Endothelial dysfunction over the course of coronary artery disease

The vascular endothelium regulates blood flow in response to physiological needs. Endothelial dysfunction is closely related to atherosclerosis and its risk factors, and it constitutes an intermediate step on the progression to adverse events throughout the natural history of coronary artery disease (CAD), often affecting clinical outcomes. Understanding the relation of endothelial function with CAD provides an important pathophysiological insight, which can be useful both in clinical and research management. In this review, we summarize the current knowledge on endothelial dysfunction and its prognostic influence throughout the natural history of CAD, from early atherosclerosis to post-transplant managemen

Endothelial dysfunction over the course of coronary artery disease

The vascular endothelium regulates blood flow in response to physiological needs. Endothelial dysfunction is closely related to atherosclerosis and its risk factors, and it constitutes an intermediate step on the progression to adverse events throughout the natural history of coronary artery disease (CAD), often affecting clinical outcomes. Understanding the relation of endothelial function with CAD provides an important pathophysiological insight, which can be useful both in clinical and research management. In this review, we summarize the current knowledge on endothelial dysfunction and its prognostic influence throughout the natural history of CAD, from early atherosclerosis to post-transplant managemen

Spain

This chapter presents a review of the situation concerning the various geomorphological hazards in the country, including some information about existing programmes for research, control and mitigation. With its great variety of climatic, geological and morphodynamic environments, Spain is subject to every kind of natural hazard: tsunamis, floods, volcanism, and mass movements. The whole of the territory is prone to some kind of geomorphological hazard but it is in the eastern and southern coastal strips that the risks are greatest. One of the main problems for the mitigation of geomorphological hazards in Spain is the lack of an appropriate regulatory framework for the incorporation of natural hazard assessments into land-use planning and management at the macro-, meso- and micro-planning levels. The coverage of hazard mapping is still far from complete or adequate, and much work remains to be done. There has been considerable diversity in the methods used for risk assessment and for the cartographic representation of natural hazards. An urgent need is to establish common, accepted methodologies and criteria, based on indicators defined as clearly as possible, and to standardize map legends and scales for different planning levels. Information programmes for the general public also need to be considerably expanded

Effect of COMBinAtion therapy with remote ischemic conditioning and exenatide on the Myocardial Infarct size: a two-by-two factorial randomized trial (COMBAT-MI)

Remote ischemic conditioning (RIC) and the GLP-1 analog exenatide activate different cardioprotective pathways and may have additive effects on infarct size (IS). Here, we aimed to assess the efficacy of RIC as compared with sham procedure, and of exenatide, as compared with placebo, and the interaction between both, to reduce IS in humans. We designed a two-by-two factorial, randomized controlled, blinded, multicenter, clinical trial. Patients with ST-segment elevation myocardial infarction receiving primary percutaneous coronary intervention (PPCI) within 6 h of symptoms were randomized to RIC or sham procedure and exenatide or matching placebo. The primary outcome was IS measured by late gadolinium enhancement in cardiac magnetic resonance performed 3–7 days after PPCI. The secondary outcomes were myocardial salvage index, transmurality index, left ventricular ejection fraction and relative microvascular obstruction volume. A total of 378 patients were randomly allocated, and after applying exclusion criteria, 222 patients were available for analysis. There were no significant interactions between the two randomization factors on the primary or secondary outcomes. IS was similar between groups for the RIC (24 ± 11.8% in the RIC group vs 23.7 ± 10.9% in the sham group, P = 0.827) and the exenatide hypotheses (25.1 ± 11.5% in the exenatide group vs 22.5 ± 10.9% in the placebo group, P = 0.092). There were no effects with either RIC or exenatide on the secondary outcomes. Unexpected adverse events or side effects of RIC and exenatide were not observed. In conclusion, neither RIC nor exenatide, or its combination, were able to reduce IS in STEMI patients when administered as an adjunct to PPCI

Inventory and quantitative assessment of geosites and geodiversity sites: a review

"Published online: 15 January 2015"The inventory and quantitative assessment of the most valuable occurrences of geodiversity are essential steps in any geoconservation strategy and in the establishment of priorities in site management. Despite the existence of many site inventories applied to different scales (countries, municipalities, parks, etc.), the criteria used for their selection are often unclear and poorly defined. This paper proposes a new approach to the concepts of geosite and geodiversity site and reviews the procedures used in the development of a systematic site inventory applied to different scales and values. Procedures to achieve a numerical evaluation of the value and degradation risk of sites are reviewed and new criteria are proposed. Finally, guidelines are presented, bearing in mind the preparation of effective geodiversity inventories, to support geoparks’ strategies. This paper aims to contribute to a better understanding and use of the above-mentioned concepts, which are essential for the implementation of geoconservation actions worldwide.The author thanks Diamantino Pereira, Flavia Lima, and Paulo Pereira for fruitful discussions and insights; Teresa Mota for the English revision; and the reviewers for significant improvements of the first submitted version. This paper results of the research done at the University of Minho and at the Geology Centre of the University of Porto, partially founded by the Foundation for Science and Technology (Portugal), strategic project with reference PEst-OE/CTE/UI0039/2014

Memoria del Mapa Geológico de España, Escala 1:50.000, 2ª Serie, 1ª Edición, (MAGNA), Hoja Nº 166, Villadiego

Se introducen los enlaces a los archivos originales que están en la página web del IGMEPeer reviewe

Memoria del Mapa Geológico de España, Escala 1:50.000, 2ª Serie, 1ª Edición, (MAGNA), Hoja Nº 198, Osorno

Se introducen los enlaces a los archivos originales que están en la página web del IGMEPeer reviewe

Persistent Pulmonary Hypertension in Corrected Valvular Heart Disease: Hemodynamic Insights and Long-Term Survival.

Background The determinants and consequences of pulmonary hypertension after successfully corrected valvular heart disease remain poorly understood. We aim to clarify the hemodynamic bases and risk factors for mortality in patients with this condition. Methods and Results We analyzed long-term follow-up data of 222 patients with pulmonary hypertension and valvular heart disease successfully corrected at least 1 year before enrollment who had undergone comprehensive hemodynamic and imaging characterization as per the SIOVAC (Sildenafil for Improving Outcomes After Valvular Correction) clinical trial. Median (interquartile range) mean pulmonary pressure was 37 mm Hg (32-44 mm Hg) and pulmonary artery wedge pressure was 23 mm Hg (18-26 mm Hg). Most patients were classified either as having combined precapillary and postcapillary or isolated postcapillary pulmonary hypertension. After a median follow-up of 4.5 years, 91 deaths accounted for 4.21 higher-than-expected mortality in the age-matched population. Risk factors for mortality were male sex, older age, diabetes mellitus, World Health Organization functional class III and higher pulmonary vascular resistance-either measured by catheterization or approximated from ultrasound data. Higher pulmonary vascular resistance was related to diabetes mellitus and smaller residual aortic and mitral valve areas. In turn, the latter correlated with prosthetic nominal size. Six-month changes in the composite clinical score and in the 6-minute walk test distance were related to survival. Conclusions Persistent valvular heart disease-pulmonary hypertension is an ominous disease that is almost universally associated with elevated pulmonary artery wedge pressure. Pulmonary vascular resistance is a major determinant of mortality in this condition and is related to diabetes mellitus and the residual effective area of the corrected valve. These findings have important implications for individualizing valve correction procedures. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT00862043.This study was funded by the Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación, Spain, the European Union–European Regional Development Fund (EC07/90772 and PI19/00649), and the Consorcio de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV).S

Riesgos geológicos en España: estado de la cuestión

Trabajo presentado en el III Congreso geológico de España y VIII Congreso Latinoamericano de Geología, celebrado en Salamanca (España), en 1992Peer reviewe

Effects of standing position on spontaneous uterine contractility and other aspects of labor

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