ABSTRACT
Using methods on cardiac catheterization from ANCALAR complete data from reporting year 2020 are now available. The rate of diagnostic coronary angiography procedures (CAG;-8,7%), total acute plus non-acute PCI (-9.9%), including non-acute PCI (-9.5%), interventions for acute PCI (-10.6%) and including STEMI-PCI (-6.8%) declined during the pandemic year 2020 for the first time compared to the years before. Moreover left ventricular angiography (-12.2%), right heart catheterization (-17.3%), myocardial biopsies (-42.5%), PCI for chronic total occlusions (CTO;-14.1%), clot catcher (-10.3%), and rotablator procedures (-6.7%), as well as electrophysiologic diagnostics (-8.3%) und therapies (ablations;-6.9%) decreased in 2020 compared to 2019 in 27 Austrian Catheterization Laboratories. It is possible that patients suffering from acute, subacute or chronic symptoms presented less frequently in tertiary centres. Private Institutions rather increased the rate of elective procedures during the pandemic year 2020 (elective non acute PCI +9.7%) in contrast to the Austrian trend. Private Institutions but decreased the rate of acute PCI (-40,5%) on a basis of low numbers in pre-existing procedures. On the other hand in non-private Institutions in five centres there was an increase in STEMI-PCI by 23% in contrast to the Austrian decreasing trend. Possibly due to limited access to surgical intensive care wards during the pandemic, percutaneous aortic valve implantations (TAVI;+4.3%), percutaneous Mitral-Clipping (+28%) and defect closure procedures (+2.2%) within Cathlabs increased in 2020 within the whole country, compared to all the years before. This new trend in cardiac procedures within catheterization laboratories was not expected fora whole year and is now documented for Austria correlating to results in the Swedish Coronary Angiography and Angioplasty Registry (SCAAR). The presentation is also available at http://iik.i-med.ac.at.
ABSTRACT
The anti-inflammatory action of adrenal-derived glucocorticoids has been recognized since several decades. This knowledge has found broad application in the clinics and today synthetic glucocorticoids are widely used in the treatment of various inflammatory diseases. However, the use of synthetic glucocorticoids in the treatment of diseases associated with viral infections of epithelial surfaces, like the lung or the intestine, is still under debate and seems not as efficient as desired. Basic research on the anti-viral immune responses and on regulatory mechanisms in the prevention of immunopathological disorders, however, has led us back again to focus on endogenous glucocorticoid synthesis. It has become established that this synthesis is not restricted to the adrenal glands alone, but that numerous tissues also produce glucocorticoids in situ. Extra-adrenal derived glucocorticoids have the capacity to locally control and maintain immune homeostasis under steady-state and inflammatory conditions. Here, we discuss the current knowledge of extra-adrenal glucocorticoid synthesis in the lung and the intestine, and its role in the regulation of anti-viral immune responses.