Surgical treatment of patients with heart failure through myocardial revascularization, ventricular reconstruction, and mitral valve surgery

Universidade Federal de São Paulo (UNIFESP) EPMUNIFESP, EPMSciEL

Risk scores: coronary artery bypass grafting with and without cardiopulmonary bypass

Universidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUNIFESP, EPMSciEL

Congratulations, Dr. Braile

Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM)UNIFESP, EPMSciEL

Myocardial revascularization without extracorporeal circulation

Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

In vitro and in vivo characterization of the RE-1 Silencing Transcription Factor (REST) activity under neuroinflammatory conditions

The ability to specifically target epigenetic and molecular mechanisms involved in neuronal development could be an alternative therapeutic strategy for neuroinflammatory/neurodegenerative disorders such as Multiple Sclerosis (MS). The transcriptional repressor RE1-Silencing Transcription Factor (REST) regulates neurogenesis and neuronal identity through cell-specific gene repression, allowing expression of its targets in mature neurons where REST is quiescent. REST dysregulation has been implicated in several neurodegenerative disorders, including Alzheimer and Huntington diseases, tumors of the nervous system, and epilepsy. We found that REST is overexpressed in the spinal cord of mice with experimental autoimmune encephalomyelitis (EAE), suggesting that its dysregulation might be an important factor in the pathogenesis of the disease. Starting from these observations, we have firstly analyzed the expression of REST target genes in EAE and characterized the cell-specificity of REST overexpression, investigating the differential contribution of neuronal and glial cell populations to REST upregulation. Moreover, in order to mimic the inflammatory EAE scenario, we have analyzed REST activity in primary neuron cultures treated with various pro-inflammatory cytokines. Altogether, this study provides the basis for understanding the molecular mechanisms of REST expression during brain inflammation and its implication in the subsequent neurodegenerative processes

Estudio SYNTAX, de la evidencia a la desobediencia

Univ Fed Sao Paulo, Escola Paulista Med, Sao Paulo, BrazilHosp Modelo, Serv Cirugia Cardiaca, La Coruna, SpainUniv Fed Sao Paulo, Escola Paulista Med, Sao Paulo, BrazilWeb of Scienc

Can coronary artery bypass surgery provide equivalent outcomes after percutaneous coronary interventions?

UNIFESP-EPMUNIFESP, EPMSciEL

Off-pump coronary artery bypass surgery in selected patients is superior to the conventional approach for patients with severely depressed left ventricular function

OBJECTIVES: Patients with coronary artery disease and left ventricular dysfunction have high mortality when kept in clinical treatment. Coronary artery bypass grafting can improve survival and the quality of life. Recently, revascularization without cardiopulmonary bypass has been presented as a viable alternative. The aim of this study is to compare patients with left ventricular ejection fractions of less than 20% who underwent coronary artery bypass graft with or without cardiopulmonary bypass. METHODS: From January 2001 to December 2005, 217 nonrandomized, consecutive, and nonselected patients with an ejection fraction less than or equal to 20% underwent coronary artery bypass graft surgery with (112) or without (off-pump) (105) the use of cardiopulmonary bypass. We studied demographic, operative, and postoperative data. RESULTS: There were no demographic differences between groups. The outcome variables showed similar graft numbers in both groups. Mortality was 12.5% in the cardiopulmonary bypass group and 3.8% in the off-pump group. Postoperative complications were statistically different (cardiopulmonary bypass versus off-pump): total length of hospital stay (days)-11.3 vs. 7.2, length of ICU stay (days)-3.7 vs. 2.1, pulmonary complications-10.7% vs. 2.8%, intubation time (hours)-22 vs. 10, postoperative bleeding (mL)-654 vs. 440, acute renal failure-8.9% vs. 1.9% and left-ventricle ejection fraction before discharge-22% vs. 29%. CONCLUSION: Coronary artery bypass grafting without cardiopulmonary bypass in selected patients with severe left ventricular dysfunction is valid and safe and promotes less mortality and morbidity compared with conventional operations