Publications

With the high initial success rates for coronary angioplasty that are reported regularly, it has become increasingly difficult to demonstrate methods or techniques that are able to provide more beneficial early results than can be achieved by conventional angioplasty. On the other hand, the incidence of late restenosis has remained much the same over the 10 years that angioplasty has been part of clinical practice, and there is still no proved intervention that modifies the restenosis process. Therefore, the problem of restenosis has assumed increasing relevance in determining the clinical value of coronary angioplasty and, accordingly, studies that address the problem of restenosis need to become more exacting. Although numerous articles have addressed the problem of restenosis in the clinical setting, many defining certain factors associated with restenosis and possible interventions to reduce the incidence of restenosis, there is surprisingly little consensus. Most of the discrepancies can be attributed to three factors: 1) the selection of patients, 2) the method of analysis, and 3) the definition of restenosis employed. This review shows how these three factors influence the outcome and conclusions of restenosis studies.

<h3>Background</h3> Transarterial chemoembolization (TACE) is the therapy which have chosen in 50-60% of patients with Hepatocellular carcinoma (HCC). Recently, Hepatoma Arterial Embolization (HAP) score stratifies patients who will benefit from the first TACE. We conducted a survey to investigate the value of HAP score in the prognosis of HCC treated with TACE in Vietnam. <h3>Methods</h3> Prospective cohort study in patients with HCC and first TACE at the Department of Internal Medicine, Hanoi Medical University Hospital, Vietnam, from January 2017 to June 2021. The HAP score (serum albumin 0.9 mg/dl, alpha-foetoprotein &gt;400 ng/ml, and tumor size &gt;7 cm), and ALBI score was applied before first TACE, mortality and survival were observed with a follow-up of 54 months. <h3>Results</h3> We included 106 patients with age of 62.8 ± 10.1 years. In this population, HCC risk factor was mainly hepatitis B with 75.5% (80/106). The HAP score classified 19, 41, 31 and 15 patients as HAP A, B, C and D, respectively, (IDDF2021-ABS-0070 Table 1). The median follow–up time was 37.5±1.2 months for HAP A, 40.8±2.9 months for HAP B, 24.0±2.5 months for HAP C and 20.4±4.1 months for HAP D. There were no deaths at the first year in HAP A. The cumulative proportion surviving at first years for HAP B, C, D was 97.4; 77.9 and 66.7, respectively. At 36 months, this percentage for HAP A, B, C and D was 92.3; 72.5; 31.1 and 27.1, respectively, (IDDF2021-ABS-0070 Table 2). Survival of all subgroups differed significantly from each other (each p &lt; 0.05) (IDDF2021-ABS-0070 Figure 2. Kaplan-Meier curve for HAP score). Area under the curve for receiver operating characteristic of HAP score was 0.71 and higher than this of ALBI grade (0.57) (IDDF2021-ABS-0070 Figure 3. ROC curves for HAP score and ALBI grade), indicating a significant performance of HAP score compared with ALBI grade in prognosis of HCC treated with TACE. <h3>Conclusions</h3> HAP is a useful score to assist for the management decisions of patients with HCC requiring TACE due to its value in predicting mortality and survival.

Background Currently, no data are available on the direct comparison between the Absorb everolimus-eluting bioresorbable vascular scaffold (Absorb BVS) and conventional metallic drug-eluting stents. Methods The ABSORB II study is a randomized, active-controlled, single-blinded, multicenter clinical trial aiming to compare the second-generation Absorb BVS with the XIENCE everolimus-eluting metallic stent. Approximately 501 subjects will be enrolled on a 2:1 randomization basis (Absorb BVS/XIENCE stent) in approximately 40 investigational sites across Europe and New Zealand. Treated lesions will be up to 2 de novo native coronary artery lesions, each located in different major epicardial vessels, all with an angiographic maximal luminal diameter between 2.25 and 3.8 mm as estimated by online quantitative coronary angiography (QCA) and a lesion length of ≤48 mm. Clinical follow-up is planned at 30 and 180 days and at 1, 2, and 3 years. All subjects will undergo coronary angiography, intravascular ultrasound (IVUS) and IVUS–virtual histology at baseline (pre–device and post–device implantation) and at 2-year angiographic follow-up. The primary end point is superiority of the Absorb BVS vs XIENCE stent in terms of vasomotor reactivity of the treated segment at 2 years, defined as the QCA quantified change in the mean lumen diameter prenitrate and postnitrate administration. The coprimary end point is the noninferiority (reflex to superiority) of the QCA-derived minimum lumen diameter at 2 years postnitrate minus minimum lumen diameter postprocedure postnitrate by QCA. In addition, all subjects allocated to the Absorb BVS group will undergo multislice computed tomography imaging at 3 years. Conclusions The ABSORB II randomized controlled trial (ClinicalTrials.gov NCT01425281) is designed to compare the safety, efficacy, and performance of Absorb BVS against the XIENCE everolimus-eluting stent in the treatment of de novo native coronary artery lesions.

No abstract is provided for this article.

Beta 2-adrenoreceptor agonists and glucocorticosteroids are the two most effective treatments for asthma and are often used in combination. Glucocorticoids mediate their anti-inflammatory effects through the action of activated glucocorticoid receptors (GRs). Many of the effects of GRs on the synthesis of cytokines and other inflammatory mediators are due to a direct interaction with other deoxyribonucleic acid (DNA)-binding proteins belonging to the basic leucine zipper (bZIP) group of transcription factors, such as activator protein-1 (AP-1) and nuclear factor-kappa B (NF-kappa B). Beta 2-agonists are potent bronchodilators at low doses and at high doses can activate gene transcription via a bZIP protein, cyclic adenosine monophosphate (cAMP) response element binding protein (CREB). Activated GRs and CREB can interact with each other within the nucleus to modulate both DNA-binding and gene transcription in either a positive or inhibitory manner, depending on cell type. In lung cells, high doses of beta 2-agonists reduce the ability of GR to bind DNA, a process which is mediated by CREB activation. Inhibition of GR DNA-binding by CREB raises the possibility that high-dose beta 2-agonists could have functional antiglucocorticoid activity and may be a basis for the reported increase in asthma morbidity and mortality in industrialized countries, which have increasing per capita beta 2-agonist use.

<b>Background</b> Chronic obstructive pulmonary disease (COPD) is an inflammatory lung condition, associated with accelerated lung aging. Immune cells in aging diseases display features of senescence (immunosenescence) and chronic inflammation (inflammaging). COPD macrophages are more pro-inflammatory and have defective phagocytic function, but features of senescence in COPD macrophages is not well studied. <b>Aim</b> To examine expression of senescence markers in macrophages from healthy and COPD subjects, in the presence and absence of oxidative stress (H₂O₂). <b>Methods</b> Peripheral blood monocytes were isolated from age-matched non-smokers (NS) (n=9) and COPD patients (n=12) and then cultured in GM-CSF for 12 days to generate monocyte-derived macrophages (MDM). MDM were then treated with ±200µM&nbsp;H₂O₂ for 48h and expression of senescence markers was measured using qPCR. <b>Results</b> At baseline, COPD MDM have increased expression of senescence markers p21CIP1 (2-fold, p&gt;0.05), p27 (2.6-fold, p&lt;0.05) and reduced anti-aging molecule, sirtuin (SIRT)6 (49%, p&lt;0.05) and increased expression of senescence associated secretory phenotype (SASP) factors interleukin (IL)6 (50-fold, p&lt;0.05) and CXCL8 (127-fold, p&lt;0.01), compared to age-matched MDM from NS. In the presence of oxidative stress (H₂O₂), COPD MDM have further increased expression of p21CIP1 (2-fold, p&lt;0.05), p27 (25%, p&gt;0.05), IL6 (8-fold, p&lt;0.05), CXCL8 (10-fold, p&lt;0.01) and reduced SIRT1 (23%, p&gt;0.05) and SIRT6 (61%, p&lt;0.05), compared to age-matched NS. <b>Conclusion</b> COPD MDM have elevated expression of senescence and SASP markers compared to healthy MDM and are more susceptible to oxidative stress induced senescence. This maybe associated with the altered macrophage phenotype in COPD.

Summary Preliminary investigation suggests that some asthmatic patients find it difficult to synchronize the release of a metered dose from a pressurized aerosol with the correct phase of inspiration. An automatic device has been developed to overcome this problem. Information is presented outlining the physical characteristics of the unit and the methods used to establish its performance in patients. It is suggested that the device may have a place in the management of asthma.