Levosimendan is a positive inotrope with vasodilating properties (inodilator) indicated for decompensated heart failure (HF) patients with low cardiac output. Accumulated evidence supports several pleiotropic effects of levosimendan beyond inotropy, the heart and decompensated HF. Those effects are not readily explained by cardiac function enhancement and seem to be related to additional properties of the drug such as anti-inflammatory, anti-oxidative and anti-apoptotic ones. Mechanistic and proof-of-concept studies are still required to clarify the underlying mechanisms involved, while properly designed clinical trials are warranted to translate preclinical or early-phase clinical data into more robust clinical evidence. The present position paper, derived by a panel of 35 experts in the field of cardiology, cardiac anesthesiology, intensive care medicine, cardiac physiology, and cardiovascular pharmacology from 22 European countries, compiles the existing evidence on the pleiotropic effects of levosimendan, identifies potential novel areas of clinical application and defines the corresponding gaps in evidence and the required research efforts to address those gaps.
F.22 Improvement to existing health/diagnostic methods/procedures
COBISS.SI-ID: 3105964ViperfavTM is a commercial F(ab’)2 antivenom prepared against European vipers venom. It is safe and effective for treating envenomation caused by Vipera aspis and Vipera berus. Therapeutic efficacy for treating Vipera ammodytes ammodytes (V. a. ammodytes) envenoming has not been yet described, although protective efficacy has been demonstrated in preclinical studies. We report on a 32-year-old man bitten by V. a. ammodytes who was treated with Viperfav™. Viperfav™ promptly reduced local extension and improved systemic pathological signs, but 24 h after the incident a recurrence of thrombocytopenia occurred despite a favorable pharmacokinetic profile with systemic clearance (1.64 (mL_h-1)_kg-1) and elimination half-life (97 h) among the highest ever reported. The recommended dose of Viperfav™ for V. aspis and V. berus bites may be inadequate for serious V. a. ammodytes envenomations. Following V. a. ammodytes bite, serial blood counts and coagulation profiles should be performed to help guide Viperfav™ treatment, along with supplemental administration as indicated.
F.22 Improvement to existing health/diagnostic methods/procedures
COBISS.SI-ID: 29680935Astrocytes support the brain through numerous functional interactions in health and disease. From the evidence discussed in this review, we show that histamine importantly influences the main astrocytic activities such as ion homeostasis, energy metabolism, neurotransmitter clearance, neurotrophic activity and immune response. These processes are mediated through at least three histamine receptor subtypes, H1, H2 and H3, expressed on the astrocyte surface. Thus, we recognize histamine as an important player in the modulation of astrocytic functions that deserves further considerations in exploring involvement of astrocytes in neurological disorders.
F.02 Acquisition of new scientific knowledge
COBISS.SI-ID: 32771801We analyzed anterior cruciate ligament reconstruction (ACLR) patients in order to evaluate degenerative changes and the effect of meniscal insufficiency at mid-term follow-up. Sixty subjects (40 patients at 5.9 years after ACLR, 20 healthy controls) underwent 3T MRI. Quantitative cartilage T2 mapping and morphological Whole Organ Magnetic Resonance Imaging Score (WORMS) evaluation were performed. Self-reported questionnaires were used for subjective clinical evaluation. Based on the meniscal status at ACLR, further subdivision within each compartment (lateral and medial) was made: menisci intact and menisci insufficient. The ACLR subjects showed significantly elevated T2 values and higher WORMS scores compared to the control group. T2 values of the anterior lateral femoral sub-compartment were significantly higher in menisci insufficient group compared to the control group. In both compartments significantly higher WORMS scores were observed in the menisci insufficient group compared to the menisci intact group. CONCLUSIONS: ACLR knees exhibit cartilage matrix and morphological degeneration at mid-term follow-up. Lateral meniscal insufficiency noted at ACLR presents a higher risk of developing degenerative changes than does the medial meniscus insufficiency; however, this difference may not be detected clinically.
F.22 Improvement to existing health/diagnostic methods/procedures
COBISS.SI-ID: 3021996Mobilized peripheral blood is the most common source of CD34+ cells intended for transplantations. The collection and enrichment of CD34+ cells could be affected by various factors and there are some controversies regarding the effects of patient-related factors. The aim of this study was to assess the impact of age, sex, and diabetes on the CD34+ cell grafts in patients with chronic heart failure. Older patients had significantly lower CD34+ cell counts than younger patients. The differences between men and women were not found. Conclusion: Before the CD34+ cells are collected the patient's age should be considered. The study did not demonstrate a significant impact of sex on the CD34+ cell count. While age and sex did not affect the mmunoselection process, diabetes slightly reduced cell recovery.
F.22 Improvement to existing health/diagnostic methods/procedures
COBISS.SI-ID: 32646105