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Chivasso P, Mastrogiovanni G, Bruno VD, Miele M, Colombino M, Triggiani D, Cafarelli F, Leone R, Rosapepe F, De Martino M, Morena E, Iesu I, Citro R, Masiello P, Iesu S. Systematic total arch replacement with thoraflex hybrid graft in acute type A aortic dissection: A single centre experience. Front Cardiovasc Med 2022; 9:997961. [PMID: 36312248 PMCID: PMC9614841 DOI: 10.3389/fcvm.2022.997961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 09/20/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction In the last two decades, a more aggressive approach has been encouraged to treat patients with acute type A aortic dissection (ATAAD), extending the repair to the aortic arch and proximal descending thoracic aorta with the frozen elephant trunk (FET) implantation. Here, we report our single-centre experience with the FET technique for the systematic treatment of emergency type A aortic dissection. Materials and methods Between December 2017 and January 2022, 69 consecutive patients were admitted with ATAAD; of those, 66 patients (62.9 ± 10.2 years of age, 81.8% men) underwent emergency hybrid aortic arch and FET repair with the multibranched Thoraflex hybrid graft and were enrolled in the study. Primary endpoints were 30 days- and in-hospital mortality. Secondary endpoints were postoperative morbidity and follow-up survival. To better clarify the impact of age on surgical outcomes, we have divided the study population into two groups: group A for patients <70 years of age (47 patients), and group B for patients ≥70 years (19 patients). Time-to-event analysis has been conducted using the Log-rank test and is displayed with Kaplan-Meier curves. A multiple Cox proportional Hazard model was developed to identify predictors of long-term survival with a stepwise backward/forward selection process. Results 30-days- and in-hospital mortality were 10.6 and 13.6%, respectively. Stroke occurred in three (4.5%) patients. Two (3.0%) patients experienced spinal cord ischemia. We did not find any statistically significant difference between the two groups in terms of main post-operative outcomes. The multivariable Cox proportional hazard model showed left ventricular ejection fraction (HR: 0.83, 95% CI: 0.79–0.92, p < 0.01), peripheral vascular disease (HR: 15.8, 95% CI: 3.9–62.9, p < 0.01), coronary malperfusion (HR: 0.10, 95% CI: 0.01–0.77, p =0.03), lower limbs malperfusion (HR: 5.1, 95% CI: 1.10–23.4, p = 0.04), and cardiopulmonary bypass time (HR: 1.02, 95% CI: 1–1.04, p = 0.01) as independent predictors of long term mortality. Conclusions Frozen elephant trunk repair to treat emergency type A aortic dissection appears to be associated with good early and mid-term clinical outcomes even in the elderly.
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Affiliation(s)
- Pierpaolo Chivasso
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy,*Correspondence: Pierpaolo Chivasso ;
| | - Generoso Mastrogiovanni
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Vito Domenico Bruno
- Bristol Medical School, Translational Health Science Department, Bristol, United Kingdom
| | - Mario Miele
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Mario Colombino
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Donato Triggiani
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Francesco Cafarelli
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Rocco Leone
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Felice Rosapepe
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Matteo De Martino
- Department of Cardiac Anesthesia, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Elvira Morena
- Department of Cardiac Anesthesia, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Ivana Iesu
- Department of Cardiology, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Rodolfo Citro
- Department of Cardiology, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Paolo Masiello
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Severino Iesu
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
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Campione E, Lanna C, Cosio T, Rosa L, Conte MP, Iacovelli F, Romeo A, Falconi M, Del Vecchio C, Franchin E, Lia MS, Minieri M, Chiaramonte C, Ciotti M, Nuccetelli M, Terrinoni A, Iannuzzi I, Coppeta L, Magrini A, Bernardini S, Sabatini S, Rosapepe F, Bartoletti PL, Moricca N, Di Lorenzo A, Andreoni M, Sarmati L, Miani A, Piscitelli P, Squillaci E, Valenti P, Bianchi L. Lactoferrin as Antiviral Treatment in COVID-19 Management: Preliminary Evidence. Int J Environ Res Public Health 2021; 18:ijerph182010985. [PMID: 34682731 PMCID: PMC8535893 DOI: 10.3390/ijerph182010985] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/04/2021] [Accepted: 10/13/2021] [Indexed: 01/08/2023]
Abstract
Lactoferrin (Lf), a multifunctional cationic glycoprotein synthesized by exocrine glands and neutrophils, possesses an in vitro antiviral activity against SARS-CoV-2. Thus, we conducted an in vivo preliminary study to investigate the antiviral effect of oral and intranasal liposomal bovine Lf (bLf) in asymptomatic and mild-to-moderate COVID-19 patients. From April 2020 to June 2020, a total of 92 mild-to-moderate (67/92) and asymptomatic (25/92) COVID-19 patients were recruited and divided into three groups. Thirty-two patients (14 hospitalized and 18 in home-based isolation) received only oral and intranasal liposomal bLf; 32 hospitalized patients were treated only with standard of care (SOC) treatment; and 28, in home-based isolation, did not take any medication. Furthermore, 32 COVID-19 negative, untreated, healthy subjects were added for ancillary analysis. Liposomal bLf-treated COVID-19 patients obtained an earlier and significant (p < 0.0001) SARS-CoV-2 RNA negative conversion compared to the SOC-treated and untreated COVID-19 patients (14.25 vs. 27.13 vs. 32.61 days, respectively). Liposomal bLf-treated COVID-19 patients showed fast clinical symptoms recovery compared to the SOC-treated COVID-19 patients. In bLf-treated patients, a significant decrease in serum ferritin, IL-6, and D-dimers levels was observed. No adverse events were reported. These observations led us to speculate a potential role of bLf in the management of mild-to-moderate and asymptomatic COVID-19 patients.
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Affiliation(s)
- Elena Campione
- Dermatology Unit, Department of Systems Medicine, Tor Vergata University Hospital, 00133 Rome, Italy; (C.L.); (T.C.); (L.B.)
- Correspondence:
| | - Caterina Lanna
- Dermatology Unit, Department of Systems Medicine, Tor Vergata University Hospital, 00133 Rome, Italy; (C.L.); (T.C.); (L.B.)
| | - Terenzio Cosio
- Dermatology Unit, Department of Systems Medicine, Tor Vergata University Hospital, 00133 Rome, Italy; (C.L.); (T.C.); (L.B.)
| | - Luigi Rosa
- Department of Public Health and Infectious Diseases, University of Rome “La Sapienza”, 00185 Rome, Italy; (L.R.); (M.P.C.); (P.V.)
| | - Maria Pia Conte
- Department of Public Health and Infectious Diseases, University of Rome “La Sapienza”, 00185 Rome, Italy; (L.R.); (M.P.C.); (P.V.)
| | - Federico Iacovelli
- Structural Bioinformatics Group, Department of Biology, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.I.); (A.R.); (M.F.)
| | - Alice Romeo
- Structural Bioinformatics Group, Department of Biology, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.I.); (A.R.); (M.F.)
| | - Mattia Falconi
- Structural Bioinformatics Group, Department of Biology, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.I.); (A.R.); (M.F.)
| | - Claudia Del Vecchio
- Department of Molecular Medicine, University of Padova, 35122 Padova, Italy; (C.D.V.); (E.F.)
| | - Elisa Franchin
- Department of Molecular Medicine, University of Padova, 35122 Padova, Italy; (C.D.V.); (E.F.)
| | - Maria Stella Lia
- Department of Experimental Medicine, Tor Vergata University Hospital, 00133 Rome, Italy; (M.S.L.); (M.M.); (A.T.)
| | - Marilena Minieri
- Department of Experimental Medicine, Tor Vergata University Hospital, 00133 Rome, Italy; (M.S.L.); (M.M.); (A.T.)
| | - Carlo Chiaramonte
- Department of Statistics, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Marco Ciotti
- Virology Unit, Tor Vergata University Hospital, 00133 Rome, Italy;
| | - Marzia Nuccetelli
- Laboratory Medicine, Department of Experimental Medicine and Surgery, Tor Vergata University Hospital, 00133 Rome, Italy; (M.N.); (S.B.)
| | - Alessandro Terrinoni
- Department of Experimental Medicine, Tor Vergata University Hospital, 00133 Rome, Italy; (M.S.L.); (M.M.); (A.T.)
| | - Ilaria Iannuzzi
- Occupational Medicine Department, University of Rome “Tor Vergata”, 00133 Rome, Italy; (I.I.); (L.C.); (A.M.)
| | - Luca Coppeta
- Occupational Medicine Department, University of Rome “Tor Vergata”, 00133 Rome, Italy; (I.I.); (L.C.); (A.M.)
| | - Andrea Magrini
- Occupational Medicine Department, University of Rome “Tor Vergata”, 00133 Rome, Italy; (I.I.); (L.C.); (A.M.)
| | - Sergio Bernardini
- Laboratory Medicine, Department of Experimental Medicine and Surgery, Tor Vergata University Hospital, 00133 Rome, Italy; (M.N.); (S.B.)
| | | | | | | | - Nicola Moricca
- Villa dei Pini Hospital, 00042 Anzio, Italy; (S.S.); (N.M.)
| | - Andrea Di Lorenzo
- Infectious Disease Unit, Tor Vergata University Hospital, 00133 Rome, Italy; (A.D.L.); (M.A.); (L.S.)
| | - Massimo Andreoni
- Infectious Disease Unit, Tor Vergata University Hospital, 00133 Rome, Italy; (A.D.L.); (M.A.); (L.S.)
| | - Loredana Sarmati
- Infectious Disease Unit, Tor Vergata University Hospital, 00133 Rome, Italy; (A.D.L.); (M.A.); (L.S.)
| | - Alessandro Miani
- Department of Environmental Sciences and Policy, University of Milan, 20133 Milan, Italy;
| | - Prisco Piscitelli
- UNESCO Chair on Health Education and Sustainable Development, University of Naples Federico II, 80131 Naples, Italy;
| | - Ettore Squillaci
- Department of Diagnostic and Molecular Imaging, Radiation Therapy and Interventional Radiology, University Hospital Tor Vergata, 00133 Rome, Italy;
| | - Piera Valenti
- Department of Public Health and Infectious Diseases, University of Rome “La Sapienza”, 00185 Rome, Italy; (L.R.); (M.P.C.); (P.V.)
| | - Luca Bianchi
- Dermatology Unit, Department of Systems Medicine, Tor Vergata University Hospital, 00133 Rome, Italy; (C.L.); (T.C.); (L.B.)
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Campione E, Lanna C, Cosio T, Rosa L, Conte MP, Iacovelli F, Romeo A, Falconi M, Del Vecchio C, Franchin E, Lia MS, Minieri M, Chiaramonte C, Ciotti M, Nuccetelli M, Terrinoni A, Iannuzzi I, Coppeda L, Magrini A, Bernardini S, Sabatini S, Rosapepe F, Bartoletti PL, Moricca N, Di Lorenzo A, Andreoni M, Sarmati L, Miani A, Piscitelli P, Valenti P, Bianchi L. Lactoferrin Against SARS-CoV-2: In Vitro and In Silico Evidences. Front Pharmacol 2021; 12:666600. [PMID: 34220505 PMCID: PMC8242182 DOI: 10.3389/fphar.2021.666600] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 03/08/2021] [Indexed: 12/14/2022] Open
Abstract
Lactoferrin (Lf) is a cationic glycoprotein synthetized by exocrine glands and is present in all human secretions. It is also secreted by neutrophils in infection and inflammation sites. This glycoprotein possesses antimicrobial activity due to its capability to chelate two ferric ions per molecule, as well as to interact with bacterial and viral anionic surface components. The cationic features of Lf bind to cells, protecting the host from bacterial and viral injuries. Its anti-inflammatory activity is mediated by the ability to enter inside the nucleus of host cells, thus inhibiting the synthesis of proinflammatory cytokine genes. In particular, Lf down-regulates the synthesis of IL-6, which is involved in iron homeostasis disorders and leads to intracellular iron overload, favoring viral replication and infection. The well-known antiviral activity of Lf has been demonstrated against DNA, RNA, and enveloped and naked viruses and, therefore, Lf could be efficient in counteracting also SARS-CoV-2 infection. For this purpose, we performed in vitro assays, proving that Lf exerts an antiviral activity against SARS-COV-2 through direct attachment to both SARS-CoV-2 and cell surface components. This activity varied according to concentration (100/500 μg/ml), multiplicity of infection (0.1/0.01), and cell type (Vero E6/Caco-2 cells). Interestingly, the in silico results strongly supported the hypothesis of a direct recognition between Lf and the spike S glycoprotein, which can thus hinder viral entry into the cells. These in vitro observations led us to speculate a potential supplementary role of Lf in the management of COVID-19 patients.
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Affiliation(s)
- Elena Campione
- Dermatology Unit, Department of Systems Medicine, Tor Vergata University Hospital, Rome, Italy
| | - Caterina Lanna
- Dermatology Unit, Department of Systems Medicine, Tor Vergata University Hospital, Rome, Italy
| | - Terenzio Cosio
- Dermatology Unit, Department of Systems Medicine, Tor Vergata University Hospital, Rome, Italy
| | - Luigi Rosa
- Department of Public Health and Infectious Diseases, University of Rome "La Sapienza", Rome, Italy
| | - Maria Pia Conte
- Department of Public Health and Infectious Diseases, University of Rome "La Sapienza", Rome, Italy
| | - Federico Iacovelli
- Department of Biology, Structural Bioinformatics Group, University of Rome "Tor Vergata", Rome, Italy
| | - Alice Romeo
- Department of Biology, Structural Bioinformatics Group, University of Rome "Tor Vergata", Rome, Italy
| | - Mattia Falconi
- Department of Biology, Structural Bioinformatics Group, University of Rome "Tor Vergata", Rome, Italy
| | | | - Elisa Franchin
- Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Maria Stella Lia
- Department of Experimental Medicine, Tor Vergata University Hospital, Rome, Italy
| | - Marilena Minieri
- Department of Experimental Medicine, Tor Vergata University Hospital, Rome, Italy
| | - Carlo Chiaramonte
- Department of Statistics, University of Rome Tor Vergata, Rome, Italy
| | - Marco Ciotti
- Virology Unit, Tor Vergata University Hospital, Rome, Italy
| | - Marzia Nuccetelli
- Laboratory Medicine, Department of Experimental Medicine and Surgery, Tor Vergata University Hospital, Rome, Italy
| | - Alessandro Terrinoni
- Department of Experimental Medicine, Tor Vergata University Hospital, Rome, Italy
| | - Ilaria Iannuzzi
- Occupational Medicine Department, University of Rome "Tor Vergata", Rome, Italy
| | - Luca Coppeda
- Occupational Medicine Department, University of Rome "Tor Vergata", Rome, Italy
| | - Andrea Magrini
- Occupational Medicine Department, University of Rome "Tor Vergata", Rome, Italy
| | - Sergio Bernardini
- Laboratory Medicine, Department of Experimental Medicine and Surgery, Tor Vergata University Hospital, Rome, Italy
| | | | | | | | | | - Andrea Di Lorenzo
- Infectious Disease Unit, Tor Vergata University Hospital, Rome, Italy
| | - Massimo Andreoni
- Infectious Disease Unit, Tor Vergata University Hospital, Rome, Italy
| | - Loredana Sarmati
- Infectious Disease Unit, Tor Vergata University Hospital, Rome, Italy
| | - Alessandro Miani
- Department of Environmental Sciences and Policy, University of Milan, Milan, Italy
| | - Prisco Piscitelli
- UNESCO Chair on Health Education and Sustainable Development, University of Naples Federico II, Naples, Italy
| | - Piera Valenti
- Department of Public Health and Infectious Diseases, University of Rome "La Sapienza", Rome, Italy
| | - Luca Bianchi
- Dermatology Unit, Department of Systems Medicine, Tor Vergata University Hospital, Rome, Italy
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Cafiero C, Rosapepe F, Palmirotta R, Re A, Ottaiano MP, Benincasa G, Perone R, Varriale E, D'Amato G, Cacciamani A, Micera A, Pisconti S. Angiotensin System Polymorphisms' in SARS-CoV-2 Positive Patients: Assessment Between Symptomatic and Asymptomatic Patients: A Pilot Study. Pharmgenomics Pers Med 2021; 14:621-629. [PMID: 34079337 PMCID: PMC8166347 DOI: 10.2147/pgpm.s303666] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/29/2021] [Indexed: 12/12/2022]
Abstract
Introduction The renin-angiotensin-aldosterone system (RAAS), a metabolic cascade regulating pressure and circulating blood volume, has been considered the main system involved in the pathogenesis of severe lung injury and organs decline in COVID-19 patients. The angiotensin I-converting enzyme (ACE1), angiotensin-converting enzyme 2 (ACE2), angiotensinogen (AGT) and receptors angiotensin II receptor type 1 (AGTR1) are key factors for SARS-CoV-2 entering in the cells, sodium and water retention with an increase blood pressure, promotion of fibrotic and inflammatory phenomena resulting in a cytokine storm. Methods In this pilot study, the frequencies of six polymorphisms in the ACE1, ACE2, AGT and AGTR1 genes were analysed in symptomatic patients affected by COVID-19 and compared with the results obtained from asymptomatic subjects. Results Thus, we have identified that rs2074192 (ACE2), rs1799752 (ACE1) and rs699 (AGT) SNPs could potentially be a valuable tool for predicting the clinical outcome of SARS-CoV-2 infected patients. A genetic predisposition may be prospected for severe internal organ damages and poor prognosis in patients with COVID-19 disease, as observed in symptomatic vs asymptomatic. Conclusion This study provides evidence that analysis of RAAS polymorphisms could be considered the key point in understanding and predicting the SARS-CoV-2 course infection.
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Affiliation(s)
| | - Felice Rosapepe
- Cardiothoracic Surgery Department, Pineta Grande Hospital, Castelvolturno, CE, Italy
| | - Raffaele Palmirotta
- Interdisciplinary Department of Medicine, School of Medicine, University of Bari 'Aldo Moro', Bari, Italy
| | - Agnese Re
- Catholic University of Sacred Heart, Rome, Italy
| | - Maria Pia Ottaiano
- Department of Molecular Medicine and Medical Biotechnology, University of Federico II, Naples, Italy
| | - Giulio Benincasa
- Department of Clinical Pathology and Molecular Biology, Pineta Grande Hospital, Castel Volturno, CE, Italy
| | - Romina Perone
- Anesthesiology Department, Pineta Grande Hospital, Castelvolturno, CE, Italy
| | | | - Gerardo D'Amato
- Endocrine and Metabolic Surgery, A Gemelli Polyclinic Foundation, Rome, Italy
| | - Andrea Cacciamani
- Research Laboratories in Ophthalmology, IRCCS - Fondazione Bietti, Rome, Italy
| | - Alessandra Micera
- Research Laboratories in Ophthalmology, IRCCS - Fondazione Bietti, Rome, Italy
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Masiello P, Longobardi A, Mastrogiovanni G, Colombino M, Panza A, Cafarelli F, Del Negro G, Triggiani D, Rosapepe F, Iesu S. EP19 INFERIOR REVERSED J SHAPED MINI STERNOTOMY FOR MITRAL VALVE SURGERY. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549954.32347.fd] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Colombino M, Longobardi A, Panza A, Mastrogiovanni G, Masiello P, Del Negro G, Rosapepe F, Bisogno A, Di Domenico A, Iesu S. OC76 THE MORE PROCEDURE (MININVASIVE, OPCAB, RAPID SURGICAL INTENSIVE CARE UNIT EXIT, EXTUBATION INTO THE OPERATING ROOM). J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549915.34133.ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Palma G, Rosapepe F, Vicchio M, Russolillo V, Cioffi S, Vosa C. Late perforation of right atrium and aortic root after percutaneous closure of patent foramen ovale. J Thorac Cardiovasc Surg 2007; 134:1054-5. [PMID: 17903534 DOI: 10.1016/j.jtcvs.2007.06.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2007] [Accepted: 06/22/2007] [Indexed: 10/22/2022]
Affiliation(s)
- Gaetano Palma
- Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, Naples, Italy
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Rossi M, Parenti G, Della Casa R, Romano A, Mansi G, Agovino T, Rosapepe F, Vosa C, Del Giudice E, Andria G. Long-term enzyme replacement therapy for pompe disease with recombinant human alpha-glucosidase derived from chinese hamster ovary cells. J Child Neurol 2007; 22:565-73. [PMID: 17690063 DOI: 10.1177/0883073807302598] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Pompe disease is a rare autosomal recessive myopathy due to the deficiency of lysosomal acid alpha-glucosidase. Clinical phenotypes range from the severe classic infantile form (hypotonia and hypertrophic cardiomyopathy), to milder late onset forms (skeletal myopathy and absence of significant heart involvement). Enzyme replacement therapy with recombinant human alpha-glucosidase derived from either rabbit milk or Chinese hamster ovary cells has been introduced and is undergoing clinical trials. Reported is a long-term follow-up of 3 Pompe patients presenting without cardiomyopathy, treated with recombinant human alpha-glucosidase derived from Chinese hamster ovary cells. This study suggests that enzyme replacement therapy can lead to significant motor and respiratory improvement in the subgroup of patients who start the therapy before extensive muscle damage has occurred. The recombinant enzyme derived from Chinese hamster ovary cells, administered at doses significantly higher than previously reported, appears to have the same safety as the drug derived from rabbit milk.
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Abstract
Giancarlo Rastelli (1933-1970) was a pioneer cardiac surgeon who developed a classification of atrioventricular canal and a novel surgical procedure that revolutionized the management of children with congenital heart disease. Rastelli lived a short, yet fascinating life. His work was ahead of its time and laid the foundation for the treatment of complex congenital cardiac anomalies.
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Affiliation(s)
- Igor E Konstantinov
- Division of Cardiovascular Surgery, Hospital for Sick Children, Toronto, Ontario, Canada.
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Abstract
Reconstruction was accomplished in a 2 heart-lung recipients with situs inversus resulting in a left-sided systemic venous atrium. We created a large common atrium that was closed on the left side, leaving an atrial cuff on the inferior right quadrant. To this we anastomosed the donor right atrium, which had been opened laterally between the cavae. This resulted in some clockwise rotation of the ventricles and anterior positioning of the apex. The right pulmonary veins passed superior to the atrial anastomosis and posterior to the donor right atrium. Cardiopulmonary function was excellent in both cases.
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Affiliation(s)
- G Rábago
- Department of Cardiovascular and Thoracic Surgery, University of Arizona, Tucson, USA
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