Pro/Anti-Inflammatory Cytokine Imbalance in Postischemic Left Ventricular Remodeling

Objectives. Cytokines play an important role in left ventricular remodeling consequent to myocardial ischemia. The aim of this study was to correlate cytokine production and lymphocyte apoptosis to post-ischemic left ventricular remodeling in patients affected by acute myocardial infarction (AMI) undergoing primary cutaneous angioplasty (PCI). Methods. In 40 patients, affected by AMI and undergoing PCI, we evaluated peripheral blood mononuclear cells (PBMCs), tumor necrosis factor-alpha (TNF-α) and interleukin 10 (IL10) production and apoptosis on day 1, day 3, day 7, 1 month and 6 months after PCI. Patients were divided into two subgroups of remodeling or not remodeling by echocardiographic criteria. Results. In the subgroup of remodeling patients, at each timepoint TNF-α production was increased significantly in comparison with the subgroup of not remodeling patients. IL10 production was statistically lower in remodeling subjects than in not remodeling ones 1 and 6 months after reperfusion. There were no differences between the two groups as regards lymphomonocyte apoptosis. Conclusions. We found an increased production of pro-inflammatory cytokine TNF-α and a corresponding decrease of anti-inflammatory/regulatory cytokine IL10 in remodeling patients and we concluded that this cytokine imbalance resulted in pro-inflammatory effects which might contribute to the progression of left ventricular remodeling

Bosentan treatment for Raynauds phenomenon and skin fibrosis in patients with Systemic Sclerosis and pulmonary arterial hypertension: an open-label, observational, retrospective study.

Raynaud's phenomenon (RP) and cutaneous fibrosis are the distinctive manifestations of scleroderma, in which Endothelin-1 plays a fundamental pathogenetic role. Bosentan, an Endothelin-1 receptor antagonist used for the treatment of pulmonary arterial hypertension, retards the beginning of new sclerodermic digital ulcers (DU). This open-label, observational, retrospective study verified the effect of Bosentan on RP and skin fibrosis in sclerodermic outpatients affected by pulmonary arterial hypertension without DU. Fourteen subjects (13 women, 1 man; mean age 60 ± 7.5 years; ten with limited and four with diffuse scleroderma) were observed at baseline (T0) and after four (T1), twelve (T2), twenty-four (T3) and forty-eight (T4) weeks during treatment with Bosentan. They were evaluated for daily quantity and duration of RP attacks and skin thickness (using modified Rodnan total skin score, MRSS). Videocapillaroscopic evaluation was performed at TO and T4. Bosentan decreased significantly the number and duration of RP attacks, beginning at T2 (p<0.05). Videocapillaroscopy showed significant improvement of microcirculatory patterns at T4 (p<0.05). MRSS decreased throughout the study, reaching the statistical significance at T3 and T4 (p<0.01) in the whole cohort. The present data suggest that Bosentan is effective in stabilmng the microcirculation involvement and in improving skin fibrosis irrespective of scleroderma patterns

European Territorial Trends - Facts and Prospects for Cities and Regions Ed. 2017

This report analyses a set of territorial trends at continental and sub-national scale, looking at patterns and determinants of regional growth, while considering pan-European and national characteristics. Past and prospective demographic and economic trends are analysed to provide a picture of ‘what, where, when and how’ things happen in European cities and regions. Specific emphasis is placed on urban areas since acknowledged sources of both opportunities and challenges. The indicators used in the analysis herein presented are freely and openly accessible in the Territorial Dashboard of the Knowledge Centre for Territorial Policies at: http://urban.jrc.ec.europa.eu/t-board/index.htmlJRC.B.3-Territorial Developmen

Antihypertensive efficacy and safety of olmesartan medoxomil and ramipril in elderly patients with mild to moderate essential hypertension: the ESPORT study.

Objective: To compare the efficacy and safety of the angiotensin II antagonist olmesartan medoxomil (O) and the ACE inhibitor ramipril (R) in elderly patients with essential arterial hypertension. Methods: After a 2-week placebo wash-out 1102 treated or untreated elderly hypertensive patients aged 65-89 years (office sitting diastolic blood pressure, DBP, 90-109 mmHg and/or office sitting systolic blood pressure, SBP, 140-179 mmHg) were randomized double-blind to 12-week treatment with O 10 mg or R 2.5 mg once-daily. After the first 2 and 6 weeks doses could be doubled in non-normalized [blood pressure (BP) < 140/90 mmHg for nondiabetic and < 130/80 mmHg for diabetic) individuals, up to 40 mg for O and 10 mg for R. Office BPs were assessed at randomization, after 2, 6 and 12 weeks of treatment, whereas 24-h ambulatory BP was recorded at randomization and after 12 weeks. Results: In the intention-to-treat population (542 patients O and 539 R) after 12 weeks of treatment baseline-adjusted office SBP and DBP reductions were greater (P < 0.01) with O [17.8 (95% confidence interval: 16.8/18.9) and 9.2 (8.6/9.8) mmHg] than with R [15.7 (14.7/16.8) and 7.7 (7.1/8.3) mmHg]. BP normalization rate was also greater under O (52.6 vs. 46.0% R, P < 0.05). In the subgroup of patients with valid ambulatory BP recording (318 O and 312 R) the reduction in 24-h average BP was larger (P < 0.05) with O [SBP: 11.0 (12.2/9.9) and DBP: 6.5 (7.2/5.8) mmHg] than with R [9.0 (10.2/7.9) and 5.4 (6.1/4.7) mmHg]. The larger blood pressure reduction obtained with O was particularly evident in the last 6 h from the dosing interval; a better homogeneity of the 24-h BP control with O was confirmed by higher smoothness indices. The proportion of patients with drug-related adverse events was comparable in the two groups (3.6 O vs. 3.6% R), as well as the number of patients discontinuing study drug because of a side effect (14 O vs. 19 R). Conclusion: In elderly patients with essential arterial hypertension O provides an effective, prolonged and well tolerated BP control, representing a useful option among first-line drug treatments of hypertension in this age group. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

MEDICAL TREATMENT OF CRVO

Purpose: A disorder of fibrinolytic power is a risk factor for both venous and arterial thrombosis. An hypofibrinolytic state has been described as a common feature in Central Retinal Vein Occlusion (CRVO) affected subjects. Aim of our study was to evaluate the efficacy of a thrombotic-risk assessement related therapy either in acute phase treatment or secondary prophylaxis in CRVO affected patients. Methods: Phase A: 60 subjects (28 female, 22 male) were respectively treated with ASA 325 mg/die (19), heparin 12500 to 25000 U/die (16) , and mesoglycan 100 mg/die (25) for one month. Phase B: 35 subjects were treated with ASA 325 mg/die for 6 months and 29 patients with mesoglycan 100 mg/die. The development of new thrombotic events was assessed by fundoscopy at one and six months. Results: In phase A 5/19 (26%) subjects in the ASA, 6/16 (37%) in the heparin and 2/25 (8%) (p< 0.001) in the mesoglycan group experienced a new thrombotic event. In phase B 13/35 (37%) in the ASA and 3/29 (10%) (p< 0.001) in the mesoglycan group showed new thrombotic signs. Conclusions: Our data suggest that a profibrinolytic treatment in thrombotic risk-profile selected subjects is safe and effective for the therapy and prophylaxis of CRVO when compared to other antithrombotic agents

Thymoma and immunodeficiency

hypogammaglobulinaemia in a small percentage of patients with thymoma.1 GS is a rare, adult-onset, immunodeficiency disease characterised by hypogammaglobulinaemia, low or absent B cells in the peripheral blood and, variably, defects in cell-mediated immunity.2 GS was often considered a subset of common variable immunodeficiency (CVID) with thymoma, whereas nowadays it is regarded as a distinct clinical entity whose pathogenesis is still uncertain.3 A bone marrow defect impairing B cell maturation due to an aggression towards B cell precursors has been suggested,4 and deficiencies in other cell lineages with eosinopenia, pure red cell aplasia or neutropenia are often reported.5 Here we report the case of a male patient who developed recurrent respiratory tract infections for two years before being diagnosed with GS. Case report A 61-year-old male presented in March 1996 with a two-year history of recurrent respiratory infections including otitis, bronchitis, sinusitis and two episodes of pneumonia. Chest X-ray and chest CT scan showed a mediastinal mass, biopsy o

Experimental evaluation of the aerodynamic performance of a large-scale high-lift morphing wing

The Smart Morphing &amp; Sensing (SMS) project was a multi-disciplinary upstream project that investigated the use of intelligent electro-active actuators to modify the lifting surface of an aircraft. In particular, the attention of the project was focused on trailing-edge, high-lift morphing devices aimed to obtain the optimal shapes to improve the aerodynamic performance of the wing of a large passenger aircraft. The present work describes the experimental assessment of the morphed aerodynamic shapes of the high-lift morphing flap developed during the project. Wind-tunnel tests were performed using a large-scale wing prototype reproducing a section of a full-scale wing of a large passenger aircraft. Several quantities were measured during the tests. Pressure measurements performed in the mid-span section of the wing showed an increase of the lift provided by the cambered morphed shape of the flap in take-off configuration and an increase of both the lift coefficient and the wing efficiency in landing configuration. Particle Image Velocimetry surveys enabled us to obtain an insight in the flow physics behind the measured performance of the morphing flap. Moreover, the deformation of the morphing flap was measured by optical systems to check the actual shape. The tests demonstrated that morphing the trailing-edge flap can be useful to optimise the aerodynamic performance of the wing during take-off and landing