P wave duration and dispersion in Holter electrocardiography of patients with obstructive sleep apnea.

PURPOSE: The underlying mechanisms of the association between obstructive sleep apnea (OSA) and atrial fibrillation (AF) remained unclear. We investigated P wave parameters as indicators of atrial conduction status among OSA patients. METHODS: We studied 42 untreated OSA patients, categorized into mild (6), moderate (18), and severe (18) OSA based on the apnea/hypopnea index (AHI) and 18 healthy controls. Twenty-four-hour Holter electrocardiography was applied to measure P wave parameters including P wave duration and P wave dispersion; difference between the maximum (P-max) and minimum (P-min) measured P wave duration. RESULTS: Mean P wave duration ranged from 110.2 ± 9.3 ms in mild OSA patients to 121.1 ± 15.4 ms in severe OSA patients and was 113.4 ± 10.0 ms in controls with no significant difference among the groups, P = 0.281. P wave dispersion and P-max were significantly longer in those with moderate OSA (68.0 ± 9.3 and 154.2 ± 9.3 ms) and those with severe OSA (71.6 ± 13.7 and 157.2 ± 13.3 ms) than controls (52.6 ± 15.3 and 142.1 ± 15.4 ms), P < 0.05. AHI was significantly correlated with P-max (r = 0.407, P = 0.012) and P wave dispersion (r = 0.431, P = 0.008). With linear regression analysis controlling for age, gender, and BMI, the AHI was independently associated with P wave dispersion (ß = 0.482, P = 0.002). CONCLUSIONS: Using Holter monitoring for measurement of P wave parameters, this study showed an association of OSA with prolonged P-max and P wave dispersion. These results indicate that patients with OSA have disturbances in atrial conduction associated with OSA severity. Repeating this study in a larger sample of patients is warranted.

RF catheter ablation of AVNRT in a patient with interrupted inferior vena cava anomaly with hemiazygos continuity with persistent left superior vena cava.

Intrahepatic interruption of the inferior vena cava (IVC) with continued hemizygous is a very rare abnormality and sometimes it may be accompanied by other cardiovascular abnormalities. Continuation of the hemizygous vein draining into the right atrium through the left superior vena cava (LSVC) is much rarer. In this paper, we have presented a patient who had simultaneous IVC interrupted with persistent LSVC and suffered from Atrioventricular nodal reentrant tachycardia (AVNRT). Finally, radiofrequencies (RF) catheter ablation for AVNRT was successfully performed through a left subclavian vein access.

Retraction: Synthesis and characterization of AFe2O4 (A: Ni, Co, Mg)-silica nanocomposites and their application for the removal of dibenzothiophene (DBT) by an adsorption process: kinetics, isotherms and experimental design.

[This retracts the article DOI: 10.1039/D1RA02780H.].

Correction: Synthesis and characterization of AFe2O4 (A: Ni, Co, Mg)-silica nanocomposites and their application for the removal of dibenzothiophene (DBT) by an adsorption process: kinetics, isotherms and experimental design.

[This corrects the article DOI: 10.1039/D1RA02780H.].

Perioperative Cardiac Troponin T and Risk of Postoperative Atrial Fibrillation in Coronary Artery Bypass Graft Surgery.

BACKGROUND: Postoperative atrial fibrillation (AF) is a common complication after cardiac surgery. We investigated whether perioperative cardiac troponin T (cTnT) is associated with the risk of AF after coronary artery bypass grafting (CABG). METHODS: Two thousand four hundred twenty-one patients with isolated CABG were studied. High sensitivity cTnT (hs-cTnT) was assessed before and then at 80 hour and 24 hour after the operation. Logistic regression models were applied to investigate the association of perioperative hs-cTnT with postoperative AF. The ROC curve analysis was applied to determine the optimal cutoff values. RESULTS: Postoperative AF was occurred in 356 (14.7%) patients. Age (adjusted odds ratio [ORs] 1.087-1.090), male gender (OR 1.390), left atrium size (ORs 1.055-1.111), on-pump coronary bypass (OR 1.561), and application of intra-aortic balloon pump (ORs 2.890-2.966) were independently associated with AF. Preoperative hs-cTnT was associated with AF in patients with off-pump coronary bypass (ORs 1.997-2.375). However, the area under the curve for preoperative hs-cTnT was 0.625 in this group. On-pump coronary bypass had major influence on postoperative hs-cTnT levels regardless of the occurrence of AF. CONCLUSIONS: Preoperative hs-cTnT level is associated with the risk of AF after isolated CABG in patients undergoing off-pump coronary bypass, but the accuracy of this biomarker is yet inadequate. Postoperative levels of hs-cTnT have no predictive value considering large influence by the surgical technique and the cardiac surgery itself. Therefore, perioperative hs-cTnT is not a clinically useful biomarker for predicting AF following CABG.

Synthesis of novel polymeric nanoparticles (methoxy-polyethylene glycol-chitosan/hyaluronic acid) containing 7-ethyl-10-hydroxycamptothecin for colon cancer therapy: in vitro, ex vivo and in vivo investigation.

The goal of the current study was to target 7-ethyl-10-hydroxycamptothecin (SN38) orally to colon tumours by synthesizing a targeting polymer. To achieve the optimum delivery for SN38, initially methoxy-polyethylene glycol (mPEG)-chitosan was synthesized and then nanoparticles were developed through ionic gelation between mPEG-chitosan and hyaluronic acid as a ligand for cell-surface glycoprotein CD44 receptor. The SN38 was loaded in nanoparticles (SN38-NPs) using the non-covalent physical adsorption method. The size of the optimized SN38-NPs was 226.7 nm, encapsulation efficiency was 89.23% and drug content was 7.98 ± 0.54% in the optimum formulation. The attachment of mPEG to chitosan was confirmed by proton nuclear magnetic resonance. The results of differential scanning calorimetry and Fourier transforms infra-red analysis indicated that SN38 existed in amorphous form and functional groups of SN38 protected in the formulations which could be a sign of suitable encapsulation of SN38 in SN38-NPs. In vitro study indicated that SN38-NPs were more potent against the cancer cells than free SN38. The cellular uptake of SN38-NPs improved up to 1.6-fold against human colorectal adenocarcinoma (Caco-2) cells. Moreover, SN38-NPs remarkably demonstrated superior anti-tumor efficacy in contrary to pure SN38. This suggests the advantage of SN38-NPs as a potent oral drug carrier which could be further explored for clinical investigations.

A new phase transfer nanocatalyst NiFe2O4-PEG for removal of dibenzothiophene by an ultrasound assisted oxidative process: kinetics, thermodynamic study and experimental design.

In this study, NiFe2O4-PEG, an effective nanocatalyst was synthesized via a hydrothermal method using different PEG concentrations and synthesis times. The synthesized nanocatalyst was used in the ultrasound assisted oxidative desulfurization (UAOD) of model fuels (e.g. n-hexane and dibenzothiophene (DBT)) for the first time. The nanocatalyst was then characterized by XRD, FTIR, BET, SEM, VSM and TEM analyses. In addition, central composite design was used to evaluate the effective variables on the UAOD process. The optimal values of effective factors such as catalyst dose, oxidant amount, irradiation time and ultrasonic power to maximize of the percentage of sulfur removal were 0.149 g, 15 mL, 11.96 min, and 70 MHz, respectively. Moreover, the kinetic aspects of the oxidation reaction of DBT in the UAOD process were investigated using a pseudo-first-order model. Furthermore, using the Arrhenius equation, an activation energy of 35.86 kJ mol-1 was obtained. Additionally, thermodynamic analysis showed that the oxidation reaction of DBT was endothermic with a positive Gibbs free of energy, indicating the non-spontaneity of oxidation of DBT in the UAOD process. Moreover, the conversion rate of DBT has increased from 57% at 35 °C to 85% at 65 °C.

Synthesis and characterization of AFe2O4 (A: Ni, Co, Mg)-silica nanocomposites and their application for the removal of dibenzothiophene (DBT) by an adsorption process: kinetics, isotherms and experimental design.

The kinetics, equilibrium, and statistical aspects of the sulfur removal process from hydrocarbon fuels by AFe2O4-silica nanocomposites (A: Ni, Mg, and Co) have been investigated in the present study. Nanocomposites were prepared via the auto-combustion sol-gel method and then employed in the adsorptive desulfurization (ADS) process. Next, the prepared samples were characterized by different analytical methods including XRD, SEM, TEM, FT-IR, TGA, and BET. The contributions of conventional parameters including adsorbent dosage and contact time were then studied by central composite design (CCD) under response surface methodology (RSM). Based on the statistical investigations, optimum conditions for ADS were an adsorbent dosage of 7.82 g per 50 ml of the model fuel and a contact time of 32 min. The adsorption amounts reached 38.6 mg g-1 for DBT. The quadratic model was applied for the analysis of variance. Based on the experimental data, the pseudo-first-order (PFO) model could explain the adsorption kinetics of the compounds. Furthermore, the Langmuir isotherm demonstrated considerable agreement with the experimental equilibrium data. According to the results, the NiFe2O4-SiO2 nanocomposite showed the best performance compared to other compounds. The sulfur removal efficiency increased from 63 to 94% upon increasing the NiFe2O4-SiO2 dosage from 3 to 9 g per 50 ml of the model fuel.

Zeta potential changing nanoemulsions based on a simple zwitterion.

HYPOTHESIS: Simple zwitterions used as auxiliary agents might have the potential to change the zeta potential of oil-in-water (o/w) nanoemulsions on the mucosa. EXPERIMENTS: The zwitterion phosphorylated tyramine (p-Tyr) was synthesized by phosphorylation of Boc-tyramine (Boc-Tyr) using phosphoryl chloride (POCl3). It was incorporated with 2% (m/v) in a self-emulsifying lipophilic phase comprising Captex 35, Cremophor EL, Capmul MCM and glycerol 85 at a ratio of 30:30:30:10 v/v. Phosphate release and resulting change in zeta potential were evaluated by incubating p-Tyr containing nanoemulsion with isolated intestinal alkaline phosphatase (AP). Mucus permeating behavior was evaluated across mucus obtained from porcine small intestinal mucosa. Subsequently, cellular uptake studies were accomplished on Caco-2 cells. FINDINGS: The p-Tyr loaded nanoemulsion exhibited a mean droplet size of 43 ± 1.7 nm and zeta potential of -8.40 mV. Phosphate moieties were rapidly cleaved from p-Tyr loaded nanoemulsions after incubation with isolated AP resulting in a shift in zeta potential from -8.40 mV to +1.2 mV. p-Tyr loaded nanoemulsion revealed a significantly (p ≤ 0.001) improved mucus permeation compared to the same nanoemulsion having been pre-treated with AP. Cellular uptake of the zeta potential changing oily droplets was 2.4-fold improved. Phosphorylated zwitterions seem to be an alternative to cationic surfactants and considered as promising auxiliary agents for zeta potential changing nanoemulsions.

Prediction of chlortetracycline adsorption on the Fe3O4 nanoparticle using molecular dynamics simulation.

Molecular dynamics (MD) simulation was applied to investigate the adsorption mechanism of chlortetracycline (CTC) antibiotic molecule as the aqueous pollutant on the Fe3O4 nanoparticle (NP). Two different NP sizes with a diameter of about 1.4 nm and 3.5 nm were selected. Initially, the stability of both NPs in water was investigated by calculating radial distribution function curves of NP atoms. Simulation results confirmed the stable crystallographic structures of both NPs. However, small NP induce greater structural stabilization. Then, CTC molecules were adsorbed on NPs surface in various pollutant concentrations. Electrostatic and hydrogen bond were the major types of interactions between CTC molecules and the adsorbent surface. CTC molecules formed a complex with NP surface from their amine side chains; while they were parallel to each other in their aromatic rings and π-π bond between two CTC molecules was formed. Diffusion rate of CTC molecules could predict the adsorption mechanism. At lower concentration of CTC, CTC molecules tend to adsorb on the NP surface. At these concentrations, the diffusion rate of CTC was high. By increasing the CTC concentration, the pollutant agglomeration was enhanced which decreased the diffusion rate. At this time, the surface of NP was saturated. In addition, the results of isotherm curves showed that CTC adsorption on small NPs could be defined with both Langmuir and Freundlich isotherm models, while Freundlich isotherm model was more appropriate for larger NPs. In conclusion, observations confirmed that MD simulation could successfully predict the behavior of CTC adsorption on the Fe3O4 NP surface. Communicated by Ramaswamy H. Sarma.

Angiotensin-converting enzyme gene polymorphism and the progression rate of focal segmental glomerulosclerosis in Iranian children.

AIM: Focal segmental glomerulosclerosis (FSGS) is one of the most common forms of glomerulonephritis leading to end-stage renal disease (ESRD). A few clinical and paraclinical factors are considered as contributing factors in progression rate. However, there are controversial reports on the relationship between ACE gene polymorphism and rapidity of progression of FSGS to ESRD in different populations. To elucidate this issue, we investigated the relationship between the insertion (I) and deletion (D) ACE gene polymorphism and rapidity of progression of FSGS to ESRD in Iranian children. METHODS: Forty-one children aged 1-18 years admitted to St AlZahra Hospital, Isfahan, and St Ali Asghar Hospital, Tehran, Iran, with idiopathic FSGS were enrolled. Renal death was defined as a glomerular filtration rate (GFR) of less than 50 mL/min per 1.73 m(2) or a decreased GFR to less than 50% compare to baseline. Reaching renal death in less or more than 2 years were labelled as rapid progressors (RP) or slow progressors (SP), respectively. Intron 16 of the ACE gene was amplified by the polymerase chain reaction technique. RESULTS: Twenty-eight patients were male and 13 were female. In 15 RP patients, the genotype distribution was 26.6% DD, 6.7% II and 66.7% ID. In 26 SP patients, the genotype was similar (38.6% DD, 7.6% II and 53.8% ID, P > 0.05). There were no statistically significant differences for ACE I/D gene polymorphism between the two groups of patients (P > 0.05). CONCLUSION: Our study revealed no correlation between ACE I/D gene polymorphism and rapidity of progression of FSGS to ESRD in Iranian children.

Performance of electrophysiologic study in an asymptomatic patient with type 2 intermittent Brugada syndrome: To do or not to do.

BACKGROUND: Brugada syndrome (BrS) is an inherited channelopathy, which is associated with sudden cardiac death due to rapid polymorphic VT or VF. There is no definite consensus regarding the management of asymptomatic patients. Some experts advocate close follow-up; others propose the programmed stimulation for risk stratification. We aimed to evaluate the benefit of complete atrial and ventricular stimulation in patients with BrS and palpitation. CASE PRESENTATION: A 30-year-old man was admitted to our hospital because of a family history of sudden cardiac death (SCD) at age less than 45 years. He complained of self-terminated episodes of palpitation with no history of syncope. Baseline ECG showed incomplete right bundle branch block (RBBB) and saddle-back-like ST deviation in V1. Flecainide challenge test (FCT) revealed Brugada pattern. Complete EPS was done for evaluation of VT/VF inducibility and probable concomitant supraventricular arrhythmias.Programmed atrial stimulation showed inducible typical slow-fast AVNRT with AH jump 75 msec. Successful slow pathway ablation was done. There was no inducible ventricular arrhythmia. CONCLUSIONS: Patients with drug-induced BrS, positive family history of SCD and also episodes of palpitation, benefit from complete EPS. However, ICD implementation is not recommended in asymptomatic patients with drug-induced BrS and negative EPS for ventricular stimulation.

The effects of beta-glucan rich oat bread on serum nitric oxide and vascular endothelial function in patients with hypercholesterolemia.

INTRODUCTION: Oats are high in soluble fibers and effective in reducing the risk of cardiovascular diseases (CVD). We assessed the effects of beta-glucan from oat bran on serum nitric oxide (NO) endothelial function in patients with hypercholesterolemia. METHOD: Sixty hypercholesterolemic patients were randomly divided to receive an experimental bread rich in beta-glucan from oat bran (intervention) or bread rich in wheat fiber (control) for four weeks. All subjects had the same diet for two-week baseline period and hypocaloric diet for four weeks of intervention. Serum NO concentration and flow-mediated dilation (FMD) were determined before and after the experiment. RESULTS: Mean age of the participants was 51.1 ± 9.3 years and 65% (n = 39) were female. After intervention, serum NO concentration increased by 50.2 ± 19.8 µmol/lit in the intervention group (P = 0.017), but no change was observed in the control group (17.5 ± 27.5 µmol/lit; P = 0.530). No change of FMD was observed in the intervention (0.48 ± 0.78%; P = 0.546) or in the control group (0.59 ± 0.92%; P = 0.533). CONCLUSION: Consumption of oat bread for four weeks increases serum NO concentration but has no effect on FMD. Further studies are warranted in this regard.