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Introduction and objectives: Right ventricle (RV) measurements are crucial for certain congenital heart diseases and various cardiovascular conditions. Echocardiographic RV diameters are especially useful for its assessment. Paediatric echocardiographic data standardisation in normal subjects is complex, scarce, and heterogeneous. The aim of this study was to establish reliable and reproducible echocardiographic reference values (Z-score) of RV diameters in a healthy Spanish paediatric cohort. Methods: A multicentre study was conducted on 661 healthy subjects (age range 0–18 years, 43.5% female). Several regression models were tested to examine the relationship between RV diameters and biometric variables. Heteroscedasticity and residual associations (Shapiro–Wilk and Breusch–Pagan tests) and confounding factors (gender, age, inter/intraobserver agreement) were considered for an unbiased standardisation. Results: Structured Z-scores were computed for each RV diameter. Predicted mean value for each diameter was determined according to age, weight, height, and different body surface area. The Haycock formula provided the best fit for basal, midcavity, and longitudinal diameters (R2 0.81, 0.82, 0.9). Confounders were not significant, and therefore not included in final models (inter/intraobserver agreement > 0.9). Conclusions: This study reports reference values for echocardiographic RV diameters from a Spanish healthy paediatric cohort using a rigorous statistical design. These Z-scores partly cover a gap in current paediatric cardiology and represent a relevant diagnostic tool for clinical practice, as well as a useful guide to decision making at any paediatric stage. Resumen: Introducción y objetivos: La cuantificación del tamaño del ventrículo derecho (VD) es crucial en determinadas cardiopatías congénitas. Para su evaluación se recomiendan distintas técnicas de imagen, siendo más accesible la medición de diámetros ventriculares mediante ecocardiografía. En pediatría la normalización de parámetros ecocardiográficos es compleja, escasa y heterogénea. El objetivo de este estudio consistió en establecer Z-score de diámetros de VD fiables y reproducibles capaces de predecir valores de referencia en población pediátrica sana española. Métodos: Estudio multicéntrico prospectivo de 661 pacientes sanos (edades 0–18 años, 43.5% mujeres). Los diámetros ecocardiográficos del VD se relacionaron con variables biométricas mediante distintas ecuaciones de regresión. Para su estandarización se analizaron factores de confusión (sexo, edad y variabilidad inter/intraobservador), heterocedasticidad y residuos (test Saphiro–Wilk y Breusch–Pagan). Resultados: Se obtuvieron curvas de normalidad (Z-score) para cada diámetro del VD que permitieron predecir el valor medio de cada diámetro en función de la edad, peso, talla y distintas superficies corporales. La superficie corporal según fórmula de Haycock ofreció un excelente ajuste para los distintos diámetros basal, medial y longitudinal (R2 0.81, 0.82, 0.9). Los factores de confusión no aportaron cambios significativos, por lo que no fueron incluidos en los modelos finales (variabilidad inter e intraobservador, CCI > 0.9). Conclusiones: Se brindan valores de referencia de diámetros VD de población pediátrica sana. Las curvas de Z-score ofrecidas cubren una importante carencia en cardiología pediátrica y son aplicables a todos los grupos de edad para evaluar el tamaño del VD, de gran interés clínico en la práctica diaria.

We present the case of an 80-year-old man who presented with symptomatic severe aortic stenosis and coronary artery disease (proximal left anterior descending artery, proximal circumflex artery, and first marginal branch). Surgical risk was considered high (Society of Thoracic Surgeons score 8.3%)

Background: Limited data are available regarding change in the nutritional status after transcatheter aortic valve replacement (TAVR). This study evaluated the prognostic impact of the change in the geriatric nutritional risk index following TAVR. Methods: TAVR patients were analyzed in a prospective and observational study. To analyze the change in nutritional status, geriatric nutritional risk index of the patients was calculated on the day of TAVR and at 3-month follow-up. The impact of the change in nutritional risk index after TAVR on all-cause mortality, heart failure hospitalization (HF-h), and the composite of all-cause death and HF hospitalization was analyzed using the Cox Proportional Hazards model. Results: Four hundred thirty-three patients were included. After TAVR, 68.4% (n=182) patients with baseline nutritional risk improved compared with 31.6% (n=84) who remained at nutritional risk. The change from no-nutritional risk to nutritional risk after TAVR occurred in 15.0% (n=25), while 85.0% (n=142) remained without risk of malnutrition. During follow-up, 157 (36.3%) patients died and 172 patients (39.7%) were hospitalized due to HF. Patients who continued to be at nutritional risk had a higher risk of mortality (hazard ratio [HR], 2.10 [95% CI, 1.30–3.39], P =0.002), HF-h (HR, 1.97 [95% CI, 1.26–3.06], P =0.000), and the composite of death and HF-h (HR, 2.0 [95% CI, 1.37–2.91], P P =0.003), HF-h (HR, 0.50 [95% CI, 0.34–0.74], P =0.001), and the composite outcome (HR, 0.44 [95% CI, 0.32–0.62], P Conclusions: Remaining at nutritional risk after TAVR confers a poor prognosis and is associated with an increased risk of mortality and HF-h, while the change from risk of malnutrition to non-nutritional risk after TAVR was associated with a halving of the risk of mortality and HF-h. Further studies are needed to identify whether patients at nutritional risk would benefit from nutritional intervention during processes of care of TAVR programs.

A 75-year-old patient with 2-vessel disease underwent percutaneous coronary intervention (PCI) for recanalization of chronic total occlusion (CTO) of the right coronary artery. Successful recanalization of the CTO was achieved by an antegrade approach to the posterolateral branch and by retrograde

Objectives The goal of this study was to determine the functional impact of paradoxical low-gradient aortic stenosis (PLGAS) and clarify whether the relevance of the valvular obstruction is related to baseline flow. Background Establishing the significance of PLGAS is particularly challenging. Methods Twenty symptomatic patients (77 ± 6 years of age; 17 female subjects) with PLGAS (mean gradient 28 ± 6 mm Hg; aortic valve area 0.8 ± 0.1 cm2; ejection fraction 66 ± 7%) underwent cardiopulmonary exercise testing combined with right-heart catheterization and Doppler echocardiographic measurements. Results Aortic valve area increased by 84 ± 23% (p 1.0 cm2 at peak exercise. Stroke volume index and blood pressure increased by 83 ± 56% and 26 ± 16%, respectively (both p Conclusions In symptomatic patients with PLGAS, the capacity to dynamically reduce vascular and valvular loads determines the effect of exercise on PCWP, which, in turn, conditions the functional status. A critically fixed valvular obstruction may not be the main mechanism of functional impairment in a large proportion of patients with PLGAS. Exercise echocardiography is suitable to study the dynamics of PLGAS.

Introduction:Cardiovascular disease (CVD) is an important cause of morbimortality in patients with low risk myelodysplastic syndrome (LR-MDS). Up to 70% of patients suffer cardiovascular events and heart disease is the second cause of death in this context. Cardiac damage etiology is complex and multifactorial in this group of patients. Iron overload cardiomyopathy (IOC) due to transfusion dependency is the most well identified factor in this setting, however other circumstances such as vascular aging, cardiac reserve reduction and high cardiac output related to chronic anemia, among others, play an important role in this population. Thus, despite its importance in MDS patients, prognostic cardiovascular predictive factors are not adequately identified, and cardiac monitoring in these patients is not sufficiently stablished. Therefore, our objectives were to determinate the prevalence and characterization of CVD in LR-MDS patients, to analyze their mortality and cardiovascular prognosis and to identify predictors of cardiovascular events or death (combined event, CE) in this setting. Material and methods: A prospective single center study with 36 LR-MDS patients (31 of them in transfusion requirements) was conducted. All patients underwent a complete hematological and cardiological assessment including ECG, cardiac biomarkers (N-terminal pro b-type natriuretic peptide (NT-proBNP) and high-sensitive cardiac T troponine (hs-cTn)) and cardiac magnetic resonance (CMR) with parametric sequences (T1, T2 and T2* mapping) and myocardial deformation by feature tracking (FT). Univariate and multivariate analysis including clinical, analytical and imaging factors for predicting the combined cardiovascular event (heart failure (HF), arrhythmia or ischemic heart disease) and/or all-cause of mortality (CE) was performed by Cox regression. Results:Thirty-six patients with LR-MDS were recruited from 2016 to 2017, with a mean age of 76 ± 10 years, 53% males. Thirty-one patients (84%) were in transfusion dependency (TD). Regarding baseline characteristics for cardiovascular disease most of them (90.9%) had CV risk factors (CVRFs) and 36% suffered of previous heart disease (Baseline characteristics, hematological and cardiac situation at inclusion in table 1). Cardiac assessment revealed high prevalence of structural heart disease, in most of cases previously unknown and significant incidence of CV events during the follow-up. Thus, Cardiac MR detected high prevalence structural heart disease (table 2). As a result of this first cardiac assessment, 15 patients (42%) required modifications in their cardiovascular treatment and most of cases needed to start cardiovascular treatment. After a median follow up of 2.2 years, 35.5% of TD patients suffered the CE, 16% died and 32% presented cardiovascular events: HF 13.9%, pacemaker implantation due to atrioventricular block 2.8%, ischemic heart disease 5.6%, and atrial fibrillation 5.6%. In the univariate analysis for the CE (table 3), higher hs-cTn (p=0,007), higher NT-proBNP (p = 0.001), T2* Conclusion: LR- MDS patients presented high prevalence of cardiovascular risk factors and structural heart disease and most of cases were only identified after an appropriate cardiological assessment. The presence of a CV event and/or death is very frequent during patients follow up. Cardiac biomarkers and CMR could improve the identification of patients at risk for CVD in which a cardiological treatment and follow-up could improve survival. Disclosures Díez-Campelo: Novartis: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Celgene Corporation: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding.

Recently, the existence of a population of stem cells located in the adipose tissue has been observed. Adipose-derived stem cells are able to differentiate into multiple cell lineages including cardiac myocytes. Hence, adipose-derived cells are emerging as a new source of adult stem cells for cardiovascular repair. In this review, we discuss the basic principles of adipose-derived stem cells (types and characteristics, obtention processes, immunophenotypic characterization, and cell potency), the initial experimental studies, and the currently ongoing clinical trials.

The goal of this study was to determine the functional impact of paradoxical low-gradient aortic stenosis (PLGAS) and clarify whether the relevance of the valvular obstruction is related to baseline flow.Establishing the significance of PLGAS is particularly challenging.Twenty symptomatic patients (77 ± 6 years of age; 17 female subjects) with PLGAS (mean gradient 28 ± 6 mm Hg; aortic valve area 0.8 ± 0.1 cmAortic valve area increased by 84 ± 23% (p 0.001) and, in 70% of subjects, it reached values1.0 cmIn symptomatic patients with PLGAS, the capacity to dynamically reduce vascular and valvular loads determines the effect of exercise on PCWP, which, in turn, conditions the functional status. A critically fixed valvular obstruction may not be the main mechanism of functional impairment in a large proportion of patients with PLGAS. Exercise echocardiography is suitable to study the dynamics of PLGAS.

Introduccion y objetivos Evaluar el efecto de una intervencion de mejora de calidad en la reduccion del riesgo cardiovascular de los pacientes hipertensos. Pacientes y metodo Estudio cuasiexperimental que incluye 2 centros de atencion primaria. Un centro fue asignado para recibir una intervencion de mejora de calidad (n = 482 pacientes hipertensos) y otro, la atencion habitual (n = 360 pacientes hipertensos). La intervencion de mejora de calidad consistio en un programa combinado para el personal sanitario que incluyo: audit, feedback, sesiones de formacion e implementacion de guias clinicas. Las mediciones principales fueron: presion arterial, lipidos, diabetes, tabaquismo y riesgo cardiovascular al inicio del seguimiento, previo a la intervencion y 1 ano despues. Resultados Las caracteristicas basales de los grupos fueron similares. El riesgo cardiovascular absoluto decrecio del 15,85 al 14,36% (p 20% en 10 anos) disminuyo en el grupo de intervencion del 30 al 25% (p 0,05). El efecto de la intervencion fue, por tanto, un descenso del riesgo relativo de 0,25 (IC del 95%, 0,14–0,35). Conclusiones El riesgo cardiovascular absoluto y relativo en pacientes hipertensos disminuyo por la intervencion de mejora de calidad. Ademas, se consiguio una reduccion del porcentaje de pacientes con riesgo cardiovascular alto.

We report the case of a 53-year-old patient with a mitral prosthesis hospitalized for heart failure. Diagnosis of mitral prosthetic thrombosis, led to a therapeutic disjunction between thrombolysis and surgery. Because of the high risk of surgical intervention, the patient was treated with r-TPA (accelerated infusion), showing immediate, successful response.

A lifetime experiment using 4279 CBA/J mice was carried out to investigate whether the pre-conceptual exposure of sperm cells to X-ray radiation or urethane would result in an increased cancer risk in the untreated progeny, and/or increased susceptibility to cancer following exposure to a promoting agent. The study consisted of four main groups, namely a control group (saline), a urethane group (1 mg/g body wt) and two X-ray radiation groups (1 Gy, 2 Gy). At 1, 3 and 9 weeks after treatment, the males of these four parental groups were mated with untreated virgin females. The offspring of each parental group was divided into two subgroups: one received s.c. urethane (0.1 mg/g body wt once) as a promoter, the other saline, at the age of 6 weeks. All animals were evaluated for the occurrence of tumours. K-ras oncogene and p53 tumour suppressor gene mutations were investigated in frozen lung tumour samples. The female offspring of male parents exposed to X-rays 1 week before their mating showed a trend towards a higher tumour incidence of the haematopoietic system than the F1 controls. In addition, a higher percentage of bronchioloalveolar adenocarcinomas in male offspring born to irradiated paternals mated 1 week after X-ray treatment points to a plausible increased sensitivity of post-meiotic germ cell stages towards transgenerational carcinogenic effects. On the other hand, no increased tumour incidence and malignancy were observed in the offspring born to irradiated paternals mated 3 and 9 weeks after X-ray treatment. Paternal urethane treatment 1, 3 and 9 weeks prior to conception did not result in significantly altered incidence or malignancy of tumours of the lung, liver and haematopoietic tissue in the offspring. K-ras mutations increased during tumour progression from bronchioloalveolar hyperplasia to adenoma. Codon 61 K-ras mutations were more frequent in lung tumours of urethane-promoted progeny from irradiated parents than from control parents. P53 mutations were absent from these lung alterations.

Introduccion y objetivos Un volumen plaquetario elevado en la fase cronica del infarto de miocardio se asocia con un mayor riesgo de episodios isquemicos recurrentes y muerte, pero el significado de este signo sobre el pronostico a corto plazo del infarto de miocardio es desconocido. Los objetivos del presente estudio fueron investigar la influencia del volumen plaquetario medio sobre el riesgo de muerte, isquemia recurrente e insuficiencia cardiaca durante la fase hospitalaria y analizar las relaciones del volumen plaquetario con variables demograficas y clinicas, obtenidas al ingreso hospitalario. Material y metodos Se estudian 1.082 pacientes con infarto de miocardio, clasificados en dos grupos de acuerdo con el volumen plaquetario medio estimado al ingreso: grupo 1, volumen plaquetario superior a 9 fl (n = 443) y grupo 2, volumen plaquetario ≤ 9 fl (n = 639). El analisis de las diferencias entre ambos grupos sobre los puntos finales del estudio fue realizado mediante tecnicas univariante y de regresion logistica. Un analisis estadistico univariante fue aplicado para investigar la relacion del volumen plaquetario con las variables basales al ingreso. Resultados Un volumen plaquetario superior a 9 fl se asocio con un aumento significativo del riesgo del punto final combinado del estudio (OR = 1,37; p = 0,026). En el estudio univariante, un volumen plaquetario elevado se relaciono con una incidencia mayor de insuficiencia cardiaca (OR = 1,46; p = 0,01) junto a un aumento no significativo del riesgo de angina/reinfarto (OR = 1,35; p = 0,07). Ademas, un volumen plaquetario superior a 9 fl se asocio con una mayor prevalencia de infarto previo, hipertension arterial y diabetes mellitus. Conclusiones Los resultados del estudio sugieren que un volumen plaquetario alto al ingreso es un predictor independiente de riesgo de insuficiencia cardiaca durante la fase hospitalaria y en nuestro estudio se asocio con una tendencia no significativa hacia una mayor tasa de episodios isquemicos recurrentes a corto plazo.

Introduccion El analisis de la variabilidad de la frecuencia cardiaca ha sido aceptado como metodo no invasivo para valorar la influencia del sistema nervioso autonomo sobre el corazon. Aunque la variabilidad de la frecuencia cardiaca se ha venido utilizando en la ultima decada en diversas patologias, los estudios en la miocardiopatia hipertrofica son escasos. Objetivos Investigar mediante el analisis de la variabilidad de la frecuencia cardiaca la actividad del sistema nervioso autonomo en pacientes con miocardiopatia hipertrofica. Pacientes y metodos La variabilidad de la frecuencia cardiaca se ha evaluado mediante el analisis del registro electrocardiografico de 24 h (Holter) en 20 pacientes con miocardiopatia hipertrofica y en 15 controles normales. Se utilizo como medida de la variabilidad de la frecuencia cardiaca el analisis espectral de las frecuencias que fueron calculadas mediante el analisis de la transformada de Fourier. Se analizan los componentes de alta frecuencia (0,15 a 0,40 Hz), los de baja frecuencia (0,04 y 0,15 Hz) y el componente global (0,01 y 1,0 Hz). Tambien se valora la relacion entre el componente de baja/alta frecuencia como indice del balance simpaticovagal del corazon. Los datos se presentan con valores medios ± DE. Se utiliza el test de la t de Student para datos no apareados. Se consideran significativos valores de p Resultados No hubo diferencias en la frecuencia cardiaca media entre los pacientes con miocardiopatia hipertrofica y los controles (media ± DE: 71 ± 9 frente a 74 ± 11 lat/min; p = NS), mientras que hubo un descenso significativo tanto en el componente global (media ± DE: 7,14 ± 1,1 frente a 7,57 ± 0,6 ln [ms 2 ]; p = 0,02), como en los componentes de altas (media ± DE: 5,22 ± 0,8 frente a 5,63 ± 1,3 ln [ms 2 ]; p = 0,04) y bajas frecuencias (media ± DE: 6,14 ± 1,2 frente a 6,72 ± 0,7 ln [ms 2 ]; p = 0,03). No hubo diferencias significativas entre el cociente de bajas/altas frecuencias (media ± DE: 1,1 ± 0,1 frente a 1,2 ± 0,1 ln [ms 2 ]; p = NS). Conclusiones Estos datos sugieren que los pacientes con miocardiopatia hipertrofica tienen una alteracion en el estado del sistema nervioso autonomo tanto en la actividad simpatica (componente de baja frecuencia) como en la actividad vagal (componente de alta frecuencia), si bien no se traduce en un desequilibrio entre actividad simpaticaparasimpatica (relacion bajas/altas frecuencias).

The infusion of different substances into the left ventricle of the brain allows substances to reach the subventricular zone, one of the neural stem cell niches in the adult brain. Implantation of an osmotic minipump delivers proteins, virus and drugs directly into the lateral ventricle to act locally. Here we describe this method consisting on a cannula implanted into the lateral ventricle and linked to an osmotic minipump via catheter. The cannula is fixed over the brain and the minipump is placed subcutaneously. This system can be maintained from days up to several weeks and ensures constant and regular delivery of the desired biological product.

The infusion of different substances into the left ventricle of the brain allows substances to reach the subventricular zone, one of the neural stem cell niches in the adult brain. Implantation of an osmotic minipump delivers proteins, virus and drugs directly into the lateral ventricle to act locally. Here we describe this method consisting on a cannula implanted into the lateral ventricle and linked to an osmotic minipump via catheter. The cannula is fixed over the brain and the minipump is placed subcutaneously. This system can be maintained from days up to several weeks and ensures constant and regular delivery of the desired biological product.

Recent advances in reperfusion strategies have dramatically reduced early mortality after acute myocardial infarction (AMI), but as a result there is a higher incidence of heart failure among survivors. Optimal medical therapy and device implantation can improve the prognosis and the quality of life of these patients. Nevertheless, mortality and rehospitalization rates are still high and entail an overwhelming cost. The field of cardiac cell therapy has emerged as a new alternative in this situation, and has made rapid progress. Its final goal is to repair the damaged myocardium and to restore cardiac function. Nevertheless, this goal is hindered by the massive loss of cardiomyocytes after an AMI (in the order of 1 billion cells) and because ischemic myocardium loses cellular and extracellular signals which guide stem cells to the cardiac lineage or to the secretion of paracrine factors (Wollert & Drexler, 2010). Studies evaluating this new approach during the last 15 years have overall succeeded to a greater or lesser extent, and evidence available so far is encouraging. Phase I and II randomized clinical trials (RCT) indicate that cell therapy is a safe treatment which can improve cardiac function after AMI and in the chronic phase of coronary artery disease (CAD). Trial results are not uniform, however, probably due 1) to a lack of standardization of cell isolation and delivery procedures, 2) to the absence of a universally accepted nomenclature, and 3) to the large number of stem cell types under investigation in different clinical settings. Nevertheless, these inconsistencies can be avoided or reduced if classical scientific methodology is followed. Although considered a relatively new field of research, stem cell experimentation must invariably walk on the path of the scientific method. Since Aristotle s time, scientific method has been used as a way to ask and answer scientific questions by making observations and doing experiments. It includes a series of steps, i.e. 1) asking a question, 2) doing background research, 3) constructing a hypothesis, 4) testing the hypothesis by doing an experiment, 5) analyzing the data and drawing a conclusion, and 6) communicating the results.

First randomized clinical trials have demonstrated that stem cell therapy can improve cardiac recovery after the acute phase of myocardial ischemia and in patients with chronic ischemic heart disease. Nevertheless, some trials have shown that conflicting results and uncertainties remain in the case of mechanisms of action and possible ways to improve clinical impact of stem cells in cardiac repair. In this paper we will examine the evidence available, analyze the main phase I and II randomized clinical trials and their limitations, discuss the key points in the design of future trials, and depict new directions of research in this fascinating field.

Background Interactions between cells and the basement membrane glycoprotein laminin are altered during colon cancer progression. Colon carcinoma and normal mucosa cells express a variety of laminin-binding proteins, including the 67-kd laminin receptor (67 LR) and a 31-kd human laminin-binding protein (HLBP31) homologous to the 31-kd human IgE-binding protein/galactoside-binding lectin. Purpose To investigate whether various laminin-binding proteins are differentially expressed in human colon carcinoma, we studied messenger RNA (mRNA) levels of the 67 LR and HLBP31 in matched tumor and adjacent normal mucosa samples from a series of 21 patients. Methods Total cellular RNA from tumor and normal mucosa was isolated and analyzed by Northern and slot blot hybridization. In addition, HLBP31 protein levels were assessed by the immunoblot technique. Quantitative laminin affinity chromatography was also used to measure the synthesis of HLBP31 protein in five human cancer cell lines. Results The steady-state mRNA level of HLBP31 was downregulated (i.e., decreased) in 18 of 21 human colon carcinomas compared with the level in their corresponding normal colonic mucosa. On average, the level of HLBP31 mRNA was decreased 50% +/- 30% (+/- SD) in the colon cancers. The mean ratio of colon cancer HLBP31 mRNA to adjacent normal mucosa HLBP31 mRNA was twofold lower in primary tumors of patients with metastases (0.3 +/- 0.2 SD) than in primary tumors of patients free of metastatic lesions (0.6 +/- 0.2 SD). The differences between the two groups of patients were statistically significant (P less than .05, Wilcoxon-Mann-Whitney test). We have previously shown that the ratio of colon cancer 67 LR mRNA to corresponding normal mucosa 67 LR mRNA was increased in the same patient population. When the two ratios (ratio of cancer to normal HLBP31 mRNA and ratio of cancer to normal 67 LR mRNA) were compared, HLBP31 mRNA/67 LR mRNA was significantly lower (P less than .05) in primary tumors with metastases (mean +/- SD, 0.3 +/- 0.2) than in primary cancers without metastases (mean +/- SD, 0.7 +/- 0.5). The steady-state level of HLBP31 mRNA was directly correlated with the amount of HLBP31 protein in both colon tissue samples and human cancer cell lines. Conclusion HLBP31 mRNA expression in colon cancer tissues is modulated inversely to that of 67 LR mRNA expression. The down-regulation of HLBP31 appears to be associated with the metastatic capabilities of colon cancer cells. Implications Prospective studies on a large cohort should determine if the systematic detection of HLBP31 and 67 LR protein and/or mRNA can be a valuable adjunct in the prognostic evaluation of primary colon cancers.

Biobanking is a new concept with solid bases in traditional pathology, the development of which is mandatory to allow effective translational research to flourish. Biobank activity is developing as a progressively complex young discipline playing a central role in biomedical research. This review analyzes the role of disease-driven biobanks in translational research, focusing on some aspects considered to be crucial for the future development of these institutions and service providers, including dedicated designs, funding, personnel, and ethical and legal frameworks, which, coupled with networked functioning, can provide an endless source of samples and, ideally, associated clinical information for biomedical research. © 2008 Elsevier Inc. All rights reserved.