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Wed, 12/14/2011 - 13:23
(Source: The Journal of Heart and Lung Transplantation)
Categories: Publications

The profile of inflammatory and metabolic response in children undergoing heart transplantation

Wed, 12/14/2011 - 04:00
In conclusion, inflammatory and metabolic response is present before HTx and acutely intensified after HTx. It may be mainly influenced by CPB duration and cardiovascular function status. (Source: Clinical Transplantation)
Categories: Publications

Osteoporosis After Transplantation

Tue, 12/13/2011 - 16:04
Abstract  Transplantation is an established therapy for end-stage diseases of kidney, lung, liver, and heart among others. Osteoporosis and fragility fractures are serious complications of organ transplantation, particularly in the first post-transplant year. Many factors contribute to the pathogenesis of osteoporosis following organ transplantation. This review addresses the mechanisms of bone loss that occurs both in the early and late post-transplant periods, including the contribution of the immunosuppressive agents as well as the specific features to bone loss after kidney, lung, liver, cardiac, and bone marrow transplantation. Prevention and treatment for osteoporosis in the transplant recipient are also discussed. Content Type Journal ArticleCategory Current Ther...

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Categories: Publications

Factors associated with the development of cardiac allograft vasculopathy – a systematic review of observational studies

Tue, 12/13/2011 - 04:00
Braga JR, Santos ISO, McDonald M, Shah PS, Ross HJ. Factors associated with the development of cardiac allograft vasculopathy – a systematic review of observational studies. 
Clin Transplant 2011 DOI: 10.1111/j.1399‐0012.2011.01565.x. 
© 2011 John Wiley & Sons A/S.Abstract:  Cardiac allograft vasculopathy (CAV) is a significant factor impacting outcomes after heart transplant. We performed a systematic review of risk factors for the development of CAV. A search of electronic databases was performed. The eligibility criteria included cohort and case–control studies with more than 50 adult patients submitted to a heart transplant. The outcome should be CAV diagnosed by angiography and/or intravascular ultrasound (IVUS). Two reviewers performed study selection, data abstracti...
Categories: Publications

The long-term survival and the risks and benefits of implantable cardioverter defibrillators in patients with hypertrophic cardiomyopathy

Mon, 12/12/2011 - 04:00
Conclusions HCM patients with an ICD have a significant cardiovascular mortality and are exposed to frequent inappropriate shocks and implant complications. These data suggest that new strategies are required to improve patient selection for ICDs and to prevent disease progression in those that receive a device. (Source: Heart)
Categories: Publications

CT for Evaluation of Myocardial Cell Therapy in Heart Failure: A Comparison With CMR Imaging

Mon, 12/12/2011 - 04:00
Conclusions This study demonstrated that cardiac MDCT can be used to evaluate infarct size, LV volumes, and LVEF after intramyocardial-delivered MSC therapy. These findings support the use of cardiac MDCT in preclinical and clinical studies for novel myocardial therapies. (Source: Journal of the American College of Cardiology: Cardiovascular Imaging)
Categories: Publications

Artificial Sweetener Disease; a new breed of sickness

Sun, 12/11/2011 - 06:00
(NaturalNews) Artificial Sweetener Disease (ASD) is sweeping across America, affecting tens of thousands of consumers, and Western medicine calls it anything but what it really is, so that doctors can prescribe expensive pharmaceuticals and set up "check up" appointments for the following weeks.Call it recurring headaches, unbearable migraines, depression, anxiety, muscle pain, arthritis flare ups, buzzing or ringing in the ears, chronic fatigue, fibromyalgia, irritable bowel syndrome (IBS), Crohn's disease, inflammation, even acid reflux, but don't call it ASD, or the patient may stop consuming synthetic sweeteners, and then not schedule more doctor visits.The symptoms of ASD can change overnight, depending on how much chemical sweetener you consume, and which ones. Some combinations are ...
Categories: Publications

Reply

Sat, 12/10/2011 - 01:32
We appreciate the comments of Dr. Joshi and colleagues regarding our report on the cardiovascular risk assessment of candidates for liver transplantation (). We agree that liver transplantation in patients with severe left ventricular systolic dysfunction carries a higher risk for cardiovascular complications and mortality. These patients should be thoroughly evaluated, as we have described, and would benefit from referral to higher volume transplantation centers with experience in caring for such patients. As noted in our report, and by Joshi et al., there have been case reports of successful transplantation in such patients, often requiring combined liver and heart transplantation (). Several potential etiologies of systolic dysfunction in patients with end-stage liver disease have been...

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Categories: Publications

World Muscle Society 2011 Report

Wed, 12/07/2011 - 12:57
At the recent World Muscle Society meeting, which took place in Portugal, a great deal of new data on exon skipping was presented, both on the status of current human clinical trials and on the efforts of investigators to improve the efficiency of the technique by combining exon-skipping with gene and stem cell delivery. Below are a few highlights from the meeting with the caveat that it was impossible to cover every poster and talk.    Muscle Stem Cells Jenny Morgan of UCL Institute of Child Health in London found that irradiating the muscles of a host mouse produced good incorporation of donor satellite cells, although it was clear that too much radiation was also detrimental. Mayana Zatz of the University of Sao Paulo, Brazil, presented data demonstrating that human mesenchymal stem c...
Categories: Publications

Antibody-Mediated Rejection in Heart Transplantation: Case Presentation with a Review of Current International Guidelines

Wed, 12/07/2011 - 06:02
Antibody-mediated rejection (AMR) (humoral rejection) of cardiac allografts remains difficult to diagnose and treat. Interest in AMR of cardiac allografts has increased over the last decade as it has become apparent that untreated humoral rejection threatens graft and patient survival. An international and multidisciplinary consensus group has formulated guidelines for the diagnosis and treatment of AMR and established that identification of circulating or donor-specific antibodies is not required and that asymptomatic AMR, that is, biopsy-proven AMR without cardiac dysfunction is a real entity with worsened prognosis. Strict criteria for the diagnosis of cardiac AMR have not been firmly established, although the diagnosis relies heavily on tissue pathological findings. Therapy remains lar...
Categories: Publications

Heart with a Hole Saves Little Girl

Wed, 12/07/2011 - 04:00
(Ivanhoe Newswire) -- They died waiting. In a seven year span, 533 kids hoping for heart transplants did not get one in time. (Source: Medical Headlines From Ivanhoe.com)
Categories: Publications

A decade of pediatric mechanical circulatory support before and after cardiac transplantation

Tue, 12/06/2011 - 04:00
Conclusions: Both VAD and ECMO support are highly effective means of bridging patients to transplantation and supporting patients after transplanatation. Ideally, the availability of smaller devices for children will have a favorable impact on the morbidity related to anticoagulation in the smallest patients. (Source: The Journal of Thoracic and Cardiovascular Surgery)
Categories: Publications

Acute Effects of Muscular Counterpulsation Therapy on Cardiac Output and Safety in Patients With Chronic Heart Failure

Tue, 12/06/2011 - 04:00
AbstractOur aim was to investigate acute effects of muscular counterpulsation (MCP) on hemodynamic parameters and to evaluate its safety in regard to myocardial integrity and interferences with implanted rhythm devices in patients with chronic heart failure (CHF). A total of 22 patients with CHF (16 male, 67.8 ± 9.5 years, New York Heart Association [NYHA] class II + III, left ventricular ejection fraction 29.6 ± 6.6%) were treated with MCP for 3 consecutive days for 45 min, while hemodynamic parameters were measured noninvasively by bioimpedance (Task Force Monitor). Laboratory control and a complete device testing were performed prior to the first and after the third treatment. In addition, continuous rhythm device interrogation was performed online during the first MCP a...
Categories: Publications

The new index to assess chronotropic response in patients with end stage liver disease undergoing dobutamine stress echocardiography

Mon, 12/05/2011 - 04:00
AbstractInability to achieve 85% of the maximum age‐predicted heart rate (MPHR) on dobutamine stress echocardiography (DSE) is defined as chronotropic incompetence and is a predictor of major cardiac events after orthotopic liver transplantation (OLT). The majority of end‐stage liver disease (ESLD) patients receive beta‐blockers for prevention of variceal bleeding. In such cases it is impossible to discern whether chronotropic incompetence is secondary to cirrhotic‐related autonomic dysfunction or merely a beta‐blocker effect. We evaluated the usefulness of maximum achieved heart rate (MAHR) and heart rate reserve (HRR) in the detection of chronotropic incompetence in ESLD patients who were on beta‐blocker therapy prior to DSE. We also evaluated the usefulness of a new index â€...

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Categories: Publications

Cumulative risk of cardiovascular events following orthotopic liver transplantation

Mon, 12/05/2011 - 04:00
Conclusion:Cardiac complications after liver transplantation are common (10% of patients experience > 1 CVE within 3 years post OLT). Patients with post‐transplant hypertension and diabetes, modifiable risk factors, are twice as likely to have a CV event. CV risk varies with etiology of liver disease, lower for cholestatic liver disease and higher for NASH. Future studies should look at validating these findings prospectively and determining if aggressive risk reduction of modifiable factors can decrease CV risk. © 2011 American Association for the Study of Liver Diseases. (Source: Liver Transplantation)
Categories: Publications

Cardiac regeneration therapy: connections to cardiac physiology

Mon, 12/05/2011 - 04:00
Without heart transplantation, a large number of patients with failing hearts worldwide face poor outcomes. By means of cardiomyocyte regeneration, cardiac regeneration therapy is emerging with great promise as a means for restoring loss of cardiac function. However, the limited success of clinical trials using bone marrow-derived cells and myoblasts with heterogeneous constituents, transplanted at a wide range of cell doses, has led to disagreement on the efficacy of cell therapy. It is therefore essential to reevaluate the evidence for the efficacy of cell-based cardiac regeneration therapy, focusing on targets, materials, and methodologies. Meanwhile, the revolutionary innovation of cardiac regeneration therapy is sorely needed to help the millions of people who suffer heart failure fro...
Categories: Publications

Arachidonic acid- and prostaglandin E2-induced cerebral vasodilation is mediated by carbon monoxide, independent of reactive oxygen species in piglets

Mon, 12/05/2011 - 04:00
This study was conducted to address the hypothesis that CO and/or ROS mediate cerebrovascular dilation in newborn pigs. Experiments were performed on anesthetized newborn pigs with closed cranial windows. Different concentrations of AA (10–8-10–6 M), PGE2 (10–8-10–6 M), iloprost (10–8-10–6 M), and their vehicle (artificial cerebrospinal fluid) were given. Piglets with PGE2 and iloprost received indomethacin (5 mg/kg iv) to inhibit cyclooxygenase. AA, PGE2, and iloprost caused concentration-dependent increases in pial arteriolar diameter. The effects of both AA and PGE2 in producing cerebral vascular dilation and associated CO production were blocked by the heme oxygenase inhibitor chromium mesoporphyrin (2 x 10–5 M), but not by the prostacyclin ana...
Categories: Publications

New Insights on OX40 in the Control of T Cell Immunity and Immune Tolerance In Vivo.

Mon, 12/05/2011 - 04:00
In this study, we demonstrate that OX40 engagement in vivo in naive mice induces initial expansion of Foxp3(+) Tregs, but the expanded Tregs have poor suppressive function and exhibit features of exhaustion. We also show that OX40 enables the activation of the Akt and Stat5 pathways in Tregs, resulting in transient proliferation of Tregs and reduced levels of Foxp3 expression. This creates a state of relative IL-2 deficiency in naive mice that further impacts Tregs. This exhausted Treg phenotype can be prevented by exogenous IL-2, as both OX40 and IL-2 agonists drive further expansion of Tregs in vivo. Importantly, Tregs expanded by both OX40 and IL-2 agonists are potent suppressor cells, and in a heart transplant model, they promote long-term allograft survival. Our data reveal a novel ro...
Categories: Publications

Left ventricular functional recovery after intracoronary injection of autologous bone marrow-derived stem cells in patients with acute myocardial infarction: A dose–response pilot study

Fri, 12/02/2011 - 04:00
Cell therapy based on autologous stem cell transplantation and hope for myocardial regeneration after acute myocardial infarction (AMI) has been the focus of many clinical trials for more than a decade. Most of the trials have used bone marrow mononuclear cell fraction (BMC) for the treatment of AMI patients but the cell doses have varied greatly between the different studies (reviewed by George et al.) . Based on a meta-analysis of several trials it has been suggested that the smallest effective dose to significantly improve left ventricular ejection fraction (LVEF) after cell administration is 108 BMCs . However, one later study reported statistically significant effects also with a smaller cell dose (6×107) . An actual dose–response study comparing the effect of two different cell do...
Categories: Publications

Self-testing can double efficacy of blood-thinning therapy

Fri, 12/02/2011 - 04:00
The prevalence of conditions such as cardiac arrythmia, blood clots, and artificial heart valves means that about 3 million people in the U.S. are eligible for blood-thinning therapy. (Source: Health Facts and Fears)

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Categories: Publications

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