44 research outputs found
ECMO a successful way to support an acutely failing heart/lungs. A chance everyone should be given
An 18-year follow-up after the first successful heart-lung transplant in Poland. Authors’ tribute to the pioneers of heart and lung transplantation
Original articleEarly results of coronary artery bypass graft surgery in women
Background: Coronary artery disease is one of the leading causes of death among women in developed countries all over the world. Coronary artery bypass grafting (CABG) is a well established therapeutic modality to treat diffuse coronary artery atherosclerosis. Aim: In this study we focused on the retrospective assessment of the early results of CABG in women as compared to the results of such treatment in men. Methods: This analysis involved 2881 patients (677 women and 2204 men) who underwent CABG between 2003 and 2005. An operative technique (conventional on-pump or off-pump) was applied in a similar proportion of patients in both groups (on-pump: 59.4% of women and 59.6% of men; NS). Women were older than men and had higher body mass index. Concomitant disorders such as diabetes mellitus, hypertension and hypercholesterolaemia were noted more frequently in female patients. Results: In the perioperative period, left ventricular failure requiring intra-aortic balloon pump insertion and administration of high doses of catecholamines was observed significantly more often in women than in men (22.1 vs. 16.1%, respectively; pWstęp: Choroba wieńcowa jest jedną z głównych przyczyn zgonów kobiet w populacji rozwiniętych społeczeństw całego świata. Chirurgiczna rewaskularyzacja mięśnia sercowego jest udokumentowaną metodą leczenia rozsianej miażdżycy tętnic wieńcowych. Cel: Retrospektywna ocena wczesnych wyników chirurgicznej rewaskularyzacji tętnic wieńcowych u kobiet i ich odniesienie do wyników uzyskanych w grupie mężczyzn. Metodyka: Analizą objęto 2881 chorych (677 kobiet, 2204 mężczyzn), którzy w latach 2003–2005 zostali poddani operacji pomostowania tętnic wieńcowych. Czas obserwacji dotyczył okresu hospitalizacji związanej z operacją. Z badania wykluczono pacjentów, u których wykonano dodatkowe procedury medyczne (plastyki czy wymiany zastawek serca, korekcje wad wrodzonych, tętniaki aorty wstępującej itd.). W grupie kobiet i mężczyzn z porównywalną częstością wykonywano zabiegi w trybie planowym, pilnym i ze wskazań życiowych. Kobiety charakteryzowało wyższe ryzyko operacyjne wyliczone wg skali Euroscore (4,2 vs 3,04,
Novel polyanions inhibiting replication of influenza viruses
Novel sulfonated derivatives of poly(allylamine hydrochloride) (NSPAHs) and N-sulfonated chitosan (NSCH) have been synthesized, and their activity against influenza A and B viruses has been studied and compared with that of a series of carrageenans, marine polysaccharides of well-documented anti-influenza activity. NSPAHs were found to be nontoxic and very soluble in water, in contrast to gel-forming and thus generally poorly soluble carrageenans. In vitro and ex vivo studies using susceptible cells (Madin-Darby canine kidney epithelial cells and fully differentiated human airway epithelial cultures) demonstrated the antiviral effectiveness of NSPAHs. The activity of NSPAHs was proportional to the molecular mass of the chain and the degree of substitution of amino groups with sulfonate groups. Mechanistic studies showed that the NSPAHs and carrageenans inhibit influenza A and B virus assembly in the cell
Serum levels of Visfatin, Omentin and Irisin in patients with end stage lung disease before and after lung transplantation
BACKGROUND: The aim of this study was to investigate serum concentrations of visfatin, irisin, and omentin in patients with end-stage lung diseases (ESLD) before and after lung transplantation (LTx) and to find relationship between adipokines levels and clinical outcomes.
MATERIAL AND METHODS: Fourteen consecutive lung transplant recipients (six males and seven females; age 32.0±14.2 years; body mass index (BMI) 21.8±5.3 kg/m²) who underwent lung transplantation with initial diagnosis of respiratory failure due to cystic fibrosis (CF), chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF) were included. Visfatin, irisin, and omentin serum levels were assayed using commercially available ELISA kits at four time points: the day of LTx (day 0), 72 hours (day 3), one month (day 30) and three months (day 90) after LTx.
RESULTS: Omentin serum concentration decreased significantly within three days after LTx (350.5±302.0 to 200.0±0.90 ng/mL; p<0.05), while visfatin serum levels decreased later, 30 days after Ltx (4.81±3.78 to 0.78±0.35 [0.4–1.1] pg/mL; p<0.05). Downregulated serum levels of both adipokines remained stable for the next two months (256.0 [201.7–642.9] ng/mL and 0.77±0.76 pg/mL, respectively; p<0.05). Serum levels of irisin were unchanged before and after Ltx. Immunosuppressive regimen did not affect serum levels of the analyzed adipokines.
CONCLUSIONS: The study showed for the first time serum omentin and visfatin levels to be decreased after LTx in ESLD patients. Successful LTx contributes to the improvement of impaired lung function parameters and attenuation of ongoing inflammatory process, resulting in altered visfatin and omentin serum levels. Additional influence of immunosuppressive treatment on omentin and visfatin serum concentration cannot be excluded
Cardiac surgery and cardiologyHow to avoid the problem of implanted aortic prosthesis mismatch?
Coronary artery disease in heart transplant recipients - diagnosis and treatment. Single centre experience based on results of elective coronary angiography
Background: Despite recent progress in clinical transplantology, coronary artery disease of transplanted heart (TxCAD) remains the main cause of long-term mortality. The role of elective coronary angiography (CAG) and percutaneous coronary interventions (PCI) in these patients has not yet been well established.Aim: To evaluate the incidence of TxCAD based on the results of elective CAG and to assess the role of potential risk factors and treatment options.Methods: We analysed the results of 227 elective CAG procedures performed in 145 patients after orthotopic heart transplantation (OHT) between 1986 and 1998. The result of CAG was considered positive when any lesion was found in coronary arteries regardless of its hemodynamic relevance, including both atherosclerotic plaques and lesions characteristic of vasculopathy. The influence of immunological (rejection of transplanted heart) and non-immunological risk factors on the development of TxCAD was analysed separately for the first 3 years after OHT and for the subsequent period.Results: Positive result of at least one CAG was found in 54 (37%) patients. The overall percentage of positive CAG was 41%, starting from 18% one year after OHT to 55% five years after surgery. Vasculopathic lesions were found in 14% of CAG procedures. Risk factor analysis showed an increasing impact over time of non-immunological factors, however, differences were not statistically significant. Hemodynamically significant lesions were found in 21 patients. In 16 of those PCI was performed. Control CAG was done in 12 patients after PCI revealing indications for another PCI in 8 of them. TxCAD was the cause of death in 3 patients in the PCI group.Conclusions: Based on the results of elective CAG, frequency of TxCAD increases with time and reaches 55% by 5 years after OHT. PCI is an effective method of treating significant coronary lesions after OHT
HTCC: Broad Range Inhibitor of Coronavirus Entry.
To date, six human coronaviruses have been known, all of which are associated with respiratory infections in humans. With the exception of the highly pathogenic SARS and MERS coronaviruses, human coronaviruses (HCoV-NL63, HCoV-OC43, HCoV-229E, and HCoV-HKU1) circulate worldwide and typically cause the common cold. In most cases, infection with these viruses does not lead to severe disease, although acute infections in infants, the elderly, and immunocompromised patients may progress to severe disease requiring hospitalization. Importantly, no drugs against human coronaviruses exist, and only supportive therapy is available. Previously, we proposed the cationically modified chitosan, N-(2-hydroxypropyl)-3-trimethylammonium chitosan chloride (HTCC), and its hydrophobically-modified derivative (HM-HTCC) as potent inhibitors of the coronavirus HCoV-NL63. Here, we show that HTCC inhibits interaction of a virus with its receptor and thus blocks the entry. Further, we demonstrate that HTCC polymers with different degrees of substitution act as effective inhibitors of all low-pathogenic human coronaviruses