Trasplante cardíaco

A heart transplant is at present considered the treatment of choice in cases of terminal cardiac insufficiency refractory to medical or surgical treatment. Due to factors such as the greater life expectancy of the population and the more efficient management of acute coronary syndromes, there is an increasing number of people who suffer from heart failure. It is estimated that the prevalence of the disease in developed countries is around 1%; of this figure, some 10% are in an advanced stage and are thus potential receptors of a heart transplant. The problem is that it is still not possible to offer this therapeutic form to all of the patients that require it. Consequently, it is necessary to optimise the results of the heart transplant through the selection of patients, selection and management of donors, perioperative management and control of the disease due to graft rejection. Since the first transplant carried out in 1967, numerous advances and changes have taken place, which has made it possible to increase survival and quality of life of those who have received a new heart. In this article we review the most relevant aspects of the heart transplant and the challenges that are currently faced

Fruit and vegetable consumption is inversely associated with blood pressure in a Mediterranean population with a high vegetable-fat intake: the Seguimiento Universidad de Navarra (SUN) Study

There is evidence that a diet rich in fruit and vegetables reduces blood pressure (BP). Characteristically, the Mediterranean diet is rich in plant-derived foods and also in fat, but studies conducted in Mediterranean countries to relate diet to BP are scarce. We studied the association between fruit and vegetable consumption and BP in a cross-sectional analysis of 4393 participants in the Seguimiento Universidad de Navarra (SUN) Study, an ongoing dynamic cohort study in Spain. Diet was measured using a food-frequency questionnaire previously validated in Spain. Fat represented more than 37% total energy intake. Subjects were considered to have undiagnosed hypertension if they reported systolic BP $140mmHg or diastolic BP$90 mmHg, and not a medical diagnosis of hypertension. The adjusted prevalence odds ratio of undiagnosed hypertension (upper v. lowest quintile) was 0·58 (95% CI 0·36, 0·91; P for trend 0·01) for vegetable consumption and 0·68 (95% CI 0·43, 1·09; P for trend 0·10) for fruit consumption. Comparing those in the highest quintile of both fruit and vegetable consumption with those in the lowest quintile of both food groups, the prevalence odds ratio was 0·23 (95% CI 0·10, 0·55; P¼0·001), after adjusting for risk factors for hypertension and other dietary exposures. In a Mediterranean population with an elevated fat consumption, a high fruit and vegetable intake is inversely associated with BP levels

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Regeneración miocárdica: el futuro al alcance de la mano

En los últimos años hemos asistido a un interés creciente por el tratamiento de la insuficiencia cardíaca mediante el trasplante de células madre. Mientras que los estudios con células madre de músculo (mioblastos) se iniciaron hace mas de 10 años, la posibilidad de que las células madre de la médula ósea tengan un enorme potencial de diferenciación y proliferación han estimulado la investigación con otros tipos de células madre. Estos estudios experimentales han demostrado, en no pocas ocasiones, resultados contradictorios lo que ha llevado a posturas enfrentadas en cuanto a la ética de iniciar estudios clínicos. Creemos que es adecuado tratar de ofrecer una visión crítica sobre la utilización de las células madre en la insuficiencia cardíaca. Quizá la pregunta mas difícil de contestar en este momento es, si la realización de ensayos clínicos esta justificado o no a la luz de los conocimientos actuales o si por el contrario debemos adquirir un conocimiento mucho más preciso de la posible eficacia de este tipo de tratamiento y de los mecanismos que justifican dicha eficacia, antes de siquiera iniciar los estudios en humanos. En nuestra opinión existen suficientes evidencias que justifican el desarrollo de ensayos clínicos a pesar de que, sin duda, existen muchos interrogantes que debemos resolver mediante estudios experimentales en animales

Regeneración miocárdica: el futuro al alcance de la mano

En los últimos años hemos asistido a un interés creciente por el tratamiento de la insuficiencia cardíaca mediante el trasplante de células madre. Mientras que los estudios con células madre de músculo (mioblastos) se iniciaron hace mas de 10 años, la posibilidad de que las células madre de la médula ósea tengan un enorme potencial de diferenciación y proliferación han estimulado la investigación con otros tipos de células madre. Estos estudios experimentales han demostrado, en no pocas ocasiones, resultados contradictorios lo que ha llevado a posturas enfrentadas en cuanto a la ética de iniciar estudios clínicos. Creemos que es adecuado tratar de ofrecer una visión crítica sobre la utilización de las células madre en la insuficiencia cardíaca. Quizá la pregunta mas difícil de contestar en este momento es, si la realización de ensayos clínicos esta justificado o no a la luz de los conocimientos actuales o si por el contrario debemos adquirir un conocimiento mucho más preciso de la posible eficacia de este tipo de tratamiento y de los mecanismos que justifican dicha eficacia, antes de siquiera iniciar los estudios en humanos. En nuestra opinión existen suficientes evidencias que justifican el desarrollo de ensayos clínicos a pesar de que, sin duda, existen muchos interrogantes que debemos resolver mediante estudios experimentales en animales

Trasplante cardíaco

A heart transplant is at present considered the treatment of choice in cases of terminal cardiac insufficiency refractory to medical or surgical treatment. Due to factors such as the greater life expectancy of the population and the more efficient management of acute coronary syndromes, there is an increasing number of people who suffer from heart failure. It is estimated that the prevalence of the disease in developed countries is around 1%; of this figure, some 10% are in an advanced stage and are thus potential receptors of a heart transplant. The problem is that it is still not possible to offer this therapeutic form to all of the patients that require it. Consequently, it is necessary to optimise the results of the heart transplant through the selection of patients, selection and management of donors, perioperative management and control of the disease due to graft rejection. Since the first transplant carried out in 1967, numerous advances and changes have taken place, which has made it possible to increase survival and quality of life of those who have received a new heart. In this article we review the most relevant aspects of the heart transplant and the challenges that are currently faced