Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The carotid body (CB) is an important organ located at the carotid bifurcation that constantly monitors the blood supplying the brain. During hypoxia, the CB immediately triggers an alarm in the form of nerve impulses sent to the brain. This activates protective reflexes including hyperventilation, tachycardia and vasoconstriction, to ensure blood and oxygen delivery to the brain and vital organs. However, in certain conditions, including obstructive sleep apnea, heart failure and essential/spontaneous hypertension, the CB becomes hyperactive, promoting neurogenic hypertension and arrhythmia. G-protein-coupled receptors (GPCRs) are very highly expressed in the CB and have key roles in mediating baseline CB activity and hypoxic sensitivity. Here, we provide a brief overview of the numerous GPCRs that are expressed in the CB, their mechanism of action and downstream effects. Furthermore, we will address how these GPCRs and signaling pathways may contribute to CB hyperactivity and cardiovascular and respiratory disease. GPCRs are a major target for drug discovery development. This information highlights specific GPCRs that could be targeted by novel or existing drugs to enable more personalized treatment of CB-mediated cardiovascular and respiratory disease.
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PMID:G-Protein-Coupled Receptor (GPCR) Signaling in the Carotid Body: Roles in Hypoxia and Cardiovascular and Respiratory Disease. 3282 27

COVID-19 is a highly infectious respiratory disease caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Starting from Wuhan (China) where it was firstly reported, it rapidly spread to the rest of the world, causing a pandemic with more than 300,000 deaths to date. We report an extremely severe case of coronavirus pneumonia in an over 80-year-old patient with hypertension, coronary heart disease, chronic heart failure, and chronic obstructive pulmonary disease. Despite a clearly poor anamnestic and clinical prognostic forecast, she was successfully discharged thanks to a careful evaluation of the case and of the complications that have arisen. Although a higher vulnerability of geriatric patients has been observed, the literature on elderly COVID-19 patients has remained very scarce, especially in those over 80. The article aims to explore factors that may allow the successful outcome and provides important elements to better understand this disease.
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PMID:Extremely Severe Case of COVID-19 Pneumonia Recovered Despite Bad Prognostic Indicators: a Didactic Report. 3283 53

Introduction Postoperative atrial fibrillation (PAF) is one of the most common complications after noncardiac thoracic surgery, increasing postoperative mortality, morbidity and hospital stay. However, the etiology of PAF still remains unclear. It is proved video-assisted thoracoscopic surgery (VATS) has significantly less morbidity and a shorter hospital stay than open procedures. Nevertheless, there is no agreement if VATS is related to incidence of PAF, with some data suggesting this procedure, by obviating surgical stress induced by ribspreading thoracotomy, may result in a decreased rate of PAF. Objectives Compare the incidence of PAF after anatomical lung resection for Non-Small-Cell Lung Cancer (NSCLC) following open surgery versus VATS. Materials and Methods Single center retrospective study of all consecutive patients diagnosed with NSCLC submitted to anatomical lung resection from 2015 to 2019 (N=564). Exclusion criteria: prior atrial fibrillation (26), previous lung surgery (29), concomitant procedures (10), pneumectomy (14), extra-lung resections (41), urgency surgery (5). The population of study was 439 patients. Primary end-point: PAF, defined by in- -hospital electrocardiographically documented atrial fibrillation requiring initiation of pharmacological therapy. The patients were divided in 2 groups according to type of procedure: thoracotomy or VATS. Patients converted from VATS for whatever reason were assigned to thoracotomy group. Univariable analysis was used to compare the baseline characteristics of the 2 groups. We use inverse probability of treatment weighting (IPTW) multivariable logistic regression model to obtain unbiased estimates of average procedure effect on PAF. A total of 22 clinical variables were included in the model. The balance between treatment groups after IPTW was assessed by standardized mean differences. Results Two hundred and eighty patients (63.8%) were submitted to thoracotomy and 159 (36.2%) to VATS. Patients submitted to VATS were more likely to be females (p=0.004), had a lower prevalence of Diabetes Mellitus (p=0.028), previous respiratory disease (p=0,042), non-adenocarcinoma (p<0.001) and chronic heart failure (p=0.026). They were submitted less often to neoadjuvant therapy (p<0.001), bilobectomy (p=0.001) and they presented higher levels of diffusing capacity for carbon monoxide (p=0.001). After IPTW adjustment, all clinical covariates were well balanced. PAF occurred in 8.6% of the patients undergoing thoracotomy and 3,8% of the patients after VATS. After IPTW adjustment, VATS was not associated with a lower incidence of PAF (OR 0.40; CI95%:0.140-1.171; p=0.095). Conclusions In this study, minimally invasive non-rib spreading VATS did not decrease the incidence of PAF when compared with standard thoracotomy regarding anatomical lung resection for NSCLC.
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PMID:Postoperative Atrial Fibrillation - Video-Assisted Thoracoscopic Surgery Versus Open Surgery. 3328 Mar 3


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