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91.
Marcos F. Minicucci Elaine Farah Daniéliso R. Fusco Ana Lúcia Cogni Paula S. Azevedo Katashi Okoshi Silméia G. Zanati Beatriz B. Matsubara Sergio A. R. Paiva Leonardo A. M. Zornoff 《Arquivos brasileiros de cardiologia》2014,102(6):549-556
Background
The effects of modern therapy on functional recovery after acute myocardial infarction (AMI) are unknown.Objectives
To evaluate the predictors of systolic functional recovery after anterior wall AMI in patients undergoing modern therapy (reperfusion, aggressive platelet antiaggregant therapy, angiotensin-converting enzyme inhibitors and beta-blockers).Methods
A total of 94 consecutive patients with AMI with ST-segment elevation were enrolled. Echocardiograms were performed during the in-hospital phase and after 6 months. Systolic dysfunction was defined as ejection fraction value < 50%.Results
In the initial echocardiogram, 64% of patients had systolic dysfunction. Patients with ventricular dysfunction had greater infarct size, assessed by the measurement of total and isoenzyme MB creatine kinase enzymes, than patients without dysfunction. Additionally, 24.5% of patients that initially had systolic dysfunction showed recovery within 6 months after AMI. Patients who recovered ventricular function had smaller infarct sizes, but larger values of ejection fraction and E-wave deceleration time than patients without recovery. At the multivariate analysis, it can be observed that infarct size was the only independent predictor of functional recovery after 6 months of AMI when adjusted for age, gender, ejection fraction and E-wave deceleration time.Conclusion
In spite of aggressive treatment, systolic ventricular dysfunction remains a frequent event after the anterior wall myocardial infarction. Additionally, 25% of patients show functional recovery. Finally, infarct size was the only significant predictor of functional recovery after six months of acute myocardial infarction. 相似文献92.
Tan TC Rahman R Jaber-Hijazi F Felix DA Chen C Louis EJ Aboobaker A 《Proceedings of the National Academy of Sciences of the United States of America》2012,109(11):4209-4214
In most sexually reproducing animals, replication and maintenance of telomeres occurs in the germ line and during early development in embryogenesis through the use of telomerase. Somatic cells generally do not maintain telomere sequences, and these cells become senescent in adults as telomeres shorten to a critical length. Some animals reproduce clonally and must therefore require adult somatic mechanisms for maintaining their chromosome ends. Here we study the telomere biology of planarian flatworms with apparently limitless regenerative capacity fueled by a population of highly proliferative adult stem cells. We show that somatic telomere maintenance is different in asexual and sexual animals. Asexual animals maintain telomere length somatically during reproduction by fission or when regeneration is induced by amputation, whereas sexual animals only achieve telomere elongation through sexual reproduction. We demonstrate that this difference is reflected in the expression and alternate splicing of the protein subunit of the telomerase enzyme. Asexual adult planarian stem cells appear to maintain telomere length over evolutionary timescales without passage through a germ-line stage. The adaptations we observe demonstrate indefinite somatic telomerase activity in proliferating stem cells during regeneration or reproduction by fission, and establish planarians as a pertinent model for studying telomere structure, function, and maintenance. 相似文献
93.
Marchaim D Chopra T Bogan C Bheemreddy S Sengstock D Jagarlamudi R Malani A Lemanek L Moshos J Lephart PR Ku K Hasan A Lee J Khandker N Blunden C Geffert SF Moody M Hiro R Wang Y Ahmad F Mohammadi T Faruque O Patel D Pogue JM Hayakawa K Dhar S Kaye KS 《American journal of infection control》2012,40(8):760-765
94.
We present a rare occurrence of metastatic proximal epithelioid sarcoma (PES) in the pleural effusion of a 23‐year‐old man, developed within one year of diagnosis in his gluteal soft tissue. The cytologic and immunoperoxidase findings are described. PES, due to its epithelioid morphology, can be confused with more common cancers in effusions such as adenocarcinoma and mesothelioma. PES is an aggressive neoplasm that differs clinically and pathologically from conventional epithelioid sarcoma. Knowledge of its cytomorphology in serous cavity effusions, a patient's clinical history and ancillary studies may lead to an accurate diagnosis. Diagn. Cytopathol. 2013. © 2011 Wiley Periodicals, Inc. 相似文献
95.
96.
Azevedo PS Cogni AL Farah E Minicucci MF Okoshi K Matsubara BB Zanati SG Fonseca AG Patini BJ Paiva SA Zornoff LA 《The Canadian journal of cardiology》2012,28(4):438-442
Background
Regardless significant therapeutic advances, mortality and morbidity after myocardial infarction (MI) are still high. For a long time, the importance of right ventricle (RV) function has been neglected. Recently, RV dysfunction has also been associated with poor outcomes in the setting of heart failure. The shape, location, and contraction conditions make the RV chamber assessment technically challenging.Methods
Our study identified clinical characteristics and left ventricle (LV) echocardiographic data performed 3-5 days after MI that could be associated with RV dysfunction (RV fractional area change [FAC] < 35%) 6 months after MI.Results
The RV dysfunction group consisted of 11 patients (RV FAC 29.4% ± 5.2) and the no RV dysfunction group of 71 patients (RV FAC 43.7% ± 5.1); (P < 0.001). Both groups presented the same baseline clinical characteristics. Left atrium (LA), interventricular septum (IVS), and left ventricular posterior wall (LVPW) were larger in RV dysfunction than in no RV dysfunction. Conversely, E wave deceleration time (EDT) was lower in RV dysfunction when compared with no RV dysfunction. Left atriumadj (adjusted by gender, age, infarct size, and body mass index) (odds ratio [OR], 1.22; confidence interval [CI], 1.016-1.47; P = 0.032), interventricular septumadj (OR, 1.49; CI, 1.01-2.23; P = 0.044), and E wave deceleration timeadj (OR, 0.98; CI, 0.97-0.98; P = 0.029) assessed soon after MI predicted RV failure after 6-months.Conclusions
LV diastolic dysfunction, resulting from anterior MI and assessed 3-5 days after the event, may play an important role in predicting RV dysfunction 6 months later. 相似文献97.
98.
The obese asthma phenotype is an increasingly common encounter in our clinical practice. Epidemiological data indicate that obesity increases the prevalence and incidence of asthma, and evidence that obesity precedes the development of asthma raises the possibility of a causal association. Obese patients with asthma experience more symptoms and increased morbidity compared with non-obese asthma patients. Despite more than a decade of research into this association, the exact mechanisms that underlie the interaction of obesity with asthma remain unclear. It is unlikely that the asthma-obesity association is simply due to comorbidities such as obstructive sleep apnoea or gastroesophageal reflux disease. Although inflammatory pathways are purported to play a role, there is scant direct evidence in humans that systemic inflammation modulates the behaviour of the asthmatic airway or the expression of symptoms in the obese. The role of non-eosinophilic airway inflammation also requires further study. Obesity results in important changes to the mechanical properties of the respiratory system, and these obesity-related factors appear to exert an additive effect to the asthma-related changes seen in the airways. An understanding of the various physiological perturbations that might be contributing to symptoms in obese patients with asthma will allow for a more targeted and rational treatment approach for these patients. 相似文献
99.
Farah N. Ali Amanda Hassinger Heather Price Craig B. Langman 《Pediatric nephrology (Berlin, Germany)》2013,28(6):959-962
Background
Acute kidney injury (AKI) carries a large burden of morbidity and mortality. Early diagnosis may lead to better strategies of clinical care. Cardiac surgery involving cardiopulmonary bypass is associated with a significant incidence of AKI. The study objective was to determine whether or not preoperative fibroblast growth factor-23 (FGF23) levels differed among pediatric patients who did or did not develop AKI following cardiac surgery.Methods
A nested case–control study was performed. FGF23 levels were measured pre- and post-operatively in 19 children without chronic kidney disease (CKD) who underwent cardiopulmonary bypass. Five patients developed AKI and 14 patients served as controls.Results
FGF23 levels in patients who developed AKI following cardiac surgery were elevated above normal levels, both pre-operatively and post-operatively compared with those patients who did not develop AKI. Relative risk of developing AKI when the pre-operative FGF23 level was >86 RU/mL was 2.0 (p?=?0.033). Preoperative FGF23 levels correlated with post-operative fluid gain (correlation coefficient 0.607, p?=?0.0059).Conclusions
FGF23 may serve as a pre-operative prognostic indicator of the development of AKI following cardiopulmonary bypass surgery in pediatric patients without CKD. Identifying patients more likely to have AKI following surgery provides a means of achieving closer clinical management of AKI and fluid balance. 相似文献100.