Objective To document changes in the clinical features of coeliac disease (CD) at presentation over the last 25 years. Design Observational study. Patients 802 subjects diagnosed between 1993 and 2017 at a single general hospital. Outcome measures Date of diagnosis, age, sex, postcode, symptoms, haematinic deficiency, smoking status, serology, family history and autoimmune phenomena. Results The incidence of diagnosed CD rose threefold during the course of the study, with a rising prevalence of positive coeliac serology and positive family history of CD, and a falling prevalence of symptoms and haematinic deficiencies. There was little change in the female predominance, age at diagnosis or high prevalence of other autoimmune conditions over the 25 years, and a paucity throughout of cigarette smokers, particularly heavy smokers. A cohort of patients with seronegative CD was identified who shared many of the characteristics of seropositive CD, but with a significantly older age at diagnosis and a higher prevalence of cigarette smokers. Conclusion There have been major changes in the epidemiology of CD over the last 25 years, of relevance to both our understanding of the aetiopathogenesis of CD and the requirement for service provision. The implications are discussed. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.Bioresorbable scaffolds have emerged as a potential breakthrough for the treatment of coronary artery lesions. The need for drug release and plaque scaffolding is temporary, and leaving a permanent stent once the process of plaque recoil and vessel healing has ended might be superfluous or even deleterious exposing the patient to the risk of very late thrombosis, eliminating vessel reactivity, impairing non-invasive imaging and precluding possible future surgical revascularization. This long-term potential limitation of permanent bare metal stents might be overcome by using a resorbable scaffold. The metallic and antithrombotic properties makes the resorbable magnesium scaffold an appealing technology for the treatment of coronary artery lesions. Notwithstanding this, its mechanical properties substantially differ from those of conventional bare metal stents, and previous experience using polymer-based scaffolds has shown that a standardized implantation technique and optimal patient and lesion selection are key factors for a successful implantation. A panel of expert cardiologists gathered to find a consensus on the best practices for Magmaris implantation in a selected patient population and to discuss the rationale for new potential future indications.Percutaneous transcatheter left atrial appendage occlusion and transcatheter mitral valve repair with the MitraClip system represent new therapeutic strategies for selected patients at high risk for both hemorrhagic and cardioembolic events or with symptomatic heart failure and moderate-to-severe mitral valve regurgitation, respectively. We report the case of an 84-year-old patient with severe degenerative mitral regurgitation hospitalized for a first episode of atrial fibrillation, angina pectoris and heart failure. The patient presented a clinical history of spontaneous cerebral bleeding, severe three-vessel coronary disease and multiple comorbidities that contraindicated a conventional surgical treatment. After an accurate clinical-instrumental evaluation, the local Heart Team indicated a combined procedure of percutaneous left atrial appendage closure and transcatheter mitral valve repair with the MitraClip system, followed by multivessel percutaneous coronary intervention (PCI) with drug-eluting stent implantation.  https://www.selleckchem.com/products/elexacaftor.html  Dual antiplatelet treatment was prescribed for 12 months after PCI.Although having different rationales and purposes, the PEGASUS-TIMI 54 and COMPASS trials present various points of contact and, especially after the first recommended year of dual antiplatelet therapy (DAPT) from an acute coronary syndrome, pose the clinical question of whether DAPT should be prolonged (PEGASUS strategy) or aspirin should be maintained by combining rivaroxaban 2.5 mg bid (COMPASS strategy). In this review, we try to trace the PEGASUS and COMPASS patient's profile by analyzing the design of each study with their inclusion/exclusion criteria, the main subanalyses and the real-world studies recently published in this setting.Bleeding is a frequently encountered complication in patients undergoing percutaneous coronary intervention (PCI) treated with a dual antiplatelet therapy regimen with aspirin plus an oral inhibitor of the P2Y12 platelet receptor (clopidogrel, prasugrel, ticagrelor) or with the combination of antiplatelet drugs and an anticoagulant in patients who have a specific indication for chronic anticoagulation therapy such as atrial fibrillation. The management of antithrombotic therapy during post-PCI bleeding is considerably challenging due to the intrinsic difficulty in estimating the balance between the bleeding risk - increased by antiplatelet and/or anticoagulant therapy - and the thrombotic risk associated with the possible discontinuation of these drugs. Currently, there are no data derived from dedicated studies in this setting and therefore the management of antithrombotic therapy in patients who suffer a hemorrhagic complication after PCI is guided by consensus documents that provide suggestions for the different types of bleeding, based on the severity of the latter. In light of the European documents available, this article will discuss the possible management strategies of antithrombotic therapy (antiplatelet and/or anticoagulant) in the different types of bleeding that can occur in patients undergoing PCI.In patients with atrial fibrillation (AF) who undergo an acute coronary syndrome (ACS), with or without percutaneous coronary intervention and coronary stent implantation, the association of dual antiplatelet therapy with an oral anticoagulant (also known as triple antithrombotic therapy, TAT) increases the risk for major and fatal bleeding. Recently, several trials have evaluated alternative therapeutic regimens to TAT, such as dual antithrombotic therapy (DAT) comprising a direct oral anticoagulant and a platelet P2Y12 receptor inhibitor. In the context of patients treated with percutaneous coronary intervention, these regimens have generally been associated with a reduction in bleeding that was not accompanied by a substantial increase in ischemic events. However, the net benefit of DAT is more controversial in the case of patients at higher thrombotic risk, such as patients with ACS. This review, based on the available literature, describes the best peri-procedural and post-procedural antithrombotic strategies for patients with AF and ACS.