1
|
Nava A. Opening Remarks at NAHN's second Annual Hispanic Health Policy Summit 2024. Hisp Health Care Int 2024; 22:65-66. [PMID: 38590238 DOI: 10.1177/15404153241243144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
|
2
|
Cerrito P, Nava A, Radovčić D, Borić D, Cerrito L, Basdeo T, Ruggiero G, Frayer DW, Kao AP, Bondioli L, Mancini L, Bromage TG. Correction: 'Dental cementum virtual histology of Neanderthal teeth from Krapina (Croatia, 130-120 kyr): an informed estimate of age, sex and adult stressors' (2022), by Cerrito et al.. J R Soc Interface 2024; 21:20240069. [PMID: 38379413 PMCID: PMC10879855 DOI: 10.1098/rsif.2024.0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 01/30/2024] [Indexed: 02/22/2024] Open
|
3
|
Nava A. NAHN Joins Climate Health Leaders to Advocate for Solutions for Pollution. Hisp Health Care Int 2023:15404153231182065. [PMID: 37312523 DOI: 10.1177/15404153231182065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
|
4
|
Nava A, Alves da Quinta D, Prato L, Girotti R, Moron G, Llera AS, Fernández EA. Novel evaluation approach for molecular signature-based deconvolution methods. J Biomed Inform 2023; 142:104387. [PMID: 37172634 DOI: 10.1016/j.jbi.2023.104387] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 03/17/2023] [Accepted: 05/07/2023] [Indexed: 05/15/2023]
Abstract
The tumoral immune microenvironment (TIME) plays a key role in prognosis, therapeutic approach and pathophysiological understanding over oncological processes. Several computational immune cell-type deconvolution methods (DM), supported by diverse molecular signatures (MS), have been developed to uncover such TIME interplay from RNA-seq tumor biopsies. MS-DM pairs were benchmarked against each other by means of different metrics, such as Pearson's correlation, R2 and RMSE, but these only evaluate the linear association of the estimated proportion related to the expected one, missing the analysis of prediction-dependent bias trends and cell identification accuracy. We present a novel protocol composed of four tests allowing appropriate evaluation of the cell type identification performance and proportion prediction accuracy of molecular signature-deconvolution method pair by means of certainty and confidence cell-type identification scores (F1-score, distance to the optimal point and error rates) as well the Bland-Altman method for error-trend analysis. Our protocol was used to benchmark six state-of-the-art DMs (CIBERSORTx, DCQ, DeconRNASeq, EPIC, MIXTURE and quanTIseq) paired to five murine tissue-specific MSs, revealing a systematic overestimation of the number of different cell types across almost all methods.
Collapse
Affiliation(s)
- A Nava
- Fundación Instituto Leloir-CONICET, Buenos Aires, Argentina; Fundación Huésped, Buenos Aires, Argentina
| | - D Alves da Quinta
- Fundación Instituto Leloir-CONICET, Buenos Aires, Argentina; Universidad Argentina de la Empresa (UADE). Instituto de Tecnología (INTEC), Buenos Aires, Argentina
| | - L Prato
- Universidad de Villa María, Córdoba, Argentina
| | - R Girotti
- Universidad Argentina de la Empresa (UADE). Instituto de Tecnología (INTEC), Buenos Aires, Argentina
| | - G Moron
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina; Centro de Investigaciones en Bioquímica Clínica e Inmunología, CONICET, Córdoba, Argentina
| | - A S Llera
- Fundación Instituto Leloir-CONICET, Buenos Aires, Argentina
| | - E A Fernández
- Facultad de Ingeniería, Carrera de Bioinformática, Universidad Católica de Córdoba (UCC), Córdoba, Argentina; Facultad de Ciencias Exactas Físicas y Naturales, Universidad Nacional de Córdoba, Córdoba, Argentina; Centro de Investigaciòn en Inmunología y Enfermedades Infecciosas, UCC, CONICET, Córdoba, Argentina.
| |
Collapse
|
5
|
Nava A. Opening Remarks at the Inaugural Hispanic Health Policy Summit held in Washington, DC. Hisp Health Care Int 2023; 21:54. [PMID: 36916237 DOI: 10.1177/15404153231163404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
|
6
|
Olmos B, Nava A, Jones EJ. Theory Integration for Examining Health Care Discrimination among Minoritized Older Adults with Chronic Illness. West J Nurs Res 2023; 45:262-271. [PMID: 36254404 DOI: 10.1177/01939459221128123] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Prevalence of chronic illnesses, including type 2 diabetes (T2DM), is increasing disproportionately among Latinx adults in the United States. Health care inequities such as health care discrimination contribute to the disparities in this population. Academic and clinical nurses must address health care discrimination from a strong theoretical framework. In this article, we integrate the minority stress theory and ecosocial theory of disease distribution to offer a whole-person model that identifies the concepts most relevant to Latinx older adults who function at multiple levels of intersectionality. This paper uses T2DM as an exemplar of chronic illness. The integrated model depicts possible pathways of physiological and psychological embodiment of lived experiences of minoritized older persons managing chronic illness who are living in a society deeply embedded with structural racism and oppression. This model may guide future research aimed at elucidating the social and structural determinants that impact health-related outcomes among Latinx older adults.
Collapse
Affiliation(s)
- Brenda Olmos
- Fran and Earl Ziegler College of Nursing, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Adrianna Nava
- National Committee for Quality Assurance (NCQA), Washington, DC, USA
| | - Emily J Jones
- Fran and Earl Ziegler College of Nursing, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| |
Collapse
|
7
|
Nava A, Estrada L, Gerchow L, Scott J, Thompson R, Squires A. Grouping people by language exacerbates health inequities-The case of Latinx/Hispanic populations in the US. Res Nurs Health 2022; 45:142-147. [PMID: 35247219 DOI: 10.1002/nur.22221] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 02/16/2022] [Indexed: 11/10/2022]
Affiliation(s)
- Adrianna Nava
- National Association of Hispanic Nurses, Lexington, Kentucky, USA
| | - Leah Estrada
- School of Nursing, Columbia University, New York City, New York, USA
| | - Lauren Gerchow
- Rory Meyers College of Nursing, Nursing New York University, New York City, New York, USA
| | - Joanie Scott
- School of Nursing, Penn State University, University Park, Pennsylvania, USA
| | - Roy Thompson
- School of Nursing, Duke University, Durham, North Carolina, USA
| | - Allison Squires
- Rory Meyers College of Nursing, New York University, New York City, New York, USA.,Grossman School of Medicine, New York University, New York City, New York, USA
| |
Collapse
|
8
|
Nava A. Opening Remarks at the Breaking Down Barriers Conference to the Future of Nursing. Hisp Health Care Int 2021; 19:212-213. [PMID: 34664514 DOI: 10.1177/15404153211050502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
9
|
Nava A. Preparing for the "COVID Effect" on the Supply of U.S. Latino Nurses. Hisp Health Care Int 2021; 19:144-145. [PMID: 34219534 DOI: 10.1177/15404153211026442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
10
|
Nava A. Health Care Access and Disparities During COVID-19. Hisp Health Care Int 2021; 19:75-76. [PMID: 33984252 DOI: 10.1177/15404153211012891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
11
|
Nava A. We Are the Future of Health Care Leadership in the United States. Hisp Health Care Int 2021; 19:4. [PMID: 33683994 DOI: 10.1177/1540415321994362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
12
|
Soliz J, Ifeanyi I, Cata JP, Katz M, Fleming J, Feng L, McHugh T, Nava A, Rahlfs TF, Gottumukkala V. Abstract PR627. Anesth Analg 2016. [DOI: 10.1213/01.ane.0000493006.14653.c6] [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]
|
13
|
Fawcett J, Aronowitz T, AbuFannouneh A, Usta MA, Fraley HE, Howlett MSL, Mtengezo JT, Muchira JM, Nava A, Thapa S, Zhang Y. Thoughts about the Name of Our Discipline. Nurs Sci Q 2015; 28:330-3. [DOI: 10.1177/0894318415599224] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This essay addresses the name of our discipline. Discussion of the use of the term, nursology, focuses on the origin of the term, its use as a name for our discipline and its use as a research method and a practice methodology. Advantages and disadvantages of nursology as the name for our discipline are gleaned from PhD program students’ responses to a question posed by Reed (1997).
Collapse
|
14
|
Desai M, Nava A, Rigoard P, Shah B, Taylor R. Optimal medical, rehabilitation and behavioral management in the setting of failed back surgery syndrome. Neurochirurgie 2015; 61 Suppl 1:S66-76. [DOI: 10.1016/j.neuchi.2014.09.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 08/19/2014] [Accepted: 09/21/2014] [Indexed: 10/24/2022]
|
15
|
Zavala MG, Nava A, Moran-Moguel MC, Salazar-Paramo M. AB0181 Padi4 haplotype a potential modulator of antigen expression in an immunological environment. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2504] [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: 11/03/2022]
|
16
|
Araujo J, Pereira A, Nardi MS, Henriques DA, Lautenschalager DA, Dutra LM, Ometto TL, Hurtado RF, Maués F, Nava A, Morais FA, Aires CC, Favorito S, Durigon EL. Detection of hantaviruses in Brazilian rodents by SYBR-Green-based real-time RT-PCR. Arch Virol 2011; 156:1269-74. [PMID: 21442233 DOI: 10.1007/s00705-011-0968-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Accepted: 03/04/2011] [Indexed: 10/18/2022]
Abstract
Current knowledge of the pathogenic hantavirus indicates that wild rodents are its primary natural reservoir. Specific primers to detect the presence of viral genomes were developed using an SYBR-Green-based real-time RT-PCR protocol. One hundred sixty-four rodents native to the Atlantic Forest biome were captured in São Paulo State, Brazil, and their tissues were tested. The presence of hantavirus RNA was detected in sixteen rodents: three specimens of Akodon montensis, three of Akodon cursor, two of Necromys lasiurus, one of Juliomys sp., one of Thaptomys nigrita, five of Oligoryzomys nigripes, and one of Oryzomys sp. This SYBR Green real-time RT-PCR method for detection of hantavirus may be useful for surveying hantaviruses in Brazil.
Collapse
Affiliation(s)
- J Araujo
- BSL 3 Laboratory of Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
|
18
|
Catalano P, Benassi V, Caldarini C, Cianfriglia L, Mosticone R, Nava A, Pantano W, Porreca F. [Health status and life style in Castel Malnome (Rome, I-II cent. A. D.)]. Med Secoli 2010; 22:111-128. [PMID: 21563471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The necropolis of Castel Malnome, chronologically framed between the I and II century AD, is located in the vicinity of Ponte Galeria (Rome), nearby the via Portuense. The excavation of the funerary site has allowed the collection of 292 inhumations, referred to the lower social classes and for the most part adult males. Regarding the funerary ritual, only the 42.8% of the graves had a tiles cover, while about one third provided grave goods. The field analysis shows that almost all the burials are primaries, and is not possible to highlight a main position of the inhumated individuals. The laboratory analysis, till today carried out on 100 individuals, shows a high degree of skeletal robustness and of occupational markers due to heavy work load (inflammation, muscle-skeletal trauma, fractures, osteoarthritis, enthesopathies). The recording of oral pathologies and aspecific stresses, in order to obtain information about the health status of the population, shows a very high frequency of caries mainly related to poor dental hygiene, and of enamel hypoplasia.
Collapse
Affiliation(s)
- P Catalano
- Soprintendenza Speciale per i Beni Archeologici di Roma, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
19
|
Abstract
The purpose of this paper is to review the history of the clinico-pathologic investigations performed at the University of Padua on an old morbid entity ("parchment heart"), which, in the 1960s, led to the clinical description of the disease, in the 1980s to the revival of the scientific interest, and in the mid 1990s to the understanding of the genetic background. All the steps of the progressive knowledge are reviewed: necropsy of young people who died suddenly, in vivo diagnosis by ECG, echocardiography, angiocardiography, endomyocardial biopsy, nuclear magnetic resonance, and diagnostic criteria. Familial occurrence with autosomic dominant transmission and various penetrance was documented. Gene defects were recently mapped both to chromosome 14q23-q24 and 1q42-q43, thus providing evidence for genetic heterogeneity. The pathologic substrates of arrhythmogenic right ventricular cardiomyopathy pointed to an acquired progressive myocardial atrophy with fibro-fatty replacement of dying myocytes. Nowadays the disease is definitively regarded as a primary myocardial disorder and it has been included in the revised WHO classification of cardiomyopathies.
Collapse
MESH Headings
- Arrhythmias, Cardiac/etiology
- Arrhythmias, Cardiac/history
- Cardiomyopathies/classification
- Cardiomyopathies/genetics
- Cardiomyopathies/history
- Chromosomes, Human, Pair 1
- Chromosomes, Human, Pair 14
- Death, Sudden, Cardiac/etiology
- Genes, Dominant
- History, 20th Century
- Humans
- Italy
- Ventricular Dysfunction, Right/classification
- Ventricular Dysfunction, Right/genetics
- Ventricular Dysfunction, Right/history
Collapse
Affiliation(s)
- C Basso
- Department of Pathology, University of Padua Medical School, Italy
| | | | | | | |
Collapse
|
20
|
Bauce B, Frigo G, Benini G, Michieli P, Basso C, Folino AF, Rigato I, Mazzotti E, Daliento L, Thiene G, Nava A. Differences and similarities between arrhythmogenic right ventricular cardiomyopathy and athlete's heart adaptations. Br J Sports Med 2008; 44:148-54. [PMID: 18603583 DOI: 10.1136/bjsm.2007.042853] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Regular intensive physical activity is associated with non-pathological changes in cardiac morphology. Differential diagnosis with arrhythmogenic right ventricular cardiomyopathy (ARVC) constitutes a frequent problem, especially in athletes showing ventricular arrhythmias with left bundle branch block morphology. AIM OF THE STUDY To assess the different clinical and non-invasive instrumental features of the subjects affected by ARVC and by athletes. METHODS Three groups of subjects (40 ARVC patients, 40 athletes and 40 controls, mean age 27 (9) years) were examined with family and personal history, physical examination, 12-lead ECG, 24-h ECG, signal-averaged ECG and 2-D and Doppler echocardiography. RESULTS 12-Lead ECG was abnormal in 62% of ARVC patients versus 7.5% of athletes and 2.5% of controls (p<0.0001). Ventricular arrhythmias and late potentials were present in 70% and 55% of ARVC subjects, respectively (vs 5% of athletes and 7.5% of controls, p<0.0001). Left ventricular parietal wall thickness and left ventricular end-diastolic diameters were significantly higher in athletes. Both athletes and ARVC patients presented a right ventricular (RV) enlargement compared with controls. Moreover, RV outflow tract, measured on parasternal long axis and at the level of aortic root, was significantly larger in ARVC patients (33.6 (4.7) mm vs 29.1 (3.4) mm and 35.6 (6.8) mm vs 30.1 (2.9) mm; p<0.0001), and RV fractional shortening and ejection fraction were significantly lower in ARVC patients compared with athletes (40 (7.9)% vs 44 (10)%; p=0.05 and 52.9 (8)% vs 59.9 (4.5)%; p<0.0001). A thickened moderator band was found to be present in similar percentage in ARVC patients and athletes. CONCLUSIONS An accurate clinical and instrumental non-invasive evaluation including echocardiography as imaging technique allows to distinguish RV alterations typical of ARVC from those detected in athletes as a consequence of intensive physical activity.
Collapse
Affiliation(s)
- B Bauce
- Department of Cardiology, University of Padua, Italy
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Nava A, Mazza E, Furrer M, Villiger P, Reinhart W. In vivo mechanical characterization of human liver. Med Image Anal 2008; 12:203-16. [DOI: 10.1016/j.media.2007.10.001] [Citation(s) in RCA: 160] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2006] [Revised: 10/01/2007] [Accepted: 10/02/2007] [Indexed: 12/01/2022]
|
22
|
Zavala-Cerna MG, Nava A, García-Castañeda E, Durán-González J, Arias-Merino MJ, Salazar-Páramo M. Serum IgG activity against cyclic citrullinated peptide in patients evaluated for rheumatoid factor correlates with the IgM isotype. Rheumatol Int 2008; 28:851-7. [PMID: 18253737 DOI: 10.1007/s00296-008-0535-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2007] [Accepted: 01/14/2008] [Indexed: 10/22/2022]
Abstract
The purpose of this study was to evaluate the frequency of seric antibodies against cyclic citrullinated peptide (a-CCP) in patients tested for rheumatoid factor (RF) reactivity, and to analyze the correlation between their titers. We obtained serum from 112 consecutive patients (85 female), aged 47.2 +/- 13.4 years and from 46 clinically healthy subjects (CHS). Patients where stratified into four subgroups: rheumatoid arthritis (RA), probable RA (PRA), spondylarthropathies and other diagnosis. The a-CCP antibodies were determined by enzyme linked immunoassay (ELISA), RF by nephelometric test (IgM) and ELISA (IgG and IgM). Analysis of variance (ANOVA) showed statistically that a-CCP antibodies differs among RA versus CHS and other diagnosis; PRA versus CHS and other diagnosis. A significant Rho value of 0.84 (P < 0.05, Spearman's correlation) was identified between a-CCP antibodies and RF in PRA subgroup. When a correlation of a-CCP antibodies with RF (both isotypes) was done, the higher correlation was observed against IgM RF. The data suggests different pathways and times for each antibody generation.
Collapse
Affiliation(s)
- M G Zavala-Cerna
- Unidad de Investigación Médica en Epidemiología Clínica, UMAE, HE, CMNO, IMSS, Guadalajara, Jalisco, México
| | | | | | | | | | | |
Collapse
|
23
|
de Pablo P, García-Torres R, Uribe N, Ramón G, Nava A, Silveira LH, Amezcua-Guerra LM, Martínez-Lavín M, Pineda C. Kidney involvement in Takayasu arteritis. Clin Exp Rheumatol 2007; 25:S10-4. [PMID: 17428356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
OBJECTIVE To evaluate whether the presence of glomerulonephritis is or is not associated with the extent of arterial wall inflammatory cell infiltrate in Takayasu arthritis (TA). METHODS Retrospective chart and pathology review of large artery and kidney specimens of TA autopsy cases. Kidney specimens were classified, according to their histopathological findings, in those with specific glomerular entities and those with non-specific, ischemic and/or hypertensive, glomerular changes. A control group of autopsy kidney specimens was utilized for comparison. Morphometric analysis was used to assess the extent of the arterial inflammatory infiltrates; results were compared among the different groups with kidney lesions. RESULTS We included 25 kidney specimens from 25 autopsies. Specific glomerular entities were present in 14 specimens; 10 (40%) were classified as diffuse mesangial proliferative glomerulonephritis (DMPG [Group A]), and 4 (16%) as other associated glomerulopathies (Group B). Non-specific changes were observed in 11 (44%) specimens (Group C). The arterial inflammatory infiltrate proportion was 9.4 % for group A, 1.4% for group B, and 2.7% for group C. Furthermore, a larger proportion of vascular inflammation was confirmed for group A when compared with the other groups (p<0.05). Group A patients were younger than those in groups B and C (p<0.005) and exhibited shorter disease duration. CONCLUSION The presence of DMPG was associated with a larger extent of vascular inflammatory cell infiltrate, suggesting a relationship between both phenomena.
Collapse
Affiliation(s)
- P de Pablo
- Division of Rheumatology, Tufts-New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Bauer M, Mazza E, Nava A, Bajka M, Lang U, Holzapfel G. In vivo characterization of the mechanics of human uterine cervices. J Biomech 2006. [DOI: 10.1016/s0021-9290(06)84361-7] [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: 11/29/2022]
|
25
|
Affiliation(s)
- St. Weiss
- Institute for Biomedical Engineering, University and ETH Zurich, Switzerland
| | - M. Bajka
- Department of Gynecology, University Hospital Zurich, Switzerland
| | - A. Nava
- Institute for Mechanical Systems, ETH Zurich, Switzerland
| | - E. Mazza
- Institute for Mechanical Systems, ETH Zurich, Switzerland
| | - P. Niederer
- Institute for Biomedical Engineering, University and ETH Zurich, Switzerland
| |
Collapse
|
26
|
Tiso N, Bauce B, Rampazzo A, Bagattin A, Nava A, Danieli GA. Gene symbol: RYR2. Disease: Arrhythmogenic right ventricular cardiomyopathy type 2. Hum Genet 2004; 114:405. [PMID: 15046075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Affiliation(s)
- N Tiso
- Department of Biology, University of Padua, Italy.
| | | | | | | | | | | |
Collapse
|
27
|
Bagattin A, Bauce B, Rampazzo A, Tiso N, Nava A, Danieli GA. Gene symbol: RYR2. Disease: Effort-induced polymorphic ventricular arrhythmias. Hum Genet 2004; 114:406. [PMID: 15046079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Affiliation(s)
- A Bagattin
- Department of Biology, University of Padua, Italy.
| | | | | | | | | | | |
Collapse
|
28
|
Weiss S, Bajka M, Nava A, Mazza E, Niederer P. A finite element model for the simulation of hydrometra. Technol Health Care 2004; 12:259-67. [PMID: 15328454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
The behaviour of the human uterus under an internal (intracavital) pressure of 150 mm Hg (20 kPa) was modelled. The application of such an intracavital or intrauterine pressure corresponds to the procedure which is performed at the beginning of hysteroscopy (hydrometra). Homogenous, isotropic material laws were implemented in a three dimensional, finite element model. The volume of the distended uterine cavity was calculated with different parameters obtained from in vivo aspiration experiments on human uteri as well as from ex vivo tensile tests on rabbit uteri for comparison purposes. The calculated results were in general agreement with in vivo measurements of hydrometra performed at the University Hospital of Zurich.
Collapse
Affiliation(s)
- St Weiss
- Institute for Biomedical Engineering, University of Zurich, Switzerland.
| | | | | | | | | |
Collapse
|
29
|
Nava A, Cannas S, Martini B. More evidence-based data are required for a consensus on the aetiology of the so-called Brugada Syndrome. Eur Heart J 2003; 24:2072; author reply 2072-3. [PMID: 14613748 DOI: 10.1016/j.ehj.2003.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
|
30
|
Kooh M, Martínez-Lavín M, Meza S, Martín-del-Campo A, Hermosillo AG, Pineda C, Nava A, Amigo MC, Drucker-Colín R. Simultaneous heart rate variability and polysomnographic analyses in fibromyalgia. Clin Exp Rheumatol 2003; 21:529-30. [PMID: 12942716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
|
31
|
Weiss S, Bajka M, Nava A, Mazza E, Niederer P. SIMULATION DER HYDROMETRA MIT HILFE DER METHODE DER FINITEN ELEMENTE. BIOMED ENG-BIOMED TE 2003. [DOI: 10.1515/bmte.2003.48.s1.276] [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: 11/15/2022]
|
32
|
Bonezzi C, Nava A, Barbieri M, Bettaglio R, Demartini L, Miotti D, Paulin L. [Validazione della versione italiana del Brief Pain Inventory nei pazienti con dolore cronico]. Minerva Anestesiol 2002; 68:607-11. [PMID: 12244292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
BACKGROUND The purpose of this study has been the validation of an Italian version of the Brief Pain Inventory (BPI), Breve Questionario per la valutazione del Dolore (BQVD), in patients with chronic pain not-caused by neoplastic illness. METHODS The analysis has been proposed to 113 patients affected by different kinds of chronic pain of non-neoplastic origin while hospitalized, both as outpatients or as in-patients. The descriptive analysis of the specimen and of each item of the BPI has been carried out. Moreover, the psychometric characteristics of the analysis, intended as an instrument to describe intensity of pain and its interference in the various aspects of life have been investigated, evaluating with factorial analysis its validity both as a construct, and its internal coherence calculating the Cronbach's alpha of the whole instrument and of each identifier with factorial analysis. RESULTS From the factorial analysis emerged a frame with three factors that have been identified as Pain intensity, Pain interference in emotional sphere and Interference in working activities. CONCLUSIONS The Brief Pain Inventory can be considered a suitable useful instrument in the global evaluation of patients affected by chronic pain since its allows a contemporaneous analysis of three factors that characterize the phenomenon and contribute equally in defining the various facet of the pain universe. The Italian version of the BPI may be included in the essential evaluation instruments in the diagnosis and therapy of chronic pain.
Collapse
Affiliation(s)
- C Bonezzi
- Unità Operativa di Cure Palliative e Terapia del Dolore, Fondazione S. Maugeri, Istituto Scientifico, Pavia, Italy.
| | | | | | | | | | | | | |
Collapse
|
33
|
Maffè GC, Ruga A, Nava A. Splenic amyloidoma. Haematologica 2002; 87:EIM02. [PMID: 11801483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Affiliation(s)
- G Carnevale Maffè
- Medicina Interna ed Oncologia Medica, IRCCS Policlinico San Matteo, Pavia, Italy.
| | | | | |
Collapse
|
34
|
Abstract
Infections of the orbit and periorbital tissues are not uncommon. Trauma, skin infections, and sinusitis are frequently the underlying cause. Studies have shown changes in epidemiology and pathogens in the last decade. Although classical manifestations are usually present, atypical cases without specific signs and symptoms may confound the diagnosis. A high index of suspicion, aided by ultrasonography, computed tomography, and magnetic resonance imaging, is frequently required for an accurate diagnosis. Prompt diagnosis and treatment may lead to resolution of the infection, thus avoiding ocular sequelae. Orbital infections may spread into the globe, causing endophthalmitis. Some patients may even need an enucleation or evisceration. New materials and techniques may improve the final result of an anophthalmic socket.
Collapse
Affiliation(s)
- J L Tovilla-Canales
- Orbit and Oculoplastics Surgery Service, Instituto de Oftalmologia Fundación Conde de Valenciana U.N.A.M., Mexico City, Mexico.
| | | | | |
Collapse
|
35
|
|
36
|
Abstract
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a heart muscle disease of unknown etiology characterized by the peculiar right ventricular (RV) involvement. Distinctive pathologic features are myocardial atrophy and fibro-fatty replacement of the RV free wall, and clinical presentation is usually related to ventricular tachycardias with a left bundle branch block pattern or ventricular fibrillation leading to cardiac arrest, mostly in young people and athletes. Later in the disease evolution, progression and extension of RV muscle disease and left ventricular involvement may result in right or biventricular heart failure. The diagnosis of ARVC may be difficult because of several problems with specificity of ECG abnormalities, different potential etiologies of ventricular arrhythmias with a left bundle branch morphology, assessment of RV structure and function, and interpretation of endomyocardial biopsy findings. Therefore, standardized diagnostic criteria have been proposed by the Study Group on ARVC of the European Society of Cardiology. According to these guidelines, the diagnosis of ARVC is based on the presence of major and minor criteria encompassing electrocardiographic, arrhythmic, morphofunctional, histopathologic, and genetic factors. Since the assessment of sudden death risk in patients with ARVC is still not well established, there are no precise guidelines to determine which patients need to be treated and what is the best management approach. The therapeutic options include beta-blockers, antiarrhythmic drugs, catheter ablation, and implantable cardioverter defibrillator (ICD). The ICD is the most effective safeguard against arrhythmic sudden death. However, its precise role in changing the natural history of ARVC by preventing sudden and nonsudden death needs to be evaluated by a prospective study of a large series of patients. In patients in whom ARVC has progressed to severe RV or biventricular systolic dysfunction with risk of thromboembolic complications, treatment consists of current therapy for heart failure including anticoagulant therapy. In cases of refractory congestive heart failure, patients may become candidates for heart transplantation.
Collapse
Affiliation(s)
- D Corrado
- Department of Cardiology, University of Padua Medical School, Via Giustiniani 2 - 35121 Padua, Italy
| | | | | | | |
Collapse
|
37
|
Hernández-Becerril N, Nava A, Reyes PA, Monteón VM. IgG subclass reactivity to Trypanosoma cruzi in chronic chagasic patients. Arch Cardiol Mex 2001; 71:199-205. [PMID: 11665655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND The anti-Trypanosoma cruzi antibodies isotype profile in Chagas' disease has been studied in relation to different clinical manifestations. A high titer of IgG anti-T. cruzi antibodies is found in patients with cardiac involvement, while a high titer of IgA anti-T. cruzi antibodies is associated with digestive forms. OBJECTIVE The aim of this work was to analyze the IgG subclass reactivity of anti-T. cruzi antibodies in patients with chronic Chagasic cardiomyopathy. METHODS Twelve consecutive chagasic patients were analyzed for IgG subclass reactivity to a T. cruzi antigenic extract. They had a complete clinical evaluation, peripheral EKG, echocardiography, left ventriculogram, and coronariography. RESULTS All patients came from rural areas of Mexico and had lived in endemic zones for over seven years. They presented left ventricular endsystolic dimension above 42 mm in 58% (7/12) and ejection fraction below 50% in 58% (7/12). We found that IgG1 and IgG2 anti-T. cruzi antibodies showed higher titer than IgG3 antibodies, with consistently low titer of IgG4 antibodies. Expression of the four IgG subclasses of anti-T. cruzi antibodies suggest a mixed Th1/Th2-like immune response under a probably continuous chronic antigenic stimulation. On the other hand, high levels of IgG2 anti-T. cruzi antibodies showed a tendency to be associated with severe cardiomegaly. CONCLUSIONS Our results suggest that a mixed Th1/Th2-like immune response may take place in chronic chagasic patients under a chronic antigenic stimulation.
Collapse
Affiliation(s)
- N Hernández-Becerril
- Laboratorio de Inmunoparasitología, Instituto Nacional de Cardiología I. Chávez, INCICH, Juan Badiano No. 1, 14080 México D.F
| | | | | | | |
Collapse
|
38
|
Turrini P, Corrado D, Basso C, Nava A, Bauce B, Thiene G. Dispersion of ventricular depolarization-repolarization: a noninvasive marker for risk stratification in arrhythmogenic right ventricular cardiomyopathy. Circulation 2001; 103:3075-80. [PMID: 11425771 DOI: 10.1161/01.cir.103.25.3075] [Citation(s) in RCA: 127] [Impact Index Per Article: 5.5] [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: 12/15/2022]
Abstract
BACKGROUND We retrospectively investigated the value of clinical and ECG findings as well as QT-QRS dispersion in predicting the risk of sudden death in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). METHODS AND RESULTS Duration and interlead variability of the QT interval and QRS complex were measured manually from standard ECGs in 20 sudden death victims with ARVC diagnosed at autopsy (group I), in 20 living ARVC patients with sustained ventricular tachycardia (group II), in 20 living ARVC patients with </=3 consecutive premature ventricular beats (group III), and in 20 control subjects (group IV). QT and QRS dispersions were greater in group I (77.5+/-10.6 ms for QT and 45.7+/-8.1 ms for QRS) compared with group II (64.5+/-13.9 ms for QT [P=0.001] and 33.5+/-8.7 ms for QRS [P=0.0004]) and in group II compared with group III (48+/-8.9 ms for QT [P<0.0001] and 28+/-5.2 ms for QRS [P<0.0001]) and group IV (33.5+/-4.8 ms for QT [P<0.0001] and 18.5+/-3.6 ms for QRS [P<0.0001]). Negative T wave beyond V(1) and syncope were statistically more frequent in group I (P=0.02 and P=0.007, respectively). On multivariate analysis, QRS dispersion remained an independent predictor of sudden death (P<0.0001), followed by syncope (P=0.09). In assessing risk of sudden death, QRS dispersion >/=40 ms had a sensitivity and specificity of 90% and 77%, respectively; QT dispersion >65 ms, 85% and 75%, respectively; negative T wave beyond V(1), 85% and 42%, respectively; and syncope, 40% and 90%, respectively. CONCLUSIONS QRS dispersion (>/=40 ms) was the strongest independent predictor of sudden death in ARVC. Syncope, QT dispersion >65 ms, and negative T wave beyond V(1) refined arrhythmic risk stratification in these patients.
Collapse
Affiliation(s)
- P Turrini
- Department of Pathology, University of Padua Medical School, Padua, Italy
| | | | | | | | | | | |
Collapse
|
39
|
Orford J, Natera G, Velleman R, Copello A, Bowie N, Bradbury C, Davies J, Mora J, Nava A, Rigby K, Tiburcio M. Ways of coping and the health of relatives facing drug and alcohol problems in Mexico and England. Addiction 2001; 96:761-74. [PMID: 11331034 DOI: 10.1046/j.1360-0443.2001.96576111.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [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: 11/20/2022]
Abstract
AIMS To compare two contrasting socio-cultural groups in terms of parameters relating to the stress - coping - health model of alcohol, drugs and the family, and to test hypotheses derived from the model in each of the two groups separately. DESIGN Cross-sectional, comparative and correlational, using standard questionnaire data, supplemented by qualitative interview data to illuminate the findings. PARTICIPANTS One hundred close relatives, mainly partners or parents, from separate families in Mexico City, and 100 from South West England. Data sources. Coping Questionnaire (CQ), Family Environment Scale (FES), Symptom Rating Test (SRT), Semi-structured interview. FINDINGS Mean symptom scores were high in both groups, and not significantly different. The hypothesis that relatives in Mexico City, a more collectivist culture, would show more tolerant - inactive coping was not supported, but there was support for the prediction that relatives in South West England would show more withdrawal coping. This result may be as much due to differences in poverty and social conditions as to differences in individualism - collectivism. As predicted by the stress - coping - health model, tolerant - inactive coping was correlated with symptoms, in both groups, after controlling for family conflict, but there was only limited support for a moderating role of coping. Wives of men with alcohol problems in Mexico City, and wives of men with other drug problems in South West England, reported particularly high levels of both engaged and tolerant - inactive coping. CONCLUSIONS Tolerant - inactive coping may be bad for relatives' health: causality may be inferred but is not yet proved. Certain groups are more at risk of coping in this way. Qualitative data help understand the nature of tolerant - inactive coping and why it occurs despite the view of relatives themselves that it is counter-productive.
Collapse
Affiliation(s)
- J Orford
- School of Psychology, University of Birmingham, Edgbaston, UK.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Abstract
BACKGROUND Patients with the ECG pattern of right bundle branch block and right precordial ST-segment elevation may experience sudden death in the setting of either arrhythmogenic right ventricular cardiomyopathy (ARVC) or a functional electrical disorder such as Brugada syndrome. METHODS AND RESULTS Among a series of 273 young (</=35 years) victims of cardiovascular sudden death who were prospectively studied from 1979 to 1998 in the Veneto Region of Italy, 12-lead ECG was available in 96 cases. Thirteen (14%; 12 males and 1 female aged 24+/-8 years) had right precordial ST-segment elevation, either isolated (9 cases) or associated with right bundle branch block (4 cases). At autopsy, all patients had ARVC (92%) except one, who had no evidence of structural heart disease. Compared with the 19 young sudden death victims with ARVC and no ST-segment abnormalities from the same series, those with AVRC and right precordial ST-segment elevation included fewer competitive athletes (17% versus 58%; P:=0.03), more often died suddenly at rest or during sleep (83% versus 26%; P:=0.003), and showed serial ECG changes over time (83% versus 0; P:=0.015), polymorphic ventricular tachycardia (33% versus 0; P:=0.016), and predominant fatty replacement of the right ventricular anterior wall (58% versus 21%; P:=0.05), CONCLUSIONS Right precordial ST-segment elevation was found in 14% of young sudden death victims with available ECG. It mostly reflected underlying ARVC with predominant right ventricular anterior wall involvement and characterized a subgroup of patients who share with Brugada patients the propensity to die from non-exercise-related cardiac arrest and to exhibit dynamic ECG changes and polymorphic ventricular tachycardia.
Collapse
Affiliation(s)
- D Corrado
- Department of Cardiology, University of Padua Medical School, Padua, Italy
| | | | | | | | | | | |
Collapse
|
41
|
Tiso N, Stephan DA, Nava A, Bagattin A, Devaney JM, Stanchi F, Larderet G, Brahmbhatt B, Brown K, Bauce B, Muriago M, Basso C, Thiene G, Danieli GA, Rampazzo A. Identification of mutations in the cardiac ryanodine receptor gene in families affected with arrhythmogenic right ventricular cardiomyopathy type 2 (ARVD2). Hum Mol Genet 2001; 10:189-94. [PMID: 11159936 DOI: 10.1093/hmg/10.3.189] [Citation(s) in RCA: 620] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Arrhythmogenic right ventricular dysplasia type 2 (ARVD2, OMIM 600996) is an autosomal dominant cardiomyopathy, characterized by partial degeneration of the myocardium of the right ventricle, electrical instability and sudden death. The disease locus was mapped to chromosome 1q42--q43. We report here on the physical mapping of the critical ARVD2 region, exclusion of two candidate genes (actinin 2 and nidogen), elucidation of the genomic structure of the cardiac ryanodine receptor gene (RYR2) and identification of RYR2 mutations in four independent families. In myocardial cells, the RyR2 protein, activated by Ca(2+), induces the release of calcium from the sarcoplasmic reticulum into the cytosol. RyR2 is the cardiac counterpart of RyR1, the skeletal muscle ryanodine receptor, involved in malignant hyperthermia (MH) susceptibility and in central core disease (CCD). The RyR2 mutations detected in the present study occurred in two highly conserved regions, strictly corresponding to those where mutations causing MH or CCD are clustered in the RYR1 gene. The detection of RyR2 mutations causing ARVD2, reported in this paper, opens the way to pre-symptomatic detection of carriers of the disease in childhood, thus enabling early monitoring and treatment.
Collapse
Affiliation(s)
- N Tiso
- Department of Biology, University of Padova, 35121 Padova, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Naccarella F, Naccarelli G, Fattori R, Nava A, Martini B, Corrado D, Masotti A, Gatti M. Arrhythmogenic right ventricular dysplasia: cardiomyopathy current opinions on diagnostic and therapeutic aspects. Curr Opin Cardiol 2001; 16:8-16. [PMID: 11124713 DOI: 10.1097/00001573-200101000-00002] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [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: 11/25/2022]
Abstract
Right Ventricular Dysplasia constitutes a genetic cardiomyopathy characterized by fibrous-adipose substitution of the right and rarely of the left ventricular myocardium. This disorder is associated with ventricular arrhythmias ranging from frequent ventricular ectopic beats, nonsustained and sustained ventricular tachycardia of left bundle branch morphology and sudden death. Therefore, the syndrome has been labelled Arrhythmogenic RVD Cardiomyopathy. Diagnostic criteria, preliminary genetic data, and clinical manifestations are summarized and critical addressed, using data from the literature and from our own experience. The most important aspects of the ECG in this syndrome are reviewed and stressed with particular attention to initial versus advanced clinical subsets. The typical anatomical abnormalities and biopsy or pathology material are presented.
Collapse
Affiliation(s)
- F Naccarella
- Cardiology Azienda USL Città di Bologna, Italy; Penn State University, Cardiology Hershey PA, USA
| | | | | | | | | | | | | | | |
Collapse
|
43
|
Turrini P, Basso C, Daliento L, Nava A, Thiene G. Is arrhythmogenic right ventricular cardiomyopathy a paediatric problem too? Images Paediatr Cardiol 2001; 3:18-37. [PMID: 22368593 PMCID: PMC3232495] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a heart muscle disease that is often familial, characterized by arrhythmias of right ventricular origin, due to transmural fatty or fibrofatty replacement of atrophic myocardium. ARVC is usually diagnosed in the clinical setting between 20 and 40 years of age. The disease is seldom recognised in infancy or under the age of 10, probably because the clinical expression of the disease is normally postponed to youth and adulthood. This review focuses its attention to the pediatric age, defined as the period of life raging from birth to 18 years. During this span of life, ARVC is not so rare as previously supposed and can be identified by applying the same diagnostic criteria proposed for the adult. Ventricular arrhythmias range from isolated ventricular arrhythmias to sustained ventricular tachycardia and fibrillation. Children and adolescents with ARVC must be carefully evaluated and followed-up especially when a family positive history is present, taking into account the high probability during this life-period that asymptomatic affected patients become symptomatic or that arrhythmias worsen during follow-up. The recent identification of the first defective gene opens new avenues for the early identification of affected subjects even when asymptomatic.
Collapse
Affiliation(s)
- P Turrini
- Department of Pathology, University of Padua Medical School, Padova, Italy
| | - C Basso
- Department of Pathology, University of Padua Medical School, Padova, Italy
| | - L Daliento
- Department of Cardiology University of Padua Medical School, Padova, Italy
| | - A Nava
- Department of Cardiology University of Padua Medical School, Padova, Italy
| | - G Thiene
- Department of Pathology, University of Padua Medical School, Padova, Italy,Contact information: Professor Gaetano Thiene, Istituto di Anatomia Patologica, Via A. Gabelli, 61, 35121 Padova - Italy Tel +390498272283 Fax +390498272284
| |
Collapse
|
44
|
Nava A, Bauce B, Basso C, Muriago M, Rampazzo A, Villanova C, Daliento L, Buja G, Corrado D, Danieli GA, Thiene G. Clinical profile and long-term follow-up of 37 families with arrhythmogenic right ventricular cardiomyopathy. J Am Coll Cardiol 2000; 36:2226-33. [PMID: 11127465 DOI: 10.1016/s0735-1097(00)00997-9] [Citation(s) in RCA: 277] [Impact Index Per Article: 11.5] [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: 10/18/2022]
Abstract
OBJECTIVES We sought to define the clinical picture and natural history of familial arrhythmogenic right ventricular cardiomyopathy (ARVC). BACKGROUND Arrhythmogenic right ventricular cardiomyopathy is a myocardial disease, often familial, clinically characterized by the impending risk of ventricular arrhythmias and sudden death. METHODS Thirty-seven ARVC families of northeast Italy were studied. Probands had a histologic diagnosis of ARVC, either at autopsy (19 families) or endomyocardial biopsy (18 families). Protocol of the investigation included basal electrocardiogram (ECG), 24-hour ECG, signal-averaged ECG, stress test and two-dimensional Doppler echocardiography. Invasive evaluation was performed when deemed necessary. RESULTS Of the 365 subjects, 151 (41%) were affected, 157 (43%) were unaffected, 17 (5%) were healthy carriers, and 40 (11%) were uncertain. Mean age at diagnosis was 31+/-13 years. By echocardiography, 64% had mild, 30% had moderate, and 6% had severe form. Forty percent had ventricular arrhythmias, 49 were treated with antiarrhythmic drugs, and two were treated with implantable cardioverter defibrillators. Sport activity was restricted in all. Of the 28 families who underwent linkage analysis, 6 mapped to chromosome 14q23-q24, 4 to 1q42-q43, and 4 to 2q32.1-q32.3. No linkage with known loci was found in four families and 10 had uninformative results. During a follow-up of 8.5+/-4.6 years, one patient died (0.08 patient/year mortality), and 15 developed an overt form of ARVC. CONCLUSIONS Arrhythmogenic right ventricular cardiomyopathy is a progressive disease appearing during adolescence and early adulthood. Systematic evaluation of family members leads to early identification of ARVC, characterized by a broad clinical spectrum with a favorable outcome. In the setting of positive family history, even minor ECG and echocardiographic abnormalities are diagnostic.
Collapse
Affiliation(s)
- A Nava
- Department of Cardiology, University of Padua Medical School, Italy.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Rampazzo A, Pivotto F, Occhi G, Tiso N, Bortoluzzi S, Rowen L, Hood L, Nava A, Danieli GA. Characterization of C14orf4, a novel intronless human gene containing a polyglutamine repeat, mapped to the ARVD1 critical region. Biochem Biophys Res Commun 2000; 278:766-74. [PMID: 11095982 DOI: 10.1006/bbrc.2000.3883] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Within the ARVD1 (arrhythmogenic right ventricular dysplasia/cardiomyopathy, type 1) critical region, mapped to 14q24.3, we detected an intronless gene of 4859 bp, predominantly expressed in the heart tissue. This gene encodes a 796-amino-acid, proline-rich protein showing polyglutamine and polyalanine tracks with variable length at the N-terminus and a C3HC4 RING finger domain at the C-terminus. CREB and AP-2 binding sites are present in the promoter region. The 5' flanking region contains neither a TATA box nor a CAAT box, but it is high in GC content and includes several Sp1 binding sites. Protein similarity searches revealed a significant match between the C-terminus and a human hypothetical protein, whose gene is located on the chromosome 19 long arm. The predicted protein shows PEST sequences, suggesting its rapid degradation. The novel intronless gene, provisionally named C14orf4 and probably encoding a nuclear protein, was excluded from being the ARVD1 gene.
Collapse
Affiliation(s)
- A Rampazzo
- Department of Biology, University of Padua, Padua, I-35121, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Abstract
UNLABELLED There are anecdotal reports and small series describing the presence of anticardiolipin antibodies in patients with Takayasu Arteritis. This communication describes a systematic study searching for non-organ specific autoantibodies which includes antinuclear antibodies, anticardiolipin and anti-beta(2) GP(1) antibodies in a cohort of 28 Mexicans with angiographic definitive diagnostic of Takayasu Arteritis. MATERIAL AND METHODS Twenty-eight consecutive patients, who fulfilled classification and diagnostic criteria for Takayasu Arteritis and had a diagnostic panaortogram, were bled to study the presence of circulating autoantibodies in a cross-sectional design. RESULTS There were no antinuclear antibodies, although a few sera had faint cytoplasm fluorescent deposit and reacted with cell extract. We did not recognize a distinct pattern. Also, there was no IgG nor IgM anticardiolipin antibodies nor anticofactor antibodies of clinical interest. DISCUSSION AND CONCLUSIONS The presence of circulating non-organ specific autoantibodies is not a characteristic feature in Takayasu Arteritis when strict diagnostic criteria are applied. The occasional presence of such immune markers could be due to technical differences in sample management, less strict diagnosis or biological variability in certain cases, but has no diagnostic value.
Collapse
Affiliation(s)
- A Nava
- Autoimmunity Research Laboratory, Hôpital Notre Dame, Centre Hospitalier de l'Université de Montréal, Quebec, Montreal, Canada
| | | | | | | | | |
Collapse
|
47
|
Abstract
The mechanism underlying cardiac arrest in patients with hypertrophic cardiomyopathy (HC) is intriguing. In the clinical setting, myocardial ischemia has long been incriminated, particularly in the young. Among 274 cardiovascular sudden deaths in the young (< or = 35 years), 19 (7.0%), 14 males and 5 females, median age 23 years, had HC. Familial occurrence of HC was ascertained in 3 (16%). SD occurred on effort in 6 (31%). Previous syncope occurred in 5 and palpitations in 3. Basal electrocardiogram (ECG) was abnormal in 7 of 8 available cases. Hypertrophy was septal asymmetric in 14. Gross examination showed large isolated or multiple septal scars in 11 (58%); at histomorphometry, the mean percent area of fibrosis of the septal myocardium was 18.6 +/- 6. Four showed a deep intramyocardial course of the left anterior descending coronary artery. At histology, myocardial disarray involved 30 +/- 16% of the septal myocardium; evidence of acute-subacute myocardial necrosis was present in 14 (74%), 1 of them with a regional acute myocardial infarction. By comparing hearts with (n = 11) and without (n = 8) areas of scar-type fibrosis, we found a statistically significant difference in terms of age (25.5 +/- 5.4 v 15.5 +/- 12.4 years, P = .04), septal thickness (25.4 +/- 5.4 v 15.4 +/- 4.9 mm, P < .001), percent increase of septal thickness versus normal value for age and sex (46.2 +/- 15 v 25.2 +/- 13.6%, P < .01) and mean score of small vessel disease (1.7 +/- 0.4 v 1.2 +/- 0.4, P = .04). Linear regression analysis showed a positive correlation of percent area of replacement fibrosis with septal thickness (P = .01) and with mean score of small vessel disease (P < .01). In conclusion, our pathologic findings of ischemic damage, either acute-subacute or in the form of fibrotic scars, support the clinical evidence that ischemia occurs in the natural history of HC and may contribute to life-threatening electrical instability.
Collapse
Affiliation(s)
- C Basso
- Department of Pathology, University of Padua Medical School, Italy
| | | | | | | | | | | |
Collapse
|
48
|
Corrado D, Fontaine G, Marcus FI, McKenna WJ, Nava A, Thiene G, Wichter T. Arrhythmogenic right ventricular dysplasia/cardiomyopathy: need for an international registry. European Society of Cardiology and the Scientific Council on Cardiomyopathies of the World Heart Federation. J Cardiovasc Electrophysiol 2000; 11:827-32. [PMID: 10921804 DOI: 10.1111/j.1540-8167.2000.tb00059.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [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: 11/28/2022]
Abstract
Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is a heart muscle disease characterized by peculiar right ventricular involvement and electrical instability that precipitates ventricular arrhythmias and sudden death. The purpose of the present consensus report of the Study Group of the European Society of Cardiology and the Scientific Council on Cardiomyopathies of the World Heart Federation is to review the considerable progress in our understanding of the etiopathogenesis, morbid anatomy, and clinical presentation of ARVD/C since its first description in 1977. This article will focus on the important but still unanswered issues, mostly regarding risk stratification, clinical outcome, and management of affected patients. Because ARVD/C is relatively uncommon and any one center may have experience with only a few patients, an international registry is being established to accumulate information and enhance the numbers of patients that can be analyzed to answer the pending questions. The registry also will facilitate pathologic, molecular, and genetics research on the etiology and pathogenesis of the disease. Furthermore, availability of an international database will enhance awareness of this largely unrecognized condition among the medical community. Physicians are encouraged to enroll patients in the International Registry of ARVD/C.
Collapse
Affiliation(s)
- D Corrado
- Department of Cardiology, University of Padova Medical School, Italy.
| | | | | | | | | | | | | |
Collapse
|
49
|
Calabrese F, Angelini A, Thiene G, Basso C, Nava A, Valente M. No detection of enteroviral genome in the myocardium of patients with arrhythmogenic right ventricular cardiomyopathy. J Clin Pathol 2000; 53:382-7. [PMID: 10889821 PMCID: PMC1731194 DOI: 10.1136/jcp.53.5.382] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIMS Despite the evidence of familial occurrence, chromosomal gene mapping, and apoptosis as a mechanism of myocyte death, the aetiopathogenesis of arrhythmogenic right ventricular cardiomyopathy (ARVC) remains speculative. Because of the frequent histological finding of focal inflammatory infiltrates, the hypothesis of an infective myocarditis aetiology has been put forward. The aim of this investigation was to test this hypothesis. The presence of enteroviruses was investigated by a highly sensitive and specific molecular technique. METHODS Endomyocardial tissue samples from 20 patients with ARVC (11 male, nine female; mean age, 40 years; SD, 16) and 20 control subjects with other cardiac diseases were analysed using reverse transcription and nested polymerase chain reaction (PCR). Myocardial samples obtained from four patients with enteroviral myocarditis and coxsackie B3 virus infected cells were used as positive controls. RESULTS Endomyocardial biopsy was diagnostic for ARVC in all patients: myocardial atrophy was seen, with less than 45% residual myocytes. Foci of inflammatory infiltrates were seen in four biopsies, and the cells were identified by immunohistochemistry as mainly T cells. All samples, from both patients with ARVC and subjects with other cardiac diseases, were negative for enteroviral genome by means of nested PCR. CONCLUSION These findings indicate that enteroviruses are not involved in the aetio-pathogenesis of ARVC. Future molecular studies should investigate the presence of other infective agents, as well as their possible role in triggering apoptosis.
Collapse
Affiliation(s)
- F Calabrese
- Institute of Pathological Anatomy, University of Padua, Padova, Italy
| | | | | | | | | | | |
Collapse
|
50
|
|