Heart Failure With Reduced Ejection Fraction Is Characterized by Systemic NEP Downregulation.

Based on the investigation of neprilysin (NEP) regulation in a translational porcine model of chronic heart failure (HF), this study concluded: 1) that kidneys might play a crucial part in systemic NEP regulation based on 20 to 100 higher NEP content and/or activity compared with any other organ; 2) NEP seems to be downregulated under HF conditions; and 3) that the value of plasma NEP concentrations and activity as biomarkers is questionable. For the first time, these data provide basic knowledge on HF-related pathophysiological alterations of the NEP system and contribute to understanding the mechanism of action of angiotensin-receptor neprilysin-inhibitors, which remains elusive despite broad clinical applications.

Comparison of 'post-patent ductus arteriosus ligation syndrome' in premature infants after surgical ligation vs. percutaneous closure.

Objective: To compare the incidence of post-PDA ligation syndrome after surgical vs. percutaneous closure of PDAs in very low birth weight (VLBW) infants.

Study Design: Cohort study comparing 59 infants who underwent surgical ligation with 25 infants who underwent percutaneous closure.

Creation and Validation of Tool to Assess Resident Competence in Neonatal Resuscitation.

Background: The American Board of Pediatrics requires that pediatricians be able to initiate stabilization of a newborn. After residency, 45% of general pediatricians routinely attend deliveries. However, there is no standard approach or tool to measure resident proficiency in newborn resuscitation across training programs.

The amount of supervision trainees receive during neonatal resuscitation is variable and often dependent on subjective criteria.

Objective: Measure variation in delivery room supervision provided by neonatologists using hypothetical scenarios and determine the factors used to guide entrustment decisions.

Study Design: A survey was distributed to members of the American Academy of Pediatrics Section on Perinatal Pediatrics. Neonatologists were presented with various newborn resuscitation scenarios and asked to choose the level of supervision they thought appropriate and grade factors on their importance in making entrustment decisions.

Intrinsic remote conditioning of the myocardium as a comprehensive cardiac response to ischemia and reperfusion.

We have previously shown that distal anterior wall ischemia/reperfusion induces gene expression changes in the proximal anterior myocardial area, involving genes responsible for cardiac remodeling. Here we investigated the molecular signals of the ischemia non-affected remote lateral and posterior regions and present gene expression profiles of the entire left ventricle by using our novel and straightforward method of 2D and 3D image reconstruction. Five or 24h after repetitive 10min ischemia/reperfusion without subsequent infarction, pig hearts were explanted and myocardial samples from 52 equally distributed locations of the left ventricle were collected.