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1.
Per Med ; 20(3): 251-269, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-37403731

RESUMO

Nanosensors are nanoscale devices that measure physical attributes and convert these signals into analyzable information. In preparation, for the impending reality of nanosensors in clinical practice, we confront important questions regarding the evidence supporting widespread device use. Our objectives are to demonstrate the value and implications for new nanosensors as they relate to the next phase of remote patient monitoring and to apply lessons learned from digital health devices through real-world examples.


Assuntos
Atenção à Saúde , Tecnologia , Humanos
2.
Mol Biol (Mosk) ; 57(2): 360-361, 2023.
Artigo em Russo | MEDLINE | ID: mdl-37000663

RESUMO

Type 2 Diabetes Mellitus (T2DM) and cardiac hypertrophy (CH) are among the top ten leading cause of deaths, worldwide. T2DM and cardiac hypertrophy are the chronic diseases, have close association and direct life-threatening complications like stroke, myocardial infarction, retinopathy, nephropathy, and limb amputation. In addition to other medical approaches, miRNAs-based strategy is considered most efficient for early detection of chronic diseases and also has potential for the treatment of T2DM and cardiac hypertrophy like it is being used for cancer in clinical trials. MicroRNAs (miRNAs) are single stranded (non-coding) of 20 to 22 nucleotides sequences which bind to their target mRNA upon the complimentary basis, to silence the protein expression at post transcriptional level. Bioinformatic databases are used like online mendelian inheritance in man (OMIM), gene testing registry (GTR), TargetScan and ShinyGO for validation of disease linked genes and sorting the common miRNAs in both diseases, such as miR-30-5p/101-3p.2/190-5p/506-3p/9-5p/128-3p/137/96-5p/7-5p/107/101-3p.1/98-5p/124-3p.2/124-3p.116-5p/15-5p/497-5p/ 424-5p/195-5p/1271-5p, let-7-5p. Aforementioned databases were also used for the miRNAs which have more than one disease linked genes target in each pathological condition. Such miRNAs for cardiac hypertrophy are: miR-19-3p/183-5p.2/153-3p/372-3p/302-3p/520-3p/373-3p/129-5p/144-3p/139-5p and for T2DM are: miR-27-3p/206/1-3p/181-5p. This finding would be helpful for the appropriate selection of miRNAs and to design applicable research project in future. It will require more validation by using the miRNAs expression analysis, mimic, and anti-miRNA approach to check their potential against cardiac hypertrophy and T2DM.


Assuntos
Diabetes Mellitus Tipo 2 , MicroRNAs , Humanos , MicroRNAs/genética , MicroRNAs/metabolismo , Diabetes Mellitus Tipo 2/genética , Cardiomegalia/genética , Perfilação da Expressão Gênica
3.
Resuscitation ; 136: 126-130, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30716427

RESUMO

BACKGROUND: Extracorporeal cardiopulmonary resuscitation (ECPR) is a resource-intensive tool that provides haemodynamic and respiratory support in patients who have suffered cardiac arrest. In this study, we investigated the cost-utility of ECPR (cost/QALY) in cardiac arrest patients treated at our institution. METHODS: We performed a retrospective review of patients who received ECPR following cardiac arrest between 2012 and 2018. All medical care-associated charges with ECPR and subsequent hospital admission were recorded. The quality-of-life of survivors was assessed with the Health Utilities Index Mark II. The cost-utility of ECPR was calculated with cost and quality-of-life data. RESULTS: ECPR was used in 32 patients (15/32 in-hospital, 47%) with a median age of 55.0 years (IQR 46.3-63.3 years), 59% male and 66% African American. The median duration of ECPR support was 2.1 days (IQR 0.9-3.8 days). Survival to hospital discharge was 16%. The median score of the Health Utilities Index Mark II at discharge for the survivors was 0.44 (IQR 0.32-0.52). The median operating cost for patients undergoing ECMO was $125,683 per patient (IQR $49,751-$206,341 per patient). The calculated cost-utility for ECPR was $56,156/QALY gained. CONCLUSIONS: The calculated cost-utility is within the threshold considered cost-effective in the United States (<$150,000/QALY gained). These results are comparable to the cost-effectiveness of heart transplantation for end-stage heart failure. Larger studies are needed to assess the cost-utility of ECPR and to identify whether other factors, such as patient characteristics, affect the cost-utility benefit.


Assuntos
Reanimação Cardiopulmonar/métodos , Oxigenação por Membrana Extracorpórea/economia , Custos Hospitalares/estatística & dados numéricos , Parada Cardíaca Extra-Hospitalar/terapia , Adulto , Idoso , Análise Custo-Benefício , Oxigenação por Membrana Extracorpórea/mortalidade , Feminino , Humanos , Tempo de Internação/economia , Masculino , Pessoa de Meia-Idade , Parada Cardíaca Extra-Hospitalar/economia , Parada Cardíaca Extra-Hospitalar/mortalidade , Anos de Vida Ajustados por Qualidade de Vida , Sistema de Registros , Estudos Retrospectivos
4.
Cell Mol Biol (Noisy-le-grand) ; 61(1): 30-5, 2015 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-25817343

RESUMO

Insulin is known to regulate blood—glucose level and promote its utilization as an energy source in cardiac tissues under normal physiological conditions as well as stimulates signaling pathways that involved cell growth and proliferation. Although recently insulin generated free radicals via NAD(P)H has been documented but the molecular mechanism is still under investigation. The aim of present study is to elucidate the reactive oxygen species (ROS) dependent possible role of insulin in cardiac abnormalities, including hypertrophy by regulation of antioxidants enzyme (SOD) activity. In the current study, 60 cardiac patients and 50 healthy individuals as well as the rat model with insulin administration were under investigation. Oxidant, anti—oxidant biochemical assays, hypertrophic marker expression via immunobloting and histopathology were performed. We observed statistically significant elevation of the reactive oxygen species level in the serum of patients as well as in the insulin administrated rat model, a mild expression of cardiac marker in experimental models along with abnormal histopathology of hearts. However, super oxide dismutase free radical scavenger activity was down regulated upon insulin treatment compared to control rats. Conclusively, the present study showed that over expression of insulin might stimulate cardiac hypertrophic signal via up regulation of free radicals and down regulation of antioxidants enzymes including SOD activity.


Assuntos
Cardiomegalia/fisiopatologia , Insulina/fisiologia , Espécies Reativas de Oxigênio/metabolismo , Regulação para Cima/fisiologia , Adulto , Idoso , Animais , Estudos de Casos e Controles , Modelos Animais de Doenças , Feminino , Humanos , Insulina/farmacologia , Masculino , Pessoa de Meia-Idade , Estresse Oxidativo/fisiologia , Ratos , Ratos Sprague-Dawley , Transdução de Sinais/fisiologia , Superóxido Dismutase/metabolismo
5.
Cell Death Dis ; 5: e1171, 2014 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-24722296

RESUMO

Heart failure is a leading cause of death in aging population. Cardiac hypertrophy is an adaptive reaction of the heart against cardiac overloading, but continuous cardiac hypertrophy is able to induce heart failure. We found that the level of miR-541 was decreased in angiotensin II (Ang-II) treated cardiomyocytes. Enforced expression of miR-541 resulted in a reduced hypertrophic phenotype upon Ang-II treatment in cellular models. In addition, we generated miR-541 transgenic mice that exhibited a reduced hypertrophic response upon Ang-II treatment. Furthermore, we found miR-541 is the target of microphthalmia-associated transcription factor (MITF) in the hypertrophic pathway and MITF can negatively regulate the expression of miR-541 at the transcriptional levels. MITF(ce/ce) mice exhibited a reduced hypertrophic phenotype upon Ang-II treatment. Knockdown of MITF also results in a reduction of hypertrophic responses after Ang-II treatment. Knockdown of miR-541 can block the antihypertrophic effect of MITF knockdown in cardiomyocytes upon Ang-II treatment. This indicates that the effect of MITF on cardiac hypertrophy relies on the regulation of miR-541. Our present study reveals a novel cardiac hypertrophy regulating pathway that was composed of miR-541 and MITF. Modulation of their levels may provide a new approach for tackling cardiac hypertrophy.


Assuntos
Cardiomegalia/genética , MicroRNAs/metabolismo , Angiotensina II , Animais , Cardiomegalia/patologia , Modelos Animais de Doenças , Regulação da Expressão Gênica , Masculino , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , MicroRNAs/genética , Fator de Transcrição Associado à Microftalmia/metabolismo , Transcrição Gênica
6.
Catheter Cardiovasc Interv ; 84(3): 416-25, 2014 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-24282074

RESUMO

BACKGROUND: Continuous intravenous adenosine infusion reportedly produces stable and maximal hyperemia to allow for fractional flow reserve (FFR) measurement; however, several observers have noted variation of the coronary/aortic (Pd/Pa) pressure ratio during the course of an adenosine infusion. METHODS: Pd/Pa pressure recordings during continuous peripheral intravenous adenosine infusion were examined in 51 patients (68 measurements) with data collected for at least 150 sec and for at least 30 sec after the lowest Pd/Pa reading. The lowest recorded Pd/Pa ratio was used as the true FFR value at maximal hyperemia. The highest subsequent Pd/Pa during the remaining period of adenosine infusion was recorded. A separate cohort of 12 patients had Pd/Pa values measured with both peripheral and central infusion. RESULTS: The average FFR value was 0.82 ± 0.10 and was recorded 99 ± 33 sec into the infusion. The Pd/Pa value showed a subsequent average increase of 0.08 ± 0.07 at 135 ± 32 sec. From the lowest measurement, Pd/Pa changed from a ratio ≤0.80 to >0.80 in 28% of recordings. In the cohort with matched recordings, central infusion reduced the severity (mean change of 0.08 vs. 0.11, P = 0.09) but not the incidence of Pd/Pa variability compared with peripheral infusion. CONCLUSION: Instability of Pd/Pa measurements is common over the course of a continuous intravenous adenosine infusion. FFR remains valid as the lowest value of Pd/Pa observed, however, Pd/Pa variability may subsequently occur and complicate pullback measurements for serial or multiple lesions.


Assuntos
Adenosina/administração & dosagem , Doença da Artéria Coronariana/diagnóstico , Vasos Coronários/fisiopatologia , Reserva Fracionada de Fluxo Miocárdico/efeitos dos fármacos , Idoso , Cateterismo Cardíaco , Angiografia Coronária , Doença da Artéria Coronariana/fisiopatologia , Vasos Coronários/efeitos dos fármacos , Feminino , Seguimentos , Reserva Fracionada de Fluxo Miocárdico/fisiologia , Humanos , Infusões Intravenosas , Masculino , Estudos Retrospectivos , Vasodilatadores/administração & dosagem
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