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BACKGROUND: Ibrutinib, a relatively new antineoplastic agent, has multiple cardiovascular effects that are still insufficiently known and evaluated, including subclinical myocardial damage. STUDY QUESTION: The present study aims to assess the role of the myocardial strain, alone and in combination with cardiac biomarkers, in the early detection of ibrutinib-induced cardiotoxicity. STUDY DESIGN: We included 31 outpatients with normal left ventricular ejection fraction (LVEF) on ibrutinib, in a tertiary University Hospital between 2019 and 2020, and evaluated them at inclusion and after 3 months. MEASURES AND OUTCOMES: Data on myocardial strain, cardiac biomarkers [high-sensitive troponin T (hs TnT) and N-terminal probrain natriuretic peptide (NT-proBNP)], and ambulatory electrocardiographic monitoring were collected. RESULTS: Myocardial deformation decreased significantly (P < 0.001) at later evaluation and hs TnT and NT-proBNP increased significantly (P = 0.019 and P = 0.03, respectively). The increase in hs TnT correlated with the increase in the left ventricle global longitudinal strain (LVGLS); in other words, it correlated with the decrease in myocardial deformation. No association was found between LVGLS increase and the increase in NT-proBNP. LVGLS modification was not significantly influenced by age, anemia, or arrhythmia burden quantified by 24-hour Holter monitoring (P = 0.747, P = 0.072, respectively; P = 0.812). LVEF did not change significantly during follow-up. CONCLUSIONS: In patients on ibrutinib, evaluation of myocardial strain is useful in identifying early cardiac drug toxicity, surpassing the sensitivity and specificity limits of LVEF. In these patients, concomitant assessment of hs TnT increases the predictive power for subclinical myocardial involvement.
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Cardiotoxicidad , Función Ventricular Izquierda , Adenina/análogos & derivados , Biomarcadores , Cardiotoxicidad/etiología , Humanos , Péptido Natriurético Encefálico , Fragmentos de Péptidos , Piperidinas , Volumen SistólicoRESUMEN
Halo nevi, known as leukoderma acquisitum centrifugum, Sutton nevus, leukopigmentary nevus, perinevoid vitiligo, or perinevoid leukoderma, together with vitiligo and melanoma-associated hypopigmentation, belong to the group of dermatoses designated as immunological leukodermas. The etiology and pathogenesis of halo nevi has not been fully elucidated. There are several mechanisms through which a lymphocytic infiltrate can induce tumoral regression. In this review, we aimed to update the knowledge about Sutton nevi starting with the clinical appearance and dermoscopic features, continuing with information regarding conventional microscopy, immunohistochemistry, and the immunological mechanisms responsible for the occurrence of halo nevi. We also included in the article original unpublished results when discussing dermoscopic, pathologic and immunohistochemical results in halo nevi. Sutton nevi are valuable models for studying antitumor reactions that the human body can generate. The slow and effective mechanism against a melanocytic skin tumor can teach us important lessons about both autoimmune diseases and anticancer defenses.
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Ibrutinib is a novel drug used in haematological malignancies. Its use is associated with an increased risk of atrial fibrillation (AF), which, in turn, exposes patients to embolic risk, including stroke. Reducing this risk requires anticoagulant therapy which is a matter of concern in the context of the increased bleeding risk of patients with haematological malignancies. In this context the presence of thrombocytopenia related to haematological disorder, ibrutinib-anticoagulants and ibrutinib-platelets interactions contribute to the amplification of the problem. The correct assessment of the thrombosis vs. haemorrhage balance represents a significant challenge for the clinician. In this paper we discuss practical issues related to anticoagulation in patients treated with ibrutinib and incident AF.
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Adenina/análogos & derivados , Anticoagulantes , Antineoplásicos/efectos adversos , Fibrilación Atrial/inducido químicamente , Neoplasias Hematológicas/tratamiento farmacológico , Hemorragia/inducido químicamente , Piperidinas/efectos adversos , Tromboembolia/prevención & control , Adenina/efectos adversos , Adenina/uso terapéutico , Anticoagulantes/efectos adversos , Anticoagulantes/uso terapéutico , Antineoplásicos/uso terapéutico , Humanos , Piperidinas/uso terapéutico , Factores de Riesgo , Accidente Cerebrovascular/prevención & control , Tromboembolia/etiologíaRESUMEN
PURPOSE: To assess the functional and refractive outcomes in hyperopia and presbyopia correction by clear lens exchange with the intraocular trifocal artificial lens (IOL) Acrysof IQ Panoptix implant at 1 year. MATERIALS AND METHODS: A number of 128 eyes (64 patients) underwent clear lens exchange with placement of the trifocal IOL Acrysof IQ Panoptix implant for hyperopia and presbyopia. Prior to the surgery the patients had a complete ocular examination. In all cases the artificial lens was implanted in the bag without any intraoperative complications. Visual acuity (VA) at distance, intermediate and near and ocular refraction were evaluated at 4 weeks, 6 and 12 months postoperatively. RESULTS: The mean age was 53.49 ±7.377 years old (range 40-73 years). As high as 51.57% of the patients were males and 48.43% were females. The mean achieved refraction was 0.26 ± 0.73D. Almost 60.93% of patients were within ±0.25D of the target refraction, with 82.03% eyes within ±0.50D of the planned correction. At 1 year after surgery, 96.45% of eyes had a stable refraction (p >0.05). At 1 year, a total of 92.25%, 89.92% and 91.47% achieved a monocular uncorrected distance, intermediate and near visual acuity of 0.2 logarithm of the minimum angle of resolution or better, respectively. At the same time point, a total of 95.35%, 91.47% and 93.80% achieved a binocular uncorrected distance, intermediate and near visual acuity of 0.2 logarithm of the minimum angle of resolution or better, respectively. There was no statistically significant difference (p>0.05) between the postoperative uncorrected and best corrected VA (distance, intermediate, near) at 6 months and postoperative uncorrected and best corrected VA (distance, intermediate, near) at 12 months. None of our patients had any intraoperative complications. Two cases (1.56%) developed posterior capsule opacification. Twelve patients (18.75%) complained about photic phenomena such as glare and haloes, but this symptom disappeared after 6 months postoperatively. As high as93.56% of patients had a high satisfaction with the outcomes of the surgery. Spectacle independence was obtained in 97.65% eyes. CONCLUSION: The Acrysof Panoptix trifocal artificial lens offers a good vision at distance, intermediate and near, with a good quality of vision and refraction.
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BACKGROUND: Atrial fibrillation (AF) is common amongst the elderly, but this group tends to be suboptimally treated. Limited data are available on the stroke prevention strategies in the elderly, especially in the Balkan region. AIM: We investigated the use of oral anticoagulant therapy (OAC) amongst elderly AF patients in clinical practice in the Balkan region. METHOD: A 12-week prospective snapshot survey (2014-2015) of consecutive non-valvular AF patients was conducted in Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Montenegro, Romania and Serbia. Data were collected via an electronic case report form. RESULTS: Of 2671 patients, 418 (15.6%) were ≥80 years old. Overall, OAC was used in 1965 patients (73.6%). Compared with younger patients, the elderly (age ≥ 80) had a higher mean CHA2 DS2 -VASc score (3.22 ± 1.71 vs 4.89 ± 1.35, P < .001) and more often a HAS-BLED score of ≥3 (n = 198 [47.0%] vs n = 625 [27.3%], P < .001), but were less likely to receive OAC (n = 269 [64.4%] vs n = 1696 [75.3%], odds ratio [OR] 0.91; 95%CI 0.86-0.97, P = .003). There was no significant association between OAC use and mean CHA2 DS2 -VASc (OR 0.86; 95%CI 0.75-1.00, P = .053) or HAS-BLED score (OR 1.21; 95%CI 0.81-1.81, P = .349) in the elderly. CONCLUSION: In the BALKAN-AF Survey, elderly AF patients were less likely to receive the guideline-adherent treatment despite their less favourable risk profile. Since OAC nonuse among the elderly was not associated with increased HAS-BLED score, factors other than patients' risk profile could influence the implementation of guideline-adherent treatment for thromboprophylaxis in the elderly AF patients.
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Accidente Cerebrovascular/prevención & control , Anciano , Anciano de 80 o más Años , Fibrilación Atrial , Peninsula Balcánica/epidemiología , Comorbilidad , Femenino , Humanos , Masculino , Factores de Riesgo , Accidente Cerebrovascular/epidemiologíaRESUMEN
This study aims to assess the capability of the 1H-NMR profiling of fruits from different genera in combination with multivariate data analysis to provide feasible information for fruit juices' authenticity in terms of botanical origin. Nine fruit varieties from four genera were selected for the experimental plan. The juice obtained from the fruits was characterized using the 1H-NMR technique, selecting the obtained amino acid profile of fruits as a potential specific fingerprint. Due to the complex information provided by the NMR spectra, a chemometric approach of the data was further applied to enable the differentiation of the fruit samples, highlighting thus its suitability as a discrimination tool for the varietal origin. The advantage of this analytical approach is given by the relatively simple working procedure, which consists of an easy, fast, and accessible preparation stage while providing complex information on fruit composition.
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Aminoácidos/química , Jugos de Frutas y Vegetales , Frutas/química , Bebidas , Humanos , Espectroscopía de Resonancia Magnética , Análisis MultivarianteRESUMEN
Methotrexate (MTX) is a folic acid analog with anti-proliferative (anti-neoplastic, cytotoxic), immunosuppressive and anti-inflammatory properties, which has been used in the treatment of various cutaneous disorders, such as psoriasis, keratoacanthoma, pityriasis rubra pilaris, atopic dermatitis, mycosis fungoides, bullous skin diseases, systemic sclerosis, morphea, lupus erythematosus, dermatomyositis and crusted scabies. Inhibition of cell proliferation is explained through its role in blocking DNA/RNA synthesis, by inhibiting dihydrofolate reductase, necessary for the production of pyrimidine and purine nucleotides. An anticancer effect can be related to α-oxoaldehyde metabolism (MTX increases methylglyoxal levels). Its anti-inflammatory property is based on the inhibition of 5-aminoimidazole-4-carboxamide ribonucleotide transformylase, thus increasing intracellular and extracellular adenosine, a purine nucleoside with anti-inflammatory effect. This drug can limit inflammation by scavenging free radicals and decreasing malondialdehyde-acetaldehyde protein-adduct production. Moreover, the anti-proliferative and anti-inflammatory effects can also be related to inhibition of the DNA methylation pathway, thus inhibiting methionine formation. The aim of the present study was to report various dermatological cases from our daily practice that demonstrate the efficacy of MTX in the treatment of cutaneous diseases, highlighting different mechanisms of action: its anti-inflammatory effect in psoriasis and its anti-proliferative, and anti-neoplastic effect in well-differentiated squamous cell carcinoma or in keratoacanthoma. Moreover, different administration pathways and doses are addressed. Assessment of the treatment plan, clinical improvement of cutaneous lesions, biologic evaluation, final aesthetic result, quality of life, as well as potential adverse effects and drug tolerance related to each case mentioned.
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ï¼The aim of the study was to investigate the differences between walnut genotypes of various geographical and genetic origins grown under the same or different environmental conditions. The biological material analyzed consisted in walnut kernels of 34 cultivars, nine advanced selections, and six hybrids harvested in 2015 and 2016, summing up to a total of 64 samples. The walnuts, walnut oil, and residue were characterized in respect to their chemical (proximate composition-fat, protein, nutritional value, fatty acids profile by ¹H-NMR) and carbon-13 isotopic composition. The data was used to statistically discriminate the cultivars according to composition, geographical area of origin, and year of harvest, comparing the Romanian cultivars, selections, and hybrids with the internationally available ones.
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Ácidos Grasos/análisis , Juglans/genética , Nueces/química , Proteínas de Plantas/análisis , Isótopos de Carbono , China , Genotipo , Grecia , Juglans/química , Juglans/clasificación , Juglans/metabolismo , Valor Nutritivo , Filogeografía , Espectroscopía de Protones por Resonancia Magnética , RumaníaRESUMEN
The aim of the study was to identify if there is a connection between the time of administration of alpha-blocker medication and cataract surgery complications. Furthermore, it was explored whether discontinuation of tamsulosin before cataract surgery influences the manifestations of intraoperative floppy iris syndrome in rats. An experimental study was conducted on 20 male Wistar rats aged 1.5-2 years (body mean weight 357 g), which were divided into four equal groups: Group 1, under tamsulosin hydrochloride 0.4 mg/day for 2 months; group 2, without any treatment in the first month, followed by tamsulosin; group 3, under tamsulosin for 1 month, followed by 1 month without any treatment; and group 4, control. The pupillary diameter was assessed before instillation of 0.5% tropicamide (mydriatic and cycloplegic agent), after 1 or 2 h from instillation and postoperatively. Furthermore, pupil constriction during surgery, the presence of floppy iris and prolapse of the iris following the main incision and during serum injection were also assessed. Other analyzed features included iris rupture, posterior capsule tear, vitreous loss, lens fragments in the vitreous, suprachoroidal bleeding and corneal haze. The iris dilator muscle thickness and the posterior epithelium was measured using light microscopy. In the control group, the largest pupillary diameters were indicated and in group 1, the smallest pupillary diameters were revealed. Statistically significant differences were indicated between group 1 and 2 and group 3 and 4. Floppy iris, iris prolapse in the main incision and during serum injection appeared at maximum frequency for group 1 with continuous treatment and low frequency for the control group. Lens fragments in the vitreous were present in the groups 1-3. Notably, intraoperative miosis had statistical relevance in group 1 and group 2. To conclude, the present findings suggested there is a clear connection between the time of administration of the alpha-blocker medication and most cataract complications. The results indicated that discontinuation of tamsulosin for one month largely reduces the manifestations of intraoperative floppy iris syndrome in rats, which may suggest to change preoperative treatment for benign prostatic hypertrophy with another class of drugs that do not interact with the iris receptors.
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Epithelial-mesenchymal transition (EMT) is involved in physiologic processes such as embryogenesis and wound healing. A similar mechanism occurs in some tumors where cells leave the epithelial layer and gain mesenchymal particularities in order to easily migrate to other tissues. This process can explain the invasiveness and aggressiveness of these tumors which metastasize, by losing the epithelial phenotype (loss of E-cadherin, desmoplakin, and laminin-1) and acquiring mesenchymal markers (N-cadherin). Complex changes and interactions happen between the tumor cells and the microenvironment involving different pathways, transcription factors, altered expression of adhesion molecules, reorganization of cytoskeletal proteins, production of ECM-degrading enzymes, and changes in specific microRNAs. The purpose of this review is to determine particularities of the EMT process in the most common malignant cutaneous tumors (squamous cell carcinoma, basal cell carcinoma, and melanoma) which still have an increasingly high incidence. More studies are required on this topic in order to establish clear correlations. High costs related to skin cancer therapies in general as well as high impact on patients' quality of life demand finding new, reliable prognostic and therapeutic markers with significant public health impact.
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Biomarcadores de Tumor/metabolismo , Carcinoma Basocelular/metabolismo , Carcinoma de Células Escamosas/metabolismo , Neoplasias Cutáneas/metabolismo , Animales , Antígenos CD/metabolismo , Cadherinas/metabolismo , Carcinoma Basocelular/genética , Carcinoma de Células Escamosas/genética , Transición Epitelial-Mesenquimal , Humanos , Melanoma/genética , Melanoma/metabolismo , Factores de Transcripción SOXB1/genética , Factores de Transcripción SOXB1/metabolismo , Transducción de Señal/genética , Neoplasias Cutáneas/genética , Microambiente Tumoral/genéticaRESUMEN
Cutaneous melanoma is the most aggressive type of skin cancer, with high invasive potential. Lentigo maligna melanoma (LMM) is a relatively rare type, accounting for about 10% of all melanomas, while the most common subtype of melanoma on the face, typically on chronically sun-exposed skin of elderly people. Its in situ stage is lentigo maligna (LM). During the process of transformation from LM to LMM, tumor cells secrete or induce the release from neighboring cells of large amounts of matrix metalloproteinases (MMPs) that degrade the extracellular matrix. Some MMPs, as MMP3 and MMP9 expressed melanoma cells is associated with statistical significance in both in vitro and in vivo studies, with an invasive phenotype. Unfortunately, there is scarce data published about MMPs expression in LM∕LMM, as majority of research on melanoma refer to superficial spreading and nodular melanoma. Our personal, unpublished yet fully data is an attempt to complete a specific panel of immunohistochemical markers that could explain the slow growing rate of LMM.
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Metaloproteinasas de la Matriz/metabolismo , Melanoma/genética , Neoplasias Cutáneas/genética , Femenino , Humanos , Masculino , Melanoma/patología , Neoplasias Cutáneas/patología , Melanoma Cutáneo MalignoRESUMEN
BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) have an increased risk for both supraventricular and ventricular arrhythmias. Autonomic dysregulation may be responsible for the development of arrhythmias in these patients, and its analysis could be useful for identifying those at high risk for arrhythmias. STUDY QUESTION: Our purpose is to analyze the role of acceleration capacity (AC) and deceleration capacity (DC), novel markers of the autonomic balance, as potential arrhythmic risk predictors in patients with COPD. STUDY DESIGN: We prospectively included 47 patients diagnosed with COPD, and a control group of 64 age-matched subjects without COPD. AC and DC values were obtained using 24-hour Holter monitoring. The arrhythmias were isolated premature atrial complexes, supraventricular tachycardias, isolated premature ventricular beats (PVC), and combined ventricular arrhythmias consisting in ventricular tachycardias or more than 10 PVC per hour. RESULTS: Supraventricular arrhythmias and isolated PVC were more frequent in the COPD group. The DC was significantly lower (3.10 vs. 5.60, P < 0.0001) and AC higher (-4.60 vs. -6.60, P = 0.002) in patients with COPD. DC was identified as a predictor of arrhythmic events with an area under the curve (AUC) for premature atrial complexes >70/d of 0.72 (0.56-0.87, P = 0.013), for supraventricular tachycardias 0.76 (0.62-0.90, P = 0.002), and for combined ventricular arrhythmias 0.69 (0.54-0.82, P = 0.025). AC was predictor only for combined ventricular arrhythmias with an AUC of 0.74 (0.58-0.85, P = 0.002). CONCLUSIONS: Patients with COPD associate a significant autonomic imbalance and a higher incidence of arrhythmias. DC could be a strong predictor for supraventricular and ventricular arrhythmias in patients with COPD with no clinically apparent cardiac disease. AC could be useful alongside with DC regarding the risk for ventricular arrhythmias, but seems to have lesser value as a predictor for supraventricular arrhythmias.
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Aceleración , Arritmias Cardíacas/epidemiología , Enfermedades del Sistema Nervioso Autónomo/epidemiología , Desaceleración , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Anciano , Arritmias Cardíacas/fisiopatología , Complejos Atriales Prematuros/epidemiología , Complejos Atriales Prematuros/fisiopatología , Enfermedades del Sistema Nervioso Autónomo/fisiopatología , Estudios de Casos y Controles , Comorbilidad , Electrocardiografía Ambulatoria , Femenino , Volumen Espiratorio Forzado , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Medición de Riesgo , Taquicardia Supraventricular/epidemiología , Taquicardia Supraventricular/fisiopatología , Taquicardia Ventricular/epidemiología , Taquicardia Ventricular/fisiopatología , Complejos Prematuros Ventriculares/epidemiología , Complejos Prematuros Ventriculares/fisiopatología , Capacidad VitalRESUMEN
AIMS: Peripheral arterial disease (PAD) is highly prevalent in general population. Data on the prevalence of symptomatic PAD in patients with atrial fibrillation (AF) are limited, and the impact of PAD on adverse outcomes in AF patients is controversial. Our aims were: (i) to define the prevalence of symptomatic PAD in European AF patients and describe its associated clinical risk factors and (ii) to establish the relationship of PAD to adverse events in AF, especially all-cause death. METHODS AND RESULTS: Atrial fibrillation patients enrolled in the EORP-AF Pilot study with data about PAD status were included in this analysis. Event rates were determined at 1-year follow-up. Peripheral arterial disease was recorded in 328 (11%) patients. Age (P < 0.0001), hypertension (P = 0.0059), diabetes mellitus (P = 0.0001), chronic heart failure (P < 0.0001), previous stroke/transient ischaemic attack (P = 0.0060), and antiplatelet drug treatment (P = 0.0001) were associated with the presence of PAD, while female gender was inversely associated (P = 0.0002). Peripheral arterial disease patients had higher absolute rates of both cardiovascular (CV) and all-cause death (both P < 0.0001). On Kaplan-Meier analysis, risk of all-cause death was higher in PAD patients compared with those without PAD (P < 0.0001), but PAD did not emerge as an independent risk factor for mortality on Cox regression analysis. A lower risk of all-cause death was associated with the prescription of statins (P = 0.0019), angiotensin-converting enzyme inhibitors (P = 0.0008), and calcium-channel blockers (P = 0.0071). CONCLUSION: Peripheral arterial disease is prevalent in 11% of AF patients and related to various atherosclerotic risk factors. Even if PAD is associated with higher risk of all-cause death on univariate analysis, this risk was significantly lowered and was no longer evident after adjusting for the use of CV prevention drugs.
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Fibrilación Atrial/epidemiología , Enfermedad Arterial Periférica/epidemiología , Anciano , Anciano de 80 o más Años , Fibrilación Atrial/diagnóstico , Fibrilación Atrial/tratamiento farmacológico , Fibrilación Atrial/mortalidad , Fármacos Cardiovasculares/uso terapéutico , Causas de Muerte , Distribución de Chi-Cuadrado , Europa (Continente)/epidemiología , Femenino , Humanos , Estimación de Kaplan-Meier , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Oportunidad Relativa , Enfermedad Arterial Periférica/diagnóstico , Enfermedad Arterial Periférica/tratamiento farmacológico , Enfermedad Arterial Periférica/mortalidad , Proyectos Piloto , Prevalencia , Pronóstico , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Sistema de Registros , Medición de Riesgo , Factores de Riesgo , Factores de TiempoRESUMEN
Methodologies for chemometric classification of five authentic red wine varieties from Murfatlar wine center, Romania, young and aged are reported. The discriminant analysis based on several anthocyanins, organic acids, (13)C/(12)C, (18)O/(16)O and D/H isotopic ratios, (1)H and (13)C NMR fingerprints revealed a very satisfactory categorization of the wines, both in terms of variety and vintage, thus illustrating the validity of selected variables for wine authentication purposes. LDA applied to the combined data shows 85.7% classification of wines according to grape variety and 71.1% classification of wines according to vintage year, including a control wine set for each categorization, thus allowing an accurate interpretation of the data. Thereby, anthocyanins, certain anthocyanin ratios, oxalic, shikimic, lactic, citric and succinic acids, sugars like glucose, amino acids like histidine, leucine, isoleucine and alanine, and also 2,3-butanediol, methanol, glycerol and isotopic variables were significant for classification of wines.
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Análisis Multivariante , Vino/análisis , Vino/clasificación , Aminoácidos/análisis , Antocianinas/análisis , Butileno Glicoles , Ácidos Carboxílicos/análisis , Análisis Discriminante , Humanos , Isótopos/análisis , Espectroscopía de Resonancia Magnética , Ácido Oxálico , Rumanía , Vitis/químicaRESUMEN
Halo (Sutton's) phenomenon has been described as a depigmented halo that is associated most commonly with acquired melanocytic nevi; but it may be associated with various types of melanocytic skin tumors, melanoma being the most concerning. Different authors have been preoccupied with elucidating morphological features of melanocytic tumors associated with a depigmented halo. We reviewed the literature and discussed the main features of melanocytic halo tumors regarding histopathological, immune microenvironment profile and dermatoscopic appearance. We highlighted similarities and differences between Sutton's nevus and halo melanoma, also presenting relevant aspects of our results. Depigmented halo must be regarded as a phenomenon that may be associated with different types of melanocytic tumors and with a broad spectrum of histopathological atypia degree. Certain correlations between the shape, diameter, symmetry observed in clinical examination, histopathological appearance, dermatoscopic aspect of peritumoral halo and central tumor type could not be established due to insufficient data and contrasting results. Further studies are expected to add valuable information regarding the depigmented halo tumors features.
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Melanocitos/citología , Melanoma/diagnóstico , Melanoma/patología , Nevo Pigmentado/patología , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/patología , Adulto , Proliferación Celular , Citoplasma/metabolismo , Dermatología/métodos , Dermoscopía , Femenino , Humanos , Inflamación , Masculino , Pigmentación , Piel/patologíaRESUMEN
Patients with chronic obstructive pulmonary disease (COPD) have an increased risk for cardiac arrhythmias. Ventricular late potentials (VLP) on signal-averaged electrocardiography (SAECG) are associated with an increased risk for malignant ventricular arrhythmias. Our aim is to investigate the modifications of SAECG parameters and the presence of VLP as possible indicators of proarrhythmic substrate in patients with COPD. We prospectively enrolled 41 consecutive patients in the COPD group and 63 patients without any history of pulmonary disease, matched for age and hypertension history, in the control group. Pulmonary function tests, arterial blood gases, echocardiography, 24-hour Holter monitoring and SAECG were performed. We measured total filtered QRS duration (QRSf), duration of high frequency, low-amplitude signals < 40 V (HFLA40), and root mean square voltage in the last 40 ms (RMS40). VLP were considered if at least two of these parameters were abnormal. Results. We did not register any significant differences in QRSf, HFLA40 or RMS40 between the two groups. In the COPD group there was a non-significant higher percentage of patients with VLP in comparison with the control group. In the COPD patients we registered a significantly higher number of isolated premature ventricular beats and of combined complex ventricular arrhythmias, consisting of polymorphic PVC, couplets, triplets or nonsustained ventricular tachycardias. None of these arrhythmic parameters correlated with SAECG variables or with the presence of VLP. Conclusion. In COPD patients parameters measured on signal-averaged electrocardiography and ventricular late potentials analysis have little value in risk stratification for ventricular arrhythmias.
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Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Anciano , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/etiología , Estudios de Casos y Controles , Electrocardiografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedad Pulmonar Obstructiva Crónica/complicacionesRESUMEN
Tracing pollution sources and transformation of nitrogen compounds in surface- and groundwater is an issue of great significance worldwide due to the increased human activity, translated in high demand of water resources and pollution. In this work, the hydrological basin of an important chemical industrial platform in Romania (Ramnicu Valcea industrial area) was characterized in terms of the physico-chemical and isotope composition of δ(18)O and δ(2)H in water samples and δ(15)N of the inorganic nitrogen species. Throughout a period of one year, water samples from the Olt River and its more important tributaries were collected monthly in the industrial area, when the seasonal and spatial isotope patterns of the surface waters and the main sources of pollution were determined. Higher inorganic nitrogen concentrations (up to 10.2 mg N L(-1)) were measured between November 2012 and April 2013, which were designated as anthropogenic additions using the mixing calculations. The main sources of pollution with inorganic nitrogen were agriculture and residential release. The inorganic nitrogen from the industrial waste water duct had a distinct δ(15)N fingerprint (mean of -8.6). Also, one industrial release into the environment was identified for Olt River, at Ionesti site, in November 2012. The mean precipitation samples had the lowest inorganic nitrogen concentrations (less than 5.5 mg N L(-1)) with a distinct δ(15)N fingerprint compared to the surface and industrial waters.
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Monitoreo del Ambiente/métodos , Residuos Industriales/análisis , Ríos/química , Contaminantes Químicos del Agua/análisis , Hidrología , Isótopos/análisis , RumaníaRESUMEN
INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is associated with higher incidence of supraventricular arrhythmias. Atrial late potentials (ALP) detected by P-wave signal-averaged electrocardiography (SAECG) could be useful in detecting the patients at risk for supraventricular arrhythmias. Our objective was to assess the role of P-wave SAECG and ALP detection for arrhythmic risk evaluation of the patients with exacerbated COPD. METHODS: We prospectively included 45 patients with exacerbation of COPD and 58 age- matched patients with no history of pulmonary disease in a control group. We performed pulmonary function tests, arterial blood gases, echocardiography, 24-hour Holter monitoring and P-wave SAECG. We measured filtered P-wave duration (FPD), the root mean square (RMS) voltages in the last 40, 30 and 20 ms of the filtered P-wave (RMS 40, RMS 30 and RMS 20), the root mean square voltage of the filtered P-wave potentials (RMS-p), and the integral of the potentials during the filtered P-wave (Integral-p). ALP was defined as FPD > 132 ms and RMS 20 < 2.3 µV. RESULTS: Isolated atrial premature beats (APB) and supraventricular tachycardias (SVT) were more frequent in the COPD group. There were no significant differences between groups regarding the P wave SAECG parameters. In the COPD group none of the supraventricular arrhythmias was correlated with ALP or any P-wave SAECG parameters. CONCLUSIONS: The patients with acute exacerbation of COPD but no apparent cardiac disease have a higher incidence of supraventricular arrhythmias. P-wave SAECG analysis and ALP detection have little value in the arrhythmic risk evaluation of these patients.
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Electrocardiografía/métodos , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Anciano , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios ProspectivosRESUMEN
One of the most important tributaries of the Danube River in Romania, the Olt River, was characterized in its middle catchment in terms of the isotopic composition using continuous flow-isotope ratio mass spectrometry (CF-IRMS). Throughout a period of 10 months, from November 2010 to August 2011, water samples from the Olt River and its more important tributaries were collected in order to investigate the seasonal and spatial isotope patterns of the basin waters. The results revealed a significant difference between the Olt River and its tributaries, by the fact that the Olt River waters show smaller seasonal variations in the stable isotopic composition and are more depleted in (18)O and (2)H. The waters present an overall enrichment in heavy isotopes during the warm seasons.
Asunto(s)
Deuterio/análisis , Monitoreo del Ambiente , Oxígeno/análisis , Ríos/química , Isótopos de Oxígeno/análisis , Rumanía , Estaciones del AñoRESUMEN
AIM: The aim of the study was to explore the anthropometric maternal characteristics and prenatal care as determinants of pregnancy weight gain. MATERIAL AND METHODS: We conducted a cross-sectional study on a total of 400 pregnant women admitted to Cuza-Voda Obstetrics and Gynecology Clinical Hospital, Iasi. Information on demographic characteristics, number of prenatal visits, and education on nutrition and food changes occurring during pregnancy were recorded in a structured questionnaire. Anthropometric parameters analyzed were pregestational BMI (body mass index) and weight gain during pregnancy. RESULTS: Weight gain was associated with pregestational BMI category. An increase in weight more than recommended occured more frequently in overweight (53.1%) and obese women (66.7%) (p < 0.001). Weight gain during pregnancy was related to area of residence, age, APCU (adequate prenatal care utilization) index. The multivariate analysis identified the following variables as significant determinants of pregnancy weight gain: inadequate prenatal care, BMI and changes in diet. CONCLUSIONS: Pregestational BMI and changes in diet during pregnancy identified as determinants of weight gain suggests that overweight and underweight women must carefully be counseled regarding recommendations for weight gain in pregnancy. Tracking diet changes is important to ensure that a weight gain lies within the guidelines recommendations.