Extracorporeal membrane oxygenation (ECMO) in the veno-arterial (VA) configuration is an established method for the treatment of refractory cardiogenic shock. Such a condition characterizes the postoperative course of approximatively 1% of cardiac surgery patients. Although some studies have reported ECMOrelated short-term results, little is known about the long-term outcomes of VA-ECMO therapy in the postcardiotomy setting. Therefore, an extensive literature search was conducted regarding articles published after 1990 reporting postoperative ECMO use. PubMed, EMBASE and Web of Science were searched for sources. In-hospital mortality was high in post-cardiotomy VA-ECMO patients, ranging from 24.8% to 52%. Long-term results were poorly reported. However, based on the limited information available, hospital survivors showed a favorable outcome, with improvement in overall clinical condition, quality of life and limited hospital readmission for cardiac-related events. To conclude, in-hospital outcome in post-cardiotomy ECMO is often unfavorable, post-discharge results show satisfactory condition, with stable improvement of overall patient clinical status and low rate of hospital readmission and cardiac-related adverse events. Data reporting is, however, scarce and hence new and detailed studies are still warranted to investigate such aspects.
IABP placement was an effective solution in order to reverse the protracted AV closure and impaired LV unloading observed during peripheral V-A ECMO support. However, the impact on the weaning rate and survival needs further investigations.
The patients were satisfied following 107 (91%) of 118 consecutive percutaneous procedures with a follow-up of 35.9 months (range 24-78 months). According to the American Orthopaedic Foot and Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal scale for the clinical assessment, a mean score of 88.2 +/- 12.9 was obtained at follow-up. The clinical results can be compared to those obtained with open techniques, with the advantages of a minimally invasive procedure.
Understanding the
interactions between nanoparticles
(NPs) and
proteins is crucial for the successful application of NPs in biological
contexts. Protein adsorption is dependent on particle size, and protein
binding to ultrasmall (1–3 nm) NPs is considered to be generally
weak. However, most studies have involved structured biomacromolecules,
while the interactions of ultrasmall NPs with intrinsically disordered
proteins (IDPs) have remained elusive. IDPs are abundant in eukaryotes
and found to associate with NPs intracellularly. As a model system,
we focused on ultrasmall gold nanoparticles (usGNPs) and tau, a cytosolic
IDP associated with Alzheimer’s disease. Using site-resolved
NMR, steady-state fluorescence, calorimetry, and circular dichroism,
we reveal that tau and usGNPs form stable multimolecular assemblies,
representing a new type of nano–bio interaction. Specifically,
the observed interaction hot spots explain the influence of usGNPs
on tau conformational transitions, with implications for the intracellular
targeting of aberrant IDP aggregation.
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