79 research outputs found
Catecholaminergic ventricular tachycardia initially diagnosed as right ventricular outflow tract arrhythmia : differential diagnosis of CPVT, LQTS and RVOT arrhythmia.
We described a case of 33 year-old woman with catecholaminergic polymorphic ventricular tachycardia (VT) with first
presentation as syncope in age of 14. In subsequent ECGs premature ventricular contractions (PVC) with morphology of left
bundle branch block-like pattern with positive R wave in leads: II, III and aVF what suggested PVC arising from right ventricular outflow tract were observed. Nonsustained VT was observed. No ventricular arrhythmias were induced during EPS. The
2 unsuccessful sessions of ablation were performed in the right ventricular outflow area. The exercise test provoked bidirectional VT. The adrenaline infusion provoked bidirectional nonsustained VT and the U wave amplitude augmentation. Betablocker was initiated (bisoprolol). The patient is free of symptoms, only single PVC is observed
Global Chronic Total Occlusion Crossing Algorithm: JACC State-of-the-Art Review
The authors developed a global chronic total occlusion crossing algorithm following 10 steps: 1) dual angiography; 2) careful angiographic review focusing on proximal cap morphology, occlusion segment, distal vessel quality, and collateral circulation; 3) approaching proximal cap ambiguity using intravascular ultrasound, retrograde, and move-the-cap techniques; 4) approaching poor distal vessel quality using the retrograde approach and bifurcation at the distal cap by use of a dual-lumen catheter and intravascular ultrasound; 5) feasibility of retrograde crossing through grafts and septal and epicardial collateral vessels; 6) antegrade wiring strategies; 7) retrograde approach; 8) changing strategy when failing to achieve progress; 9) considering performing an investment procedure if crossing attempts fail; and 10) stopping when reaching high radiation or contrast dose or in case of long procedural time, occurrence of a serious complication, operator and patient fatigue, or lack of expertise or equipment. This algorithm can improve outcomes and expand discussion, research, and collaboration
Global Chronic Total Occlusion Crossing Algorithm
The authors developed a global chronic total occlusion crossing algorithm following 10 steps: 1) dual angiography; 2) careful angiographic review focusing on proximal cap morphology, occlusion segment, distal vessel quality, and collateral circulation; 3) approaching proximal cap ambiguity using intravascular ultrasound, retrograde, and move-the-cap techniques; 4) approaching poor distal vessel quality using the retrograde approach and bifurcation at the distal cap by use of a dual-lumen catheter and intravascular ultrasound; 5) feasibility of retrograde crossing through grafts and septal and epicardial collateral vessels; 6) antegrade wiring strategies; 7) retrograde approach; 8) changing strategy when failing to achieve progress; 9) considering performing an investment procedure if crossing attempts fail; and 10) stopping when reaching high radiation or contrast dose or in case of long procedural time, occurrence of a serious complication, operator and patient fatigue, or lack of expertise or equipment. This algorithm can improve outcomes and expand discussion, research, and collaboration.info:eu-repo/semantics/publishedVersio
Improved functionalization of oleic acid-coated iron oxide nanoparticles for biomedical applications
Superparamagnetic iron oxide nanoparticles
can providemultiple benefits for biomedical applications
in aqueous environments such asmagnetic separation or
magnetic resonance imaging. To increase the colloidal
stability and allow subsequent reactions, the introduction
of hydrophilic functional groups onto the particlesâ
surface is essential. During this process, the original
coating is exchanged by preferably covalently bonded
ligands such as trialkoxysilanes. The duration of the
silane exchange reaction, which commonly takes more
than 24 h, is an important drawback for this approach. In
this paper, we present a novel method, which introduces
ultrasonication as an energy source to dramatically
accelerate this process, resulting in high-quality waterdispersible nanoparticles around 10 nmin size. To prove
the generic character, different functional groups were
introduced on the surface including polyethylene glycol
chains, carboxylic acid, amine, and thiol groups. Their
colloidal stability in various aqueous buffer solutions as
well as human plasma and serum was investigated to
allow implementation in biomedical and sensing
applications.status: publishe
Rationale and design of a prospective substudy of clinical endpoint adjudication processes within an investigator-reported randomised controlled trial in patients with coronary artery disease: the GLOBAL LEADERS Adjudication Sub-StudY (GLASSY)
pragmatic and superiority randomised controlled trial
designed to challenge the current treatment paradigm of dual
antiplatelet therapy (DAPT) for 12 months followed by aspirin
monotherapy among patients undergoing percutaneous
coronary intervention. By design, all study endpoints are
investigator reported (IR) and not subject to formal adjudication
by an independent Clinical Event Committee (CEC), which may
introduce detection, reporting or ascertainment bias.
Methods and analysis We designed the GLOBAL LEADERS
Adjudication Sub-StudY (GLASSY) to prospectively implement,
in a large sample of patients enrolled within the GLOBAL
LEADERS trial (7585 of 15 991, 47.5%), an independent
adjudication process of reported and unreported potential
endpoints, using standardised CEC procedures, in order
to assess whether 23-month ticagrelor monotherapy
(90mg twice daily) after 1-month DAPT is non-inferior to a
standard regimen of DAPT for 12 months followed by aspirin
monotherapy for the primary efficacy endpoint of death, nonfatal myocardial infarction, non-fatal stroke or urgent target
vessel revascularisation and superior for the primary safety
endpoint of type 3 or 5 bleeding according to the Bleeding
Academic Research Consortium criteria. This study will
comprehensively assess the comparative safety and efficacy
of the two tested antithrombotic strategies on CEC-adjudicated
ischaemic and bleeding endpoints and will provide insights
into the role of a standardised CEC adjudication process on
the interpretation of study findings by quantifying the level
of concordance between IR-reported and CEC-adjudicated
events.
Ethics and dissemination GLASSY has been approved
by local ethics committee of all study sites and/or by the
central ethics committee for the country depending on
country-specific regulations. In all cases, they deemed that
it was not neces
Regulatory T cell-derived extracellular vesicles modify dendritic cell function
Regulatory T cells (Treg) are a subpopulation of T cells that maintain tolerance to self and limit other immune responses. They achieve this through different mechanisms including the release of extracellular vesicles (EVs) such as exosomes as shown by us, and others. One of the ways that Treg derived EVs inhibit target cells such as effector T cells is via the transfer of miRNA. Another key target for the immunoregulatory function of Tregs is the dendritic cells (DCs). In this study we demonstrate directly, and for the first time, that miRNAs are transferred from Tregs to DCs via Treg derived EVs. In particular two miRNAs, namely miR-150-5p and miR-142-3p, were increased in DCs following their interaction with Tregs and Treg derived exosomes. One of the consequences for DCs following the acquisition of miRNAs contained in Treg derived EVs was the induction of a tolerogenic phenotype in these cells, with increased IL-10 and decreased IL-6 production being observed following LPS stimulation. Altogether our findings provide data to support the idea that intercellular transfer of miRNAs via EVs may be a novel mechanism by which Tregs regulate DC function and could represent a mechanism to inhibit immune reactions in tissues
- âŠ