Case Report: Remote magnetic navigation and accessory pathways ablation in a single ventricle young adult with complex corrective surgeries

Supraventricular arrhythmias have become an increasingly significant contributor to the risk of mortality and morbidity in adults with complex congenital heart disease (CHD), especially in light of recent advances in palliative corrective surgeries. Because of their unique characteristics, they demand specific treatment approaches. While pharmaco-logical interventions are an option, they have limited effectiveness and may lead to side effects. Although performing radiofrequency ablation (RFA) can be exceptionally challenging in patients with complex CHD, due to particular vascular access and also modified anatomy, it has paved the way to enhance comprehension of the underlying mechanisms of supraventricular arrhythmias. This, in turn, enables the provision of improved therapies and, ultimately, an enhancement in the quality of life and symptom management for these patients. The purpose of this case report is to highlight the benefits of utilizing advanced technologies such as three-dimensional electro-anatomical mapping systems, remote magnetic navigation, and highly flexible mapping and ablation catheters during RFA in a young adult with complex congenital heart disease. Although he lacked venous connections to the right atrium (RA) due to multiple corrective surgeries we, remarkably, were capable to advance a decapolar deflectable diagnostic catheter inside the Fontan tunnel and from there to record and stimulate the RA. Successful ablation of two accessory pathways was achieved with no arrhythmia recurrence during follow-up

Multifunctional ZnO Nanoparticle: Based Coatings for Cultural Heritage Preventive Conservation

Coatings based on nanoparticles embedded in various filmogenic materials are still a hot topic in nanomaterial research, due to the exceptional variety of applications. The chapter present recent progress in synthesis and characterization of hybrid material with ZnO nanoparticles and their use as functional coatings for various substrates. The antibacterial and UV protection efficiency of ZnO nanoparticle-based coatings on paper and stone are discussed, with particular emphasize on the specific requirements for application in cultural heritage preventing conservation. Functional materials based on ZnO are presented as possible treatment for protection of historic and archaeological textiles and metal artifacts. Trends in environmental friendly methods to fabricate the ZnO nanoparticles will be evaluated, compared to classic ones, in terms of material characteristics and efficiency

Management of macrovascular diabetic complications: a single-center case series analysis of consecutively attending patients in primary care

Introduction. The prevalence of diabetes mellitus is increasing, with type 2 diabetes (T2DM) being a major health priority for any public health system. Increased arterial stiffness in patients with diabetes will lead to the appearance of vascular complications. Increased arterial stiffness in patients with diabetes usually leads to vascular complications. Any earlier diagnosis of impaired macrovascular evidence may lead to improved outcomes in patient care. The objective of our study was to assess and evaluate the finger-toe pulse wave velocity (ftPWV), as a measure of arterial stiffness, in order to assist with early detection of macrovascular diabetic complications. Materials and Methods. The observational case series included 140 patients who are registered in a primary care office, of whom 73 were previously diagnosed with diabetes mellitus (study group). The age-matched non-diabetic group included 67 consecutive registered patients who visited the practice for other reasons. Results. The mean age of all patients was 51.42±11.57 years, with DM patients being with 4.5 years older than the non-DM patients (CI 95% and CI 95%). There was a significantly higher mean value of ftPWV in the DM group (p = 0.0039) although the study presented some limitations. Conclusions. The mean value of ftPWV was statistically significant higher in diabetic patients. The assessment of ftPWV is a non-invasive test, and the data can be used as a useful marker of vascular stiffness in primary care, thus providing an early diagnosis of macrovascular complications during the monitoring and care of the diabetic patient

Silica Nanoparticles Loaded with Curcumin—Encapsulation Efficiency

Curcumin is a natural compound, being a well-known ingredient in different foods. There are [...

Synthesis and Morphological Investigation of Flower-Like ZnO Nanostructures

In recent years, ZnO nanostructures have attracted great interest due to their significantpotential applications. [...

Exposure to Iron Oxide Nanoparticles Coated with Phospholipid-Based Polymeric Micelles Induces Biochemical and Histopathological Pulmonary Changes in Mice

The biochemical and histopathological changes induced by the exposure to iron oxide nanoparticles coated with phospholipid-based polymeric micelles (IONPs-PM) in CD-1 mice lungs were analyzed. After 2, 3, 7 and 14 days following the intravenous injection of IONPs-PM (5 and 15 mg Fe/kg bw), lactate dehydrogenase (LDH) activity, oxidative stress parameters and the expression of Bax, Bcl-2, caspase-3 and TNF-α were evaluated in lung tissue. An increase of catalase (CAT) and glutathione reductase (GR) activities on the second day followed by a decrease on the seventh day, as well as a decline of lactate dehydrogenase (LDH), superoxide dismutase (SOD) and glutathione peroxidase (GPx) activity on the third and seventh day were observed in treated groups vs. controls. However, all these enzymatic activities almost fully recovered on the 14th day. The reduced glutathione (GSH) and protein thiols levels decreased significantly in nanoparticles-treated groups and remained diminished during the entire experimental period; by contrast malondialdehyde (MDA) and protein carbonyls increased between the 3rd and 14th day of treatment vs. control. Relevant histopathological modifications were highlighted using Hematoxylin and Eosin (H&E) staining. In addition, major changes in the expression of apoptosis markers were observed in the first week, more pronounced for the higher dose. The injected IONPs-PM generated a dose-dependent decrease of the mouse lung capacity, which counteracted oxidative stress, thus creating circumstances for morphopathological lesions and oxidation processes

Photocatalytic techniques to prevent and combat healthcare associated infections

An ever-increasing rate of morbidity and mortality caused by healthcare associated infections is reported annually. Air circulation mediates contact with microbial contaminated aerosols and represents a major risk of transmitting healthcare associated infections. We propose a revolutionary technique for the protection of interior surfaces based on a photocatalytic composition with doped TiO2 or ZnO type semiconductor metal oxides which exert antimicrobial effect. In principle, there is an activation of the photocatalytic coating with light from the normal lighting apparatus, which may incorporate one or more sources of photocatalytic excitation light. By studying the air circulation in the hospital, it is possible to design light fixtures with specific design of light distribution, in order to perform the disinfection of the air and surfaces and to amplify the antimicrobial effect. The disinfection process does not affect patients or healthcare professionals, it can be done in their presence and has a continuous, controllable effect. Photocatalytic paint in combination with a prototype luminaire with a precise spectrum light sources, light output and a light intensity distribution curve relative to the shape and dimensions of the rooms, shows that the proposed method may represent a successful alternative to classical methods of disinfection in hospitals. This technique can also be used in other areas of interest

The Complex Role of Botulinum Toxin in Enhancing Goal Achievement for Post-Stroke Patients

Introduction. The rehabilitation medical team is responsible for the therapeutic management of post-stroke patients and, therefore, for the complex therapeutic approach of spasticity. Considering the generous arsenal at our disposal in terms of both pharmacological treatment, through the possibility of administering botulinum toxin to combat spasticity, and in terms of accurate assessment through developed functional scales such as the GAS (Goal Attainment Scale), one of our purposes is to monitor the parameters that influence the achievement of functional goals set by patients together with the medical team in order to render the patients as close as possible to achieving their proposed functional goals, thus enhancing their quality of life. By assessing and establishing statistical and clinical correlations between the GAS and quantifiable parameters related to the affected post-stroke upper limb, namely degree of spasticity, motor control, pain level and evolution of pain under treatment with BoNT-A (abobotulinum toxin A), and patients’ overall response to BoNT-A treatment, we aim to quantify the improvement of the therapeutic management of post-stroke patients with spasticity and develop a more personalized and effective approach to their disability and impairment. Results and discussions. The analysis concluded that there were two independent predictors of the Achieved GAS-T score (the study’s endpoint parameter) motor control at any level of the upper limb and number of prior BoNT-A injections. The number of prior BoNT-A injections was an independent predictor of Achieved GAS-T score improvement but had no significant influence over Baseline GAS-T score. Enhancement in proximal and intermediate motor control showed a GAS score improvement of 3.3 points and a 0.93-point GAS score improvement for wrist motor control progress. From a separate viewpoint, patients with motor deficit on the left side have shown significantly greater improvement in Changed GAS-T scores by 2.5 points compared to patients with deficits on the right side; however, we note as a study limitation the fact that there was no statistical analysis over the dominant cerebral hemisphere of each patient. Conclusions. Improvement in the Achieved GAS-T score means better achievement of patients’ goals. Thus, after the BoNT- A intervention, at follow-up evaluation, GAS was found to be directly correlated with improvement in motor control of the affected upper limb. Mobility of the corresponding limb was enhanced by pain decrease during p-ROM (passive range of motion) and by amelioration of spasticity. Materials and Methods. We conducted an observational, non-randomized clinical study on 52 stroke patients, a representative sample of patients with post-stroke spasticity and disability from our neurological rehabilitation clinic, who have been treated and undergone a specific rehabilitation program in our tertiary diagnostic and treatment medical center, including BoNT-A focal treatment for spasticity in the affected upper limb. The primary objective of the study was to assess the influence of abobotulinum toxin A treatment on the Goal Attainment Scale. Secondary objectives of the study included the assessment of BoNT-A treatment efficacy on spasticity with the MAS (Modified Ashworth Scale), pain with the NRS (Numerical Rating Scale), and joint passive range of motion (p-ROM), identifying demographic, clinical, and pharmacological factors that influence the response to BoNT-A treatment, as well as to conduct a descriptive and exploratory analysis of the studied variables

Synthesis and Nonlinear Optical Studies of N-Containing Heterocyclic Compounds

Introduction: The organic compounds which contain a “push–pull” system, that means a couple donor (D)–acceptor (A) connected to a system which contributes to the delocalization of the π-electrons, define the classic structures with optical response due to large hyperpolarizabilities [...