Cerebrovascular events in takotsubo syndrome: short and long-term outcome. Results from a multicenter-prospective registry

Abstract Background Several studies have shown that Takotsubo syndrome (TTS) secondary to neurological disorders is associated with higher rate of in-hospital complications. Imaging brain studies found that atrophy or damage of some regions and their altered connectivity with other brain regions are typical features of TTS patients. Aim of the study To evaluate rates of in hospital and long-term follow up events in TTS patients with history or acute cerebrovascular events (CVE). Methods 395 consecutive patients were enrolled in a multicenter prospective registry. History, clinical data, echocardiographic parameters and in-hospital and long-term follow up events of all patients were evaluated. Results Prevalence of CVE among TTS patients was 9.4% (N=37). Compared to the control group, these patients were older (80±7 vs 71±12 years, p=0.01) and predominantly men (24% vs 9%, p=0.01). No differences in terms of cardiovascular risk factors and left ventricular ejection fraction at admission and discharge were found between the two groups. The prevalence of physical stressors was higher in the CVE group (67% vs 44% p=0.01). The incidence of in-hospital adverse events was higher in the CVE group (70% vs 29%), mainly driven by higher rates of cardiogenic shock (19 vs 8%, p=0.01) and in-hospital death (19 vs 4%, p=0.01). At long-term follow-up, patients in the CVE group had higher mortality rates (38% vs 20%, p=0.01). Patients presenting with acute CVE, 10 out of 37 patients (27%), when compared with chronic CVE had higher in-hospital mortality rates (40% vs 11%, p=0.01). Conclusion TTS patients with history or CVE had higher rates of in-hospital events and death at long-term follow-up. Acute CVEs in the setting of TTS are associated with a worse prognosis. Funding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Ospedali Riuniti di Foggia. Università di Foggi

Effect of the surface chemical composition and of added metal cation concentration on the stability of metal nanoparticles synthesized by pulsed laser ablation in water

Metal nanoparticles (NPs) made of gold, silver, and platinum have been synthesized by means of pulsed laser ablation in liquid aqueous solution. Independently from the metal nature, all NPs have an average diameter of 10 ± 5 nm. The ζ-potential values are:-62 ± 7 mV for gold,-44 ± 2 mV for silver and-58 ± 3 for platinum. XPS analysis demonstrates the absence of metal oxides in the case of gold and silver NPs. In the case of platinum NPs, 22% of the particle surface is ascribed to platinum oxidized species. This points to a marginal role of the metal oxides in building the negative charge that stabilizes these colloidal suspensions. The investigation of the colloidal stability of gold NPs in the presence of metal cations shows these NPs can be destabilized by trace amounts of selected metal ions. The case of Ag+ is paradigmatic since it is able to reduce the NP ζ-potential and to induce coagulation at concentrations as low as 3 μM, while in the case of K+ the critical coagulation concentration is around 8 mM. It is proposed that such a huge difference in destabilization power between monovalent cations can be accounted for by the difference in the reduction potential

Salting-out approach is worthy of comparison with ultracentrifugation for extracellular vesicle isolation from tumor and healthy models

The role of extracellular vesicles (EVs) has been completely re-evaluated in the recent decades, and EVs are currently considered to be among the main players in intercellular commu-nication. Beyond their functional aspects, there is strong interest in the development of faster and less expensive isolation protocols that are as reliable for post-isolation characterisations as already-established methods. Therefore, the identification of easy and accessible EV isolation techniques with a low price/performance ratio is of paramount importance. We isolated EVs from a wide spectrum of samples of biological and clinical interest by choosing two isolation techniques, based on their wide use and affordability: ultracentrifugation and salting-out. We collected EVs from human cancer and healthy cell culture media, yeast, bacteria and Drosophila culture media and human fluids (plasma, urine and saliva). The size distribution and concentration of EVs were measured by nanoparticle tracking analysis and dynamic light scattering, and protein depletion was measured by a colori-metric nanoplasmonic assay. Finally, the EVs were characterised by flow cytometry. Our results showed that the salting-out method had a good efficiency in EV separation and was more efficient in protein depletion than ultracentrifugation. Thus, salting-out may represent a good alternative to ultracentrifugation

Effect of the Surface Chemical Composition and of Added Metal Cation Concentration on the Stability of Metal Nanoparticles Synthesized by Pulsed Laser Ablation in Water

Metal nanoparticles (NPs) made of gold, silver, and platinum have been synthesized by means of pulsed laser ablation in liquid aqueous solution. Independently from the metal nature, all NPs have an average diameter of 10 ± 5 nm. The ζ-potential values are: −62 ± 7 mV for gold, −44 ± 2 mV for silver and −58 ± 3 for platinum. XPS analysis demonstrates the absence of metal oxides in the case of gold and silver NPs. In the case of platinum NPs, 22% of the particle surface is ascribed to platinum oxidized species. This points to a marginal role of the metal oxides in building the negative charge that stabilizes these colloidal suspensions. The investigation of the colloidal stability of gold NPs in the presence of metal cations shows these NPs can be destabilized by trace amounts of selected metal ions. The case of Ag+ is paradigmatic since it is able to reduce the NP ζ-potential and to induce coagulation at concentrations as low as 3 μM, while in the case of K+ the critical coagulation concentration is around 8 mM. It is proposed that such a huge difference in destabilization power between monovalent cations can be accounted for by the difference in the reduction potential

photochemical activity of the bacterial reaction center in polymer like phospholipids reverse micelles

An integral membrane protein, the photosynthetic bacterial reaction center (RC), has been incorporated in reverse micelle viscoelastic gels made of phosphatidylcholine and phosphatidylserine. Due to the dynamic nature of the gels, the use of a technique which shares the same timescale of the charge recombination is advised, in order to correlate the kinetic behaviour of the RC to the hosting-system properties. Self-diffusion and conductivity measurements have been used to investigate the properties of the model system lecithin/cyclohexane/water. The results indicate that such techniques can describe the properties of the system on a long characteristic time-scale. As a consequence, the kinetic behaviour of the RC has been studied by means of flash-spectro-photometry and related to the structural properties of the hosting gel, investigated by means of conductivity. The conductivity data are consistent with a water-induced sphere-to-rod transition of the phospholipid aggregates. Furthermore, increasing the ratio [water]/[lipid], a maximum in the hydrodynamic dimension of the giant worm-like reverse micelles is found. The experimental P+ decay has been resolved into three exponential components which are strongly affected by the system composition. The functionality of the binding site QB is dependent on the ratio [water]/[lipid] supporting the hypothesis of a water role in the binding process

Survival after laparoscopic and open surgery for colon cancer: a comparative, single-institution study

BACKGROUND: Some recent studies have suggested that laparoscopic surgery for colorectal cancer may provide a potential survival advantage when compared with open surgery. This study aimed to compare cancer-related survivals of patients who underwent laparoscopic or open resection of colon cancer in the same, high volume tertiary center. METHODS: Patients who had undergone elective open or laparoscopic surgery for colon cancer between January 2002 and December 2010 were analyzed. A clinical database was prospectively compiled. Survival analysis was calculated by using the Kaplan-Meier method. RESULTS: A total of 460 resections were performed. There were no significant differences between the laparoscopic (n = 227) and the open group (n = 233) apart from tumor stage: stage I tumors were more frequent in the laparoscopic group whereas stage II tumors were more frequent in the open group. The mean number of harvested lymph nodes was significantly higher in the laparoscopic than in the open group (20.0 ± 0.7 vs 14.2 ± 0.5, P < 0.01). The 5-year cancer-related survival for patients undergoing laparoscopic resection was significantly higher than that following open resections (83.1% vs 68.5%, P = 0.01). By performing a stage-to-stage comparison, we found that the improvement in survival in the laparoscopic group occurred mainly in patients with stage II tumors. CONCLUSIONS: Our study shows a survival advantage for patients who had undergone laparoscopic surgery for stage II colon cancer. This may be correlated with a higher number of harvested lymph nodes and thus a better stage stratification of these patients

Use of lipid bilayers as support for biomolecules integration in OTFT biosensors

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How young radiologists use contrast media and manage adverse reactions: an international survey

Objectives: To collect real-world data about the knowledge and self-perception of young radiologists concerning the use of contrast media (CM) and the management of adverse drug reactions (ADR). Methods: A survey (29 questions) was distributed to residents and board-certified radiologists younger than 40&nbsp;years to investigate the current international situation in young radiology community regarding CM and ADRs. Descriptive statistics analysis was performed. Results: Out of 454 respondents from 48 countries (mean age: 31.7 ± 4&nbsp;years, range 25–39), 271 (59.7%) were radiology residents and 183 (40.3%) were board-certified radiologists. The majority (349, 76.5%) felt they were adequately informed regarding the use of CM. However, only 141 (31.1%) received specific training on the use of CM and 82 (18.1%) about management ADR during their residency. Although 266 (58.6%) knew safety protocols for handling ADR, 69.6% (316) lacked confidence in their ability to manage CM-induced ADRs and 95.8% (435) expressed a desire to enhance their understanding of CM use and handling of CM-induced ADRs. Nearly 300 respondents (297; 65.4%) were aware of the benefits of contrast-enhanced ultrasound, but 249 (54.8%) of participants did not perform it. The preferred CM injection strategy in CT parenchymal examination and CT angiography examination was based on patient’s lean body weight in 318 (70.0%) and 160 (35.2%), a predeterminate fixed amount in 79 (17.4%) and 116 (25.6%), iodine delivery rate in 26 (5.7%) and 122 (26.9%), and scan time in 31 (6.8%) and 56 (12.3%), respectively. Conclusion: Training in CM use and management ADR should be implemented in the training of radiology residents. Critical relevance statement: We highlight the need for improvement in the education of young radiologists regarding contrast media; more attention from residency programs and scientific societies should be focused on training about contrast media use and the management of adverse drug reactions. Key points: • This survey investigated training of young radiologists about use of contrast media and management adverse reactions. • Most young radiologists claimed they did not receive dedicated training. • An extreme heterogeneity of responses was observed about contrast media indications/contraindications and injection strategy. Graphical Abstract: (Figure presented.