Acute left main coronary occlusion after transcatheter aortic valve implantation: life-saving intervention using the snare technique-a case report

Transcatheter aortic valve implantation (TAVI) has rapidly evolved and changed the field of structural cardiovascular intervention. Its advances lead to a marked reduction in the risk of complications and improved outcomes. However, TAVI is still associated with potential serious complications.publishersversionpublishe

220901

Unmanned vehicles used in ocean science, defense operations and commercial activities collect large amounts of data that is further processed onshore. For real-time information exchange, the wireless link between the unmanned vehicle and onshore devices must be reliable. In this work, we empirically evaluate a WiFi link between an autonomous underwater vehicle on the surface and an onshore device under real-world conditions. This work allowed i) collecting a large-scale realistic dataset and ii) identifying major factors impairing communication in such scenarios. The TX-RX antenna alignment, the operation mode (manual vs automatic) and varying reflecting surface induced by AUV mobility lead to sudden changes (e.g. nulls) in the received signal strength that can be larger than 20 dB. This study provides useful insights to the design of robust vessel-to-shore short-range communications.info:eu-repo/semantics/publishedVersio

Behaviour of the antioxidant tert-butylhydroquinone on the storage stability and corrosive character of biodiesel

AbstractThe behaviour of the antioxidant tert-butylhydroquinone (TBHQ) on the storage stability of biodiesel was investigated. Storage conditions were simulated through static immersion corrosion tests in biodiesel (with and without TBHQ) using copper coupons. Measurements of oxidation stability (Rancimat induction period) and metal release at different stages of corrosion were performed. After 24h of the static immersion test, the neat and TBHQ-doped biodiesels presented induction times below the EN 14214 limit (6h). Copper release was more intense in the neat biodiesel which evidenced that TBHQ retarded the corrosion process as a corrosion inhibitor. Ion trap–time-of-flight mass spectrometry (IT–TOF-MS) revealed the presence of considerable amounts of tert-butylquinone (TBQ) in the TBHQ-doped biodiesel exposed to the corrosion process. As TBHQ molecules adsorb at the copper surface to inhibit corrosion, these molecules are catalytically oxidised to TBQ. IT–TOF-MS also indicated the formation of new molecules of high molecular weight only presented in the TBHQ-doped biodiesel deteriorated by the corrosion process. MS2 spectra gave clear evidence of the formation of new complexes between free radicals of long-chain molecules (fatty acid derivatives) and TBQ radicals during biodiesel deterioration

Overcoming challenges in pediatric formulation with a patient-centric design approach: a proof-of-concept study on the design of an oral solution of a bitter drug

Designing oral formulations for children is very challenging, especially considering their peculiarities and preferences. The choice of excipients, dosing volume and palatability are key issues of pediatric oral liquid medicines. The purpose of the present study is to develop an oral pediatric solution of a model bitter drug (ranitidine) following a patient centric design process which includes the definition of a target product profile (TPP). To conclude on the matching of the developed solution to TPP, its chemical and microbiological stability was analyzed over 30 days (stored at 4 °C and room temperature). Simulation of use was accomplished by removing a sample with a syringe every day. Taste masking was assessed by an electronic tongue. The developed formulation relied on a simple taste masking strategy consisting in a mixture of sweeteners (sodium saccharine and aspartame) and 0.1% sodium chloride, which allowed a higher bitterness masking effectiveness in comparison with simple syrup. The ranitidine solution was stable for 30 days stored at 4 °C. However, differences were noted between the stability protocols (unopened recipient and in‐use stability) showing the contribution of the simulation of use to the formation of degradation products. Stock solution was subjected to acid and alkali hydrolysis, chemical oxidation, heat degradation and a photo degradation stability assessment. The developed pediatric solution matched the TPP in all dimensions, namely composition suitable for children, preparation and handling adapted to hospital pharmaceutical compounding and adequate stability and quality. According to the results, in‐use stability protocols should be preferred in the stability evaluation of pediatric formulations.This work was supported by national funds from FCT—Fundação para a Ciência e a Tecnologia, I.P., Portugal, in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of the Research Unit on Applied Molecular Biosciences—UCIBIO and the project LA/P/0140/2020 of the Associate Laboratory Institute for Health and Bioeconomy—i4HB. This research was also supported by and Federal Government of Nigeria NEEDS Assessment grant‐2018. The authors are grateful to FCT (Portugal) for financial support by national funds FCT/MCTES to CIMO (UIDB/00690/2020 and UIDP/00690/2020) and to the Associate Laboratory SusTEC (LA/P/0007/2020). Ítala M.G. Marx also acknowledges the Ph.D. research grant (SFRH/BD/137283/2018) provided by FCT.info:eu-repo/semantics/publishedVersio

SARS‐CoV2 pneumonia recovery is linked to expansion of innate lymphoid cells type 2 expressing CCR10

© 2021 The Authors. European Journal of Immunology published by Wiley-VCH GmbH. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.Accelerate lung repair in SARS-CoV-2 pneumonia is essential for pandemic handling. Innate lymphoid cells (ILCs) are likely players, given their role in mucosal protection and tissue homeostasis. We studied ILC subpopulations at two time points in a cohort of patients admitted in the hospital due to SARS-CoV-2 infection. COVID-19 patients with moderate/severe respiratory failure featured profound depletion of circulating ILCs at hospital admission, in agreement with overall lymphocyte depletion. However, ILCs recovered in direct correlation with lung function improvement as measured by oxygenation index and in negative association with inflammatory and lung/endothelial damage markers like RAGE. While both ILC1 and ILC2 expanded, ILC2 showed the most striking phenotype changes, with CCR10 upregulation in strong correlation with these parameters. Overall, CCR10+ ILC2 emerge as relevant contributors to SARS-CoV-2 pneumonia recovery.This work was funded by the following grants from Fundação para a Ciência e a Tecnologia (FCT), Portugal, through “APOIO ESPECIAL RESEARCH4COVID-19,” project numbers 125 to SMF and 803 to ACT. AMCG and GBF received fellowships funded by FCT (DOCTORATES4COVID-19, 2020.10202.BD) and JANSSEN- CILAG FARMACÊUTICA, respectively.info:eu-repo/semantics/publishedVersio

Coronary computed tomography angiography-adapted Leaman score as a tool to noninvasively quantify total coronary atherosclerotic burden

To describe a coronary computed tomography angiography (CCTA)-adapted Leaman score (CT-LeSc) as a tool to quantify total coronary atherosclerotic burden with information regarding localization, type of plaque and degree of stenosis and to identify clinical predictors of a high coronary atherosclerotic burden as assessed by the CT-LeSc. Single center prospective registry including a total of 772 consecutive patients undergoing CCTA (Dual-source CT) from April 2011 to March 2012. For the purpose of this study, 581 stable patients referred for suspected coronary artery disease (CAD) without previous myocardial infarction or revascularization procedures were included. Pre-test CAD probability was determined using both the Diamond-Forrester extended CAD consortium method (DF-CAD consortium model) and the Morise score. Cardiovascular risk was assessed with the HeartScore. The cut-off for the 3rd tercile (CT-LeSc ≥8.3) was used to define a population with a high coronary atherosclerotic burden. The median CT-LeSc in this population (n = 581, 8,136 coronary segments evaluated; mean age 57.6 ± 11.1; 55.8 % males; 14.6 % with diabetes) was 2.2 (IQR 0-6.8). In patients with CAD (n = 341), the median CT-LeSc was 5.8 (IQR 3.2-9.6). Among patients with nonobstructive CAD, most were classified in the lowest terciles (T1, 43.0 %; T2, 36.1 %), but 20.9 % were in the highest tercile (T3). The majority of the patients with obstructive CAD were classified in T3 (78.2 %), but 21.8 % had a CT-LeSc in lower terciles (T1 or T2). The independent predictors of a high CT-LeSc were: Male sex (OR 1.73; 95 % CI 1.04-2.90) diabetes (OR 2.91; 95 % CI 1.61-5.23), hypertension (OR 2.54; 95 % CI 1.40-4.63), Morise score ≥16 (OR 1.97; 95 % CI 1.06-3.67) and HeartScore ≥5 (OR 2.42; 95 % CI 1.41-4.14). We described a cardiac CT adapted Leaman score as a tool to quantify total (obstructive and nonobstructive) coronary atherosclerotic burden, reflecting the comprehensive information about localization, degree of stenosis and type of plaque provided by CCTA. Male sex, hypertension, diabetes, a HeartScore ≥5 % and a Morise score ≥16 were associated with a high coronary atherosclerotic burden, as assessed by the CT-LeSc. About one fifth of the patients with nonobstructive CAD had a CT-LeSc in the highest tercile, and this could potentially lead to a reclass

A practical clinical score

Copyright © 2022 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.INTRODUCTION AND OBJECTIVES: Obstructive coronary artery disease (CAD) remains the most common etiology of heart failure with reduced ejection fraction (HFrEF). However, there is controversy whether invasive coronary angiography (ICA) should be used initially to exclude CAD in patients presenting with new-onset HFrEF of unknown etiology. Our study aimed to develop a clinical score to quantify the risk of obstructive CAD in these patients. METHODS: We performed a cross-sectional observational study of 452 consecutive patients presenting with new-onset HFrEF of unknown etiology undergoing elective ICA in one academic center, between January 2005 and December 2019. Independent predictors for obstructive CAD were identified. A risk score was developed using multivariate logistic regression of designated variables. The accuracy and discriminative power of the predictive model were assessed. RESULTS: A total of 109 patients (24.1%) presented obstructive CAD. Six independent predictors were identified and included in the score: male gender (2 points), diabetes (1 point), dyslipidemia (1 point), smoking (1 point), peripheral arterial disease (1 point), and regional wall motion abnormalities (3 points). Patients with a score ≤3 had less than 15% predicted probability of obstructive CAD. Our score showed good discriminative power (C-statistic 0.872; 95% CI 0.834-0.909: p<0.001) and calibration (p=0.333 from the goodness-of-fit test). CONCLUSIONS: A simple clinical score showed the ability to predict the risk of obstructive CAD in patients presenting with new-onset HFrEF of unknown etiology and may guide the clinician in selecting the most appropriate diagnostic modality for the assessment of obstructive CAD.proofepub_ahead_of_prin

Mercury levels in house dust samples from Covilhã, Portugal - Preliminary results from 6x60x6 Project

A avaliação da qualidade do ambiente interior, particularmente do ambiente doméstico, por ser aquele em que o ser humano passa a maior parte do seu tempo, reveste-se de particular importância. Esta qualidade é modulada por um conjunto de fatores entre os quais se encontram os contaminantes ambientais com potencial tóxico, que têm vindo a ser quantificados de forma consistente no pó doméstico, uma matriz com grande capacidade integradora. Este trabalho, que utiliza o mercúrio como caso de estudo, integra-se no âmbito de um projeto pioneiro e multidisciplinar, em que se pretende estudar por um período de sessenta dias, seis habitações particulares localizadas na cidade da Covilhã, para compreender de que forma as características do imóvel e os hábitos dos habitantes podem influenciar a qualidade do ambiente interior e consequentemente a saúde dos residentes. Os níveis de mercúrio total nas amostras de pó doméstico variaram entre 138,7 ppb e 1075,5 ppb, com um só dos imóveis a transcender o valor máximo permissível estabelecido pela Portaria Nº1450/2007. Estabelece-se uma comparação com os valores registados para outros estudos similares e traça-se um plano de ação para o pleno desenvolvimento do estudo.The evaluation of indoor environmental quality, particularly of households, is of paramount importance since modern humans spend most of their time indoors. Environmental contaminants with toxic potential play a central role in the modulation of indoor quality and recent trends have pointed towards their quantification in dust, which is a highly integrative matrix. The present work uses mercury as a case study integrated in a pioneering multidisciplinary study aiming to ascertain (by measuring a set of parameters for sixty days in six houses built in six different decades – 6x60x6) how the household characteristics and residents’ habits modulate indoor environmental quality and, in turn, drive impacts upon their health. Total mercury levels in house dust samples varied between 138.7 ppb and 1075.5 ppb, with a single house recording a value higher than the limit admissible by Portuguese law (Portaria Nº1450/2007). A comparison of the obtained values with similar studies worldwide is performed and an action plan for the full development of the study is drafted. Keywords: Indoor environment, Metals, Mercury, House dustinfo:eu-repo/semantics/publishedVersio

Acute Effects of the New Method Sarcoplasma Stimulating Training Versus Traditional Resistance Training on Total Training Volume, Lactate and Muscle Thickness

Background: Trained subjects have difficulty in achieving continued results following years of training, and the manipulation of training variables through advanced resistance training (RT) methods is widely recommended to break through plateaus.Objective: The purpose of the present study was to compare the acute effects of traditional RT (TRT) versus two types of sarcoplasma stimulating training (SST) methods on total training volume (TTV), lactate, and muscle thickness (MT).Methods: Twelve trained males (20.75 ± 2.3 years; 1.76 ± 0.14 meters; body mass = 79.41 ± 4.6 kg; RT experience = 4.1 ± 1.8 years) completed three RT protocols in a randomly sequenced order: TRT, SST contraction type (SST-CT), or SST rest interval variable (SST-RIV) with 7 days between trials in arm curl (elbow flexors) and triceps pulley extension (elbow extensors) performed on the same day.Results: The SST groups displayed greater acute biceps and triceps brachii (TB) MT versus the TRT session, with no difference in lactate levels between them. The SST-CT resulted in greater biceps and TB MT versus the SST-RIV session. The TTV was greater for the TRT session versus the SST sessions, except in the case of the elbow flexors (no difference was observed between TRT and SST-CT), and higher for the SST-CT versus the SST-RIV.Conclusion: Trained subjects may benefit from using the SST method as this method may offer a superior MT stimulus and reduced training time, even with a lower TTV

Diabetes as an independent predictor of high atherosclerotic burden assessed by coronary computed tomography angiography: The coronary artery disease equivalent revisited

(1) To study the prevalence and severity of coronary artery disease (CAD) in diabetic patients. (2) To provide a detailed characterization of the coronary atherosclerotic burden, including the localization, degree of stenosis and plaque composition by coronary computed tomography angiography (CCTA). Single center prospective registry including a total of 581 consecutive stable patients (April 2011-March 2012) undergoing CCTA (Dual-source CT) for the evaluation of suspected CAD without previous myocardial infarction or revascularization procedures. Different coronary plaque burden indexes and plaque type and distribution patterns were compared between patients with (n = 85) and without diabetes (n = 496). The prevalence of CAD (any plaque; 74.1 vs. 56 %; p = 0.002) and obstructive CAD (≥50 % stenosis; 31.8 vs. 10.3 %; p<0.001) were significantly higher in diabetic patients. The remaining coronary atherosclerotic burden indexes evaluated (plaque in LM-3v-2v with prox. LAD; SIS; SSS; CT-LeSc) were also significantly higher in diabetic patients. In the per segment analysis, diabetics had a higher percentage of segments with plaque in every vessel (2.6/13.1/7.5/10.5 % for diabetics vs. 1.4/7.1/3.3/4.4 % for nondiabetics for LM, LAD, LCx, RCA respectively; p<0.001 for all) and of both calcified (19.3 vs. 9.2 %, p<0.001) and noncalcified or mixed types (14.4 vs. 7.0 %; p<0.001); the ratio of proximal-to-distal relative plaque distribution (calculated as LM/proximal vs. mid/distal/branches) was lower for diabetics (0.75 vs. 1.04; p = 0.009). Diabetes was an independent predictor of CAD and was also associated with more advanced CAD, evaluated by indexes of coronary atherosclerotic burden. Diabetics had a significantly higher prevalence of plaques in every anatomical subset and for the different plaque composition. In this report, the relative geographic distribution of the plaques within each subgroup, favored a more mid-to-distal localization in the diabetic patients