Optimisation of imaging protocols in interventional cardiology: impact on patient doses.

The purpose of this work is to evaluate the impact of the imaging protocol as part of the optimisation of patient doses in interventional cardiology. This paper reports the results of an initial study to refine the existing fluoroscopy and cine settings, evaluates a new imaging protocol by measuring the image quality and phantom entrance air kerma values, and tests the clinical implementation of the new protocol in terms of the reduction in patient doses and the impact on clinical images. The initial study developed a new fluoroscopy mode using 7.5 frames s-1 (instead of the previous 15 frames s-1) with a similar dose/frame and a reduction of approximately 26% in dose/frame for the existing standard cine mode. For the new imaging protocol, the reduction in entrance air kerma was characterised for water depths of 16, 20, and 24 cm and the image quality was evaluated using a Leeds test object. A reduction in dose of around 50% was observed for the low fluoroscopy mode and an 18%-38% reduction was measured for cine. The image quality was unchanged in fluoroscopy mode and did not suffer noticeable alterations in cine mode. In the clinical implementation, cardiologists evaluated the new imaging protocol in clinical practice and cooperated with medical physicists to ensure full optimisation. The image quality criteria evaluated the ability to visualise the standard coronary arteries and small vessels (<2 mm), and the proper visualisation of the heart and diaphragm. A total of 1635 interventional cardiac procedures were assessed. The median kerma-area product exhibited a reduction of 37% for CA and 43% for PTCA examinations, and the quality of the clinical images was considered sufficient for standard clinical practice.

Occupational dose reduction in cardiac catheterisation laboratory: a randomised trial using a shield drape placed on the patient.

The aim of this study was to evaluate the occupational radiation dose in interventional cardiology by using a shielding drape on the patient. A random study with and without the protective material was conducted. The following control parameters were registered: demographic data, number of stents, contrast media volume, fluoroscopy time, number of cine images, kerma-area product and cumulative air kerma. Occupational dose data were obtained by electronic active dosemeters. No statistically significant differences in the analysed control parameters were registered. The median dose value received by the interventional cardiologist was 50% lower in the group with a shielding drape with a statistically significant p-value <0.001. In addition, the median value of the maximum scatter radiation dose was 31% lower in this group with a statistically significant p-value <0.001. This study showed that a shielding drape is a useful tool for reducing the occupational radiation dose in a cardiac catheterisation laboratory.

Reduction of occupational radiation dose in staff at the cardiac catheterisation laboratory by protective material placed on the patient.

Reducing occupational radiation dose in cardiac catheterisation laboratories is one of the objectives of the radiation protection system because the procedures performed involve high levels of radiation compared with others in health care. Recommendations on protection methods used are referred to different structural types and personal protection tools. In this work, the effectiveness of a shielding drape above the patient in different geometric shapes for a standard procedure in interventional cardiology was evaluated. Values of personal dose equivalent Hp(10) obtained simultaneously with three active electronic semiconductor dosemeters located at the usual position of staff and at the C-arm have been used to show the usefulness of the shielding drape.

The TITAN-AMI multicenter registry evaluating the usage of Titan2 stent in patients with ST segment elevation myocardial infarction. Final result at 12-month follow-up.

AIM: Primary percutaneous coronary intervention with stent implantation is the recommended treatment for patients with ST elevation myocardial infarction (STEMI). Data from randomised trials showed good performance by a titanium-nitric-oxide coated stent in this context. The aim of this study was to confirm these data. METHODS: A multicentre registry was compiled in 23 hospitals in Spain in an all-comers population. We selected patients with STEMI from a global Titan AMI registry that included patients with acute coronary syndrome. Primary endpoint was the composite of cardiac death, non-fatal myocardial infarction, stent thrombosis and target lesion revascularisation, at 12-month follow-up. RESULTS: The study included 893 patients with STEMI. We included all possibilities for PCI: 86.6% primary, 5% facilitated after successful fibrinolysis and 8.4% rescue PCI after failed fibrinolysis. The primary endpoint was reached in 8.4% of the patients: cardiac death 2.7%, reinfarction 3.4%, target lesion revascularisation 3.5% and definite or probable stent thrombosis 2.8%. The majority of stent thromboses presented in the first 30 days after PCI. CONCLUSION: A bioactive stent (titanium-nitric-oxide coated stent) is a possible alternative for the treatment of patients with STEMI. One-year follow-up showed better results than those presented by a regular bare-metal stent or first-generation drug-eluting stent in terms of stent thrombosis.

Ultrasonic monitoring of malolactic fermentation in red wines.

The progress of malolactic fermentation in red wines has been monitored by using ultrasonic techniques. The evolution of ultrasonic velocity of a tone burst 1MHz longitudinal wave was measured, analyzed and compared to those parameters of oenological interest obtained simultaneously by analytical methods. Semi-industrial tanks were used during measurements pretending to be in real industrial conditions. Results showed that the ultrasonic velocity mainly changes as a result of the conversion by lactic acid bacteria of malic acid into lactic acid and CO2. Overall, the present study has demonstrated the potential of the ultrasonic technique in monitoring the malolactic fermentation process.

Antioxidant properties of sparkling wines produced with ß-glucanases and commercial yeast preparations.

UNLABELLED: The aim of this study was to evaluate the in vitro antioxidant potential of sparkling wines produced with ß-glucanases, autolysated yeasts, yeast cell walls, and purified mannoproteins. Total antioxidant capacity (measured by 2,2-diphenyl-1-picrylhydrazyl [DPPH] radical-scavenging method and ferric reducing antioxidant power [FRAP] assay), and hydroxyl radical-scavenging activity (HRSA) were higher in the wine samples with coadjuvants (in relation to the control wine). The highest values of antioxidant activity were achieved with purified mannoproteins and, in lesser extent, with ß-glucanases. Neutral polysaccharides and total proteins were highly and positively correlated with DPPH, FRAP, and HRSA assays. However, correlations between the levels of each different phenolic family and antioxidant and radical-scavenging activities were not found. ß-Glucanase and commercial yeast preparations can be excellent coadjuvants to increase the antioxidant properties of sparkling wines. PRACTICAL APPLICATION: ß-Glucanase and commercial yeast preparations can be excellent coadjuvants to increase the antioxidant properties of sparkling wines. The suggested improvement has significant implication for the production of high added value sparkling wines.

Ultrarapid quantitation of maize proteins by perfusion and monolithic reversed-phase high-performance liquid chromatography.

The main objective of this study was to develop a new methodology alternative to the classical Kjeldahl analysis for determining maize proteins in maize products and seeds. For that purpose, two different chromatographic methodologies using perfusion and monolithic stationary phases, both enabling rapid separations of maize proteins, were investigated. Due to the difficulty to find suitable standards for this type of analysis, three different maize products were initially tested as proteins standards: zein F4000, corn gluten meal, and maize flour. Different figures of merit (i.e., linearity, correlation coefficient, precision, limits of detection and quantitation), as well as the presence of matrix inferences, were investigated. The results obtained for the different chromatographic stationary phases and protein standards were compared in order to select the most suitable analytical conditions. Despite both perfusion and monolithic methodologies resulting, in general, as appropriate for the quantitation of maize proteins, the highest reduction of analysis time and lowest detection and determination limits provided by perfusion methodology enabled to select this one as the method of choice for the quantitation of maize proteins. Regarding the different protein standards studied in this work, in general the best results were obtained using the zein standard. Compared to Kjeldahl methodology, perfusion chromatography yields total protein contents in shorter analysis time while enabling the separation of the different kinds of proteins. Due to the high diversity and complexity of industrial maize products, the proposed chromatographic method could be a very useful tool for their routine analysis.

Estimation of the percentage of transgenic Bt maize in maize flour mixtures using perfusion and monolithic reversed-phase high-performance liquid chromatography and chemometric tools.

The estimation of the percentage of transgenic Bt maize in maize flour mixtures has been achieved in this work by high-performance liquid chromatography using perfusion and monolithic columns and chemometric analysis. Principal component analysis allowed a preliminary study of the data structure. Then, linear discriminant analysis was used to develop decision rules to classify samples in the established categories (percentages of transgenic Bt maize). Finally, linear regression (LR) and multivariate regression models (namely, principal component analysis regression (PCR), partial least squares regression (PLS-1), and multiple linear regression (MLR)) were assayed for the prediction of the percentages of transgenic Bt maize present in a maize flour mixture. Using the relative areas of the protein peaks, MLR provided the best models and was able to predict the percentage of transgenic Bt maize in flour mixtures with an error of ±5.3%, ±2.3%, and ±3.8% in the predictions of Aristis Bt, DKC6575, and PR33P67, respectively.

Influence of somatic cell count and breed on capillary electrophoretic protein profiles of ewes' milk: a chemometric study.

Bulk tank ewe milk from the Assaf, Castellana, and Churra breeds categorized into 3 somatic cell count (SCC) groups (<500,000; 1,000,000 to 1,500,000; and >2,500,000 cells/mL) was used to investigate changes in chemical composition and capillary electrophoresis protein profiles. The results obtained indicated that breed affected fat, protein, and total solids levels, and differences were also observed for the following milk proteins: beta-, beta1-, beta2-, and alpha(s1)-III-casein, alpha-lactalbumin, and beta-lactoglobulin. High SCC affected fat and protein contents and bacterial counts. The level of beta1-, beta2-, and alpha(s1)-I-casein, and alpha-lactalbumin were significantly lower in milk with SCC scores >2,500,000 cells/mL. A preliminary study of the chemical, microbiological, and electrophoretic data was performed by cluster analysis and principal components analysis. Applying discriminant analysis, it was possible to group the milk samples according to breed and level of SCC, obtaining a prediction of 100 and 97% of the samples, respectively.

Monolithic supports for the characterization of commercial maize products based on their chromatographic profile. Application of experimental design and classification techniques.

Modern analytical techniques based on the use of RP-HPLC with monolithic stationary phases and the application of experimental design and classification tools have been applied to the analysis of maize proteins. Solubilization conditions of maize proteins and separation conditions (temperature, detection wavelength, type and concentration of ion-pairing agent, and gradient) were optimized. The elution gradient was optimized by the application of experimental design techniques. The optimized method consisted of a linear binary gradient of water/acetonitrile/0.1% trifluoroacetic acid in three steps at a flow rate of 3 mL/min with a column temperature of 35 degrees C and UV detection at 280 nm. The developed method enabled the separation of maize proteins in an analysis time close to 8 min. Moreover, this is the first time that commercial maize products have been characterized by the use of multivariate classification techniques.

Development of a perfusion reversed-phase high performance liquid chromatography method for the characterisation of maize products using multivariate analysis.

A perfusion reversed-phase high performance liquid chromatography (RP-HPLC) method has been designed to allow rapid (3.4 min) separations of maize proteins with high resolution. Several factors, such as extraction conditions, temperature, detection wavelength and type and concentration of ion-pairing agent were optimised. A fine optimisation of the gradient elution was also performed by applying experimental design. Commercial maize products for human consumption (flours, precocked flours, fried snacks and extruded snacks) were characterised for the first time by perfusion RP-HPLC and their chromatographic profiles allowed a differentiation among products relating the different technological process used for their preparation. Furthermore, applying discriminant analysis makes it possible to group the samples according with the technological process suffered by maize products, obtaining a good prediction in 92% of the samples.