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Procedural success was as high as 94% and more than 90% of cases were treated without any complication. The most common complication during PCI with RA was vessel dissection (8.8%) and no procedural death occurred. None of the clinical nor procedural characteristics were associated with burr entrapment or vascular access hematoma. We identified as independent predictor of treated vessel dissection the female sex (OR 16.9, 95% CI 1.55-183.77, p less then 0.05). Logistic regression revealed age (OR 1.17, 95% CI 1.02-1.33, p less then 0.02) as the only independent predictor of MACE. We therefore calculated the ROC curve on age in predicting MACE, that showed a C-statistics of 0.75 (95% CI 0.628 to 0.852, p=0.02), with 80 years old as the best threshold in defining high risk population. CONCLUSIONS RA is a feasible and safe procedure. Females and elderly patients must be carefully selected in order to balance the risk/benefit ratio in these high-risk populations.BACKGROUND A blunted heart rate reserve (HRR) during dipyridamole stress echocardiography (DSE) is a prognostically unfavorable sign of cardiac autonomic dysfunction. Short-term adjustments of heart rate (HR) are thought to rise from changes in neural input to the heart. DSE is applied in potential heart donors to rule out underlying coronary artery disease and left ventricular dysfunction. AIM to assess HRR during DSE in brain death. METHODS We enrolled 2 Groups Group 1 (n=49, 22 men, 54.6±8.8 years) with patients in brain death enrolled in the nationwide marginal donor heart recruiting program; Group 2 (n=49, 18 men, 66.4±12.0 years) referred to DSE for suspected or known coronary artery disease. All underwent DSE (0.84 mg/kg in 6') by quality-controlled readers certified via web-based training (1487/CE Lazio-1). We assessed left ventricular contractile reserve (LVCR) as stress/rest ratio of force (systolic blood pressure /end-systolic volume). HRR was calculated as the peak/rest HR ratio from 12-lead EKG. RESULTS The 2 groups were similar for prevalence of inducible ischemia (4/49 vs 9/49, p=ns). Group 1 showed higher resting HR (Group 1= 88.1±15.5 vs Group 2= 66.5±11.5 bpm, p less then 0.01) and similar peak HR (Group 1=94.7±15.3 vs Group 2=89.5±19.3 bpm, p=0.144), with blunted HRR (Group 1= 1.08±0.10 vs Group 2= 1.36±0.31 bpm, p less then 0.01). HRR was unrelated to LVCR. CONCLUSIONS HRR is almost abolished and unrelated to LVCR in brain-dead patients during DSE. The modulation of neural input to the heart is essential to determine HRR, and plays no significant role in determining the inotropic response during DSE.BACKGROUND Disease Management Programs (DMPs) for heart failure (HF) patients have been developed to better control patients' well-being as well as their daily drug intake. DMPs for HF are not always accepted by the patients, and the reasons for this phenomenon are largely unknown. We hypothesized that patients from rural areas accept a DMP more likely than patients living in a big city. Thus, a pilot study investigated differences in the attitude towards DMPs between HF-patients in one rural and one urban hospital in Austria. METHODS Patients admitted because of HF to 2 hospitals, one with rural and one with urban populations, were included prospectively by using a questionnaire. RESULTS Included were 60 patients, 43% females with a mean age of 76 years, in each hospital 30 patients. Rural patients were more interested in a nurse-based DMP than urban (n=30) (p=0.029). After discharge, urban patients planned more often to attend a specialist than rural (p=0.005). No differences were found regarding gender, age, willingness to be included into a telenursing-based program and estimation of knowledge about HF. CONCLUSIONS Structures of the health care system and patients' attitudes must be considered when planning DMPs. Development of DMPs which are accepted by urban patients will be relevant for the future.Graft-versus-host disease (GvHD) is a commonly occurring immunological reaction and frequent complication following allogeneic hematopoietic stem cell transplantation. Its highly diverse manifestations including skin involvement as the most common appearance of GvHD, can dramatically influence patient's quality of life, in particular in the chronic stage, in addition to patient's decreased survival outcome. Hence, the role of the dermatologist has become very crucial in an interdisciplinary setting, particularly since appearances of GvHD in the skin can be multifaceted and challenging. Clinical manifestation of the acute GvHD (aGvHD) is limited to erythematous maculopapular rash and oral mucosal lesions while the chronic form manifests in a wider range in a localized area or disseminated including involvement of nail, scalp and genital area. This article aims to provide a comprehensive overview on the variable cutaneous presentations of acute and chronic GvHD for a proper and early diagnosis on the one hand, and to discuss updated therapeutic options for both acute and chronic GvHD on the other hand, to initiate an adequate treatment to obtain the most beneficial clinical outcome.Nevus-associated melanoma (NAM) is defined on histopathological basis by the coexistence of melanoma and nevus components. Melanomas developing on pre-existing congenital or acquired nevi are usually of the superficial spreading subtype and harbor the BRAFV600E mutation. NAM accounts for almost one-third of melanoma cases As compared to de novo melanoma, NAM develops on younger patients, is more frequently located on the trunk, and is associated with a high nevus count, light eye color and history of frequent sunburns. NAM has been regarded as a model to investigate melanoma origin. Molecular analysis defining the mutation profile of NAM's nevus and melanoma components supported the existence of two pathways of melanoma development, the first not involving clinically visible precursors, the second involving melanocytic nevi as precursors. Concerning diagnosis, dermatoscopy may identify nevus and melanoma components when located side-by-side, but no specific criteria have been described when superimposed. selleckchem In-vivo reflectance confocal microscopy significantly enhances the recognition of NAM by allowing the detection of nevus remnants when superficially located.