Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 137
Filtrar
Mais filtros

Base de dados
País/Região como assunto
Tipo de documento
Intervalo de ano de publicação
1.
Appl Environ Microbiol ; : e0101424, 2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38953370

RESUMO

Bacterial and fungal copper radical oxidases (CROs) from Auxiliary Activity Family 5 (AA5) are implicated in morphogenesis and pathogenesis. The unique catalytic properties of CROs also make these enzymes attractive biocatalysts for the transformation of small molecules and biopolymers. Despite a recent increase in the number of characterized AA5 members, especially from subfamily 2 (AA5_2), the catalytic diversity of the family as a whole remains underexplored. In the present study, phylogenetic analysis guided the selection of six AA5_2 members from diverse fungi for recombinant expression in Komagataella pfaffii (syn. Pichia pastoris) and biochemical characterization in vitro. Five of the targets displayed predominant galactose 6-oxidase activity (EC 1.1.3.9), and one was a broad-specificity aryl alcohol oxidase (EC 1.1.3.7) with maximum activity on the platform chemical 5-hydroxymethyl furfural (EC 1.1.3.47). Sequence alignment comparing previously characterized AA5_2 members to those from this study indicated various amino acid substitutions at active site positions implicated in the modulation of specificity.IMPORTANCEEnzyme discovery and characterization underpin advances in microbial biology and the application of biocatalysts in industrial processes. On one hand, oxidative processes are central to fungal saprotrophy and pathogenesis. On the other hand, controlled oxidation of small molecules and (bio)polymers valorizes these compounds and introduces versatile functional groups for further modification. The biochemical characterization of six new copper radical oxidases further illuminates the catalytic diversity of these enzymes, which will inform future biological studies and biotechnological applications.

2.
3.
Emerg Infect Dis ; 29(5): 1002-1006, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-37015283

RESUMO

We analyzed 1,303 SARS-CoV-2 whole-genome sequences from Vietnam, and found the Alpha and Delta variants were responsible for a large nationwide outbreak of COVID-19 in 2021. The Delta variant was confined to the AY.57 lineage and caused >1.7 million infections and >32,000 deaths. Viral transmission was strongly affected by nonpharmaceutical interventions.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , SARS-CoV-2/genética , Vietnã/epidemiologia , Surtos de Doenças
4.
Artigo em Inglês | MEDLINE | ID: mdl-36617390

RESUMO

Chronic total occlusions with proximal cap ambiguity remains the most challenging to recanalize and are associated with higher failure rate. We describe the "power knuckle" technique, in which the subintimal space proximal to the proximal cap is safely entered with a knuckle wire supported by a microcatheter and an inflated balloon. The "power knuckle" can facilitate entry into the extraplaque space for subsequent antegrade dissection and re-entry.

5.
Catheter Cardiovasc Interv ; 102(5): 834-843, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37676010

RESUMO

BACKGROUND: There is limited data on the use of the balloon-assisted subintimal entry (BASE) technique in chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS: We analyzed the baseline clinical and angiographic characteristics and outcomes of 155 CTO PCIs that utilized the BASE technique at 31 US and non-US centers between 2016 and 2023. RESULTS: The BASE technique was used in 155 (7.9%) of 1968 antegrade dissection and re-entry (ADR) cases performed during the study period. The mean age was 66 ± 10 years, 88.9% of the patients were men, and the prevalence of diabetes (44.6%), hypertension (90.5%), and dyslipidemia (88.7%) was high. Compared with 1813 ADR cases that did not use BASE, the target vessel of the BASE cases was more commonly the RCA and less commonly the LAD. Lesions requiring BASE had longer occlusion length (42 ± 23 vs. 37 ± 23 mm, p = 0.011), higher Japanese CTO (J-CTO) (3.4 ± 1.0 vs. 3.0 ± 1.1, p < 0.001) and PROGRESS-CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention chronic total occlusion) (1.8 ± 1.0 vs. 1.5 ± 1.0, p = 0.008) scores, and were more likely to have proximal cap ambiguity, side branch at the proximal cap, blunt/no stump, moderate to severe calcification, and proximal tortuosity. Technical (71.6% vs. 75.5%, p = 0.334) and procedural success (71.6% vs. 72.8%, p = 0.821), as well as major adverse cardiac events (MACE) (1.3% vs. 4.1%, p = 0.124), were similar in ADR cases that used BASE and those that did not. CONCLUSIONS: The BASE technique is used in CTOs with longer occlusion length, higher J-CTO score, and more complex angiographic characteristics, and is associated with moderate success but also low MACE.


Assuntos
Oclusão Coronária , Intervenção Coronária Percutânea , Masculino , Humanos , Pessoa de Meia-Idade , Idoso , Feminino , Intervenção Coronária Percutânea/efeitos adversos , Intervenção Coronária Percutânea/métodos , Resultado do Tratamento , Estudos Prospectivos , Angiografia Coronária , Oclusão Coronária/diagnóstico por imagem , Oclusão Coronária/terapia , Oclusão Coronária/etiologia , Doença Crônica , Sistema de Registros , Fatores de Risco
6.
Phys Chem Chem Phys ; 25(29): 20015-20025, 2023 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-37461994

RESUMO

This work investigates the mixed site occupancy of aluminium and silicon atoms in the ß-AlFeSi phase. For this purpose, the six mixed Al/Si sites of the ß-AlFeSi structure were considered independent and alternatively substituted by Al or Si, thus generating 64 ordered structures or end-members. The enthalpy of formation of each end-member was calculated by DFT. These calculations allowed us to derive the enthalpy of mixing of the solid solution at 0 K, over a wide range of chemical compositions, from the Al-Fe binary system to the Si-Fe binary system. In addition, the heat capacities of the solid solution were determined using a Debye model based on the calculation of the elastic constants and the equation of state of each end-member. These heat capacity values were used along with the enthalpy of formation we calculated to determine the Gibbs free energies of all the end-members of the ß-AlFeSi structure. Finally, the configurational entropy of mixing from the Compound Energy Formalism (CEF) for the configurational entropy of mixing was subsequently used to calculate the occupation fractions of the Si sites on the Al sites of the ß-AlFeSi structure, at 300 K and 938 K, the latter being the thermal decomposition temperature of this compound. These original site occupancy data were used to quantify the chemical ordering of the solid solution and to compare different sublattice (SL) models. We thus highlight that the SL model of the ß-AlFeSi solution most commonly accepted in the literature generates considerable errors in its thermodynamic description, contrary to the model proposed in this paper, which is both simple and particularly accurate, consisting in merging the sites Al(1)-Al(6), the sites Al(2)-Al(3) as well as the sites Al(4)-Al(5).

7.
BMC Urol ; 23(1): 209, 2023 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-38104056

RESUMO

BACKGROUND: To investigate the regulatory role of microRNA (miR)-148a-3p in mouse corpus cavernous pericyte (MCPs)-derived extracellular vesicles (EVs) in the treatment of diabetes-induced erectile dysfunction (ED). METHODS: Mouse corpus cavernous tissue was used for MCP primary culture and EV isolation. Small-RNA sequencing analysis was performed to assess the type and content of miRs in MCPs-EVs. Four groups of mice were used: control nondiabetic mice and streptozotocin-induced diabetic mice receiving two intracavernous injections (days - 3 and 0) of phosphate buffered saline, MCPs-EVs transfected with reagent control, or MCPs-EVs transfected with a miR-148a-3p inhibitor. miR-148a-3p function in MCPs-EVs was evaluated by tube-formation assay, migration assay, TUNEL assay, intracavernous pressure, immunofluorescence staining, and Western blotting. RESULTS: We extracted EVs from MCPs, and small-RNA sequencing analysis showed miR-148a-3p enrichment in MCPs-EVs. Exogenous MCPs-EV administration effectively promoted mouse cavernous endothelial cell (MCECs) tube formation, migration, and proliferation, and reduced MCECs apoptosis under high-glucose conditions. These effects were significantly attenuated in miR-148a-3p-depleted MCPs-EVs, which were extracted after inhibiting miR-148a-3p expression in MCPs. Repetitive intracavernous injections of MCPs-EVs improved erectile function by inducing cavernous neurovascular regeneration in diabetic mice. Using online bioinformatics databases and luciferase report assays, we predicted that pyruvate dehydrogenase kinase-4 (PDK4) is a potential target gene of miR-148a-3p. CONCLUSIONS: Our findings provide new and reliable evidence that miR-148a-3p in MCPs-EVs significantly enhances cavernous neurovascular regeneration by inhibiting PDK4 expression in diabetic mice.


Assuntos
Diabetes Mellitus Experimental , Disfunção Erétil , Vesículas Extracelulares , MicroRNAs , Animais , Humanos , Masculino , Camundongos , Diabetes Mellitus Experimental/complicações , Diabetes Mellitus Experimental/metabolismo , Células Endoteliais , Disfunção Erétil/etiologia , Disfunção Erétil/terapia , MicroRNAs/genética , Pericitos , Regeneração
8.
Arch Environ Contam Toxicol ; 85(3): 229-244, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37017706

RESUMO

Stable isotope signatures (δ13C, δ15N) and trace elements (TEs) were analyzed from invertebrates and fish to assess food web structure and the biomagnification or biodilution of Cu, Pb, Cd, Zn, Mn, Cr, Hg and As in coastal waters of Ha Tinh Province, Central Vietnam. δ13C and δ15N values of purported food sources (sediments, phytoplankton, macroalgae, and zooplankton) ranged from -21.24 ± 0.39‰ to -16.72 ± 1.02‰ and from 3.02 ± 0.70‰ to 7.30 ± 0.42‰, respectively. The δ13C and δ15N values in invertebrates and fish ranged from -19.75 ± 0.10‰ to -18.68 ± 0.40‰, and from 7.02 ± 1.21‰ to 9.10 ± 0.29‰. The δ15N values showed that the food web structure could be divided into four trophic levels. The benthic invertebrates had significantly higher concentrations of Cu, Pb, Zn, Cd and As. Hg concentrations tended to accumulate higher in the crabs and fish. The biodilution of Pb, Cd, Zn, Cr was observed throughout the food web, whereas biomagnification was observed for Cr, Mn, and As in bivalves; Cd and Zn in gastropods; Pb, Cd, Zn, and As in crabs; Cd in prawns and Hg in fish.


Assuntos
Mercúrio , Oligoelementos , Poluentes Químicos da Água , Animais , Oligoelementos/análise , Cádmio , Vietnã , Chumbo , Poluentes Químicos da Água/análise , Isótopos de Nitrogênio/análise , Invertebrados , Peixes , Mercúrio/análise , Cadeia Alimentar , Monitoramento Ambiental
9.
Int J Mol Sci ; 24(3)2023 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-36769259

RESUMO

Severe vascular and nerve damage from diabetes is a leading cause of erectile dysfunction (ED) and poor response to oral phosphodiesterase 5 inhibitors. Argonaute 2 (Ago2), a catalytic engine in mammalian RNA interference, is involved in neurovascular regeneration under inflammatory conditions. In the present study, we report that Ago2 administration can effectively improve penile erection by enhancing cavernous endothelial cell angiogenesis and survival under diabetic conditions. We found that although Ago2 is highly expressed around blood vessels and nerves, it is significantly reduced in the penis tissue of diabetic mice. Exogenous administration of the Ago2 protein restored erectile function in diabetic mice by reducing reactive oxygen species production-signaling pathways (inducing eNOS Ser1177/NF-κB Ser536 signaling) and improving cavernous endothelial angiogenesis, migration, and cell survival. Our study provides new evidence that Ago2 mediation may be a promising therapeutic strategy and a new approach for diabetic ED treatment.


Assuntos
Diabetes Mellitus Experimental , Diabetes Mellitus Tipo 1 , Disfunção Erétil , Animais , Humanos , Masculino , Camundongos , Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Tipo 1/metabolismo , Disfunção Erétil/tratamento farmacológico , Disfunção Erétil/etiologia , Mamíferos/metabolismo , Óxido Nítrico Sintase Tipo III/metabolismo , Ereção Peniana , Pênis/irrigação sanguínea , Espécies Reativas de Oxigênio/metabolismo , Estreptozocina/farmacologia
10.
BMC Microbiol ; 22(1): 41, 2022 02 03.
Artigo em Inglês | MEDLINE | ID: mdl-35114945

RESUMO

BACKGROUND: Amoxicillin-resistant Helicobacter pylori (H. pylori) strains seem to have increased over time in Vietnam. This threatens the effectiveness of H. pylori eradication therapies with this antibiotic. This study aimed to investigate the prevalence of primary resistance of H. pylori to amoxicillin and to assess its association with pbp1A point mutations in Vietnamese patients. MATERIALS AND METHODS: Naive patients who presented with dyspepsia undergoing upper gastrointestinal endoscopy were recruited. Rapid urease tests and PCR assays were used to diagnose H. pylori infection. Amoxicillin susceptibility was examined by E-tests. Molecular detection of the mutant pbp1A gene conferring amoxicillin resistance was carried out by real-time PCR followed by direct sequencing of the PCR products. Phylogenetic analyses were performed using the Tamura-Nei genetic distance model and the neighbor-joining tree building method. RESULTS: There were 308 patients (46.1% men and 53.9% women, p = 0.190) with H. pylori infection. The mean age of the patients was 40.5 ± 11.4 years, ranging from 18 to 74 years old. The E-test was used to determine the susceptibility to amoxicillin (minimum inhibitory concentration (MIC) ≤ 0.125 µg/ml) in 101 isolates, among which the rate of primarily resistant strains to amoxicillin was 25.7%. Then, 270 sequences of pbp1A gene fragments were analysed. There were 77 amino acid substitution positions investigated, spanning amino acids 310-596, with the proportion varying from 0.4 to 100%. Seven amino acid changes were significantly different between amoxicillin-sensitive (AmoxS) and amoxicillin-resistant (AmoxR) samples, including Phe366 to Leu (p <  0.001), Ser414 to Arg (p <  0.001), Glu/Asn464-465 (p = 0.009), Val469 to Met (p = 0.021), Phe473 to Val (p <  0.001), Asp479 to Glu (p = 0.044), and Ser/Ala/Gly595-596 (p = 0.001). Phylogenetic analyses suggested that other molecular mechanisms might contribute to amoxicillin resistance in H. pylori in addition to the alterations in PBP1A. CONCLUSIONS: We reported the emergence of amoxicillin-resistant Helicobacter pylori strains in Vietnam and new mutations statistically associated with this antimicrobial resistance. Additional studies are necessary to identify the mechanisms contributing to this resistance in Vietnam.


Assuntos
Substituição de Aminoácidos/genética , Amoxicilina/farmacologia , Antibacterianos/farmacologia , Resistência a Medicamentos/genética , Helicobacter pylori/efeitos dos fármacos , Helicobacter pylori/genética , Proteínas de Ligação às Penicilinas/genética , Mutação Puntual/genética , Adolescente , Adulto , Idoso , Proteínas de Bactérias/genética , Feminino , Trato Gastrointestinal/microbiologia , Trato Gastrointestinal/patologia , Infecções por Helicobacter/epidemiologia , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Vietnã/epidemiologia , Adulto Jovem
11.
Catheter Cardiovasc Interv ; 99(4): 1065-1073, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35077606

RESUMO

BACKGROUND: Chronic total occlusions (CTO) are common and are associated with lower percutaneous coronary intervention (PCI) success rates, often due to failure of antegrade guidewire crossing. Local, intralesional delivery of collagenase (MZ-004) may facilitate guidewire crossing in CTO. AIMS: To evaluate the effect of MZ-004 in facilitating antegrade wire crossing in CTO angioplasty. METHODS: A total of 76 patients undergoing CTO PCI were enrolled at 13 international sites: 38 in the randomized training stage (collagenase [MZ-004] 900 or 1200 µg) and 38 in the placebo-controlled stage (MZ-004 900 or 1200 µg or placebo). Patients received the MZ-004 or identical volume saline (placebo group) in a double-blind design, injected via microcatheter directly into the proximal cap of the CTO. The following day patients underwent CTO PCI using antegrade wire techniques only. RESULTS: Patients were generally similar except for a trend for higher Japanese chronic total occlusion (J-CTO) score in the MZ-004 group (MZ-004 J-CTO score 1.9 vs. 1.4, p = 0.07). There was a numerical increase in the rates of guidewire crossing in the MZ-004 groups compared to placebo (74% vs. 63%, p = 0.52). Guidewire crossing with a soft-tip guidewire (≤1.5 g tip load) was significantly higher in the MZ-004 groups (0% in placebo, 17% in 900 µg, and 29% in 1200 µg MZ-004 group, p = 0.03). Rates of the major adverse cardiovascular event were similar between groups. CONCLUSION: Local delivery of MZ-004 into coronary CTOs appears safe and may facilitate CTO crossing, particularly with softer tipped guidewires. These data support the development of a pivotal trial to further evaluate this agent.


Assuntos
Oclusão Coronária , Intervenção Coronária Percutânea , Doença Crônica , Colagenases , Angiografia Coronária/métodos , Oclusão Coronária/cirurgia , Oclusão Coronária/terapia , Vasos Coronários , Humanos , Intervenção Coronária Percutânea/efeitos adversos , Intervenção Coronária Percutânea/métodos , Resultado do Tratamento
12.
Sensors (Basel) ; 23(1)2022 Dec 24.
Artigo em Inglês | MEDLINE | ID: mdl-36616796

RESUMO

Speech emotion recognition (SER) is one of the most exciting topics many researchers have recently been involved in. Although much research has been conducted recently on this topic, emotion recognition via non-verbal speech (known as the vocal burst) is still sparse. The vocal burst is concise and has meaningless content, which is harder to deal with than verbal speech. Therefore, in this paper, we proposed a self-relation attention and temporal awareness (SRA-TA) module to tackle this problem with vocal bursts, which could capture the dependency in a long-term period and focus on the salient parts of the audio signal as well. Our proposed method contains three main stages. Firstly, the latent features are extracted using a self-supervised learning model from the raw audio signal and its Mel-spectrogram. After the SRA-TA module is utilized to capture the valuable information from latent features, all features are concatenated and fed into ten individual fully-connected layers to predict the scores of 10 emotions. Our proposed method achieves a mean concordance correlation coefficient (CCC) of 0.7295 on the test set, which achieves the first ranking of the high-dimensional emotion task in the 2022 ACII Affective Vocal Burst Workshop & Challenge.


Assuntos
Emoções , Percepção da Fala , Fala , Atenção
13.
Catheter Cardiovasc Interv ; 96(1): E98-E101, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-31584234

RESUMO

A controlled antegrade dissection and reentry technique is the most commonly employed crossing strategy for long coronary chronic total occlusions. The development of compressive hematoma is a recognized complication and results in the impairment of distal vessel visualization and hinders successful reentry attempts. We describe a novel technique utilizing a widely available microcatheter to decompress the subintimal hematoma to restore distal visualization and allow successful reentry.


Assuntos
Cateterismo Cardíaco/instrumentação , Cateteres Cardíacos , Oclusão Coronária/terapia , Hematoma/terapia , Intervenção Coronária Percutânea/instrumentação , Idoso de 80 Anos ou mais , Cateterismo Cardíaco/efeitos adversos , Doença Crônica , Oclusão Coronária/diagnóstico por imagem , Desenho de Equipamento , Hematoma/diagnóstico por imagem , Hematoma/etiologia , Humanos , Masculino , Miniaturização , Intervenção Coronária Percutânea/efeitos adversos , Resultado do Tratamento
14.
Sensors (Basel) ; 20(9)2020 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-32392858

RESUMO

Electric energy consumption forecasting is an interesting, challenging, and important issue in energy management and equipment efficiency improvement. Existing approaches are predictive models that have the ability to predict for a specific profile, i.e., a time series of a whole building or an individual household in a smart building. In practice, there are many profiles in each smart building, which leads to time-consuming and expensive system resources. Therefore, this study develops a robust framework for the Multiple Electric Energy Consumption forecasting (MEC) of a smart building using Transfer Learning and Long Short-Term Memory (TLL), the so-called MEC-TLL framework. In this framework, we first employ a k-means clustering algorithm to cluster the daily load demand of many profiles in the training set. In this phase, we also perform Silhouette analysis to specify the optimal number of clusters for the experimental datasets. Next, this study develops the MEC training algorithm, which utilizes a cluster-based strategy for transfer learning the Long Short-Term Memory models to reduce the computational time. Finally, extensive experiments are conducted to compare the computational time and different performance metrics for multiple electric energy consumption forecasting on two smart buildings in South Korea. The experimental results indicate that our proposed approach is capable of economical overheads while achieving superior performances. Therefore, the proposed approach can be applied effectively for intelligent energy management in smart buildings.

16.
Biotechnol Bioeng ; 115(2): 390-400, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29030961

RESUMO

Methods of producing medium-chain-length poly-3-hydroxyalkanoate (mcl-PHA) with high content of the dominant subunit, 3-hydroxydecanoate (HD), were examined with an emphasis on a high yield of polymer from decanoic acid. High HD content was achieved by using a ß-oxidation knockout mutant of Pseudomonas putida KT2440 (designated as P. putida DBA-F1) or by inhibiting ß-oxidation with addition of acrylic acid (Aa) to wild type P. putida KT2440 in carbon-limited, fed-batch fermentations. At a substrate feed ratio of decanoic acid and acetic acid to glucose (DAA:G) of 6:4 g/g, P. putida DBA-F1 accumulated significantly higher HD (97 mol%), but much lower biomass (8.5 g/L) and PHA (42% of dry biomass) than the wild type. Both biomass and PHA concentrations were improved by decreasing the ratio of DAA:G to 4:6. Moreover, when the substrate feed ratio was further decreased to 2:8, 18 g/L biomass containing 59% mcl-PHA consisting of 100 mol% HD was achieved. The yield of PHA from decanoic acid was 1.24 (g/g) indicating that de novo synthesis had contributed to production. Yeast extract and tryptone (YET) addition allowed the mutant strain to accumulate 74% mcl-PHA by weight with 97 mol% HD at a production rate of 0.41 g/L/hr, at least twice that of published data for any ß-oxidation knock-out mutant. Higher biomass concentration was achieved with Aa inhibition of ß-oxidation in the wild type but the HD content (84 mol%) was less than that of the mutant. A carbon balance showed a marked increase in supernantant organic carbon for the mutant indicating overflow metabolism. Increasing the dominant monomer content (HD) greatly increased melting point, crystallinity, and rate of crystallization.


Assuntos
Ácidos Decanoicos/metabolismo , Poli-Hidroxialcanoatos/análise , Poli-Hidroxialcanoatos/metabolismo , Pseudomonas putida/metabolismo , Reatores Biológicos/microbiologia , Ácidos Decanoicos/química , Oxirredução , Poli-Hidroxialcanoatos/química , Pseudomonas putida/genética
17.
Catheter Cardiovasc Interv ; 91(1): 53-56, 2018 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-29068125

RESUMO

Contemporary chronic total occlusion (CTO) percutaneous coronary interventional (PCI) techniques are increasingly dependent upon dissection and reentry techniques (DARTs) especially for long occluded lesions. DARTs can result in compressive hematomas during CTO interventions and traditional treatment with balloon angioplasty and/or coronary stenting are often suboptimal and may extend the hematoma distally. We describe the novel use of a cutting balloon to "express" these compressive hematomas and restore antegrade coronary blood flow.


Assuntos
Angioplastia Coronária com Balão/efeitos adversos , Angioplastia Coronária com Balão/instrumentação , Cateteres Cardíacos , Oclusão Coronária/cirurgia , Hematoma/cirurgia , Idoso , Doença Crônica , Angiografia Coronária , Circulação Coronária , Oclusão Coronária/diagnóstico por imagem , Oclusão Coronária/fisiopatologia , Stents Farmacológicos , Desenho de Equipamento , Hematoma/diagnóstico por imagem , Hematoma/etiologia , Humanos , Masculino , Resultado do Tratamento
18.
Catheter Cardiovasc Interv ; 91(4): 725-734, 2018 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-28303648

RESUMO

Despite improvements in guidewire technologies, the traditional antegrade wire escalation approach to chronic total occlusion (CTO) recanalization is successful in only 60-80% of selected cases. In particular, long, calcified, and tortuous occlusions are less successfully approached with a true-to-true lumen approach. Frequently, the guidewire tracks into the subadventitial space, with no guarantee of distal re-entry into the true lumen. The ability to manage the subadventitial space has been a key step in the tremendous improvement in success rates of contemporary CTO percutaneous coronary intervention (PCI), whether operating antegradely or retrogradely. A modern approach to CTO PCI involves understanding the concept of "vessel architecture," which is based on the distinction between coronary structures (occlusive plaque, comprising the disrupted intima and media, and the outer adventitia) and extravascular space. The vessel architecture represents a safe work environment for guidewire and device manipulation. This review provides an anatomy-based description of the concept of vessel architecture, along with a historical perspective of subadventitial techniques for CTO PCI, and outcome data of CTO PCI utilizing the subadventitial space. © 2017 Wiley Periodicals, Inc.


Assuntos
Túnica Adventícia/cirurgia , Oclusão Coronária/cirurgia , Vasos Coronários/cirurgia , Intervenção Coronária Percutânea/métodos , Túnica Adventícia/diagnóstico por imagem , Doença Crônica , Angiografia Coronária , Oclusão Coronária/diagnóstico por imagem , Vasos Coronários/diagnóstico por imagem , Humanos , Intervenção Coronária Percutânea/efeitos adversos , Complicações Pós-Operatórias/prevenção & controle , Fatores de Risco , Resultado do Tratamento
19.
Inorg Chem ; 56(3): 1152-1160, 2017 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-28161941

RESUMO

The subtle energetic differences underpinning adjacent lanthanide discrimination are explored with diglycolamide ligands. Our approach converges liquid-liquid extraction experiments with solution-phase X-ray absorption spectroscopy (XAS) and density functional theory (DFT) simulations, spanning the lanthanide series. The homoleptic [(DGA)3Ln]3+ complex was confirmed in the organic extractive solution by XAS, and this was modeled using DFT. An interplay between steric strain and coordination energies apparently gives rise to a nonlinear trend in discriminatory lanthanide ion complexation across the series. Our results highlight the importance of optimizing chelate molecular geometry to account for both coordination interactions and strain energies when designing new ligands for efficient adjacent lanthanide separation for rare-earth refining.

20.
J Antimicrob Chemother ; 71(3): 762-74, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26661398

RESUMO

BACKGROUND: There are limited data from resource-limited settings on antiretroviral resistance mutations that develop in patients failing second-line PI ART. METHODS: We performed a cross-sectional virological assessment of adults on second-line ART for ≥6 months between November 2006 and December 2011, followed by a prospective follow-up over 2 years of patients with virological failure (VF) at the Hospital for Tropical Diseases, Vietnam. VF was defined as HIV RNA concentrations ≥1000 copies/mL. Resistance mutations were identified by population sequencing of the pol gene and interpreted using the 2014 IAS-USA mutation list and the Stanford algorithm. Logistic regression modelling was performed to identify predictors of VF. RESULTS: Two hundred and thirty-one patients were enrolled in the study. The median age was 32 years; 81.0% were male, 95.7% were on a lopinavir/ritonavir-containing regimen and 22 (9.5%) patients had VF. Of the patients with VF, 14 (64%) carried at least one major protease mutation [median: 2 (IQR: 1-3)]; 13 (59%) had multiple protease mutations conferring intermediate- to high-level resistance to lopinavir/ritonavir. Mutations conferring cross-resistance to etravirine, rilpivirine, tipranavir and darunavir were identified in 55%, 55%, 45% and 27% of patients, respectively. Higher viral load, adherence <95% and previous indinavir use were independent predictors of VF. The 2 year outcomes of the patients maintained on lopinavir/ritonavir included: death, 7 (35%); worsening virological/immunological control, 6 (30%); and virological re-suppression, 5 (25%). Two patients were switched to raltegravir and darunavir/ritonavir with good HIV control. CONCLUSIONS: High-prevalence PI resistance was associated with previous indinavir exposure. Darunavir plus an integrase inhibitor and lamivudine might be a promising third-line regimen in Vietnam.


Assuntos
Terapia Antirretroviral de Alta Atividade/métodos , Farmacorresistência Viral , Infecções por HIV/tratamento farmacológico , Infecções por HIV/virologia , Inibidores da Protease de HIV/farmacologia , HIV-1/efeitos dos fármacos , Mutação , Adolescente , Adulto , Estudos Transversais , Feminino , Seguimentos , HIV-1/genética , HIV-1/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Falha de Tratamento , Vietnã , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA