Benefit of isolated surgical valve repair or replacement for functional tricuspid regurgitation and long-term outcomes stratified by the TRI-SCORE.

Background And Aims: Severe tricuspid regurgitation is associated with increased mortality rates, but benefit of its correction and ideal timing are not clearly determined. This study aimed to identify patient subsets who might benefit from the surgery.

Methods: In TRIGISTRY, an international cohort study of consecutive patients with severe isolated functional tricuspid regurgitation (33 centres, 10 countries), survival rates up to 10 years were compared between patients who underwent isolated tricuspid valve surgery (repair or replacement) and those conservatively managed, overall and according to TRI-SCORE category (low: ≤3, intermediate: 4-5, and high: ≥6).

Predictive value of the TRI-SCORE for in-hospital mortality after redo isolated tricuspid valve surgery.

Objectives: The TRI-SCORE reliably predicts in-hospital mortality after isolated tricuspid valve surgery (ITVS) on native valve but has not been tested in the setting of redo interventions. We aimed to evaluate the predictive value of the TRI-SCORE for in-hospital mortality in patients with redo ITVS and to compare its accuracy with conventional surgical risk scores.

Methods: Using a mandatory administrative database, we identified all consecutive adult patients who underwent a redo ITVS at 12 French tertiary centres between 2007 and 2017.

TRI-SCORE: a new risk score for in-hospital mortality prediction after isolated tricuspid valve surgery.

Aims: Isolated tricuspid valve surgery (ITVS) is considered to be a high-risk procedure, but in-hospital mortality is markedly variable. This study sought to develop a dedicated risk score model to predict the outcome of patients after ITVS for severe tricuspid regurgitation (TR).

Methods And Results: All consecutive adult patients who underwent ITVS for severe non-congenital TR at 12 French centres between 2007 and 2017 were included.

Isolated tricuspid valve surgery: impact of aetiology and clinical presentation on outcomes.

Aims: The aim of this study was to identify determinants of in-hospital and mid-term outcomes after isolated tricuspid valve surgery (ITVS) and more specifically the impact of tricuspid regurgitation (TR) mechanism and clinical presentation.

Methods And Results: Among 5661 consecutive adult patients who underwent a tricuspid valve (TV) surgery at 12 French tertiary centres in 2007-2017 collected from a mandatory administrative database, we identified 466 patients (8% of all tricuspid surgeries) who underwent an ITVS. Most patients presented with advanced disease [47% in New York Heart Association (NYHA) III/IV, 57% with right-sided heart failure (HF) signs].

[Acute exacerbations of COPD admitted to hospital: predictive factors of 3 year mortality].

Introduction: COPD is a disease whose gravity is underestimated by doctors and patients. The development of acute exacerbations (AE) accelerates the progression of the disease and leads to increased financial costs, notably on account of hospitalisation.

Materials And Methods: An observational prospective study will be undertaken based on a cohort of consecutive patients hospitalised in departments of respiratory medicine in general hospitals.

The lipid composition of high-density lipoprotein affects its re-absorption in the kidney by proximal tubule epithelial cells.

The kidney is believed to play a major role in the clearance of apoA-I (apolipoprotein A-I) and HDL (high-density lipoprotein) particles from the bloodstream. Proximal tubule epithelial cells of the kidney appear to prevent the loss of these proteins in the urine by re-absorbing them from the urinary filtrate. Experiments were undertaken to investigate the factors that regulate the renal re-absorption of apoA-I and small HDL in a transformed human proximal tubule epithelial (HKC-8) cell line.

Alterations in slow-twitch muscle phenotype in transgenic mice overexpressing the Ca2+ buffering protein parvalbumin.

The purpose of this study was to determine whether induced expression of the Ca2+ buffering protein parvalbumin (PV) in slow-twitch fibres would lead to alterations in physiological, biochemical and molecular properties reflective of a fast fibre phenotype. Transgenic (TG) mice were generated that overexpressed PV in slow (type I) muscle fibres. In soleus muscle (SOL; 58 % type I fibres) total PV expression was 2- to 6-fold higher in TG compared to wild-type (WT) mice.

Phosphatidylinositol promotes cholesterol transport in vivo.

To examine the role that lipoprotein charge plays in cholesterol metabolism in vivo, we characterized the effects of an intravenous injection of 40 micromol of an uncharged phospholipid (phosphatidylcholine, PC) or an anionic phospholipid (phosphatidylinositol, PI) into fasted rabbits. PC injection had a negligible effect on lipoprotein charge and composition, similar to that observed in a saline-injected animal. In contrast, PI injection caused a significant increase in the net negative surface charge of all lipoproteins after only 10 min, followed by a gradual return to normal by 24 h.

[Hypersomnia. Sleep apnea syndrome and somnolence].

A RECENTLY DEFINED SYNDROME: Sleep apnea syndrome is defined as 5 episodes of apnea or 10 episodes of hyopnea per hour of sleep; the cardinal symptom is excessive diurnal somnolence. Two factors could explain sleep apnea syndrome: hypoxemia and fragmented sleep. ROLE OF HYPOXEMIA: Early studies focused on hypoxemia, but few took into account the effect of subjective complaints of somnolence.

Treatment of respiratory failure using minitracheotomy and intratracheal oxygenation in selected patients with chronic lung disease.

Objective: To evaluate the efficacy of minitracheotomy (MT) insertion for intratracheal oxygen insufflation (ITO2) on arterial blood gases and survival in patients with respiratory failure from chronic lung disease.

Design: Open, prospective clinical study.

Setting: A 12-bed medical intensive care unit in a non-university hospital.

[Results of an educational program on the autonomy of patients tracheotomized for chronic respiratory insufficiency].

In 1984 an educational programme was drawn up for patients with chronic respiratory failure and tracheotomies (IRCT) aimed at their obtaining independence and self-sufficiency. A prospective evaluation was made in parallel with the diary cards of the nurses (SI) measuring the level of dependence of care, defined by 15 characteristics and based on objective and analysable data. After excluding those patients who are already independent (22), decreased or transferred on account of decompensation (23) or removal of the tracheostomy tube (27), 92 patients (46 obstructive and 46 restrictive) coming from 31 centres of respiratory care or intensive care were studied between January 1985 and December 1986: 17 patients were bed-ridden and non-educable and were used as control subjects (T), and 75 patients entered the educational programme.

[Complications of tracheotomy].

The complications of tracheotomy are reviewed and divided into two categories: early and late complications depending on whether the cannula has been removed or remains in situ. In the acute period, severe haemorrhages (0.3 to 2%) and oesophagotracheal fistulae (0.