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Pubblicazioni recenti - cardiovascular
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Anti-citrullinated protein antibody specificities, rheumatoid factor isotypes and incident cardiovascular events in patients with rheumatoid arthritis.
Arthritis Rheumatol2020 May;():. doi: 10.1002/art.41381.
Westerlind Helga, Rönnelid Johan, Hansson Monika, Alfredsson Lars, Mathsson-Alm Linda, Serre Guy, Cornillet Martin, Holmdahl Rikard, Jakobsson Per-Johan, Skriner Karl, Klareskog Lars, Saevarsdottir Saedis, Askling Johan,
Abstract
OBJECTIVE:
To investigate the relationship between anti-citrullinated protein antibodies (ACPA), specific sub-specificities, rheumatoid factor (RF) isotypes, and incident cardiovascular (CV) events in patients with rheumatoid arthritis (RA).
METHODS:
We centrally typed baseline sera from Swedish new-onset RA cases diagnosed 1996-2009 for anti-CCP2, 20 ACPA sub-specificities, and RF isotypes. We followed patients longitudinally in nationwide registers for acute coronary syndrome (ACS), stroke, CV-related death, and major adverse CV events (MACE). We assessed the association between each serological marker and CV outcome, and the impact of adjustment for baseline DAS28, smoking and income, using Cox proportional hazards model. We also explored associations with all-cause mortality.
RESULTS:
We included 2814 patients. Median follow-up was 13 years, during which 375 ACS, stroke, and CV deaths occurred. Occurrence and/or levels of anti-CCP2 associated with ACS (hazard ratio (HR) 1.46 (95% confidence interval (CI) 1.03-2.06), stroke (HR=1.47 (95%CI 1.03-2.10), CV death (levels, p=0.024) and MACE (HR=1.34 (95%CI 1.06-1.70)). We similarly observed associations with the number of ACPA sub-specificities, which could not, however, be attributed to any individual or group of ACPA sub-specificities. IgM RF associated with all CV endpoints except ACS, and IgA RF exclusively associated with CV death. Adjustment for smoking, income and DAS28 decreased most HRs, while IgA RF remained associated to CV death (HR=1.61 (95%1.05-2.48)). All serological makers associated with all-cause mortality.
CONCLUSIONS:
RF isotypes and ACPA are associated with future CV events. ACPA levels and number of sub-specificities seem more important than the occurrence of particular sub-specificities. These associations were not explained by smoking.
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Reply.
Arthritis Rheumatol2020 May;():. doi: 10.1002/art.41377.
Atiquzzaman Mohammad, Karim Mohammad Ehsanul, Kopec Jacek, Wong Hubert, Anis Aslam H,
Abstract
We are pleased to respond to the commentary by Dr. Chao Cheng and colleagues on our recent publication entitled "Role of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) in the Association between Osteoarthritis and Cardiovascular Diseases: A Longitudinal Study" that was published in Arthritis & Rheumatology in November 2019 (1). The commentary raises important issues about further exploring the characteristics of our study population (the elderly) in whom it is well known that both the chronic conditions of OA and CVD are more prevalent.
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Comparative Risks of Cardiovascular Disease in Systemic Lupus Erythematosus, Diabetes and General Medicaid Patients.
Arthritis Care Res (Hoboken)2020 May;():. doi: 10.1002/acr.24328.
Barbhaiya Medha, Feldman Candace H, Chen Sarah K, Guan Hongshu, Fischer Michael A, Everett Brendan M, Costenbader Karen H,
Abstract
OBJECTIVE:
Cardiovascular disease (CVD) risk is elevated in patients with systemic lupus erythematosus (SLE) and diabetes mellitus (DM), but whether CVD risk in SLE is as high as in DM is unknown. We compared CVD risks between SLE, DM, and general population U.S. Medicaid patients.
METHODS:
In a cohort study, we identified age-and-sex matched (1:2:4) adults with SLE, DM or general population from Medicaid Analytic eXtract (MAX), 2007-2010. We collected baseline sociodemographic factors, comorbidities, and medications. Cox regression models calculated hazard ratios (HRs) of hospitalized non-fatal CVD events (combined myocardial infarction [MI] and stroke), and MI and stroke separately, accounting for competing risk of death and adjusting for covariates. We compared risks in age-stratified models.
RESULTS:
We identified 40,212 SLE, 80,424 DM, and 160,848 general population patients, of whom 92.5% were female, with mean age of 40.3 (±12.1) years. Non-fatal CVD incidence rate per 1,000 person-years was 8.99 for SLE, 7.07 for DM, and 2.36 for general population. Non-fatal CVD risk was higher in SLE compared to DM (HR 1.27 [95% CI 1.15-1.40]), driven by excess risk at ages 18-39 (HR 2.22 [95% CI 1.81-2.71]). SLE had higher CVD risk compared to the general population (HR 2.67 [95% CI 2.38-2.99]).
CONCLUSION:
SLE patients had 27% higher risk of non-fatal CVD events compared to age-and sex-matched DM patients and over twice the risk of the Medicaid general population. The highest relative risk occurred at ages 18-39. These high risks merit aggressive evaluation for modifiable factors and research to identify prevention strategies.
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Lower urinary ?-Klotho is associated with lower angiotensin-(1-7) and higher blood pressure in young adults born preterm with very low birthweight.
J Clin Hypertens (Greenwich)2020 May;():. doi: 10.1111/jch.13897.
South Andrew M, Shaltout Hossam A, Gwathmey TanYa M, Jensen Elizabeth T, Nixon Patricia A, Diz Debra I, Chappell Mark C, Washburn Lisa K,
Abstract
Early-life factors including preterm birth and VLBW increase the risk of hypertension, but the mechanisms remain poorly understood. Reductions in the anti-aging protein ?-klotho are associated with hypertension, possibly due to angiotensin (Ang) II activation, but the mechanisms are incompletely understood and clinical evidence is lacking. The association of ?-klotho with the alternative Ang-(1-7) pathway, which counteracts Ang II to lower BP, is undescribed. We hypothesized that lower urinary ?-klotho is associated with higher BP and lower urinary Ang-(1-7) in preterm-born VLBW young adults. In a cross-sectional analysis of data from a prospective cohort of 141 preterm-born VLBW young adults, we assessed the associations among urinary ?-klotho/creatinine, Ang II/creatinine, Ang-(1-7)/creatinine, Ang II/Ang-(1-7), and BP using generalized linear models adjusted for age and hypertensive pregnancy and conducted a sensitivity analysis in 32 term-born young adults. Among those born preterm, lower ?-klotho/creatinine was associated with higher systolic BP (adjusted ? (a?): -2.58 mm Hg, 95% CI -4.99 to -0.17), lower Ang-(1-7)/creatinine (ln a?: 0.1, 0.04-0.16), and higher Ang II/Ang-(1-7) (ln a?: -0.14, -0.21 to -0.07). In term-born participants, ?-klotho/creatinine was inversely associated with Ang II/creatinine (ln a?: -0.15, -0.27 to -0.03) and Ang II/Ang-(1-7) (ln a?: -0.15, -0.27 to -0.03). In preterm-born young adults with VLBW, lower urinary ?-klotho/creatinine was associated with higher SBP, lower urinary Ang-(1-7)/creatinine, and higher urinary Ang II/Ang-(1-7). Reduced renal ?-klotho expression could lead to renal Ang-(1-7) suppression as a novel mechanism for the development of hypertension among individuals born preterm with VLBW.
© 2020 Wiley Periodicals LLC.
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Another evidence of the Oral-Lung Axis: oral health as a determinant of lung health.
Oral Dis2020 May;():. doi: 10.1111/odi.13448.
Qi Yinliang, Dai Ruoxi,
Abstract
Gomes-Filho published a systematic review and confirmed a strong association between periodontitis and pneumonia (Gomes-Filho et al., 2020). Unlike the well-established association between cardiovascular diseases and periodontitis as supported by more than 50 observational studies (cohort and case-control studies) during the past 25 years (Stewart & West, 2016), fewer observational studies have been conducted to study the association between periodontitis and pneumonia as demonstrated in this systematic review. Increasing attention has been given to this filed recently as some researchers raised the concept of "The Oral-Lung Axis", proposing oral health as a determinant of lung health (Gaeckle et al., 2020).
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In vivo detection of human cutaneous beta-carotene using computational optical clearing.
J Biophotonics2020 May;():. doi: 10.1002/jbio.202000124.
Morovati Armin, Ansari Mohammad Ali, Tuchin Valery V,
Abstract
The content of dermal beta-carotene can be a good indicator showing the body health. Because, it is involved in production of vitamin A maintaining healthy skin and mucous membranes. Also, it reduces the risk of cardiovascular diseases and its antioxidant capacity prevents the formation of cancerous cells. In this work, we use Raman spectroscopy and a low-cost diffuse reflectance spectroscopy (DRS) to detect the dermal beta-carotene spectra. We apply computational optical clearing (OC) method to in vivo evaluation the concentration of this chromophore. The results show that Raman spectroscopy is a good tool for in vitro detection of carotenoids but is not able to clearly discriminate the individual carotenoids in skin tissue in vivo. The results also show that using OC enhances the ability of low-cost diffuse reflection spectroscopy for in vivo detection of dermal beta-carotene in humans. This method can be used as a low-cost and portable device to screening the concentration of chromophores such as melanin and carotenoid molecules for oncological studies. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
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Ex vivo and in vivo studies of Viola tricolor Linn. as potential cardio protective and hypotensive agent: Inhibition of voltage-gated Ca ion channels.
FASEB J2020 May;():. doi: 10.1096/fj.202000658R.
Saqib Fatima, Mujahid Khizra, Aslam Muhammad Arif, Modhi Alotaibi, Moga Marius Alexandru, Bobescu Elena, Marceanu Luigi,
Abstract
Viola tricolor Linn. is used as cardio-protective and anti-hypertensive agent in traditional medicine. Current study objective was to evaluate cardio-protective and hypotensive effects of Viola tricolor L. in vitro and in vivo studies. Viola tricolor L. crude extract (Vt.Cr) and its fractions (Aqueous and organic) were tested at rabbit atria and aorta coupled to Power Lab Data Acquisition System for cardio depressant and vasorelaxant effects in vitro whereas in vivo Blood Pressure was checked by invasive method in normotensive ketamine-diazepam anesthetized rats. Isoproterenol was employed for acute myocardial infarction (AMI) and left ventricular hypertrophy (LVH) development and cardioprotective effects of Vt.Cr were evaluated hemodynamically and histopathologically. Vt.Cr and its fractions decreased heart rate and contractile force in paired atria and relaxed Phenylephrine (1 µM) and K (80 mM) stimulated contractions in aorta possibly mediated through Voltage dependent L-type calcium channels blockage supported by in vivo hypotensive action. In LVH, Vt.Cr lowered Angiotensin Converting Enzymes and renin, increased cyclic Guanosine Monophosphate and nitric oxide levels, decreased cardiomyocytes size and fibrosis attributed to Gallic acid as detected by High Performance Liquid Chromatography. Partial positive results were seen hemodynamically and histologically in AMI Viola tricolor L. showed vasorelaxant, cardio-relaxant, hypotensive, and cardio protective effect validating traditional practice in cardiovascular disorders.
© 2020 Federation of American Societies for Experimental Biology.
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MiR-302b-5p enhances the neuroprotective effect of IGF-1 in methyl-4-phenyl-1,2,3,6-tetrahydropyridine-induced Parkinson's disease by regulating inducible nitric-oxide synthase.
Cell Biochem Funct2020 May;():. doi: 10.1002/cbf.3534.
Cui Xiaorui, Li Mingpeng, He Zhengchu, Hu Lin, Liu Jianping, Yan Jianhui, Hua Liming,
Abstract
Parkinson's disease (PD) is a neurodegenerative disease which results in damage in neuronal cells. Insulin-like growth factor (IGF)-1 was previously reported to play a role of neuroprotection in some diseases. Nitric oxide (NO) can also regulate neuronal cells. However, the mechanisms underlying IGF-1 and NO in PD still need to be elucidated. In present study, we explored the interaction between IGF-1 and inducible Nitric-Oxide Synthase (iNOS) in PD progression. We firstly constructed PD models by methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) or MPP treatment. Then RT-qPCR revealed that IGF-1 expression was downregulated while iNOS expression was upregulated in MPTP model. Moreover, IGF-1 elevation or iNOS depletion enhanced cell viability and blocked cell apoptosis. Rescue assay disclosed iNOS overexpression reversed the effect on viability and apoptosis mediated by IGF-1 upregulation. Furthermore, IGF-1 was identified to positively regulate miR-302b-5p which could target iNOS. MiR-302b-5p could abolish the inhibitory function IGF-1 exerted on cell apoptosis and iNOS could counteract miR-302b-5p upregulation-triggered inhibition on cell apoptosis as well. Besides, we observed the deficiency of miR-302b-5p improved the lesioned neurobehavior of MPTP-treated mice. To sum up, present study proved that miR-302b-5p enhanced the neuroprotective effect of IGF-1 in MPTP-induced PD by regulating iNOS, recommending a novel therapeutic target for PD treatment. SIGNIFICANCE OF THE STUDY: In this study, we mainly explored that IGF-1 was decreased while iNOS was boosted in MPTP-induced PD mice model; IGF-1 suppressed while iNOS promoted MPP -induced toxicity and apoptosis in SH-SY5Y cells; miR-302b-5p ehanhced the neuroprotective effect of IGF-1 via targeting Inos; deficiency of miR-302b-5p improved the lesioned neurobehavior of MPTP-treated mice.
© 2020 John Wiley & Sons Ltd.
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In Vitro Generation of Vascular Wall-Typical Mesenchymal Stem Cells (VW-MSC) from Murine Induced Pluripotent Stem Cells Through VW-MSC-Specific Gene Transfer.
Methods Mol Biol2020 ;2155():83-97. doi: 10.1007/978-1-0716-0655-1_7.
Steens Jennifer, Klump Hannes, Klein Diana,
Abstract
Among the adult stem cells, multipotent mesenchymal stem cells (MSCs) turned out to be a promising option for cell-based therapies for the treatment of various diseases including autoimmune and cardiovascular disorders. MSCs bear a high proliferation and differentiation capability and exert immunomodulatory functions while being still clinically safe. As tissue-resident stem cells, MSCs can be isolated from various tissue including peripheral or umbilical cord blood, placenta, blood, fetal liver, lung, adipose tissue, and blood vessels, although the most commonly used source for MSCs is the bone marrow. However, the proportion of MSCs in primary isolates from adult tissue biopsies is rather low, and therefore MSCs must be intensively expanded in vitro before the MSCs find particular use in therapies that may require extensive and repetitive cell replacement. Therefore, more easily accessible sources of MSCs are needed. Here, we present a detailed protocol to generate tissue-typical MSCs by direct linage conversion using transcription factors defining target MSC identity from murine induced pluripotent stem cells (iPSCs).
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Abiotrophia defectiva as a cause of infective endocarditis with embolic complications in children.
Infection2020 May;():. doi: 10.1007/s15010-020-01454-z.
Song Seung Ha, Ahn Bin, Choi Eun Hwa, Lee Seung-Pyo, Cho Eun Young, Bae Eun Jung, Lee Sang Yun, Song Mi Kyoung, Kim Woong Han, Kim Geena, Kim Taek Soo, Han Mi Seon,
Abstract
Abiotrophia defectiva is a rare pathogen of infective endocarditis (IE) but is frequently involved in embolic complication and valvular dysfunction. IE caused by A. defectiva in children is poorly studied. This study reports four cases of A. defectiva IE in children and reviews previously reported five pediatric cases of A. defectiva IE. Most of the patients presented with a subacute course, with prolonged fever or atypical symptoms. Eight patients had embolic complications at presentation. All nine children were treated with combination antimicrobial therapy and six of them received surgical intervention. All patients recovered well without relapse. A. defectiva should be considered in children with infective endocarditis, especially in those with atypical presentations. As complications are frequent and more than half of the patients need surgical treatment, prompt diagnosis along with appropriate treatment is necessary.
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Tobacco Research in the Eastern Mediterranean Region: A Scoping Review of Published Studies from Seven Countries.
J Community Health2020 May;():. doi: 10.1007/s10900-020-00850-8.
Hamadeh Randah R, Borgan Saif M, Khabsa Joanne, Sibai Abla M,
Abstract
While surveillance on a global scale has been showing a decline in tobacco smoking in the past decade, rates in the Eastern Mediterranean Region (EMR) remained stable with some countries showing rising trends. This study aimed to analyze the landscape of tobacco research in the EMR, present data on publication trends, and identify research gaps and opportunities to guide future tobacco research in the region. We conducted a scoping review of tobacco research in seven countries from January 2000 to December 2013. Three hundred and forty eight studies were identified, the majority of which were published in international journals and in English language. There was an increase in publications over time, with a significant positive linear trend (p?=?0.03). Descriptive cross-sectional and case-control studies were the most common study designs (67.0%), and only 8% were longitudinal studies. Papers that reported, in part or solely, on waterpipe tobacco smoking (WTS) constituted 25.6% of the total publication pool. Tobacco consumption was treated as an exposure variable in half of the papers and mostly in relation to cancer and cardiovascular diseases, as an outcome measure in 37.7%, and as a confounding variable in 14.7% of the papers. Studies that examined associations of tobacco with other behaviors (5.3%) were lacking. The scarcity of high-evidence tobacco research in the EMR, together with the relatively deficient data on WTS and associations with other factors warrant the need for discussions on research priority setting and guidance on funding allocations in the region.
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Children's heart and COVID-19: Up-to-date evidence in the form of a systematic review.
Eur J Pediatr2020 May;():. doi: 10.1007/s00431-020-03699-0.
Sanna Giulia, Serrau Gaia, Bassareo Pier Paolo, Neroni Paola, Fanos Vassilios, Marcialis Maria Antonietta,
Abstract
The new coronavirus disease outbreak in 2019 (COVID-19) represents a dramatic challenge for healthcare systems worldwide. As to viral tropism, lungs are not the only COVID-19 target but also the heart may be involved in a not negligible percentage of the infected patients. Myocarditis-related cardiac dysfunction and potentially life-threatening arrhythmias are the main aftermaths. A few studies showed that myocardial injury in adult patients is often linked with a fatal outcome. Conversely, scientific evidence in children is sparse, although several reports were published with the description of a cardiac involvement in COVID-19 paediatric patients. In these young subjects, a background of surgically treated congenital heart disease seems to be a predisposing factor.Conclusion: This systematic review is aimed at summarizing all COVID-19 cases with a cardiac involvement published in paediatric age and trying to explain the underlying mechanisms responsible for COVID-19-related myocardial damage.What is Known:? Coronaviruses proved to be able to jump from animals to humans.? The outbreak of COVID-19 started from China (Dec 2019) and became pandemic.What is New:? Even in childhood, COVID-19 is not without the risk of cardiac involvement.? Myocarditis, heart failure, and arrhythmias are among the possible manifestations.
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Clinical inertia in the treatment of heart failure: a major issue to tackle.
Heart Fail Rev2020 May;():. doi: 10.1007/s10741-020-09979-z.
Verhestraeten Caroline, Heggermont Ward A, Maris Michael,
Abstract
Despite an enormous improvement in heart failure management during the last decades, the hospitalization and mortality rate of heart failure patients still remain very high. Clinical inertia, defined as the lack of treatment intensification in a patient not at evidence-based goals for care, is an important underlying cause. Clinical inertia is extensively described in hypertension and type 2 diabetes mellitus, but increasingly recognized in heart failure as well. Given the well-established guidelines for the management of heart failure, these are still not being reflected in clinical practice. While the absolute majority of patients were treated by guideline-directed heart failure drugs, only a small percentage of these patients reached the correct guideline-recommended target dose of angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, beta-blockers, mineralocorticoid receptor antagonists, and angiotensin receptor-neprilysin inhibitors. This considerable under-treatment leads to a large number of avoidable hospitalizations and deaths. This review discusses clinical inertia in heart failure and explains its major contributing factors (i.e., physician, patient, and system) and touches upon some recommendations to prevent clinical inertia and ameliorate heart failure treatment.
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Twisting and constriction of a HeartMate II driveline in the area of a repair site.
J Artif Organs2020 May;():. doi: 10.1007/s10047-020-01181-0.
Maier Sven, Beyersdorf Friedhelm, Benk Christoph,
Abstract
The driveline's durability is crucial for optimal long-term support with a left-ventricular assist device (LVAD). The incidence of percutaneous driveline fracture after HeartMate II LVAD implantation is low. For the first time, we describe a patient with an already repaired driveline and a massive constriction and twisting of the driveline in the area of the repair site. This dramatic finding necessitates a renewed exchange of the external part of the driveline by the manufacturer. Due to the increasing number of patients with elongated LVAD support, the stability of the driveline and possible repairs including the replacement of the driveline are becoming more and more important. Our case report describes a possible serious late complication after replacement of the driveline, shows possible risks for this development, and describes the necessity of a prophylactic X-ray examination of repaired drivelines to detect such complications as early as possible.
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Two way network construction and analysis of mRNA, miRNA and lncRNA reveals critical regulators and regulatory modules in cardiovascular diseases.
Genes Genomics2020 May;():. doi: 10.1007/s13258-020-00952-6.
Charles Sona, Natarajan Jeyakumar,
Abstract
BACKGROUND:
Cardiovascular diseases contribute to the leading cause of deaths (31%) in the world population.
OBJECTIVE:
The objective of this study is to compile non-coding RNA-gene interaction into a core regulatory network whose dysregulation might play an important role in disease progression.
METHOD:
We applied a structured approach to reconstruct the interaction network of lncRNAs, miRNAs and genes involved in cardiovascular diseases. For network construction, we used 'diseasome to interactome' and 'interactome to diseasome' approaches and developed two regulatory networks in heart disorders. In diseasome to interactome approach, starting from a disease-centric network we, expanded the data into an interaction network. However in interactome to diseasome, we used a set of guide genes, miRNAs and lncRNAs to arrive at the common diseases. The disease-centric network in combination with the interaction network will shed light on the interconnected components in a huge diseasome network implicated in heart disorders and manifested through small sub-networks while progressing. Using the above networks we created a sub-networks consisting only of hub genes, miRNAs and lncRNAs on both approaches. The dysregulation of any one of the hubs can lead to a disease condition.
RESULTS:
The top ranking hubs common in both the sub-networks were found to be VEGFA, MALAT1, HOTAIR, H19 and hsa-miR-15a. Our network based study reveals an entanglement of regulatory sub-network of miRNAs, lncRNAs and genes in multiple conditions.
CONCLUSION:
The identification of hubs in the core triple node network of elements in disease development and progression demonstrates a promising role for network based approaches in targeting critical molecules for drug development.
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Levels of Physical Activity and Physical Fitness in Pediatric Pacemaker Patients: A Cross-Sectional Study.
Pediatr Cardiol2020 May;():. doi: 10.1007/s00246-020-02384-1.
Teber Sena, Saglam Melda, Ertugrul Ilker, Vardar-Yagli Naciye, Cakmak Aslihan, Calik-Kutukcu Ebru, Inal-Ince Deniz, Arikan Hulya, Karagoz Tevfik,
Abstract
Children with heart diseases have reduced physical activity (PA) levels relative to their peers, which in turn increases cardiovascular risk. To the best of our knowledge, physical fitness and objectively measured PA levels have not been previously studied in children with pacemakers. We evaluated PA levels and physical fitness in pediatric pacemaker patients compared to their healthy peers. Twenty-eight pediatric patients with pacemakers (15 female, 13 male; mean age 13.43?±?3.68 years) and 24 healthy subjects (14 female, 10 male; mean age 13.08?±?3.67 years) were included. Physical fitness was assessed using the Munich Fitness Test (MFT). SenseWear Armband metabolic Holter device was used to record the PA for 7 consecutive days. MFT total and sub-parameter scores were significantly lower in the patient group (p??0.05). Duration of mean moderate to vigorous PA was higher than 60 min/day recommended in PA guidelines in both patients and healthy subjects. These results provide initial data on PA and fitness in children with pacemakers and suggest that physical fitness and activity levels in children with pacemakers are lower than in healthy peers. Appropriate exercise programs may improve PA levels in pediatric pacemaker patients. Awareness of the importance of PA should be raised among the parents and families of these children.
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Aortic Geometry in Patients with Duplication 7q11.23 Compared to Healthy Controls.
Pediatr Cardiol2020 May;():. doi: 10.1007/s00246-020-02375-2.
Lechich Kirstie M, Zarate Yuri A, Daily Joshua A, Collins R Thomas,
Abstract
The aim of this study was to compare the size and geometry of the aorta in patients with 7q11.23 duplication (Dup7) to healthy controls. We retrospectively reviewed all echocardiograms in all patients with Dup7 evaluated at our institutions from June 2017 through September 2019. All standard aortic diameter measurements were made and recorded. Z-scores for the measurements were calculated. For comparison, a set of control echocardiograms was developed by randomly selecting 24 normal echocardiograms in age-matched patients who had undergone echocardiograms for an indication of either chest pain or syncope. In 58 echocardiograms from 21 Dup7 patients, all aortic measurements were increased compared to controls (p?
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Pharmacokinetics and Safety of Dabigatran Etexilate after Single and Multiple Oral Doses in Healthy Chinese Subjects.
Eur J Drug Metab Pharmacokinet2020 May;():. doi: 10.1007/s13318-020-00626-4.
Duan Jingli, Yang Li, Li Haiyan, Yamamura Norio, Harada Akiko,
Abstract
BACKGROUND AND OBJECTIVE:
Dabigatran etexilate is a non-vitamin K antagonist oral anticoagulant (NOAC) that is used to prevent stroke and systemic embolism in adults with nonvalvular atrial fibrillation (NVAF) and one or more risk factors. Pharmacokinetic data on this anticoagulant in Chinese subjects are limited. This study aimed to provide further information on the pharmacokinetic profile of dabigatran in healthy Chinese subjects, together with its safety profile.
METHODS:
This was an open-label, single-centre, phase I study. Subjects were randomized into 110 and 150 mg dabigatran etexilate treatment groups. Each subject received 7 days of treatment: a single dose on day 1, no dose on days 2-3, and then multiple doses on days 4-10. Blood samples were collected to analyze the pharmacokinetic profile of dabigatran. All adverse events (AEs) were recorded. Routine clinical laboratory tests, a physical examination, vital signs, and 12-lead electrocardiogram (ECG) measurements were performed.
RESULTS:
A total of 28 subjects (14 males and 14 females) were randomized in this trial. The plasma concentration of total dabigatran reached its maximum measured concentration at a median time of 3-4 h from the dose of interest (either the initial single dose on day 1 or the final dose on day 10) under fed conditions, and declined with an elimination half-life of 10.7-10.9 h following the dose of interest. There was a modest difference in pharmacokinetic profile between male and female subjects. None of the subjects experienced a serious adverse event (SAE) or an AE of moderate or severe intensity. The investigator reported that 17 of the 28 subjects had mild treatment-emergent AEs that resolved without any concomitant treatment or intervention. No clinically significant changes in vital signs or ECG parameters were observed.
CONCLUSIONS:
This study revealed the pharmacokinetic characteristics and good safety profile of dabigatran in healthy Chinese subjects.
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Novel endoscopic marking clip equipped with resin-conjugated fluorescent indocyanine green during laparoscopic surgery for gastrointestinal cancer.
Langenbecks Arch Surg2020 May;():. doi: 10.1007/s00423-020-01902-2.
Namikawa Tsutomu, Iwabu Jun, Hashiba Motoi, Munekage Masaya, Uemura Sunao, Yamada Takayoshi, Kitagawa Hiroyuki, Mizuta Hiroshi, Okamoto Ken, Uchida Kazushige, Sato Takayuki, Kobayashi Michiya, Hanazaki Kazuhiro,
Abstract
PURPOSE:
Intraoperative identification of the cancer location is often difficult to conduct during laparoscopic surgery, especially in early-stage cancers. This study aimed to investigate the feasibility and accuracy of a novel endoscopic clip resin-conjugated fluorescent indocyanine green during laparoscopic surgery for gastrointestinal cancer.
METHODS:
Preoperative placement of endoscopic marking clips equipped with resin-conjugated fluorescent indocyanine green was performed to determine the resection margin in eight patients with gastrointestinal cancer. During laparoscopic surgery, a dedicated laparoscopic system with a xenon light source was used to detect fluorescence. The evaluation determined whether the fluorescent from the clips was visualized during laparoscopic surgery.
RESULTS:
Fluorescent signal emitted from ICG in the resin of the clips was detected in six patients from the outer layer of the serosal surfaces of the gastrointestinal tract, and the clips aided in accurate resection line of the organ. There were no significant differences of age, gender, and BMI between the patients in whom we could and could not detect ICG fluorescence.
CONCLUSIONS:
The results demonstrated the usefulness of a novel clip-equipped fluorescent resin, which is a promising diagnostic tool to detect accurate tumor location during laparoscopic surgery.
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Statement from the North American Society for Cardiovascular Imaging on imaging strategies to reduce the scarcity of healthcare resources during the COVID-19 outbreak.
Int J Cardiovasc Imaging2020 May;():. doi: 10.1007/s10554-020-01861-1.
Kicska Gregory, Litmanovich Diana E, Ordovas Karen G, Young Phillip M, Dennie Carole, Truong Quynh A, Abbara Suhny, Kirsch Jacobo,
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an evolving global pandemic that is predicted to strain healthcare resources at multiple locations throughout North America and the World. As of April 6, 2020, the apex of infection rates is predicted to occur within 1 to 5 weeks at various locations. Widespread reports of personal protective equipment (PPE) shortages, and healthcare worker exposure to disease have become commonplace. To mitigate this crisis, we are suggesting imaging strategies that aim to use the least PPE, require the smallest number of potential staff exposures, and streamlines utilization of imaging. They are broadly organized by (1) substituting a noninvasive diagnostic test in place of a semi-invasive or invasive diagnostic tests, and (2) consolidating diagnostic imaging.
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