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1.
Circ Cardiovasc Interv ; 16(4): e012511, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-36974680

RESUMEN

BACKGROUND: Twenty percent to 40% of patients are affected by angina after percutaneous coronary intervention (PCI), which is associated with anxiety, depression, impaired physical function, and reduced quality of life. Understanding patient and procedural factors associated with post-PCI angina may inform alternative approaches to treatment. METHODS: Two hundred thirty patients undergoing PCI completed the Seattle Angina Questionnaire (SAQ-7) and European quality of life-5 dimension-5 level (EQ-5D-5L) questionnaires at baseline and 3 months post-PCI. Patients received blinded intracoronary physiology assessments before and after stenting. A post hoc analysis was performed to compare clinical and procedural characteristics among patients with and without post-PCI angina (defined by follow-up SAQ-angina frequency score <100). RESULTS: Eighty-eight of 230 patients (38.3%) reported angina 3 months post-PCI and had a higher incidence of active smoking, atrial fibrillation, and history of previous myocardial infarction or PCI. Compared with patients with no angina at follow-up, they had lower baseline SAQ summary scores (69.48±24.12 versus 50.20±22.59, P<0.001) and EQ-5D-5L health index scores (0.84±0.15 versus 0.69±0.22, P<0.001). Pre-PCI fractional flow reserve (FFR) was lower among patients who had no post-PCI angina (0.56±0.15 versus 0.62±0.13, P=0.003). Percentage change in FFR after PCI had a moderate correlation with angina frequency score at follow-up (r=0.36, P<0.0001). Patients with post-PCI angina had less improvement in FFR (43.1±33.5% versus 67.0±50.7%, P<0.001). There were no between-group differences in post-PCI FFR, coronary flow reserve, or corrected index of microcirculatory resistance. Patients with post-PCI angina had lower SAQ-summary scores (64.01±22 versus 95.16±8.72, P≤0.001) and EQ-5D-5L index scores (0.69±0.26 versus 0.91±0.17, P≤0.001) at follow-up. CONCLUSIONS: Larger improvements in FFR following PCI were associated with less angina and better quality of life at follow-up. In patients with stable symptoms, intracoronary physiology assessment can inform expectations of angina relief and quality of life improvement after stenting and thereby help to determine the appropriateness of PCI. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT03259815.


Asunto(s)
Enfermedad de la Arteria Coronaria , Reserva del Flujo Fraccional Miocárdico , Intervención Coronaria Percutánea , Humanos , Angina de Pecho/diagnóstico , Angina de Pecho/terapia , Angina de Pecho/epidemiología , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/terapia , Microcirculación , Intervención Coronaria Percutánea/efectos adversos , Calidad de Vida , Resultado del Tratamiento
2.
J Ethnopharmacol ; 203: 171-181, 2017 May 05.
Artículo en Inglés | MEDLINE | ID: mdl-28344030

RESUMEN

ETHNOPHARMACOLOGICAL RELEVANCE: Antimicrobial drug resistance is a growing threat to global public health. Historical records and herbal texts relating to traditional Celtic medicine indicate an extensive pharmacopeia of plants for treating infections likely caused by microbes. However, a major barrier for successful integration of these remedies into mainstream practice is the current lack of accurate interpretation and scientific validation. MATERIALS AND METHODS: We investigated the flora of the Isle of Arran, Scotland, via in situ targeted screening of 83 out of 138 plants identified in Meddygion Myddvai (a 14th century Welsh manuscript) to treat conditions related to microbial infections, and an additional 18 plants from modern ethnobotanical knowledge on the island (Scottish School of Herbal Medicine). In a follow-up proof-of-concept study, bioassay-guided fractionation was performed to identify bioactive constituents from two high scoring hits that inhibited Staphylococcus aureus (Gram-positive) and Escherichia coli (Gram-negative) bacterial growth. RESULTS: 67 historical plants (80.7%) and 14 modern plants (77.8%) were found to have detectable levels of antimicrobial activity when tested using Mobile Discovery kits, with human saliva as a source of bacteria for screening. Sabinene, a natural bicyclic monoterpene from juniper "berries" (Juniperus communis L.) and alliin, a natural sulfoxide from garlic cloves (Allium sativum L.), were isolated and confirmed as primary antibacterial leads. CONCLUSION: Using historical medical sources such as those associated with traditional Celtic medicine to guide rigorous, evidence-based scientific investigation, provides additional leads for new and alternative bioactive molecules for combating bacterial diseases.


Asunto(s)
Antibacterianos/historia , Medicina Tradicional/historia , Preparaciones de Plantas/historia , Plantas Medicinales/química , Antibacterianos/aislamiento & purificación , Antibacterianos/farmacología , Bacterias/efectos de los fármacos , Infecciones Bacterianas/tratamiento farmacológico , Infecciones Bacterianas/historia , Etnobotánica/historia , Etnofarmacología/historia , Historia Medieval , Humanos , Fitoterapia/historia , Fitoterapia/métodos , Preparaciones de Plantas/farmacología , Escocia
3.
J Drugs Dermatol ; 2(3): 303-6, 2003 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-12848113

RESUMEN

Our lift lip technique consists of an excision of the white part of the upper lip directly beneath the nose in the shape of a 'bull's-horn', with advancement of the inferior border of the incision to the area directly beneath the nose. Pre-operative markings on the skin ensure the lip lift is approximately symmetric. Advancement of the inferior edge of skin directly beneath the nasal base lifts the lip, producing more visible vermilion and about 3 mm of tooth show at rest. The position of the final incision is such that it is located within the shadow of the nose. Meticulous technique produces an almost invisible scar. The amount and width of skin excised is individualized depending on the desired aesthetic goals. The procedure is straightforward and is usually performed under local anesthetic. Abdominal fat is frequently injected into both the upper and lower lips to increase the volume and improve the rejuvenation. Lip lifts using this technique provide an immediate, dramatic, and permanent result.


Asunto(s)
Labio/cirugía , Cirugía Plástica/métodos , Anestesia Local/métodos , Femenino , Humanos , Masculino , Nariz/cirugía , Nariz/trasplante , Trasplante de Tejidos/métodos
4.
J Biol Chem ; 277(14): 11735-45, 2002 Apr 05.
Artículo en Inglés | MEDLINE | ID: mdl-11821381

RESUMEN

DNA methylation is an epigenetic modification of DNA. There are currently three catalytically active mammalian DNA methyltransferases, DNMT1, -3a, and -3b. DNMT1 has been shown to have a preference for hemimethylated DNA and has therefore been termed the maintenance methyltransferase. Although previous studies on DNMT3a and -3b revealed that they act as functional enzymes during development, there is little biochemical evidence about how new methylation patterns are established and maintained. To study this mechanism we have cloned and expressed Dnmt3a using a baculovirus expression system. The substrate specificity of Dnmt3a and molecular mechanism of its methylation reaction were then analyzed using a novel and highly reproducible assay. We report here that Dnmt3a is a true de novo methyltransferase that prefers unmethylated DNA substrates more than 3-fold to hemimethylated DNA. Furthermore, Dnmt3a binds DNA nonspecifically, regardless of the presence of CpG dinucleotides in the DNA substrate. Kinetic analysis supports an Ordered Bi Bi mechanism for Dnmt3a, where DNA binds first, followed by S-adenosyl-l-methionine.


Asunto(s)
ADN (Citosina-5-)-Metiltransferasas/metabolismo , Metilación de ADN , Animales , Baculoviridae/metabolismo , Bioquímica/métodos , Catálisis , Línea Celular , Islas de CpG , ADN/metabolismo , ADN Metiltransferasa 3A , ADN Complementario/metabolismo , Relación Dosis-Respuesta a Droga , Insectos , Cinética , Ratones , Modelos Químicos , Unión Proteica , Proteínas Recombinantes/metabolismo , S-Adenosilmetionina/metabolismo , Especificidad por Sustrato , Factores de Tiempo
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