Escola ciutadana i ciutat educadora

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How to evaluate resting ECG and imaging in children practising sport: a critical review and proposal of an algorithm for ECG interpretation

The athlete's heart is a well-known phenomenon in adults practising competitive sports. Unfortunately, to date, most of the studies on training-induced cardiac remodelling have been conducted in adults and the current recommendations refer mainly to adult individuals. However, an appropriate interpretation of resting ECG and imaging in children practising sports is crucial, given the possibility of early detect life-threatening conditions and managing therapy and eligibility to sports competitions in the rapidly growing paediatric athlete population. While several articles have been published on this topic in adult athletes, a practical guide for the clinical evaluation of paediatric athletes is still missing. In this critical review, we provided a comprehensive description of the current evidence on training-induced remodelling in paediatric athletes with a practical approach for clinicians on how to interpret the resting 12-lead ECG and cardiac imaging in the paediatric athlete. Indeed, given that training may mimic potential cardiovascular disorders, clinicians evaluating children practising sports should pay attention to the risk of missing a diagnosis of a life-threatening condition. However, this risk should be balanced with the risk of overdiagnosis and unwarranted disqualification from sports practice, when interpreting an ECG as pathological while, on the contrary, it may represent a physiological expression of athlete's heart. Accordingly, we proposed an algorithm for the evaluation of normal, borderline, and abnormal ECG findings that can be useful for the readers for their daily clinical practice

Wpływ lewosimendanu podawanego bez dawki nasycającej na skurczową i rozkurczową funkcję serca u pacjentów ze schyłkową niewydolnością serca

Wstęp: Lewosimendan (L) jest lekiem stosowanym w terapii ciężkiej niewydolności serca (HF). Działa inotropowo dodatnio oraz wazodylatacyjnie, nie zwiększając zapotrzebowania serca na tlen. W ostrej HF lewosimendan poprawia parametry hemodynamiczne. W dostępnych publikacjach wykazano, że pozytywnie wpływa na funkcję rozkurczową lewej komory (LV). Celem niniejszego badania była ocena wpływu lewosimendanu na zmiany długiej osi LV, która jest wczesnym markerem dysfunkcji rozkurczowej. Metody: Do badania włączono 41 pacjentów w średnim wieku 62 &#177; 12 lat przyjętych do kliniki autorów niniejszej pracy z powodu ostrej HF w klasie IV według NYHA z istotną dysfunkcją LV. Dwudziestu sześciu pacjentom podano lewosimendan w dawce 0,1 &#956;g/kg/min w ciągu 24 godzin bez dawki nasycającej (grupa L), zaś 15 chorych poddano standardowej terapii (grupa C). Wyniki: Grupy nie różniły się między sobą pod względem podstawowych danych demograficznych, klinicznych i wyników badań biochemicznych. Po tygodniu od leczenia lewosimendanem obserwowano istotną poprawę wydolności w klasie NYHA oraz obniżenie stężenia N-końcowego propeptydu natriuretycznego typu B (pro-BNP). W badaniu echokardiograficznym obserwowano poprawę funkcji skurczowej (p < 0,05) i frakcji wyrzutowej LV (p < 0,05) przy redukcji wskaźnika E/E&#8217; (p < 0,05) w grupie L. Grupę L podzielono na podgrupę z aktywnym niedokrwieniem i bez niedokrwienia oraz wykazano istotną poprawę funkcji skurczowej w pierwszej podgrupie. Nie wykazano różnic między podgrupami w odniesieniu do funkcji rozkurczowej LV. Wnioski: Stosowanie lewosimendanu bez dawki nasycającej poprawia funkcję LV i klasę NYHA u pacjentów z ostrą HF. Wydaje się, że przedłużony wpływ na parametry hemodynamiczne jest związany z działaniem aktywnych metabolitów leku. (Folia Cardiologica Excerpta 2012; 7, 2: 71-77

Multi-phosphorylation of the intrinsically disordered unique domain of c-Src studied by in-cell and real-time NMR

Intrinsically disordered regions (IDRs) are preferred sites for post-translational modifications essential for regulating protein function. The enhanced local mobility of IDRs facilitates their observation by NMR spectroscopy in vivo. Phosphorylation events can occur at multiple sites and respond dynamically to changes in kinase-phosphatase networks. Here we used real-time NMR spectroscopy to study the effect of kinases and phosphatases present in Xenopus oocytes and egg extracts on the phosphorylation state of the 'unique domain' of c-Src. We followed the phosphorylation of S17 in oocytes, and of S17, S69, and S75 in egg extracts by NMR spectroscopy, MS, and western blotting. Addition of specific kinase inhibitors showed that S75 and S69 are phosphorylated by CDKs (cyclin-dependent kinases) differently from Cdk1. Moreover, although PKA (cAMP-dependent protein kinase) can phosphorylate S17 in vitro, this was not the major S17 kinase in egg extracts. Changes in PKA activity affected the phosphorylation levels of CDK-dependent sites, thus suggesting indirect effects of kinase-phosphatase networks. This study provides a proof-of-concept of the use of real-time in vivo NMR spectroscopy to characterize kinase/phosphatase effects on intrinsically disordered regulatory domains

Psychological complications in patients with acromegaly: relationships with sex, arthropathy, and quality of life

Current treatment of acromegaly restores a normal life expectancy in most cases. So, the study of persistent complications affecting patients' quality of life (QoL) is of paramount importance, especially motor disability and depression. In a large cohort of acromegalic patients we aimed at establishing the prevalence of depression, to look for clinical and sociodemographic factors associated with it, and to investigate the respective roles (and interactions) of depression and arthropathy in influencing QoL

Autoadjusting-CPAP effect on serum Leptin concentrations in Obstructive Sleep Apnoea patients

© 2008 Drummond et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Microwave spectro-polarimetry of matter and radiation across space and time

From Springer Nature via Jisc Publications RouterHistory: received 2020-07-29, accepted 2021-03-02, registration 2021-03-03, pub-print 2021-06, pub-electronic 2021-07-03, online 2021-07-03Publication status: PublishedAbstract: This paper discusses the science case for a sensitive spectro-polarimetric survey of the microwave sky. Such a survey would provide a tomographic and dynamic census of the three-dimensional distribution of hot gas, velocity flows, early metals, dust, and mass distribution in the entire Hubble volume, exploit CMB temperature and polarisation anisotropies down to fundamental limits, and track energy injection and absorption into the radiation background across cosmic times by measuring spectral distortions of the CMB blackbody emission. In addition to its exceptional capability for cosmology and fundamental physics, such a survey would provide an unprecedented view of microwave emissions at sub-arcminute to few-arcminute angular resolution in hundreds of frequency channels, a data set that would be of immense legacy value for many branches of astrophysics. We propose that this survey be carried out with a large space mission featuring a broad-band polarised imager and a moderate resolution spectro-imager at the focus of a 3.5 m aperture telescope actively cooled to about 8K, complemented with absolutely-calibrated Fourier Transform Spectrometer modules observing at degree-scale angular resolution in the 10–2000 GHz frequency range. We propose two observing modes: a survey mode to map the entire sky as well as a few selected wide fields, and an observatory mode for deeper observations of regions of specific interest