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Pubblicazioni recenti - cardiac disease
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Novel approach for Recanalization and Limb Saving Following Acute Thrombosis of Upper Limb Arteries in Two Neonates After Congenital Heart Surgery.
Klin Padiatr2020 Oct;():. doi: 10.1055/a-1258-4349.
Al-Ata Jameel, Abdelmohsen Gaser, Bahaidarah Saud, Alkhushi Naif, Zaher Zaher,
Abstract
Neonates with congenital heart disease are at a high risk of vascular thrombosis. Thrombosis may occur due to vascular injury, increased blood viscosity secondary to polycythemia associated with congenital cyanotic heart diseases, or stasis of blood flow associated with low cardiac output (Schmidt B & Andrew M., Pediatrics 1995; 96: 939-943. Veldman A et al.,Vasc Health Risk Manag 2008; 4: 1337-1348).
Thieme. All rights reserved.
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Minimally invasive repair of the mitral valve partially affected by an in situ left atrial appendage occluder in a patient with end-stage renal disease.
Interact Cardiovasc Thorac Surg2020 Oct;31(4):585. doi: 10.1093/icvts/ivaa138.
Bauer Sebastian, Sugimura Yukiharu, Lichtenberg Artur, Akhyari Payam,
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An endoscopic repair of residual post-myocardial infarction ventricular septal defect.
Interact Cardiovasc Thorac Surg2020 Oct;31(4):580-582. doi: 10.1093/icvts/ivaa127.
Laskawski Grzegorz, Abdelbar Abdelrahman, Zacharias Joseph,
Abstract
Post-myocardial infarction (MI) ventricular septal defect (VSD) is a serious condition that is, fortunately, less diagnosed nowadays due to the advances in early diagnosis and treatment of ischaemic heart disease (incidence 1-2%). Despite the lower mortality of both surgical and interventional closure of the defect (25%) as compared to medical therapy (40-50%), there are still risks of residual leak in both approaches. Herein, we describe a case of a successful endoscopic-assisted repair of a delayed residual leak post-MI VSD after surgical repair. An attempt for interventional closure of the leaking point had failed; an endoscopic-assisted minimal access closure was successfully performed.
© The Author(s) 2020. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
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Endocardial fibroelastosis in a dog with congestive heart failure.
J Vet Cardiol2020 Sep;32():33-39. doi: S1760-2734(20)30079-5.
Schreiber N, Baron Toaldo M, Romero-Palomo F, Sydler T, Glaus T,
Abstract
In a 6-month-old, intact female, Japanese spitz presenting with severe dyspnea, lung ultrasonography revealed confluent B lines associated with severe echocardiographic left sided volume overload and systolic dysfunction. A congenital shunt or valvular dysplasia was not demonstrable. On electrocardiogram, there was a constant sinus rhythm, respectively sinus tachycardia. Cardiac troponin I was normal. Within 2 days of admission, the dog died of heart failure. On macroscopic postmortem examination, the left ventricle and atrium were markedly dilated, and the left ventricular endocardium had a mild diffuse whitish appearance. Histopathology revealed moderate to severe thickening of the left ventricular endocardium, composed mostly of abundant elastic fibers and fewer collagen fibers, diagnostic for endocardial fibroelastosis. In addition, there were mild degenerative changes of the atrioventricular valves. Endocardial fibroelastosis is a rare congenital disease and should be considered in a young dog if more common causes of echocardiographic dilated cardiomyopathy phenotype are ruled out.
Copyright © 2020 Elsevier B.V. All rights reserved.
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2020 APHRS/HRS Expert Consensus Statement on the Investigation of Decedents with Sudden Unexplained Death and Patients with Sudden Cardiac Arrest, and of Their Families.
Heart Rhythm2020 Oct;():. doi: S1547-5271(20)30953-X.
Stiles Martin K, Wilde Arthur A M, Abrams Dominic J, Ackerman Michael J, Albert Christine M, Behr Elijah R, Chugh Sumeet S, Cornel Martina C, Gardner Karen, Grad Jodie Ingles, James Cynthia A, Jimmy Juang Jyh-Ming, Kääb Stefan, Kaufman Elizabeth S, Krahn Andrew D, Lubitz Steven A, MacLeod Heather, Morillo Carlos A, Nademanee Koonlawee, Probst Vincent, Saarel Elizabeth V, Sacilotto Luciana, Semsarian Christopher, Sheppard Mary N, Shimizu Wataru, Skinner Jonathan R, Tfelt-Hansen Jacob, Wang Dao Wu, ,
Abstract
This international multidisciplinary document intends to provide clinicians with evidence-based practical patient-centered recommendations for evaluating patients and decedents with (aborted) sudden cardiac arrest and their families. The document includes a framework for the investigation of the family allowing steps to be taken, should an inherited condition be found, to minimize further events in affected relatives. Integral to the process is counseling of the patients and families, not only because of the emotionally charged subject, but because finding (or not finding) the cause of the arrest may influence management of family members. The formation of multidisciplinary teams is essential to provide a complete service to the patients and their families, and the varied expertise of the writing committee was formulated to reflect this need. The document sections were divided up and drafted by the writing committee members according to their expertise. The recommendations represent the consensus opinion of the entire writing committee, graded by Class of Recommendation and Level of Evidence. The recommendations were opened for public comment and reviewed by the relevant scientific and clinical document committees of the Asia Pacific Heart Rhythm Society (APHRS) and the Heart Rhythm Society (HRS); the document underwent external review and endorsement by the partner and collaborating societies. While the recommendations are for optimal care, it is recognized that not all resources will be available to all clinicians. Nevertheless, this document articulates the evaluation that the clinician should aspire to provide for patients with sudden cardiac arrest, decedents with sudden unexplained death, and their families.
Copyright © 2020. Published by Elsevier Inc.
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Reducing Waiting Time for Remote Patients in Telemedicine with Considering Treated Patients in Emergency Department Based on Body Sensors Technologies and Hybrid Computational Algorithms: Toward Scalable and Efficient Real Time Healthcare Monitoring System.
J Biomed Inform2020 Oct;():103592. doi: S1532-0464(20)30221-5.
Hussein Salman Omar, Imad Aal-Nouman Mohammed, Taha Zahraa K,
Abstract
BACKGROUND:
Scalability challenge in real time healthcare monitoring system relates to several issues. One of the insistent issues is the increasing in the number of patients. Increasing in the patients' number causes long queue and increase the waiting time for the patients in their seeking for healthcare services. Thus, an ethical issue raises as the healthcare providers should provide fast services for all patients. Recent studies have proposed scalable models that are limited to (1) triaging remote patients for the optimal emergency level and (2) prioritizing remote patients with the highest triage level to receive immediate healthcare services. However, these studies have shown limitations, that is, (1) they have not addressed the waiting time for all patients with different triage levels in the same waiting queue; and (2) they have not considered Emergency Department EDs patients. Therefore, considering the remote patients with the treated patients in EDs in one healthcare system is a demand, to efficiently handle all the patients' requests and productively manage the medical resources.
OBJECTIVE:
This study aims to reduce the waiting time for the remote patients in telemedicine with considering treated patients in EDs. The study presents a scalable telemedicine model to improve the ability of real time healthcare monitoring system in accommodating the increasing number of patients with chronic heart disease by reducing their waiting time for healthcare services, prioritizing the patients who have the most emergency cases and provide all the patients by fast healthcare services. The proposed model called Triaging and Prioritizing Model "TPM".
METHOD:
The proposed model "TPM" considers triaging and prioritizing all patients (remote and EDs patients) as two sequential processes. The TPM was formulated to triage the patients based on hybrid algorithms which combine Evidence-Theory with Fuzzy Cluster Means (FCM) and then prioritize the patients based on dedicated computational algorithm. A simulation, on 580 chronic heart diseases patients, was implemented. The patients considered as they have different emergency levels based on four vital data acquisition tools: electrocardiogram sensor, blood pressure sensor, oxygen saturation sensor and a text input as non-sensory based acquisition tool.
RESULTS:
Computational results show the superiority of the proposed model (TPM) in accommodating large numbers of patients and reducing their waiting time for services compared with relevant benchmark studies. In 1,185 minutes, TPM managed the (580) patients' requests. By contrast, the benchmark managed only 256 patients at the same amount of time. In addition to that, TPM shows improvements in terms of waiting time and services provisioning rates compared with benchmark methods.
CONCLUSION:
All patients with the different emergency levels receive services with less waiting time compared with the relevant studies. The proposed model (TPM) model considers both of remote patients and treated patients in EDs efficiently. TPM improves response time for the medical services, reduces waiting time for all patients and consequently, saves more lives.
Copyright © 2020. Published by Elsevier Inc.
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A systematic review of post-translational modifications in the mitochondrial permeability transition pore complex associated with cardiac diseases.
Biochim Biophys Acta Mol Basis Dis2020 Oct;():165992. doi: S0925-4439(20)30340-9.
Alves-Figueiredo H, Silva-Platas C, Lozano O, Vázquez-Garza E, Guerrero-Beltrán C E, Zarain-Herzberg A, García-Rivas G,
Abstract
The mitochondrial permeability transition pore (mPTP) opening is involved in the pathophysiology of multiple cardiac diseases, such as ischemia/reperfusion injury and heart failure. A growing number of evidence provided by proteomic screening techniques has demonstrated the role of post-translational modifications (PTMs) in several key components of the pore in response to changes in the extra/intracellular environment and bioenergetic demand. This could lead to a fine, complex regulatory mechanism that, under pathological conditions, can shift the state of mitochondrial functions and, thus, the cell's fate. Understanding the complex relationship between these PTMs is still under investigation and can provide new, promising therapeutic targets and treatment approaches. This review, using a systematic review of the literature, presents the current knowledge on PTMs of the mPTP and their role in health and cardiac disease.
Copyright © 2020. Published by Elsevier B.V.
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Glucokinase in stellate ganglia cooperates with P2×3 receptor to develop cardiac sympathetic neuropathy in type 2 diabetes rats.
Brain Res Bull2020 Oct;():. doi: S0361-9230(20)30661-4.
Xu Xiumei, Liu Baoe, Yang Jingjian, Zou Yuting, Sun Minghao, Li Zijing, Li Lin, Yang Runan, Zou Lifang, Li Guilin, Liu Shuangmei, Li Guodong, Liang Shangdong,
Abstract
Glucokinase (GCK) may be involved in inflammatory pathological changes, while the P2?×?3 receptor in the stellate ganglia (SG) is related to diabetic cardiac autonomic neuropathy. In this study, we explored the relationship between the upregulated GCK in SG and diabetic cardiac sympathy. The expression and location of GCK and P2?×?3 in SG of type 2 diabetes mellitus (T2DM) rats were assessed. Changes in cardiac function were determined by measuring blood pressure, sympathetic nerve activity, heart rate, and heart rate variability. P2?×?3 agonist-activated currents in isolated stellate ganglion neurons and cultured human embryonic kidney 293 (HEK293) cells were recorded using whole-cell patch clamp techniques. The upregulated expression of GCK in SG of T2DM rats was decreased after treatment with GCK short hairpin RNA (shRNA). GCK shRNA treatment also improved the blood pressure, sympathetic nerve activity, heart rate, and heart rate variability in T2DM rats. By contrast, the expression of P2?×?3 and tumor necrosis factor ? (TNF-?) was lessened by GCK shRNA treatment. In addition, adenosine triphosphate (ATP)-activated currents in stellate ganglion neurons and HEK293 cells co-transfected with GCK and P2?×?3 receptor plasmids were reduced after GCK shRNA treatment. In T2DM rats, knockdown of GCK relieved the diabetic cardiac sympathy mediated by P2?×?3 receptor-involved upregulation of GCK in SG.
Copyright © 2020 Elsevier Inc. All rights reserved.
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Balance between the toxicity and anticancer activitiy of arsenic trioxide in treatment of acute promyelocytic leukemia.
Toxicol Appl Pharmacol2020 Oct;():115299. doi: S0041-008X(20)30425-7.
Wang Qian Qian, Hua Hao Ying, Naranmandura Hua, Zhu Hong-Hu,
Abstract
Arsenic trioxide (ATO) has a long history and it is recognized as both poison and drug for more than two thousand years. Since the establishment of ATO as a frontline therapeutic agent for acute promyelocytic leukemia (APL), the survival of APL patients have been greatly improved and APL is tunred from highly fatal to highly curable disease. Mechanistically, ATO can induce PML/RAR? fusion protein degradation, causing APL cell differentiation and apoptosis. On the other hand, the side effects such as differentiation syndrome, cardiac conduction abnormalities and liver toxicity are often observed during the ATO treatment of APL in clinic. It is likely that the therapeutic and adverse effects of ATO is probably associated with its distinct pattern of metabolism and direct or indirect effects on different organs. In this review, we provided a comprehensive and in-depth elaboration of the cytotoxic mechanisms of ATO and its methylated metabolites based on in vivo or in vitro studies, trying to clarify the importance of achieving balance between the toxicity and anti-leukemic activity of ATO in APL treatment.
Copyright © 2020. Published by Elsevier Inc.
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Antiviral activity and safety of remdesivir against SARS-CoV-2 infection in human pluripotent stem cell-derived cardiomyocytes.
Antiviral Res2020 Oct;():104955. doi: S0166-3542(20)30369-7.
Choi Seong Woo, Shin Jin Soo, Park Soon-Jung, Jung Eunhye, Park Yun-Gwi, Lee Jiho, Kim Sung Joon, Park Hun-Jun, Lee Jung-Hoon, Park Sung-Min, Moon Sung-Hwan, Ban Kiwon, Go Yun Young,
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is considered as the most significant global public health crisis of the century. Several drug candidates have been suggested as potential therapeutic options for COVID-19, including remdesivir, currently the only authorized drug for use under an Emergency Use Authorization. However, there is only limited information regarding the safety profiles of the proposed drugs, in particular drug-induced cardiotoxicity. Here, we evaluated the antiviral efficacy and cardiotoxicity of remdesivir using cardiomyocytes-derived from human pluripotent stem cells (hPSC-CMs) as an alternative source of human primary cardiomyocytes (CMs). In this study, remdesivir exhibited up to 60-fold higher antiviral activity in hPSC-CMs compared to Vero E6 cells; however, it also induced moderate cardiotoxicity in these cells. To gain further insight into the drug-induced arrhythmogenic risk, we assessed QT interval prolongation and automaticity of remdesivir-treated hPSC-CMs using a multielectrode array (MEA). As a result, the data indicated a potential risk of QT prolongation when remdesivir is used at concentrations higher than the estimated peak plasma concentration. Therefore, we conclude that close monitoring of the electrocardiographic/QT interval should be advised in SARS-CoV-2-infected patients under remdesivir medication, in particular individuals with pre-existing heart conditions.
Copyright © 2020 Elsevier B.V. All rights reserved.
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Developmental patterns in the nasopharyngeal microbiome during infancy are associated with asthma risk.
J Allergy Clin Immunol2020 Oct;():. doi: S0091-6749(20)31416-0.
Tang Howard H F, Lang Anna, Teo Shu Mei, Judd Louise M, Gangnon Ronald, Evans Michael D, Lee Kristine E, Vrtis Rose, Holt Patrick G, Lemanske Robert F, Jackson Daniel J, Holt Kathryn E, Inouye Michael, Gern James E,
Abstract
BACKGROUND:
Studies indicate that the nasal microbiome may correlate strongly with the presence or future risk of childhood asthma.
OBJECTIVES:
In this study, we tested whether developmental trajectories of the nasopharyngeal microbiome in early life and the composition of the microbiome during illnesses were related to risk of childhood asthma.
METHODS:
Children participating in the Childhood Origins of Asthma study (n=285) provided nasopharyngeal mucus samples in the first two years of life, during routine healthy study visits (2, 4, 6, 9, 12, 18 and 24 months of age) and episodes of respiratory illnesses, which were analyzed for respiratory viruses and bacteria. We identified developmental trajectories of early-life microbiome composition, as well as predominant bacteria during respiratory illnesses, and correlated these with presence of asthma at 6, 8, 11, 13 and 18 years of age.
RESULTS:
Of the four microbiome trajectories identified, a Staphylococcus-dominant microbiome in the first 6 months of life was associated with increased risk of recurrent wheezing by age 3 years and asthma that persisted throughout childhood. In addition, this trajectory was associated with the early onset of allergic sensitization. During wheezing illnesses, detection of rhinoviruses and predominance of Moraxella were associated with asthma that persisted throughout later childhood.
CONCLUSION:
In infancy, the developmental composition of the microbiome during healthy periods and the predominant microbes during acute wheezing illnesses are both associated with the subsequent risk of developing persistent childhood asthma.
CLINICAL IMPLICATION:
Identifying factors that promote early colonization with S. aureus may lead to future interventional studies to prevent childhood asthma.
Copyright © 2020. Published by Elsevier Inc.
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