Why, When and How Should Clinicians Use Physiology in Patients with Acute Coronary Syndromes?

Current data support the use of coronary physiology in patients with acute coronary syndrome (ACS). In patients with ST-elevation MI, the extent of myocardial damage and microvascular dysfunction create a complex conundrum to assimilate when considering clinical management and risk stratification. In this setting, the index of microcirculatory resistance emerged as an accurate tool to identify patients at risk of suboptimal myocardial reperfusion after primary percutaneous coronary intervention who may benefit from novel adjunctive therapies. In the context of non-ST-elevation ACS, coronary physiology should be carefully interpreted and often integrated with intracoronary imaging, especially in cases of ambiguous culprit lesion. Conversely, the functional assessment of bystander coronary disease is favoured by the available evidence, aiming to achieve complete revascularisation. Based on everyday clinical scenarios, the authors illustrate the available evidence and provide recommendations for the functional assessment of infarct-related artery and non-culprit lesions in patients with ACS

ORAl iMmunosuppressive therapy to prevent in-Stent rEstenosiS (RAMSES) cooperation: a patient-level meta-analysis of randomized trials

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Mirror quiescence and high-sensitivity position measurements with feedback

We present a detailed study of how phase-sensitive feedback schemes can be used to improve the performance of optomechanical devices. Considering the case of a cavity mode coupled to an oscillating mirror by the radiation pressure, we show how feedback can be used to reduce the position noise spectrum of the mirror, cool it to its quantum ground state, or achieve position squeezing. Then, we show that even though feedback is not able to improve the sensitivity of stationary position spectral measurements, it is possible to design a nonstationary strategy able to increase this sensitivity.Comment: 25 pages, 11 figure

Status of the GEO600 gravitational wave detector

The GEO600 laser interferometric gravitational wave detector is approaching the end of its commissioning phase which started in 1995.During a test run in January 2002 the detector was operated for 15 days in a power-recycled michelson configuration. The detector and environmental data which were acquired during this test run were used to test the data analysis code. This paper describes the subsystems of GEO600, the status of the detector by August 2002 and the plans towards the first science run

Polyacetylenes from Sardinian Oenanthe fistulosa: A Molecular Clue to risus sardonicus

An investigation of Oenanthe fistulosa from Sardinia afforded oenanthotoxin (1a) and dihydrooenanthotoxin (1b) from the roots and the diacetylenic epoxydiol 2 from the seeds. The absolute configuration of 1a and 1b was established as R by the modified Mosher's method, and the structure of 2 by chemical correlation with (+)-(3R,8S)-falcarindiol. Oenanthotoxin (1a) and dihydrooenanthotoxin (1b) were found to potently block GABAergic responses, providing a molecular rationale for the symptoms of poisoning from water-dropwort (Oenanthe crocata) and related plants. These observations bear relevance for a series of historical and ethnopharmacological observations on the identification of the Sardonic herb and the molecular details of the facial muscular contraction caused by its ingestion (risus sardonicus)

The status of GEO 600

The GEO 600 laser interferometer with 600m armlength is part of a worldwide network of gravitational wave detectors. GEO 600 is unique in having advanced multiple pendulum suspensions with a monolithic last stage and in employing a signal recycled optical design. This paper describes the recent commissioning of the interferometer and its operation in signal recycled mode

Recomendações sobre revascularização do miocárdio

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