withdrawn 2017 hrs ehra ecas aphrs solaece expert consensus statement on catheter and surgical ablation of atrial fibrillation

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Passivation of Metallic Stents After Arterial Gene Transfer of phVEGF165Inhibits Thrombus Formation and Intimal Thickening

AbstractObjectives. This study sought to test the hypothesis that direct gene transfer of an endothelial cell mitogen could passivate metallic stents by accelerating endothelialization of the prosthesis.Background. Thrombosis and restenosis comprise the principal clinical manifestations of compromised biocompatibility of endovascular stents. Previous studies have demonstrated that endothelial recovery at sites of balloon injury is a critical determinant of consequent intimal thickening and mural thrombus. We therefore investigated the potential for an endothelial cell mitogen delivered as plasmid DNA to optimize stent biocompatibility.Methods. Naked plasmid DNA encoding vascular endothelial growth factor (VEGF)/vascular permeability factor (VPF) (phVEGF165) was delivered locally using a hydrogel-coated balloon angioplasty catheter to 16 rabbit iliac arteries in which metallic stents had been placed at the site of balloon injury; the contralateral iliac artery of each rabbit was balloon injured and stented but not transfected.Results. Stent endothelialization was accelerated by phVEGF165gene transfer (87.38 ± 5.06% vs. 33.13 ± 9.73% [mean ± SEM] of the planimetered stent surface in the treated vs. contralateral limb, p = 0.005). This was associated with a significant reduction in mural thrombus (3.7 ± 2.4% vs. 32.7 ± 9.7%, p = 0.01) at day 7 and intimal thickening (maximal intimal area 0.61 ± 0.09 vs. 1.44 ± 0.12 mm2, p < 0.0001) at day 28. No benefit was observed from pCMV-luciferase in 14 similarly instrumented control rabbits.Conclusions. These findings indicate that arterial gene transfer of naked plasmid DNA encoding for an endothelial cell mitogen may successfully passivate endovascular stents by accelerating stent endothelialization, thereby reducing in-stent thombus and obstruction due to intimal thickening.(J Am Coll Cardiol 1997;29:1371–9

The development of family therapy in Ireland

In Ireland family therapy is a small profession, with under 200 registered therapists. The Irish family therapy movement began in the mid-1970s. By 1980 the Family Therapy Network of Ireland in the Republic of Ireland and the Northern Ireland Branch of the UK Association Family therapy had been founded. At present there are three main family therapy training centers in Ireland: two in the south (the Mater University Hospital, affiliated to University College Dublin and Clanwilliam Institute) and one in the north (at Queen’s University Belfast). There is no statutory registration and licensing of family therapists in Ireland. Accredited professional family therapy programs in Ireland are 4-year part-time courses culminating in masters level qualifications. A primary degree in medicine, nursing, psychology, social science or education is a prerequisite for entry. Family therapists in Ireland work in both private practice and the public health service. Most family therapists in the public sector are employed as social workers, psychologists, psychiatrists or nurses, and conduct family therapy as part of their broader professional roles. Couple therapy in Ireland is provided by family therapists, and also by voluntary couple counselors based in networks of local centers, some of which were originally religiously affiliated, without a formal connection to national family therapy associations. The three major future challenges for Irish family therapy are creating a research infrastructure, developing a career structure in the public health service, and introducing statutory registration.Author has checked copyrightDM, 9/12/201