The Association between Serum Follistatin-like Proteins and Cardiovascular Diseases: A Systematic Review and Meta-analysis.

BACKGROUND: Follistatin-like proteins (FSTLs) are adipomyokines secreted by adipocytes and myocytes. Previous studies have reported an increase in circulating FSTL1 levels in response to cardiovascular injuries. In this study, we conducted a systematic review and metaanalysis to assess the association between circulating FSTLs and Cardiovascular Diseases (CVDs). METHODS: We performed a comprehensive literature search using PubMed, Web of Science, Scopus, and Embase databases. After screening the articles, we selected eligible studies, extracted relevant data, and calculated the pooled Standardized Mean Difference (SMD). We also conducted a sensitivity analysis to identify sources of heterogeneity and assessed publication bias. RESULTS: Among the 577 articles initially retrieved, we included 5 studies comprising a total of 941 cases with CVDs and 446 controls. All included studies measured FSTL1 levels. The pooled SMD analysis revealed a significant difference in circulating FSTL1 levels between subjects with CVDs and control groups (SMD = 0.853, 95% CI = 0.158-1.548, P = 0.016). Heterogeneity was primarily attributed to a single study that measured FSTL1 levels in heart failure patients with preserved ejection fraction. No publication bias was observed. CONCLUSION: Our findings demonstrate significantly higher levels of FSTL1 in patients with CVD compared to control subjects. This suggests that FSTL1 may have potential as a diagnostic and prognostic biomarker in CVDs. However, further well-designed studies are needed to validate its clinical utility.

Elucidating the Role of Pro-renin Receptors in Pancreatic Ductal Adenocarcinoma Progression: A Novel Therapeutic Target in Cancer Therapy.

Pancreatic cancer is a highly aggressive malignancy with a very poor prognosis. The 5- year survival in these patients is very low, and most patients develop drug resistance to current therapies, so additional studies are needed to identify the potential role of new drug targets for the treatment of pancreatic cancer. Recent investigations have been performed regarding the roles of pro-renin receptors (PRR) in the initiation and development of cancers. PRR is a component of the local renin-angiotensin system (RAS). Local tissue RAS has been known in diverse organ systems, including the pancreas. Various investigations have implicated that PRRs are associated with the upregulation of various signaling pathways, like the renin-angiotensin system pathway, PI3K/Akt/mTOR, and the Wnt-signaling pathways, to contribute to pathological conditions, including cancer. In this review, we presented an overview of the role of PRR in the progression of pancreatic adenocarcinoma.

Trans-catheter closure of ASD and abnormal connection of left pulmonary vein to vertical vein: A case report.

RATIONALE: Partial anomalous pulmonary venous connection is a rare congenital anomaly in which one or more pulmonary veins are connected to the venous circulation leading to left to right heart shunt. Although correction of anomalous pulmonary venous connection is achieved through surgery, there are rare instances where the abnormal pulmonary vein has dual connection to both left atrium and the major systemic veins. Under these circumstances, catheter-based treatment might become a feasible option. PATIENT CONCERNS: A 22-year-old female presented with exertional dyspnea, holo-systolic murmur in left sternal border, and fixed splitting of S2 in examination. DIAGNOSIS: The patient was diagnosed with secundum type atrial septal defect (ASD) and dual drainage of left upper pulmonary vein. INTERVENTIONS: The patient was candidate for device closure. Under TEE guidance, occluder devices were deployed in the upper part of vertical vein and subsequently in place of ASD. OUTCOMES: Echocardiogram in the next day showed complete occlusion of flow through the vertical vein and ASD. Dual antiplatelet was prescribed on discharge. Follow-up echocardiography after 3 months showed obvious improvement in RV size. Due to suspicion for clot formation, TEE was done and thrombosis with approximate length of extension of 15 mm was detected back to the device. The patient is following for 5 years. Repeated TEE after 2 years did not show any change in the burden of clot. LESSONS: For comprehensive evaluation of patients with ASD, assessment of pulmonic veins is crucial and in the presence of a vertical vein, the dual drainage of pulmonic veins should be considered.