Интегрированная система определения нарушений микроциркуляции крови

Наразі актуальною проблемою медицини є надійность діагностики захворювань задля їх вчасного лікування. Одним з можливих інформаційних джерел про стан організму є дослідження гемодинаміки, яке може визначити наявність певних патологічних відхилень в тканинах та органах. Основною метою роботи є створення неінвазивного методу ранньої діагностики порушень гемодинаміки та теоретичних засад дії автоматизованої системи, яка дозволить реєструвати параметри мікроциркуляції крові, що надає можливість на підставі їх аналізу підвищити точність та вірогідність діагностики. У статті йдеться про можливість створення нових систем діагностики стану гемодинаміки організму, зокрема аналізу мікроциркуляції крові. За результатами роботи запропоновано схему інтегрованого аналізатора, який дозволяє оцінювання гемодинаміки та функціонального стану організму за інтегрованими показниками мікроциркуляції кровообігу, враховуючи різні біологічні процеси, що супроводжують обмін речовин організму. Цей підхід дозволяє підвищити надійність діагностики багатьох захворювань.Actual problems of modern medicine is the reliability of the diagnosis of diseases for their timely treatment. One of the possible sources of information about the state of the body is the study of hemodynamics, which will determine the presence of certain abnormalities in the tissues and organs. The main objective is to develop a non-invasive method for early diagnosis of hemodynamics and the theoretical foundations of the action of the automated system, which allows to register the parameters of blood microcirculation, allowing on the basis of their analysis to improve the accuracy and reliability of the diagnosis. The article presents the possible ways of creating a new diagnostic systems hemodynamic status of the organism, in particular of blood microcirculation analysis. The scheme of integrated analyzer, which allows you to evaluate hemodynamics and functional state of the organism on integrated indicators of microcirculation blood flow is offered. Principles of system taking into account the various biological processes that accompany the body's metabolism. This approach allows you to increase the reliability of diagnosis of many diseases.Актуальной проблемой современной медицины является надежность диагностики заболеваний для их своевременного лечения. Одним из возможных информационных источников о состоянии организма является исследование гемодинамики, которое позволит определить наличие определенных патологических отклонений в тканях и органах. Основной целью работы является создание неинвазивного метода ранней диагностики нарушений гемодинамики и теоретических основ действия автоматизированной системы, которая позволит регистрировать параметры микроциркуляции крови, позволяет на основании их анализа повысить точность и достоверность диагностики. В статье приведены возможные пути создания новых систем диагностики состояния гемодинамики организма, в частности анализа микроциркуляции крови. Предложена схема интегрированного анализатора, который позволяет оценивать гемодинамику и функциональное состояние организма по интегрированным показателям микроциркуляции кровообращения, учитывая различные биологические процессы, сопровождающие обмен веществ организма. Этот подход позволяет повысить надежность диагностики многих заболеваний

Виртуализация жизненного пространства человека и проблемы интернет-игровой зависимости (IGD)

Moving of objects of culture and interpersonal communication in virtual space leads to virtualization lifestyle of the modern man, calling his new feelings, needs and dependency. One of the most essential dependency is Internet gaming disorder IGD, which attracts the attention of many researchers because their status has not been fully determined, and their influence is constantly increasing. The article presents a review of studies of this problem are the definition and the signs of Internet gaming addiction, is characterized by the potential addictors in different age and gender categories. Shown social, existential, economic and cultural factors associated with Internet gambling, defined the prospects of solution.Перемещение объектов культуры и межличностной коммуникации в цифровое пространство приводит к виртуализации жиз- ненного пространства современного человека, вызывая его новые не- свободы, потребности и зависимости. Одной из наиболее существенных зависимостей современного человека становятся интернет-игровые рас- стройства IGD (Internet Game Disorder), которые привлекают внимание многих исследователей, поскольку их статус до конца не определен, а их влияние постоянно усиливается. В статье представлен обзор исследова- ний данной проблемы, даны дефиниции и признаки интернет-игровой зависимости, охарактеризованы потенциальные аддикторы в разных воз- растных и гендерных категориях. Показаны социальные, экзистенциаль- ные, экономические и культурные факторы, связанные с интернет-игро- вой зависимостью, обозначены перспективы решения проблемы

A História da Igreja Presbiteriana Nova Jerusalém: Realidade e desafios no bairro Cidade 2000 em Fortaleza (CE)

A Reforma Protestante no Século XVI é um dosprincipais divisores de águas do Cristianismo. A partir delasurgiram várias igrejas que se espalharam pelo mundo levandoa mensagem cristã. Com a Igreja Presbiteriana não foidiferente. João Calvino, em Genebra, Suíça, criou uma Igrejaque ficou conhecida, nas Ilhas Britânicas, como Presbiteriana.Devido a perseguições, muitos desses cristãos emigrarampara os Estados Unidos e participaram da construção dessepaís. Posteriormente, essa Igreja enviou missionários ao Brasile em 1882 uma missão chega ao Ceará e funda a Igreja Presbiterianade Fortaleza (IPF). Em 1995 um grupo de membrosdessa Igreja inicia um trabalho em um colégio de Fortalezae a partir desse trabalho surge a Igreja Presbiteriana NovaJerusalém (IPNJ). Assim, o propósito do presente trabalho écontar a história de fundação da IPNJ e seus desafios, tendocomo pano de fundo a própria história do Presbiterianismono Brasil e no Ceará

Spin-dependent electron impact ionisation of lithium from threshold to 80 eV

Baum G, Kisker E, Raith W, Schröder W, Sillmen U, Zenses D. Spin-dependent electron impact ionisation of lithium from threshold to 80 eV. J.Phys. B. 1981;14(22):4377-4388.The ionisation asymmetry is measured in a crossed-beam experiment utilising a W/EuS field emitter as a source of polarised electrons and dual-frequency optical pumping as the polarising process for the lithium atomic beam. The antiparallel-parallel asymmetry of the total ionisation cross section is positive with a broad maximum of 0.35 near threshold and a gradual decrease towards higher energies. A comparison is made with results of binary encounter and Born approximations. At threshold no significant variation of the asymmetry with energy is observed within a resolution of 0.3 eV

Performance hémodynamique de prothèses valvulaires aortiques percutanées et stratégies d'implantation lors de procédures « valve-in-valve » : études in vitro et in vivo

"Thèse en cotutelle Doctorat en médecine expérimentale, Université Laval, Québec, Canada, Philosophiæ doctor (Ph. D.), et Aix-Marseille Université, Marseille, France"L’implantation de prothèse valvulaire aortique percutanée (TAVI), a émergé comme une alternative moins invasive que la chirurgie pour les patients avec sténose sévère et haut risque chirurgical. Les résultats prometteurs tant hémodynamiques que cliniques du TAVI pourraient conduire à étendre ce traitement à une population de plus en plus large avec anatomie plus complexe ou risque chirurgical plus bas, ainsi qu’aux patients avec bioprothèses chirurgicales (BPs) dégénérées. Cette dernière application également appelée « Valve-in-Valve » (ViV), consiste à implanter une prothèse percutanée dans une BP défaillante et permet d’éviter la réintervention chirurgicale invasive associée à un risque de mortalité augmenté. Cependant, deux complications hémodynamiques majeures limitent la généralisation de ces techniques percutanées. Dans le contexte du TAVI « classique », il s’agit des fuites périvalvulaires (PVL) dont la présence est associée à une mortalité augmentée. Ces fuites pourraient être plus sévères dans des anneaux non circulaires. L’effet du surdimensionnement de la prothèse percutanée, pour assurer son étanchéité, sur l’hémodynamie est mal connu et pourrait avoir un impact négatif. De plus, les exigences en termes de performance hémodynamique et de durabilité de la prothèse percutanée doivent être plus hautes chez une population à plus bas risque chirurgical. Il est donc important de déterminer la faisabilité du TAVI et de caractériser la performance hémodynamique dans ces situations d’implantation. Dans le contexte ViV, la présence de hauts gradients (≥ 20 mmHg) post-procéduraux est fréquente et a été associée à une mortalité augmentée. Ces gradients élevés, traduisent souvent une sténose résiduelle et sont particulièrement fréquents dans les BPs sténosées de taille nominale ≤ 21 mm. Les petites BPs et le mode de dégénérescence ont également été associés à une mortalité augmentée. Ainsi, le ViV n’est pas indiqué dans la plupart des petites BPs et par conséquent, il n’existe actuellement aucune recommandation pour leur traitement. Les facteurs que sont les petites BPs et le mode de dégénérescence actuellement mis en cause ne sont pas assez spécifiques et excluent trop de patients qui pourraient bénéficier du traitement. Par ailleurs, le bénéfice hémodynamique réel du ViV par rapport aux statuts avant ViV n’a pas été étudié. Il est donc nécessaire de préciser les facteurs associés non seulement à la performance hémodynamique post-ViV mais également à l’utilité du traitement. iv L’objectif général de ce travail doctoral est de comprendre les interactions entre la prothèse percutanée et l’anneau aortique ou la BP à traiter, impliquées dans la performance hémodynamique, en particulier dans des conditions d’implantation complexes, afin d’étendre les indications du TAVI. Dans le contexte ViV, le défi est de préciser les facteurs modifiables et non modifiables associés à la performance et à l’utilité hémodynamiques du traitement, afin d’identifier les patients susceptibles d’en bénéficier et de proposer des stratégies d’implantation pour éviter la sténose résiduelle.Transcatheter aortic valve implantation (TAVI) has emerged as a less invasive alternative to surgery for patients with severe aortic stenosis and high surgical risk. The promising hemodynamic and clinical outcomes after TAVI has led to extend indications to a larger population including patients with complex anatomy or lower surgical risk, as well as patients with degenerated surgical bioprostheses (BPs). The latter application of TAVI referred to as Valve-in-Valve (ViV) consists in implanting a transcatheter prosthesis within a failing BP in order to avoid redo surgery which is associated with an increased risk of mortality. However, generalization of transcatheter procedures remains limited by 2 major concerns. Regarding "classical" TAVI, the incidence of perivalvular leaks has been associated with increased risk of mortality and may be worsened in non circular annuli. Oversizing, which is used to secure the device, might have a negative impact on the prosthesis hemodynamics but its real effect is unknown. Moreover, the treatment of a lower risk and younger population requires excellent hemodynamic performance and valve durability. It is thus necessary to determine the feasibility of TAVI and to assess the hemodynamic performance in those complex situations. Regarding ViV implantations, the Achille's heel has been residual stenosis. Indeed, elevated post-procedural gradients are common following ViV, especially in BPs with label size ≤ 21 mm, and have been associated with increased mortality. However, there is only few experience in small BPs which are currently excluded from ViV indications and for which there is no recommendation. The factors that have been identified are not specific enough and ViV might be beneficial to a large proportion of patients which are currently excluded from indications. Besides, the actual hemodynamic benefit associated with ViV has not been evaluated (vs. pre ViV status). It is thus necessary to determine precisely the factors associated with both post-ViV hemodynamic performance and which treatment utility. The general objective of this work is to understand the interactions between the transcatheter prosthesis and the aortic annulus or the BP to be treated, which impact the hemodynamic performance, especially in complex conditions of implantation, in order to extend the indications of TAVI. In the context of ViV, the objective is to specify the modifiable and non-modifiable factors associated with the hemodynamic performance and utility of the treatment. The final aim is to identify patients who will benefit from ViV and to provide strategies of implantation in order to avoid residual stenosis

Elastin-like polymer coating on CoCr surfaces for cardiovascular applications

Cardiovascular diseases have emerged as a major concern since they are the first cause of death in developed countries. The advent of percutaneous transluminal coronary angioplasty consisted in an alternative to invasive surgery. Especially the introduction of cardiovascular stents has significantly meliorated the potential of angioplasty, e.g. with the use of drug eluting and bioadsorbable stents. Still, restenosis remains a major implant-related complication and can imply re intervention. Therefore, research has focused on limiting and/r avoided restenosis by investigating the field of surface treatments and drug delivery material. The rapidly developing field of material technology and engineering has enable design of molecular-specific surfaces for a new generation of vascular devices. This project has been focused on how to promote endothelialization on a bare metal CoCr alloy stent still widely used nowadays. The knowledge about biological response and interactions between extra cellular matrix proteins and cellular agents has lead to explore the potential of genetically engineered protein based polymers such as elastin-like polymers which mimic properties of the human elastin. This project has for general goal to promote endothelialization on CoCr-alloy by functionalizing the surfaces with REDV elastin-like biopolymer which contains a specific domain for endothelial cell adhesion. For that purpose different surface treatments have been performed on CoCr in order to enhance the biopolymer adhesion. First surfaces have been activated by means of O2 plasma, acid HNO3 and NaOH basic etching. Afterwards, a series has been CPTES silanized previous to biopolymer adsorption. Finally, REDV elastin-like biopolymer has been physically and/or chemically attached to the different treated surfaces. All treatments have been thoroughly physic-chemically characterized before and after all treatments steps. Finally special attention has been paid to the study of biopolymer coating stability after some thermal and/or mechanical treatments in order to determine the best surface treatment conditions of adhesion and the efficiency of previous surface treatments. REDV elastin-like biopolymer was successfully adsorbed on CoCr ASTM F-90 alloy surfaces. It was biofunctionalized CoCr ASTM F-90 alloy surfaces through CPTES silane. Silanization increased biopolymer adsorption but the efficiency was low. NaOH activated samples presented a higher CPTES silane attachment and biopolymer adhesion as observed by an increase of adhered HUVEC cells compared to other treatments. REDV elastin-like biopolymer is more sensitive to mechanical and thermal treatments probably due to a detachment and/or denaturation of the biomolecule. The increase of silanization efficiency on treated CoCr surfaces could enhance biopolymer stability as observed for NaOH treated surfaces.Incomin

Hemodynamic performance of transcatheter aortic valve prostheses and strategie of implantation for valve-in-valve procedures : in vitro and in vivo studies

L’implantation valvulaire aortique percutanée (TAVI) a émergé comme une alternative à la chirurgie pour les patients avec sténose sévère et haut risque chirurgical. Cette technique s’étend à une population plus large (e.g. anatomie plus complexe, risque chirurgical plus bas), ainsi qu'au traitement Valve-in-Valve (ViV) des bioprothèses (BPs) chirurgicales défaillantes. Cependant, deux complications majeures en limitent la généralisation. En TAVI « classique », la présence de fuites péripothétiques a été associée à une mortalité augmentée. Les effets du surdimensionnement de la prothèse percutanée pour assurer son étanchéité, ou de la forme de l’anneau souvent non circulaire, sur la performance hémodynamique, sont mal connus. En ViV, la présence de hauts gradients est fréquente et associée à une mortalité augmentée. Les BPs de taille nominale ≤ 21 mm et le mode de dégénérescence par sténose, facteurs mis en cause dans la sténose résiduelle et associés à une mortalité augmentée, ne sont pas assez spécifiques et il n’existe actuellement aucune recommandation pour le traitement des petites BPs. Par ailleurs, le bénéfice hémodynamique réel du ViV par rapport aux statuts avant ViV n’a pas été étudié.L’objectif général de ce travail doctoral est de comprendre les interactions entre la prothèse percutanée et l’anneau aortique ou la BP à traiter, impliquées dans la performance hémodynamique, en particulier dans des conditions d’implantation complexes, afin d’étendre les indications du TAVI. En ViV, le défi est de préciser les facteurs associés à sa performance et son utilité hémodynamique et de proposer des stratégies d’implantation afin d’optimiser le succès de la procédure.Transcatheter aortic valve implantation (TAVI) has emerged as an alternative to surgery for patients with severe aortic stenosis and high surgical risk. This technique is extending to a wider population (e.g. with more complex anatomy or lower surgical risk), as well as to patients with degenerated surgical bioprostheses (BPs). However, two major concerns remain limiting. Regarding “classical TAVI”, periprosthetic leaks have been associated with increased mortality. Oversizing is used to secure the device within the aortic annulus which is often non circular. The effects of oversizing and annulus shape on the hemodynamic performance are unknown. Regarding ViV implantations, elevated post-procedural gradients are common and have been associated with increased mortality. The principal factors associated with this residual stenosis as well as with increased risk of mortality, have been BPs label size ≤ 21 mm and mode of failure by stenosis. These factors are not specific enough and there is currently no recommendation for the treatment of small BPs. Besides, the actual hemodynamic benefit associated with ViV has not been evaluated (vs. pre ViV status).The general objective of this work is to understand the interactions between the transcatheter prosthesis and the aortic annulus or the BP to be treated, which impact the hemodynamic performance, especially in complex conditions of implantation, in order to extend the indications of TAVI. In the context of ViV, the objective is to specify the factors associated with the hemodynamic performance and utility of the treatment. The final aim is to provide strategies of implantation in order to optimize the success of the procedure

Elastin-like polymer coating on CoCr surfaces for cardiovascular applications

Cardiovascular diseases have emerged as a major concern since they are the first cause of death in developed countries. The advent of percutaneous transluminal coronary angioplasty consisted in an alternative to invasive surgery. Especially the introduction of cardiovascular stents has significantly meliorated the potential of angioplasty, e.g. with the use of drug eluting and bioadsorbable stents. Still, restenosis remains a major implant-related complication and can imply re intervention. Therefore, research has focused on limiting and/r avoided restenosis by investigating the field of surface treatments and drug delivery material. The rapidly developing field of material technology and engineering has enable design of molecular-specific surfaces for a new generation of vascular devices. This project has been focused on how to promote endothelialization on a bare metal CoCr alloy stent still widely used nowadays. The knowledge about biological response and interactions between extra cellular matrix proteins and cellular agents has lead to explore the potential of genetically engineered protein based polymers such as elastin-like polymers which mimic properties of the human elastin. This project has for general goal to promote endothelialization on CoCr-alloy by functionalizing the surfaces with REDV elastin-like biopolymer which contains a specific domain for endothelial cell adhesion. For that purpose different surface treatments have been performed on CoCr in order to enhance the biopolymer adhesion. First surfaces have been activated by means of O2 plasma, acid HNO3 and NaOH basic etching. Afterwards, a series has been CPTES silanized previous to biopolymer adsorption. Finally, REDV elastin-like biopolymer has been physically and/or chemically attached to the different treated surfaces. All treatments have been thoroughly physic-chemically characterized before and after all treatments steps. Finally special attention has been paid to the study of biopolymer coating stability after some thermal and/or mechanical treatments in order to determine the best surface treatment conditions of adhesion and the efficiency of previous surface treatments. REDV elastin-like biopolymer was successfully adsorbed on CoCr ASTM F-90 alloy surfaces. It was biofunctionalized CoCr ASTM F-90 alloy surfaces through CPTES silane. Silanization increased biopolymer adsorption but the efficiency was low. NaOH activated samples presented a higher CPTES silane attachment and biopolymer adhesion as observed by an increase of adhered HUVEC cells compared to other treatments. REDV elastin-like biopolymer is more sensitive to mechanical and thermal treatments probably due to a detachment and/or denaturation of the biomolecule. The increase of silanization efficiency on treated CoCr surfaces could enhance biopolymer stability as observed for NaOH treated surfaces.Incomin

Hemodynamic performance of transcatheter aortic valve prostheses and strategie of implantation for valve-in-valve procedures : in vitro and in vivo studies

L’implantation valvulaire aortique percutanée (TAVI) a émergé comme une alternative à la chirurgie pour les patients avec sténose sévère et haut risque chirurgical. Cette technique s’étend à une population plus large (e.g. anatomie plus complexe, risque chirurgical plus bas), ainsi qu'au traitement Valve-in-Valve (ViV) des bioprothèses (BPs) chirurgicales défaillantes. Cependant, deux complications majeures en limitent la généralisation. En TAVI « classique », la présence de fuites péripothétiques a été associée à une mortalité augmentée. Les effets du surdimensionnement de la prothèse percutanée pour assurer son étanchéité, ou de la forme de l’anneau souvent non circulaire, sur la performance hémodynamique, sont mal connus. En ViV, la présence de hauts gradients est fréquente et associée à une mortalité augmentée. Les BPs de taille nominale ≤ 21 mm et le mode de dégénérescence par sténose, facteurs mis en cause dans la sténose résiduelle et associés à une mortalité augmentée, ne sont pas assez spécifiques et il n’existe actuellement aucune recommandation pour le traitement des petites BPs. Par ailleurs, le bénéfice hémodynamique réel du ViV par rapport aux statuts avant ViV n’a pas été étudié.L’objectif général de ce travail doctoral est de comprendre les interactions entre la prothèse percutanée et l’anneau aortique ou la BP à traiter, impliquées dans la performance hémodynamique, en particulier dans des conditions d’implantation complexes, afin d’étendre les indications du TAVI. En ViV, le défi est de préciser les facteurs associés à sa performance et son utilité hémodynamique et de proposer des stratégies d’implantation afin d’optimiser le succès de la procédure.Transcatheter aortic valve implantation (TAVI) has emerged as an alternative to surgery for patients with severe aortic stenosis and high surgical risk. This technique is extending to a wider population (e.g. with more complex anatomy or lower surgical risk), as well as to patients with degenerated surgical bioprostheses (BPs). However, two major concerns remain limiting. Regarding “classical TAVI”, periprosthetic leaks have been associated with increased mortality. Oversizing is used to secure the device within the aortic annulus which is often non circular. The effects of oversizing and annulus shape on the hemodynamic performance are unknown. Regarding ViV implantations, elevated post-procedural gradients are common and have been associated with increased mortality. The principal factors associated with this residual stenosis as well as with increased risk of mortality, have been BPs label size ≤ 21 mm and mode of failure by stenosis. These factors are not specific enough and there is currently no recommendation for the treatment of small BPs. Besides, the actual hemodynamic benefit associated with ViV has not been evaluated (vs. pre ViV status).The general objective of this work is to understand the interactions between the transcatheter prosthesis and the aortic annulus or the BP to be treated, which impact the hemodynamic performance, especially in complex conditions of implantation, in order to extend the indications of TAVI. In the context of ViV, the objective is to specify the factors associated with the hemodynamic performance and utility of the treatment. The final aim is to provide strategies of implantation in order to optimize the success of the procedure