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1.
Arterioscler Thromb Vasc Biol ; 41(1): 390-400, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33176447

RESUMO

OBJECTIVE: The platelet phenotype in certain patients and clinical contexts may differ from healthy conditions. We evaluated platelet activation through specific receptors in healthy men and women, comparing this to patients presenting with ST-segment-elevation myocardial infarction and non-ST-segment-elevation myocardial infarction. Approach and Results: We identified independent predictors of platelet activation through certain receptors and a murine MI model further explored these findings. Platelets from healthy women and female mice are more reactive through PARs (protease-activated receptors) compared with platelets from men and male mice. Multivariate regression analyses revealed male sex and non-ST-segment-elevation myocardial infarction as independent predictors of enhanced PAR1 activation in human platelets. Platelet PAR1 signaling decreased in women and increased in men during MI which was the opposite of what was observed during healthy conditions. Similarly, in mice, thrombin-mediated platelet activation was greater in healthy females compared with males, and lesser in females compared with males at the time of MI. CONCLUSIONS: Sex-specific signaling in platelets seems to be a cross-species phenomenon. The divergent platelet phenotype in males and females at the time of MI suggests a sex-specific antiplatelet drug regimen should be prospectively evaluated.


Assuntos
Plaquetas/metabolismo , Infarto do Miocárdio sem Supradesnível do Segmento ST/sangue , Ativação Plaquetária , Receptor PAR-1/sangue , Infarto do Miocárdio com Supradesnível do Segmento ST/sangue , Idoso , Animais , Plaquetas/efeitos dos fármacos , Estudos de Casos e Controles , Modelos Animais de Doenças , Feminino , Humanos , Masculino , Camundongos Endogâmicos C57BL , Pessoa de Meia-Idade , Fenótipo , Ativação Plaquetária/efeitos dos fármacos , Fatores Sexuais , Transdução de Sinais , Trombina/farmacologia
2.
J Cardiovasc Electrophysiol ; 31(4): 860-867, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32048776

RESUMO

INTRODUCTION: The need for transvenous lead extractions due to cardiac implantable electronic device (CIED)-related infections continues to rise. Current guidelines recommend complete device removal in the setting of an active infection, which can be challenging in pacemaker-dependent patients. METHODS: We retrospectively reviewed all leadless pacemaker implants between January 2018 and November 2019 and identified a subset of patients who had undergone a concomitant CIED extraction in the setting of an active infection. Baseline characteristics, procedural details, and clinical follow-ups were recorded. RESULTS: Seventeen patients received a leadless pacemaker during the same procedure as the CIED extraction. There were no procedural complications. All patients were being treated for an active CIED infection at the time of the procedure. Fourteen patients (82.4%) were completely pacemaker-dependent and four patients (23.5%) had positive blood cultures at the time of the leadless pacemaker implantation. During a median follow-up of 143 days (interquartile range: 57, 181 days), there were no recurrent infections. CONCLUSION: Simultaneous leadless pacemaker implantation and CIED extraction are safe and feasible in the setting of an active infection. This strategy may be particularly useful in patients that are pacemaker-dependent.


Assuntos
Arritmias Cardíacas/terapia , Remoção de Dispositivo , Marca-Passo Artificial/efeitos adversos , Implantação de Prótese/instrumentação , Infecções Relacionadas à Prótese/cirurgia , Idoso , Idoso de 80 Anos ou mais , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/fisiopatologia , Remoção de Dispositivo/efeitos adversos , Feminino , Humanos , Masculino , Implantação de Prótese/efeitos adversos , Infecções Relacionadas à Prótese/diagnóstico , Infecções Relacionadas à Prótese/microbiologia , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento
3.
Bioresour Technol ; 337: 125490, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34320769

RESUMO

In the present study, starch-based potato peel waste biomass (PWB) was utilized as a potential substrate for hydrogen production via dark fermentation by the thermophillic amylase producing strain Parageobacillus thermoglucosidasius KCTC 33548. Supplementation of Fe3O4 nanoparticles (300 mg/L) led to a 4.15-fold increase in hydrogen production as compared to the control. The addition of optimized concentrations of both Fe3O4 nanoparticles (300 mg/L) and L-cysteine (250 mg/L) during hydrogen fermentation using pure starch and PWB generated maximum cumulative hydrogen yields of 167 and 71.9 mL with maximum production rates of 2.81 and 1.26 mL/h, respectively. Further, the correlation between Fe3O4 and the expression of hydrogenase isoforms and the related hydrogenase activity was explored. The possible mechanisms of the action of Fe3O4 on enhanced hydrogenase activity and hydrogen production was elucidated. To our knowledge, there are no such studies reported on enhanced hydrogen production from PWB in a single step.


Assuntos
Nanopartículas , Solanum tuberosum , Bacillaceae , Biomassa , Fermentação , Hidrogênio , Amido/metabolismo
4.
Circ Arrhythm Electrophysiol ; 13(6): e008662, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32347743

RESUMO

BACKGROUND: The novel SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is responsible for the global coronavirus disease 2019 pandemic. Small studies have shown a potential benefit of chloroquine/hydroxychloroquine±azithromycin for the treatment of coronavirus disease 2019. Use of these medications alone, or in combination, can lead to a prolongation of the QT interval, possibly increasing the risk of Torsade de pointes and sudden cardiac death. METHODS: Hospitalized patients treated with chloroquine/hydroxychloroquine±azithromycin from March 1 to the 23 at 3 hospitals within the Northwell Health system were included in this prospective, observational study. Serial assessments of the QT interval were performed. The primary outcome was QT prolongation resulting in Torsade de pointes. Secondary outcomes included QT prolongation, the need to prematurely discontinue any of the medications due to QT prolongation, and arrhythmogenic death. RESULTS: Two hundred one patients were treated for coronavirus disease 2019 with chloroquine/hydroxychloroquine. Ten patients (5.0%) received chloroquine, 191 (95.0%) received hydroxychloroquine, and 119 (59.2%) also received azithromycin. The primary outcome of torsade de pointes was not observed in the entire population. Baseline corrected QT interval intervals did not differ between patients treated with chloroquine/hydroxychloroquine (monotherapy group) versus those treated with combination group (chloroquine/hydroxychloroquine and azithromycin; 440.6±24.9 versus 439.9±24.7 ms, P=0.834). The maximum corrected QT interval during treatment was significantly longer in the combination group versus the monotherapy group (470.4±45.0 ms versus 453.3±37.0 ms, P=0.004). Seven patients (3.5%) required discontinuation of these medications due to corrected QT interval prolongation. No arrhythmogenic deaths were reported. CONCLUSIONS: In the largest reported cohort of coronavirus disease 2019 patients to date treated with chloroquine/hydroxychloroquine±azithromycin, no instances of Torsade de pointes, or arrhythmogenic death were reported. Although use of these medications resulted in QT prolongation, clinicians seldomly needed to discontinue therapy. Further study of the need for QT interval monitoring is needed before final recommendations can be made.


Assuntos
Arritmias Cardíacas/induzido quimicamente , Azitromicina/efeitos adversos , Betacoronavirus , Cloroquina/efeitos adversos , Infecções por Coronavirus/tratamento farmacológico , Eletrocardiografia/efeitos dos fármacos , Hidroxicloroquina/efeitos adversos , Pneumonia Viral/tratamento farmacológico , Antibacterianos/efeitos adversos , Antibacterianos/uso terapêutico , Antimaláricos/efeitos adversos , Antimaláricos/uso terapêutico , Arritmias Cardíacas/complicações , Arritmias Cardíacas/epidemiologia , Azitromicina/uso terapêutico , COVID-19 , Cloroquina/uso terapêutico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Quimioterapia Combinada , Seguimentos , Humanos , Hidroxicloroquina/uso terapêutico , Incidência , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Estudos Prospectivos , Fatores de Risco , SARS-CoV-2 , Estados Unidos/epidemiologia
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