Percutaneous Pulmonary Valve Implantation: Initial Experience

Os doentes com cardiopatias submetidos a intervenção cirúrgica com implantação de condutos entre o ventrículo direito e a artéria pulmonar (VD-AP) podem desenvolver estenose e/ou insuficiência pulmonares ao longo do tempo. Nestas situações, associadas a arritmias cardíacas, disfunção ventricular direita e morte súbita, a re-intervenção cirúrgica permanece um desafio pela complexidade, mortalidade e morbilidade significativas. A implantação percutânea de válvulas pulmonares (IPVP), recentemente desenvolvida, representa uma abordagem alternativa para estes doentes. Objectivo: Reportar a experiência inicial com a IPVP, analisando o seu impacto no manejo destes doentes. Material e Métodos: Avaliação prospectiva dos dados clínicos, ecocardiográficos, da ressonância magnética, hemodinâmicos e angiográficos dos doentes submetidos a IPVP. Resultados: Seis doentes em classe funcional igual ou superior a II com disfunção do conduto VD-AP foram submetidos a IPVP. Tinham todos evidência de insuficiência e 5/6 de estenose. O procedimento consistiu na implantação de stents não cobertos no conduto para reforçar a sua rigidez e prevenir fracturas dos stents valvulados pulmonares Melody ® (Medtronic), que foram em seguida implantados com sucesso em todos. Obteve-se uma redução da pressão ventricular direita (94±27 para 44±7mmHg), da relação entre a pressão ventricular direita e esquerda (94±27 para 44±7%), do gradiente do conduto (65±28 para 11±4mmHg) e ausência de regurgitação pulmonar. O procedimento teve uma duração mediana de 180 minutos e decorreu sem complicações major. Os doentes tiveram alta em mediana dois dias após o procedimento. Na última avaliação, em mediana 7,8 meses após o procedimento, os doentes encontramse em classe funcional I (5) ou II (1), sem evidência não invasiva de disfunção do conduto. Conclusões: Os nossos resultados acompanham a experiência actual com esta modalidade terapêutica, com excelentes resultados nestes grupo de doentes complexos. A implementação da IPVP em doentes com cardiopatia congénita que requerem re-intervenção no tracto de saída do ventrículo direito tem-se revelado uma técnica promissora, embora complexa, alternativa a mais uma intervenção cirúrgica

IL10 Low-Frequency Variants in Behçet's Disease Patients

To explain the missing heritability after the genome-wide association studies era, sequencing studies allow the identification of low-frequency variants with a stronger effect on disease risk. Common variants in the interleukin 10 gene (IL10) have been consistently associated with Behçet's disease (BD) and the goal of this study is to investigate the role of low-frequency IL10 variants in BD susceptibility

Evolutionary relationships among barley and <i>Arabidopsis</i> core circadian clock and clock-associated genes

The circadian clock regulates a multitude of plant developmental and metabolic processes. In crop species, it contributes significantly to plant performance and productivity and to the adaptation and geographical range over which crops can be grown. To understand the clock in barley and how it relates to the components in the Arabidopsis thaliana clock, we have performed a systematic analysis of core circadian clock and clock-associated genes in barley, Arabidopsis and another eight species including tomato, potato, a range of monocotyledonous species and the moss, Physcomitrella patens. We have identified orthologues and paralogues of Arabidopsis genes which are conserved in all species, monocot/dicot differences, species-specific differences and variation in gene copy number (e.g. gene duplications among the various species). We propose that the common ancestor of barley and Arabidopsis had two-thirds of the key clock components identified in Arabidopsis prior to the separation of the monocot/dicot groups. After this separation, multiple independent gene duplication events took place in both monocot and dicot ancestors. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00239-015-9665-0) contains supplementary material, which is available to authorized users

Bayesian estimation of genetic parameters for multivariate threshold and continuous phenotypes and molecular genetic data in simulated horse populations using Gibbs sampling

<p>Abstract</p> <p>Background</p> <p>Requirements for successful implementation of multivariate animal threshold models including phenotypic and genotypic information are not known yet. Here simulated horse data were used to investigate the properties of multivariate estimators of genetic parameters for categorical, continuous and molecular genetic data in the context of important radiological health traits using mixed linear-threshold animal models via Gibbs sampling. The simulated pedigree comprised 7 generations and 40000 animals per generation. Additive genetic values, residuals and fixed effects for one continuous trait and liabilities of four binary traits were simulated, resembling situations encountered in the Warmblood horse. Quantitative trait locus (QTL) effects and genetic marker information were simulated for one of the liabilities. Different scenarios with respect to recombination rate between genetic markers and QTL and polymorphism information content of genetic markers were studied. For each scenario ten replicates were sampled from the simulated population, and within each replicate six different datasets differing in number and distribution of animals with trait records and availability of genetic marker information were generated. (Co)Variance components were estimated using a Bayesian mixed linear-threshold animal model via Gibbs sampling. Residual variances were fixed to zero and a proper prior was used for the genetic covariance matrix.</p> <p>Results</p> <p>Effective sample sizes (ESS) and biases of genetic parameters differed significantly between datasets. Bias of heritability estimates was -6% to +6% for the continuous trait, -6% to +10% for the binary traits of moderate heritability, and -21% to +25% for the binary traits of low heritability. Additive genetic correlations were mostly underestimated between the continuous trait and binary traits of low heritability, under- or overestimated between the continuous trait and binary traits of moderate heritability, and overestimated between two binary traits. Use of trait information on two subsequent generations of animals increased ESS and reduced bias of parameter estimates more than mere increase of the number of informative animals from one generation. Consideration of genotype information as a fixed effect in the model resulted in overestimation of polygenic heritability of the QTL trait, but increased accuracy of estimated additive genetic correlations of the QTL trait.</p> <p>Conclusion</p> <p>Combined use of phenotype and genotype information on parents and offspring will help to identify agonistic and antagonistic genetic correlations between traits of interests, facilitating design of effective multiple trait selection schemes.</p