A pressão coronária (às vezes) mente. . .

Comment on: Comparative analysis of fractional flow reserve and instantaneous wave-free ratio: Results of a five-year registry. [Rev Port Cardiol. 2018]info:eu-repo/semantics/publishedVersio

The Multi-center Evaluation of the Accuracy of the Contrast MEdium INduced Pd/Pa RaTiO in Predicting FFR (MEMENTO-FFR) Study.

AIMS: Adenosine administration is needed for the achievement of maximal hyperaemia fractional flow reserve (FFR) assessment. The objective was to test the accuracy of Pd/Pa ratio registered during submaximal hyperaemia induced by non-ionic contrast medium (contrast FFR [cFFR]) in predicting FFR and comparing it to the performance of resting Pd/Pa in a collaborative registry of 926 patients enrolled in 10 hospitals from four European countries (Italy, Spain, France and Portugal). METHODS AND RESULTS: Resting Pd/Pa, cFFR and FFR were measured in 1,026 coronary stenoses functionally evaluated using commercially available pressure wires. cFFR was obtained after intracoronary injection of contrast medium, while FFR was measured after administration of adenosine. Resting Pd/Pa and cFFR were significantly higher than FFR (0.93±0.05 vs. 0.87±0.08 vs. 0.84±0.08, p<0.001). A strong correlation and a close agreement at Bland-Altman analysis between cFFR and FFR were observed (r=0.90, p<0.001 and 95% CI of disagreement: from -0.042 to 0.11). ROC curve analysis showed an excellent accuracy (89%) of the cFFR cut-off of ≤0.85 in predicting an FFR value ≤0.80 (AUC 0.95 [95% CI: 0.94-0.96]), significantly better than that observed using resting Pd/Pa (AUC: 0.90, 95% CI: 0.88-0.91; p<0.001). A cFFR/FFR hybrid approach showed a significantly lower number of lesions requiring adenosine than a resting Pd/Pa/FFR hybrid approach (22% vs. 44%, p<0.0001). CONCLUSIONS: cFFR is accurate in predicting the functional significance of coronary stenosis. This could allow limiting the use of adenosine to obtain FFR to a minority of stenoses with considerable savings of time and costs.info:eu-repo/semantics/publishedVersio

cFFR as an alternative to FFR: please do not contrast simplicity!

info:eu-repo/semantics/publishedVersio

Turbulence Hierarchy in a Random Fibre Laser

Turbulence is a challenging feature common to a wide range of complex phenomena. Random fibre lasers are a special class of lasers in which the feedback arises from multiple scattering in a one-dimensional disordered cavity-less medium. Here, we report on statistical signatures of turbulence in the distribution of intensity fluctuations in a continuous-wave-pumped erbium-based random fibre laser, with random Bragg grating scatterers. The distribution of intensity fluctuations in an extensive data set exhibits three qualitatively distinct behaviours: a Gaussian regime below threshold, a mixture of two distributions with exponentially decaying tails near the threshold, and a mixture of distributions with stretched-exponential tails above threshold. All distributions are well described by a hierarchical stochastic model that incorporates Kolmogorov's theory of turbulence, which includes energy cascade and the intermittence phenomenon. Our findings have implications for explaining the remarkably challenging turbulent behaviour in photonics, using a random fibre laser as the experimental platform.Comment: 9 pages, 5 figure

Production of bioethanol from sweet potato, agro industrial wastes

One fraction of the existent petroleum is not extractable or the difficulties associated to extraction are very expensive making them unviable. This situation leads to a decrease in petroleum stocks all over the world and a resulting increment on its price, affecting in particular the transportation sector, since there is no relevant alternative to fossil petroleum

Observation of Replica Symmetry Breaking in the 1D Anderson Localization Regime in an Erbium-Doped Random Fiber Laser

The analogue of the paramagnetic to spin-glass phase transition in disordered magnetic systems, leading to the phenomenon of replica symmetry breaking, has been recently demonstrated in a two-dimensional random laser consisting of an organic-based amorphous solid-state thin film. We report here the first demonstration of replica symmetry breaking in a one-dimensional photonic system consisting of an erbium-doped random fiber laser operating in the continuous-wave regime based on a unique random fiber grating system, which plays the role of the random scatterers and operates in the Anderson localization regime. The clear transition from a photonic paramagnetic to a photonic spin glass phase, characterized by the probability distribution function of the Parisi overlap, was verified and characterized. In this unique system, the radiation field interacts only with the gain medium, and the fiber grating, which provides the disordered feedback mechanism, does not interfere with the pump

Herpetic esophagitis: a diagnosis to remember

Introdução: A esofagite herpética é uma doença frequente em doentes imunodeprimidos, sendo raros os casos descritos em indivíduos imunocompetentes. Caso clínico: Os autores descrevem o caso de uma adolescente, admitida no serviço de urgência com febre, odinofagia, disfagia para líquidos e sólidos e dor retroesternal, com três dias de evolução. Realizou endoscopia digestiva alta, que revelou erosões lineares e redondas no terço inferior do esófago. O estudo anatomo-patológico das biópsias realizadas foi sugestivo de esofagite herpética. Conclusão: A esofagite herpética é uma doença frequentemente subdiagnosticada na criança e adolescente imunocompetentes, pelo que não deve ser esquecida. O diagnóstico definitivo depende da realização de endoscopia digestiva alta com colheita tecidular. Habitualmente é autolimitada e o tratamento é de suporte. A utilização do aciclovir é controversa, mas o seu início precoce parece encurtar a duração da doença