Shock cardiogénico / Cardiogenic shock

Enero 25, 2017. No. 2580

Shock cardiogénico: Falla de la entrega y uso del oxígeno Cardiogenic Shock: Failure of Oxygen Delivery and Oxygen Utilization. Lim HS1. Clin Cardiol. 2016 Aug;39(8):477-83. doi: 10.1002/clc.22564. Epub 2016 Aug 10. Abstract Cardiogenic shock remains a highly lethal condition. Conventional therapy including revascularization and mechanical circulatory support aims to improve cardiac output and oxygen delivery, but increasing basic and clinical observations indicate wider circulatory and cellular abnormalities, particularly at the advanced stages of shock. Progressive cardiogenic shock is associated with microcirculatory and cellular abnormalities. Cardiogenic shock is initially characterized by a failure to maintain global oxygen delivery; however, progressive cardiogenic shock is associated with the release of pro-inflammatory cytokines, derangement of the regulation of regional blood flow, microcirculatory abnormalities, and cellular dysoxia. These abnormalities are analogous to septic shock and may not be reversed by increase in oxygen delivery, even to supranormal levels. Earlier mechanical circulatory support in cardiogenic shock may limit the development of microcirculatory and cellular abnormalities. PDF Adrenomedulina. Un marcador de daño hemodinámico, disfunción orgánica y mal pronóstico en shock cardiogénico Adrenomedullin: a marker of impaired hemodynamics, organ dysfunction, and poor prognosis in cardiogenic shock. Tolppanen H1,2,3, Rivas-Lasarte M4,5, Lassus J6, Sans-Roselló J5, Hartmann O7, Lindholm M8, Arrigo M4,9,10, Tarvasmäki T11, Köber L8, Thiele H12, Pulkki K13,14, Spinar J15,16, Parissis J17, Banaszewski M18, Silva-Cardoso J19, Carubelli V20, Sionis A5, Harjola VP11, Mebazaa A4,21,22. Ann Intensive Care. 2017 Dec;7(1):6. doi: 10.1186/s13613-016-0229-2. Epub 2017 Jan 4. Abstract BACKGROUND: The clinical CardShock risk score, including baseline lactate levels, was recently shown to facilitate risk stratification in patients with cardiogenic shock (CS). As based on baseline parameters, however, it may not reflect the change in mortality risk in response to initial therapies. Adrenomedullin is a prognostic biomarker in several cardiovascular diseases and was recently shown to associate with hemodynamic instability in patients with septic shock. The aim of our study was to evaluate the prognostic value and association with hemodynamic parameters of bioactive adrenomedullin (bio-ADM) in patients with CS. METHODS: CardShock was a prospective, observational, European multinational cohort study of CS. In this sub-analysis, serial plasma bio-ADM and arterial blood lactate measurements were collected from 178 patients during the first 10 days after detection of CS. RESULTS: Both bio-ADM and lactate were higher in 90-day non-survivors compared to survivors at all time points (P < 0.05 for all). Lactate showed good prognostic value during the initial 24 h (AUC 0.78 at admission and 0.76 at 24 h). Subsequently, lactate returned normal (≤2 mmol/L) in most patients regardless of later outcome with lower prognostic value. By contrast, bio-ADM showed increasing prognostic value from 48 h and beyond (AUC 0.71 at 48 h and 0.80 at 5-10 days). Serial measurements of either bio-ADM or lactate were independent of and provided added value to CardShock risk score (P < 0.001 for both). Ninety-day mortality was more than double higher in patients with high levels of bio-ADM (>55.7 pg/mL) at 48 h compared to those with low bio-ADM levels (49.1 vs. 22.6%, P = 0.001). High levels of bio-ADM were associated with impaired cardiac index, mean arterial pressure, central venous pressure, and systolic pulmonary artery pressure during the study period. Furthermore, high levels of bio-ADM at 48 to 96 h were related to persistently impaired cardiac and end-organ function. CONCLUSIONS: Bio-ADM is a valuable prognosticator and marker of impaired hemodynamics in CS patients. High levels of bio-ADM may show shock refractoriness and developing end-organ dysfunction and thus help to guide therapeutic approach in patients with CS. Study identifier of CardShock study NCT01374867 at clinicaltrials.gov. KEYWORDS: Adrenomedullin; Biomarkers; Cardiogenic shock; Hemodynamics; Lactate; Mortalit PDF Conceptos actuales en choque cardiogénico Dr. Octavio González-Chon, Dr. Javier Sánchez-Zavala, Dr. Eduardo Arias-Sánchez, Dra.Sandra María del Carmen García-López Revista Mexicana de Anestesisoslogía Vol. 32. Supl. 1, Abril-Junio 2009 pp S65-S67 PDF Curso Internacional de Actualidades en Anestesiología Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Cuidad de México, Febrero 9-11, 2017 Informes  ceddem_innsz@yahoo.com  Regional Anesthesiology and Acute Pain Medicine Meeting April 6-8, 2017, San Francisco, California, USA ASRA American Society of Regional Anesthesia and Pain Medicine Información / Information California Society of Anesthesiologists Annual Meeting April 27-30, 2017 San Francisco California Información / Information

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org Copyright © 2015

Conversión directa de fibroblastos humanos en células de Schwann que facilitan la regeneración del nervio periférico lesionado in vivo

Conversión directa de fibroblastos humanos en células de Schwann que facilitan la regeneración del nervio periférico lesionado in vivo



http://www.traumaysiniestros.com.mx/academia/conversion-directa-de-fibroblastos-humanos-en-celulas-de-schwann-que-facilitan-la-regeneracion-del-nervio-periferico-lesionado-in-vivo/




Direct Conversion of Human Fibroblasts into Schwann Cells That Facilitate Regeneration of Injured Peripheral Nerve In Vivo

Fuente

Este artículo es originalmente publicado en:



http://stemcellstm.alphamedpress.org/




http://onlinelibrary.wiley.com/doi/10.1002/sctm.16-0122/abstract


De:




Sowa, Y., Kishida, T., Tomita, K., Yamamoto, K., Numajiri, T. and Mazda, O. (2017), Direct Conversion of Human Fibroblasts into Schwann Cells That Facilitate Regeneration of Injured Peripheral Nerve In Vivo. STEM CELLS Translational Medicine. doi:10.1002/sctm.16-0122



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Open Access
Creative Commons

Copyright © 2017 by AlphaMed Press



Abstract


Schwann cells (SCs) play pivotal roles in the maintenance and regeneration of the peripheral nervous system. Although transplantation of SCs enhances repair of experimentally damaged peripheral and central nerve tissues, it is difficult to prepare a sufficient number of functional SCs for transplantation therapy without causing adverse events for the donor. Here, we generated functional SCs by somatic cell reprogramming procedures and demonstrated their capability to promote peripheral nerve regeneration. Normal human fibroblasts were phenotypically converted into SCs by transducing SOX10 and Krox20 genes followed by culturing for 10 days resulting in approximately 43% directly converted Schwann cells (dSCs). The dSCs expressed SC-specific proteins, secreted neurotrophic factors, and induced neuronal cells to extend neurites. The dSCs also displayed myelin-forming capability both in vitro and in vivo. Moreover, transplantation of the dSCs into the transected sciatic nerve in mice resulted in significantly accelerated regeneration of the nerve and in improved motor function at a level comparable to that with transplantation of the SCs obtained from a peripheral nerve. The dSCs induced by our procedure may be applicable for novel regeneration therapy for not only peripheral nerve injury but also for central nerve damage and for neurodegenerative disorders related to SC dysfunction. © Stem Cells Translational Medicine 2017.



Resumen
Las células de Schwann (SC) desempeñan papeles fundamentales en el mantenimiento y la regeneración del sistema nervioso periférico. Aunque el trasplante de SC mejora la reparación de los tejidos periféricos y nerviosos centrales experimentalmente dañados, es difícil preparar un número suficiente de SC funcionales para la terapia de trasplante sin provocar eventos adversos para el donante. Aquí, hemos generado SC funcionales mediante los procedimientos de reprogramación de células somáticas y demostrado su capacidad para promover la regeneración de los nervios periféricos. Los fibroblastos humanos normales se convirtieron fenotípicamente en SC mediante la transducción de genes SOX10 y Krox20 seguido de cultivo durante 10 días, dando como resultado aproximadamente 43% de células Schwann directamente convertidas (dSCs). Los dSCs expresaron proteínas específicas de SC, factores neurotróficos secretados y células neuronales inducidas para extender las neuritas. Los dSCs también mostraron capacidad de formación de mielina tanto in vitro como in vivo. Además, el trasplante de los dSCs en el nervio ciático trasectado en ratones dio como resultado una regeneración significativamente acelerada del nervio y en función motora mejorada a un nivel comparable al de trasplante de los SC obtenidos a partir de un nervio periférico. Los dSCs inducidos por nuestro procedimiento pueden ser aplicables para la terapia de regeneración novedosa no sólo para la lesión del nervio periférico, sino también para el daño del nervio central y para los trastornos neurodegenerativos relacionados con la disfunción del SC. © Stem Cells Translational Medicine 2017.

Protocols and Manufacturing for Cell-Based Therapies
Direct Conversion of Human Fibroblasts into Schwann Cells That Facilitate Regeneration of Injured Peripheral Nerve In Vivo

Authors

Yoshihiro Sowa,


Tsunao Kishida,


Koichi Tomita,


Kenta Yamamoto,


Toshiaki Numajiri,


Osam Mazda


First published: 9 January 2017Full publication history
DOI: 10.1002/sctm.16-0122View/save citation
Cited by: 0 articles


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El biomarcador Coll2-1 demuestra la eficacia clínica del condroitin sulfato

El biomarcador Coll2-1 demuestra la eficacia clínica del condroitin sulfato



http://clinicaderodilla.xyz/academia/el-biomarcador-coll2-1-demuestra-la-eficacia-clinica-del-condroitin-sulfato/

Efecto del sulfato de condroitina en los biomarcadores solubles de la osteoartritis: un método para analizar e interpretar los resultados de un ensayo abierto en pacientes con osteoartritis unilateral de rodilla.

Effect of chondroitin sulfate on soluble biomarkers of osteoarthritis: a method to analyze and interpret the results from an open-label trial in unilateral knee osteoarthritis patients.

Fuente
Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/27716158

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5053075/

https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-016-1268-4

De:

Möller I¹, Gharbi M², Martinez Serrano H³, Herrero Barbero M³, Verges Milano J³, Henrotin Y⁴.



BMC Musculoskelet Disord. 2016 Oct 6;17(1):416.





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Author information ► Article notes ► Copyright and License information ▼

Copyright © The Author(s). 2016

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Abstract

BACKGROUND:

The aim of this study was to investigate the effects of chondroitin sulfate (CS) on the serum levels of Coll2-1 in patients with knee OA.

CONCLUSION:

This study proposes a new approach for the analysis and the interpretation of the individual variation in biomarker levels and introduces the notion of metabolic responders.

Resumen

ANTECEDENTES:
El objetivo de este estudio fue investigar los efectos del sulfato de condroitina (CS) en los niveles séricos de Coll2-1 en pacientes con OA de rodilla.


CONCLUSIÓN:
Este estudio propone un nuevo enfoque para el análisis y la interpretación de la variación individual en los niveles de biomarcadores e introduce la noción de respondedores metabólicos.

TRIAL REGISTRATION:

ID ISRCTN63795830 . The trial was retrospectively registered on 2 October, 2015.

KEYWORDS:

Biomarkers; Cartilage metabolism; Chondroitin sulfate; Osteoarthritis; Pain

PMID: 27716158   PMCID:  PMC5053075DOI:  10.1186/s12891-016-1268-4

[PubMed – in process] 

Free PMC Article

Tormenta de citoquinas / Cytokine storm

Enero 24, 2017. No. 2579 Estimad@ Dr@ Víctor Valdés:

Agentes para disminuir la tormenta de citoquinas Agents to reduce cytokine storm. Gerlach H1. F1000Res. 2016 Dec 22;5:2909. doi: 10.12688/f1000research.9092.1. eCollection 2016. Abstract The increasing insight into pathomechanisms of dysregulated host response in several inflammatory diseases led to the implementation of the term "cytokine storm" in the literature more than 20 years ago. Direct toxic effects as well as indirect immunomodulatory mechanisms during cytokine storm have been described and were the basis for the rationale to use several substances and devices in life-threatening infections and hyperinflammatory states. Clinical trials have been performed, most of them in the form of minor, investigator-initiated protocols; major clinical trials focused mostly on sepsis and septic shock. The following review tries to summarize the background, pathophysiology, and results of clinical investigations that had implications for the development of therapeutic strategies and international guidelines for the management of hyperinflammation during syndromes of cytokine storm in adult patients, predominantly in septic shock. KEYWORDS: cytokine storm; hyperinflammation; sepsis; septic shock PDF  Curso Internacional de Actualidades en Anestesiología Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Cuidad de México, Febrero 9-11, 2017 Informes  ceddem_innsz@yahoo.com  Regional Anesthesiology and Acute Pain Medicine Meeting April 6-8, 2017, San Francisco, California, USA ASRA American Society of Regional Anesthesia and Pain Medicine Información / Information California Society of Anesthesiologists Annual Meeting April 27-30, 2017 San Francisco California Información / Information

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org Copyright © 2015