Optimization of concentrations of Ca+ and Mg++ for myocardial protection for neonates and infants – an overview

IMSP Spitalul Clinic RepublicanÎn timpul clampării aortei (Ao) cu circulaţia extracorporeală (CEC), inima este izolată de perfuzia restului corp uman. Chirurgul este dator de a asigura protecţia adecvată a miocardului, şi în acelaş timp să dispună de cîmpul operator ideal pentru corecţia chirurgicală cît mai bună posibilă. Este importanta optimizarea concentraţiilor ionilor Ca+ şi Mg++ pentru prevenirea disfuncţiei postoperatorii a cordului. Acest reviu concretizează principiile protecţiei miocardului şi ultimele succese ale tehnicilor de protecţie a miocardului în timpul CEC- ului la copiii mici. During aortic clamp with extracorporeal circulation (ECC), the heart is isolated from the rest of the human body perfuzion. The surgeon is obliged to ensure the adequate protection of the heart muscle, and at the same time to have clean operating field for surgical correction as best possible. Optimisation of concentrations of Ca + and Mg ++ is important for prevention of postoperative cardiac insufficiency. This review embodies the principles of the protection of the heart muscle and recent successes of the chemical techniques of heart muscle perfusion during the ECC in small children

Strategies Proposed by Healthy Kids, Healthy Communities Partnerships to Prevent Childhood Obesity

IntroductionHealthy Kids, Healthy Communities (HKHC) is an initiative of the Robert Wood Johnson Foundation to prevent obesity among high-risk children by changing local policies, systems, and environments. In 2009, 105 community partnerships applied for funding from HKHC. Later that year, the Centers for Disease Control and Prevention (CDC) released recommended community strategies to prevent obesity by changing environments and policies. The objective of this analysis was to describe the strategies proposed by the 41 HKHC partnerships that received funding and compare them to the CDC recommendations.MethodsWe analyzed the funded proposals to assess the types and prevalence of the strategies proposed and mapped them onto the CDC recommendations.ResultsThe most prevalent strategies proposed by HKHC-funded partnerships were providing incentives to retailers to locate and serve healthier foods in underserved areas, improving mechanisms for purchasing food from farms, enhancing infrastructure that supports walking and cycling, and improving access to outdoor recreational facilities.ConclusionThe strategies proposed by HKHC partnerships were well aligned with the CDC recommendations. The popular strategies proposed by HKHC partnerships were those for which there were existing examples of successful implementation. Our analysis provides an example of how information from communities, obtained through grant-writing efforts, can be used to assess the status of the field, guide future research, and provide direction for future investments

DFT Calculations of Isotropic Coupling Constants of Phenoxyl and Aroxyl Radicals

Hybrid density-functional calculations were carried out to corroborate the identity of phenoxyl radicals observed by EPR spectroscopy after oxidation of selected mono- and polyphenols with horseradish peroxidase/hydrogen peroxide or after alkaline autoxidation. Whereas quantitative correlations of experimental and theoretical coupling constants were less satisfactory, we could confirm formation of a bi-radical after initial oxidation of 2,4,6-trimethylphenol, the mesomeric structures of gallate ester aroxyl radicals and identify the radical site of a model gallotannin, hamamelitannin

Komplex molekuláris genetikai vizsgálati algoritmus myeloproliferativ neoplasiák diagnosztikájában

Introduction: Mutations in Janus kinase 2, calreticulin and thrombopoietin receptor genes have been identified in the genetic background of Philadelphia chromosome negative, "classic" myeloproliferative neoplasms. Aim: The aim of the authors was to identify driver mutations in a large myeloproliferative cohort of 949 patients. Method: A complex array of molecular techniques (qualitative and quantitative allele-specific polymerase chain reactions, fragment analyzes, high resolution melting and Sanger sequencing) was applied. Results: All 354 patients with polycythemia vera carried Janus kinase 2 mutations (V617F 98.6%, exon 12: 1.4%). In essential thrombocythemia (n = 468), the frequency of V617F was 61.3% (n = 287), that of calreticulin 25.2% (n = 118), and that of thrombopoietin receptor mutations 2.1% (n = 10), while 11.3% (n = 53) were triple-negative. Similar distribution was observed in primary myelofibrosis (n = 127): 58.3% (n = 74) V617F, 23.6% (n = 30) calreticulin, 6.3% (n = 8) thrombopoietin receptor mutation positive and 11.8% (n = 15) triple-negative. Conclusions: The recent discovery of calreticulin gene mutations led to definite molecular diagnostics in around 90% of clonal myeloproliferative cases. Orv. Hetil., 2014, 155(52), 2074-2081

Distinct clinical characteristics of myeloproliferative neoplasms with calreticulin mutations

Somatic insertions/deletions in the calreticulin gene have recently been discovered to be causative alterations in myeloproliferative neoplasms. A combination of qualitative and quantitative allele-specific polymerase chain reaction, fragment-sizing, high resolution melting and Sanger-sequencing was applied for the detection of three driver mutations (in Janus kinase 2, calreticulin and myeloproliferative leukemia virus oncogene genes) in 289 cases of essential thrombocythemia and 99 cases of primary myelofibrosis. In essential thrombocythemia, 154 (53%) Janus kinase 2 V617F, 96 (33%) calreticulin, 9 (3%) myeloproliferative leukemia virus oncogene gene mutation-positive and 30 triple-negative (11%) cases were identified, while in primary myelofibrosis 56 (57%) Janus kinase 2 V617F, 25 (25%) calreticulin, 7 (7%) myeloproliferative leukemia virus oncogene gene mutation-positive and 11 (11%) triple-negative cases were identified. Patients positive for the calreticulin mutation were younger and had higher platelet counts compared to Janus kinase 2 mutation-positive counterparts. Calreticulin mutation-positive patients with essential thrombocythemia showed a lower risk of developing venous thrombosis, but no difference in overall survival. Calreticulin mutation-positive patients with primary myelofibrosis had a better overall survival compared to that of the Janus kinase 2 mutation-positive (P=0.04) or triple-negative cases (P=0.01). Type 2 calreticulin mutation occurred more frequently in essential thrombocythemia than in primary myelofibrosis (P=0.049). In essential thrombocythemia, the calreticulin mutational load was higher than the Janus kinase 2 mutational load (P<0.001), and increased gradually in advanced stages. Calreticulin mutational load influenced blood counts even at the time point of diagnosis in essential thrombocythemia. We confirm that calreticulin mutation is associated with distinct clinical characteristics and explored relationships between mutation type, load and clinical outcome

Surgical correction of valvular pathology in infants and children. Results and perspectives

Department of Cardiac Surgery, Republican Hospital, Chisinau, the Republic of MoldovaBackground: Valvular pathology in infants and children pose numerous problems such as valvular narrow rings, inconveniences of mechanical valves prosthesis, accelerated degeneration of bioprosthetic valves and homografts. Valvular repair is the goal of intervention, because restoration of valvular anatomy and function allows growth and avoids the problems of valvular substitution. When reconstruction fails or is not feasible, valve replacement becomes inevitable. The goal of this article is to address valve surgical options for all four valve positions within the pediatric sector. We review current literature and our practice to support our preferences. Material and methods: A group of 205 patients under the age of 18 with valvular pathology was operated on at our institution in 1988-2006. Results: Hospital mortality was 4.3% in aortic group and 5.4% in a mitral group of patients. Valvular repair was possible in 84% and 78.3% of each group respectively. Aortic annuloplasty was done in 6.4% of patients. We inserted minimal 21 mm prosthesis in a mitral position and 19 mm in aortic position. Long – term results need to be evaluated. Conclusions: A multitude of options and surgical experiences exist. Valvular repair remains a procedure of choice in a pediatric group of patients

Developing the Active Communities Tool to Implement the Community Guide's Built Environment Recommendation for Increasing Physical Activity

Physical activity is higher in communities that include supportive features for walking and bicycling. In 2016, the Community Preventive Services Task Force released a systematic review of built environment approaches to increase physical activity. The results of the review recommended approaches that combine interventions to improve pedestrian and bicycle transportation systems with land use and environmental design strategies. Because the recommendation was multifaceted, the Centers for Disease Control and Prevention determined that communities could benefit from an assessment tool to address the breadth of the Task Force recommendations. The purpose of this article is to describe the systematic approach used to develop the Active Communities Tool. First, we created and refined a logic model and community theory of change for tool development. Second, we reviewed existing community-based tools and abstracted key elements (item domains, advantages, disadvantages, updates, costs, permissions to use, and psychometrics) from 42 tools. The review indicated that no tool encompassed the breadth of the Community Guide recommendations for communities. Third, we developed a new tool and pilot tested its use with 9 diverse teams with public health and planning expertise. Final revisions followed from pilot team and expert input. The Active Communities Tool comprises 6 modules addressing all 8 interventions recommended by the Task Force. The tool is designed to help cross-sector teams create an action plan for improving community built environments that promote physical activity and may help to monitor progress toward achieving community conditions known to promote physical activity

Local Patch Blind Spectral Watermarking Method for 3D Graphics

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