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1.
Artigo em Inglês | MEDLINE | ID: mdl-38577931

RESUMO

BACKGROUND: Previous studies have documented a high rate of implantation success with the ACURATE neo2 valve, as well as a reduction in paravalvular leak (PVL) compared to its predecessor, the ACURATE neo. However, there are no studies that have reviewed and compared the long-term clinical and hemodynamic outcomes of these patients. AIMS: This study aimed to evaluate the results of the ACURATE neo transcatheter aortic valve in a real-world context, and to compare the results of the outcomes of both generations of this device (ACURATE neo and ACURATE neo2), with a specific focus on procedural success, safety, and long-term effectiveness. METHODS: A prospective study including all consecutive patients treated with the ACURATE neo device in seven hospitals was conducted (Clinical Trials Identification Number: NCT03846557). The primary endpoint consisted of a composite of adverse events, including mortality, aortic insufficiency, and other procedural complications. As the second-generation device (ACURATE neo2) replaced the ACURATE neo during the study period, hemodynamic and clinical results before admission, at 30 days, and at 1 year of follow-up were compared between the two generations. RESULTS: A total of 296 patients underwent transcatheter aortic valve implantation with the ACURATE device, with 178 patients receiving the ACURATE neo and 118 patients receiving the ACURATE neo2. In the overall population, the absence of device success occurred in 14.5%. The primary reason for the absence of device success was the presence of para-valvular regurgitation ≥ 2. There were no instances of coronary occlusions, valve embolization, annulus rupture, or procedural deaths. ACURATE neo2 was associated with a significantly higher device success rate (91.7% vs. 82%, p = 0.04), primarily due to a significantly lower rate of para-valvular regurgitation, which remained significant at 1 year. CONCLUSION: The use of ACURATE neo and neo2 transcatheter aortic valves is associated with satisfactory clinical results and an extremely low rate of complications. The ACURATE neo2 enables a significantly higher device success rate, primarily attributed to a significant reduction in the rate of PVL.

2.
J Integr Neurosci ; 23(2): 43, 2024 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-38419454

RESUMO

In the initial assessment of a headache patient, several dangerous secondary etiologies must be considered. A thorough history and physical examination, along with a comprehensive differential diagnosis may alert a physician to the diagnosis of a secondary headache particularly when it is accompanied by certain clinical features. Evaluation and workup include a complete neurological examination, consideration of neuroimaging, and serum/spinal fluid analysis if indicated. Careful attention to the patients' history and physical examination will guide the diagnostic work-up and management. In this review, we summarize the diagnostic workup of various primary and secondary headache etiologies. Although most headaches are primary in nature, it is essential to screen for headache "red flags", as they can suggest life threatening secondary etiologies. When secondary causes are suspected, appropriate neuroimaging can further differentiate the underlying cause. The appropriate imaging is dependent on the most likely secondary etiology, which is deduced from history and physical examination. When no red flags are present, primary headaches are more likely. These can be differentiated by frequency, location, duration, triggers, and presence of aura. The different clinical presentations for secondary headaches, as well as the distinguishing features for primary headaches are outlined in this review.


Assuntos
Transtornos da Cefaleia , Humanos , Cefaleia/diagnóstico , Cefaleia/etiologia , Neuroimagem/efeitos adversos , Diagnóstico Diferencial
3.
Cardiovasc Diagn Ther ; 13(5): 792-804, 2023 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-37941845

RESUMO

Background: Drug-eluting stents (DES) are considered the therapy of choice in ST-segment elevation myocardial infarction (STEMI); however, a low persistent rate of revascularizations and stent thrombosis exist over the time. We have previously shown that a paclitaxel (PTX)-drug-coated balloon (DCB) after a bare-metal stent (BMS) implantation (DCB-combined strategy) yields superior angiographic and clinical results compared to BMS in the short term. However, the long-term safety and efficacy of this approach remain uncertain. Methods: An 8-year clinical follow-up was conducted on patients enrolled in the randomized PEBSI-1 trial (NCT01839890). The original trial included patients who suffered a STEMI, patients were randomly assigned to receive a DCB-combined strategy or BMS only and the primary endpoint was in-stent late luminal loss (LLL) at 9-month follow-up. After the completion of this study, death, myocardial re-infarction, ischemia-driven repeated revascularizations included target lesion revascularization (TLR) and target vessel revascularization (TVR), and stent thrombosis, were assessed by yearly contact by a clinical visit, telephone or by electronic records. These outcomes were adhered to ARC-2 criteria. Results: The rate of incomplete follow-up was very low, with only 3 out of 111 patients (2.7%) in the DCB-combined strategy group and 1 out of 112 patients (0.9%) in the BMS group. At 8 years there were a lower rate of TVR [3.7% vs. 14.3%; hazard ratio (HR): 0.243; 95% confidence interval (CI): 0.081-0.727; P=0.006], and a trend towards lower TLR (2.8% vs. 8.9%; HR: 0.300; 95% CI: 0.083-1.090; P=0.052) in the DCB-combined strategy group. No statistical difference between the DCB-combined strategy and BMS groups were found for all causes of death, deaths from cardiovascular disease, reinfarctions or stent thrombosis. Notably in the DCB-combined strategy group, no episode of stent thrombosis occurred after the first year. Similarly, there were no cardiovascular deaths, TVR and TLR in the DCB-combined strategy group after 5 years. In contrast, during the period from year 5 to 8, the BMS group experienced an additional cardiovascular death, as well as one case of TVR, one case of TLR, and one case of stent thrombosis. Conclusions: In STEMI patients, the DCB-combined strategy maintains its safety and clinical efficacy over time. Our rates of TVR, TLR, and very late stent thrombosis (VLST) at very long-term are the lowest ever found in a STEMI trial. Further studies are warranted to assess the potential superiority of this novel strategy as compared with new-generation DES to prevent very late events in these patients. Trial Registration: ClinicalTrials.gov; identifier: NCT01839890.

4.
Curr Chin Sci ; 3(5): 386-395, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37981909

RESUMO

Cerebral cavernous malformations (CCMs) are comprised of tissue matter within the brain possessing anomalous vascular architecture. In totality, the dilated appearance of the cavernomatakes on a mulberry-like shape contributed by the shape and relation to vascular and capillary elements. Analyzing its pathophysiology along with its molecular and genetic pathways plays a vital role in whether or not a patient receives GKRS, medical management, or Surgery, the most invasive of procedures. To avoid neurological trauma, microsurgical resection of cavernomas canbe guided by the novel clinical application of a 3D Slicer with Sina/MosoCam. When cavernomas present in deep lesions with poor accessibility, gamma knife stereotactic radiosurgery (GKSR) is recommended. For asymptomatic and non-multilobal lesions, medical and symptom management is deemed standard, such as antiepileptic therapy. The two-hit hypothesis serves to explain the mutations in three key genes that are most pertinent to the progression of cavernomas: CCM1/KRIT1, CCM2/Malcavernin, and CCM3/PDCD10. Various exon deletions and frameshift mutations can cause dysfunction in vascular structure through loss and gain of function mutations. MEKK3 and KLF2/4 are involved in a protein kinase signaling cycle that promotes abnormal angiogenesis and cavernoma formation. In terms of potential treatments, RhoKinase inhibitors have shown to decrease endothelial to mesenchymal transition and CCM lesion development in mice models. All in all, understanding the research behind the molecular genetics in CCMs can foster personalized medicine and potentially create new neurosurgical and medicative treatments.

5.
Front Res Metr Anal ; 8: 1096226, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37476020

RESUMO

Our work provides a novel method for rich information discovery about the evolution of technical fields and company developments through patent relationships. A new exploratory method and graphical tool to discover technology proximity based on patent classification information are introduced. By technology we mean a technical field (defined by an International Patent Classification-IPC-code or a combination of them) or an organization (such as a tech company, research center, or institution). A single data structure is used for characterizing both technical fields and organizations, to visualize them as items of the very same body. This new method generates two graphs: the first graph, the TechnologyMap, visualizes technology items in a 2D plot wherein technical fields and companies will appear positioned relative to each other; the. A second graph, the Focused TechnologyMap, visualizes technology items with respect to a selected one, the focus, which is located in the center of a circle whose radii correspond to the complete set of IPC codes. This article represents the process and algorithms used for production of the graphs, and solidifies the assumptions of validity by presenting two of the many successful test cases to which it was applied.

6.
Exp Parasitol ; 241: 108357, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35998724

RESUMO

Schistosomiasis mansoni is an infectious parasitic disease caused by worms of the genus Schistosoma, and praziquantel (PZQ) is the medication available for the treatment of schistosomiasis. However, the existence of resistant strains reinforces the need to develop new schistosomicidal drugs safely and effectively. Thus, the (±)-licarin A neolignan incorporated into poly-Ɛ-caprolactone (PCL) nanoparticles and not incorporated were evaluated for their in vivo schistosomicidal activity. The (±)-licarin A -loaded poly(ε-caprolactone) nanoparticles and the pure (±)-licarin A showed a reduction in the number of worm eggs present in spleens of mice infected with Schistosoma mansoni. In addition, the (±)-licarin A incorporated in the concentration of 20 mg/kg and 200 mg/kg reduced the number of worms, presenting percentages of 56.3% and 41.7%, respectively.


Assuntos
Nanopartículas , Esquistossomose mansoni , Esquistossomicidas , Animais , Caproatos , Lactonas , Lignanas , Camundongos , Poliésteres , Schistosoma mansoni , Esquistossomose mansoni/tratamento farmacológico , Esquistossomose mansoni/parasitologia , Esquistossomicidas/farmacologia , Esquistossomicidas/uso terapêutico
7.
Rev Esp Cardiol (Engl Ed) ; 75(12): 1001-1010, 2022 Dec.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-35272968

RESUMO

INTRODUCTION AND OBJECTIVES: Transcatheter edge-to-edge repair (TEER) should be considered in patients with heart failure and secondary mitral regurgitation (MR). Angiotensin receptor-neprilysin inhibitors (ARNIs) have been demonstrated to improve prognosis in heart failure. We aimed to evaluate the impact ARNIs on patient selection and outcomes. METHODS: The population of the Spanish TEER prospective registry (March 2012 to January 2021) was divided into 2 groups: a) TEER before the ARNI era (n=450) and b) TEER after the recommendation of ARNIs by European Guidelines (n=639), with further analysis according to intake (n=52) or not (n=587) of ARNIs. RESULTS: A total of 1089 consecutive patients underwent TEER for secondary MR. In the ARNI era, there was a reduction in left ventricle dilation (82mL vs 100mL, P=.025), and better function (35% vs 38%, P=.011). At 2 years of follow-up, mortality (10.6% vs 17.3%, P <.001) and heart failure readmissions (16.6% vs 27.8%, P <.001) were lower in the ARNI era, but not recurrent MR. In the ARNI era, 1- and 2-year mortality were similar irrespective of ARNI intake but patients on ARNIs had a lower risk of readmission+mortality at 2 years (OR, 0.369; 95%CI, 0.137-0.992; P=.048), better NYHA class, and lower recurrence of MR III-IV (1.9% vs 14.3%, P=.011). CONCLUSIONS: Better patient selection for TEER has been achieved in the last few years with a parallel improvement in outcomes. The use of ARNIs was associated with a significant reduction in overall events, better NYHA class, and lower MR recurrence.


Assuntos
Insuficiência Cardíaca , Insuficiência da Valva Mitral , Neprilisina , Humanos , Insuficiência Cardíaca/tratamento farmacológico , Valva Mitral/diagnóstico por imagem , Valva Mitral/cirurgia , Insuficiência da Valva Mitral/tratamento farmacológico , Insuficiência da Valva Mitral/cirurgia , Neprilisina/antagonistas & inibidores , Receptores de Angiotensina , Resultado do Tratamento
8.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1391569

RESUMO

Objetivo: Descripción de la actualidad de la morbimortalidad de pacientes COVID-19 positivo en el Hospital General Docente "Ambato", para comprender el comportamiento del virus. Método: Descriptiva observacional y análisis de casos de morbimortalidad de pacientes. Resultados: La mayor prevalencia de casos COVID-19 se encuentra en adultos maduros (40-65 años) con un 48.1% de los casos registrados. Conclusión: La patogenia en pacientes COVID-19; en los registros proporcionados por el Hospital General Docente Ambato, se evidencia que la existencia de alguna comorbilidad de transcurso crónico, sobre todo en patologías cardiovasculares, respiratorias, renales y endocrino-metabólicas; sumándole a esto, en las poblaciones más vulnerables como son de adultos maduros (40 ­ 64 años de edad); de adultos mayores (> de 65 años); explicarían la tasa elevada de mortalidad y las implicaciones de la aparición de casos críticos, debido a la gravedad de las complicaciones evolutivas conduciendo a la vida humana a un desenlace fatal.


Objective: Description of the current morbimortality of COVID-19 positive patients at the Hospital General Docente "Ambato", in order to understand the behavior of the virus. Method: Descriptive observational and case analysis of patient morbimortality. Results: the highest prevalence of COVID-19 cases is found in mature adults (40-65 years) with 48.1% of registered cases. Conclusion: The pathogenesis in COVID-19 patients; in the records provided by the Hospital General Docente Ambato, it is evident that the existence of some comorbidity of chronic course, especially in cardiovascular, respiratory, renal and endocrine-metabolic pathologies; adding to this, in the most vulnerable populations such as mature adults (40 - 64 years of age); older adults (> 65 years of age); would explain the high mortality rate and the implications of the appearance of critical cases, due to the severity of the evolutionary complications leading to a fatal outcome in human life.

9.
Pharmaceutics ; 15(1)2022 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-36678662

RESUMO

This paper presents the influence of the presence of a modified organoclay, Cloisite® 20A (MMTA) on the structural and drug release properties of ureasil organic-inorganic hybrid. Sol-gel process was used to prepare the hybrid nanocomposites containing sodium diclofenac (DCF) at 5% wt. The effect of the amount of MMTA incorporated into the ureasil hybrid matrix was evaluated and characterized in depth by different techniques such as X-ray diffraction (XRD), small angle X-ray scattering (SAXS), differential scanning calorimetry (DSC), and swelling properties. The influence of MMTA on ureasil nanocomposites release profile was evaluated by in situ UV-vis. The diffraction patterns of the UPEO-MMTA nanocomposites showed a synergistic contribution effect that led to an intensity increase and narrowed the diffraction peaks, evidencing a crystallite PEO growth as a function of the modified nanoclay content. The interactions between polyether chains and the hydrogenated tallow of MMTA led to an easy intercalation process, as observed in UPEO-MMTA nanocomposites containing low (1% wt) or high (20% wt) nanoclay content. The waterway (channels) created in UPEO-MMTA nanocomposites contributed to a free volume increase in the swollen network compared to UPEO without MMTA. The hypothesis of the channels created after intercalation of the PEO phase in the interlayer of MMTA containing organoammonium ions corroborates with the XRD results, swelling studies by SAXS, and release assays. Furthermore, when these clay particles were dispersed in the polymeric matrix by an intercalation process, water uptake improvement was observed, with an increased amount of DCF release. The design of ureasil-MMTA nanocomposites containing modified nanoclay endows them with tunable properties; for example, swelling degree followed by amount of controlled drug release, opening the way for more versatile biomedical applications.

10.
Nat Prod Res ; 36(22): 5872-5878, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34963393

RESUMO

Lignan dinitrohinokinin displays important biological activities, which led to the preparation of its poly-ε-caprolactone nanoparticles. Kinetics analysis revealed initially slow drug release followed by a prolonged, moderate release 6 h later due to DNHK diffusion through the polymeric matrix. Molecular dynamics simulations show that DNHK molecules that interact stronger with other DNHK molecules near the PCL/DNHK surface are more difficult to dissociate from the nanoparticle. The smaller diameter nanocapsules with negative surface charge conferred good colloidal stability. The formulations showed a size distribution with monodisperse systems formation. In vivo evaluation of schistosomicidal activity against Schistosoma mansoni showed that DNHK, when incorporated into nanoparticles, caused egg number reduction of 4.2% and 28.1% at 40 mg/kg and 94.2% and 84.4% at 400 mg/kg in the liver and the spleen, respectively. The PCL nanoparticles were stable in aqueous dispersion and could be optimized to be used as a promising lignan release agent.


Assuntos
Lignanas , Nanopartículas , Esquistossomicidas , Portadores de Fármacos , Lignanas/farmacologia , Poliésteres
11.
Nat Prod Res ; 36(18): 4696-4703, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34736364

RESUMO

This work aimed to synthesize poly (D, L-lactic-co-glycolic acid) (PLGA) microparticles containing hinokinin (HNK) and to evaluate their cytotoxic activity against tumoral SiHa cells and non-tumoral HaCaT cells. Hinokinin was incorporated into PLGA (PLGA-HNK) with an encapsulation efficiency of 84.18 ± 2.32%. PLGA and PLGA-HNK were characterized by SEM microscopy and showed spherical morphology with an average size of ∼3.33. Encapsulation efficiency was determined by a calibration curve using UV-vis spectroscopy. PLGA-HNK more active inhibiting proliferation of SiHa cells (IC50 = 14.68 µM) than free HNK (IC50 = 225.5 µM). In relation to HaCaT cells, PLGA-HNK showed no significant difference compared to the negative control. These results led to an increase in HNK bioavailability and thereby, biological activity. In silico prediction analysis suggests that HNK is cytotoxic against SiHa cells with E6 and MDM2 inhibition as possible main mechanism of action.


Assuntos
Antineoplásicos , Nanopartículas , 4-Butirolactona/análogos & derivados , Antineoplásicos/química , Antineoplásicos/farmacologia , Benzodioxóis , Ácido Láctico/química , Lignanas , Nanopartículas/química , Tamanho da Partícula , Ácido Poliglicólico/química , Copolímero de Ácido Poliláctico e Ácido Poliglicólico
12.
Int J Cardiol ; 345: 29-35, 2021 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-34610357

RESUMO

BACKGROUND: Isolated atrial fibrillation can cause mitral regurgitation (MR) in patients with normal left ventricular systolic function and no organic disease of the mitral valve. Little information is available regarding outcomes of Mitraclip in patients with atrial functional mitral regurgitation (AFMR). We aimed to evaluate 12-month clinical and echocardiographic outcomes of transcatheter mitral valve repair (TMVR) with MitraClip in patients with AFMR compared to those with ventricular functional or degenerative/mixed MR. METHODS: Registry-based analysis of all consecutive patients who underwent TMVR and were included in the Spanish Registry of Mitraclip. Changes in MR and NYHA functional class, and a combined endpoint including all-cause mortality and hospitalizations due to heart failure were the main outcomes. RESULTS: Overall, 1074 (69.1% male, 73.3 ± 10.2 years-old) patients were analyzed in this report. 48 patients (4.5%) presented AFMR. AFMR was significantly reduced after TMVR, with a procedural success rate of 91.7%, and this reduction persisted at 12-month (p < 0.001). Patients with AFMR showed a significant functional improvement at 6- and 12-month follow-up in our series (baseline: NYHA III 70.8% IV 18.8% vs. 1-year: NYHA III 21.7% IV 0%; p < 0.001). The probability of survival free of readmission for heart failure and all-cause mortality within the first year after TMVR was 74.9%. Procedural and clinical outcomes, as well as recurrent rates of MR were similar acutely and at 1-year compared to other etiologies. CONCLUSION: TMVR in patients with AFMR showed no significant differences compared to ventricular functional or degenerative/mixed MR regarding MR reduction or clinical outcomes.


Assuntos
Implante de Prótese de Valva Cardíaca , Insuficiência da Valva Mitral , Idoso , Idoso de 80 Anos ou mais , Cateterismo Cardíaco , Ecocardiografia , Feminino , Átrios do Coração , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/diagnóstico por imagem , Valva Mitral/cirurgia , Insuficiência da Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/cirurgia , Resultado do Tratamento
13.
Dalton Trans ; 50(25): 8907-8916, 2021 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-34105549

RESUMO

Here, we demonstrate a facile and scalable preparation via sol-gel chemistry of hybrid polyurea gels containing various amounts of a phosphorescent inorganic octahedral molybdenum cluster-based ternary salt, namely Cs2Mo6Br14. The influence of the Cs2Mo6Br14 content (1-10 wt%) on the polyurea matrix and its physical properties are studied in depth by Fourier transform infrared spectroscopy (FTIR), differential scanning calorimetry (DSC) and X-ray fluorescence microanalysis (µ-XRF). Regardless of the amount of cluster loaded into the polyurea, the integrity of these species was preserved and their dispersion is homogeneous as shown by µ-XRF mapping. Spectroscopic-structural analyses reveal a significant increase of the chain mobility (glass transition temperature Tg) from -65 °C to -55 °C after the incorporation of Cs2Mo6Br14 (DSC analyses). The FTIR studies show that the homogeneity of the dispersion is ensured by supramolecular interactions between the ether-type oxygen atoms of the PEO chains and the cluster compound. Photoluminescence studies show that the metal cluster emission properties are well retained within the host matrix whatever the loaded content. Such a combination of materials demonstrates the feasibility to fabricate a rubber NIR-emitting device. Moreover, the loaded polyurea is also able to produce reactive oxygen species (ROS) upon irradiation in the UV-A region, opening new perspectives as versatile membranes in the field of photodynamic therapy.

14.
Chem Biodivers ; 18(6): e2100052, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33905595

RESUMO

In this study, the trypomastigotes of a Y strain of Trypanosoma cruzi were inoculated intraperitoneally into male BALB/c mice weighing approximately 25 g each, which were divided into groups for evaluation of the trypanocidal activity. For the treatment of experimental groups, encapsulated and unencapsulated (-)-cubebin, Benznidazole, and two groups as negative controls were used. The encapsulated (-)-cubebin showed a 68.1 % encapsulation efficiency. The parasitemia peak of substances remained around the 9th day after the observed reduction in the number of circulating trypomastigotes. The encapsulated (-)-cubebin and (-)-cubebin unloaded showed a decrease of 61.3 % and 58.5 % in the number of parasites as compared to the negative control, respectively. Moreover, animals treated with encapsulated (-)-cubebin had a higher survival time as compared to the other groups. In conclusion, the results obtained were more promising for encapsulated (-)-cubebin as compared to unloaded particles.


Assuntos
Lignanas/farmacologia , Microesferas , Tripanossomicidas/farmacologia , Trypanosoma cruzi/efeitos dos fármacos , Animais , Cápsulas , Injeções Intraperitoneais , Lignanas/administração & dosagem , Lignanas/química , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Simulação de Acoplamento Molecular , Testes de Sensibilidade Parasitária , Tripanossomicidas/administração & dosagem , Tripanossomicidas/química
15.
Acta Neurol Belg ; 121(3): 721-728, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32651877

RESUMO

OBJECTIVE: Assess the effect of Whole-Body Vibration (WBV) therapy in functional balance status of Parkinson's disease (PD) patients and compare this to conventional and combined therapy. INTRODUCTION: PD patients experience a decreased mobility, inactivity, and loss of independence as consequence of disturbances in gait, posture, and balance. Rehabilitation therapy is a non-pharmacological way of improving functionality. One of the most studied modalities is WBV, with multiple studies showing improvement in motor function. However, results in this manner are inconsistent. METHODS: Forty-five patients were enrolled in a non-randomized controlled trial and divided into three groups. Group 1 received conventional therapy (thermotherapy, stretching, strengthening, coordination and balance). Group 2 received WBV therapy, and group 3 patients underwent a combined therapy protocol. A total of 20 sessions (3 per week) were conducted, assessing Berg Balance Scale (BBS) before initial and after final session. RESULTS: The 3 intervention groups showed significant improvement in BBS scores after concluding the 20-session trial compared to initial assessment. When comparing mean change in BBS score from initial to final assessment, the combined therapy group had a greater increase compared to conventional therapy, but no significant differences were observed comparing to WBV group. Mean change in BBS score showed no significant difference between conventional therapy and WBV therapy group. CONCLUSIONS: WBV therapy is a useful tool as co-adjuvant in conventional therapy. The combination of both therapies is a significant therapeutic alternative for the improvement of functional balance status in PD patients compared to conventional therapy alone.


Assuntos
Terapia por Exercício/métodos , Doença de Parkinson/terapia , Equilíbrio Postural/fisiologia , Vibração/uso terapêutico , Idoso , Feminino , Marcha/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/fisiopatologia , Resultado do Tratamento
16.
Rev. esp. cardiol. Supl. (Ed. impresa) ; 20(supl.E): 14-20, dic. 2020. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-195342

RESUMO

La pandemia por COVID-19 ha puesto a prueba a toda la población de nuestro país y en particular a los profesionales sanitarios en una situación en que la capacidad de adaptación y rapidez de la respuesta son cruciales para ayudar a frenar la expansión del virus. En un entorno de incertidumbre con necesidad acuciante de Información para tratar de proporcionar la mejor atención a los pacientes afectos de enfermedades cardiovasculares, la Sociedad Española de Cardiología ha elaborado una serie de documentos que ayudan a la toma de decisiones


The COVID-19 pandemic has posed a challenge to the entire Spanish population and, in particular, to medical professionals who are dealing with a situación in which adaptability and rapid reactions are crucial for helping to slow the spread of the virus. At a time of uncertainty when there is an urgent need for Información to ensure that patients with cardiovascular disease receive the best care, the Spanish Society of Cardiology has produced a series of documents to aid decision-making


Assuntos
Humanos , Sociedades Médicas , Cardiologia/normas , Serviço Hospitalar de Cardiologia/normas , Infecções por Coronavirus/prevenção & controle , Pneumonia Viral/virologia , Pandemias , Espanha
17.
Pharmaceutics ; 12(11)2020 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-33153183

RESUMO

Lentiviral vectors (LVs) have gained value over recent years as gene carriers in gene therapy. These viral vectors are safer than what was previously being used for gene transfer and are capable of infecting both dividing and nondividing cells with a long-term expression. This characteristic makes LVs ideal for clinical research, as has been demonstrated with the approval of lentivirus-based gene therapies from the Food and Drug Administration and the European Agency for Medicine. A large number of functional lentiviral particles are required for clinical trials, and large-scale production has been challenging. Therefore, efforts are focused on solving the drawbacks associated with the production and purification of LVsunder current good manufacturing practice. In recent years, we have witnessed the development and optimization of new protocols, packaging cell lines, and culture devices that are very close to reaching the target production level. Here, we review the most recent, efficient, and promising methods for the clinical-scale production ofLVs.

18.
Genes (Basel) ; 11(4)2020 04 08.
Artigo em Inglês | MEDLINE | ID: mdl-32276518

RESUMO

The capacity of Topoisomerase II (Topo II) to remove DNA catenations that arise after replication is essential to ensure faithful chromosome segregation. Topo II activity is monitored during G2 by a specific checkpoint pathway that delays entry into mitosis until the chromosomes are properly decatenated. Recently, we demonstrated that the mitotic defects that are characteristic of cells depleted of MCPH1 function, a protein mutated in primary microcephaly, are not a consequence of a weakened G2 decatenation checkpoint response. However, the mitotic defects could be accounted for by a minor defect in the activity of Topo II during G2/M. To test this hypothesis, we have tracked at live single cell resolution the dynamics of mitosis in MCPH1 depleted HeLa cells upon catalytic inhibition of Topo II. Our analyses demonstrate that neither chromosome alignment nor segregation are more susceptible to minor perturbation in decatenation in MCPH1 deficient cells, as compared with control cells. Interestingly, MCPH1 depleted cells were more prone to mitotic cell death when decatenation was perturbed. Furthermore, when the G2 arrest that was induced by catalytic inhibition of Topo II was abrogated by Chk1 inhibition, the incidence of mitotic cell death was also increased. Taken together, our data suggest that the MCPH1 lack of function increases mitotic cell hypersensitivity to the catalytic inhibition of Topo II.


Assuntos
Proteínas de Ciclo Celular/genética , Proteínas do Citoesqueleto/genética , DNA Topoisomerases Tipo II/genética , Pontos de Checagem da Fase G2 do Ciclo Celular/efeitos dos fármacos , Mitose/genética , Domínio Catalítico/genética , DNA Catenado/genética , Inibidores Enzimáticos/farmacologia , Pontos de Checagem da Fase G2 do Ciclo Celular/genética , Células HeLa , Humanos , Inibidores da Topoisomerase II/farmacologia
19.
Cardiovasc Revasc Med ; 21(4): 508-513, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31401071

RESUMO

OBJECTIVES: This study sought to assess the efficacy of the drug-coated balloon (DCB) ESSENTIAL for the treatment of in-stent restenosis (ISR). BACKGROUND: DCBs have proven a valid therapeutic option for the management of ISR in several clinical trials, yet no class effect can be claimed. Accordingly, every new DCB model has to be individually evaluated through clinical studies. METHODS: This is a prospective, multicenter study including consecutive patients undergoing percutaneous coronary intervention for ISR with the ESSENTIAL DCB. A 6-month quantitative coronary angiography (QCA)/optical coherence tomography (OCT) follow-up was scheduled. The primary endpoint was OCT-derived in-segment maximal area stenosis. Secondary endpoints included QCA-derived in-segment late lumen loss (LLL) and target lesion failure (TLF) rates at 6, 12, and 24 months. TLF was defined as the composite of cardiac death, target vessel myocardial infarction, and target lesion revascularization. RESULTS: A total of 31 patients were successfully treated with DCB, with 67% of ISR corresponding to drug-eluting stents (DES). At 6 months, 26 patients underwent the scheduled angiographic follow-up. The mean value for in-segment maximal area stenosis was 51.4 ±â€¯13% and the median value was 53% (IQR 46.4-59.5). In the DES-ISR subgroup, these parameters were 52.6 ±â€¯10% and 55.2% (IQR 49.3-58.5), respectively. In-segment LLL was 0.25 ±â€¯0.43 mm with only 2 (7.7%) patients showing binary restenosis (>50%). The incidence of TLF was 10% at 6 months, 13.3% at 12 months, and 13.3% at 24 months. CONCLUSIONS: In this study, the ESSENTIAL DCB showed sustained efficacy in the prevention of recurrent restenosis after treatment of ISR. SUMMARY: We sought to assess the efficacy of the drug-coated balloon ESSENTIAL for the treatment of in-stent restenosis through a prospective, multicenter study including QCA and OCT assessment at 6-month follow-up. The primary endpoint was in-segment maximal area stenosis. Among the 31 patients successfully treated with the ESSENTIAL DCB, an angiographic follow-up was conducted in 26. Mean in-segment maximal area stenosis was 51.4 ±â€¯13% and the median value was 53% (IQR 46.4-59.5). In the DES-ISR subgroup, corresponding values were 52.6 ±â€¯10% and 55.2% (IQR 49.3-58.5), respectively. The observed in-segment LLL was 0.25 ±â€¯0.43 mm and binary restenosis rate was 7.7%. TLF was 10% at 6 months and 13.3% at 12 and 24 months.


Assuntos
Angioplastia Coronária com Balão/instrumentação , Fármacos Cardiovasculares/administração & dosagem , Materiais Revestidos Biocompatíveis , Angiografia Coronária , Doença da Artéria Coronariana/terapia , Reestenose Coronária/terapia , Vasos Coronários/diagnóstico por imagem , Paclitaxel/administração & dosagem , Intervenção Coronária Percutânea/instrumentação , Stents , Tomografia de Coerência Óptica , Idoso , Angioplastia Coronária com Balão/efeitos adversos , Angioplastia Coronária com Balão/mortalidade , Fármacos Cardiovasculares/efeitos adversos , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/mortalidade , Reestenose Coronária/diagnóstico por imagem , Reestenose Coronária/etiologia , Reestenose Coronária/mortalidade , Desenho de Equipamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paclitaxel/efeitos adversos , Intervenção Coronária Percutânea/efeitos adversos , Intervenção Coronária Percutânea/mortalidade , Valor Preditivo dos Testes , Estudos Prospectivos , Fatores de Risco , Espanha , Resultado do Tratamento
20.
Chemistry ; 25(67): 15248-15251, 2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31529648

RESUMO

Hybrid materials that combine diureasil matrices and octahedral molybdenum clusters have been synthesized to design lead-, cadmium- and rare-earth-free emitters for lighting or optoelectronic applications. This association leads to homogeneous and stable hybrids, for which the emission color can be tailored in the entire visible range, including white light; this is thanks to effective energy transfers from the host to the nanocluster.

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