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1.
Adv Med Sci ; 2024 Aug 30.
Artículo en Inglés | MEDLINE | ID: mdl-39218035

RESUMEN

PURPOSE: The goal of the study was to identify markers of organ function used in daily routines that could potentially aid in the overall evaluation of the cardiovascular system in patients with right-ventricle heart failure due to pulmonary arterial hypertension (PAH) and left-ventricle heart failure. We analyzed correlations between parameters from right heart catheterization (RHC), cardiopulmonary exercise test (CPET), and selected laboratory parameters of thyroid, liver, kidneys function and iron homeostasis. PATIENTS AND METHODS: A retrospective analysis included 107 patients (mean age 57.6±16.2; 34.6% women), comprising 57 patients with PAH (mean age 54.0±18.2; 49.1% women) and 50 patients with heart failure with reduced ejection fraction (HFrEF) <40% (mean age 61.6±12.7; 18% women). All patients underwent CPET. Each patient in the PAH group had RHC performed. Fifteen patients from the HFrEF group underwent RHC, which confirmed the suspicion of pulmonary hypertension (HFrEF-SPH). RESULTS: CPET and laboratory parameters' analysis showed strong correlations between ventilation/carbon dioxide production (VE/VCO2) slope and NT-proBNP in HFrEF without secondary PH and HFrEF-SPH groups. In the PAH group, VE/VCO2 slope correlated with liver and thyroid function but also with morphological parameters of red-cell system. Analysis of correlations between laboratory and hemodynamic parameters revealed significant correlations between pulmonary arterial pressure, pulmonary vascular resistance (PVR) and red-cell parameters, especially strong with fT4 in the PAH group. CONCLUSIONS: In HFrEF-SPH patients, laboratory parameters strongly correlated with pulmonary pressures and pulmonary capillary wedge pressure (PCWP).

2.
ACS Appl Mater Interfaces ; 16(33): 43474-43488, 2024 Aug 21.
Artículo en Inglés | MEDLINE | ID: mdl-39113533

RESUMEN

This study explores the synergistic effect between the Rh and Pd of bimetallic Rh-Pd/C catalysts for the catalytic hydro-defluorination (HDF) of 4-fluorophenol (4-FP). It was found that 4-FP could not be efficiently hydro-defluorinated over 6% Pd/C and 6% Rh/C due to the inherent properties of Pd and Rh species in the dissociation of H2 and the activation of C-F bonds. Compared with 6% Pd/C and 6% Rh/C, bimetallic Rh-Pd/C catalysts, especially 1% Rh-5% Pd/C, exhibited much higher catalytic activity in the HDF of 4-FP, suggesting that the synergistic effect between the Rh and Pd of the catalyst was much more positive. Catalyst characterizations (BET, XRD, TEM, and XPS) were introduced to clarify the mechanism for the synergistic effect between the Rh and Pd of the catalyst in the HDF reaction and revealed that it was mainly attributed to the bifunctional mechanism: Pd species were favorable for the dissociation of H2, and Rh species were beneficial to the activation of C-F bonds in the HDF reaction. Meanwhile, the interaction between Rh and Pd species enabled Rh and Pd to exhibit a more positive synergistic effect, which promoted the migration of atomic H* from Pd to Rh species and thus enhanced the HDF of 4-FP. Furthermore, 1% Rh-5% Pd/C prepared using 20-40 equiv NaBH4 exhibited the best performance in the catalytic HDF of 4-FP. Catalysis characterizations suggested that appropriate Rh3+/Rh0 and Pd2+/Pd0 ratios were beneficial to the dissociation of H2 and the activation of C-F bonds, which caused the more positive synergistic effect between the Rh and Pd of Rh-Pd/C in the HDF reaction. This work offers a valuable strategy for enhancing the performance of catalytic HDF catalysts via promoting synergistic effects.

3.
J Colloid Interface Sci ; 676: 691-700, 2024 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-39059276

RESUMEN

Developing efficient and stable photocatalysts for solar hydrogen (H2) energy conversion is meaningful but challenging. Herein, a novel photocatalyst with Rh single atoms (Rh SAs) anchoring in ß-ketoimine-linked covalent organic frameworks (TpPa-1) via RhC3N sites is proposed for achieving highly efficient H2 production in phosphate buffer saline (PBS) solution with sodium ascorbate (SA) as sacrificial agent under visible light. TpPa-1 with abundant N and C-chelate sites provides a reliable basis for anchoring Rh single atoms. The optimized Rh SAs/TpPa-1 exhibits an outstanding hydrogen evolution activity (1836.81µmol h-1 g-1), 9.34 and 2.27 folds enhancement than that of pristine TpPa-1 and Rh NPs/TpPa-1. X-ray absorption fine structure (XAFS) combined with density functional theory (DFT) calculations reveal that the significant improvement in H2 evolution performance on Rh SAs/TpPa-1 originates from the unique RhC3N coordination environment, promoting the charge separation and migration at the atomic interface, and thus decreasing the energy barrier for H* formation. Notably, in situ Raman technique confirmed Rh SAs was the main active sites (RhH) for proton reduction.

4.
BMC Genomics ; 25(1): 525, 2024 May 28.
Artículo en Inglés | MEDLINE | ID: mdl-38807041

RESUMEN

BACKGROUND: The Rh blood group system is characterized by its complexity and polymorphism, encompassing 56 different antigens. Accurately predicting the presence of the C antigen using genotyping methods has been challenging. The objective of this study was to evaluate the accuracy of various genotyping methods for predicting the Rh C and to identify a suitable method for the Chinese Han population. METHODS: In total, 317 donors, consisting 223 D+ (including 20 with the Del phenotype) and 94 D- were randomly selected. For RHC genotyping, 48C and 109bp insertion were detected on the Real-time PCR platform and -292 substitution was analyzed via restriction fragment length polymorphism (RFLP). Moreover, the promoter region of the RHCE gene was sequenced to search for other nucleotide substitutions between RHC and RHc. Agreement between prediction methods was evaluated using the Kappa statistic, and comparisons between methods were conducted via the χ2 test. RESULTS: The analysis revealed that the 48C allele, 109bp insertion, a specific pattern observed in RFLP results, and wild-type alleles of seven single nucleotide polymorphisms (SNPs) were in strong agreement with the Rh C, with Kappa coefficients exceeding 0.8. However, there were instances of false positives or false negatives (0.6% false negative rate for 109bp insertion and 5.4-8.2% false positive rates for other methods). The 109bp insertion method exhibited the highest accuracy in predicting the Rh C, at 99.4%, compared to other methods (P values≤0.001). Although no statistical differences were found among other methods for predicting Rh C (P values>0.05), the accuracies in descending order were 48C (94.6%) > rs586178 (92.7%) > rs4649082, rs2375313, rs2281179, rs2072933, rs2072932, and RFLP (92.4%) > rs2072931 (91.8%). CONCLUSIONS: None of the methods examined can independently and accurately predict the Rh C. However, the 109bp insertion test demonstrated the highest accuracy for predicting the Rh C in the Chinese Han population. Utilizing the 109bp insertion test in combination with other methods may enhance the accuracy of Rh C prediction.


Asunto(s)
Pueblo Asiatico , Técnicas de Genotipaje , Polimorfismo de Nucleótido Simple , Sistema del Grupo Sanguíneo Rh-Hr , Humanos , Alelos , Pueblo Asiatico/genética , China , Pueblos del Este de Asia , Frecuencia de los Genes , Genotipo , Técnicas de Genotipaje/métodos , Polimorfismo de Longitud del Fragmento de Restricción , Regiones Promotoras Genéticas , Sistema del Grupo Sanguíneo Rh-Hr/genética
5.
J Robot Surg ; 18(1): 116, 2024 Mar 11.
Artículo en Inglés | MEDLINE | ID: mdl-38466445

RESUMEN

Robotics may facilitate the realization of fully minimally invasive right hemicolectomy, including intra-corporeal anastomosis and off-midline extraction, when compared to laparoscopy. Our aim was to compare laparoscopic right hemicolectomy with robotic right hemicolectomy in terms of peri-operative outcomes. MEDLINE was searched for original studies comparing laparoscopic right hemicolectomy with robotic right hemicolectomy in terms of peri-operative outcomes. The systematic review complied with the PRISMA 2020 recommendations. Variables related to patients' demographics, surgical procedures, post-operative recovery and pathological outcomes were collected and qualitatively assessed. Two-hundred and ninety-three publications were screened, 277 were excluded and 16 were retained for qualitative analysis. The majority of included studies were observational and of limited sample size. When the type of anastomosis was left at surgeon's discretion, intra-corporeal anastomosis was favoured in robotic right hemicolectomy (4/4 studies). When compared to laparoscopy, robotics allowed harvesting more lymph nodes (4/15 studies), a lower conversion rate to open surgery (5/14 studies), a shorter time to faeces (2/3 studies) and a shorter length of stay (5/14 studies), at the cost of a longer operative time (13/14 studies). Systematic review of existing studies, which are mostly non-randomized, suggests that robotic surgery may facilitate fully minimally invasive right hemicolectomy, including intra-corporeal anastomosis, and offer improved post-operative recovery.


Asunto(s)
Colectomía , Laparoscopía , Tiempo de Internación , Tempo Operativo , Procedimientos Quirúrgicos Robotizados , Colectomía/métodos , Humanos , Procedimientos Quirúrgicos Robotizados/métodos , Laparoscopía/métodos , Anastomosis Quirúrgica/métodos , Resultado del Tratamiento , Conversión a Cirugía Abierta/estadística & datos numéricos
6.
Am J Med Sci ; 367(6): 375-381, 2024 06.
Artículo en Inglés | MEDLINE | ID: mdl-38467374

RESUMEN

BACKGROUND: Our study aimed to assess the clinical and hemodynamic characteristics of pulmonary hypertension (PH) in patients with overlapping obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD), referred to OSA-COPD overlap syndrome (OS). METHODS: We enrolled a total of 116 patients with OS, COPD, or OSA who underwent right heart catheterization (RHC) due to suspected PH. We conducted a retrospective analysis of the clinical and hemodynamic characteristics of these patients. RESULTS: Among the three groups (OS group, n = 26; COPD group, n = 36; OSA group, n = 54), the prevalence of PH was higher in the OS group (n = 17, 65.4%)compared to OSA group (n = 26,48.1%) and COPD group (n = 20,55.6 %). Among three groups with PH, the superior vena cava pressure (CVP) and right ventricular pressure (RAP) were higher in the OS group than in the OSA group (P < 0.05). Patients in the OS and COPD groups had higher pulmonary artery wedge pressure (PAWP) than in the OSA group (14.88 ± 4.79 mmHg, 13.45 ± 3.68 mmHg vs. 11.00 ± 3.51 mmHg, respectively, P < 0.05). OS patients with PH exhibited higher respiratory event index (REI), time spent with SpO2 <90%, oxygen desaturation index (ODI), minimal SpO2 (MinSpO2) and mean SpO2 (MSpO2) compared to OS patients without PH. After adjusting for potential covariates, we found that MinSpO2 (OR 0.937, 95 % CI 0.882-0.994, P = 0.032), MSpO2 (OR 0.805, 95% CI 0.682-0.949, P = 0.010), time spent with SpO2 <90% (OR 1.422, 95% CI 1.137-1.780, P = 0.002), and FEV1 % pred (OR 0.977, 95 % CI 0.962-0.993, P = 0.005) were related to the development of PH. CONCLUSIONS: Patients with OS showed higher prevalence of PH, along with higher PAWP, CVP and RAP. Worse nocturnal hypoxemia was found in OS patients with PH.


Asunto(s)
Hemodinámica , Hipertensión Pulmonar , Enfermedad Pulmonar Obstructiva Crónica , Apnea Obstructiva del Sueño , Humanos , Hipertensión Pulmonar/fisiopatología , Hipertensión Pulmonar/etiología , Masculino , Femenino , Apnea Obstructiva del Sueño/fisiopatología , Apnea Obstructiva del Sueño/complicaciones , Apnea Obstructiva del Sueño/epidemiología , Persona de Mediana Edad , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Estudios Retrospectivos , Anciano , Cateterismo Cardíaco
7.
J Thorac Dis ; 16(1): 51-64, 2024 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-38410615

RESUMEN

Background: Transthoracic echocardiography (TTE) is recommended as the most important noninvasive screening tool for the diagnosis of pulmonary hypertension (PH), sonographers usually measure the volume of regurgitant flow rather than evaluating the spectral quality, so physicians will determine whether the ultrasound measurements of pulmonary arterial systolic pressure (US-PASP) are reliable based on the volume of tricuspid regurgitation (TR). Therefore, for the first time, we grade the quality of TR spectrum (TRS) based on its integrity and clarity, aiming to assess clinical application value of different tricuspid regurgitant spectrum quality grades (TR-SQG), and investigate whether the accuracy of US-PASP is more trustworthy than TR. Methods: We retrospectively analyzed 108 patients with chronic thromboembolic PH (CTEPH) to compare the correlation and agreement between US-PASP and right heart catheterization measurements of PASP (RHC-PASP). TR area (TRA) and TRS were measured in each patient, and TR-SQG was performed. Results: The correlation coefficients between US-PASP and RHC-PASP were r=0.622 (P<0.001), r=0.754 (P<0.001), r=0.595 (P<0.001) in mild, moderate, severe TR, and r=0.301 (P=0.135), r=0.747 (P<0.001), r=0.739 (P<0.001), r=0.828 (P<0.001) in TR-SQG I-IV, respectively. Bland-Altman analysis revealed the mean biases of 5.05, 3.06, 7.62 mmHg in mild, moderate, severe TR, and -16.47, -8.07, 1.82, 6.09 mmHg in TR-SQG I-IV, respectively. In mild TR with the TR-SQG III and IV, the correlation coefficients between US-PASP and RHC-PASP were r=0.779 (P<0.001), intraclass correlation coefficient (ICC) =0.774, paired t-test P=0.160, respectively; and the consistency was significantly higher than that of mild TR without considering TR-SQG. In moderate TR with the TR-SQG III and IV, the r=0.749, ICC =0.746, paired t-test P=0.298 between US-PASP and RHC-PASP. Conclusions: The US-PASP with TR-SQG III or IV is trustworthy, and its accuracy and consistency are better than those predicted by the traditional severity of TR. The establishment of the ultrasound evaluation system of TR-SQG helps clinicians to judge whether the US-PASP is accurate, credible, and reliable.

8.
Sensors (Basel) ; 23(20)2023 Oct 16.
Artículo en Inglés | MEDLINE | ID: mdl-37896596

RESUMEN

The outreach of healthcare services is a challenge to remote areas with affected populations. Fortunately, remote health monitoring (RHM) has improved the hospital service quality and has proved its sustainable growth. However, the absence of security may breach the health insurance portability and accountability act (HIPAA), which has an exclusive set of rules for the privacy of medical data. Therefore, the goal of this work is to design and implement the adaptive Autonomous Protocol (AutoPro) on the patient's remote healthcare (RHC) monitoring data for the hospital using fully homomorphic encryption (FHE). The aim is to perform adaptive autonomous FHE computations on recent RHM data for providing health status reporting and maintaining the confidentiality of every patient. The autonomous protocol works independently within the group of prime hospital servers without the dependency on the third-party system. The adaptiveness of the protocol modes is based on the patient's affected level of slight, medium, and severe cases. Related applications are given as glucose monitoring for diabetes, digital blood pressure for stroke, pulse oximeter for COVID-19, electrocardiogram (ECG) for cardiac arrest, etc. The design for this work consists of an autonomous protocol, hospital servers combining multiple prime/local hospitals, and an algorithm based on fast fully homomorphic encryption over the torus (TFHE) library with a ring-variant by the Gentry, Sahai, and Waters (GSW) scheme. The concrete-ML model used within this work is trained using an open heart disease dataset from the UCI machine learning repository. Preprocessing is performed to recover the lost and incomplete data in the dataset. The concrete-ML model is evaluated both on the workstation and cloud server. Also, the FHE protocol is implemented on the AWS cloud network with performance details. The advantages entail providing confidentiality to the patient's data/report while saving the travel and waiting time for the hospital services. The patient's data will be completely confidential and can receive emergency services immediately. The FHE results show that the highest accuracy is achieved by support vector classification (SVC) of 88% and linear regression (LR) of 86% with the area under curve (AUC) of 91% and 90%, respectively. Ultimately, the FHE-based protocol presents a novel system that is successfully demonstrated on the cloud network.


Asunto(s)
Automonitorización de la Glucosa Sanguínea , Seguridad Computacional , Humanos , Glucemia , Confidencialidad , Privacidad , Atención a la Salud
9.
Catheter Cardiovasc Interv ; 102(6): 1105-1108, 2023 11.
Artículo en Inglés | MEDLINE | ID: mdl-37855191

RESUMEN

Intracardiac masses and specifically right atrial thrombi can be difficult to manage and carry a high mortality rate. Typically, surgical removal or mechanical thrombectomy can be performed though may not be suitable for all patients. We present a unique case of a sickle cell patient with a large pedunculated right atrial thrombus that was successfully extracted using the novel ONO Retrieval Device.


Asunto(s)
Fibrilación Atrial , Cardiopatías , Trombosis , Humanos , Trombectomía , Cardiopatías/diagnóstico por imagen , Cardiopatías/cirugía , Resultado del Tratamiento , Trombosis/diagnóstico por imagen , Trombosis/etiología , Trombosis/cirugía
10.
J Robot Surg ; 17(5): 2315-2321, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37341877

RESUMEN

Robotics facilitates the realization of intra-corporeal anastomosis during right hemicolectomy and allows extracting the operative specimen through a C-section, offering potential benefits in terms of post-operative recovery and incidence of incisional hernia. Therefore, we progressively implemented robotic right hemicolectomy (robRHC) in our centre, and would like to report our initial experience with the technique. Consecutive patients who underwent robRHC within a single centre were prospectively included. Variables related to patients' demographics, surgical procedures, post-operative recovery and pathological outcomes were collected. Sixty patients underwent robRHC in our centre. Indications for robRHC were colon cancer in 58 patients (96.7%) and polyps not amenable to endoscopic resection in 2 patients (3.3%). Fifty-eight patients underwent robRHC with D2 lymphadenectomy and central vessel ligation (96.7%), and two patients (3.3%) had robRHC associated with another procedure. All patients had intra-corporeal anastomosis. The mean ± operative time was of 200.4 ± 114.9 min. Two conversions (3.3%) to open surgery were performed. The mean ± SD length of stay was of 5.4 ± 3.8 days. Seven patients (11.7%) experienced a post-operative complication with a Clavien-Dindo score ≥ 2. Two patients (3.5%) had an anastomotic leak. The mean ± SD number of harvested lymph nodes was of 22.4 ± 7.6. All patients had negative pathological margins (R0 resection). To conclude, robotic RHC is a safe procedure, which can be implemented with satisfying peri- and post-operative outcomes. The potential benefits of the technique remain to be demonstrated by randomized controlled trials.


Asunto(s)
Neoplasias del Colon , Laparoscopía , Procedimientos Quirúrgicos Robotizados , Robótica , Humanos , Procedimientos Quirúrgicos Robotizados/métodos , Estudios Prospectivos , Resultado del Tratamiento , Colectomía/métodos , Neoplasias del Colon/cirugía , Neoplasias del Colon/patología , Laparoscopía/métodos , Estudios Retrospectivos
11.
Catheter Cardiovasc Interv ; 102(2): 375-380, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-37265045

RESUMEN

Rheumatic heart disease is among the common causes of cardiovascular morbidity in developing countries. Here we present the hemodynamic interplay of stenotic rhematic involvement of aortic, mitral, and tricuspid valves in a 35-year-old female. Though noninvasive imaging by echocardiography and doppler has taken the upper hand today, this case illustrates the crucial role of cardiac catheterization in understanding the hemodynamics and patient management of rheumatic multivalvular heart disease.


Asunto(s)
Estenosis de la Válvula Mitral , Cardiopatía Reumática , Femenino , Humanos , Adulto , Constricción Patológica , Resultado del Tratamiento , Hemodinámica , Ecocardiografía , Cardiopatía Reumática/diagnóstico por imagen , Estenosis de la Válvula Mitral/diagnóstico por imagen , Estenosis de la Válvula Mitral/etiología
12.
Exp Neurol ; 363: 114383, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-36921751

RESUMEN

Oxytocin receptor (OTR) activation at the spinal level produces antinociception. Some data suggest that central OTR activation enhances social interaction via an increase of endocannabinoids (eCB), but we do not know if this could occur at the spinal level, modulating pain transmission. Considering that oxytocin via OTR stimulates diacylglycerol formation, a key intermediate in synthesizing 2-arachidonylglycerol (2-AG), an eCB molecule, we sought to test the role of the eCB system on the spinal oxytocin-induced antinociception. Behavioral and electrophysiological experiments were conducted in naïve and formalin-treated (to induce long-term mechanical hypersensitivity) male Wistar rats. Intrathecal RHC 80267 injections, an inhibitor of the enzyme diacylglycerol lipase (thus, decreasing 2-AG formation), produces transient mechanical hypersensitivity, an effect unaltered by oxytocin but reversed by gabapentin. Similarly, in in vivo extracellular recordings of naïve spinal wide dynamic range cells, juxtacellular picoinjection of RHC 80267 increases the firing of nociceptive Aδ-, C-fibers, and post-discharge, an effect unaltered by oxytocin. Interestingly, in sensitized rats, oxytocin picoinjection reverses the RHC 80627-induced hyperactivity of Aδ-fibers (but not C- or post-discharge activity). In contrast, a sub-effective dose of JZL184 (a monoacylglycerol lipase inhibitor, thus favoring 2-AG levels), which does not have per se an antinociceptive effect in the formalin-induced hypernociception, the oxytocin-induced antinociception is boosted. Similarly, electrophysiological experiments suggest that juxtacellular JZL184 diminishes the neuronal firing of nociceptive fibers, and co-injection with oxytocin prolongs and enhances the antinociceptive effect. These data may imply that 2-AG formation may play a role in the spinal antinociception induced by oxytocin.


Asunto(s)
Endocannabinoides , Oxitocina , Ratas , Masculino , Animales , Humanos , Oxitocina/farmacología , Ratas Wistar , Cuidados Posteriores , Alta del Paciente , Receptores de Oxitocina , Fibras Nerviosas Amielínicas , Analgésicos/farmacología , Formaldehído
13.
J Pak Med Assoc ; 73(3): 677-680, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-36932781

RESUMEN

Choledochal Cyst (CC), also known as the biliary cyst, is one of the rare inherited anomalies of intrahepatic and/or extrahepatic biliary system characterised by varying degrees of cystic dilatation of the biliary tract without acute obstruction. The prevalence ranges from 1 in 13,000 people to 1 in 2 million people with preponderance in Asia1, particularly in Japan. Moreover, the presentation also varies in children and adults, and is usually vaguer and non-specific in adults. The prevalence is even lower in males, with female to male ratio being 3:1-4:12. We present here three cases of adult choledochal cysts excised in our surgical unit in the last five years. We discuss the aetiopathogenesis, presentation, diagnosis, surgical treatment, and complications of choledochal cysts based on the available literature. It is crucial to establish a multidisciplinary group of professionals, that comprises paediatric surgeons, pathologists, paediatric gastroenterologists, physiotherapists, nutritionists, oncologists, and radiologists, to get acceptable outcomes in diagnosing and treating children with choledochal cysts.


Asunto(s)
Quiste del Colédoco , Adulto , Niño , Humanos , Masculino , Femenino , Quiste del Colédoco/cirugía , Quiste del Colédoco/diagnóstico , Atención Terciaria de Salud , Resultado del Tratamiento
14.
Life (Basel) ; 13(1)2023 Jan 03.
Artículo en Inglés | MEDLINE | ID: mdl-36676077

RESUMEN

Exercise-induced pulmonary hypertension EIPH has been defined as an increase in mean pulmonary arterial pressure (mPAP) during exercise in otherwise normal values at rest. EIPH reflects heart and/or lung dysfunction and may precede the development of manifest pulmonary hypertension (PH) in a proportion of patients. It is also associated with decreased life expectancy in patients with heart failure with reduced ejection fraction (HFrEF) or left ventricle (LV) valvular diseases. Diastolic dysfunction exacerbated during exercise relates to increased LV filling pressure and left atrial pressure (LAP). In this context backward, transmitted pressure alone or accompanied with backward blood flow promotes EIPH. The gold standard of EIPH assessment remains the right heart catheterization during exercise, which is an accurate but invasive method. Alternatively, non-invasive diagnostic modalities include exercise stress echocardiography (ESE) and cardiopulmonary exercise testing (CPET). Both diagnostic tests are performed under gradually increasing physical stress using treadmill and ergo-cycling protocols. Escalating workload during the exercise is analogous to the physiological response to real exercise. The results of the latter techniques show good correlation with invasive measurements, but they suffer from lack of validation and cut-off value determination. Although it is not officially recommended, there are accumulated data supporting the importance of EIPH diagnosis in the assessment of other mild/subclinical or probably fatal diseases in patients with latent PH or heart failure or LV valvular disease, respectively. Nevertheless, larger, prospective studies are required to ensure its role in clinical practice.

15.
Curr Rheumatol Rev ; 19(2): 168-173, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36043727

RESUMEN

OBJECTIVE: Behçet's disease (BD) is a chronic inflammatory disease with multiple organ involvements. Although cardiac involvement is not common, it can increase patient morbidity and mortality and decrease life quality. In the present study, echocardiographic abnormalities in BD with no cardiac symptoms were investigated. METHODS: This cross-sectional descriptive-analytic study was performed on patients referred to Imam Reza Hospital in Mashhad from 2015 to 2018. The participants were divided into control and BD groups. Patients with BD were diagnosed based on ISG criteria. All participants underwent transthoracic echocardiography. Echocardiographic parameters were compared between BD and control groups. RESULTS: In this study, the severity of aortic (AR), mitral (MR), and tricuspid valve regurgitation (TR) was higher in BD than in the control group, while only TR severity showed a statistically significant difference (p-value < 0.001). Systolic Pulmonary Artery Pressure (sPAP) was significantly higher in BD compared to the control group (24.6 mmHg versus 22.81 mmHg, respectively) (pvalue = 0.019). CONCLUSION: It seems echocardiography is valuable in evaluating a cardiac function, even in asymptomatic patients. Cases with moderate mitral and aortic regurgitation were only observed in BD. Long-term follow-up is suggested, and further studies are required.


Asunto(s)
Síndrome de Behçet , Insuficiencia de la Válvula Tricúspide , Humanos , Síndrome de Behçet/diagnóstico por imagen , Estudios Transversales , Ecocardiografía
16.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-1004881

RESUMEN

【Objective】 To prove the necessity of precise red blood cell transfusion by studying the frequency of double population of Rh blood group C and E antigen after allogeneic red blood cell transfusion in our hospital and its influence on blood transfusion efficacy. 【Methods】 From June 2021 to March 2022, 296 blood recipients, transfused with ABO homogeneous but RhC/E phenotypes unknown 2U-RBC suspension, were enrolled from Beijing Jishuitan Hospital, and the ABO, RhD, RhC, RhE blood type before transfusion and double population frequency of C and E antigens after transfusion were detected. Patients with RhC and E not changed in comparison with pre-transfusion were set as group A(n=135), with RhC becoming double population as group B (n=18), with RhE becoming double population as group C (n=116), and with both RhC and RhE changed to double population as group D(n=27). The levels of red blood cell (RBC), haemoglobin (Hb) and hematocrit (HCT) before and after blood transfusion were compared among the four groups. 【Results】 The negative rates of RhD, RhC and RhE in 296 patients were 0.34%(1/296), 20.27%(60/296) and 67.57%(200/296), respectively. There were 17 cases out of positive screening for unexpected antibodies, among which 7 cases were of anti-E, with the highest proportion. After RBCs transfusion, the double population frequencies of C and E antigens were 15.20%(45/296) and 48.31%(143/296), respectively. The levels of RBC, Hb and HCT in group A, B, C and D were significantly increased, and the difference was statistically significant (P group C > group B> group D. 【Conclusion】 The Rh blood group C and E antigen double population has an significant influence on the efficacy of blood transfusion.

17.
JACC Asia ; 2(3): 235-243, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-36338398

RESUMEN

Background: The time-velocity integral of the left ventricular outflow tract (TVILVOT) has been demonstrated to correlate with heart failure hospitalization and mortality, but the association of TVILVOT with the severity and prognosis of pulmonary arterial hypertension (PAH) has not been evaluated. Objectives: The aim of this study was to investigate the predictive value of baseline TVILVOT in PAH. Methods: A total of 225 consecutive patients with a diagnosis of incident PAH were prospectively studied and echocardiology-derived TVILVOT was measured at enrollment followed by right heart catheterization examination within 48 hours. Cox proportional hazards analysis was performed to assess the association between baseline variables and mortality. Results: During a median follow-up period of 33.8 months, 44 patients died of cardiovascular events. Baseline TVILVOT was significantly lower in the nonsurvivors compared with the survivors (P < 0.001). Baseline TVILVOT was positively correlated with stroke volume obtained by right heart catheterization (r = 0.709; P < 0.001), and inversely correlated with N-terminal pro-B-type natriuretic peptide (r = -0.533; P < 0.001), pulmonary vascular resistance (r = -0.423; P < 0.001). Multivariate analysis showed that baseline TVILVOT (hazard ratio: 0.856; 95% CI: 0.780-0.941; P = 0.001) was an independent predictor of cardiovascular mortality in PAH. Patients with a baseline TVILVOT <17.1 cm (median value) had a significantly worse survival than those with a baseline TVILVOT ≥17.1 cm (P < 0.001). Conclusions: The findings of this study suggest that noninvasive TVILVOT provides a practical method to assess the severity and predict long-term outcome of PAH.

18.
JACC Asia ; 2(3): 218-234, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-36338410

RESUMEN

Pulmonary hypertension (PH) is a progressive and severe disorder in pulmonary hemodynamics. PH can be fatal if not well managed. Fibrosing mediastinitis (FM) is a rare and benign fibroproliferative disease in the mediastinum, which may lead to pulmonary vessel compression and PH. PH caused by FM (PH-FM) is a pathologic condition belonging to group 5 in the World Health Organization PH classification. PH-FM has a poor prognosis because of a lack of effective therapeutic modalities and inappropriate diagnosis. With the development of percutaneous pulmonary vascular interventional therapy, the prognosis of PH-FM has been greatly improved in recent years. This article provides a comprehensive review on the epidemiology, pathophysiologic characteristics, clinical manifestations, diagnostic approaches, and treatment modalities of PH-FM based on data from published reports and our medical center with the goal of facilitating the diagnosis and treatment of this fatal disease.

19.
Data Brief ; 45: 108620, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36426024

RESUMEN

Secondary amines play a very important role in today's chemical industry owing to their extensive applications in agricultural, pharmaceutical, textile, polymer and in personal care fields [1] Unfortunately, most of the amine synthesis processes at the industrial level are fossil-based and imply economic and environmental problems. However, the heterogeneously catalyzed reductive amination of lignin-derived phenolics has been recognized as an efficient and ecofriendly method for the synthesis of primary or higher order amines [2]. In this sense, metal-supported catalysts, specifically palladium, and rhodium-based materials, have demonstrated their effectivity to produce secondary amines [3,4]. Therefore, there is a crescent interest in evaluating their roles within the reaction mechanisms by testing different reaction conditions and phenolics sources. Nevertheless, there is a lack of experimental data allowing to establish a correlation between the nature of the metallic clusters, the operational parameters, and steric effects of alkyl-phenolics with the activity and selectivity to amines. Accordingly, this dataset includes reliable experimental measurements on the use of Pd/C and Rh/C as catalysts for the reductive amination of phenols (RAPhs). A complete set of characterization techniques was applied to inspect the structural and textural properties of these materials which will allow its further correlation with the reaction performance. Therefore, data regarding transmission electron microscopy (TEM), High-resolution transmission electron microscopy (HR-TEM), scanning electron microscopy (SEM) with energy dispersive X-Ray analysis (EDX), X-ray diffraction (XRD) and specific surface area (BET) with pore size distribution (BJH) are provided here. Furtheremore, experimental data on the catalytic activity (in batch and/or dynamic modes) under different reaction conditions (phenol concentration, amine concentration, hydrogen pressure, temperature and alkyl-substituted phenols) are also included in the dataset. The data provided here could support the understanding on the role of active sites nature (Pd or Rh), the effect of operational parameters and the reactivity order for substituted phenols on the aforementioned reaction. Finally, we have included a sample datasheet which could aid the reader to perform preliminary kinetic analysis using the provided dataset.

20.
JACC Case Rep ; 4(21): 1439-1442, 2022 Nov 02.
Artículo en Inglés | MEDLINE | ID: mdl-36388711

RESUMEN

We report the case of a 37-year-old man who presented with shortness of breath 1 year post heart transplantation. He was receiving tacrolimus, methylprednisolone, and mycophenolate. An angiogram showed spontaneous coronary artery dissection involving the left anterior descending artery. Percutaneous coronary intervention was performed successfully, with stent placement and return of flow. (Level of Difficulty: Advanced.).

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