Infective Cardiomyopathy

Both the infectious agent and development of inflammatory response to infection can lead to irreversible myocardial injury, which affects the outcome of short- and long-term prognosis. In the case of the rapid elimination of the infectious agent and rapid withholding of inflammatory process, changes in myocardium are small. If the immune response does not lead to complete elimination of infectious agent or inflammation progresses after removing the virus, chronic myocardial damage may develop. Persistence of the virus in myocardium, postinfectious immune reaction, autoimmunity, and primary cardiac damage may result in the development of progressive ventricular dysfunction, development of cardiac arrhythmias, and exacerbation of symptom. Because of the long-term consequences, it is important to diagnose infective cardiomyopathy (IC) quickly and start appropriate treatment. However, IC is still a diagnostic challenge. Infective cardiomyopathy is often underdiagnosed because of a wide spectrum of factors causing IC—infectious, toxic, immunologic, and various clinical manifestation. The processes responsible for the development of IC take place at the cellular level, which is why it is important to make the diagnosis not only based on clinical symptoms and imaging but also to confirm it with the use of histological, immunohistochemical, and molecular studies. Progress in the diagnosis and understanding of the pathomechanisms responsible for the development of IC contributed to the use of new therapeutic options. Immunosuppresive and immunomodulative treatment is still of limited use. However, in some cases of viral IC, targeted antiviral treatment can be added to the standard heart failure therapy resulting in improvement of the prognosis

Modyfikacja metody „T and protrusion” z wykorzystaniem stentu BiOSS LimC oraz klasycznego stentu lekowego w terapii bifurkacji pnia lewej tętnicy wieńcowej u pacjenta z zawałem serca z uniesieniem odcinka ST

The following case report concerns 61 year old male with a history of hipertension, type 2 diabetes, admitted because of antero-lateral STEMI with typical chest pain of 6 hours duration and orthopnoe. He was given loading dose of ASA and ticagrelor ,unfractioned heparin, also intravenous morphine and furosemide and has been transferred directly to the cath-lab. Coronary angio via femoral approach revealed critical, ostial Medina 0,1,1 type lesions in Left Anterior Descending (LAD) and Circumflex Artery (Cx), 70 % stenosis in marginal branch, fairly normal recessive right coronary artery (RCA), with TIMI 1 flow in LAD and TIMI 3 Cx and RCA. Taking into consideration lesions morphology and TIMI 1 flow in LAD, 2 stent strategy was chosen using bifurcation dedicated stent (BiossLimC , Balton, PL) and T-and protrusion (TAP) with successful result and immediate regression of chest pain and dyspnoea. Small, stable distal edge dissection was noted, however because of severe lumbar pain patient asked for ending the procedure as fast as possible and eventually IVUS evaluation was not performed. During next 5 days of hospitalization, patient was free of any sympthoms, quickly mobilized and dicharged, his blood tests were with typical troponin dynamics. His echocardiographic assessment revealed LVEF of 38%, akinesis of inferior wall and antero-lateral hypokinesis. He was discharged on ASA, ticagrelor, atorvastatin, eplerenon, ramipril, nebivolol, pantoprazole, metformin, insuline and scheduled for further evaluation in the context of indications for an ICD.Opis przypadku dotyczy 61-letniego pacjenta z nadciśnieniemtętniczym i cukrzycą typu 2, przyjętego z rozpoznaniem zawałuz uniesieniem odcinka ST (STEMI, ST-elevation myocardialinfarction) ściany przednio-bocznej. W wywiadzie dławicawysiłkowa od kilku miesięcy poprzedzających hospitalizację,w dniu przyjęcia silny, spoczynkowy ból dławicowy, trwającyokoło 6 godzin. Chory został przyjęty bezpośrednio do pracownihemodynamiki, wymagał podaży morfiny ze względu na silnedolegliwości bólowe oraz dożylnie furosemidu ze względu naobjawy zastoju w krążeniu małym. W koronarografii z dostępuprzez tętnicę udową wykazano krytyczne zwężenia ze zwapnieniamiw początkowych odcinkach gałęzi przedniej zstępującej(GPZ) i gałęzi okalającej (GO) (Medina 0,1,1) oraz około70-procentowe zwężenie w gałęzi marginalnej (GM) 1, przyrecesywnej prawej tętnicy wieńcowej (PTW), z przepływemTIMI 1 w GPZ i TIMI 3 w GO. Ze względu na morfologię zmianyzadecydowano o dwustentowej metodzie leczenia, z zastosowaniemstentu dedykowanego do leczenia bifurkacji-BIOSSLimC (Balton). Angioplastykę z implantacją 2 stentów pokrytychcytostatykim wykonano metodą zmodyfikowanego TAP(T and Protrusion), uzyskując przepływ TIMI (thrombolysis inmyocardial infarction) 3 w GPZ i GO. W kontrolnych projekcjachwykazano brzeżną, stabilną dyssekcję przy dystalnym brzegustentu w GPZ. Ze względu na brak zgody chorego na kontynuacjęzabiegu ostatecznie nie wykonano oceny ultrasonografii wewnątrznaczyniowej(IVUS, intravascular ultrasound). W trakciedalszej obserwacji pacjent bez dolegliwości dławicowych, bezobjawów niewydolności serca. W badaniach laboratoryjnychodnotowano wysokie wartości markerów martwiczych. W badaniuechokardiograficznym uwidoczniono akinezę ściany dolneji przegrody, hipokinezę ściany przedniej i bocznej z frakcjąwyrzutową 38%. Po 5 dobach hospitalizacji, pacjenta wypisanodobrym stanie ogólnym, z zaleceniem przyjmowania kwasuacetylosalicylowego, tikagreloru, atorwastatyny, eplerenonu,ramiprilu, nebiwololu, pantoprazolu, metforminy i insuliny

Niewydolność serca w przebiegu nieleczonego nadciśnienia tętniczego oraz zaburzeń metabolicznych

We present the case of a 38-year-old previously untreated patient admitted to the hospital because of hypertensivecrisis. The patient apart from hypertension was initially diagnosed with heart failure, diabetes type 2, dyslipidemia.Coronary ischemic disease was excluded due to angiography. Cardiac magnetic resonance imaging has shown thealternations indicating metabolic etiology of heart failure. After hypertension, hypolipidemic and diabetes treatment,patient’s general condition, normalization of blood pressure and lipids values, glycemic control and the improvementof left ventricular systolic function were observed.Przedstawiamy przypadek 38-letniego dotychczas nie leczonego pacjenta przyjętego do szpitala z powodu kryzy nadciśnieniowej. U chorego poza nadciśnieniem tętniczym stwierdzono wieńcową, cukrzycę typu 2, dyslipidemię. Na podstawie koronarografii wykluczono chorobę wieńcową. W rezonansie magnetycznym serca (MRI) stwierdzono zmiany wskazujące na etiologię metaboliczną. Po zastosowanym leczeniu hipotensyjnym, hipolipemicznym i diabetologicznym uzyskano poprawę stanu pacjenta, normalizację wartości ciśnienia tętniczego (RR), poziomu lipidów, dobrą kontrolę glikemii oraz poprawę funkcji skurczowej lewej komory

Nowo rozpoznane nadciśnienie tętnicze u pacjentki w trakcie hormonoterapii anastrozolem z powodu raka gruczołu piersiowego

We present the case of 63-year-old patient with breast cancer treated with anastrozole, in whom the developmentof arterial hypertension during chemotherapy occurred. The patient using an aromatase inhibitor for the oncologicaltreatment, did not experience the development of other diseases of the cardiovascular system besides elevated bloodpressure. After inclusion of five antihypertensive drugs normal blood pressure was achieved.Przedstawiamy przypadek 63-letniej pacjentki leczonej anastrozolem z powodu nowotworu piersi, u której w tracie chemioterapii doszło do rozwoju nadciśnienia tętniczego. U pacjentki leczonej inhibitorem aromatazy w leczeniu onkologicznym, poza tym nie doszło do rozwoju innych schorzeń układu sercowo-naczyniowego. Po włączeniu 5 leków hipotensyjnych uzyskano prawidłowe wartości ciśnienia tętniczego

Radial versus femoral access in patients treated with percutaneous coronary intervention and rotational atherectomy

Background: The association between periprocedural complications and the type of vascular access in patients treated with percutaneous coronary intervention (PCI) and rotational atherectomy (RA) has not been investigated as frequently as in an overall group of patients treated with PCI. Aims: The aim of this study was to assess the associations between the type of vascular access and selected periprocedural complications in a group of patients treated with PCI and RA. Methods: ased on a nationwide Polish registry (National Registry of Percutaneous Coronary Interventions [ORPKI]), we analyzed 536 826 patients treated with PCI between the years 2014 and 2018. The study included 2713 patients (0.5% of the overall group of patients treated with PCI [n = 536 826]) treated with PCI and RA. Among them, 1018 (37.5%) were treated via femoral access, and 1653 (60.9%) via radial access. Subsequently, these patients were subject to comparison, which was proceeded by propensity score matching. Results: Following propensity score matching, multiple regression analysis revealed that patients undergoing PCI via femoral access experienced coronary artery perforation significantly less frequently than those managed via radial access (odds ratio, 0.29; 95% CI, 0.08–0.92; P = 0.04). We did not observe any significant associations between the type of vascular access and the periprocedural mortality rate (P = 0.99), cardiac arrest (P = 0.41), puncture‑site bleeding (P = 0.99), allergic reaction (P = 0.32), myocardial infarction (P = 0.48), no‑reflow phenomenon (P = 0.82), or the overall complication rate (P = 0.31). Conclusion: In patients treated with PCI and RA, femoral access is associated with a lower rate of coronary artery perforations as compared with radial access

Modern applications of machine learning in quantum sciences

In these Lecture Notes, we provide a comprehensive introduction to the most recent advances in the application of machine learning methods in quantum sciences. We cover the use of deep learning and kernel methods in supervised, unsupervised, and reinforcement learning algorithms for phase classification, representation of many-body quantum states, quantum feedback control, and quantum circuits optimization. Moreover, we introduce and discuss more specialized topics such as differentiable programming, generative models, statistical approach to machine learning, and quantum machine learning.Comment: 268 pages, 87 figures. Comments and feedback are very welcome. Figures and tex files are available at https://github.com/Shmoo137/Lecture-Note

The Fourteenth Data Release of the Sloan Digital Sky Survey: First Spectroscopic Data from the extended Baryon Oscillation Spectroscopic Survey and from the second phase of the Apache Point Observatory Galactic Evolution Experiment

The fourth generation of the Sloan Digital Sky Survey (SDSS-IV) has been in operation since July 2014. This paper describes the second data release from this phase, and the fourteenth from SDSS overall (making this, Data Release Fourteen or DR14). This release makes public data taken by SDSS-IV in its first two years of operation (July 2014-2016). Like all previous SDSS releases, DR14 is cumulative, including the most recent reductions and calibrations of all data taken by SDSS since the first phase began operations in 2000. New in DR14 is the first public release of data from the extended Baryon Oscillation Spectroscopic Survey (eBOSS); the first data from the second phase of the Apache Point Observatory (APO) Galactic Evolution Experiment (APOGEE-2), including stellar parameter estimates from an innovative data driven machine learning algorithm known as "The Cannon"; and almost twice as many data cubes from the Mapping Nearby Galaxies at APO (MaNGA) survey as were in the previous release (N = 2812 in total). This paper describes the location and format of the publicly available data from SDSS-IV surveys. We provide references to the important technical papers describing how these data have been taken (both targeting and observation details) and processed for scientific use. The SDSS website (www.sdss.org) has been updated for this release, and provides links to data downloads, as well as tutorials and examples of data use. SDSS-IV is planning to continue to collect astronomical data until 2020, and will be followed by SDSS-V.Comment: SDSS-IV collaboration alphabetical author data release paper. DR14 happened on 31st July 2017. 19 pages, 5 figures. Accepted by ApJS on 28th Nov 2017 (this is the "post-print" and "post-proofs" version; minor corrections only from v1, and most of errors found in proofs corrected

Evaluating the contribution of rare variants to type 2 diabetes and related traits using pedigrees

Significance Contributions of rare variants to common and complex traits such as type 2 diabetes (T2D) are difficult to measure. This paper describes our results from deep whole-genome analysis of large Mexican-American pedigrees to understand the role of rare-sequence variations in T2D and related traits through enriched allele counts in pedigrees. Our study design was well-powered to detect association of rare variants if rare variants with large effects collectively accounted for large portions of risk variability, but our results did not identify such variants in this sample. We further quantified the contributions of common and rare variants in gene expression profiles and concluded that rare expression quantitative trait loci explain a substantive, but minor, portion of expression heritability.</jats:p

Science from an Ultra-Deep, High-Resolution Millimeter-Wave Survey

Opening up a new window of millimeter-wave observations that span frequency bands in the range of 30 to 500 GHz, survey half the sky, and are both an order of magnitude deeper (about 0.5 uK-arcmin) and of higher-resolution (about 10 arcseconds) than currently funded surveys would yield an enormous gain in understanding of both fundamental physics and astrophysics. In particular, such a survey would allow for major advances in measuring the distribution of dark matter and gas on small-scales, and yield needed insight on 1.) dark matter particle properties, 2.) the evolution of gas and galaxies, 3.) new light particle species, 4.) the epoch of inflation, and 5.) the census of bodies orbiting in the outer Solar System.Comment: 5 pages + references; Submitted to the Astro2020 call for science white paper

A new strategy for enhancing imputation quality of rare variants from next-generation sequencing data via combining SNP and exome chip data

Background: Rare variants have gathered increasing attention as a possible alternative source of missing heritability. Since next generation sequencing technology is not yet cost-effective for large-scale genomic studies, a widely used alternative approach is imputation. However, the imputation approach may be limited by the low accuracy of the imputed rare variants. To improve imputation accuracy of rare variants, various approaches have been suggested, including increasing the sample size of the reference panel, using sequencing data from study-specific samples (i.e., specific populations), and using local reference panels by genotyping or sequencing a subset of study samples. While these approaches mainly utilize reference panels, imputation accuracy of rare variants can also be increased by using exome chips containing rare variants. The exome chip contains 250 K rare variants selected from the discovered variants of about 12,000 sequenced samples. If exome chip data are available for previously genotyped samples, the combined approach using a genotype panel of merged data, including exome chips and SNP chips, should increase the imputation accuracy of rare variants. Results: In this study, we describe a combined imputation which uses both exome chip and SNP chip data simultaneously as a genotype panel. The effectiveness and performance of the combined approach was demonstrated using a reference panel of 848 samples constructed using exome sequencing data from the T2D-GENES consortium and 5,349 sample genotype panels consisting of an exome chip and SNP chip. As a result, the combined approach increased imputation quality up to 11 %, and genomic coverage for rare variants up to 117.7 % (MAF < 1 %), compared to imputation using the SNP chip alone. Also, we investigated the systematic effect of reference panels on imputation quality using five reference panels and three genotype panels. The best performing approach was the combination of the study specific reference panel and the genotype panel of combined data. Conclusions: Our study demonstrates that combined datasets, including SNP chips and exome chips, enhances both the imputation quality and genomic coverage of rare variants