Δευτέρα 1 Ιανουαρίου 2018
Beating-Heart Mitral Valve Repair Using a Novel ePTFE Cordal Implantation Device: A Prospective Trial
AbstractBackground
Conventional mitral valve (MV) operations allow direct anatomic assessment and repair on an arrested heart, but require cardiopulmonary bypass, aortic cross-clamping, sternotomy or thoracotomy, and cardioplegic cardiac arrest, and are associated with significant perioperative disability, and risks of morbidity and mortality.
ObjectivesThis study evaluated safety and performance of a transesophageal echocardiographic-guided device designed to implant artificial expanded polytetrafluoroethylene (ePTFE) cords on mitral leaflets in the beating heart.
MethodsIn a prospective multicenter study, 30 consecutive patients with severe degenerative mitral regurgitation (MR) were treated with a mitral valve repair system (MVRS) via small left thoracotomy. The primary (30-day) endpoint was successful implantation of cords with MR reduction to moderate or less.
ResultsThe primary endpoint was met in 27 of 30 patients (90%). Three patients required conversion to open mitral surgery. There were no deaths, strokes, or permanent pacemaker implantations. At 1 month, MR was mild or less in 89% (24 of 27) and was moderate in 11% (3 of 27). At 6 months, MR was mild or less in 85 % (22 of 26), moderate in 8% (2 of 26), and severe in 8% (2 of 26). Favorable cardiac remodeling at 6 months included decreases in end-diastolic (161 ± 36 ml to 122 ± 30 ml; p < 0.001) and left atrial volumes (106 ± 36 ml to 69 ± 24 ml; p < 0.001). The anterior-posterior mitral annular dimension decreased from 34.7 ± 5.8 mm to 28.2 ± 5.1 mm; p < 0.001 as did the mitral annular area (10.0 ± 2.7 cm2 vs. 6.9 ± 2.0 cm2; p < 0.0001).
ConclusionsMVRS ePTFE cordal implantation can reduce the invasiveness and morbidity of conventional MV surgery. The device's safety profile is promising and prospective trials comparing the outcomes of the MVRS to conventional MV repair surgery are warranted. (CE Mark Study for the Harpoon Medical Device [TRACER]; NCT02768870)
http://ift.tt/2EtRUt9
Primary Prevention With Statins in the Elderly
Abstract
The burden of atherosclerotic cardiovascular disease (ASCVD) in high-income countries is mostly borne by the elderly. With increasing life expectancy, clear guidance on sensible use of statin therapy to prevent a first and potentially devastating ASCVD event is critically important to ensure a healthy aging population. Since 2013, 5 major North American and European guidelines on statin use in primary prevention of ASCVD have been released by the American College of Cardiology/American Heart Association, the UK National Institute for Health and Care Excellence, the Canadian Cardiovascular Society, U.S. Preventive Services Task Force, and the European Society of Cardiology/European Atherosclerosis Society. Guidance on using statin therapy in primary ASCVD prevention in the growing elderly population (>65 years of age) differs markedly. The authors discuss the discrepant recommendations, place them into the context of available evidence, and identify circumstances in which uncertainty may hamper the appropriate use of statins in the elderly.
http://ift.tt/2Esm9jZ
Temporal Trends of De Novo Malignancy Development After Heart Transplantation
AbstractBackground
Malignancy is a concern in cardiac transplant recipients, but the temporal trends of de novo malignancy development are unknown.
ObjectivesThe goal of this study was to describe the temporal trends of the incidence, types, and predictors of de novo malignancy in cardiac transplant recipients.
MethodsThe authors analyzed the temporal trends of post-transplant incidence, types, and predictors of malignancy using 17,587 primary adult heart-only transplant recipients from the International Society for Heart and Lung Transplantation registry. The main study outcomes included the incidence of, types of, and time to de novo malignancy.
ResultsThe risk of any de novo solid malignancy between years 1 and 5 after transplantation was 10.7%. The cumulative incidence by malignancy type was: skin cancer (7.0%), non-skin solid cancer (4.0%), and lymphoproliferative disorders (0.9%). There was no temporal difference in the time to development according to malignancy type. However, the cumulative incidence of de novo solid malignancy increased from 2000 to 2005 vs. 2006 to 2011 (10.0% vs. 12.4%; p < 0.0001). Survival in patients after de novo malignancy was markedly lower than in patients without malignancy (p < 0.0001). Older recipients and patients who underwent transplantation in the recent era had a higher risk of de novo malignancy.
ConclusionsMore than 10% of adult heart transplant recipients developed de novo malignancy between years 1 and 5 after transplantation, and this outcome was associated with increased mortality. The incidence of post-transplant de novo solid malignancy increased temporally, with the largest increase in skin cancer. Individualized immunosuppression strategies and enhanced cancer screening should be studied to determine whether they can reduce the adverse outcomes of post-transplantation malignancy.
http://ift.tt/2lCjYlb
Platelet-Derived MRP-14 Induces Monocyte Activation in Patients With Symptomatic Peripheral Artery Disease
AbstractBackground
Peripheral artery disease (PAD), a diffuse manifestation of atherothrombosis, is a major cardiovascular threat. Although platelets are primary mediators of atherothrombosis, their role in the pathogenesis of PAD remains unclear.
ObjectivesThe authors sought to investigate the role of platelets in a cohort of symptomatic PAD.
MethodsThe authors profiled platelet activity, mRNA, and effector roles in patients with symptomatic PAD and in healthy controls. Patients with PAD and carotid artery stenosis were recruited into ongoing studies (NCT02106429 and NCT01897103) investigating platelet activity, platelet RNA, and cardiovascular disease.
ResultsPlatelet RNA sequence profiling mapped a robust up-regulation of myeloid-related protein (MRP)-14 mRNA, a potent calcium binding protein heterodimer, in PAD. Circulating activated platelets were enriched with MRP-14 protein, which augmented the expression of the adhesion mediator, P-selectin, thereby promoting monocyte–platelet aggregates. Electron microscopy confirmed the firm interaction of platelets with monocytes in vitro and colocalization of macrophages with MRP-14 confirmed their cross talk in atherosclerotic manifestations of PAD in vivo. Platelet-derived MRP-14 was channeled to monocytes, thereby fueling their expression of key PAD lesional hallmarks and increasing their directed locomotion, which were both suppressed in the presence of antibody-mediated blockade. Circulating MRP-14 was heightened in the setting of PAD, significantly correlated with PAD severity, and was associated with incident limb events.
ConclusionsThe authors identified a heightened platelet activity profile and unraveled a novel immunomodulatory effector role of platelet-derived MRP-14 in reprograming monocyte activation in symptomatic PAD. (Platelet Activity in Vascular Surgery and Cardiovascular Events [PACE]; NCT02106429; and Platelet Activity in Vascular Surgery for Thrombosis and Bleeding [PIVOTAL]; NCT01897103)
http://ift.tt/2lBP0tC
Κυριακή 31 Δεκεμβρίου 2017
Combining advantages of homogeneous organocatalysis and heterogeneous catalysis with thermosensitive single-chain nanoparticles in a representative tetrahydropyranilation of alcohols
Publication date: 31 January 2018
Source:Polymer, Volume 136
Author(s): Misha Rumyantsev, Sergey Rumyantsev
A significant scientific problem solved in this work is the development of effective polymer catalysts that allow carrying out organic reactions under homogeneous conditions with high rates and to remove catalyst from the system as a heterophase without the use of special treatment, thus combining the advantages of both homogeneous and heterogeneous catalysis. Kinetic experiments show high catalytic activity of the synthesized catalyst in homogeneous regime even at low dosage of the catalyst. Thus, it was demonstrated that tetrahydropyranilation of methanol was completed in nearly quantitative yield of the corresponding ether in 80 min at 60 °C with a dosage of the polymeric catalyst as low as 0.2 mol%. On the other hand anomalous decrease in the values of the effective rate constant was observed when the reaction was run at temperatures below the phase transition temperature. Kinetic data were used along with thermodynamic calculations to discuss the effect of the synthesized polymeric catalyst on the stabilization of the transition state. The high activity of the catalyst is complemented by its high sedimentation ability; thus, it usually takes a few minutes for the polymer to precipitate from the alcohol solution when cooled below the phase-transition temperature after the completion of the reaction. It was also revealed via dynamic light scattering that catalytic polymers adopt a thermodynamically stable conformation of the single-chain nanoparticles with average hydrodynamic radius in the range 2–2.5 nm.
Graphical abstract
http://ift.tt/2CqbcRK
Selective synthesis of highly soluble cyclic olefin copolymers with pendant vinyl groups using 1,5-hexadiene as a comonomer
Publication date: 31 January 2018
Source:Polymer, Volume 136
Author(s): Ryo Tanaka, Akane Sasaki, Takuma Takenaka, Yuushou Nakayama, Takeshi Shiono
Copolymerization of norbornene (NB) and 1,5-hexadiene (HD) was performed using a fluorenylamido-ligated titanium catalyst which conducts copolymerization of NB and 1-alkene. The obtained copolymers possessed pendant vinyl groups, of which content was varied from 0 to 9.4% by the initial feed ratio of the monomers. The copolymers were soluble in various solvents even at high conversion (>85%), showing that the crosslinking of pendant vinyl groups was negligible. The glass transition temperature of the copolymer was changed from 79 °C to over 300 °C, depending on the comonomer composition. Post-functionalization of the pendant vinyl groups with 3,3,4,4,5,5,6,6,6-nonafluoro-1-hexene via ruthenium-catalyzed metathesis reaction was also performed and fluoroalkyl-functionalized cyclic olefin copolymer was successfully obtained. The fluorinated copolymer film showed higher contact angle than the unfunctionalized copolymer.
Graphical abstract
http://ift.tt/2CpEMH1
Effects of pH on the photophysics of conjugated polyelectrolyte complexes
Publication date: 31 January 2018
Source:Polymer, Volume 136
Author(s): Pamela Schleissner, Alexander L. Ayzner
We have previously reported the formation of complexes between oppositely charged, conjugated polyelectrolytes (CPECs), resulting in electronic energy transfer between the donor and acceptor components. The ionic self-assembly process that forms CPECs is heavily influenced by environmental circumstances including solvent composition, temperature, and pH. In this article, we report the effect of polyelectrolyte chain protonation on complex formation and resulting energy transfer. The particular polyelectrolytes used in this study were a pH inactive energy donor and an acceptor polymer with protonatable sidechains. We find that over a large range of acidic pH, the optical properties do not change appreciably up to precipitation (pH 3). Surprisingly in the basic regime where the acceptor polymer is fully deprotonated, complex formation is hindered. However, at pH 11, which corresponds to an excess ion concentration of 0.001 M, the photophysical properties of the complex begin to once again resemble that of the neutral or acidic environments. Our results show that the CPEC displays impressive stability over a relatively broad range of proton concentrations, which may have implications for the construction of supramolecular light-harvesting assemblies.
Graphical abstract
http://ift.tt/2Ctk60M
Near infrared hyperspectral dataset of healthy and infected apple tree leaves images for the early detection of apple scab disease
Source:Data in Brief, Volume 16
Author(s): Maroua Nouri, Nathalie Gorretta, Pierre Vaysse, Michel Giraud, Christian Germain, Barna Keresztes, Jean-Michel Roger
This dataset presents two series of hyperspectral images of healthy and infected apple tree leaves acquired daily, from two days after inoculation until an advanced stage of infection (11 days after inoculation). The hyperspectral images were calibrated by reflection correction and registered to match the geometry of one reference image. On the last experiment day, scab positions are provided.
http://ift.tt/2CrQyRa
Fibroblast and keratinocyte gene expression following exposure to extracts of neem plant (Azadirachta indica)
Source:Data in Brief, Volume 16
Author(s): Takao Someya, Katsura Sano, Kotaro Hara, Yoshimasa Sagane, Toshihiro Watanabe, R.G.S. Wijesekara
This data article provides gene expression profiles, determined by using real-time PCR, of fibroblasts and keratinocytes treated with 0.01% and 0.001% extracts of neem plant (Azadirachta indica), local name "Kohomba" in Sri Lanka, harvested in Sri Lanka. For fibroblasts, the dataset includes expression profiles for genes encoding hyaluronan synthase 1 (HAS1), hyaluronan synthase 2 (HAS2), hyaluronidase-1 (HYAL1), hyaluronidase-2 (HYAL2), versican, aggrecan, CD44, collagen, type I, alpha 1 (COL1A1), collagen, type III, alpha 1 (COL3A1), collagen, type VII, alpha 1 (COL7A1), matrix metalloproteinase 1 (MMP1), acid ceramidase, basic fibroblast growth factor (bFGF), fibroblast growth factor-7 (FGF7), vascular endothelial growth factor (VEGF), interleukin-1 alpha (IL-1α), cyclooxygenase-2 (cox2), transforming growth factor beta (TGF-β), and aquaporin 3 (AQP3). For keratinocytes, the expression profiles are for genes encoding HAS1, HAS2, HYAL1, HYAL2, versican, CD44, IL-1α, cox2, TGF-β, AQP3, Laminin5, collagen, type XVII, alpha 1 (COL17A1), integrin alpha-6 (ITGA6), ceramide synthase 3 (CERS3), elongation of very long chain fatty acids protein 1 (ELOVL1), elongation of very long chain fatty acids protein 4 (ELOVL4), filaggrin (FLG), transglutaminase 1 (TGM1), and keratin 1 (KRT1). The expression profiles are provided as bar graphs.
http://ift.tt/2BZVTMm
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