Recent trends in early outcome of adult patients after heart transplantation: a single-institution review of 251 transplants using standard donor organs.

Older age, prior transplantation, pulmonary hypertension, and mechanical support are commonly seen in current potential cardiac transplant recipients. Transplants in 436 consecutive adult patients from 1994 to 1999 were reviewed. There were 251 using standard donors in 243 patients (age range 18-69 years). To emphasize recipient risk, 185 patients who received a nonstandard donor were excluded from analysis. The indications for transplant were ischemic heart disease (n = 123, 47%), dilated cardiomyopathy (n = 82, 32%), and others (n=56, 21%). One hundred and forty-nine (57%) recipients were listed as status I; 5 and 6% were supported with an intra-aortic balloon and an assist device, respectively. The 30-d survival and survival to discharge were 94.7 and 92.7%, respectively; 1-year survival was 89.1%. Causes of early death were graft failure (n = 6), infection (n = 4), stroke (n = 4), multiorgan failure (n = 3) and rejection (n = 2). Predictors were balloon pump use alone (OR= 11.4, p =0.002), pulmonary vascular resistance > 4 Wood units (OR = 5.7, p = 0.007), pretransplant creatinine > 2.0 mg/dL (OR = 6.9, p = 0.004) and female donor (OR = 8.3, p = 0.002). Recipient age and previous surgery did not affect short-term survival. Heart transplantation in the current era consistently offers excellent early and 1-year survival for well-selected recipients receiving standard donors. Early mortality tends to reflect graft failure while hospital mortality may be more indicative of recipient selection.     

No association between DUP25 and anxiety disorders.

Gratacos et al. [2001: Cell 106:367-379] described an interstitial duplication dup(15)q24q26 (DUP25) in patients with anxiety disorders; this duplication was found in approximately 90% of patients and in 7% of controls. In order to determine if DUP25 is present in additional individuals susceptible to panic attacks, we tested 44 patients with anxiety disorders, using probes 251c23 and 216c14 mapping in the 15q24 and 15q26 region. We have not detected any DUP25. Our results suggest that DUP25 is not common in people with anxiety disorders in the population tested here.     

Human prostatic-carcinoma cell-line lncap degrades luteinizing-hormone-releasing hormone

Recent evidence suggests a direct antiproliferative effect of LHRH agonists on the prostatic carcinoma cell line LNCaP. In the present study the possible presence of a LHRH degrading activity (LHRH-DA) in soluble fractions of LNCaP cell homogenates has been investigated. The results obtained show that an LHRH-DA is present in the soluble fraction of LNCaP cells with apparent Km and Vmax values of 31.6 mu M and 4.5 pmol/min/mu g protein respectively. The degradation pattern of LHRH is characterized by two major initial degradation products identified as LHRH 1-5 and LHRH 1-6 fragments. The degradation of the tracer [pGlu-H-3]LHRH, used as a substrate, is inhibited by synthetic unlabelled LHRH (IC50 7.9 mu M) and by several LHRH agonists with different kinetics and potencies; the LHRH agonist [DSer-(tBu)(6),Gly(10)-Aza]LHRH was the most potent blocker of LHRH-DA present in LNCaP cells; this enzymatic activity is also inhibited in a dose dependent manner by somatostatin, TRH, bacitracin and dithiothreitol. The LHRH-DA present in the soluble fraction of LNCaP cells does not seem to be modified by the deprivation of steroids from the culture medium, In conclusion, the presence in LNCaP cells of a soluble peptidase able to degrade LHRH might reinforce the possibility that the prostate is a target for the action of LHRH and of LHRH analogs.     

Expanding the clinical spectrum of STIP1 homology and U-box containing protein 1-associated ataxia

Journal of Neurology - STUB1 has been first associated with autosomal recessive (SCAR16, MIM# 615768) and later with dominant forms of ataxia (SCA48, MIM# 618093). Pathogenic variations in STUB1...     

Impact of COVID-19 lockdown on sleep quality in university students and administration staff

Journal of Neurology - In Italy, lockdown due to COVID-19 health emergency started on March 10 and partially ended on May 3rd, 2020. There was a significant increase of psychological distress and...     

Myocardial "bridges". A new pathogenetic problem in angina without coronary obstruction (author's transl)]

Six patients showing at coronary angiography normal coronary arteries during dyastole, but a segmental constriction of the left anterior descending artery during systole, were studied. Four of these patients in which the degree of systolic artery narrowing was more evident had typical angina and positive stress test. In two of these cases, a probable idiopathic cardiac hypertrophy was present. The pathogenetic significance of the angiographic findings are discussed, on the basis of common knowledge of coronary physiology and of pathophysiology of angina with normal coronary arteries.     

Cardiac medication during pregnancy,data from the ROPAC

Background

Data on pharmacological management during pregnancy are scarce. The aim of this study was to describe the type and frequency of cardiac medication used in pregnancy in patients with cardiovascular disease and to assess the relationship between medication use and fetal outcome.

Methods and results

Between 2007 and 2011 sixty hospitals in 28 countries enrolled 1321 pregnant women. All patients had structural heart disease (congenital 66%, valvular 25% or cardiomyopathy 7% or ischemic 2%). Medication was used by 424 patients (32%) at some time during pregnancy: 22% used beta-blockers, 8% antiplatelet agents, 7% diuretics, 2.8% ACE inhibitors and 0.5% statins. Compared to those who did not take medication, patients taking medication were older, more likely to be parous, have valvular heart disease and were less often in sinus rhythm. The odds ratio of fetal adverse events in users versus non-users of medication was 2.6 (95% CI 2.0–3.4) and after adjustment for cardiac and obstetric parameter was 2.0 (95% CI 1.4–2.7). Babies of patients treated with beta-blockers had a significantly lower adjusted birth weight (3140 versus 3240 g, p = 0.002). The highest rate of fetal malformation was found in patients taking ACE inhibitors (8%).

Conclusion

One third of pregnant women with heart disease used cardiac medication during their pregnancy, which was associated with an increased rate of adverse fetal events. Birth weight was significantly lower in children of patients taking beta-blockers. A randomized trial is needed to distinguish the effects of the medication from the effects of the underlying maternal cardiac condition.