Left atrial appendage thrombosis and persistent atrial fibrillation: Combined treatment with a totally thoracoscopic approach

Minimally invasive surgical ablation is generally contraindicated in patients with atrial fibrillation and thrombosis of the left atrial appendage. We have treated three of these patients using an innovative technique based on a bilateral video-thoracoscopic approach, performing a continuous encircling lesion at the pulmonary veins outflow with radio-frequency ablation, simultaneously excluding the left atrial appendage. The postoperative course was uneventful, without neurologic events and all patients maintained a stable sinus rhythm at 1-year follow-up. This procedure represents a new mini-invasive method to treat persistent atrial fibrillation when partial thrombosis of the left atrial appendage contraindicates other ablation techniques

Interleukin-1 receptor antagonist gene (IL-1RN) polymorphism is a predictive factor of clinical pregnancy after IVF

BACKGROUND Only 25% of IVF transfer cycles lead to a clinical pregnancy, calling for continued technical progress but also more in depth analysis of patients' individual characteristics. The interleukin-1 (IL-1) system and matrix metalloproteinases (MMPs) are strongly implicated in embryo implantation. The genes coding for IL-1Ra (gene symbol IL-1RN), IL-1β, MMP2 and MMP9 bear functional polymorphisms. We analysed the maternal genetic profile at these polymorphic sites in IVF patients, to determine possible correlations with IVF outcome. METHODS One hundred and sixty women undergoing an IVF cycle were enrolled and a buccal smear was obtained. The presence of IL-1RN variable number of tandem repeats and IL-1B + 3953, MMP2-1306 and MMP9-1562 single nucleotide substitutions were determined. Patients were divided into pregnancy failures (119), biochemical pregnancies (8) and clinical pregnancies (33). RESULTS There was a 40% decrease in IL-1RN*2 allele frequency (P = 0.024) and a 45% decrease in IL-1RN*2 carrier status in the clinical pregnancy group as compared to the pregnancy failure group (P = 0.017). This decrease was still statistically significant after a multivariate logistic regression analysis. The likelihood of a clinical pregnancy was decreased accordingly in IL-1RN*2 carriers: odds ratio = 0.349, 95% confidence interval = 0.2-0.8, P = 0.017. The IL-1B, MMP2 and MMP9 polymorphisms showed no correlation with IVF outcome. CONCLUSIONS IL-1RN*2 allele carriage is associated with a poor prognosis of achieving a pregnancy after IV

Hydrogel-nanoparticles composite system for controlled drug delivery

Biodegradable poly(ethylene glycol)-block-poly(-lactic acid) (PEG-b-PLA) nanoparticles (NPs) were prepared by nanoprecipitation with controlled dimension and with different electric charges, as monitored by dynamic light scattering (DLS). Then NPs were loaded within hydrogels (HG) developed for biomedical applications in the central nervous system, with different pore sizes (30 and 90 nm). The characteristics of the resulting composite hydrogel-NPs system were firstly studied in terms of ability to control the release of small steric hindrance drug mimetic. Then, diffusion-controlled release of different charged NPs from different entangled hydrogels was studied in vitro and correlated with NPs electric charges and hydrogel mean mesh size. These studies showed different trends, that depend on NPs superficial charge and HG mesh size. Release experiments and diffusion studies, then rationalized by mathematical modeling, allowed us to build different drug delivery devices that can satisfy different medical needs

Feições geomorfológicas e solos nos locais em que foram construídos os geoglifos no Estado do Acre.

Distribuição dos Geoglifos na Amazônia Ocidental. Relações Ambientais dos Geoglifos no Município de Plácido de Castro. Localização dos Geoglifos em Relação Às Feições Geomorfológicas. Localização dos Geoglifos em Relação às Classes e Características dos Solos. Ocorrência de Geoglifos em Argissolos. Ocorrência de Geoglifos em Latossolos. Ocorrência de Geoglifos em Plintossolos. Características dos Solos nos Geoglifos. Falta de Evidências de Sítios de Habitação no Interior dos Geoglifos

COMPLICAÇÃO NA EXODONTIA DE TERCEIRO MOLAR SUPERIOR INCLUSO: DESLOCAMENTO PARA O SEIO MAXILAR - RELATO DE CASO

            O deslocamento de terceiros molares superiores para dentro do seio maxilar é uma das complicações trans-operatórias que podem ocorrer quando a remoção destes dentes é realizada. O diagnóstico diferencial para análise da localização do dente deverá ser feita através de exames por imagens, averiguando a posição e o envolvimento deste com o seio maxilar, visto que há a possibilidade do elemento dentário estar deslocado para o espaço pterigopalatino. O trabalho apresenta o relato do caso da paciente O.S., submetida à cirurgia para remoção de um terceiro molar superior esquerdo incluso que foi deslocado para o interior do seio maxilar. A intenção é demonstrar como foi feito este diagnóstico, a técnica cirúrgica utilizada e o controle do caso a longo prazo. O acesso através da parede lateral do seio maxilar e a manutenção da lâmina cortical com levantamento da mucosa do seio mostra-se uma técnica eficiente, permitindo um bom reparo ósseo, demonstrado pela radiografia e pelo quadro clínico pós-operatório da paciente

A INFLUÊNCIA DA QUÍMICA NA EVOLUÇÃO DOS COMPUTADORES

Os fenômenos e transformações que a química estuda estão presentes em nosso cotidiano. Quando o assunto é computador é possível perceber a presença da química nos chips, no plástico, no vidro do monitor e nos metais dos circuitos e gabinetes, dentre outros locais. Devido à importância da química para o desenvolvimento da informática, esse trabalho teve como objetivo demonstrar sua contribuição no decorrer da evolução das gerações dos computadores, focando principalmente a parte de hardware

Low incidence of permanent complications during catheter ablation for atrial fibrillation using open-irrigated catheters: A multicentre registry

Aims Despite catheter ablation (CA) has become an accepted treatment option for symptomatic, drug-resistant atrial fibrillation (AF), the safety of this procedure continues to be cause for concern. The aim of the present study was to assess the incidence of complications with permanent sequelae of CA for AF using open-irrigated catheters in a contemporary, unselected population of consecutive patients. Methods and results From 1 January 2011 to 31 December 2011, data from 2167 consecutive patients who underwent CA for AF using an open-irrigated catheter in 29 Italian centres were collected. All the complications occurring to the patient from admission to the 30th post-procedural day were recorded. No procedure-related death was observed. Complications occurred in 81 patients (3.7%): 46 patients (2.1%) suffered vascular access complications; 13 patients (0.6%) cardiac tamponade, successfully drained in all the cases; six patients (0.3%) arterial thromboembolism (four transient ischaemic attack and two ischaemic strokes); five (0.2%) patients conservatively treated pericardial effusion; three patients (0.1%) phrenic nerve paralysis; three patients (0.1%) pericarditis; three patients (0.1%) haemothorax, and two patients (0.1%) other isolated adverse events. At multivariate analysis, only female sex [odds ratio (OR) 2.5, confidence interval (CI): 1.5-3.7, P < 001] and the operator experience (OR 0.5, CI: 0.4-0.7, P < 001) related to the complications. Only five (0.2%) patients developed permanent sequelae from their complications. Conclusion Catheter ablation for AF with the use of open-irrigated catheters is currently affected by a very low rate of complications leading to permanent sequelae. \uc2\ua9 2014 Published on behalf of the European Society of Cardiology

RET PLCγ Phosphotyrosine Binding Domain Regulates Ca2+ Signaling and Neocortical Neuronal Migration

The receptor tyrosine kinase RET plays an essential role during embryogenesis in regulating cell proliferation, differentiation, and migration. Upon glial cell line-derived neurotrophic factor (GDNF) stimulation, RET can trigger multiple intracellular signaling pathways that in concert activate various downstream effectors. Here we report that the RET receptor induces calcium (Ca2+) signaling and regulates neocortical neuronal progenitor migration through the Phospholipase-C gamma (PLCγ) binding domain Tyr1015. This signaling cascade releases Ca2+ from the endoplasmic reticulum through the inositol 1,4,5-trisphosphate receptor and stimulates phosphorylation of ERK1/2 and CaMKII. A point mutation at Tyr1015 on RET or small interfering RNA gene silencing of PLCγ block the GDNF-induced signaling cascade. Delivery of the RET mutation to neuronal progenitors in the embryonic ventricular zone using in utero electroporation reveal that Tyr1015 is necessary for GDNF-stimulated migration of neurons to the cortical plate. These findings demonstrate a novel RET mediated signaling pathway that elevates cytosolic Ca2+ and modulates neuronal migration in the developing neocortex through the PLCγ binding domain Tyr1015