85 research outputs found

    Efficacy of sildenafil therapy in children with pulmonary hypertension secondary to congenital heart disease

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    Mother and Child’s Institute, Department of Cardiology, Republic of MoldovaPurpose: pulmonary hypertension (PH) resulting from congenital heart disease (CHD) remains one of the most difficult childhood illness to treat. Sildenafil, a selective inhibitor of phosphodiesterase-5, is known as an effective and promising pulmonary vasodilator, with minors and insignifi cant reverse effects. Methods: we have evaluated the efficacy and the tolerability of sildenafil in chidren with advanced PH secondary CHD with shunts (simple (14 pts), mixed (35 pts) and complex (28 pts). In this monocentric, double-blind, placebocontrolled study we randomly assigned 77 pts with advanced PH (35 with repaired shunts, 31-palliative procedure and 11 inoperable pts) to placebo or Sildenafil orally, with the dose of 1-2 mg/kg/day each 8h for 6-12 months. The Sildenafil group consisted of 38 pts (mean age 19,9±5,3 months: 16 boys/22 girls) and the placebo group – 39 pts (mean age 21,7±7,8 months: 22 boys/17 girls). The study protocol included: functional class (FC) NYHA/Ross; O2 saturation; 6-min walk test; transthoracic echocardiogram (mean PAP, tricuspid annular plane systolic excursion (TAPSE), myocardial performance index (MPI or Tei index), right cardiac catheterisation, measuring pulmonary vascular resistance (PVR). In addition a special questionnaire of evidence of adverse reactions was available. Results: at the patients treated with Sildenafil was observed an improvement of FC NYHA/Ross from 3,16±0,1 to 2,15±0,1 (p<0,001); O2 sat (+3,1±0,5%) comparing with placebo (+0,6±0,3%), (p<0,001); an effort tolerance estimated by 6-minute walk test (+152,5±17,4 m at 6 months and +184,3±21,2m at 12 months of treatment), (p<0,001); the decreasing of mean PAP, with 22,0±2,22 at 6 months and with 19,03±2,3 mmHg at 12 months (p<0,001) and PVRI had decreased with 2,45±0,19 UW·m2 (p<0,001); the improvement of the systolic function, TAPSE from 16,55±0,34 to 20,7±0,64 mm/m2 (p<0,001) and global function of RV (Tei index) with 0,15±0,01(-31%) to initial (p<0,001). In placebo group the respective signs slightly changed and only PVR diminished from 6,4±0,1 to 5,7±0,3 UW/m2 (p<0,05). There was no death in the sildenafil-treated cases, contrary to 5 in the placebo group. Conclusions: Sildenafil is efficient in treating PH secondary to congenital systemic-to-pulmonary shunts, but even more effective in corrected surgical shunts. Sildenafil improves FC, tolerability at effort, O2 sat, systolic and global function of RV, diminishing PAPm and PVRI comparing with placebo. This remedy has good tolerability, with minors and insignifi cant adverse reactions and favourable impact on the quality of life

    Лёгочная гипоплазия у детей

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    Department of Pediatry, NicolaeTestemitanu State Medical and Pharmaceutical University, Research Institute for Maternal and Child Health Care, Chisinau, Republic of MoldovaPulmonary hypoplasia is a congenital malformation of the bronchial tree and lung parenchyma. Caused by the frailty of the embryogenesis mechanisms, it manifests through incomplete development of lung tissue. The severity of the injury depends on when the malformations appear at the prenatal age and the presence of additional anatomical abnormalities. One third of patients with Pulmonary Hypoplasia have additional abnormalities in other organs and systems (examples: heart defects, renal and urinary malformations, locomotor system malformations, etc.) We present a clinical case of diagnosed Hypoplasia in the right lung of a newborn who also has agenesis of the left kidney and paresis of the right facial nerve as well. We discuss the etiologic factors responsible for development of these congenital malformations. Following specialized literature, we do not exclude the impact of the renal and urinary malformations, nervous system disorders, and the impact of the multifactorial teratogens in development of HP in children.Лёгочная гипоплазия является врожденным порокoм развития бронхиального дерева и лёгочной паренхимы, обусловленной хрупкостью эмбриогенеза, которая проявляется неполноценным развитием лёгочной ткани. Тяжесть аномалий зависит от момента её возникновения в пренатальном периоде и наличие дополнительных анатомических аномалий. У 1/3 пациентов с лёгочной гипоплазией диагностируются сопутствующие аномалии других органов и систем (пороки сердца, пороки мочевыделительной системы, опорно-двигателъной системы и др.). Мы представляем клинический случай с гипоплазией правого лёгкого, диагностированного у новорождённого, у которого наблюдается и гипоплазия правой лёгочной артерии, агенезия левой почки, парез правого лицевого нерва. Обсуждается значимость этиологического фактора развития этих врождённых пороков. По данным литературы не исключается ролъ врождённых пороков мочевыделительной системы или патологий нервной системы и тератогенного полифакториалъного воздействия развития гипоплазии лёгкого у детей

    Optical and photosensitive properties of lamellar nanocomposites obtained by Cd intercalation of GaTe

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    By Cd-vapor heat treatment, at temperatures from 623 to 833 K, of GaTe single crystals, GaTe-CdTe composite is formed. CdTe amount is increasing together with heat treatment temperature. Absorption, photoconductivity and photoluminescence spectra of the composite contain particularities characteristic to GaTe and CdTe components. The absorption and photoconductivity edges display two thresholds at 1.66 eV (GaTe) and 1.50 eV (CdTe). Short lifetime recombination states form at the surface of composite samples, leading to narrowing of the photoconductivity bands in the high energy region, up to 1.8 eV. Widening of the absorption and photoconductivity bands in the low energy region is determined by absorption processes taking place in both GaTe and CdTe components

    Menelaus' theorem, Clifford configurations and inversive geometry of the Schwarzian KP hierarchy

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    It is shown that the integrable discrete Schwarzian KP (dSKP) equation which constitutes an algebraic superposition formula associated with, for instance, the Schwarzian KP hierarchy, the classical Darboux transformation and quasi-conformal mappings encapsulates nothing but a fundamental theorem of ancient Greek geometry. Thus, it is demonstrated that the connection with Menelaus' theorem and, more generally, Clifford configurations renders the dSKP equation a natural object of inversive geometry on the plane. The geometric and algebraic integrability of dSKP lattices and their reductions to lattices of Menelaus-Darboux, Schwarzian KdV, Schwarzian Boussinesq and Schramm type is discussed. The dSKP and discrete Schwarzian Boussinesq equations are shown to represent discretizations of families of quasi-conformal mappings.Comment: 26 pages, 9 figure

    An Integrated TCGA Pan-Cancer Clinical Data Resource to Drive High-Quality Survival Outcome Analytics

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    For a decade, The Cancer Genome Atlas (TCGA) program collected clinicopathologic annotation data along with multi-platform molecular profiles of more than 11,000 human tumors across 33 different cancer types. TCGA clinical data contain key features representing the democratized nature of the data collection process. To ensure proper use of this large clinical dataset associated with genomic features, we developed a standardized dataset named the TCGA Pan-Cancer Clinical Data Resource (TCGA-CDR), which includes four major clinical outcome endpoints. In addition to detailing major challenges and statistical limitations encountered during the effort of integrating the acquired clinical data, we present a summary that includes endpoint usage recommendations for each cancer type. These TCGA-CDR findings appear to be consistent with cancer genomics studies independent of the TCGA effort and provide opportunities for investigating cancer biology using clinical correlates at an unprecedented scale. Analysis of clinicopathologic annotations for over 11,000 cancer patients in the TCGA program leads to the generation of TCGA Clinical Data Resource, which provides recommendations of clinical outcome endpoint usage for 33 cancer types

    Genomic, Pathway Network, and Immunologic Features Distinguishing Squamous Carcinomas

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    This integrated, multiplatform PanCancer Atlas study co-mapped and identified distinguishing molecular features of squamous cell carcinomas (SCCs) from five sites associated with smokin

    Pan-Cancer Analysis of lncRNA Regulation Supports Their Targeting of Cancer Genes in Each Tumor Context

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    Long noncoding RNAs (lncRNAs) are commonly dys-regulated in tumors, but only a handful are known toplay pathophysiological roles in cancer. We inferredlncRNAs that dysregulate cancer pathways, onco-genes, and tumor suppressors (cancer genes) bymodeling their effects on the activity of transcriptionfactors, RNA-binding proteins, and microRNAs in5,185 TCGA tumors and 1,019 ENCODE assays.Our predictions included hundreds of candidateonco- and tumor-suppressor lncRNAs (cancerlncRNAs) whose somatic alterations account for thedysregulation of dozens of cancer genes and path-ways in each of 14 tumor contexts. To demonstrateproof of concept, we showed that perturbations tar-geting OIP5-AS1 (an inferred tumor suppressor) andTUG1 and WT1-AS (inferred onco-lncRNAs) dysre-gulated cancer genes and altered proliferation ofbreast and gynecologic cancer cells. Our analysis in-dicates that, although most lncRNAs are dysregu-lated in a tumor-specific manner, some, includingOIP5-AS1, TUG1, NEAT1, MEG3, and TSIX, synergis-tically dysregulate cancer pathways in multiple tumorcontexts
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