A Sample-saving preparation to extract DNA-binding proteins from cardiac and vascular tissues.
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Animals↗
Biomedical subjects
Roberto Ferrari
Publications and source records attributed to Roberto Ferrari.
Future strategies of reverse remodeling prevention of hibernation.
A complex interrelationship exists among chronic ischemic left ventricular dysfunction, persistence of myocardial viability and possibility to limit progression of chronic heart failure. Cardiac remodeling is influenced by several factors still under investigation. Hibernation is basically an adaptive mechanism to chronically abnormal coronary blood flow, characterized by metabolic and structural alterations of the cardiac tissue, that are fully recovered upon revascularization. The estimate of the prevalence of myocardial viability in patients with chronic ischemic left ventricular dysfunction is crucial and different figures can be obtained by applying different diagnostic techniques and analyzing different cohorts of patients. In patients with chronic heart failure and substantial areas of myocardial ischemia and viability, revascularization is likely to prolong survival. The amount of viable myocardium needed to be clinically relevant remains to be established: only randomized prospective studies, focusing on both functional improvement and prognosis, will give an evidence-based conclusion. An aggressive and thoughtful surgical approach to patients with ischemic heart failure can yield satisfying long-term results, with survival rates superior to medical management alone, and can constitute a true and valid alternative to heart transplantation.
Heart Failure↗
[Echocardiography with reconstructed M-mode: technical aspects and clinical applications].
Reconstructed M-mode imaging is a new post-processing technique that permits the reconstruction of any cardiac structure and flow from cine-loops of different sources (tissue, color Doppler and tissue Doppler cine-loops) in M-mode format. This technique can be useful in a number of clinical situations and can facilitate the echocardiographic examination, allowing for correct and easy M-mode analysis to be performed at any time, both at the patient's bedside as well as off-line. In this paper the fundamental technical features and current clinical applications of reconstructed M-mode imaging are illustrated and discussed.
Arrhythmias, Cardiac↗
[Refractory heart failure. Antagonism of tumor necrosis factor alpha and endothelin in humans: 2 promises still to be honored].
Excessive biohumoral activation participates in the pathophysiology and progression of congestive heart failure (CHF). Pharmacological inhibition of the renin-angiotensin-aldosterone and beta-adrenergic systems improves the mortality and morbidity of this disease. Among other detrimental molecules, two local factors, tumor necrosis factor (TNF)-alpha and endothelin (ET) both contribute to the worsening of CHF. TNF-alpha can induce many of the cellular modifications typically associated with CHF, such as myocyte death, interstitial tissue derangement and negative inotropism. On the other hand ET promotes vasoconstriction, and cell growth and proliferation. On the premise of some favorable experimental studies, selective antagonism of TNF-alpha or ET has been tested in clinical trials in order to control the progression of or even reverse CHF. However, contrasting results have been obtained so far with either approach, in accordance with other unfavorable data from animal models of heart failure. Etanercept (Enbrel, a recombinant dimer of two p75sTNFR molecules fused to the Fc fragment of human IgG1) has proved to be useful and effective in basic and animal experiments, while contrasting data have been reported on humans. The Randomized EtaNErcept Worldwide evALuation (RENEWAL) trial has recently been prematurely stopped due to impossibility of showing statistically significant results with the pre-specified sample size. Results of phase II to III clinical trials on different ET receptor antagonists in CHF have yielded conflicting results, so that none of the agents of this class have been labeled for CHF. The mechanisms by which TNF-alpha and ET might exert their negative biological actions are discussed together with an analysis of the possible reasons why they have failed so far in human CHF.
Animals↗
[Quality system Vision 2000].
A recent document of the Italian Ministry of Health points out that all structures which provide services to the National Health System should implement a Quality System according to the ISO 9000 standards. Vision 2000 is the new version of the ISO standard. Vision 2000 is less bureaucratic than the old version. The specific requests of the Vision 2000 are: a) to identify, to monitor and to analyze the processes of the structure, b) to measure the results of the processes so as to ensure that they are effective, d) to implement actions necessary to achieve the planned results and the continual improvement of these processes, e) to identify customer requests and to measure customer satisfaction. Specific attention should be also dedicated to the competence and training of the personnel involved in the processes. The principles of the Vision 2000 agree with the principles of total quality management. The present article illustrates the Vision 2000 standard and provides practical examples of the implementation of this standard in cardiological departments.
Italy↗