical connective capturing the notion of reparational
Abstract In this paper we present a description of an OWL Ontology of fundamental legal concepts ... more Abstract In this paper we present a description of an OWL Ontology of fundamental legal concepts developed within the ESTRELLA European project. The aim of the ontology is to contribute to enable semantic access to digital legal information and clarify the legal ...
A 71 year-old man with a history of previous anterior myocardial infarction, triple coronary arte... more 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).
International angiology: a journal of the International Union of Angiology
Impaired endothelial function and increased carotid intima-media thickness are key events in the ... more Impaired endothelial function and increased carotid intima-media thickness are key events in the atherosclerotic process and predict future cardiovascular events in subjects with and without coronary artery disease. The purpose of this study was to investigate whether the vasodilator response to increased flow in the brachial artery and the presence of carotid lesions may have a prognostic significance for in-stent restenosis in patients undergoing coronary angioplasty. The study population included 58 patients undergoing percutaneous coronary intervention (PCI) with stenting and at least 10 months of follow-up. All patients underwent ultrasound detection of brachial artery reactivity 30 days after PCI. Flow mediated dilatation (FMD) was investigated after 5 minutes of occlusion of the artery and nitroglycerin mediated dilation (NMD) was investigated after administration of sublingual nitrates. Vascular echography was performed to measure intima media thickness (IMT) of carotid arte...
Italian heart journal. Supplement: official journal of the Italian Federation of Cardiology
The aim of the present study was to reevaluate the indications to electrophysiological study afte... more 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.
International angiology : a journal of the International Union of Angiology, 2009
The aim of the study was to evaluate the prevalence of carotid atherosclerosis and endothelial dy... more The aim of the study was to evaluate the prevalence of carotid atherosclerosis and endothelial dysfunction in 45 young patients (38 mens and 7 females) with myocardial infarction (MI), age 29-45, mean age 42+/-3 years, to verify its possible role as a marker of coronary atherosclerosis. Vascular echography was performed to verify the presence of carotid atherosclerosis and/or endothelial dysfunction in 45 young patients with MI and in 45 healthy control subjects well matched for age and sex. We observed a normal intima media thickness (IMT) only in 30% of patients with juvenile myocardial infarction (JMI) compared with 66% in the control group (P<0.0001) and 34% of patients showed an increased IMT compared with 24% of healthy subjects (P<0.0001). Compared with control subjects, patients with JMI had lower flow-mediated reactivity of the brachial arteries (P<0.05). There was a negative linear relationship between flow-mediated dilation and IMT (P<0.001). The severity of c...
ABSTRACT The aim of our study was to determine if patients with multifocal atherosclerosis have a... more ABSTRACT The aim of our study was to determine if patients with multifocal atherosclerosis have a worse prognosis than patients with atherosclerosis only in the coronary bed. We studied 45 subjects admitted to intensive coronary care unit of the Division of Cardiology with the diagnosis of acute myocardial infarction (AMI). Traditional cardiovascular risk factors were investigated and laboratory analysis included measurement of plasma lipids, glycemia, fibrinogen and high-sensitivity-C-reactive protein (hs-CRP). Each patient underwent coronary-angiography as well as carotid and peripheral arterial ultrasound examination. A follow-up of 13+/-2 months was performed. We found that the severity of coronary atherosclerosis is significantly associated with the presence of carotid (P&lt;0.05) and peripheral atherosclerosis (P&lt;0.005). Markers of inflammation, hs-CRP (P&lt;0.005) and fibrinogen (P&lt;0.05), were significantly associated with multifocal atherosclerosis. We have shown that an increased number of coronary vessels with atherosclerotic stenosis is associated with a higher value of carotid (P&lt;0.0001) and peripheral intima media thickness (P&lt;0.0001). During 13 months of follow-up the incidence of fatal or non fatal events was 18%. The multivariate analysis showed that the variables independently associated with fatal and non fatal events were: male sex (P&lt;0.001), family history of cardiovascular disease (P&lt;0.005), hypertension (P&lt;0.01), diabetes mellitus (P&lt;0.05), higher levels of total cholesterol (P&lt;0.05), smoking habit (P&lt;0.05), and multifocal atherosclerosis (P&lt;0.05). The ultrasound examination of carotid and peripheral atherosclerotic lesions may be useful in placing patients with AMI in a category of higher risk of cerebrovascular and cardiovascular events. Moreover, the precocious identification of patients at risk can suggest a more aggressive pharmacological treatment and a more accurate follow-up in order to avoid future events.
Type 2 diabetes is associated with an increase in the risk of coronary heart disease, by a factor... more Type 2 diabetes is associated with an increase in the risk of coronary heart disease, by a factor of two to four. The scientific community has suggested that all patients with diabetes could be treated as if they had a prior coronary heart disease. A computer review of 11-year prevalence (from 1991 to 2002) of type 2 diabetes among 3242 patients admitted to the Intensive Coronary Care Unit of the Division of Cardiology of the University Hospital ''Paolo Giaccone'', Palermo, was carried out, with the diagnosis of ST elevation myocardial infarction (STEMI) (51%), non ST elevation myocardial infarction (NSTEMI) (6%) or unstable angina (UA) (43%). Prevalence of type 2 diabetes was 31.5% on the overall population; in particular, a higher prevalence was found among STEMI affected patients (37% of the diabetic patients). The average number of days of an in-hospital stay was of 10.4+/-3.1 for diabetic patients without complications (N.=602) and of 15.9+/-4.4 for diabetic pat...
The clinical and prognostic role of cardiac natriuretic peptides (CNP) in patients with heart fai... more The clinical and prognostic role of cardiac natriuretic peptides (CNP) in patients with heart failure is well known; recently, several studies have evaluated the possibility of using CNP to evaluate their potential prognostic role in patients with acute coronary syndromes (ACS). The aim of this study was to evaluate the short term prognostic value of NT-proBNP in 70 patients admitted for ACS. The authors studied 70 patients with ACS, evaluating, at admission, clinical-anamnestic, instrumental and laboratory characteristics including NT-proBNP plasma levels. Patients were monitored in a 6-month-follow-up to record adverse fatal events and their possible correlation with baseline characteristics. The incidence of adverse events during the follow-up period was 28% (10 patients). In patients with adverse events, the authors observed lower left ventricle ejection fraction (P=0.01), higher prevalence of ST elevation myocardial infarction (P=0.03) and higher NT-proBNP levels (P=0.03), comp...
A non-monotonic logic of institutional agency is defined combining a computationally oriented non... more A non-monotonic logic of institutional agency is defined combining a computationally oriented non- monotonic system (Defeasible Logic) and inten- sional notions of agency.
This paper presents an approach for the specification and implementation of e-contracts for Web m... more This paper presents an approach for the specification and implementation of e-contracts for Web monitoring. This is done in the setting of RuleML. We argue that monitoring contract execution requires also a logical account of deontic concepts and of violations. Accordingly, RuleML is extended to cover these aspects. 1 Background and Motivation Business contracts are mutual agreements between two or
In this paper we propose a temporal extension of Defeasible Logic to model legal modifications, s... more In this paper we propose a temporal extension of Defeasible Logic to model legal modifications, such as abrogation and annulment. Hence, this frame- work overcomes the difficulty, discussed elsewhere (7), of capturing these modi- fication types using belief and base revision.
In this paper we present a Gentzen system for reasoning with contrary- to-duty obligations. The i... more In this paper we present a Gentzen system for reasoning with contrary- to-duty obligations. The intuition behind the system is that a contrary- to-duty is a special kind of normative exception. The logical machinery to formalize this idea is taken from substructural logics and it is based on the definition of a new non-classical connective capturing the notion of reparational
Abstract In this paper we present a description of an OWL Ontology of fundamental legal concepts ... more Abstract In this paper we present a description of an OWL Ontology of fundamental legal concepts developed within the ESTRELLA European project. The aim of the ontology is to contribute to enable semantic access to digital legal information and clarify the legal ...
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Papers by Antonino Rotolo