Hydroxyapatite Nanopowder Synthesis with a Programmed Resorption Rate

A microwave, solvothermal synthesis of hydroxyapatite (HAp) nanopowder with a programmed material resorption rate was developed. The aqueous reaction solution was heated by a microwave radiation field with high energy density. The measurements included powder X-ray diffraction (PXRD) and the density, specific surface area (SSA), and chemical composition as specified by the inductively coupled plasma optical emission spectrometry technique (ICP-OES). The morphology and structure were investigated using scanning electron microscopy (SEM) and transmission electron microscopy (TEM). A degradation test in accordance with norm ISO 10993-4 was conducted. The developed method enables control of the average grain size and chemical composition of the obtained HAp nanoparticles by regulating the microwave radiation time. As a consequence, it allows programming of the material degradation rate and makes possible an adjustment of the material activity in a human body to meet individual resorption rate needs. The authors synthesized a pure, fully crystalline hexagonal hydroxyapatite nanopowder with a specific surface area from 60 to almost 240 m2/g, a Ca/P molar ratio in the range of 1.57–1.67, and an average grain size from 6 nm to over 30 nm. A 28-day degradation test indicated that the material solubility ranged from 4 to 20 mg/dm3

Multidisciplinary approach to a patient with end-stage heart failure and colon adenocarcinoma — intra aortic balloon pump-supported tumor resection and bridge to heart transplantation

Non-cardiac, potentially curative surgeries in patients with chronic end-stage heart failure and significant arrhythmias are associated with very high risk of adverse events and mortality. A hemodynamic support in this clinical scenario is a novel and reasonable approach. Intra-aortic balloon pump (IABP), with its feasibility, long-term safety record, minimal invasiveness and availability, constitutes the best and valid option. As an example we present a case of an IABP supported colon adenocarcinoma resection in a patient with end stage heart failure.Niekardiologiczne, naprawcze zabiegi operacyjne u chorych w schyłkowej fazie niewydolności serca oraz z istotnymi zaburzeń rytmu serca są obarczone bardzo wysokim ryzykiem wystąpienia niepożądanych zdarzeń lub zgonu. W tej sytuacji wsparcie hemodynamiczne może być nowatorskim i uzasadnionym wyborem. Kontrapulsacja wewnątrzaortalna, metoda szeroko dostępna, mało inwazyjna i bezpieczna wydaje się być najbardziej interesującą opcją. Wobec powyższego prezentujemy przypadek implantacji kontrapulsacji wewnątrzaortalnej przed operacją resekcji gruczolakoraka okrężnicy u chorego w schyłkowej fazie niewydolnością serca

The influence of severe mitral regurgitation on major adverse cardiac and cerebrovascular events after myocardial infarction in 1-year follow-up: Data from PL-ACS registry

Background: Mitral regurgitation (MR) is frequently observed in patients with myocardial infarction (MI). However, the incidence of severe MR in contemporary population is unknown. Aims: The study evaluates the prevalence and prognostic impact of severe MR in contemporary population of patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI). Methods: The study group consists of 8062 patients enrolled in the Polish Registry of Acute Coronary Syndromes over the years 2017‒2019. Only the patients with full echocardiography performed during the index hospitalization were eligible. Primary composite outcome was 12-month major adverse cardiac and cerebrovascular events (MACCE) (death, non-fatal MI, stroke and heart failure [HF] hospitalization) compared between patients with and without severe MR. Results: 5561 NSTEMI patients and 2501 STEMI patients were enrolled into the study. Severe MR occurred in 66 (1.19%) NSTEMI patients and 30 (1.19%) STEMI patients. Multivariable regression models revealed that severe MR is an independent risk factor of all-cause death in 12-month observation (odds ratio [OR], 1.839; 95% confidence interval [CI], 1.012‒3.343; P = 0.046) in all MI patients. Patients with NSTEMI and severe MR had higher mortality (22.7% vs. 7.1%), HF rehospitalization rate (39.4% vs. 12.9%) and MACCE occurrence (54.5% vs. 29.3%). Severe MR was associated with higher mortality (20% vs. 6%) and higher HF rehospitalization (30% vs. 9.8%), stroke (10% vs. 0.8%) and MACCE rates (50% vs. 23.1%) in STEMI patients. Conclusions: Severe MR is associated with higher mortality and MACCE occurrence in patients with MI in 12-month follow-up. Severe MR is an independent risk factor of all-cause death

Position of the Polish Cardiac Society on therapeutic targets for LDL cholesterol concentrations in secondary prevention of myocardial infarctions

Cardiovascular diseases account for 43% of deaths in Poland. The COVID-19 pandemic increased the number of cardiovascular deaths by as much as 16.7%. Lipid metabolism disorders are observed in about 20 million Poles. Lipid disorders are usually asymptomatic, they cause a significant increase in the risk of cardiovascular diseases. Up to 20% of patients who experience an acute coronary syndrome (ACS) may experience a recurrence of a cardiovascular event within a year, and up to 40% of these patients may be re-hospitalized. Within 5 years after a myocardial infarction, 18% of patients suffer a second ACS and 13% have got a stroke. Lipid-lowering therapy is an extremely important element of comprehensive management, both in primary and secondary prevention, and its main goal is to prevent or extend the time to the onset of heart or vascular disease and reduce the risk of cardiovascular events. A patient with a history of ACS belongs to the group of a very high risk of a cardiovascular event due to atherosclerosis. In this group of patients, low-density lipoprotein cholesterol levels should be aimed below 55 mg/dl (1.4 mmol/l). Many scientific guidelines define the extreme risk group, which includes not only patients with two cardiovascular events within two years, but also patients with a history of ACS and additional clinical factors: peripheral vascular disease, multivessel disease (multilevel atherosclerosis), or multivessel coronary disease, or familial hypercholesterolemia, or diabetes with at least one additional risk factor: elevated Lp(a) >50 mg/dl or hsCRP >3 mg/l, or chronic kidney disease (eGFR <60 ml/min/1.73 m2). In this group of patients, the LDL-C level should be aimed at below 40 mg/dl (1.0 mmol/l). Achieving therapeutic goals in patients after ACS should occur as soon as possible. For this purpose, a high-dose potent statin should be added to the therapy at the time of diagnosis, and ezetimibe should be added if the goal is not achieved after 4–6 weeks. Combination therapy may be considered in selected patients from the beginning. After 4–6 weeks of combination therapy, if the goal is still not achieved, adding a proprotein convertase subtilisin/kexin type 9 protein inhibitor or inclisiran should be considered. In order to increase compliance with the recommendations, Polish Cardiac Society and Polish Lipid Society propose to attach in the patient’s discharge letter a statement clearly specifying what drugs should be used and what LDL-C values should be achieved. It is necessary to cooperate between the patient and the doctor, to follow the recommendations and take medicines regularly, to achieve and maintain therapeutic goals

A new approach to ticagrelor-based de-escalation of antiplatelet therapy after acute coronary syndrome. A rationale for a randomized, double-blind, placebo-controlled, investigator-initiated, multicenter clinical study

© 2021 Via Medica. This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license. https://creativecommons.org/licenses/by/4.0/The risk of ischemic events gradually decreases after acute coronary syndrome (ACS), reaching a stable level after 1 month, while the risk of bleeding remains steady during the whole period of dual antiplatelet treatment (DAPT). Several de-escalation strategies of antiplatelet treatment aiming to enhance safety of DAPT without depriving it of its efficacy have been evaluated so far. We hypothesized that reduction of the ticagrelor maintenance dose 1 month after ACS and its continuation until 12 months after ACS may improve adherence to antiplatelet treatment due to better tolerability compared with the standard dose of ticagrelor. Moreover, improved safety of treatment and preserved anti-ischemic benefit may also be expected with additional acetylsalicylic acid (ASA) withdrawal. To evaluate these hypotheses, we designed the Evaluating Safety and Efficacy of Two Ticagrelor-based De-escalation Antiplatelet Strategies in Acute Coronary Syndrome — a randomized clinical trial (ELECTRA-SIRIO 2), to assess the influence of ticagrelor dose reduction with or without continuation of ASA versus DAPT with standard dose ticagrelor in reducing clinically relevant bleeding and main-taining anti-ischemic efficacy in ACS patients. The study was designed as a phase III, randomized, multicenter, double-blind, investigator-initiated clinical study with a 12-month follow-up.Peer reviewedFinal Published versio

A practical approach to the ESC 2022 cardio-oncology guidelines. Comments by a team of experts: cardiologists and oncologists

The 2022 European Society of Cardiology (ESC) guidelines [1] are a comprehensive document, prepared jointly by experts in cardiology and oncology. In the case of an oncological patient, it is necessary to individualize care in relation to the cardiological condition, the stage of the cancer and the type of potential anti-cancer therapy. Cardiac care optimisation should be undertaken before the start of oncological therapy, and continued during oncological therapy, as well as long-term after its completion [2]. The published ESC Guidelines were supplemented with a practical comments of a team of polish cardiology and oncology experts

Production and Properties of Molybdenum Disulfide/Graphene Oxide Hybrid Nanostructures for Catalytic Applications

Molybdenum disulfide (MoS2) can be an excellent candidate for being combined with carbon nanomaterials to obtain new hybrid nanostructures with outstanding properties, including higher catalytic activity. The aim of the conducted research was to develop the novel production method of hybrid nanostructures formed from MoS2 and graphene oxide (GO). The nanostructures were synthesized in different weight ratios and in two types of reactors (i.e., impinging jet and semi-batch reactors). Physicochemical analysis of the obtained materials was carried out, using various analytical techniques: particle size distribution (PSD), thermogravimetric analysis (TGA), FT-IR spectroscopy, X-ray diffraction (XRD), and scanning electron microscopy (SEM). Due to the potential application of materials based on MoS2 as the catalyst for hydrogen evolution reaction, linear sweep voltammetry (LSV) of the commercial MoS2, synthesized MoS2 and the obtained hybrid nanostructures was performed using a three-electrode system. The results show that the developed synthesis of hybrid MoS2/GO nanostructures in continuous reactors is a novel and facile method for obtaining products with desired properties. The hybrid nanostructures have shown better electrochemical properties and higher onset potentials compared to MoS2 nanoparticles. The results indicate that the addition of carbon nanomaterials during the synthesis improves the activity and stability of the MoS2 nanoparticles

Size Control of Cobalt-Doped ZnO Nanoparticles Obtained in Microwave Solvothermal Synthesis

This article presents the method of size control of cobalt-doped zinc oxide nanoparticles (Zn1−xCoxO NPs) obtained by means of the microwave solvothermal synthesis. Zinc acetate dihydrate and cobalt(II) acetate tetrahydrate dissolved in ethylene glycol were used as the precursor. It has been proved by the example of Zn0.9Co0.1O NPs (x = 10 mol %) that by controlling the water quantity in the precursor it is possible to precisely control the size of the obtained Zn1−xCoxO NPs. The following properties of the obtained Zn0.9Co0.1O NPs were tested: skeleton density (helium pycnometry), specific surface area (BET), dopant content (ICP-OES), morphology (SEM), phase purity (XRD), lattice parameter (Rietveld method), average crystallite size (FW1/5/4/5M method and Scherrer’s formula), crystallite size distribution (FW1/5/4/5M method), and average particle size (from TEM and SSA). An increase in the water content in the precursor between 1.5% and 5% resulted in the increase in Zn0.9Co0.1O NPs size between 28 nm and 53 nm. The X-ray diffraction revealed the presence of only one hexagonal phase of ZnO in all samples. Scanning electron microscope images indicated an impact of the increase in water content in the precursor on the change of size and shape of the obtained Zn0.9Co0.1O NPs. The developed method of NPs size control in the microwave solvothermal synthesis was used for the first time for controlling the size of Zn1−xCoxO NPs