Determinants of long-term outcome of repaired pulmonary valve stenosis

Publication date: Available online 24 May 2019Source: Revista Española de Cardiología (English Edition)Author(s): Laura Galian-Gay, Blanca Gordon, Josep Ramón Marsal, Agnès Rafecas, Antonia Pijuan Domènech, Miguel Angel Castro, Maria T. Subirana Domènech, Carlos Sureda, Berta Miranda, Gerard Martí, David García-Dorado, Laura Dos SubiràAbstractIntroduction and objectivesAlthough pulmonary valve stenosis (PVS) is considered a low risk congenital heart disease, there have been reports of complications and the need for reintervention throughout follow-up. The aims of this study were to evaluate the long-term outcome of repaired PVS and to identify predictors of cardiovascular complications and reintervention.MethodsWe studied 158 adult patients with repaired PVS (repair procedures performed from 1957 to 2010) receiving active follow-up in a tertiary referral center.ResultsA total of 95 patients (60%) received surgical treatment, and 63 patients (40%) received percutaneous pulmonary balloon valvuloplasty. At the end of follow-up (27 years, IQR, 20-33 years), most patients (n = 134, 84.8%) were in New York Heart Association functional class I, but 61 patients (38.6%) required a reintervention, mainly pulmonary valve replacement (17.7%, n = 28), and 19 patients (12%) had at least one cardiovascular complication: 13 (8.2%) supraventricular arrhythmias, 6 (3.8%) heart failure, 5 (3.2%) stroke, 1 (0.6%) ...
Source: Revista Espanola de Cardiologia - Category: Cardiology Source Type: research

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Publication date: Available online 11 October 2019Source: Advances in Biological RegulationAuthor(s): Raymond D. BlindAbstractThe higher-order inositol phosphate second messengers inositol tetrakisphosphate (IP4), inositol pentakisphosphate (IP5) and inositol hexakisphosphate (IP6) are important signaling molecules that regulate DNA-damage repair, cohesin dynamics, RNA-editing, retroviral assembly, nuclear transport, phosphorylation, acetylation, crotonylation, and ubiquitination. This functional diversity has made understanding how inositol polyphosphates regulate cellular processes challenging to dissect. However, some i...
Source: Advances in Biological Regulation - Category: Biology Source Type: research
Orbitides are a class of small naturally occurring cyclic peptides with structural and functional diversities. Their chemical properties make this class feasible to be obtained by solid phase peptide synthesis (SPPS). Therefore, this synthetic accessibility enables useful application and facilitates the identification of analogues, bioactivity studies, and thus, enables them to be applied to obtain peptide libraries. The aim of this work was to investigate the effects of orbitides and their linear synthetic analogues on the migration of neonatal human foreskin fibroblasts. The screening of linear peptide analogues, origina...
Source: Journal of the Brazilian Chemical Society - Category: Chemistry Source Type: research
Renin –angiotensin–aldosterone system inhibitors have proven clinical benefit in management of patients with heart failure with reduced ejection fraction. However, there are no guidelines to manage decline in kidney function that occurs with initiation and titration of renin–angiotensin–aldosteron e system agents during management of heart failure. We discuss the complex interplay of kidney function and heart failure in the presence of renin–angiotensin–aldosterone system agents and suggest a clinical algorithm for management of acute decline in kidney function.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Commentary Source Type: research
Although mild acute kidney injury (AKI) commonly encountered in clinical practice may resolve completely, it is increasingly apparent from human and animal data that more severe AKI often progresses to chronic kidney disease (CKD).1 After kidney injury, tubular epithelial cells (TECs) are primarily responsible for regeneration and repair by proliferating, de-differentiating, migrating, and redifferentiating.2 Depending on the extent of injury, additional repair may occur through fibrosis, the replacement of nonviable kidney tissue by the extracellular matrix.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Nephrology Digest Source Type: research
Science tells us that a lot of good things happen in our brains while we sleep – learning and memories are consolidated and waste is removed, among other things. New research shows for the first time that important immune cells called microglia – which play an important role in reorganizing the connections between nerve cells, fighting infections, and repairing damage – are also primarily active while we sleep.
Source: University of Rochester Medical Center Press Releases - Category: Universities & Medical Training Authors: Source Type: news
Source: Clinical Drug Investigation - Category: Drugs & Pharmacology Source Type: research
Neutrophils respond to various stimuli by decondensing and releasing nuclear chromatin characterized by citrullinated histones as neutrophil extracellular traps (NETs). This achieves pathogen immobilization or initiation of thrombosis, yet the molecular mechanisms of NET formation remain elusive. Peptidyl arginine deiminase-4 (PAD4) achieves protein citrullination and has been intricately linked to NET formation. Here we show that citrullination represents a major regulator of proteolysis in the course of NET formation. Elevated cytosolic calcium levels trigger both peptidylarginine deiminase-4 (PAD4) and calpain activity ...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
ConclusionsLinagliptin showed cardiovascular and renal safety in Asian patients with T2DM and established CVD with albuminuria and/or kidney disease.
Source: Diabetology International - Category: Endocrinology Source Type: research
Objectives: To determine the feasibility and impact of real-time anti-factor Xa (aFXa) level monitoring and enoxaparin dose adjustment in orthopaedic trauma. To examine the adequacy of standard fixed-dose enoxaparin chemoprophylaxis and to examine whether patient-specific factors influence enoxaparin metabolism. Design: Prospective cohort. Setting: Academic Level-I trauma center. Patients: Postoperative adult orthopaedic trauma patients undergoing acute fracture or nonunion surgery of the pelvis, acetabulum, or lower extremity placed on 30 mg of enoxaparin twice daily. Intervention: Peak steady-state aFXa lev...
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research
Conclusions: We observed a significant inverse relationship between surgeon volume and complication rates when controlling for patient and injury characteristics. In contrast to previous research, a volume–outcome relationship was not observed at the hospital level. These results suggest that such complex injuries should be triaged to the most experienced providers. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research
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