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    ABSTRACT: More patients with end-stage heart failure are now being supported by left ventricular assist devices (LVAD) as a bridge to heart transplant. The LVAD unloads the failing heart and modifies the myocardial structure, with regression of left ventricular hypertrophy. The regression of hypertrophy has been reported histomorphologically in paired samples of myocardial tissues obtained from the same patient at the time of LVAD implantation and the heart excised at transplant. The understanding of the mechanisms of recovery may contribute to strategic development for LVAD weaning and the use of LVAD as a destination therapy.
    Heart Failure Clinics 01/2014; 10(1 Suppl):S63-74.
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    ABSTRACT: The care of immunosuppressed patients has constantly improved over the years, and pharmacologic developments contributed significantly to this success. However, despite these advances, current anti-infectious agents are limited in their efficacy by either weak specificity or side effects, including suppression of bone marrow function. Control of infection will ultimately depend on reconstitution of specific immunity. Thus, adoptive cellular immunotherapy represents an attractive, low-toxicity strategy to restore specific immune surveillance, and prevent/treat potentially life-threatening disease due to pathogens relevant to the immunosuppressed host. Evidence derived from trials conducted in recipients of hematopoietic stem cell transplantation indicate that adoptive transfer of antigen-specific T cells is a feasible and safe strategy to restore protective immunity and prevent or reverse virus-associated disease. Despite the great potential, immunotherapy for viral and fungal disease still has a marginal role in the management of immunosuppressed patients. This is due to limitations inherent to the technologies and products employed, and, more importantly, to the financial and structural requirements that are associated with GMP production. However, cell therapy offers a unique opportunity to restore antipathogen immune surveillance, and it is therefore conceivable that application of this strategy will increase in the next few years.
    Early Human Development. 01/2014; 90:S16–S18.
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    ABSTRACT: Lung cancer is among the most common cancers in the world. Despite advances in defining the molecular mechanisms involved in lung oncogenesis and the remarkable efforts made to improve screening programs for secondary cancer prevention, patients' prognosis remains poor. Moreover, wide international inequalities remain apparent, even among developed countries. Here we analyze and discuss the findings of the extensive work by Walters S et al., recently published in "Thorax", which aimed to clarify whether differences in stage at diagnosis might explain these divergences. A better understanding of why survival differences between different states still exist will facilitate policy design to increase lung cancer overall survival itself and to bring it up to the highest international standards. It is the first international population-based study of lung cancer survival by stage at diagnosis and includes nearly 60,000 patients. By using a well detailed and appropriate statistical approach, authors conclude that improvement in outcomes is primarily related to a proper initial disease staging and that socioeconomic international and interregional inequalities might play a relevant role in this scenario. Our review takes in consideration both the methodological and scientific issues of the paper, focusing on the potential consequences in lung cancer management and on the need, in the post genomic era, of a molecular-based epidemiologic approach.
    Minerva medica 12/2013;

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