Absorb Bioresorbable Vascular Scaffold (BVS) for the treatment of coronary artery disease in clinical practice

Drug-eluting stents (DES) are widely used as first choice devices in percutaneous coronary interventions (PCI). However, certain concerns are associated with the use of DES, i.e. neo-atherosclerosis, late stent thrombosis and hypersensitivity reactions to the DES polymer. Bioresorbable scaffolds (BRS) such as the Absorb Bioresorbable Vascular Scaffold (BVS) are the next development within the field of PCI, introducing the concept of supporting the natural healing process following initial intervention without leaving any foreign body materials resulting in late adverse events. The first-generation devices have shown encouraging results in multiple studies of selected patients with non-complex lesions up to the point of full bioresorption. It supported the introduction in regular patient care. During its introduction in daily clinical practice outside the previous selected patient groups, a careful approach should be followed in which outcome is continuously monitored. The aim of this thesis was to investigate the safety and efficacy of the Absorb BVS in more complex lesions and higher-risk patients, when treated in a diverse clinical practice

Frontier Missionary: Felix De Andreis, 1778-1820: Correspondence and Historical Writings

A chronicle of the life and journey of the Vincentian missionary Felix De Andreis, in his own words. From his native Italy to the far reaches of frontier America. …this volume documents in detail the arrival of the Vincentians in the United States and paints a vivid picture of a country from its infancy.https://via.library.depaul.edu/vincentian_ebooks/1003/thumbnail.jp

Sources of intrinsic rotation in the low flow ordering

A low flow, $\delta f$ gyrokinetic formulation to obtain the intrinsic rotation profiles is presented. The momentum conservation equation in the low flow ordering contains new terms, neglected in previous first principles formulations, that may explain the intrinsic rotation observed in tokamaks in the absence of external sources of momentum. The intrinsic rotation profile depends on the density and temperature profiles and on the up-down asymmetry.Comment: 20 page

Ractopamine-induced changes in the proteome of post-mortem beef longissimus lumborum muscle

Ractopamine is a beta-adrenergic agonist that is approved for use in beef cattle, pigs and turkeys as a repartitioning agent to increase lean muscle deposition and decrease lipogenesis. Although the effects of dietary ractopamine on the proteome profile of post-mortem pork muscles have been examined, its influence on beef muscle proteome has not been studied. Therefore, the objective of this study was to examine the effect of ractopamine on the proteome profile of post-mortem beef longissimus lumborum (LL) muscle. LL muscle samples were obtained from the carcasses of six (n = 6) steers fed ractopamine (RAC; 400 mg ractopamine hydrochloride for 28 days) and six (n = 6) steers fed no ractopamine (CON). The muscle proteome was analysed using two-dimensional gel electrophoresis and tandem mass spectrometry. Five differentially abundant spots were identified, and all the spots were over-abundant in RAC. The identified proteins were involved in muscle structure development (F-actin-capping protein subunit beta-2; PDZ and LIM domain protein-3), chaperone activity (heat shock protein beta-1), oxygen transport (myoglobin), and glycolysis (L-lactate dehydrogenase A chain). These results suggested that dietary ractopamine could influence the abundance of enzymes associated with muscle development and muscle fibre type shift in beef LL muscle.Keywords: growth promotants, meat quality, proteomic

Impact of calcium on procedural and clinical outcomes in lesions treated with bioresorbable vascular scaffolds - A prospective BRS registry study

Background: There is limited data on the impact of calcium (Ca) on acute procedural and clinical outcomes in patients with lesions treated with bioresorbable vascular scaffolds (BRS). We sought to evaluate the effect of calcium on procedural and clinical outcomes in a 'real world' population. Methods: Clinical outcomes were compared between patients with at least 1 moderately or heavily calcified lesion (Ca) and patients with no/mild calcified lesions (non-Ca) enrolled in our institutional BRS registry. Results: 455 patients (N) with 548 lesions (L) treated with 735 BRS were studied. Patients in the Ca group (N = 160, L = 200) had more complex (AHA B2/C lesion: 69.0% in Ca vs 14.9% in non-Ca, p. <. 0.001) and significantly longer lesions (27.80. ±. 15.27 vs 19.48. ±. 9.92. mm, p. <. 0.001). Overall device success rate was 99.1% with no significant differences between the groups. Despite more aggressive lesion preparation and postdilation compared to non Ca, acute lumen gain was significantly less in Ca lesions (1.50. ±. 0.66 vs 1.62. ±. 0.69. mm, p = 0.040) with lower final MLD (2.28. ±. 0.41 vs 2.36. ±. 0.43, p = 0.046). There were no significant differences in all-cause mortality, total definite scaffold thrombosis (ST), target lesion revascularization and myocardial infarction between the 2 groups. Late ST was more frequent in the Ca group compared to non Ca group (late ST: 2.1 vs 0%, p = 0.02). Conclusions: Clinical outcomes after BRS implantation in calcified and non-calcified lesions were similar. A remarkable difference in timing of thrombosis was observed, with an increased rate of late thrombosis in calcified lesions

Social and economic value of Portuguese community pharmacies in health care

Background: Community pharmacies are major contributors to health care systems across the world. Several studies have been conducted to evaluate community pharmacies services in health care. The purpose of this study was to estimate the social and economic benefits of current and potential future community pharmacies services provided by pharmacists in health care in Portugal. Methods: The social and economic value of community pharmacies services was estimated through a decision-model. Model inputs included effectiveness data, quality of life (QoL) and health resource consumption, obtained though literature review and adapted to Portuguese reality by an expert panel. The estimated economic value was the result of non-remunerated pharmaceutical services plus health resource consumption potentially avoided. Social and economic value of community pharmacies services derives from the comparison of two scenarios: "with service" versus "without service". Results: It is estimated that current community pharmacies services in Portugal provide a gain in QoL of 8.3% and an economic value of 879.6 million euros (Msic), including 342.1 Msic in non-remunerated pharmaceutical services and 448. 1 Msic in avoided expense with health resource consumption. Potential future community pharmacies services may provide an additional increase of 6.9% in QoL and be associated with an economic value of 144.8 Msic: 120.3 Msic in non-remunerated services and 24.5 Msic in potential savings with health resource consumption. Conclusions: Community pharmacies services provide considerable benefit in QoL and economic value. An increase range of services including a greater integration in primary and secondary care, among other transversal services, may add further social and economic value to the society

Are BVS suitable for ACS patients? Support from a large single center real live registry

Objectives To investigate one-year outcomes after implantation of a bioresorbable vascular scaffold (BVS) in patients presenting with acute coronary syndrome (ACS) compared to stable angina patients. Background Robust data on the outcome of BVS in the setting of ACS is still scarce. Methods Two investigator initiated, single-center, single-arm BVS registries have been pooled for the purpose of this study, namely the BVS Expand and BVS STEMI registries. Results From September 2012-Octob

Observation of Parity Violation in the Omega-minus -> Lambda + K-minus Decay

The alpha decay parameter in the process Omega-minus -> Lambda + K-minus has been measured from a sample of 4.50 million unpolarized Omega-minus decays recorded by the HyperCP (E871) experiment at Fermilab and found to be [1.78 +/- 0.19(stat) +/- 0.16(syst)]{\times}10^{-2}. This is the first unambiguous evidence for a nonzero alpha decay parameter, and hence parity violation, in the Omega-minus -> Lambda + K-minus decay.Comment: 10 pages, 7 figure

Initial experience with everolimus-eluting bioresorbable vascular scaffolds for treatment of patients presenting with acute myocardial infarction

Aims: Limited data are currently available on midterm outcomes after implantation of everolimus-eluting bioresorbable vascular scaffolds (BVS) for treatment of acute ST-elevation myocardial infarction (STEMI). Methods and results: Patients presenting with STEMI and undergoing primary percutaneous coronary intervention in the initial experience with BVS were evaluated and compared with patients treated with everolimus-eluting metal stents (EES) by applying propensity matching. Quantitative coronary angiography analysis, and 18-month clinical follow-up were reported. A total of 302 patients were analysed, 151 with BVS and 151 with EES. Baseline clinical characteristics were similar between groups. Final TIMI 3 flow was 87.4% vs. 86.1%, p=0.296. At 18-month follow-up, all-cause mortality was 2.8% vs. 3.0% in the BVS and EES groups respectively, p=0.99; the MACE rate was higher in the BVS group (9.8% vs. 3.6%, p=0.02); target lesion revascularisation was 5.7% vs. 1.3%, p=0.05. The 30-day MACE rate in BVS patients without post-dilatation was 6.8%, while in patients with post-dilatation it was 3.6%. Scaffold thrombosis (ST) occurred primarily in the acute phase (acute ST 2.1% vs. 0.7%, p=0.29; subacute 0.7% vs. 0.7%, p=0.99; late 0.0% vs. 0.0%; very late 1.5% vs. 0.0%, p=0.18). All three BVS cases with acute ST had no post-dilatation at the index procedure. Conclusions: STEMI patients treated during the early experience with BVS had similar acute angiographic results as compared with the EES group. Clinical midterm follow-up data showed a higher clinical events rate compared with metal stents. The majority of clinical events occurred in the early phase after implantation and mainly in cases without post-dilatation. Optimisation of the implantation technique in the acute clinical setting is of paramount importance for optimal short and mid-term outcomes