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Aortic valve stenosis provides complementary information to bleeding risk scores in non-valvular atrial fibrillation patients initiating anticoagulation

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Journal of Geriatric Cardiology 2020年第3期17卷 141-148,I0005-I0007页

作者： Gines Elvira-Ruiz Cesar Caro-martinez Pedro JoseFlores-Blanco Juan JoseCerezo-Manchado Helena Albendin-iglesias Alejandro Lova-Navarro Francisco Arregui-Montoya Francisca mar.a Munoz-Franco Natalia Garcia-Iniesta Arcadio Garcia-Alberola JoseLuis Bailen-Lorenzo Domingo Andres Pascual-Figal Sergio Manzano-Fernández Department of Cardiology University Hospital Virgen de la ArrixacaMurciaSpain Instituto Murciano de Investigación en Biomedicina(IMIB) MurciaSpain Department of Cardiology University Hospital Morales MeseguerMurciaSpain Department of Hematology University Hospital Virgen de la ArrixacaMurciaSpain Department of Internal Medicine University Hospital Virgen de la ArrixacaMurciaSpain School of Medicine University of MurciaMurciaSpain Department of Cardiology Hospital Vega BajaAlicanteSpain

Background The identification of modifiable bleeding risk factors may be of *** aim is to evaluate if aortic stenosis(AS)provides additional information to bleeding risk scores for predicting major bleeding(MB)in non-valvular atrial fibrillation(AF).Methods We designed a retrospective multi-center study including 2880 consecutive non-valvular AF patients initiating oral anticoagulation between January 2013 and December *** was defined as moderate or severe according to European echocardiography guidelines ***,ATRIA and ORBIT scores were used to evaluate the bleeding *** was defined according to the International Society on Thrombosis and Haemostasia criteria and registered at 18 months of *** 168(5.8%)patients had *** with AS had higher risk for MB compared to those without AS(HR=2.13,95%CI:1.40-3.23,P<0.001).Patients without AS and low-intermediate bleeding risk(0 points)showed the lowest MB rate,whereas the MB rate observed among patients with AS and high bleeding risk(2 points)was the highest *** and reclassification analyses showed that AS provided additional information to bleeding risk scores for predicting MB at 18 months of *** In this population,AS was associated with an increased risk for MB at midterm *** three scoring systems showed a moderate discriminatory ability for ***,the addition of AS was associated with a significant improvement in their predictive *** suggest that the presence of this valvulopathy should be taken into account for bleeding risk assessment.

关键词： Anticoagulants Aortic stenosis Atrial fibrillation Major bleeding Valvular disease

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Intertwined leukocyte balances in tumours and peripheral blood as robust predictors of right and left colorectal cancer survival

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World Journal of Gastrointestinal Oncology 2022年第1期14卷 295-318页

作者： Ramón Cantero-Cid Karla marina Montalbán-Hernández Jenny Guevara Alejandro Pascual-iglesias Elisa Pulido JoséCarlos Casalvilla Cristóbal mar.ano Cristina Barragán Serrano Jaime Valentín Gloria Cristina Bonel-Pérez JoséAvendaño-Ortiz Verónica Terrón Roberto Lozano-Rodríguez Alejandro martín-Quirós Elvira marín Eva Pena Laura Guerra-Pastrián Eduardo López-Collazo Luis Augusto Aguirre Tumor Immunology Laboratory The Innate Immune Response GroupHospital La Paz Institute for Health Research(IdiPAZ)Madrid 28046Spain Digestive Surgery Service La Paz University HospitalMadrid 28046Spain Emergency Department and Emergent Pathology Research Group Hospital La Paz Institute for Health Research(IdiPAZ)Madrid 28046Spain Pathologic Anatomy Service Hospital La PazMadrid 28046Spain

BACKGROUND Colorectal cancer(CRC)accounts for 9.4%of overall cancer deaths,ranking second after lung *** the large number of factors tested to predict their outcome,most patients with similar variables show big differences in ***,right-sided CRC(RCRC)and left-sided CRC(LCRC)patients exhibit large differences in outcome after surgical intervention as assessed by preoperative blood leukocyte *** hypothesised that stronger indexes than circulating(blood)leukocyte ratios to predict RCRC and LCRC patient outcomes will result from combining both circulating and infiltrated(tumour/peritumour fixed tissues)concentrations of *** To seek variables involving leukocyte balances in peripheral blood and tumour tissues and to predict the outcome of CRC *** Sixty-five patients diagnosed with colon adenocarcinoma by the Digestive Surgery Service of the La Paz University Hospital(Madrid,Spain)were enrolled in this study:43 with RCRC and 22 with *** were followed-up from January 2017 to march 2021 to record overall survival(OS)and recurrence-free survival(RFS)after surgical *** concentrations in peripheral blood were determined by routine laboratory ***-fixed samples of tumour and peritumoural tissues were assessed for leukocyte concentrations by immunohistochemical detection of CD4,CD8,and CD14 marker *** of leukocyte concentration in blood and tissues were calculated and evaluated for their predictor values for OS and RFS with Spearman correlations and Cox univariate and multivariate proportional hazards regression,followed by the calculation of the receiver-operating characteristic and area under the curve(AUC)and the determination of Youden’s optimal cutoff values for those variables that significantly correlated with either RCRC or LCRC patient *** patients from the cohort were randomly assigned to modelling and validation sets,and clinician-friendly nomogra

关键词： Left colorectal cancer Leukocyte ratios Prognostic variables Recurrence-free survival Right colorectal cancer Overall survival

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Pulmonary vein stenosis:Etiology,diagnosis and management

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World Journal of Cardiology 2016年第1期8卷 81-88页

作者： Pablo Pazos-López Cristina García-Rodríguez Alba Guitián-González Emilio Paredes-Galán mar.a ángel De La Guarda álvarez-Moure mar.a Rodríguez-álvarez José Antonio Baz-Alonso Elvis Teijeira-Fernández Francisco Eugenio Calvo-iglesias Andrés íniguez-Romo Department of Cardiology Complexo Hospitalario Universitario de Vigo Hospital álvaro Cunqueiro Department of Radiology Complexo Hospitalario Universitario de Vigo Hospital álvaro Cunqueiro Diagnostic Imaging Unit Galaria Empresa Pública de Servicios Sanitarios Hospital do Meixoeiro

Pulmonary vein stenosis(PVS) is rare condition characterized by a challenging diagnosis and unfavorable prognosis at advance stages. At present, injury from radiofrequency ablation for atrial fibrillation has become the main cause of the disease. PVS is characterized by a progressive lumen size reduction of one or more pulmonary veins that, when hemodynamically significant, may raise lobar capillary pressure leading to signs and symptoms such as shortness of breath, cough, and hemoptysis. Image techniques(transesophageal echocardiography, computed tomography, magnetic resonance and perfusion imaging) are essential to reach a final diagnosis and decide an appropriate therapy. In this regard, series from referral centers have shown that surgical and transcatheter interventions may improve prognosis. The purpose of this article is to review the etiology, assessment and management of PVS.

关键词： Pulmonary vein stenosis Pulmonary vein stenosis etiology Pulmonary vein stenosis causes Pulmonary vein stenosis diagnosis Pulmonary vein stenosis management Pulmonary vein stenosis treatment

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Hepatitis C: Problems to extinction and residual hepatic and extrahepatic lesions after sustained virological response

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World Journal of Hepatology 2022年第1期14卷 62-79页

作者： Sara Cuesta-Sancho Mercedes Márquez-Coello Francisco Illanes-Álvarez Denisse Márquez-Ruiz Ana Arizcorreta Fátima Galán-Sánchez Natalia Montiel Manuel Rodriguez-iglesias José-Antonio Girón-González Medicina Interna Hospital Universitario Puerta del MarFacultad de MedicinaUniversidad de CádizInstituto para la Investigación e Innovación en Ciencias Biomédicas de Cádiz(INiBICA)Cádiz 11009Spain Microbiología Hospital Universitario Puerta del MarFacultad de MedicinaUniversidad de CádizInstituto para la Investigación e Innovación en Ciencias Biomédicas de Cádiz(INiBICA)Cádiz 11009Spain

Loss of follow-up or reinfections hinder the expectations of hepatitis C eradicationdespite the existence of highly effective treatments. Moreover, the elimination ofthe infection does not imply the reversion of those chronic alterations derivedfrom the previous infection by hepatitis C virus (HCV). This review analyzes therisk factors associated with loss to follow-up in diagnosis or treatment, and thepossibility of reinfection. Likewise, it assesses the residual alterations induced bychronic HCV infection considering the liver alterations (inflammation, fibrosis,risk of decompensation, hepatocellular carcinoma, liver transplantation) and, onthe other hand, the comorbidities and extrahepatic manifestations (cryoglobulinemia,non-Hodgkin lymphoma, peripheral insulin resistance, and lipid, boneand cognitive alterations). Peculiarities present in subjects coinfected with humanimmunodeficiency virus are analyzed in each section.

关键词： Hepatitis C virus Sustained virological response Direct antiviral agents Human immunodeficiency virus Cirrhosis decompensation Hepatocarcinoma Extrahepatic complications

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Clinical and prognostic implications of atrial fibrillation in patients undergoing transcatheter aortic valve implantation

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World Journal of Cardiology 2012年第1期4卷 8-14页

作者： Pablo Salinas Raúl Moreno Luis Calvo Santiago Jiménez-Valero Guillermo Galeote Angel Sánchez-Recalde Teresa López-Fernández Sergio Garcia-Blas Diego iglesias Luis Riera Isidro Moreno-Gómez Jose mar.a Mesa Ignacio Plaza Rocio Ayala Rosa Gonzalez José-Luis López-Sendón Division of Interventional Cardiology University Hospital La Paz Unit of Echocardiography University Hospital La Paz Department of Cardiology University Hospital La Paz Vascular Surgery University Hospital La Paz Department of Cardiac Anaesthesia University Hospital La Paz Cardiac Surgery University Hospital La Paz Department of Cardiology Hospital Infanta Sofia Department of Cardiology Hospital de la Cruz Roja

AIM: To study a cohort of consecutive patients under-going transcatheter aortic valve implantation (TAVI) and compare the outcomes of atrial fibrillation (AF) patients vs patients in sinus rhythm (SR). METHODS: All consecutive patients undergoing TAVI in our hospital were included. The AF group comprised patients in AF at the time of TAVI or with history of AF, and were compared with the SR group. Procedural, echocardiographic and follow-up variables were compared. Likewise, the CHA 2 DS 2-VASC stroke risk score and HAS-BLED bleeding risk score and antithrombotic treatment at discharge in AF patients were compared with that in SR patients. RESULTS: From a total of 34 patients undergoing TAVI, 17 (50%) were allocated to the AF group, of whom 15 (88%) were under chronic oral anticoagulation. Patients in the AF group were similar to those in the SR group except for a trend (P = 0.07) for a higher logistic EuroSCORE (28% vs 19%), and a higher prevalence of hypertension (82% vs 53%) and chronic renal failure (17% vs 0%). Risk of both stroke and bleeding was high in the AF group (mean CHA 2 DS 2-VASC 4.3, mean HAS-BLED 2.9). In the AF group, treatment at discharge included chronic oral anticoagulation in all except one case, and in association with an antiplatelet drug in 57% of patients. During a mean follow-up of 11 mo (maximum 32), there were only two strokes, none of them during the peri-procedural period: one in the AF group at 30 mo and one in the SR group at 3 mo. There were no statistical differences in procedural success, and clinical outcome (survival at 1 year 81% vs 74% in AF and SR groups, respectively, P = NS). CONCLUSION: Patients in AF undergoing TAVI show a trend to a higher surgical risk. However, in our cohort, patients in AF did not have a higher stroke rate compared to the SR group, and the prognosis was similar in both groups.

关键词： Aortic stenosis Transcatheter aortic valve implantation Stroke Atrial fibrillation

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An Event Horizon Imager(EHI) Mission Concept Utilizing Medium Earth Orbit Sub-mm Interferometry

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空间科学学报 2021年第2期41卷 211-233页

作者： KUDRIASHOV V marTIN-NEIRA M ROELOFS F FALCKE H BRINKERINK C BARYSHEV A HOGERHEIJDE M YOUNG A POURSHAGHAGHI H KLEIN-WOLT M MOSCIBRODZKA M DAVELAAR J BARAT I DUESMANN B VALENTA V PERDIGUES ARMENGOL J M DE WILDE D marTIN iglesias P ALAGHA N VAN DER VORST M Department of Astrophysics/IMAPP Radboud University NijmegenP.O.Box 90106500 GL Nijmegenthe Netherlands ESTEC/ESA Keplerlaan 12201 A2 Noordurigkthe Netherlands mar Planck Institute for Radio Astrorny Auf dem Higel 69D-53121 Bon(Endenich)Germany University of Groningen Landleven 129747 AD Groningenthe Netherlands Leiden Observatory Leiden UniversityPO Box 95132300 RALeidenthe Netherlands Anton Pannekoek Institute for Astronomy University of AmsterdamScience Park 9041098 XHAmsterdamthe Netherlands Center for Computational Astrophysics Flatiron Institute162 Fifth AvenueNew YorkNY 10010USA

Submillimeter interferometry has the potential to image supermassive black holes on event horizon scales,providing tests of the theory of general relativity and increasing our understanding of black hole accretion *** Event Horizon Telescope(EHT) performs these observations from the ground,and its main imaging targets are Sagittarius A~* in the Galactic Center and the black hole at the center of the M87 ***,the EHT is fundamentally limited in its performance by atmospheric effects and sparse terrestrial(u,v)-coverage(Fourier sampling of the image).The scientific interest in quantitative studies of the horizon size and shape of these black holes has motivated studies into using space interferometry which is free of these *** resolution considerations and interstellar scattering effects push the desired observing frequency to bands above 500 *** paper presents the requirements for meeting these science goals,describes the concept of interferometry from Polar or Equatorial Medium Earth Orbits(PECMEO) which we dub the Event Horizon Imager(EHI),and utilizes suitable space technology *** this concept,two or three satellites orbit at slightly different orbital radii,resulting in a dense and uniform spiral-shaped(u,v)-coverage over *** local oscillator signals are shared via an inter-satellite link,and the data streams are correlated on-board before final processing on the ***-satellite metrology and satellite positioning are extensively employed to facilitate the knowledge of the instrument position vector,and its time *** European space heritage usable for both the front ends and the antenna technology of such an instrument is *** and future sensors for the required inter-satellite metrology are *** performance estimates and simulation results are given.

关键词： Instrumentation Space VLBI Radio Telescopes

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Membrane and Subcellular Muscle Injury Are Induced by Single or Multiple Exposure to Cigarette Smoke

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Open Journal of Pathology 2014年第3期4卷 125-137页

作者： Ana mar.a Fleig-Mayer Alba Ramirez-Sarmiento Amanda iglesias Montserrat Morla Carlos Coronell Diego Rodríguez Simona Pichinni Josep Lloreta Piergiorgio Zuccaro Xavier Busquets Joaquim Gea Jose R.Jardim Mauricio Orozco-Levi Centro Universitario do Triangulo(UNITRI) Avenida nicomedes Alves Dos Santos4545-GaveaUberlandiaPulmonary Rehabilitation CenterRespiratory DivisionFederal University of Sao PauloSao PauloBrazil Group of Research in Injury Immune Response and Function(LIF)Municipal Institute of Medical Research(IMIM)Carrer Dr.Aiguader 88BarcelonaE-08003Spain Servei de Pneumologia Hospital del MarPasseig Maritim 25BarcelonaE-08003Spain Centro en Red de Investigacion de Enfermedades Respiratorias(CIBERES) Recinto Hospital Joan March Carretera Soller Km.1207110BunyolaMallorcaIlles BalearsSpain Institut Universitari d’Investigacio en Ciencies de la Salut(IUNICS)and Department de Biologia Universitat Illes Balears(UIB)Cra de ValldemossaKm 7.5PalmaIlles BalearsSpain Laboratorio Di Biochimica Clinica Istituto Superiore Di Sanita.Viale Regina Elena 29900161RomaItaly Respiratory Department Fundacion Cardiovascular de ColombiaCalle 155A 23-58FloridablancaSantanderColombia Servei d’Anatomia Patologica Hospital del MarPasseig Maritim 25BarcelonaE-08003Spain

Cigarette smoking is the main cause of chronic obstructive pulmonary disease (COPD). Diaphragm injury is observed in patients with COPD. However, the potential role of smoking in triggering or perpetuating muscle injury is unknown. The present study was aimed at evaluating the potential role of commercial tobacco smoke as a direct cause of skeletal muscle injury in experimental conditions. Seventy Wistar rats (170 - 250 g) were assigned to smoking (n = 49) or non-smoking (n = 21) groups. The smoking groups were submitted to a single or multiple (i.e., five or thirty) daily sessions of cigarette smoking in an inhalatory chamber (time length: 2 h each session). The level of exposure was constant and assessed by CO concentrations (50 ppm) and serum cotinine analysis. Animals submitted to a single smoke exposure and the corresponding controls were euthanized in groups at 0 h, 2 h, 4 h, 24 h or 48 h after completing the exposure. Animals submitted to multiple exposures were euthanized at 0 h after smoking. Samples from vastus lateralis muscle were obtained and processed for assessing cell injury and selected protein expression. Monoclonal anti-albumin antibodies were used to identify muscle fibers with sarcolemmal (membrane) injury. Subcellular muscle injury was assessed using transmission electron microscopy (EM). MyoD, myogenin and α-tubulin were immunodetected using western blot techniques. Exposure to cigarette smoke associated with significant membrane damage (mean relative difference (MRD) with controls: +181%, p = 0.004) and sarcomere disruptions (MRD: +226%, p = 0.001). Expression of MyoD and myogenin (normalized to α-tubulin) were significantly increased at 4 h and remained increased at 48 h post-exposure. We conclude that not only a single but also consecutive exposure to tobacco smoke have acute deleterious effects on peripheral muscle structure. A rapid induction of subrogate markers of skeletal muscle stress and repair processes associates to sarcolemmal and

关键词： Skeletal Muscle Muscle Injury Muscle Regeneration Quadriceps Cigarette Smoking

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