Timing of Coronary Artery Bypass Grafting Surgery after Acute Myocardial Infarction

Background: Optimal timing for CABG surgery after myocardial infarction remains a matter of debate. The aim of our study was to analyze the effect of timing of CABG after acute myocardial infarction on operative mortality and morbidity. Methods: This prospective study included 60 patients who underwent isolated CABG within 30 days of acute myocardial infarction over 20 months (from the first of November 2014 till the end of June 2016) in Kasr Al-Ainy University Hospitals. Patients were divided into two groups; the early group (0 – 3 days) included 14 patients (23.3%) and the late group (4 – 30 days) included 46 patients (76.7%). The primary outcome was all-cause hospital mortality. Results: Our study included 43 males (71.7%) and 17 females (28.3%). The mean age was 58.4 ± 7.3 years. The total mortality rate was 8.3%. Patients undergoing early CABG experienced a higher mortality rate than those undergoing late CABG (21.4% vs 4.3%, P = 0.043). Also, early CABG was associated with more postoperative complications. Cardiogenic shock and early CABG were independent risk factors of mortality. Conclusion: CABG in the first 3 days after acute myocardial infarction was associated with high mortality and morbidity in comparison with late CABG. This suggests that CABG may best be deferred for more than 3 days after acute MI in non-urgent cases

Complementary and alternative medicine for the treatment and diagnosis of asthma and allergic diseases

The use of Complementary/Alternative Medicines (CAM) is largely diffused and constantly increasing, especially in the field of allergic diseases and asthma. Homeopathy, acupuncture and phytotherapy are the most frequently utilised treatments, whereas complementary diagnostic techniques are mainly used in the field of food allergy- intolerance. Looking at the literature, the majority of clinical trials with CAMS are of low methodological quality, thus difficult to interpret. There are very few studies performed in a rigorously controlled fashion, and those studies provided inconclusive results. In asthma, none of the CAM have thus far been proved more effective than placebo or equally effective as standard treatments. Some herbal products, containing active principles, have displayed some clinical effect, but the herbal remedies are usually not standardised and not quantified, thus carry the risk of toxic effects or interactions. None of the alternative diagnostic techniques (electrodermal testing, kinesiology, leukocytotoxic test, iridology, hair analysis) have been proved able to distinguish between healthy and allergic subjects or to diagnose sensitizations. Therefore these tests must not be used, since they can lead to delayed or incorrect diagnosis and therapy

Use of complementary medicine among patients with allergic rhinitis: an Italian nationwide survey.

Background: A growing use of complementary alternative medicine (CAM) has been found in Europe as well in Italy for chronic diseases, including the allergic rhinitis. The study aims at investigating the prevalence and the pattern of use of CAM amongst patient with allergic rhinitis. Methods: A 12-item questionnaire was developed by a panel of experts and administered to patients with moderate/severe allergic rhinitis consecutively referring during the study time-frame to seven allergy clinics placed all around Italy. The items covered several topics including reason for choosing CAM, its clinical efficacy, schedule of treatment, costs, type of therapy. Results: Overall 359 questionnaires were analysed. 20% of patients declared CAM use. A significant correlation between the use of CAM and female sex (p\u2009<\u20090.01) and with a higher level of education (p\u2009<\u20090.01) was observed. CAM users were adults (36% in the range between 20 and 40 years and 32% between 41 and 60 years). Youngsters (<\u200920 years) (7%) and elderly (>\u200960) (25%) less frequently used CAM.The most used type of CAM was homoeopathy (77% of patients). 60% of users would recommend CAM despite a poor clinical efficacy according to 67% of them. Conclusions: Although no evidence supports CAM efficacy and safety, the number of patients who relies on it is not negligible. As allergic rhinitis is not a trivial disease, the use of CAM as the only treatment for it should be discouraged at any level, but by general practitioner and specialist in particular

Prevalence of severe asthma according to the drug regulatory agency perspective: An Italian experience

Severe asthma prevalenc

Correlation induced phonon softening in low density coupled bilayer systems

We predict a possible phonon softening instability in strongly correlated coupled semiconductor bilayer systems. By studying the plasmon-phonon coupling in coupled bilayer structures, we find that the renormalized acoustic phonon frequency may be softened at a finite wave vector due to many-body local field corrections, particularly in low density systems where correlation effects are strong. We discuss experimental possibilities to search for this predicted phonon softening phenomenon.Comment: 4 pages with 2 figure

A multi-centre study on quality of life and absenteeism in patients with CRS referred for endoscopic surgery

Aims: This study summarises the health-related quality of life (HRQOL) scores and absenteeism caused by sinus problems in patients awaiting surgery with the diagnoses recurrent acute rhinosinusitis (RARS), chronic rhinosinusitis with nasal polyps (CRS+NP) or CRS without nasal polyps (CRS-NP), in a prospective multi-centre study. Methodology: Two hundred and seven patients with RARS, CRS+NP or CRS-NP were enrolled. EP3OS definitions of CRS and NP were used. The patients completed the 22 Sinonasal Outcome Test (SNOT-22), the short-form 36-item questionnaire (SF-36), the Hospital Anxiety and Depression Scale (HAD) and a total Visual Analogue Scale (VAS) regarding rhinosinusitis symptoms. Results: SNOT-22 and VAS scores indicated severe disease. Comparison of the HRQOL scores in the three rhinosinusitis subgroups showed statistical differences in nine of the SNOT-22 items and in the SF-36 subscale of bodily pain. Mean scores of SF-36 were significantly lower than that of the normal Swedish population. According to the HAD scores, 28% of the patients had probable or possible anxiety or depression disorder. Fifty-seven percent of the patients reported absenteeism from work due to sinus problems. Conclusions: RARS, CRS+NP and CRS-NP significantly decrease HRQOL. Some statistically significant differences in HRQOL were found between the three rhinosinusitis subgroups. Absenteeism due to chronic sinus conditions is considerable

Carie precoce dell’infanzia e batteri cariogeni materni : quale associazione? Studio retrospettivo

Razionale - La carie rapidamente destruente dell\u2019infanzia rappresenta un grave problema di salute pubblica nella maggior parte dei Paesi industrializzati. Obiettivi - Scopo del presente lavoro \ue8 stato quello di quantificare le concentrazioni salivari degli streptococchi del gruppo mutans (sm) nelle madri nel puerperio e di associarle con la prevalenza della patologia cariosa rilevata nei bambini durante il quarto anno di et\ue0. Materiali e Metodi - Lo studio \ue8 stato di tipo retrospettivo. \uc8 stata registrata la prevalenza di carie su 494 bambini di et\ue0 media 48 mesi, calcolando l\u2019indice di carie dmfs (decayed missing, filled surface). Sono state inoltre raccolte informazioni di carattere generale dei genitori e alcune variabili correlate alla carie relative ai bambini con l\u2019ausilio di un questionario autosomministrato rivolto ai genitori. I dati clinici e quelli comportamentali/anamnestici sono stati associati con la concentrazione salivare di sm registrati nelle madri (n=489) entro il terzo giorno dal parto. Risultati - Il 31,27% delle madri (n=178) presentava una positivit\ue0 agli sm, mentre il 69,73% (n=311) \ue8 risultato negativo. L\u2019esperienza di carie registrata nei bambini non \ue8 risultata statisticamente associata alla concentrazione di sm registrati nelle mamme al puerperio (p=0,62). N\ue9 il livello di istruzione della madre, n\ue9 la lingua parlata in famiglia risultano associate alle concentrazioni degli sm in maniera statisticamente significativa (p=0,76 e 0,50 rispettivamente). Solo la frequenza di cibi dolci assunti dal bambino pi\uf9 di una volta al giorno \ue8 risultata statisticamente associata alla concentrazione di sm materni. I figli di madri con una concentrazione di sm superiore al valore soglia di 105 CFU/ml hanno un rischio di 1,61 di assumere cibi dolci pi\uf9 di una volta al giorno (p=0,01). Conclusioni - I risultati del presente studio confermano che la carie \ue8 una malattia legata ai comportamenti e come tale prevenibile con strategie preventive a carattere educativo di cui il pediatra dovrebbe farsi carico.Background - The early childhood caries is a serious public health problem in most industrialized countries. Objectives - The purpose of this study was to quantify the concentrations of salivary mutans streptococci (ms) in mothers immediately after delivery and to associate them with the prevalence of caries disease registered in children during the fourth year of age. Materials and Methods - A retrospective study was designed and performed. The caries prevalence of 494 children (mean age 48 months) was evaluated, using the caries index dmfs (decayed missing, filled surface). General information on parents and some variables related to dental caries in children were collected through a self-administered questionnaire to parents. Clinical data and behavioural/medical history were associated with the concentration of ms recorded in mothers (n = 489) in the third day after delivery. Results - 31.3% of mothers (n=178) had high concentrations of ms, while 69.7% (n=311) showed low concentrations. The children\u2019s caries experience was not statistically associated with the concentration of ms registered in mothers (p=0.62). Neither the mother\u2019s education level, nor the language spoken at home, were statistically significant associated with the concentration of ms (p = 0.76 and 0.50, respectively). Only the frequent intake of sweetened foods by children (more than once a day) was statistically associated with the concentration of maternal ms. The children from mothers with a concentration of ms higher than a threshold value of 105 CFU/ml had a risk of 1.61 to take sweet foods more than once per day (p = 0.01). Conclusion - The results of the present study confirm that caries is a disease strongly related to behaviours; prevention strategies performed by the paediatrician, such as educational intervention, are necessary to reduce the prevalence of the disease

Interaction between lamellar twinning and catalyst dynamics in spontaneous core-shell InGaP nanowires

FAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULOCNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOCAPES - COORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIORSemiconductor nanowires oriented along the [211] direction usually present twins parallel to their axis. For group IV nanowires this kind of twin allows the formation of a catalyst-nanowire interface composed of two equivalent {111} facets. For III-V nanowires, however, the twin will generate two facets with different polarities. In order to keep the orientation stable, a balance in growth rates for these different facets must be reached. We report here the observation of stable, micron-long -oriented InGaP nanowires with a spontaneous core-shell structure. We show that stacking fault formation in the crystal region corresponding to the {111} A facet termination provides a stable NW/NP interface for growth along the direction. During sample cool down, however, the catalyst migrates to a lateral {111} B facet, allowing the growth of branches perpendicular to the initial orientation. In addition to that, we show that the core-shell structure is non-concentric, most likely due to the asymmetry between the facets formed in the NW sidewall; this effect generates stress along the nanowire, which can be relieved through bending.Semiconductor nanowires oriented along the [211] direction usually present twins parallel to their axis. For group IV nanowires this kind of twin allows the formation of a catalyst-nanowire interface composed of two equivalent {111} facets. For III-V nanowires, however, the twin will generate two facets with different polarities. In order to keep the orientation stable, a balance in growth rates for these different facets must be reached. We report here the observation of stable, micron-long -oriented InGaP nanowires with a spontaneous core-shell structure. We show that stacking fault formation in the crystal region corresponding to the {111} A facet termination provides a stable NW/NP interface for growth along the direction. During sample cool down, however, the catalyst migrates to a lateral {111} B facet, allowing the growth of branches perpendicular to the initial orientation. In addition to that, we show that the core-shell structure is non-concentric, most likely due to the asymmetry between the facets formed in the NW sidewallthis effect generates stress along the nanowire, which can be relieved through bending.7291272212727FAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULOCNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOCAPES - COORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIORFAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULOCNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOCAPES - COORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIORFAPESP [2013/02300-1]CNPq [479486/2012-3]2013/02300-1479486/2012-3Sem informaçãoWe acknowledge the National Laboratory of Nanotechnology (LNNANO/CNPEM) for granting access to their electron microscopy facilities. We also acknowledge Th. Chiaramonte for discussions on NW growth and H. T. Obata for technical assistance. This work was financially supported by FAPESP (grant 2013/02300-1), CNPq (grant 479486/2012-3) and CAPES. D.S. Oliveira acknowledges FAPESP for funding his scholarship