Bioimpedance real-time charazterization of neointimal tissue inside stents

It is hereby presented a new approach to monitor restenosis in arteries fitted with a stent during an angioplasty. The growth of neointimal tissue is followed up by measuring its bioimpedance with Electrical Impedance Spectroscopy (EIS). Besides, a mathematical model is derived to analytically describe the neointima’s histological composition from its bioimpedance. The model is validated by finite-element analysis (FEA) with COMSOL Multiphysics®. Satisfactory correlation between the analytical model and the FEA simulation is achieved for most of the characterization range, detecting some deviations introduced by the thin "double layer" that separates the neointima and the blood. It is shown how to apply conformal transformations to obtain bioimpedance models for stack-layered tissues over coplanar electrodes. Particularly, this is applied to characterize the neointima in real-time. This technique is either suitable as a main mechanism of restenosis follow-up or it can be combined with proposed blood-pressure-measuring intelligent stents to auto-calibrate the sensibility loss caused by the adherence of the tissue on the micro-electro-mechanical sensors (MEMS).Ministerio de Economía, Industria y Competitividad (Spain): projects TEC2013-46242-C3-1-PMinisterio de Economía, Industria y Competitividad (Spain): projects TEC2013-46242-C3-2-

Real-time electrical bioimpedance characterization of neointimal tissue for stent applications

To follow up the restenosis in arteries stented during an angioplasty is an important current clinical problem. A new approach to monitor the growth of neointimal tissue inside the stent is proposed on the basis of electrical impedance spectroscopy (EIS) sensors and the oscillation-based test (OBT) circuit technique. A mathematical model was developed to analytically describe the histological composition of the neointima, employing its conductivity and permittivity data. The bioimpedance model was validated against a finite element analysis (FEA) using COMSOL Multiphysics software. A satisfactory correlation between the analytical model and FEA simulation was achieved in most cases, detecting some deviations introduced by the thin “double layer” that separates the neointima and the blood. It is hereby shown how to apply conformal transformations to obtain bioimpedance electrical models for stack-layered tissues over coplanar electrodes. Particularly, this can be applied to characterize the neointima in real-time. This technique is either suitable as a main mechanism for restenosis follow-up or it can be combined with proposed intelligent stents for blood pressure measurements to auto-calibrate the sensibility loss caused by the adherence of the tissue on the micro-electro-mechanical sensors (MEMSs).This work was carried out in collaboration with the Cardiology Department of the UHMV Hospital, Santander (Spain) and was funded by the Spanish Government’s “Ministerio de Economía, Industria y Competitividad” under the joint projects TEC2013-46242-C3-1-P and TEC2013-46242-C3, co-financed with FEDER

CiTiEs (Ciudades: Tiempo + Espacio). Implementación de itinerarios didácticos para la enseñanza virtual y presencial del Patrimonio cultural de Madrid a través del aprendizaje cooperativo

Retomando los itinerarios didácticos diseñados en un PID anterior (2019/20, nº 363), se implementarán materiales digitales para la Educación patrimonial de Madrid. Se utilizarán técnicas de aprendizaje cooperativo y recursos para la enseñanza virtual.Depto. de Didáctica de las Ciencias Experimentales , Sociales y MatemáticasFac. de EducaciónFALSEsubmitte

Association Between Preexisting Versus Newly Identified Atrial Fibrillation and Outcomes of Patients With Acute Pulmonary Embolism

Background Atrial fibrillation (AF) may exist before or occur early in the course of pulmonary embolism (PE). We determined the PE outcomes based on the presence and timing of AF. Methods and Results Using the data from a multicenter PE registry, we identified 3 groups: (1) those with preexisting AF, (2) patients with new AF within 2 days from acute PE (incident AF), and (3) patients without AF. We assessed the 90-day and 1-year risk of mortality and stroke in patients with AF, compared with those without AF (reference group). Among 16 497 patients with PE, 792 had preexisting AF. These patients had increased odds of 90-day all-cause (odds ratio [OR], 2.81; 95% CI, 2.33-3.38) and PE-related mortality (OR, 2.38; 95% CI, 1.37-4.14) and increased 1-year hazard for ischemic stroke (hazard ratio, 5.48; 95% CI, 3.10-9.69) compared with those without AF. After multivariable adjustment, preexisting AF was associated with significantly increased odds of all-cause mortality (OR, 1.91; 95% CI, 1.57-2.32) but not PE-related mortality (OR, 1.50; 95% CI, 0.85-2.66). Among 16 497 patients with PE, 445 developed new incident AF within 2 days of acute PE. Incident AF was associated with increased odds of 90-day all-cause (OR, 2.28; 95% CI, 1.75-2.97) and PE-related (OR, 3.64; 95% CI, 2.01-6.59) mortality but not stroke. Findings were similar in multivariable analyses. Conclusions In patients with acute symptomatic PE, both preexisting AF and incident AF predict adverse clinical outcomes. The type of adverse outcomes may differ depending on the timing of AF onset.info:eu-repo/semantics/publishedVersio

Rate and duration of hospitalisation for acute pulmonary embolism in the real-world clinical practice of different countries : Analysis from the RIETE registry

publishersversionPeer reviewe

Comparison of seven prognostic tools to identify low-risk pulmonary embolism in patients aged <50 years

publishersversionPeer reviewe

Low-power implantable transmitter for restenosis monitoring in intelligent-stents

Grado en Ingeniería en Electrónica Industrial y Automátic

Symptomatic subsegmental versus more central pulmonary embolism: Clinical outcomes during anticoagulation

Background: The optimal therapy of patients with acute subsegmental pulmonary embolism (PE) is controversial. Methods: We used the RIETE (Registro Informatizado Enfermedad TromboEmb\uf3lica) database to compare the rate of symptomatic PE recurrences during anticoagulation in patients with subsegmental, segmental, or more central PEs. Results: Among 15&nbsp;963 patients with a first episode of symptomatic PE, 834 (5.2%) had subsegmental PE, 3797 (24%) segmental, and 11&nbsp;332 (71%) more central PE. Most patients in all subgroups received initial therapy with low-molecular-weight heparin, and then most switched to vitamin K antagonists. Median duration of therapy was 179, 185, and 204&nbsp;days, respectively. During anticoagulation, 183 patients developed PE recurrences, 131 developed deep vein thrombosis (DVT), 543 bled, and 1718 died (fatal PE, 135). The rate of PE recurrences was twofold higher in patients with subsegmental PE than in those with segmental (hazard ratio [HR], 2.13; 95% confidence interval [CI], 1.16-3.85) or more central PE (HR, 1.89; 95% CI, 1.12-3.13). On multivariable analysis, patients with subsegmental PE had a higher risk for PE recurrences than those with central PE (adjusted HR, 1.75; 95% CI, 1.02-3.03). After stratifying patients with subsegmental PE according to ultrasound imaging in the lower limbs, the rate of PE recurrences was similar in patients with DVT, in patients without DVT, and in those with no ultrasound imaging. Conclusions: Our study reveals that the risk for PE recurrences in patients with segmental PE is not lower than in those with more central PE, thus suggesting that the risk of PE recurrences is not influenced by the anatomic location of PE