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Funding of publication (Jochen Hefner, 18 February 2015)

This publication was funded by the German Research Foundation (DFG) and the University of Wuerzburg in the funding programme Open Access Publishing. read full comment

Comment on: Hefner et al. BMC Cardiovascular Disorders, 15:3

 Acknowledgement (Jin Woo Chung, 21 October 2014)

This paper was written as part of Konkuk University's research support program for its faculty on sabbatical leave in 2009  read full comment

Comment on: Kim et al. BMC Cardiovascular Disorders, 14:116

  Red cell distribution width may not have a prognostic value in patients with stable coronary artery disease (Yasemin GULCAN KURT, 30 May 2014)

Yasemin Gulcan Kurt1, Tuncer Cayci1, Ibrahim Aydin2,... read full comment

Comment on: Osadnik et al. BMC Cardiovascular Disorders, 13:113

use in the clinical (Joon Anderson, 17 November 2011)

This is a good study, but we need to confirm this result in the clinical trial, because the cardiomyopathy is a real adverse effect of trastuzumab when we used it in the treatmnet of Her2/neu positive breast cancer.
read full comment

Comment on: Yousif et al. BMC Cardiovascular Disorders, 11:62

intersting study!! (MARIA LUISE, 17 November 2011)

This is agood study to explained the mechanism of trastuzumab toxicity. read full comment

Comment on: Yousif et al. BMC Cardiovascular Disorders, 11:62

How much ALE to the PYNT? (Richard Richards, 12 August 2010)

Grossi postulates that plausibility might be a concept better understood by patients than probability.(1) Can it be conveyed to a patient whether it is plausible that they would benefit from taking a drug?

The number needed to treat (NNT) is a well established and easily understood means of describing the effectiveness of a treatment.(2,3) Based on the change in absolute risk, it represents the probability of successfully treating a patient. However, many treatments are for chronic disease and thus continuous and lifelong. NNTs are fine for one off treatments such as a surgical procedure or a course of antibiotics but begin to lose meaning when there is a dimension of time as well. Laupacis and colleagues suggested dealing with this by using a standard duration such as 5 years... read full comment

Comment on: Grossi BMC Cardiovascular Disorders, 5:31

The rate of change is more important than change itself (justin zaman, 14 July 2009)

Developing countries undergoing economic changes are now facing the phenomenon of the epidemiological transition, resulting in cardiovascular diseases being the leading cause of mortality in these countries, and resulting in increasing levels of disability. However, differences exist in this more recent epidemiological transition to that previously experienced by developed countries. Those in lower-income brackets have an increasingly high prevalence of risk factors, inconsistent with the notion these are diseases of affluence,  whilst cardiovascular deaths in the developing countries are occurring at an earlier age compared with developed countries, with adverse implications on the health of the workforce.

The term ‘transition’ implies the act of passing from... read full comment

Comment on: Gupta et al. BMC Cardiovascular Disorders, 9:28

Intraplaque iron as a modifiable atherogenic factor. (Jerome Sullivan, 01 July 2009)

Comment on: Tavora F, et al. BMC Cardiovascular Disorders 2009; 9(1):27.

The significance of the findings of Tavora et al (1) on iron and myeloperoxidase in unstable atherosclerotic plaques is best appreciated in the context of the growing literature on the role of iron as a modifiable risk factor for atherosclerosis (2). The study also provides evidence compatible with the "iron/heart hypothesis" that postulates a protective effect of iron depletion against cardiovascular disease (3-5).

Significant increases in iron concentration are present in human atherosclerotic lesions and in lesions in cholesterol fed animals in comparison to levels in the healthy arterial wall (6-8). Iron concentration (7) and induction of ferritin expression (9) are increased in very... read full comment

Comment on: Tavora et al. BMC Cardiovascular Disorders, 9:27

Cluster effect to be considered - suggest design amend (Ameet Bakhai, 11 May 2009)

Dear Colleagues,

This is an excellent innovation to be tested and a very well designed study. My main concern is that there will be a cluster effect that needs to be considered given that some patients at one centre and health care workers may overlap with each other and this is not an intervention that can be blinded. This will impact on resource and QoL impact. A more elegant design would be to enroll more centres and randomise centres to remove this effect to enable an unbiased impact on QoL and resource outcome. As you have stated - there is little doubt telephone strategies work but do they work due to the additional attention / scrutiny / manpower contact given or due to the mental attitudes of the patients being altered by the cognitive component?

We would be... read full comment

Comment on: Hawkes et al. BMC Cardiovascular Disorders, 9:16

Bedside recognizing diabetics with or without CHD real risk or silent CHD. (Sergio Stagnaro, 14 November 2006)

Sirs,All authors must agree with such as statemente “Diabetes is an important predictor of mortality patients with ACS”. However, on the base of my clinical biophysical-semeiotic data, we have to divide diabetics with CHD in two categories: on the one hand, diabetic patients involved also by coronary endothelial dysfunction, evaluated bedside in “quantitative” way, and diabetics without impairement of coronary endothel function, showing physiological, type I preconditioning, i.e., normal blood-flow through nutritional capillaries of heart vessels (1-6).The presence of subclinical disease substantially increases the risk of subsequent CHD for individuals with hypertension, diabetes mellitus, or elevated C-reactive protein. Notoriously, subclinical, and consequently... read full comment

Comment on: Peterson et al. BMC Cardiovascular Disorders, 6:41

Is the “Lipid adipose product” (LAP) really an alternative index for the assessment of cardiovascular risk in obesity? (Alexis Malavazos, 12 June 2006)

Emanuele Cereda1, Federica Ermetici2, Lelio Morricone2, Bruno Ambrosi2 and Alexis Elias Malavazos1,2Recently, the “lipid accumulation product” (LAP), a new index describing central lipid overaccumulation, alternative to BMI (describing weight overaccumulation), has been proposed for recognizing cardiovascular risk by Kahn HS. (1). In further analysis, this continuous indicator of lipid accumulation has been demonstrated to perform better than BMI also for identifying adults with insulin resistance, elevated glucose, and diabetes (2). With interest in such matter and in agreement with this statement, we would ask to the author what is the real utility of LAP in recognising cardiovascular risk factors among obese patients (BMI ≥30 kg/m2).In fact, when estimating population... read full comment

Comment on: Kahn BMC Cardiovascular Disorders, 6:5

A Clinical Biophysical-Semeiotic Contribution reliable in prompt recognizing CAD, even silent.. (Sergio Stagnaro, 16 February 2005)

Sir,all doctors must agree with such as statement: “We need to refine our current strategy to provide optimal treatment for such patients [i.e. with chest pain due to CAD]. Troponin is a blunt screening tool for the assessment of patients with acute coronary syndromes without ST elevation, and we should avoid compounding this by ignoring clinical factors”. A 47-year-long clinical experience allows me to state that we need to refine our current bed-side strategy, learnong the paramount developments of physical semeiotics (See having plenty of laboratory data, to provide precise diagnosis, and optimal treatment for such patients on very large scale. I think that physicians all around the world should identify apparently healthy people, first of... read full comment

Comment on: Doyle et al. BMC Cardiovascular Disorders, 5:5

An overlooked QC parameter of hypertension: tissue oxygenation, at basal line and under stress. (Sergio Stagnaro, 23 January 2005)

A 47-year-long clinical experience with the aid of Biophysical Semeiotics (1, 2) (See HONCode web site 233736, allows me to state that an hypertensive patient shows high QC exclusively in case that his or her tissue oxigenation is in normal values (1-4)and consequently there is not increased free radical level in the diverse biological systems (5-6). In treating hypertension our goal is to provide the normal Microcirculatory Functional Reserve in heart,kidney, retina,and peripheral macrovascular vessel walls.1)Stagnaro-Neri M., Stagnaro S., Stadio pre-ipertensivo e monitoraggio terapeutico della ipertensione arteriosa. Omnia Medica Therapeutica. Archivio, 1-13, 1989-90 19902) Stagnaro Sergio, Stagnaro-Neri Marina. Introduzione alla Semeiotica Biofisica. Il... read full comment

Comment on: Asch et al. BMC Cardiovascular Disorders, 5:1

Smoking and CRP, from the clinical view-point. (Sergio Stagnaro, 03 December 2004)

Bed-side evaluating Acute Phase Proteins (APP), including C Reactive Protein (CRP), is nowadays possible by means of Biophysical Semeiotics (See my site, HONCode N° 233736,, Practical Application,URL: . APP are notoriously numerous proteins, synthesized by the liver; their bed-side evaluation has proved to be useful, from both diagnostic and prognostic view-point, as allows me to state a 47-year-long well-established “clinical experience (1-6). In addition, such as original assessement represents an useful tool in research, and permits doctor to perform therapeutic monitoring in a new, remarkable, and reliable way. For example, according to the authors of this... read full comment

Comment on: Gander et al. BMC Cardiovascular Disorders, 4:17

Biophysical Semeiotic Constitutions, Genomics, and Cardio-Vascular Diseases. (Sergio Stagnaro, 07 November 2004)

Sir,as show GENEQUEST, PROCARDIS, and GENECARD, 3 genome-wide searches for genetic regions that are linked with coronary disease and other CVD (1-3), genome scans for coronary risk factors, such as blood pressure, body weight, lipids, and diabetes, have also been published in recent times (4). There is still, however, a long distance to travel from recognizing chromosomes abnormalities to the particular genes and the specific causative DNA variants (n-DNA and mit-DNA, of course), apart from the expense in doing that. By contrast, doctor can nowadays “clinically” recognize in a “quantitative” way the different biophysical-semeiotics constitutions and, then, the diverse risk factors as well as the diverse “real” risk, like that for CAD (See HONCode site... read full comment

Comment on: Williams et al. BMC Cardiovascular Disorders, 4:20

Endothelial cell function can ameliorate under safer drugs, such as Melatonin-Adenosine. (Sergio Stagnaro, 10 October 2004)

Sirs,the authors conclude their intriguing paper stating that “The increase of resting [Ca2+]i after incubation with cerivastatin or fluvastatin may provide an explanation for the direct effects of statins on the endothelial-dependent vasodilatation and restoration of endothelial activity in vivo”. In addition, it is remembered that inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase (statins) are drugs widely used in the treatment of hypercholesterolaemia. A large number of clinical trials (4S, CARE, WOSCOPS) has demonstrated that treatment of patients with statins reduces the number of cardiac or cerebral ischaemic events even in the absence of further reduction in serum cholesterol levels. In my opinion, these drugs (statins), since a long time, need to be... read full comment

Comment on: Heinke et al. BMC Cardiovascular Disorders, 4:4

Anorexic but not Nervous (Rod McClymont, 17 July 2004)

The principles illustrated in this case hold true in the adolescent age group. A 19 year old female with a 6 month history of progressive intake restriction and weight loss was referred to me for management with a diagnosis of anorexia nervosa. She had a very low BMI and denied any symptoms suggestive of gastrointestinal or other chronic disease process. Initial examination was as expected except for tachycardia- a very unusual finding. The albumin was a little low and the ESR a little raised- again very unusual findings. She turned out to have Crohn's Disease isolated to the terminal ileum and regained weight steadily when this was treated.Standing tachycardia, usually with significant postural hypotension, can be a sign of dehydration from fluid restriction in anorexia nervosa. These... read full comment

Comment on: Krantz et al. BMC Cardiovascular Disorders, 4:10

Biophysical Semeiotics is really useful in order to bed-side recognizing heart ischaemic disease, even before its onset, i.e., real risk of coronary artery disease. (Sergio Stagnaro, 11 March 2004)

Sirs,in primary prevention of CAD we need clearly a clinical tool, appliable on very large scale in individual apparently healthy. Modifications of apo-a, as well as lipo-a blood levels are associated with CAD risk. However these data indicate the presence of relevant inherited factors, we can recognize also at the bed side , as follows.It is well known that patients, involved by risk of CAD or with CAD, may have no symptoms at all over years or decades, and that the electrocardiographic features of ischaemia may be induced by exercise without accompaning angina (1). (See "Coronary artery disease, in my site HONCode, N° 233736, other words, we need a clinical tool reliable in rapid detecting both the risk of CAD, clinically silent, and CAD, also in... read full comment

Comment on: Emanuele et al. BMC Cardiovascular Disorders, 3:12