Combined Use of High-Sensitive Cardiac Troponin, Copeptin, and the Modified HEART Score for Rapid Evaluation of Chest Pain Patients.

Clinical short-term risk stratification is a recommended approach in patients with chest pain and possible acute myocardial infarction (AMI) to further improve high safety of biomarker-based rule-out algorithms. The study aim was to assess clinical performance of baseline concentrations of high-sensitivity cardiac troponin T (hs-TnT) and copeptin and the modified HEART score (mHS) in early presenters to the emergency department with chest pain. This cohort study included patients with chest pain with onset maximum of 6 h before admission and no persistent ST-segment elevation on electrocardiogram. hs-TnT, copeptin, and the mHS were assessed from admission data. The diagnostic and prognostic value for three baseline rule-out algorithms: (1) single hs-TnT < 14 ng/l, (2) hs-TnT < 14 ng/l/mHS ≤ 3, and (3) hs-TnT < 14 ng/l/mHS ≤ 3/copeptin < 17.4 pmol/l, was assessed with sensitivity and negative predictive value. Primary diagnostic endpoint was the diagnosis of AMI. Prognostic endpoint was death and/or AMI within 30 days. Among 154 enrolled patients, 44 (29%) were classified as low-risk according to the mHS; AMI was diagnosed in 105 patients (68%). For ruling out AMI, the highest sensitivity and NPV from all studied algorithms were observed for hs-TnT/mHS/copeptin (100%, 95% CI 96.6-100, and 100%, 95% CI 75.3-100). At 30 days, the highest event-free survival was achieved in patients stratified with hs-TnT/mHS/copeptin algorithm (100%) with 100% (95% CI 75.3-100) NPV and 100% (95% CI 96.6-100) sensitivity. The combination of baseline hs-TnT, copeptin, and the mHS has an excellent sensitivity and NPV for short-term risk stratification. Such approach might improve the triage system in emergency departments and be a bridge for inclusion to serial blood sampling algorithms

Application of membranes from polyacrylonitrite doped with graphen oxide in purification of industrial wastewater generated during processing of metals

W pracy zaprezentowano wyniki badań nad zastosowaniem membran kompozytowych z poliakrylonitrylu (PAN) domieszkowanego tlenkiem grafenu (GO) do usuwania zanieczyszczeń ze ścieków pogalwanicznych. Membrany otrzymywano metodą inwersji faz z roztworu PAN i GO w N,N-dimetyloformamidzie (DMF). Pozyskane ścieki wstępnie podczyszczano za pomocą flokulanta Magnafloc®336. Następnie w celi ultrafiltracyjnej AMICON prowadzono ultrafiltrację podczyszczonych ścieków, na wytworzonych wcześniej membranach kompozytowych PAN/GO. Badania właściwości fizykochemicznych oraz składu roztworów przed i po procesach zintegrowanego oczyszczania prowdzono za pomocą spektrofotometru UV-Vis oraz atomowej spektrometrii absorpcyjnej (ASA). W wyniku prowadzonej flokulacji ze ścieków zostały usunięte fosforany (97%), chlorki (5,2%), siarczany (5,9%) oraz żelazo (82%). Natomiast w trakcie ultrafiltracji całkowicie usunięto aniony fosforanowe (100%) oraz żelazo (91÷92%), cynk (68÷84%), ołów (65–98%) i kadm (~67%).The paper presents the results of research on the use of composite membranes of polyacrylonitrile (PAN) doped with graphene oxide (GO) to remove the contaminations of galvanic wastewater. Membranes were obtained using phase inversion method from PAN and GO solution in N,N-dimethylformamide (DMF). Wastewater was pre-treated with the flocculant Magnafloc®336. Next, ultrafiltration of the treated wastewater was carried out in the ultrafiltration cell AMICON on the PAN/GO composite membranes prepared beforehand. The physicochemical properties and composition of solutions before and after the integrated purification process were analyzed by means of a UV-Vs spectrophotometer and atomic absorption spectrometry (AAS). As a result of flocculation from wastewater, phosphates (97%), chlorides (5,2%), sulfates (5,9%) and iron (82%) have been removed. In addition, as a result of ultrafiltration, a complete removal of phosphate anions (100%) and iron (~91–92%), zinc (68÷84%), lead (65–98%) and cadmium (~67%) was achieved

Clinical Studies of Rheocardiography Application to Hemodynamic Monitoring of Patients with Dilated Cardiomyopathy

Impedance cardiography is a non-invasive, cheap and easy to use method of long term hemodynamic monitoring. Nowadays this method is perceived as an alternative for invasive monitoring of the patients. The goal of the presented papers was to compare the results of rheocardiography with reference invasive monitoring

The Anatomic Structure of Pulmonary Arteries as a Source of Unreliability in Thermodilution Cardiac Output Measurement

One of the most fundamental examination in intensive care medicine is cardiac output measurement, realized by pulmonary artery catherization. The thermodilution cardiac output estimation method is not resistant to various kinds of disturbances, which significantly decreases its sensitivity and specificity. The paper depicts investigations related to analysis of presumable new source of unreliability - asymmetric blood flow through pulmonary vessels. The investigations consisted of two phases: clinical examination (to obtain anatomical data) and computer modeling (to simulate the flow symmetry)

Clinical Studies of Rheocardiography Application to Hemodynamic Monitoring of Patients with Dilated Cardiomyopathy

Impedance cardiography is a non-invasive, cheap and easy to use method of long term hemodynamic monitoring. Nowadays this method is perceived as an alternative for invasive monitoring of the patients. The goal of the presented papers was to compare the results of rheocardiography with reference invasive monitoring

Theoretical and model analysis of the unreliability of cardiac output measurement by means of the thermodilution method

Thermodilution is the clinically most often applied method of cardiac output measurements. This method is based on thermal indicator (iced isotonic salt solution) variation measurements by a Swan-Ganz catheter located inside the pulmonary artery. The unreliability of thermodilution should be estimated theoretically because of the lack of references. In this paper an attempt has been made to estimate theoretically the unreliability of thermodilution cardiac output measurements

Model Study of Cardiac Output Measurement by Thermodilution in Thermal Instability

Cardiac output is one of the most valuable hemodynamic parameter. It is measured commonly with intravascular pressures by pulmonary artery catheterization technique. The cardiac output itself is measured by dilution of thermal marker method (thermodilution), which is not resistant for various disturbances. In this paper the influence of blood temperature on metrological properties of thermal dilution method was described

Evaluation of impedance rheocardiography suitability in hemodynamic monitoring of patients with serious left ventricle injury

Reokardiografia impedancyjna, będąca nieinwazyjną metodą oceny stanu hemodynamicznego pacjenta, zdobywa w ostatnich latach uznanie jako cenne uzupełnienie badań echokardiograficznych i monitorowania inwazyjnego. W prezento- wanej pracy porównano wartości wybranych parametrów hemodynamicznych monitorowanych metodą reokardiografii z referencyjną metodą termodylucji. Badania przeprowadzono w czasie wstępnej diagnostyki przed zabiegiem transplantacji serca w grupie 22 chorych, hospitalizowanych z powodu niewydolności krążenia w przebiegu kardiomiopatii rozstrzeniowej.The rheocardiography is a non-invasive method of patient’s hemodynamic state assessment. Recently it has been recognized as a valuable complement of echocardiography and invasive monitoring. In this paper the selected hemodynamic parameters measured by rheocardiography were compared with reference (thermodilution). The examinations were as a pre-diagnostic to heart transplantation (HTX) performed on 22 patients hospitalized because of circulatory insufficiency in course of dilated cardiomyopathy