Preeclampsia: What Does the Father Have to Do with It?

Preeclampsia (PE) is one of the leading causes of maternal and fetal morbidity and mortality, with incidence rates ranging between 2 and 5 % in the Western World. The exact causes of the disease remain largely unknown, because of the complex pathophysiologic mechanisms involved in the process. Genetic, environmental, and epigenetic parameters have been implicated by various authors as culprits for the pathogenesis of PE. Recent reports in the literature highlight the paternal role. Still, the exact extent and mechanism remain elusive. In this systematic review, we attempt to present data regarding the paternal role in a concise and comprehensive manner.

Christian Andreas Doppler: A legendary man inspired by the dazzling light of the stars.

Christian Andreas Doppler is renowned primarily for his revolutionary theory of the Doppler effect, which has deeply influenced many areas of modern science and technology, including medicine. His work has laid the foundations for modern ultrasonography and his ideas are still inspiring discoveries more than a hundred years after his death. Doppler may well earn the title of Homo Universalis for his broad knowledge of physics, mathematics and astronomy and most of all for his indefatigable investigations for new ideas and his ingenious mind. According to Bolzano: "It is hard to believe how fruitful a genius Austria has in this man". His legacy of scientific achievement have seen Doppler honoured in the later years on coinage and money, names of streets, educational institutions, rock groups, even of a lunar crater; while the ultimate tribute to his work is the countless references to the homonymous medical eponym.

Myocardial structure and matrix metalloproteinases.

Metalloproteinases (MMPs) are enzymes which enhance proteolysis of extracellular matrix proteins. The pathophysiologic and prognostic role of MMPs has been demonstrated in numerous studies. The present review covers a wide a range of topics with regards to MMPs structural and functional properties, as well as their role in myocardial remodeling in several cardiovascular diseases. Moreover, the clinical and therapeutic implications from their assessment are highlighted.

Ultrasound contrast agents: updated data on safety profile.

Contrast echocardiography represents a major technological advancement in the constantly evolving field of cardiovascular imaging. Over the last twenty years numerous studies have been published, illustrating the incremental value of contrast implementation into a variety of clinical scenarios. However, serious concerns have been raised about contrast safety profile, mainly based on postmarketing observational data and several animal studies. The latter have investigated contrast bio effects under experimental conditions that are not consistent with daily clinical practice. On the other hand, numerous clinical trials with large registries have proven otherwise. Not only contrast agents are efficient, but they also demonstrate a remarkable safety profile. So the question is: should we fear contrast utilization or should we consider them as an adjunctive and indispensable clinical tool for daily bedside practice?

Contrast echo: really safe after all?

Echocardiography has been integrated into clinical practice as an indispensable tool providing adjunctive diagnostic and prognostic information, crucial for optimal patient management. In addition, contrast echocardiography is regarded as a major technological breakthrough in the field of cardiovascular imaging as it provides not only images of superior quality, but also extents the clinical application of echocardiography in a variety of clinical scenarios including the assessment of coronary artery disease, cardiomyopathies and structural heart disease. However, several experimental studies and data deriving from post-market observations have put contrast agents to the test due to raised concerns regarding their safety profile. Specifically, animal studies have demonstrated detrimental bioeffects, presumably attributed to a phenomenon called inertial cavitation, which lead to endothelial dysfunction of various organs including the heart. Therefore, the European Medicines Agency (EMEA) and the Food and Drug Administration (FDA), in 2004 and 2007 respectively, issued warnings, according to which contrast implementation in echocardiography was considered hazardous, as it was connected to fatalities occurring several minutes after intravenous infusion. On the other hand, multiple large clinical trials have contradicted contrast incrimination, by illustrating an excellent safety profile of contrast agent utilization in a variety of clinical settings such as hospitalized patient in the Intensive Care Unit and stress echocardiography, condition that could render patients prone to ischemic and arrhythmic events. Moreover, the documented clinical efficacy of contrast agents has led both the EMEA and the FDA to reconsider their initial statements and reinstate contrast deployment during echocardiographic examinations. As a result, the American Society of Echocardiography published in 2008 a consensus statement, according to which an extended list of applications was recommended.