251
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Rossano JW, Jang GY. Pediatric heart failure: current state and future possibilities. Korean Circ J 2015; 45:1-8. [PMID: 25653697 PMCID: PMC4310974 DOI: 10.4070/kcj.2015.45.1.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 10/07/2014] [Indexed: 01/16/2023] Open
Abstract
Heart failure is a complex pathophysiological syndrome that can occur in children from a variety of diseases, including cardiomyopathies, myocarditis, and congenital heart disease. The condition is associated with a high rate of morbidity and mortality and places a significant burden on families of affected children and to society as a whole. Current medical therapy is taken largely from the management of heart failure in adults, though clear survival benefit of these medications are lacking. Ventricular assist devices (VADs) have taken an increasingly important role in the management of advanced heart failure in children. The predominant role of these devices has been as a bridge to heart transplantation, and excellent results are currently achieved for most children with cardiomyopathies. There is an ongoing investigation to improve outcomes in high-risk populations, such as small infants and those with complex congenital heart disease, including patients with functionally univentricular hearts. Additionally, there is an active investigation and interest in expansion of VADs beyond the predominant utilization as a bridge to a heart transplant into ventricular recovery, device explant without a heart transplantation (bridge to recovery), and placement of devices without the expectation of recovery or transplantation (destination therapy).
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Affiliation(s)
- Joseph W Rossano
- The Cardiac Center, The Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Gi Young Jang
- Department of Pediatrics, Korea University Hospital, Ansan, Korea
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252
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Roy A, Guatimosim S, Prado VF, Gros R, Prado MAM. Cholinergic activity as a new target in diseases of the heart. Mol Med 2015; 20:527-37. [PMID: 25222914 DOI: 10.2119/molmed.2014.00125] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 09/09/2014] [Indexed: 12/21/2022] Open
Abstract
The autonomic nervous system is an important modulator of cardiac signaling in both health and disease. In fact, the significance of altered parasympathetic tone in cardiac disease has recently come to the forefront. Both neuronal and nonneuronal cholinergic signaling likely play a physiological role, since modulating acetylcholine (ACh) signaling from neurons or cardiomyocytes appears to have significant consequences in both health and disease. Notably, many of these effects are solely due to changes in cholinergic signaling, without altered sympathetic drive, which is known to have significant adverse effects in disease states. As such, it is likely that enhanced ACh-mediated signaling not only has direct positive effects on cardiomyocytes, but it also offsets the negative effects of hyperadrenergic tone. In this review, we discuss recent studies that implicate ACh as a major regulator of cardiac remodeling and provide support for the notion that enhancing cholinergic signaling in human patients with cardiac disease can reduce morbidity and mortality. These recent results support the idea of developing large clinical trials of strategies to increase cholinergic tone, either by stimulating the vagus or by increased availability of Ach, in heart failure.
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Affiliation(s)
- Ashbeel Roy
- Robarts Research Institute, The University of Western Ontario, London, Ontario, Canada.,Department of Physiology and Pharmacology, The University of Western Ontario, London, Ontario, Canada
| | - Silvia Guatimosim
- Department of Physiology and Biophysics, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Vania F Prado
- Robarts Research Institute, The University of Western Ontario, London, Ontario, Canada.,Department of Physiology and Pharmacology, The University of Western Ontario, London, Ontario, Canada.,Department of Anatomy and Cell Biology, The University of Western Ontario, London, Ontario, Canada
| | - Robert Gros
- Robarts Research Institute, The University of Western Ontario, London, Ontario, Canada.,Department of Physiology and Pharmacology, The University of Western Ontario, London, Ontario, Canada.,Department of Medicine, University of Western Ontario, London, Ontario, Canada
| | - Marco A M Prado
- Robarts Research Institute, The University of Western Ontario, London, Ontario, Canada.,Department of Physiology and Pharmacology, The University of Western Ontario, London, Ontario, Canada.,Department of Anatomy and Cell Biology, The University of Western Ontario, London, Ontario, Canada
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253
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Tanaka S, Tanaka S, Kawakami K. Methodological issues in observational studies and non-randomized controlled trials in oncology in the era of big data. Jpn J Clin Oncol 2015; 45:323-7. [PMID: 25589456 DOI: 10.1093/jjco/hyu220] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Non-randomized controlled trials, cohort studies and database studies are appealing study designs when there are urgent needs for safety data, outcomes of interest are rare, generalizability is a matter of concern, or randomization is not feasible. This paper reviews four typical case studies from methodological viewpoints and clarifies how to minimize bias in observational studies in oncology. In summary, researchers planning observational studies should be cautious of selection of appropriate databases, validity of algorithms for identifying outcomes, comparison with incident users or self-control, rigorous collection of information on potential confounders and reporting details of subject selection. Further, a careful study protocol and statistical analysis plan are also necessary.
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Affiliation(s)
- Shiro Tanaka
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
| | - Sachiko Tanaka
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
| | - Koji Kawakami
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
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254
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Biondi-Zoccai G, Abbate A, Benedetto U, Palmerini T, D'Ascenzo F, Frati G. Network meta-analysis for evidence synthesis: what is it and why is it posed to dominate cardiovascular decision making? Int J Cardiol 2015; 182:309-14. [PMID: 25585376 DOI: 10.1016/j.ijcard.2015.01.023] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 12/22/2014] [Accepted: 01/04/2015] [Indexed: 02/08/2023]
Abstract
Clinical decision-making requires synthesis of an often complex evidence base. Novel tools have been developed building upon the historical approach of reviewing the literature focusing on a specific topic. Stemming from qualitative reviews, systematic reviews of randomized clinical trials, typically encompassing statistical pooling with pairwise meta-analysis, have been devised and are now considered one of the uppermost ladders in the hierarchy of clinical evidence. In the last decade, the exponential growth in randomized trials and the introduction of original computational methods have created the novel opportunity to compare indirectly competing treatments, as well as combining effect estimates stemming from head-to-head trials with those obtained by indirect comparisons. These methods include adjusted indirect comparison meta-analysis, network meta-analysis, and mixed treatment comparison. While still the focus of intense research and debate, they represent a powerful tool for evidence synthesis and comparative effectiveness in cardiovascular research, and thus are likely to become increasingly popular and impactful in shaping research agenda and clinical practice. This is clearly highlighted by a number of recent landmark network meta-analyses on smoking cessation therapies, coronary stents, and management of patent foramen ovale in patients with history of cryptogenic stroke.
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Affiliation(s)
- Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; Eleonora Lorillard Spencer Cenci Foundation, Rome, Italy; VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA.
| | - Antonio Abbate
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Umberto Benedetto
- Department of Cardiac Surgery, Harefield Hospital, London, United Kingdom
| | - Tullio Palmerini
- Dipartimento Cardio-Toraco-Vascolare, University of Bologna, Italy
| | | | - Giacomo Frati
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy
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255
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Kim J, Park SW, Lee Y, Seo H. Clinical Outcomes of Robot-assisted Arm Rehabilitation in Stroke Patients. BRAIN & NEUROREHABILITATION 2015. [DOI: 10.12786/bn.2015.8.1.46] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Jungsoo Kim
- Myongji Choonhey Rehabilitation Hospital, Korea
| | | | | | - Hyojin Seo
- Myongji Choonhey Rehabilitation Hospital, Korea
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256
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Atturu G, Homer-Vanniasinkam S, Russell DA. Pharmacology in peripheral arterial disease: what the interventional radiologist needs to know. Semin Intervent Radiol 2014; 31:330-7. [PMID: 25435658 DOI: 10.1055/s-0034-1393969] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Peripheral arterial disease (PAD) is a progressive disease with significant morbidity and mortality. Risk factor control, using diet and lifestyle modification, exercise, and pharmacological methods, improves symptoms and reduces associated cardiovascular events in these patients. Antiplatelet agents and anticoagulants may be used to reduce the incidence of acute events related to thrombosis. The armamentarium available for symptom relief and disease modification is discussed. Novel treatments such as therapeutic angiogenesis are in their evolutionary phase with promising preclinical data.
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Affiliation(s)
- Gnaneswar Atturu
- Leeds Vascular Institute, Leeds General Infirmary, Leeds, United Kingdom
| | | | - David A Russell
- Leeds Vascular Institute, Leeds General Infirmary, Leeds, United Kingdom
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257
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Králíková E, Kmeťová A, Štěpánková L, Zvolská K, Felbrová V, Kulovaná S, Bortlíček Z, Blaha M, Fraser K. Tobacco dependence, the most important cardiovascular risk factor: treatment in the Czech Republic. Physiol Res 2014; 63:S361-8. [PMID: 25428741 DOI: 10.33549/physiolres.932864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Smoking is the most important cardiovascular (CV) risk factor. Stopping smoking halves the CV risk. Every clinician should provide a brief intervention with smokers. Intensive treatment should be available to those who need it. There are 37 Centers for Tobacco Dependence in the Czech Republic, which offer treatment including a psychobehavioral intervention and pharmacotherapy (varenicline, nicotine, bupropion). Czech physicians, pharmacists and nurses are regularly educated about smoking cessation. We describe the results of intensive treatment offered by our centers. Treatment includes screening (1 h), an intervention (2 h), and follow-up visits during the next 12 months. Among 3532 patients, 34.3 % had CO-validated abstinence at 12-months (including 489 patients who attended the screening visit + only the 12-month follow up visit). Among patients who underwent the intervention, the abstinence rate was 38.2 %. The majority of patients who underwent the intervention (N=2470) used some form of pharmacotherapy. After one year, the abstinence rate was 43.4 %, compared to 15.9 % (N=573) without pharmacotherapy. Only 28 % of patients came on the recommendation of a physician. Despite the decrease in CV risk following smoking cessation and the effectiveness of treatment, centers are underutilized.
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Affiliation(s)
- E Králíková
- Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.
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258
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Sharma A, Thakar S, Lavie CJ, Garg J, Krishnamoorthy P, Sochor O, Arbab-Zadeh A, Lichstein E. Cardiovascular adverse events associated with smoking-cessation pharmacotherapies. Curr Cardiol Rep 2014; 17:554. [PMID: 25410148 DOI: 10.1007/s11886-014-0554-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Smoking continues to be the leading cause of preventable deaths in the USA, accounting for one in every five deaths every year, and cardiovascular (CV) disease remains the leading cause of those deaths. Hence, there is increasing awareness to quit smoking among the public and counseling plays an important role in smoking cessation. There are different pharmacological methods to help quit smoking that includes nicotine replacement products available over the counter, including patch, gum, and lozenges, to prescription medications, such as bupropion and varenicline. There have been reports of both nonserious and serious adverse CV events associated with the use of these different pharmacological methods, especially varenicline, which has been gaining media attention recently. Therefore, we systematically reviewed the various pharmacotherapies used in smoking cessation and analyzed the evidence behind these CV events reported with these therapeutic agents.
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Affiliation(s)
- Abhishek Sharma
- Division of Cardiovascular Medicine, State University of New York Downstate Medical Center, Brooklyn, NY, USA,
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259
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Zhao WW, Chen R, Dai PP, Li XL, Xu JJ, Chen HY. A General Strategy for Photoelectrochemical Immunoassay Using an Enzyme Label Combined with a CdS Quantum Dot/TiO2 Nanoparticle Composite Electrode. Anal Chem 2014; 86:11513-6. [DOI: 10.1021/ac503969e] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Wei-Wei Zhao
- State Key Laboratory of Analytical
Chemistry for Life Science, School of Chemistry and Chemical Engineering, Nanjing University, Nanjing 210093, Jiangsu, China
| | - Ru Chen
- State Key Laboratory of Analytical
Chemistry for Life Science, School of Chemistry and Chemical Engineering, Nanjing University, Nanjing 210093, Jiangsu, China
| | - Pan-Pan Dai
- State Key Laboratory of Analytical
Chemistry for Life Science, School of Chemistry and Chemical Engineering, Nanjing University, Nanjing 210093, Jiangsu, China
| | - Xiang-Ling Li
- State Key Laboratory of Analytical
Chemistry for Life Science, School of Chemistry and Chemical Engineering, Nanjing University, Nanjing 210093, Jiangsu, China
| | - Jing-Juan Xu
- State Key Laboratory of Analytical
Chemistry for Life Science, School of Chemistry and Chemical Engineering, Nanjing University, Nanjing 210093, Jiangsu, China
| | - Hong-Yuan Chen
- State Key Laboratory of Analytical
Chemistry for Life Science, School of Chemistry and Chemical Engineering, Nanjing University, Nanjing 210093, Jiangsu, China
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260
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Lu X, Huang B, Zheng J, Tao Y, Yu W, Tang L, Zhu R, Li S, Li L. Decompressive craniectomy for the treatment of malignant infarction of the middle cerebral artery. Sci Rep 2014; 4:7070. [PMID: 25400113 PMCID: PMC4233335 DOI: 10.1038/srep07070] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 10/28/2014] [Indexed: 11/09/2022] Open
Abstract
Early decompressive craniectomy (DC) has been shown to reduce mortality in malignant middle cerebral artery (MCA) infarction, whereas efficacy of DC on functional outcome is inconclusive. Here, we performed a meta-analysis to estimate the effects of DC on malignant MCA infarction and investigated whether age of patients and timing of surgery influenced the efficacy. We systematically searched PubMed, Medline, Embase, Cochrane library, Web of Science update to June 2014. Finally, A total of 14 studies involved 747 patients were included, of which 8 were RCTs (341 patients). The results demonstrated that early DC (within 48 h after stroke onset) decreased mortality (OR = 0.14, 95%CI = 0.08, 0.25, p<0.0001) and number of patients with poor functional outcome (modified Rankin scale (mRS)>3) (OR = 0.38, 95%CI = 0.20, 0.73, p = 0.004) for 12 months follow-up. In the subgroup analysis stratified by age, early DC improved outcome both in younger and older patients. However, later DC (after 48h after stroke onset) might not have a benefit effect on lowering mortality or improving outcome in patients with malignant infarction. Together, this study suggested that decompressive surgery undertaken within 48 h reduced mortality and increased the number of patients with a favourable outcome in patients with malignant MCA infarction.
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Affiliation(s)
- XiaoCheng Lu
- Department of Neurosurgery, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu, 210029, China
| | - BaoSheng Huang
- Department of Neurosurgery, Sir Run Run Shaw Hospital, Nanjing Medical University, Long Mian Road, Nanjing, Jiangsu, 211166, China
| | - JinYu Zheng
- 1] Department of Neurosurgery, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu, 210029, China [2] Department of Neurosurgery, The Affiliated Huai'an Hospital of Xuzhou Medical College, No. 62 South Huaihai Road, Huai'an, 223002, China
| | - Yi Tao
- Department of Neurosurgery, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu, 210029, China
| | - Wan Yu
- Department of Neurosurgery, Jiangsu Province Hospital on the Intergration of Chinese and Western Medicine, Nanjing university of Traditional Chinese Medicine, Nanjing, 210028, China
| | - LinJun Tang
- Department of Neurosurgery, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu, 210029, China
| | - RongLan Zhu
- Department of Neurosurgery, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu, 210029, China
| | - Shuai Li
- Department of Neurosurgery, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu, 210029, China
| | - LiXin Li
- Department of Neurosurgery, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu, 210029, China
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261
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Barry AR, Koshman SL, Pearson GJ. Adverse drug reactions: The importance of maintaining pharmacovigilance. Can Pharm J (Ott) 2014; 147:233-8. [PMID: 25360149 DOI: 10.1177/1715163514536523] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Arden R Barry
- Mazankowski Alberta Heart Institute (Barry, Koshman, Pearson), Alberta Health Services, Edmonton
| | - Sheri L Koshman
- Mazankowski Alberta Heart Institute (Barry, Koshman, Pearson), Alberta Health Services, Edmonton
| | - Glen J Pearson
- Mazankowski Alberta Heart Institute (Barry, Koshman, Pearson), Alberta Health Services, Edmonton
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262
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Pok S, Vitale F, Eichmann SL, Benavides OM, Pasquali M, Jacot JG. Biocompatible carbon nanotube-chitosan scaffold matching the electrical conductivity of the heart. ACS NANO 2014; 8:9822-32. [PMID: 25233037 PMCID: PMC4212726 DOI: 10.1021/nn503693h] [Citation(s) in RCA: 132] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 09/18/2014] [Indexed: 05/21/2023]
Abstract
The major limitation of current engineered myocardial patches for the repair of heart defects is that insulating polymeric scaffold walls hinder the transfer of electrical signals between cardiomyocytes. This loss in signal transduction results in arrhythmias when the scaffolds are implanted. We report that small, subtoxic concentrations of single-walled carbon nanotubes, on the order of tens of parts per million, incorporated in a gelatin-chitosan hydrogel act as electrical nanobridges between cardiomyocytes, resulting in enhanced electrical coupling, synchronous beating, and cardiomyocyte function. These engineered tissues achieve excitation conduction velocities similar to native myocardial tissue (22 ± 9 cm/s) and could function as a full-thickness patch for several cardiovascular defect repair procedures, such as right ventricular outflow track repair for Tetralogy of Fallot, atrial and ventricular septal defect repair, and other cardiac defects, without the risk of inducing cardiac arrhythmias.
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Affiliation(s)
- Seokwon Pok
- Department of Bioengineering and Department of Chemical & Biomolecular Engineering, Department of Chemistry, Department of Materials Science & NanoEngineering, and The Smalley Institute for Nanoscale Science & Technology, Rice University, Houston, Texas 77005, United States
| | - Flavia Vitale
- Department of Bioengineering and Department of Chemical & Biomolecular Engineering, Department of Chemistry, Department of Materials Science & NanoEngineering, and The Smalley Institute for Nanoscale Science & Technology, Rice University, Houston, Texas 77005, United States
| | - Shannon L. Eichmann
- Department of Bioengineering and Department of Chemical & Biomolecular Engineering, Department of Chemistry, Department of Materials Science & NanoEngineering, and The Smalley Institute for Nanoscale Science & Technology, Rice University, Houston, Texas 77005, United States
| | - Omar M. Benavides
- Department of Bioengineering and Department of Chemical & Biomolecular Engineering, Department of Chemistry, Department of Materials Science & NanoEngineering, and The Smalley Institute for Nanoscale Science & Technology, Rice University, Houston, Texas 77005, United States
| | - Matteo Pasquali
- Department of Bioengineering and Department of Chemical & Biomolecular Engineering, Department of Chemistry, Department of Materials Science & NanoEngineering, and The Smalley Institute for Nanoscale Science & Technology, Rice University, Houston, Texas 77005, United States
| | - Jeffrey G. Jacot
- Department of Bioengineering and Department of Chemical & Biomolecular Engineering, Department of Chemistry, Department of Materials Science & NanoEngineering, and The Smalley Institute for Nanoscale Science & Technology, Rice University, Houston, Texas 77005, United States
- Division of Congenital Heart Surgery, Texas Children’s Hospital, Houston, Texas 77030, United States
- Address correspondence to
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263
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Macrophage migration inhibitory factor (MIF) knockout preserves cardiac homeostasis through alleviating Akt-mediated myocardial autophagy suppression in high-fat diet-induced obesity. Int J Obes (Lond) 2014; 39:387-96. [PMID: 25248618 PMCID: PMC4355049 DOI: 10.1038/ijo.2014.174] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 09/05/2014] [Accepted: 09/17/2014] [Indexed: 12/20/2022]
Abstract
Background Macrophage migration inhibitory factor (MIF) plays a role in the development of obesity and diabetes. However, whether MIF plays a role in fat diet-induced obesity and associated cardiac anomalies still remains unknown. The aim of this study was to examine the impact of MIF knockout on high fat diet-induced obesity, obesity-associated cardiac anomalies and the underlying mechanisms involved with a focus on Akt-mediated autophagy. Methods Adult male wild-type (WT) and MIF knockout (MIF−/−) mice were placed on 45% high fat diet for 5 months. Oxygen consumption, CO2 production, respiratory exchange ratio (RER), locomotor activity, and heat generation were measured using energy calorimeter. Echocardiographic, cardiomyocyte mechanical and intracellular Ca2+ properties were assessed. Apoptosis was examined using TUNEL staining and western blot analysis. Akt signaling pathway and autophagy markers were evaluated. Cardiomyocytes isolated from WT and MIF−/− mice were treated with recombinant mouse MIF (rmMIF). Results High fat diet feeding elicited increased body weight gain, insulin resistance, and caloric disturbance in WT and MIF−/− mice. High fat diet induced unfavorable geometric, contractile and histological changes in the heart, the effects of which were alleviated by MIF knockout. In addition, fat diet-induced cardiac anomalies were associated with Akt activation and autophagy suppression, which were nullified by MIF deficiency. In cardiomyocytes from WT mice, autophagy was inhibited by exogenous rmMIF through Akt activation. In addition, MIF knockout rescued palmitic acid-induced suppression of cardiomyocyte autophagy, the effect of which was nullified by rmMIF. Conclusions These results indicate that MIF knockout preserved obesity-associated cardiac anomalies without affecting fat diet-induced obesity, probably through restoring myocardial autophagy in an Akt-dependent manner. Our findings provide new insights for the role of MIF in obesity and associated cardiac anomalies.
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264
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Kohli P, Whelton SP, Hsu S, Yancy CW, Stone NJ, Chrispin J, Gilotra NA, Houston B, Ashen MD, Martin SS, Joshi PH, McEvoy JW, Gluckman TJ, Michos ED, Blaha MJ, Blumenthal RS. Clinician's guide to the updated ABCs of cardiovascular disease prevention. J Am Heart Assoc 2014; 3:e001098. [PMID: 25246448 PMCID: PMC4323829 DOI: 10.1161/jaha.114.001098] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
To facilitate the guideline-based implementation of treatment recommendations in the ambulatory setting and to encourage participation in the multiple preventive health efforts that exist, we have organized several recent guideline updates into a simple ABCDEF approach. We would remind clinicians that evidence-based medicine is meant to inform recommendations but that synthesis of patient-specific data and use of appropriate clinical judgment in each individual situation is ultimately preferred.
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Affiliation(s)
- Payal Kohli
- Division of Cardiology, University of California San Francisco (UCSF), San Francisco, CA (P.K.)
| | - Seamus P. Whelton
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD (S.P.W., S.H., J.C., N.A.G., B.H., D.A., S.S.M., P.H.J., J.W.M.E., T.J.G., E.D.M., M.J.B., R.S.B.)
| | - Steven Hsu
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD (S.P.W., S.H., J.C., N.A.G., B.H., D.A., S.S.M., P.H.J., J.W.M.E., T.J.G., E.D.M., M.J.B., R.S.B.)
| | - Clyde W. Yancy
- Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL (C.W.Y., N.J.S.)
| | - Neil J. Stone
- Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL (C.W.Y., N.J.S.)
| | - Jonathan Chrispin
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD (S.P.W., S.H., J.C., N.A.G., B.H., D.A., S.S.M., P.H.J., J.W.M.E., T.J.G., E.D.M., M.J.B., R.S.B.)
| | - Nisha A. Gilotra
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD (S.P.W., S.H., J.C., N.A.G., B.H., D.A., S.S.M., P.H.J., J.W.M.E., T.J.G., E.D.M., M.J.B., R.S.B.)
| | - Brian Houston
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD (S.P.W., S.H., J.C., N.A.G., B.H., D.A., S.S.M., P.H.J., J.W.M.E., T.J.G., E.D.M., M.J.B., R.S.B.)
| | - M. Dominique Ashen
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD (S.P.W., S.H., J.C., N.A.G., B.H., D.A., S.S.M., P.H.J., J.W.M.E., T.J.G., E.D.M., M.J.B., R.S.B.)
| | - Seth S. Martin
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD (S.P.W., S.H., J.C., N.A.G., B.H., D.A., S.S.M., P.H.J., J.W.M.E., T.J.G., E.D.M., M.J.B., R.S.B.)
| | - Parag H. Joshi
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD (S.P.W., S.H., J.C., N.A.G., B.H., D.A., S.S.M., P.H.J., J.W.M.E., T.J.G., E.D.M., M.J.B., R.S.B.)
| | - John W. McEvoy
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD (S.P.W., S.H., J.C., N.A.G., B.H., D.A., S.S.M., P.H.J., J.W.M.E., T.J.G., E.D.M., M.J.B., R.S.B.)
| | - Ty J. Gluckman
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD (S.P.W., S.H., J.C., N.A.G., B.H., D.A., S.S.M., P.H.J., J.W.M.E., T.J.G., E.D.M., M.J.B., R.S.B.)
| | - Erin D. Michos
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD (S.P.W., S.H., J.C., N.A.G., B.H., D.A., S.S.M., P.H.J., J.W.M.E., T.J.G., E.D.M., M.J.B., R.S.B.)
| | - Michael J. Blaha
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD (S.P.W., S.H., J.C., N.A.G., B.H., D.A., S.S.M., P.H.J., J.W.M.E., T.J.G., E.D.M., M.J.B., R.S.B.)
| | - Roger S. Blumenthal
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD (S.P.W., S.H., J.C., N.A.G., B.H., D.A., S.S.M., P.H.J., J.W.M.E., T.J.G., E.D.M., M.J.B., R.S.B.)
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265
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Detection of ischaemic heart disease in symptomatic women. Nat Rev Cardiol 2014; 11:505-6. [DOI: 10.1038/nrcardio.2014.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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266
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Zevallos J, Santiago F, González J, Rodríguez A, Pericchi L, Rodríguez-Mercado R, Nobo U. Burden of stroke in Puerto Rico. Int J Stroke 2014; 10:117-9. [PMID: 25141980 DOI: 10.1111/ijs.12350] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 06/30/2014] [Indexed: 11/30/2022]
Abstract
Stroke is the fifth leading cause of death and the first cause of long-term disability in Puerto Rico. Trained staff reviewed and independently validated the medical records of patients who had been hospitalized with possible stroke at any of the 20 largest hospitals located in Puerto Rico during 2007, 2009, and 2011. The mean age of the 5005 newly diagnosed stroke patients (51·2% female) was 70 years. At the time of hospitalization, women were 4½ years older, were less likely to be married (60·2% vs. 39·9%, P < 0·001), smoked less (5·8% vs. 13·4%, P < 0·001), and had significantly higher proportion of diabetes (56·0% vs. 54·8%), hypertension (89·1% vs. 85·0%), and low density lipoprotein-cholesterol (LDL-Chol) > 100 mg/dL (65·7% vs. 57·5%) P < 0·05. Ischemic stroke represented 75% of all types of strokes. Atrial fibrillation was mentioned in 7·9% of the medical records. The risk for dying before discharge was similar for both genders, but was 40% higher for women than for men at one-year follow-up: age-adjusted odds ratio = 1·4 (95% confidence interval = 1·2-1·5).
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Affiliation(s)
- Juan Zevallos
- FIU Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA
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267
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Abraham WT, Stough WG, Piña IL, Linde C, Borer JS, De Ferrari GM, Mehran R, Stein KM, Vincent A, Yadav JS, Anker SD, Zannad F. Trials of implantable monitoring devices in heart failure: which design is optimal? Nat Rev Cardiol 2014; 11:576-85. [DOI: 10.1038/nrcardio.2014.114] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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268
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Abstract
Targeting a specific blood pressure based upon patient risk has been the approach to reducing cardiovascular risk in patients with hypertension. Drug selection was based upon compelling indications with titration and the addition of other agents as needed until the blood pressure target was achieved. However, new information has emerged describing improved methods for measuring blood pressure, a re-evaluation of blood pressure targets and additional therapeutic approaches that together may further reduce cardiovascular risk in patients with hypertension.
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269
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270
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Maurovich-Horvat P, Ferencik M, Voros S, Merkely B, Hoffmann U. Comprehensive plaque assessment by coronary CT angiography. Nat Rev Cardiol 2014; 11:390-402. [PMID: 24755916 DOI: 10.1038/nrcardio.2014.60] [Citation(s) in RCA: 250] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Most acute coronary syndromes are caused by sudden luminal thrombosis due to atherosclerotic plaque rupture or erosion. Preventing such an event seems to be the only effective strategy to reduce mortality and morbidity of coronary heart disease. Coronary lesions prone to rupture have a distinct morphology compared with stable plaques, and provide a unique opportunity for noninvasive imaging to identify vulnerable plaques before they lead to clinical events. The submillimeter spatial resolution and excellent image quality of modern computed tomography (CT) scanners allow coronary atherosclerotic lesions to be detected, characterized, and quantified. Large plaque volume, low CT attenuation, napkin-ring sign, positive remodelling, and spotty calcification are all associated with a high risk of acute cardiovascular events in patients. Computation fluid dynamics allow the calculation of lesion-specific endothelial shear stress and fractional flow reserve, which add functional information to plaque assessment using CT. The combination of morphologic and functional characteristics of coronary plaques might enable noninvasive detection of vulnerable plaques in the future.
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Affiliation(s)
- Pál Maurovich-Horvat
- MTA-SE Lendület Cardiovascular Imaging Research Group, Heart and Vascular Centre, Semmelweis University, 68 Varosmajor ut, 1025 Budapest, Hungary
| | - Maros Ferencik
- Cardiac MR PET CT Program, Division of Cardiology and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge Street, Suite 400, Boston, MA 02114. USA
| | - Szilard Voros
- Stony Brook University, 101 Nicolls Road, Stony Brook, NY 11794 USA
| | - Béla Merkely
- MTA-SE Lendület Cardiovascular Imaging Research Group, Heart and Vascular Centre, Semmelweis University, 68 Varosmajor ut, 1025 Budapest, Hungary
| | - Udo Hoffmann
- Cardiac MR PET CT Program, Division of Cardiology and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge Street, Suite 400, Boston, MA 02114. USA
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271
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Abstract
Cardiovascular diseases (CVDs) cause nearly one-third of all deaths worldwide. Coronary heart disease (CHD) accounts for the greatest proportion of CVDs, and risk factors such as hypertension, cigarette smoking, diabetes mellitus or elevated glucose level, elevated cholesterol levels, and obesity or being overweight are the top six causes of death globally. Ecological and population-based longitudinal studies, conducted globally or within individual countries, have established the role of traditional and novel risk factors and measures of subclinical disease in the prediction of CHD. Risk assessment with short-term or long-term risk prediction algorithms can help to identify individuals who would benefit most from risk-factor interventions. Evaluation of novel risk factors and screening for subclinical atherosclerosis can also help to identify individuals at highest cardiovascular risk. Prevention of CHD focuses on identifying and managing risk factors at both the population and individual levels through primordial, primary, and secondary prevention. Epidemiological studies have provided the hypotheses for subsequent clinical trials that have documented the efficacy of risk-factor interventions, which are the basis of preventive cardiology. Future research efforts will determine the screening and intervention strategies that have the greatest effect on CHD prevention.
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272
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Elrashidi MY, Ebbert JO. Emerging drugs for the treatment of tobacco dependence: 2014 update. Expert Opin Emerg Drugs 2014; 19:243-60. [PMID: 24654737 DOI: 10.1517/14728214.2014.899580] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Tobacco dependence remains a global epidemic and the largest preventable cause of morbidity and mortality around the world. Smoking cessation has benefits at all ages but remains challenging for several reasons, among which are the complexities of nicotine addiction and limitations of available pharmacotherapies. AREAS COVERED This review summarizes current and emerging pharmacotherapies for the treatment of tobacco dependence, including first- and second-line recommended agents. Medications with alternative primary indications that have been investigated as potential treatments for tobacco dependence are also discussed. Articles reviewed were obtained through searches of PubMed, Ovid MEDLINE, ClinicalTrials.gov and the Pharmaprojects database. EXPERT OPINION Current evidence suggests that the two most effective pharmacotherapies to treat tobacco dependence are varenicline and combination nicotine replacement therapy. Alternative agents investigated demonstrate mixed rates of success in achieving long-term abstinence from smoking. No single pharmacotherapy will serve as a universally successful treatment given the complex underpinnings of tobacco dependence and individuality of smokers. The ultimate goal of tobacco research with respect to pharmacotherapeutic development continues to be providing clinicians with an armamentarium of drugs to choose from allowing for tailoring of treatment for smokers.
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273
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Affiliation(s)
- Jonathan M Samet
- Department of Preventive Medicine, Keck School of Medicine of USC, and Institute for Global Health, University of Southern California, Los Angeles, CA
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274
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Gaudin A, Yemisci M, Eroglu H, Lepêtre-Mouelhi S, Turkoglu OF, Dönmez-Demir B, Caban S, Fevzi Sargon M, Garcia-Argote S, Pieters G, Loreau O, Rousseau B, Tagit O, Hildebrandt N, Le Dantec Y, Mougin J, Valetti S, Chacun H, Nicolas V, Desmaële D, Andrieux K, Capan Y, Dalkara T, Couvreur P. Squalenoyl adenosine nanoparticles provide neuroprotection after stroke and spinal cord injury. NATURE NANOTECHNOLOGY 2014; 9:1054-1062. [PMID: 25420034 PMCID: PMC4351925 DOI: 10.1038/nnano.2014.274] [Citation(s) in RCA: 166] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 10/21/2014] [Indexed: 05/19/2023]
Abstract
There is an urgent need to develop new therapeutic approaches for the treatment of severe neurological trauma, such as stroke and spinal cord injuries. However, many drugs with potential neuropharmacological activity, such as adenosine, are inefficient upon systemic administration because of their fast metabolization and rapid clearance from the bloodstream. Here, we show that conjugation of adenosine to the lipid squalene and the subsequent formation of nanoassemblies allows prolonged circulation of this nucleoside, providing neuroprotection in mouse stroke and rat spinal cord injury models. The animals receiving systemic administration of squalenoyl adenosine nanoassemblies showed a significant improvement of their neurologic deficit score in the case of cerebral ischaemia, and an early motor recovery of the hindlimbs in the case of spinal cord injury. Moreover, in vitro and in vivo studies demonstrated that the nanoassemblies were able to extend adenosine circulation and its interaction with the neurovascular unit. This Article shows, for the first time, that a hydrophilic and rapidly metabolized molecule such as adenosine may become pharmacologically efficient owing to a single conjugation with the lipid squalene.
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Affiliation(s)
- Alice Gaudin
- Institut Galien Paris-Sud UMR CNRS 8612, Faculty of Pharmacy, University of Paris-Sud XI, 92296 Châtenay-Malabry, France
| | - Müge Yemisci
- Institute of Neurological Sciences and Psychiatry, Hacettepe University, Ankara 06100, Turkey
| | - Hakan Eroglu
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Hacettepe University, Ankara 06100, Turkey
| | - Sinda Lepêtre-Mouelhi
- Institut Galien Paris-Sud UMR CNRS 8612, Faculty of Pharmacy, University of Paris-Sud XI, 92296 Châtenay-Malabry, France
| | - Omer Faruk Turkoglu
- Department of Neurosurgery, Ankara Ataturk Research & Education Hospital, 06800 Bilkent Ankara, Turkey
| | - Buket Dönmez-Demir
- Institute of Neurological Sciences and Psychiatry, Hacettepe University, Ankara 06100, Turkey
| | - Seçil Caban
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Hacettepe University, Ankara 06100, Turkey
| | - Mustafa Fevzi Sargon
- Department of Anatomy, Faculty of Medicine, Hacettepe University, Ankara 06100, Turkey
| | | | - Grégory Pieters
- CEA Saclay, iBiTecS-S/SCBM, Labex LERMIT, 91191 Gif-sur-Yvette, France
| | - Olivier Loreau
- CEA Saclay, iBiTecS-S/SCBM, Labex LERMIT, 91191 Gif-sur-Yvette, France
| | - Bernard Rousseau
- CEA Saclay, iBiTecS-S/SCBM, Labex LERMIT, 91191 Gif-sur-Yvette, France
| | - Oya Tagit
- NanoBioPhotonics, Institut d’Electronique Fondamentale, University of Paris-Sud XI, 91405, Orsay Cedex, France
| | - Niko Hildebrandt
- NanoBioPhotonics, Institut d’Electronique Fondamentale, University of Paris-Sud XI, 91405, Orsay Cedex, France
| | - Yannick Le Dantec
- EA3544, Faculty of Pharmacy, University of Paris-Sud XI, 92296 Châtenay-Malabry, France
| | - Julie Mougin
- Institut Galien Paris-Sud UMR CNRS 8612, Faculty of Pharmacy, University of Paris-Sud XI, 92296 Châtenay-Malabry, France
| | - Sabrina Valetti
- Institut Galien Paris-Sud UMR CNRS 8612, Faculty of Pharmacy, University of Paris-Sud XI, 92296 Châtenay-Malabry, France
| | - Hélène Chacun
- Institut Galien Paris-Sud UMR CNRS 8612, Faculty of Pharmacy, University of Paris-Sud XI, 92296 Châtenay-Malabry, France
| | - Valérie Nicolas
- Institut d’Innovation Thérapeutique, IFR141 ITFM, Faculty of Pharmacy, University of Paris-Sud XI, 92296 Châtenay-Malabry, France
| | - Didier Desmaële
- Institut Galien Paris-Sud UMR CNRS 8612, Faculty of Pharmacy, University of Paris-Sud XI, 92296 Châtenay-Malabry, France
| | - Karine Andrieux
- Institut Galien Paris-Sud UMR CNRS 8612, Faculty of Pharmacy, University of Paris-Sud XI, 92296 Châtenay-Malabry, France
- Correspondence and requests for materials should be adressed to P.C. and K.A. ,
| | - Yilmaz Capan
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Hacettepe University, Ankara 06100, Turkey
| | - Turgay Dalkara
- Institute of Neurological Sciences and Psychiatry, Hacettepe University, Ankara 06100, Turkey
| | - Patrick Couvreur
- Institut Galien Paris-Sud UMR CNRS 8612, Faculty of Pharmacy, University of Paris-Sud XI, 92296 Châtenay-Malabry, France
- Correspondence and requests for materials should be adressed to P.C. and K.A. ,
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