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In the original publication [...].
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Drought stress in arid regions is a serious factor affecting yield quantity and quality of economic crops. Under drought conditions, the application of nano-elements and nano-agents of water retention improved the water use efficiency, growth performance, and yield quantity of drought-stressed plants. For this objective, two field experiments were performed and organized as randomized complete block designs with six replications. The treatments included kaolin (5 t. ha-1) bentonite (12.5 t. ha-1), perlite (1.25 t.ha-1), N-zeolite (1.3 L.ha-1), N-silicon (2.5 L.ha-1), and N-zinc (2.5 L.ha-1). The current study showed that the application of silicon, zinc, and zeolite nanoparticles only positively influenced the morphological, physiological, and biochemical properties of the drought-stressed coriander plant. Exogenous application of N-silicon, N-zinc, and N-zeolite recorded the higher growth parameters of drought-stressed plants; namely, plant fresh weight, plant dry weight, leaf area, and root length than all the other treatments in both seasons. The improvement ratio, on average for both seasons, reached 17.93, 17.93, and 18.85% for plant fresh weight, 73.46, 73.46, and 75.81% for plant dry weight, 3.65, 3.65, and 3.87% for leaf area, and 17.46, 17.46, and 17.16% for root length of drought-stressed plants treated with N-silicon, N-zinc, and N-zeolite, respectively. For physiological responses, the application of N-zeolite, N-silicon, and N-zinc significantly increased leaf chlorophyll content, photosynthetic rate, water use efficiency, chlorophyll fluorescence, and photosystem II efficiency compared with the control in both seasons, respectively. Similar results were observed in antioxidant compounds, nutrient accumulation, and phytohormones. In contrast, those treatments markedly reduced the value of transpiration rate, nonphotochemical quenching, MDA, ABA, and CAT compared to control plants. Regarding the seed and oil yield, higher seed and oil yields were recorded in drought-stressed plants treated with N-zeolite followed by N-silicon and N-zinc than all the other treatments. Application of N-zeolite, N-silicon and N-zinc could be a promising approach to improve plant growth and productivity as well as to alleviate the adverse impacts of drought stress on coriander plants in arid and semi-arid areas.
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With this research, we aimed to determine the impact of grafting and rootstock seed treated with Streptomyces griseus (MT210913) (S. griseus) or shikimic acid (SA) at a 60 ppm concentration on tomato (Solanum lycopersicum L.) production grown under low-temperature conditions. Two open-field trials were performed during both winter seasons of 2020 and 2021 at the Experimental Farm, Faculty of Agriculture, Cairo University, Giza, Egypt. A tomato cultivar (Peto 86) was used as a scion and two tomato phenotypes were employed as rootstocks (Solanum cheesmaniae L. (line LA 524) and GS hybrid), as well as self-grafted as a control. Effects of sub-optimal temperature on vegetative growth, yield, and fruit quality were tested. The results indicate that, under cold stress, rootstock seed priming, especially with S. griseus, enhanced plant growth, total yield, and fruit quality properties. GS hybrid rootstock was more effective than that of S. cheesmaniae rootstock in terms of mitigating the negative effect of cold stress. GS hybrid, inoculated with S. griseus, increased the total yield per plant by 10.5% and 5.7% in the first and second seasons, respectively. Higher levels of GA3 and mineral content were noticed in leaves that were grafted and treated with S. griseus compared to the control treatment. Additionally, the great enhancing effects of all anatomical features of tomato plants were recorded with GS hybrid rootstock, inoculated by S. griseus. These results prove that grafting on GS hybrid rootstock treated with S. griseus is a potential choice to alleviate the cold stress of commercial tomato varieties.
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The nonlinear optical properties of pure ZnO and Ni-doped ZnO thin films are explored using the Z-scan technique at different input laser intensities and an excitation wavelength of 750 nm by 100 fs laser pulses. The pure ZnO and Ni-doped ZnO thin films were prepared by radio frequency magnetron sputtering at room temperature. A scanning electron microscope equipped with energy-dispersive x-ray spectroscopy was used to measure the thickness and composition of the thin films, while a UV-visible spectrophotometer was used to measure the linear optical properties. The structure of the thin films was measured using x-ray diffraction. Saturable absorption (SA) was observed in the pure ZnO thin film, while Ni-doped ZnO illustrated a combination of SA and reverse SA (RSA). The nonlinear absorption coefficient (ß) and nonlinear refractive index (n2) of both pure ZnO and Ni-doped ZnO thin films were found to be input laser intensity dependent. As the input laser intensity increased, the nonlinear absorption coefficient and the nonlinear refractive index of both samples increased. An enhancement of two times in the nonlinear refractive index was observed for the Ni-doped ZnO thin film compared to the pure ZnO thin film. The optical limiting behavior of pure ZnO and Ni-doped ZnO thin films was investigated, and the data demonstrated that Ni-doped ZnO thin film is a good candidate for optical limiter applications due to the presence of strong RSA.
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Nano-fertilizers are a new tool that can be used to address plant production challenges, and it addresses such nutrient deficiencies through smart agriculture approaches. Iron (Fe) is a vital element for several metabolic and physiological processes; however, Fe deficiency is common in poorly fertile soils (sand soil) and in arid areas. Therefore, additional research is required to select the most efficient form of iron absorbance. This research was implemented on broad bean plants (Vicia faba L. var. major Harz) to examine the impact of three iron sources: nano-iron (FeNPs, T1), iron sulfate (T2), and chelated iron (T3) as a foliar spray on the morphological properties, physiological attributes, and nutritional status of these plants compared to the untreated plants (control). The obtained results showed that foliar spraying with FeNPs, chelated iron and sulphate iron fertilizers increased plant height by 35.01%, 26.2, and 20.4%; leaf area by 38.8%, 18.3%, and 8.1%; the fresh weight of the plant by 47%, 32.8%, and 7.3%; the dry weight of the plant by 52.9%, 37.3%, and 11.2%; and the number of branches by 47%, 31.3%, and 25.6 %, respectively, compared to the control treatment (CT). Furthermore, the application of FeNPs, chelated iron, and sulphate iron fertilizers improved the number of pods by 47.9%, 24.8%, and 6.1%; the number of seeds by 32.8%, 7.9%, and 2.8%; and seed weight by 20.8%, 9.1%, and 5.4%, compared to control treatment (CT). Additionally, foliar application of FeNPs showed the highest values of photosynthesis rate (Pn), water-use efficiency (WUE), total chlorophyll, and phytohormones (IAA, GA3) compared to all the other treatments. The anatomical structure revealed an enhancement of leaf size and thickness (epidermis cells and mesophyll tissue) affected by FeNPs treatment compared to other treatments. Foliar application of FeNPs also improved the total content of carbohydrates, crude protein, element content (N, P, K, Ca, Na, Fe, Zn, Mn, and Cu), and some amino acids such as lysine, arginine, phenylalanine, isoleucine, and tyrosine in the seeds of broad beans. Based on the above results, the maximum values of all tested measurements were observed when FeNPs were used as the foliar spraying followed by chelated and sulphate iron fertilizers. Therefore, these findings suggest that using FeNPs, as a foliar treatment, could be a promising strategy for reducing the Fe deficiency in sandy soil and enhancing plant growth, pod yield, and pod quality of broad bean plants in addition to being environmentally favored in arid areas.
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Frequent applications of synthetic insecticides might cause environmental pollution due to the high residue. In addition, increasing insecticide resistance in many insect pests requires novel pest control methods. Nanotechnology could be a promising field of modern agriculture, and is receiving considerable attention in the development of novel nano-agrochemicals, such as nanoinsectticides and nanofertilizers. This study assessed the effects of the lethal and sublethal concentrations of chlorantraniliprole, thiocyclam, and their nano-forms on the development, reproductive activity, oxidative stress enzyme activity, and DNA changes in the black cutworm, Agrotis ipsilon, at the molecular level. The results revealed that A. ipsilon larvae were more susceptible to the nano-forms than the regular forms of both nano chlorine and sulfur within the chlorantraniliprole and thiocyclam insecticides, respectively, with higher toxicities than the regular forms (ca. 3.86, and ca.2.06-fold, respectively). Significant differences in biological parameters, including developmental time and reproductive activity (fecundity and hatchability percent) were also observed. Correspondingly, increases in oxidative stress enzyme activities were observed, as were mutagenic effects on the genomic DNA of A. ipsilon after application of the LC50 of the nano-forms of both insecticides compared to the control. These promising results could represent a crucial step toward developing efficient nanoinsecticides for sustainable control of A. ipsilon.
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Lepidópteros , AnimaisRESUMO
AIM: To evaluate the ability to assess the coronary arteries using pre-procedural computed tomography (CT; high-pitch mode) in patients referred for transcatheter aortic valve implantation (TAVI). METHODS AND MATERIALS: CT and invasive coronary angiography (ICA) were performed pre-TAVI in 100 patients (46 women; 79 ± 5.9 years). CT was performed in prospectively ECG-triggered high-pitch mode after intravenous administration of 70 ml iodinated contrast medium. Image quality was assessed using a four-point scale (graded 0-3). Significant coronary artery stenosis (≥50% diameter) was graded as either present or absent by one observer and in one-third of patients by two observers independently. ICA was the standard of reference. Results were reported per segment and per patient. RESULTS: Twenty-two percent of patients had known coronary artery disease (CAD). In two cases, a coronary anomaly was detected. Diagnostic image quality (grade 1-3) was achieved in 30.3% of segments. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 75%, 80.5%, 16%, and 98.5%, respectively. Significant coronary stenosis could be ruled out completely in all segments in three patients. The interrater agreement per patient was excellent (kappa = 1). CONCLUSION: Relevant coronary findings can frequently be observed in high-pitch TAVI-planning CT. Despite the limitations of the technique and in patients referred to pre-TAVI evaluation (rapid heart rate, coronary calcifications, etc.), a valid evaluation of coronary arteries is possible in a considerable proportion of segments with a high NPV; however, few studies were completely free of motion artefacts to dependably exclude CAD using this technique in this challenging group of patients.
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Estenose da Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/cirurgia , Angiografia por Tomografia Computadorizada/métodos , Angiografia Coronária/métodos , Substituição da Valva Aórtica Transcateter , Idoso , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/cirurgia , Meios de Contraste , Eletrocardiografia , Feminino , Humanos , Masculino , Intensificação de Imagem Radiográfica/métodos , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
The Corona pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) calls on the Saudi government to take action to control the infection. The government closed borders, prohibited travel, limited outdoor movements, and told primary and secondary care facilities to reduce all regular non-urgent health services. It is not known whether these measures have impacted the prevalence of parasitic intestinal infections. This study has therefore been carried out to investigate this issue. Dataset of 217 stool samples submitted to the King Faisal Medical Complex (KFMC) Microbiology Laboratory in Taif, Saudi Arabia for parasitological examination during the pandemic (January-June 2020) and 649 samples submitted during the corresponding months of the previous year (January-June 2019) were extracted and analyzed. Overall, 24.1% (209/866) of samples were parasitespositives; 26.6% (173/649) before and 16.5% (36/217) during the pandemic, with 79% reduction. There was a significant difference in gender-parasitism between the two periods where the majority of parasitism were for males (p<0.001). Infections were frequent in patients aged 5- 14 years both before (84/649; 12.9%) and during (12/217; 5.5%) the pandemic, with significant difference observed between the two cohorts (p<0.002). Moreover, the majority of infected patients were non-Saudi (67.9%; 142/209), with a significant difference in nationality reported, (p=0.024). Protozoa were identified in 21.8% (189) of all samples investigated, of which, Blastocystis hominis, Entamoeba coli, Giardia lamblia, Entamoeba histolytica/dispar and Cryptosporidium species were identified in 6.1% (53), 5.4% (47), 5.0% (44), 2.8% (25), and 2.3% (20), respectively. Helminths were diagnosed in 2.3% (20/866) of samples. Eggs of hookworm, Ascaris, Taenia spp, and Hymenolepis nana were detected in 0.9% (8), 0.5% (5), 0.3% (3) and 0.4% (4), respectively. In parallel with our research hypothesis, a substantial decrease in the burden of intestinal parasitic infections was recorded with the lock-down measures taken during the Corona pandemic.
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COVID-19/terapia , Helmintíase/epidemiologia , Enteropatias Parasitárias/epidemiologia , Infecções por Protozoários/epidemiologia , Adolescente , Animais , COVID-19/epidemiologia , Criança , Pré-Escolar , Controle de Doenças Transmissíveis , Fezes/parasitologia , Feminino , Helmintos/isolamento & purificação , Humanos , Masculino , Estudos Retrospectivos , SARS-CoV-2 , Arábia Saudita/epidemiologiaRESUMO
In the present work, copper/chitosan nanocomposites (Cu/CS) were prepared in an aqueous solution in the presence of CS as stabilizer and CuSO4·5H2O precursor. The Cu/CS NPs formation was proved through transmission electron microscopy (TEM), Dynamic light scattering (DLS), Fourier Transform infrared (FT-IR) spectroscopy and XRD diffraction. Cotton and cotton/polyester fabrics were gamma-radiation grafted by padding to pickup of 100%, in nanocomposites based on Cu/CS NPs loaded in polymer blends of poly(vinyl alcohol) (PVA) and plasticized starch (PLST). The grafted fabrics were characterized in terms of tensile mechanical, crease recovery and water absorption properties. The results showed that cotton fabrics displayed higher water absorption (%) than cotton/polyester fabrics for all PVA/PLST compositions and water absorption was found to decrease with increasing the ratio of PVA in the PVA/PLST blends. Cotton/polyester fabrics displays crease recovery angle (CRA) value of 147.6 upon treated with PVA/PLST (80/20%) and gamma irradiated to 30 kGy compared to CRA value of 125.0 for cotton fabrics treated under the same conditions. For cotton fabrics, the tensile strength was largely depends on the irradiation dose, in which the tensile strength of the treated fabric with the different formulations is higher than the untreated fabric. The antimicrobial activity of the fabrics against gram-positive bacteria (Staphylococcus aurous) and gram-negative bacteria (Escherichia coli) was investigated. In case of gram-positive bacteria cotton fabric showed the highest impact, for both 50/50 and 20/80 PVA/PLST of 14 and 14.5 mm inhibition zone, whilst, cotton/polyester fabric recorded 6 and 5 mm inhibition zone against gram-negative bacteria for 50/50 and 20/80 PVA/PLST, respectively.
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Antibacterianos/farmacologia , Quitosana/química , Sulfato de Cobre/farmacologia , Fibra de Algodão , Raios gama , Nanocompostos , Poliésteres/química , Absorção Fisico-Química , Antibacterianos/química , Antibacterianos/efeitos da radiação , Quitosana/efeitos da radiação , Sulfato de Cobre/química , Sulfato de Cobre/efeitos da radiação , Fibra de Algodão/microbiologia , Fibra de Algodão/efeitos da radiação , Composição de Medicamentos , Escherichia coli/efeitos dos fármacos , Escherichia coli/crescimento & desenvolvimento , Poliésteres/efeitos da radiação , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/crescimento & desenvolvimento , Propriedades de Superfície , Resistência à Tração , Água/químicaRESUMO
@#The Corona pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARSCoV- 2) calls on the Saudi government to take action to control the infection. The government closed borders, prohibited travel, limited outdoor movements, and told primary and secondary care facilities to reduce all regular non-urgent health services. It is not known whether these measures have impacted the prevalence of parasitic intestinal infections. This study has therefore been carried out to investigate this issue. Dataset of 217 stool samples submitted to the King Faisal Medical Complex (KFMC) Microbiology Laboratory in Taif, Saudi Arabia for parasitological examination during the pandemic (January-June 2020) and 649 samples submitted during the corresponding months of the previous year (January-June 2019) were extracted and analyzed. Overall, 24.1% (209/866) of samples were parasitespositives; 26.6% (173/649) before and 16.5% (36/217) during the pandemic, with 79% reduction. There was a significant difference in gender-parasitism between the two periods where the majority of parasitism were for males (p<0.001). Infections were frequent in patients aged 5- 14 years both before (84/649; 12.9%) and during (12/217; 5.5%) the pandemic, with significant difference observed between the two cohorts (p<0.002). Moreover, the majority of infected patients were non-Saudi (67.9%; 142/209), with a significant difference in nationality reported, (p=0.024). Protozoa were identified in 21.8% (189) of all samples investigated, of which, Blastocystis hominis, Entamoeba coli, Giardia lamblia, Entamoeba histolytica/dispar and Cryptosporidium species were identified in 6.1% (53), 5.4% (47), 5.0% (44), 2.8% (25), and 2.3% (20), respectively. Helminths were diagnosed in 2.3% (20/866) of samples. Eggs of hookworm, Ascaris, Taenia spp, and Hymenolepis nana were detected in 0.9% (8), 0.5% (5), 0.3% (3) and 0.4% (4), respectively. In parallel with our research hypothesis, a substantial decrease in the burden of intestinal parasitic infections was recorded with the lock-down measures taken during the Corona pandemic.
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The authors P. Orellana and N. El-Haj were inadvertently deleted in the original paper.
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Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Serviço Hospitalar de Radiologia/normas , Cintilografia/normas , Betacoronavirus , COVID-19 , Infecções por Coronavirus/prevenção & controle , Equipamentos e Provisões/normas , Humanos , Medicina Nuclear/métodos , Medicina Nuclear/normas , Pandemias/prevenção & controle , Segurança do Paciente/normas , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto , SARS-CoV-2 , Organização Mundial da SaúdeRESUMO
Vibration-based structural health monitoring (SHM) for long-span bridges has become a dominant research topic in recent years. The Nam O Railway Bridge is a large-scale steel truss bridge located on the unique main rail track from the north to the south of Vietnam. An extensive vibration measurement campaign and model updating are extremely necessary to build a reliable model for health condition assessment and operational safety management of the bridge. The experimental measurements are carried out under ambient vibrations using piezoelectric sensors, and a finite element (FE) model is created in MATLAB to represent the physical behavior of the structure. By model updating, the discrepancies between the experimental and the numerical results are minimized. For the success of the model updating, the efficiency of the optimization algorithm is essential. Particle swarm optimization (PSO) algorithm and genetic algorithm (GA) are employed to update the unknown model parameters. The result shows that PSO not only provides a better accuracy between the numerical model and measurements, but also reduces the computational cost compared to GA. This study focuses on the stiffness conditions of typical joints of truss structures. According to the results, the assumption of semi-rigid joints (using rotational springs) can most accurately represent the dynamic characteristics of the truss bridge considered.
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The neutrophil gelatinase-associated lipocalin (NGAL) has been emerging as a novel biomarker of acute kidney injury while its value in lupus nephritis is uncertain. The aim of this study was to assess urinary NGAL levels as a marker for disease activity in patients with lupus nephritis.This study included 70 systemic lupus erythematosus (SLE) patients; 50 with active lupus nephritis (LN) and 20 without as well as 20 matched controls. The neutrophil gelatinase-associated lipocalin (NGAL) in both serum and urine samples was measured by enzyme-linked immunosorbent assay (ELISA). Patients with active LN received standard treatment then assessed for response as well as the value of urinary NGAL (uNGAL). Our results revealed that, The SLE patients with or without LN had an elevated urinary NGAL as compared to controls (p < 0.000) and the mean of uNGAL was (20.67 ± 5.34),(10.63 ± 3.53),(5.65 ± 2.49) respectively. Furthermore,Urinary NGAL levels in LN patients were significantly higher than those in non-LN patients (P < 0.0001). In the ROC curve analysis , the diagnostic performance of uNGAL for discriminating patients with nephritis from those without nephritis showed that the best cutoff value was 13.66 ng/ml ,sensitivity 92%,specificity 75%,area undercurve (0.959) and (P < 0.0001). Measurement of urinary NGAL levels showed an excellent diagnostic performance for discriminating patients with LN from SLE without nephritis.
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Lipocalina-2/urina , Nefrite Lúpica/urina , Adolescente , Adulto , Biomarcadores/urina , Estudos de Casos e Controles , Feminino , Humanos , Nefrite Lúpica/diagnóstico , Masculino , Curva ROC , Adulto JovemRESUMO
Gamma radiation was used to prepare blend hydrogels from poly(vinyl alcohol) (PVA) and low ratios of methylcellulose (MC). The structure-property behavior was characterized by IR spectroscopy, gel fraction, differential scanning calorimetry (DSC) and swelling at room temperature and different pH values. The PVA/MC hydrogels were used as a carrier for doxycycline hyclate (DOX-h) drug. The results showed that the gel fraction of PVA/MC hydrogels decreased greatly with increasing the ratio of MC in the initial feeding solution. The PVA/MC hydrogels displayed pH-sensitive swelling character. The drug uptake-release study indicated that PVA/MC hydrogels possessed controlled release behavior and that the release process depends on pH. In this respect, the release of DOX-h drug was significant in alkaline medium.
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Portadores de Fármacos/química , Portadores de Fármacos/síntese química , Hidrogéis/química , Hidrogéis/síntese química , Metilcelulose/química , Álcool de Polivinil/química , Técnicas de Química Sintética , Doxiciclina/química , Liberação Controlada de Fármacos , Raios gama , Concentração de Íons de Hidrogênio , RadioquímicaRESUMO
Over the last 60 years, the International Atomic Energy Agency (IAEA) has been working to introduce, expand and improve radiotherapy services, working with partners such as the World Health Organization (WHO) to improve cancer diagnosis, treatment, care and control through collective action in low- and middle-income countries (LMICs). The Lancet Oncology Commission on radiotherapy published a report that defined five calls for action to expand global access to radiotherapy, drawing on the previous work of the Global Taskforce on Radiotherapy for Cancer Control. The IAEA supports LMICs in the development of the required national infrastructure and regulatory authority for radiation and nuclear safety and in the training of human resources necessary for the provision of high-quality effective and safe radiation medicine services for the diagnosis, treatment and palliative care of cancer patients, helping in this way to address the different priorities outlined in the Lancet Commission report.
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Países em Desenvolvimento , Necessidades e Demandas de Serviços de Saúde , Radioterapia , Humanos , Agências Internacionais , Neoplasias/radioterapiaRESUMO
BACKGROUND: Cardiogenic shock remains the most serious complication of patients hospitalized with acute myocardial infarction (AMI). Early revascularization is the cornerstone of invasive therapy, while mechanical support with intra-aortic balloon pump (IABP) is debatable. From our institutional shock registry we sought to determine predictors of in-hospital mortality-including the aspect of IABP timing-and to develop a clinical risk score for shock patients with AMI. METHODS: From January 2005 till December 2010, 102 patients with cardiogenic shock due to AMI treated with primary percutaneous coronary intervention (PCI) and IABP were analyzed. Univariate and multivariate logistic regression analyses were used to identify independent predictors of in-hospital mortality. Logistic regression analysis and receiver-operating curves were used to generate a mortality risk score. RESULTS: The mean age of the cohort was 70.1 ± 11.0 years and 70 % were men. One third of patients had a non-ST segment elevation myocardial infarction and 30 % had to be resuscitated before coronary intervention. Mean left ventricular ejection fraction was 25 %. After admission, 23 % of patients developed an acute renal failure and 10 % needed renal dialysis during hospital stay. In 52 % of patients IABP therapy was initiated after primary PCI, while the remaining patients had an IABP-assisted primary PCI. All-cause in-hospital mortality was 40.2 %. Using multivariate analysis, age (odds ratio [OR] 1.08, p = 0.006), resuscitation before PCI (OR 3.46, p = 0.045), vasopressor use (OR 7.88, p = 0.003), acute renal failure (OR 11.18, p = 0.001), and IABP implantation after PCI (OR 4.36, p = 0.011) were independently associated with in-hospital mortality. Based on these predictors, a mortality-risk score was calculated as follows: 1.5 × IABP timing before PCI + 0.1 × age + resuscitation before PCI + 2 × vasopressor use + 2.5 × acute renal failure. Using a cut-off value of 10.4, this score had a specificity of 83 % and a sensitivity of 82 % for prediction of in-hospital death. CONCLUSIONS: We identified age, vasopressor use, resuscitation before PCI, acute renal failure and IABP implantation after PCI as independent predictors of in-hospital mortality in patients with cardiogenic shock due to AMI. The timing of IABP insertion was the only modifiable factor predicting in-hospital mortality in our cohort. Consequently, balloon pumping should be started before PCI to improve outcome of cardiogenic shock patients.
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Intervenção Coronária Percutânea , Choque Cardiogênico/mortalidade , Idoso , Idoso de 80 Anos ou mais , Feminino , Mortalidade Hospitalar , Humanos , Balão Intra-Aórtico , Masculino , Infarto do Miocárdio , Choque Cardiogênico/terapia , Resultado do TratamentoRESUMO
AIM: Significant aortic regurgitation (AR) has been reported in 20% of patients undergoing transfemoral aortic valve implantation (TAVI) and has been associated with increased mortality. Depending on the population included and the type of implanted prosthesis, several anatomical and procedural factors have been linked with increased risk of post-TAVI AR. While the impact of patients' gender on this complication, is still contradictory. We sought to assess the impact of patients' gender on the risk of significant AR after TAVI. METHODS: We included 323 consecutive patients (136 men) who underwent transfemoral implantation of either self-expandable or balloon-expandable prostheses for treatment of symptomatic aortic stenosis. RESULTS: After TAVI 52 patients (16.1%) had AR grade ≥ 2/4 as evaluated by angiography. They were more frequently male (59.6% vs. 40.4%, P = 0.005), received self-expandable (94.2% vs. 63.5%, P < 0.001) and bigger size prostheses (28 ± 1.9 vs. 27.3 ± 2.1 mm, P = 0.028) and had reduced left ventricular ejection fraction (45.3% ± 14.2% vs. 51.2% ± 13%, P = 0.003) compared to patients with AR grade < 2/4 (N. = 271). In multivariate analysis, men (OR 2.13 [95% CI, 1.08-4.18]) and prosthesis type (OR 13.17 [95% CI, 3.24-57.97]) were identified as independent predictors of AR grade ≥ 2/4. CONCLUSION: Alongside with the implantation of self-expandable aortic prosthesis, male gender independently increases the risk of significant AR in patients undergoing TAVI. The question if this finding is related to gender biology itself or to gender-related aggregation of subtle anatomic characteristics needs further investigations.