Carotid artery stenting protected with an emboli containment system

Background and Purpose—Fear of distal embolization and stroke has aroused concern regarding carotid stenting. Devices to protect the cerebral circulation may make carotid stenting safer. Methods—A multidisciplinary study group tested a balloon occlusion-aspiration emboli entrapment device in conjunction with carotid stenting. The device consists of an elastomeric balloon on a steerable wire with a detachable adapter that inflates and deflates the distal temporary occlusion balloon. An aspiration catheter is used to remove trapped emboli after stenting and before occlusion balloon deflation. Results—Seventy-five patients with severe internal carotid artery stenosis were treated with stents deployed with this cerebrovasculature protection system. All 75 patients (100%) had grossly visible particulate material aspirated, and all were treated successfully without major or minor stroke or death at 30 days. Preintervention stenosis was 81 10%, and residual stenosis was 5 7%. Nine patients (12%) had angiographic evidence of thrombus before intervention, but no patient had thrombus or vessel cutoff after the procedure. Four patients (5%) developed transient neurological symptoms during protection balloon occlusion, but symptoms resolved with balloon deflation. The 22 to 667 particles aspirated per patient ranged from 3.6 to 5262 m in maximum diameter (mean, 203 256 m). These particles included fibrous plaque debris, lipid or cholesterol vacuoles, and calcific plaque fragments. Conclusions—Protected carotid stenting was performed successfully and safely in this study early in the experience with cerebrovascular protection devices. Particulate emboli are frequent with stenting, and cerebral protection will likely be necessary to minimize stroke. Randomized trials comparing protected carotid stenting with endarterectomy are warranted. (Stroke. 2002;33:1308-1314.)Fil: Whitlow, Patrick L.. No especifíca;Fil: Lylyk, Pedro. No especifíca;Fil: Londero, Walter Hugo. No especifíca;Fil: Mendiz, Oscar A.. No especifíca;Fil: Mathias, Klaus. No especifíca;Fil: Jaeger, Horst. No especifíca;Fil: Parodi, Juan. No especifíca;Fil: Schönholz, Claudio. No especifíca;Fil: Milei, Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Cardiológicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Cardiológicas; Argentin

Estudo sistemático da família Cichlidae na região central do Rio Grande do Sul. I Gêneros: Aequidens, Chichlaurus e Geophagus

Among the specimens of the Cichlidae family collected in the central region of the State of Rio Grande do Sul (Brazil), the initial studies were done in genera represented by orbicular forms, which comprise: Aequidens, Cichlaurus and Geophagus. Of these genera, four species were found in different proportions: Aequidens portalegrensis, Cichlaurus facetus, Geophagus brasiliensis and Geophagus gymnogenys.Entre os exemplares da família Cichlidae, coletados na região central do Rio Grande do Sul, foram estudados inicialmente os géneros representados pelas formas orbiculares: Aequidens, Cichlaurus e Geophagus. Destes gêneros, encontrou-se 4 espécies que ocorreram em proporções bastante variadas: Aequidens portalegrensis, Cichlaurus facetus, Geophagus brasiliensis e Geophagus gymnogenys

Inventário da fauna ictiológica do Rio Ibicuí-Mirim, RS

A survey of the ichthyologic fauna of the Ibicuí Mirim River, RS, Brazil, was carried out at four different spots resulting in the collection of 3.388 fish specimens that were classified in eight orders, twenty four families, fifty nine genera and eighty one species.O levantamento da fauna ictiológica do Rio Ibicuí Mirim, RS, realizado em quatro pontos, resultou na coleta de 3.388 espécies de peixes que foram enquadrados em oitos ordens, vinte e quatro familías, cinquenta e nove gêneros e oitenta e uma espécies

The Emergence of the ‘Social Licence to Operate’ in the Extractive Industries?

The ‘social licence to operate’ (SLO) is a construct that has potential to transform the mining sector internationally. The SLO is increasing in importance because it can reduce all risks during the energy project life-cycle that are detrimental to the success of energy projects. This paper analyses how SLO's are at first perceived by interdisciplinary energy scholars before examining the legal nature of an SLO and looking at the effectiveness of such an agreement from the perspectives of both the energy company and the local community. In essence, this research seeks to address what is the legal basis of an SLO. Further, an original case study on Columbia is presented which highlights the SLO in action and its transformative effect. The paper also engages in new debates around the relationship of SLOs to related energy concepts such as the energy justice and environmental impact statements, which are also vital to energy infrastructure developmen

Risk factors of visceral leishmaniasis: a case control study in north-western Ethiopia

Background Visceral leishmaniasis (VL, also called “kala-azar”), is a life threatening neglected tropical infectious disease which mainly affects the poorest of the poor. VL is prevalent in Ethiopia particularly in the northwest of the country. Understanding the risk factors of VL infection helps in its prevention and control. The aim of the present study was to identify the factors associated with VL. Methods A case–control study was carried out during the period of January-July 2013 in northwest Ethiopia. Cases and controls were diagnosed using clinical presentation, the rk39 rapid diagnostic test and Direct Agglutination Test (DAT). A total of 283 (84.8% males versus 15.2% females) participants were interviewed. 90 cases and 193 controls were involved, matched by age, sex and geographical location with a ratio of 1:2 (case: controls). Univariate and backward multivariate conditional logistic regression were used to identify risk factors of VL. Results Elevated odds of VL was associated with goat ownership (OR = 6.4; 95%: confidence interval [Cl]: 1.5-28.4), living in houses with cracked wall (OR = 6.4; 95% Cl: 1.6-25.6), increased family size (OR = 1.3; 95% Cl: 1.0-1.8) and the number of days spent in the farm field (OR = 1.1; 95% Cl: 1.0-1.2). However, daily individual activities around the home and farm fields, mainly sleeping on a bed (OR = 0.2; 95%: Cl 0.03-0.9), sleeping outside the house under a bed net (OR = 0.1; 95% Cl: 0.02-0.36)] and smoking plant parts in the house during the night time (OR = 0.1; 95% Cl: 0.01-0.6) were associated with decreased odds of being VL case. Conclusion Our findings showed that use of bed net and smoke could be helpful for the prevention of VL in the area particularly among individuals who spend most of their time in the farm. VL control effort could be focused on improving housing conditions, such as sealing cracks and crevices inside and outside houses. Further research is warranted to elucidate the role of goats in the transmission of L. donovani, assess the impact of bed nets and the role of the traditional practice of smoking plants

A LOV Protein Modulates the Physiological Attributes of Xanthomonas axonopodis pv. citri Relevant for Host Plant Colonization

Recent studies have demonstrated that an appropriate light environment is required for the establishment of efficient vegetal resistance responses in several plant-pathogen interactions. The photoreceptors implicated in such responses are mainly those belonging to the phytochrome family. Data obtained from bacterial genome sequences revealed the presence of photosensory proteins of the BLUF (Blue Light sensing Using FAD), LOV (Light, Oxygen, Voltage) and phytochrome families with no known functions. Xanthomonas axonopodis pv. citri is a Gram-negative bacterium responsible for citrus canker. The in silico analysis of the X. axonopodis pv. citri genome sequence revealed the presence of a gene encoding a putative LOV photoreceptor, in addition to two genes encoding BLUF proteins. This suggests that blue light sensing could play a role in X. axonopodis pv. citri physiology. We obtained the recombinant Xac-LOV protein by expression in Escherichia coli and performed a spectroscopic analysis of the purified protein, which demonstrated that it has a canonical LOV photochemistry. We also constructed a mutant strain of X. axonopodis pv. citri lacking the LOV protein and found that the loss of this protein altered bacterial motility, exopolysaccharide production and biofilm formation. Moreover, we observed that the adhesion of the mutant strain to abiotic and biotic surfaces was significantly diminished compared to the wild-type. Finally, inoculation of orange (Citrus sinensis) leaves with the mutant strain of X. axonopodis pv. citri resulted in marked differences in the development of symptoms in plant tissues relative to the wild-type, suggesting a role for the Xac-LOV protein in the pathogenic process. Altogether, these results suggest the novel involvement of a photosensory system in the regulation of physiological attributes of a phytopathogenic bacterium. A functional blue light receptor in Xanthomonas spp. has been described for the first time, showing an important role in virulence during citrus canker disease

Global standards of Constitutional law : epistemology and methodology

Just as it led the philosophy of science to gravitate around scientific practice, the abandonment of all foundationalist aspirations has already begun making political philosophy into an attentive observer of the new ways in which constitutional law is practiced. Yet paradoxically, lawyers and legal scholars are not those who understand this the most clearly. Beyond analyzing the jurisprudence that has emerged from the expansion of constitutional justice, and taking into account the development of international and regional law, the ongoing globalization of constitutional law requires comparing the constitutional laws of individual nations. Following Waldron, the product of this new legal science can be considered as ius gentium. This legal science is not as well established as one might like to think. But it can be developed on the grounds of the practice that consists in ascertaining standards. As abstract types of best “practices” (and especially norms) of constitutional law from around the world, these are only a source of law in a substantive, not a formal, sense. They thus belong to what I should like to call a “second order legal positivity.” In this article I will undertake, both at a methodological and an epistemological level, the development of a model for ascertaining global standards of constitutional law

Recent results on heavy-ion induced reactions of interest for neutrinoless double beta decay at INFN-LNS

Abstract. The possibility to use a special class of heavy-ion induced direct reactions, such as double charge exchange reactions, is discussed in view of their application to extract information that may be helpful to determinate the nuclear matrix elements entering in the expression of neutrinoless double beta decay halflife. The methodology of the experimental campaign presently running at INFN - Laboratori Nazionali del Sud is reported and the experimental challenges characterizing such activity are describe