Vertical transmission of maternal DNA through extracellular vesicles associates with altered embryo bioenergetics during the periconception period.

The transmission of DNA through extracellular vesicles (EVs) represents a novel genetic material transfer mechanism that may impact genome evolution and tumorigenesis. We aimed to investigate the potential for vertical DNA transmission within maternal endometrial EVs to the pre-implantation embryo and describe any effect on embryo bioenergetics. We discovered that the human endometrium secretes all three general subtypes of EV - apoptotic bodies (ABs), microvesicles (MVs), and exosomes (EXOs) - into the human endometrial fluid (EF) within the uterine cavity. EVs become uniformly secreted into the EF during the menstrual cycle, with the proportion of different EV populations remaining constant; however, MVs contain significantly higher levels of mitochondrial (mt)DNA than ABs or EXOs. During the window of implantation, MVs contain an eleven-fold higher level of mtDNA when compared to cells-of-origin within the receptive endometrium, which possesses a lower mtDNA content and displays the upregulated expression of mitophagy-related genes. Furthermore, we demonstrate the internalization of EV-derived nuclear-encoded (n)DNA/mtDNA by trophoblast cells of murine embryos, which associates with a reduction in mitochondrial respiration and ATP production. These findings suggest that the maternal endometrium suffers a reduction in mtDNA content during the preconceptional period, that nDNA/mtDNA become packaged into secreted EVs that the embryo uptakes, and that the transfer of DNA to the embryo within EVs occurs alongside the modulation of bioenergetics during implantation.

Nonlinearity measurement undergoing dispersion and loss.

Accurate knowledge of the nonlinear coefficient is extremely important to make reliable predictions about optical pulses propagating along waveguides. Nevertheless, determining this parameter when dispersion and loss are as important as nonlinear effects brings both theoretical and experimental challenges that have not yet been solved. A general method for measuring the nonlinear coefficient of waveguides under these demanding conditions is here derived and demonstrated experimentally in a kilometer-long standard silica fiber pumped close to 2 µm.

Bioactive or Drug-Eluting Stents in 75 Years or Older Patients: The BIODES-75 Registry.

BACKGROUND: TiNO-coated BAS have demonstrated competitive outcomes compared to drug-eluting stents (DES). These devices allow short antiplatelet regimens and may be a good option for the growing elderly population undergoing percutaneous coronary intervention (PCI). METHODS: Multicenter observational trial in routine clinical practice. A propensity-score matched analysis compared a prospective cohort of patients ≥ 75 years undergoing PCI with BAS, with a contemporary and retrospective cohort treated with last-generation DES. The co-primary endpoints of the study were the Target-Lesion-Failure (Cardiac death, non-fatal myocardial infarction, or target lesion revascularization) and Major Adverse Cardiovascular Events (total death, non-fatal myocardial infarction, stroke, or new revascularization) at 1 year. RESULTS: Whole population included 1000 patients, and 326 patients in each group were matched for analysis. No differences in primary endpoints were found: TLF 10.4% vs. 11% (HR 0.96 (Confidence Interval 95%, 0.36-1.7; p = 0.87)) and MACE 16.3% vs. 17.2% (HR 0.98 (Confidence Interval 95%; 0.3-1.5, p = 0.93)). Patients treated with BAS received shorter antiplatelets regimens (dual antiplatelet therapy at 1 year, 25.7% vs. 70.6%, p = 0.0001), and they presented lower incidence of bleeding (3.7% vs. 11.7%, HR 0.3 (IC 95% 0.16-0.6, p = 0.001)). CONCLUSION: In this real-life registry of patients ≥ 75 years, BAS were similar to the latest-generation DES in terms of efficacy and reduced the duration of the antithrombotic therapy, lowering bleeding events.

Recent Advances in Forward Brillouin Scattering: Sensor Applications.

In-fiber opto-mechanics based on forward Brillouin scattering has received increasing attention because it enables sensing the surrounding of the optical fiber. Optical fiber transverse acoustic resonances are sensitive to both the inner properties of the optical fiber and the external medium. A particularly efficient pump and probe technique-assisted by a fiber grating-can be exploited for the development of point sensors of only a few centimeters in length. When measuring the acoustic resonances, this technique provides the narrowest reported linewidths and a signal-to-noise ratio better than 40 dB. The longitudinal and transverse acoustic velocities-normalized with the fiber radius-can be determined with a relative error lower than 10-4, exploiting the derivation of accurate asymptotic expressions for the resonant frequencies. Using this technique, the Poisson's ratio of an optical fiber and its temperature dependence have been measured, reducing the relative error by a factor of 100 with respect to previously reported values. Using a single-point sensor, discriminative measurements of strain and temperature can be performed, achieving detection limits of ±25 µÎµ and ±0.2 °C. These results show the potential of this approach for the development of point sensors, which can be easily wavelength-multiplexed.

Resultados de la terapia dirigida por catéter en la tromboembolia pulmonar aguda / Results of catheter-directed therapy in acute pulmonary embolism

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Measurement of the soliton number in guiding media through continuum generation.

No general approach is available yet to measure directly the ratio between chromatic dispersion and the nonlinear coefficient, and hence the soliton number for a given optical pulse, in an arbitrary guiding medium. Here we solve this problem using continuum generation. We experimentally demonstrate our method in polarization-maintaining and single-mode fibers with positive and negative chromatic dispersion. Our technique also offers new opportunities to determine the chromatic dispersion of guiding media over a broad spectral range while pumping at a fixed wavelength.

Correction to: Double chimney stent technique in bilateral sequential coronary occlusion during corevalve valve-in-valve procedure.

This corrects the article DOI: 10.23736/S0026-4725.19.05064-3.

The Feasibility and Safety of Ambulatory Percutaneous Coronary Interventions in Complex Lesions.

BACKGROUND: The safety and feasibility of ambulatory PCI has been demonstrated in selected patients with "simple" lesions, but it is not well known whether it could be applied in more "complex" scenarios. METHODS: Main objective is to assess the feasibility and safety of ambulatory complex PCI. Prospective multicentre registry of 1047 consecutive patients planned for ambulatory trans-radial PCI. Outcomes in patients with "complex angioplasty" (CA group: 313 (30%)) were analysed and compared with those of "simple angioplasty" (SA group: 734, 70%). The feasibility (% of patients finally discharged) and safety (MACE at 24 h and at 1 month) were compared between groups. We also analyse admissions, visits to the emergency department and minor vascular complications. RESULTS: Feasibility was higher for SA (80.6% vs. 63.6%, OR 1.89, 95% CI 1.52-2.35, p < 0.001). Ambulatory PCI was very safe in both groups. In CA no MACE occurred at 24 h (vs. 0.17% SA) or 30 days (vs. 0.68% in SA). There were also no differences in re-admissions, visits to the emergency department or minor vascular complications (there was a non-significant tendency to higher rate of radial occlusion at 1 month in the CA group, 5.5% vs. 2.7%, p: 0.07). CONCLUSIONS: The feasibility of ambulatory PCI in selected patients with complex lesions is lower than in simple lesions, however when it is possible, it is as safe as in selected patients with simple lesions.

Theory about the Embryo Cryo-Treatment.

Background: To create hypothesis, which can give a logical explanation related to the benefits of freezing/thawing embryos. Cryopreservation is not only a technology used for storing embryos, but also a method of embryo treatment that can potentially improve the success rate in infertile couples. Methods: From the analysis of multiple results in assisted reproductive technology, which have no satisfactory explanation to date, we found evidence to support a 'therapeutic' effect of the freezing/thawing of embryos on the process of recovery of the embryo and its subsequent implantation. Results: Freezing/thawing is a way to activate the endogenous survival and repair responses in preimplantation embryos. Several molecular mechanisms can explain the higher success rate of ET using thawed embryos compared to fresh ET in women of advanced reproductive age, the higher miscarriage rate in cases of thawed blastocyst ET compared to thawed ET at early cleavage embryo, and the higher perinatal parameters of born children after thawed ET. Embryo thawing induces a stress. Controlled stress is not necessarily detrimental, because it generates a phenomenon that is counteracted by several known biological responses aimed to repair mitochondrial damage of membrane and protein misfolding. The term for favorable biological responses to low exposures to stress is called hormesis. Conclusions: This thesis will summarize the role of cryopreservation in the activation of a hormetic response, preserving the mitochondrial function, improving survival, and having an impact on the process of implantation, miscarriage, and the development of pregnancy.

Seguridad y factibilidad de la intervención coronaria percutánea ambulatoria en pacientes seleccionados: datos de un registro multicéntrico español / Safety and feasibility of outpatient percutaneous coronary intervention in selected patients: a Spanish multicenter registry

Introducción y objetivos: El aumento exponencial de la intervención coronaria y la generalización del acceso radial son el escenario ideal para iniciar programas de angioplastia ambulatoria con el objetivo de disminuir ocupación y reducir el coste manteniendo la seguridad. Se presentan por primera vez datos de un registro multicéntrico español sobre angioplastia transradial ambulatoria en pacientes seleccionados. Métodos: Registro prospectivo de angioplastia ambulatoria electiva con acceso radial-cubital en pacientes con cardiopatía isquémica estable. Los pacientes eran dados de alta el mismo día y se realizó seguimiento a las 24 h y a los 30 días. Se analizan la seguridad y la factibilidad. Resultados: De un total de 723 pacientes incluidos (el 76% varones; edad, 66,6 ± 10,5 años), a 533 (73,7%) se les dio finalmente el alta tras 4-12 h de vigilancia. El motivo más frecuente de ingreso entre los 190 (26,7%) restantes fue inestabilidad clínica tras el procedimiento (60,5%). El antecedente de arteriopatía periférica, un valor de creatinina basal más elevado, la realización del procedimiento ad hoc y sobre enfermedad multivaso fueron predictores independientes de ingreso. A las 24 h se registró un evento adverso mayor (0,19%) en 1 paciente que necesitó ingreso por hemorragia mayor no relacionada con el acceso vascular. A los 30 días se registraron 3 eventos mayores (0,56%), 1 trombosis subaguda de stent, 1 revascularización sobre un vaso diferente del tratado y 1 ictus minor. A los 30 días habían necesitado ingreso 8 pacientes (1,5%). Conclusiones: La aplicación de un programa de angioplastia ambulatoria transradial-cubital con alta tras 4-12 h de vigilancia es factible y segura en pacientes apropiadamente seleccionados (AU)

Introduction and objectives: The exponential increase in coronary interventions plus the generalization of the radial approach represent the ideal scenario for starting outpatient angioplasty programs with the aim of reducing the costs while maintaining safety. This article reports data from a multicenter Spanish registry on fully ambulatory transradial angioplasty in selected patients for the first time. Methods: Prospective registry of elective outpatient transradial-ulnar angioplasty in patients with stable coronary disease. Patients were discharged the same day and were followed up at 24 hours and 30 days. Safety and feasibility were analyzed. Results: Of the 723 patients included (76% male; age, 66.6 ± 10.5 years), 533 (73.7%) were finally discharged after 4 to 12 hours of surveillance. Among the remaining 190 (26.7%) patients, the most common reason for hospitalization was clinical instability after the procedure (60.5%). Independent predictors of admission were a history of peripheral artery disease, a higher baseline creatinine level, ad hoc performance of the procedure, and multivessel disease. At 24 hours, there was 1 major adverse event in 1 patient (0.19%), who required hospitalization for major bleeding not related to vascular access. At 30 days, there were 3 major adverse events (0.56%): 1 subacute stent thrombosis, 1 revascularization of a vessel other than the treated vessel, and 1 minor stroke. Eight patients (1.5%) required admission at 30 days. Conclusions: The application of an outpatient transradial-ulnar angioplasty program with discharge after 4 to 12 hours’ surveillance is safe and feasible in well-selected patients (AU)

Safety and Feasibility of Outpatient Percutaneous Coronary Intervention in Selected Patients: A Spanish Multicenter Registry.

INTRODUCTION AND OBJECTIVES: The exponential increase in coronary interventions plus the generalization of the radial approach represent the ideal scenario for starting outpatient angioplasty programs with the aim of reducing the costs while maintaining safety. This article reports data from a multicenter Spanish registry on fully ambulatory transradial angioplasty in selected patients for the first time. METHODS: Prospective registry of elective outpatient transradial-ulnar angioplasty in patients with stable coronary disease. Patients were discharged the same day and were followed up at 24hours and 30 days. Safety and feasibility were analyzed. RESULTS: Of the 723 patients included (76% male; age, 66.6±10.5 years), 533 (73.7%) were finally discharged after 4 to 12hours of surveillance. Among the remaining 190 (26.7%) patients, the most common reason for hospitalization was clinical instability after the procedure (60.5%). Independent predictors of admission were a history of peripheral artery disease, a higher baseline creatinine level, ad hoc performance of the procedure, and multivessel disease. At 24hours, there was 1 major adverse event in 1 patient (0.19%), who required hospitalization for major bleeding not related to vascular access. At 30 days, there were 3 major adverse events (0.56%): 1 subacute stent thrombosis, 1 revascularization of a vessel other than the treated vessel, and 1 minor stroke. Eight patients (1.5%) required admission at 30 days. CONCLUSIONS: The application of an outpatient transradial-ulnar angioplasty program with discharge after 4 to 12 hours' surveillance is safe and feasible in well-selected patients.

Safety of transradial diagnostic cardiac catheterization in patients under oral anticoagulant therapy.

BACKGROUND: Cardiac catheterization in anticoagulated patients is usually performed after the anticoagulation has been withdrawn, at least in the previous 48h, and sometimes bridging therapy with heparin is used. METHODS: A prospective observational study including 489 patients undergoing transradial catheterization was conducted. A total of 140 patients were under acenocoumarol (group A) and they were compared with the remainder (group B) for complications after the procedure (bleeding and vascular access complications). RESULTS: Patients in group A were older (74±12 years vs. 68±17 years, p<0.01) and the main indication for anticoagulation was atrial fibrillation (58.6%). No complications occurred during the procedures. There were no acute bleedings just after the bandage removal. During the first 24h, only 3 (2.1%) radial occlusions in group A and 2 (0.6%) in group B (p=0.14) were recorded. Hematomas between 5 and 10cm appeared in 5% of the group A vs. 4.6% in group B. During the 1-month follow-up period, one more radial occlusion in each group was recorded and there were 4 (1.1%) additional mild hematomas in group B and none in group A (p=0.48). CONCLUSIONS: Performing a transradial diagnostic cardiac catheterization without removal of the oral chronic anticoagulation appears safe in patients under acenocumarol therapy.

Incidencia y pronóstico de las complicaciones mecánicas del IAMCEST sometido a angioplastia primaria: datos de un registro unicéntrico de Código Infarto / Incidence and prognosis of mechanical complications of stemi after primary angioplasty: Data from a single-center registry of an infarction code program

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