Panminerva medica
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Studies on major depressive disorders (MDD) pathophysiology show decreased blood levels of brain-derived neurotrophic factor (BDNF) that increase after antidepressant treatment. The link between BDNF levels and antidepressants is still controversial. In addiction, there is a relationship between MDD and concurrent cognitive function. Hippocampus is linked to memory and learning and BDNF is abundant in this area. For this reason we investigated the presence of any association between paroxetine treatment, BDNF levels and cognitive performances in depressed patients. ⋯ To our knowledge this is one of the few studies on the effects of paroxetine treatment on plasma BDNF levels. We confirm literature data regarding the link between BDNF plasma levels, depression and antidepressant treatments. In addiction we found a specific cognitive deficit of depressed patients.
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Mitral valve regurgitation (MR) is a frequent condition usually associated with heart failure and reduced survival. Surgery remains the gold standard treatment but a significant number of patients are not optimal candidates due to age, comorbidities or poor left ventricular function. ⋯ However, mitral apparatus is a complex scenario and there are several potential targets for improving mitral regurgitation. The aim of this paper was to review the current trnascatheter technology developed to treat MR.
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Optimal management of multivessel disease (MVD) is a complex medical decision with significant prognostic implications. Despite the advent of clinical and angiographic scores to aid with treatment delineation, therapy for MVD must be individualized for each patient and his/her clinical presentation. ⋯ Several patient factors including clinical presentation, severity of coronary artery disease, presence of left ventricular dysfunction and other comorbidities, and the patient's personal preferences should guide the decision making process. In this review, we discuss the management of MVD with regards to decisions of revascularization versus GDMT alone, mode of revascularization, extent of revascularization (i.e., complete versus incomplete), the strategy of angiography- versus ischemia-guided revascularization, and MVD management in the setting of an acute coronary syndrome.