Usefulness of Tissue Doppler Imaging for the Diagnosis of Right Ventricular Myocardial Infarction and Determination of Infarct related Artery in Acute Inferior Wall Myocardial Infarction.

INTRODUCTION: In approximately half of patients with inferior wall myocardial infarction, right ventricular myocardial infarction (RVMI) develops1,2 In patients with RVMI, the risk of death in the hospital is high and major complications are greater. For early diagnosis, electrocardiography and two dimensional echocardiography are used, but these methods are occasionally insufficient. Tissue Doppler imaging (TDI) has evolved as a new technique that enables myocardial velocities to be detected and makes the quantitative assessment of the systolic and diastolic movements of myocardial walls possible. This study was designed to test the usefulness both of the right ventricular peak myocardial systolic velocity (Sm) and of the Myocardial performance index (MPI) obtained by pulsedwave TDI in the diagnosis of RVMI and in determining the infarct-related artery (IRA) in patients with acute inferior wall myocardial infarctions. Importance of identifying RVMI: Despite the initial observation of serious hemodynamic consequences of right ventricular infarction nearly two decades ago, this condition has received little clinical attention until recent years. Right ventricular infarction contributes markedly to hemodynamic instability, atrioventricular conduction block, and in-hospital mortality in patients with inferior myocardial infarctions. As compared with all clinical variables available at the time of admission,right ventricular infarction was associated with a relative risk of in-hospitalmortality of 7.7 (95 percent confidence interval, 2.6 to 23) and a risk of major in-hospital complications of 4.7 (95 percent confidence interval, 2.4 to 9). Ultimately, 95 percent of patients without evidence of right ventricular infarction at the time of admission were discharged from the hospital, as compared with only 69 percent of those in whom right ventricular infarction complicated the acute inferior myocardial infarction. METHODS: Forty patients who experienced a first acute inferior MI (mean [± SD] age, 57 ± 9 years) were prospectively assessed. An ST-segment elevation of 0.1 mV in V4- V6R lead derivations was defined as an RVMI. From the echocardiographic apical four-chamber view, the myocardial systolic velocity Sm, the peak early diastolic velocity Em , peak late diastolic velocity Am, the ejection time, the isovolumetric relaxation time, and the contraction time of the right ventricle were recorded at the level of the tricuspid annulus by using TDI. Then, the MPI was calculated. The patients were classified into the following three groups, according to the localization of the infarct-related (IRA) detected using coronary angiography: group I, proximal right coronary artery; group II, distal right coronary artery; and group III, circumflex coronary artery. RESULTS: RVMIs were detected in fifteen patients, and the IRA in 18 patients was the proximal right coronary artery. The right ventricular Sm was observed to be significantly low in patients with RVMIs and those in group I compared to those without RVMIs and those in groups II and III (11.5 ± 2.5 vs 15.1 ± 3 cm/s, respectively; and 14.9 ± 2.6 cm/s, respectively [p < 0.001])., The MPI was high in the same patient groups (0.74 ± 0.13 vs 0.56 ± 0.15 in group II and 0.54 ± 0.07 in group III, respectively [p <0.001]). In the diagnosis of RVMI , and in the diagnosis of the proximal right coronary artery as the IRA, the sensitivity, specificity, negative predictive value, and positive predictive value of an Sm < 12 cm/s were calculated as 83%, 93%, 90%, and 88%. The sensitivity, specificity, negative predictive value, and positive predictive value of an MPI of > 0.70 were 78%, 91%, 88% and 82%

On elementary extensions in Fuzzy Predicate Logics

10 páginas.-- Comunicación presentada a la International Conference on Information Processing and Management of Uncertainty in Knowledge-Based Systems (IPMU) celebrada en Dortmund (Alemania) del 28 de Junio al 2 de Julio de 2010.Our work is a contribution to the model-theoretic study of equality-free fuzzy predicate logics. We give a characterization of ele- mentary equivalence in fuzzy predicate logics using elementary exten- sions and introduce an strengthening of this notion, the so-called strong elementary equivalence. Using the method of diagrams developed in [5] and elementary extensions we present a counterexample to Conjectures 1 and 2 of [8].Research partially funded by the spanish projects CONSOLIDER (CSD2007- 0022), MULOG2 (TIN2007-68005-C04-01) and ARINF (TIN2009-14704-C03-03) by the ESF Eurocores-LogICCC/MICINN project FFI2008-03126- E/FILO and by the Generalitat de Catalunya under the grants 2009-SGR 1433 and 1434.Peer reviewe

Practical Value of Echo Doppler Evaluation of Aortic and Mitral Stenosis: A Comparative Study with Cardiac Catheterization

This retrospective analysis compares data derived by echocardiography and cardiac catheterization in the evaluation of aortic and mitral valve stenosis. Sixty-seven patients, aged 69 ± 12 years, underwent 76 catheterization procedures. In all studies the Doppler recording was technically adequate. In 64 studies of patients with aortic stenosis, correlation was good between the gradient obtained at catheterization (peak 51 ± 28 mm Hg, mean 48 ± 24 mm Hg) and the Doppler gradient (peak 73 ± 29 mm Hg, mean 41 ±17 mm Hg) (R = 0.78 peak, 0.77 mean). In 15 studies the aortic valve area, 0.8 ± 0.2 cm2, calculated by the simplified continuity equation, correlated well with the catheterization valve area, 0.7 + 0.3 cm2, calculated by the Gorlin equation (R = 0.80). In 14 studies in mitral stenosis patients, the mean gradient at catheterization was 11 ±5 mmHg compared to the Doppler gradient of 8 ±4 mmHg (R = 0.58). The mitral valve area was 1.1 ± 0.3 cm2 by the Gorlin equation and 1.2 ± 0.3 cm2 by echo Doppler, using pressure half-time. When cardiac rhythm, the presence and severity of regurgitation, and the cardiac index were analyzed, none was shown to have demonstrable influence cm the accuracy of the Doppler study. Doppler echocardiography can be used reliably to assess valvular stenosis in a clinical, noninvasive laboratory where routine tests are performed and interpreted by more than one individual

Registration of ICGL 6 (Puckered Leaf Mutant) Peanut Genetic Stock

ICGL (Reg. no. GS-1, PI 561916) is a compact spanish-type peanut (Arachis hypogaea L. subsp. fastigiata Waldron var. vulgaris Hartz) puckered leaf mutant isolated from a normalleaf peanut cultivar 'OG 66-6-1'. It was released in 1991 by the International Crops Research Institute for the Semi-Arid Tropics (ICRISAT) for its peculiar leaf characteristics. Puckered leaf symptoms (partially crinkled, with a yellow stripe along the leaf margin) start appearing 1 wk after emergence; the first few leaves (older leaves) have a normal phenotype. The genotype of the puckered leaf characteristic in the mutant is proposed as nlfilJNlJM

Percutaneous glue embolization for recalcitrant iatrogenic portal hemorrhage

N-butyl cyanoacrylate glue is well established as a transcatheter or direct injection embolic agent. Herein, targeted glue embolization was performed by direct needle injection into peripheral portal branches and along the surface of the liver to directly treat actively extravasating portal venous injury. In both cases, hemodynamically unstable patients underwent exploratory laparotomy, which was not able to definitively treat the hemorrhage. Subsequently, emergent visceral angiography and indirect portography revealed active portal phase extravasation. Transhepatic direct needle injection of the peripheral portal active extravasation with glue was successful in both cases and the patients stabilized, demonstrating this as an efficacious salvage approach

Antimicrobial activities of eugenol and cinnamaldehyde against the human gastric pathogen <i>Helicobacter pylori</i>

Background: Eradication of Helicobacter pylori is an important objective in overcoming gastric diseases. Many regimens are currently available but none of them could achieve 100% success in eradication. Eugenol and cinnamaldehyde that are commonly used in various food preparations are known to possess antimicrobial activity against a wide spectrum of bacteria. Aim: The present study was performed to assess the in vitro effects of eugenol and cinnamaldehyde against indigenous and standard H. pylori strains, their minimum inhibitory concentrations (MICs) and time course lethal effects at various pH. Methods: A total of 31 strains (29 indigenous and one standard strain of H. pylori ATCC 26695, one strain of E. coli NCIM 2089) were screened. Agar dilution method was used for the determination of drug sensitivity patterns of isolates to the commonly used antibiotics and broth dilution method for the test compounds. Results: Eugenol and cinnamaldehyde inhibited the growth of all the 30 H. pylori strains tested, at a concentration of 2 μg/ml, in the 9th and 12th hours of incubation respectively. At acidic pH, increased activity was observed for both the compounds. Furthermore, the organism did not develop any resistance towards these compounds even after 10 passages grown at sub-inhibitory concentrations. Conclusion: These results indicate that the two bioactive compounds we tested may prevent H. pylori growth in vitro, without acquiring any resistance

Developing infrared spectroscopic detection for stratifying brain tumour patients: glioblastoma multiforme vs. lymphoma

Over a third of brain tumour patients visit their general practitioner more than five times prior to diagnosis in the UK, leading to 62% of patients being diagnosed as emergency presentations. Unfortunately, symptoms are non-specific to brain tumours, and the majority of these patients complain of headaches on multiple occasions before being referred to a neurologist. As there are currently no methods in place for the early detection of brain cancer, the affected patients’ average life expectancy is reduced by 20 years. These statistics indicate that the current pathway is ineffective, and there is a vast need for a rapid diagnostic test. Attenuated total reflection Fourier-transform infrared (ATR-FTIR) spectroscopy is sensitive to the hallmarks of cancer, as it analyses the full range of macromolecular classes. The combination of serum spectroscopy and advanced data analysis has previously been shown to rapidly and objectively distinguish brain tumour severity. Recently, a novel high-throughput ATR accessory has been developed, which could be cost-effective to the National Health Service in the UK, and valuable for clinical translation. In this study, 765 blood serum samples have been collected from healthy controls and patients diagnosed with various types of brain cancer, contributing to one of the largest spectroscopic studies to date. Three robust machine learning techniques - random forest, partial least squares-discriminant analysis and support vector machine - have all provided promising results. The novel high-throughput technology has been validated by separating brain cancer and non-cancer with balanced accuracies of 90% which is comparable to the traditional fixed diamond crystal methodology. Furthermore, the differentiation of brain tumour type could be useful for neurologists, as some are difficult to distinguish through medical imaging alone. For example, the highly aggressive glioblastoma multiforme and primary cerebral lymphoma can appear similar on magnetic resonance imaging (MRI) scans, thus are often misdiagnosed. Here, we report the ability of infrared spectroscopy to distinguish between glioblastoma and lymphoma patients, at a sensitivity and specificity of 90.1% and 86.3%, respectively. A reliable serum diagnostic test could avoid the need for surgery and speed up time to definitive chemotherapy and radiotherapy