Giuseppe Biondi-Zoccai - Böcker

Aging and Troponin: Clinical Implications and Uses Beyond Diagnosis examines the multifaceted role of troponin in clinical medicine, with a special focus on aging. This comprehensive reference provides essential technical knowledge, diagnostic and prognostic applications, and model development insights from leading experts in clinical biochemistry, pathology, and epidemiology. The book emphasizes the impact of aging on troponin test results and their interpretation, addressing age-related disorders such as renal failure. Sections cover the technical aspects of troponin assays, comparing traditional and high-sensitivity assays and exploring point-of-care testing advancements.The book also examine age-related changes and intra- and inter-individual variability in troponin levels, focuses on diagnostic applications, including troponin as a biomarker for cardiac injury and dysfunction, and the effects of age, sex, and renal impairment on diagnostic sensitivity and specificity, and discusses troponin's prognostic value for mortality in various conditions, including heart disease, sepsis, and COVID-19, and its role as a marker of organ biological age. The final section offers cutting-edge insights into the clinical applicability of troponin testing, highlighting the benefits of incorporating high-sensitivity assays into clinical workflows and providing perspectives and age-related considerations from practicing physicians on implementation and evidence-based practice.Explores how aging affects troponin levels and their interpretation in various medical conditionsDetails high-sensitivity assays and point-of-care testing tailored for elderly patientsHighlights troponin's role in predicting mortality and cardiovascular events in older adultsExamines troponin variants as indicators of muscle quality and aging-related changesOffers strategies for integrating age-adjusted troponin testing into clinical practice

This book provides comprehensive information on transcatheter aortic valve implantation (TAVI), which was introduced for the treatment of aortic valve disease less than two decades ago. It explains how TAVI has delivered satisfactory results even in high and intermediate risk patients and outlines how it continues to evolve, thus requiring awareness of state of the art approaches to indication, risk stratification, device choice, procedure, and follow-up. In addition, it reports on the complex and multidisciplinary approach needed to maximize the efficacy, safety, and appropriateness of TAVI, providing detailed clinical, interventional and surgical perspectives focusing on the development of this cardiovascular intervention.Starting with the history of TAVI, addressing the interventional anatomy of aortic valve disease, and reporting on the expert authors’ day-to-day experiences, this highly informative book offers an essential update for all cardiologists and surgeons interested in transcatheter aortic valve implantation, as well as any clinician, decision-maker and stakeholder involved in patient selection, procedural management, and follow-up.

This book is the first exclusively devoted to the systematic synthesis of diagnostic test accuracy studies. It builds upon the major recent developments in reporting standards, search methods, and, in particular, statistical tools specifically devoted to diagnostic studies. In addition, it borrows extensively from the latest advances in systematic reviews and meta-analyses of intervention studies. After a section dedicated to methods for designing reviews, synthesizing evidence and appraising inconsistency in research, the application of these approaches is demonstrated in the context of case studies from various clinical disciplines. Diagnosis is central in medical decision-making, and in many other fields of human endeavor, such as education and psychology. The plurality of sources of evidence on diagnostic test accuracy poses a huge challenge for practitioners and researchers, as do the multiple dimensions of evidence validity, which include sensitivity, specificity, predictive values, and likelihood ratios. This book offers an invaluable resource for anyone aiming to improve decision-making processes in diagnosis, classification or risk prognostication, from epidemiologists to biostatisticians, radiologists, laboratory physicians and graduate students, as any physician interested in refining his methodological skills in clinical diagnosis.

Performing any diagnostic test in medicine is always a matter of trying to get the condition of the patient diagnosed properly with the least effort, exposure, discomfort and at the same time with the lowest possible error probability.Pre-test probability is helpful but often imprecise, effectively overestimating the patient's risk profile. In a broader prevention objective, the phases of a disease, its onset, progression, and complications must be taken into account. The negative predictive value, which is so important, has in turn its main limitation in identifying the healthy patient, that is, the one who does not belong to any cluster of patients in which we would act in terms of prevention.In coronary syndromes, the goal is instead to evaluate coronary heart disease, from mild to more extensive and significant forms. For this purpose, it is necessary to use parameters that investigate different and complementary aspects: stenosis, ischemia, the morphology ofthe atherosclerotic plaque, metabolic processes, in particular vitality and apoptosis, the presence of inflammatory processes.The possibility, already present thanks to Hybrid Imaging, of 'joining’ exams that study different aspects, will allow the patient to be increasingly characterized not only from a diagnostic point of view but also from a prognostic and personalized therapeutic choice.

Performing any diagnostic test in medicine is always a matter of trying to get the condition of the patient diagnosed properly with the least effort, exposure, discomfort and at the same time with the lowest possible error probability.Pre-test probability is helpful but often imprecise, effectively overestimating the patient's risk profile. In a broader prevention objective, the phases of a disease, its onset, progression, and complications must be taken into account. The negative predictive value, which is so important, has in turn its main limitation in identifying the healthy patient, that is, the one who does not belong to any cluster of patients in which we would act in terms of prevention.In coronary syndromes, the goal is instead to evaluate coronary heart disease, from mild to more extensive and significant forms. For this purpose, it is necessary to use parameters that investigate different and complementary aspects: stenosis, ischemia, the morphology ofthe atherosclerotic plaque, metabolic processes, in particular vitality and apoptosis, the presence of inflammatory processes.The possibility, already present thanks to Hybrid Imaging, of 'joining’ exams that study different aspects, will allow the patient to be increasingly characterized not only from a diagnostic point of view but also from a prognostic and personalized therapeutic choice.

?This book is an ideal guide to umbrella reviews, overviews of reviews, and meta-epidemiologic studies for evidence synthesis. Research is conducted at different levels: primary research consists of original studies while secondary research comprises qualitative reviews, systematic reviews, and meta-analyses.

This book is the first exclusively devoted to the systematic synthesis of diagnostic test accuracy studies.

?This book is an ideal guide to umbrella reviews, overviews of reviews, and meta-epidemiologic studies for evidence synthesis. Research is conducted at different levels: primary research consists of original studies while secondary research comprises qualitative reviews, systematic reviews, and meta-analyses.