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1.
Sci Rep ; 14(1): 9138, 2024 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-38644366

RESUMO

Phosphorene is a unique semiconducting two-dimensional platform for enabling spintronic devices integrated with phosphorene nanoelectronics. Here, we have designed an all phosphorene lattice lateral spin valve device, conceived via patterned magnetic substituted atoms of 3d-block elements at both ends of a phosphorene nanoribbon acting as ferromagnetic electrodes in the spin valve. Through First-principles based calculations, we have extensively studied the spin-dependent transport characteristics of the new spin valve structures. Systematic exploration of the magnetoresistance (MR) of the spin valve for various substitutional atoms and bias voltage resulted in a phase diagram offering a colossal MR for V and Cr-substitutional atoms. Such MR can be directly attributed to their specific electronic structure, which can be further tuned by a gate voltage, for electric field controlled spin valves. The spin-dependent transport characteristics here reveal new features such as negative conductance oscillation and switching of the sign of MR due to change in the majority spin carrier type. Our study creates possibilities for the design of nanometric spin valves, which could enable integration of memory and logic elements for all phosphorene 2D processors.

2.
Skeletal Radiol ; 2024 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-38388702

RESUMO

OBJECTIVE: Use subchondral bone length (SBL), a new MRI-derived measure that reflects the extent of cartilage loss and bone flattening, to predict the risk of progression to total knee replacement (TKR). METHODS: We employed baseline MRI data from the Osteoarthritis Initiative (OAI), focusing on 760 men and 1214 women with bone marrow lesions (BMLs) and joint space narrowing (JSN) scores, to predict the progression to TKR. To minimize bias from analyzing both knees of a participant, only the knee with a higher Kellgren-Lawrence (KL) grade was considered, given its greater potential need for TKR. We utilized the Kaplan-Meier survival curves and Cox proportional hazards models, incorporating raw and normalized values of SBL, JSN, and BML as predictors. The study included subgroup analyses for different demographics and clinical characteristics, using models for raw and normalized SBL (merged, femoral, tibial), BML (merged, femoral, tibial), and JSN (medial and lateral compartments). Model performance was evaluated using the time-dependent area under the curve (AUC), Brier score, and Concordance index to gauge accuracy, calibration, and discriminatory power. Knee joint and region-level analyses were conducted to determine the effectiveness of SBL, JSN, and BML in predicting TKR risk. RESULTS: The SBL model, incorporating data from both the femur and tibia, demonstrated a predictive capacity for TKR that closely matched the performance of the BML score and the JSN grade. The Concordance index of the SBL model was 0.764, closely mirroring the BML's 0.759 and slightly below JSN's 0.788. The Brier score for the SBL model stood at 0.069, showing comparability with BML's 0.073 and a minor difference from JSN's 0.067. Regarding the AUC, the SBL model achieved 0.803, nearly identical to BML's 0.802 and slightly lower than JSN's 0.827. CONCLUSION: SBL's capacity to predict the risk of progression to TKR highlights its potential as an effective imaging biomarker for knee osteoarthritis.

3.
Sci Rep ; 14(1): 4371, 2024 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-38388641

RESUMO

Transition metal oxides (TMO) are the preferred materials for metal ion battery cathodes because of their high redox potentials and good metal-ion intercalation capacity, which serve as an outstanding replacement for layered sulphide. In this work, using first-principles calculations based on Density functional theory approach, we explored the structural and electronic properties which comprise of adsorption and diffusion behaviour along with the analysis of voltage profile and storage capacity of Ru doped two-dimensional transition metal oxide [Formula: see text], [Formula: see text], and [Formula: see text] monolayers. The adsorption of alkali ions (Li, Na) to the surface of TMOs is strengthened by Ru-atom doping. Ru doping enhanced the adsorption energy of Li/Na-ion by 25%/11% for [Formula: see text], 8%/13% for [Formula: see text], and 10%/11% [Formula: see text] respectively. The open circuit voltage (OCV) also increases due to the high adsorption capacity of doped Monolayers. Ru doping makes the semiconducting TMOs conduct, which is suitable for battery application. As alkali ion moves closer to the dopant site, the adsorption energy increases. When alkali ions are close to the vicinity of doping site, their diffusion barrier decrease and rises as they go further away. Our current findings will be useful in finding ways to improve the storage performance of 2D oxide materials for application in energy harvesting and green energy architecture.

4.
Nat Biotechnol ; 42(3): 448-457, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37217752

RESUMO

Recent advances in wearable ultrasound technologies have demonstrated the potential for hands-free data acquisition, but technical barriers remain as these probes require wire connections, can lose track of moving targets and create data-interpretation challenges. Here we report a fully integrated autonomous wearable ultrasonic-system-on-patch (USoP). A miniaturized flexible control circuit is designed to interface with an ultrasound transducer array for signal pre-conditioning and wireless data communication. Machine learning is used to track moving tissue targets and assist the data interpretation. We demonstrate that the USoP allows continuous tracking of physiological signals from tissues as deep as 164 mm. On mobile subjects, the USoP can continuously monitor physiological signals, including central blood pressure, heart rate and cardiac output, for as long as 12 h. This result enables continuous autonomous surveillance of deep tissue signals toward the internet-of-medical-things.


Assuntos
Dispositivos Eletrônicos Vestíveis , Humanos , Sinais Vitais
5.
J Postgrad Med ; 70(2): 113-115, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38099610

RESUMO

ABSTRACT: We report a 16-year-old boy who presented with abdominal pain and severe hyperglycemia. His random blood glucose on admission was above 300 mg/dL, without ketosis. Urine examination revealed mild ketonuria. Renal function tests were normal. Antibodies to glutamate acid decarboxylase (anti-GAD) and islet tyrosine phosphatase 2 (anti-IA2) were negative. Findings on enhanced abdominal computed tomography scan were compatible with complete dorsal pancreatic agenesis. The body and tail of the pancreas were not visualized. Additionally, ectopic and malrotated left kidney was detected. Magnetic resonance cholangiopancreatography confirmed the absence of the dorsal pancreatic duct. The patient was treated with multiple subcutaneous insulin injections and attained good glycemic control. He is currently doing well on follow-up. The present case is a rare combination of complete agenesis of the dorsal pancreas with an ectopic, malrotated kidney. Clinical awareness of this rare association will help improve patient management.


Assuntos
Anormalidades Congênitas , Diabetes Mellitus Tipo 1 , Insulina , Pâncreas/anormalidades , Humanos , Masculino , Adolescente , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/tratamento farmacológico , Insulina/uso terapêutico , Insulina/administração & dosagem , Rim/anormalidades , Tomografia Computadorizada por Raios X , Colangiopancreatografia por Ressonância Magnética , Hipoglicemiantes/uso terapêutico , Resultado do Tratamento
6.
Artigo em Inglês | MEDLINE | ID: mdl-37878424

RESUMO

This perspective article provides a brief overview on materials, fabrications, beamforming, and applications for wearable ultrasound devices, a rapidly growing field with versatile implications. Recent developments in miniaturization and soft electronics have significantly advanced wearable ultrasound devices. Such devices offer distinctive advantages over traditional ultrasound probes, including prolonged usability and operator independence, and has demonstrated their effectiveness in continuous monitoring, non-invasive therapies, and advanced human-machine interfaces. Wearable ultrasound devices can be classified into three main categories: rigid, flexible, and stretchable, each having unique properties and fabrication strategies. Key unique strategies in device design, packaging, and beamforming for each type of wearable ultrasound devices are reviewed. Furthermore, we highlight the latest applications enabled by wearable ultrasound technology, encompassing continuous health monitoring, therapy, and human-machine interfaces. This article concludes by discussing the outstanding challenges within the field and outlines potential pathways for future advancements.

7.
Sci Rep ; 13(1): 16599, 2023 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-37789039

RESUMO

Semiconductors with controllable electronic transport coupled with magnetic behaviour, offering programmable spin arrangements present enticing potential for next generation intelligent technologies. Integrating and linking these two properties has been a long standing challenge for material researchers. Recent discoveries in two-dimensional (2D) magnet shows an ability to tune and control the electronic and magnetic phases at ambient temperature. Here, we illustrate controlled spin transport within the magnetic phase of the 2D semiconductor CrOBr and reveal a substantial connection between its magnetic order and charge carriers. First, we systematically analyse the strain-induced electronic behaviour of 2D CrOBr using density functional theory calculations. Our study demonstrates the phase transition from a magnetic semiconductor → half metal → magnetic metal in the material under strain application, creating intriguing spin-resolved conductance with 100% spin polarisation and spin-injection efficiency. Additionally, the spin-polarised current-voltage (I-V) trend displayed conductance variations with high strain-assisted tunability and a peak-to-valley ratio as well as switching efficiency. Our study reveals that CrOBr can exhibit highly anisotropic behaviour with perfect spin filtering, offering new implications for strain engineered magneto-electronic devices.

8.
Sci Rep ; 13(1): 13696, 2023 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-37608024

RESUMO

Atomically thin two-dimensional (2D) Janus materials and their Van der Waals heterostructures (vdWHs) have emerged as a new class of intriguing semiconductor materials due to their versatile application in electronic and optoelectronic devices. Herein, We have invstigated most probable arrangements of different inhomogeneous heterostructures employing one layer of transition metal dichalcogenide, TMD (MoS2, WS2, MoSe2, and WSe2) piled on the top of Janus TMD (MoSeTe or WSeTe) and investigated their structural, electronic as well as optical properties through first-principles based calculations. After that, we applied twist engineering between the monolayers from 0[Formula: see text] 60[Formula: see text] twist angle, which delivers lattice reconstruction and improves the performance of the vdWHs due to interlayer coupling. The result reveals that all the proposed vdWHs are dynamically and thermodynamically stable. Some vdWHs such as MoS2/MoSeTe, WS2/WSeTe, MoS2/WSeTe, MoSe2/MoSeTe, and WS2/MoSeTe exhibit direct bandgap with type-II band alignment at some specific twist angle, which shows potential for future photovoltaic devices. Moreover, the electronic property and carrier mobility can be effectively tuned in the vdWHs compared to the respective monolayers. Furthermore, the visible optical absorption of all the Janus vdWHs at [Formula: see text] = 0[Formula: see text] can be significantly enhanced due to the weak inter-layer coupling and redistribution of the charges. Therefore, the interlayer twisting not only provides an opportunity to observe new exciting properties but also gives a novel route to modulate the electronic and optoelectronic properties of the heterostructure for practical applications.

9.
J Antimicrob Chemother ; 78(9): 2203-2208, 2023 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-37452731

RESUMO

BACKGROUND: Neisseria gonorrhoeae is identified as a priority pathogen due to its capacity to rapidly develop antimicrobial resistance (AMR). Following the easing of SARS-CoV-2 pandemic travel restrictions across international borders in the state of New South Wales (NSW), Australia, a surge of gonococcal isolates with raised ceftriaxone MIC values were detected. METHODS: All N. gonorrhoeae isolates (n = 150) with increased ceftriaxone MIC values in NSW between 1 January 2021 and July 2022 from males and females from all sites were sequenced. RESULTS: A new emergence and rapid expansion of an N. gonorrhoeae ST7827 clone was documented within NSW, Australia and provides further evidence of the ability of N. gonorrhoeae to undergo sufficient genomic changes and re-emerge as a geographically restricted subclone. Mapping AMR determinants to MIC results did not reveal any genomic pattern that correlated with MIC values. CONCLUSIONS: The rapid dissemination and establishment of this clone at the population level is a new and concerning demonstration of the agility of this pathogen, and underscores concerns about similar incursions and establishment of MDR clones. Moreover, it is notable that in this context the AMR genotype-phenotype correlates remain unclear, which requires further investigation to enable better understanding of genomic aspects of AMR in N. gonorrhoeae.


Assuntos
Gonorreia , Neisseria gonorrhoeae , Genótipo , Fenótipo , Áustria/epidemiologia , Neisseria gonorrhoeae/efeitos dos fármacos , Neisseria gonorrhoeae/genética , Gonorreia/epidemiologia , Ceftriaxona/farmacologia , Filogenia , Humanos
10.
BJA Educ ; 23(4): 144-152, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36960439
11.
Morphologie ; 107(358): 100595, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36932014

RESUMO

This report highlights a coronary artery anomaly (CAA) involving three right coronary arteries (RCAs) arising from the anterior aortic sinus and a single left coronary artery (LCA) from the left posterior aortic sinus. Furthermore, each of the three RCAs originated with separate ostia. The 1st RCA was the right conus artery which originated through the anterior ostium. The 2nd RCA from the middle ostium mimicked a typical RCA. The 3rd RCA that originated from the posterior ostium had an initial retro-aortic course and then ran between the ascending aorta and atria. It eventually terminated as the circumflex artery after reaching the left end of the posterior coronary sulcus. The LCA was normal anatomically except that it did not give the circumflex branch. The knowledge of this type of unusual branching pattern of the coronary artery may be useful to clinicians.


Assuntos
Anomalias dos Vasos Coronários , Humanos , Anomalias dos Vasos Coronários/diagnóstico por imagem , Aorta
12.
Int J Biol Macromol ; 232: 123460, 2023 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-36731706

RESUMO

The treatment of infected wounds in patients with highly sensitive skin is challenging. Some of the available wound dressings cause further skin tear and bleeding upon removal thereby hindering the healing process. In this study, dissolvable antibacterial wound dressing patches loaded with cephalexin monohydrate were prepared from different amounts of sodium alginate (SA) and carboxymethyl cellulose (CMC) by the solvent casting evaporation technique. The patches displayed good tensile strength (3.83-13.83 MPa), appropriate thickness (0.09 to 0.31 mm) and good flexibility (74-98 %) suitable for the skin. The patches displayed good biodegradability and low moisture uptake suitable to prevent microbial invasion on the wound dressings upon storage. The release profile of the drug from the patches was sustained in the range of 47-80 % for 48 h, revealing their capability to inhibit bacterial infection. The biological assay showed that the patches did not induce cytotoxic effects on HaCaT cells, revealing good biocompatibility. The antimicrobial effect of the patches on the different strains of bacteria used in the study was significant. The cell migration (66.7-74.3 %) to the scratched gap was promising revealing the patches' capability to promote wound closure. The results obtained show that the wound dressings are potential materials for the treatment of infected wounds.


Assuntos
Alginatos , Antibacterianos , Humanos , Alginatos/farmacologia , Antibacterianos/farmacologia , Cicatrização , Bandagens/microbiologia , Pele
13.
bioRxiv ; 2023 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-36711660

RESUMO

Maximizing protein secretion is an important target in the design of engineered living systems. In this paper, we characterize a tradeoff between cell growth and per cell protein secretion in the curli biofilm secretion system of E Coli Nissile 1917. Initial characterization using 24-hour continuous growth and protein production monitoring confirms decreased growth rates at high induction leading to a local maximum in total protein production at intermediate induction. Propidium iodide staining at the endpoint indicates that cellular death is a dominant cause of growth reduction. Assaying variants with combinatorial constructs of inner and outer membrane secretion tags, we find that diminished growth at high production is specific to secretory variants associated with accumulation of protein containing the outer membrane transport tag in the periplasmic space. RNA sequencing experiments indicate upregulation of known periplasmic stress response genes in the highly secreting variant, further implicating periplasmic stress in the growth-secretion tradeoff. Overall, these results motivate additional strategies for optimizing total protein production and longevity of secretory engineered living systems.

14.
Nature ; 613(7945): 667-675, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36697864

RESUMO

Continuous imaging of cardiac functions is highly desirable for the assessment of long-term cardiovascular health, detection of acute cardiac dysfunction and clinical management of critically ill or surgical patients1-4. However, conventional non-invasive approaches to image the cardiac function cannot provide continuous measurements owing to device bulkiness5-11, and existing wearable cardiac devices can only capture signals on the skin12-16. Here we report a wearable ultrasonic device for continuous, real-time and direct cardiac function assessment. We introduce innovations in device design and material fabrication that improve the mechanical coupling between the device and human skin, allowing the left ventricle to be examined from different views during motion. We also develop a deep learning model that automatically extracts the left ventricular volume from the continuous image recording, yielding waveforms of key cardiac performance indices such as stroke volume, cardiac output and ejection fraction. This technology enables dynamic wearable monitoring of cardiac performance with substantially improved accuracy in various environments.


Assuntos
Ecocardiografia , Desenho de Equipamento , Coração , Dispositivos Eletrônicos Vestíveis , Humanos , Débito Cardíaco , Ecocardiografia/instrumentação , Ecocardiografia/normas , Coração/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , Volume Sistólico , Dispositivos Eletrônicos Vestíveis/normas , Pele
15.
J Nucl Cardiol ; 30(1): 193-200, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36417121

RESUMO

BACKGROUND: Radionuclide ventriculography (RNVG) can be used to quantify mechanical dyssynchrony and may be a valuable adjunct in the assessment of heart failure with reduced ejection fraction (HFrEF). The study aims to investigate the effect of beta-blockers on mechanical dyssynchrony using novel RNVG phase parameters. METHODS: A retrospective study was carried out in a group of 98 patients with HFrEF. LVEF and dyssynchrony were assessed pre and post beta-blockade. Dyssynchrony was assessed using synchrony, entropy, phase standard deviation, approximate entropy, and sample entropy from planar RNVG phase images. Subgroups split by ischemic etiology were also investigated. RESULTS: An improvement in dyssynchrony and LVEF was measured six months post beta-blockade for both ischemic and non-ischemic groups. CONCLUSIONS: A significant improvement in dyssynchrony and LVEF was measured post beta-blockade using novel measures of dyssynchrony.


Assuntos
Insuficiência Cardíaca , Disfunção Ventricular Esquerda , Humanos , Estudos Retrospectivos , Volume Sistólico , Ventriculografia com Radionuclídeos , Imagem do Acúmulo Cardíaco de Comporta
16.
J Microbiol Immunol Infect ; 56(1): 150-162, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35864068

RESUMO

BACKGROUND: Trichomonas vaginalis, a parasitic flagellated protozoan, is one of the main non-viral sexually transmitted diseases worldwide. Treatment options for trichomoniasis are limited to nitroimidazole compounds. However, resistance to these drugs has been reported, which requires the development of new anti-Trichomonas agents that confer suitable efficacy and less toxicity. METHODS: In the present work, we assessed the effectiveness of the liposomal system containing essential oils of Bunium persicum and Trachyspermum ammi against T. vaginalis in vitro. The chemical composition of B. persicum and T. ammi were analyzed using gas chromatography-mass spectrometry (GC-MS). Liposomal vesicles were prepared with phosphatidylcholine) 70%) and cholesterol)30%) using the thin-film method. The essential oils of B. persicum and T. ammi were loaded into the liposomes using the inactive loading method. Liposomal vesicles were made for two plants separately. Their physicochemical features were tested using Zeta-Sizer, AFM and SEM. The anti-Trichomonas activity was determined after 12 and 24 h of parasite cultures in TYI-S-33 medium. RESULTS: After 12 and 24 h of administration, the IC50 of the B. persicum essential oil nano-liposomes induced 14.41 µg/mL and 45.19 µg/mL, respectively. The IC50 of T. ammi essential oil nano-liposomes induced 8.08 µg/mL and 25.81 µg/mL, respectively. CONCLUSIONS: These data suggested that nano-liposomes of the essential oils of B. persicum and T. ammi may be a promising alternative to current treatments for Trichomonas infection.


Assuntos
Ammi , Apiaceae , Óleos Voláteis , Humanos , Óleos Voláteis/farmacologia , Óleos Voláteis/química , Apiaceae/química , Extratos Vegetais
17.
Artigo em Inglês | MEDLINE | ID: mdl-36439049

RESUMO

Background: Uganda's population, though, largely characterized by young people, has seen the number of people aged 60 and over grow from 686,000 twenty years ago, to 1,433,596 in 2014. Effective caring for the well-being of this population requires strategic and deliberate planning that involves Quality Of Life (QoL) assessments. QoL assessments among the elderly are important in evaluating the efficacy of strategies, such as health interventions, welfare programs, health care and well-being of the elderly. However, elderly in Uganda face several challenges, ranging from loneliness, poor housing, lack of social and financial support and poor health. These may negatively affect older persons' quality of life and consequently their perceptions and attitudes towards aging. Methods: The study was carried out in 2019 in the communities of Nansana and Busukuma town councils in Wakiso district, Uganda. The participants were 380 people 60 years and older. To establish the association between perceptions of ageing and QoL, this study utilized a locally adapted version of the Older Person's Quality of Life Questionnaire (OPQOL) and the Brief Ageing Perceptions Questionnaire (B-APQ). The OPQOL assesses three domains of QoL: Health QoL (HQoL); Social economic QoL (SQoL); and Psychosocial QoL (PQoL). The B-APQ assesses perceptions about physical age, participation in social activities, and perceptions about ability to regulate emotions as one ages. Pearson's Chi-square tests were used to characterize the relationship between the perceptions and quality of life. Results: The majority of the respondents, 61% (95%CI 56.7-64.8), had negative perceptions towards ageing. Eighty six percent had poor HQoL, 90% poor SQoL and 83% poor PQoL. There was a significant association between good HQoL and positive perception about participation in social activities (X2 = 7.3670, P = 0.007) as well as with positive perception on regulation of emotions (X2 = 18.1803, P<0.001). There was a significant association between good SQoL and positive perception about participation in social activities (X2 = 5.3472, P = 0.021), as well with positive perception on regulation of emotions (X2 = 10.5128, P<0.001). A significant association between good PQoL and positive perception on regulation of emotions (X2 = 9.2414, P= 0.002). Conclusion: Positive perceptions of ageing are associated with good QoL. Directly addressing perceptions of ageing could be a low cost and effective strategy to improve the QoL of older persons in SSA.

18.
Cancers (Basel) ; 14(9)2022 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-35565375

RESUMO

BACKGROUND: Cancer Trials Ireland (CTI) is the national cooperative group in Ireland. The SARS-CoV-2 pandemic led to significant ongoing disruptive change in healthcare from March 2020 to the present day. Its impact and legacy on a national clinical trials organisation was assessed. METHODS: A review was conducted of prospectively acquired communications, team logs and time sheets, trial activation, closure and accrual, for the period 2019 to September 2021. An online survey of the impact of the pandemic on clinical investigators and of clinical trials units was performed. A National Cancer Retreat was organised on 21 May 2021 to identify and address pandemic related disruption and develop adaptive strategies. RESULTS: In the weeks after the pandemic was declared, remote working was initiated by all central office staff. Nationally, clinical trial accrual fell by 54% compared to the same period in 2019, radiotherapy trial accrual by 90%, and translational studies by 36%. Staff reassignment of research nurse staff occurred in 60% of units, trial monitoring was reduced in 42%, and trial initiations fell by 67%. Extreme fluctuations in monitoring hours were noted paralleling lockdown measures. Significant impact on all clinical trials units was noted including staff reassignments, reduced access to diagnostic imaging and reduced institutional supports. Remote clinic visits and remote monitoring was widely adopted. The National Cancer Retreat identified flexibility in trial conduct, staff recruitment and retention, the need for harmonisation of processes, and research staff support in the context of remote working as priorities. CONCLUSION: The pandemic has had a significant ongoing negative impact on cancer clinical trial activity in Ireland. Adaptive strategies including trial flexibility, expanded telehealth and remote monitoring, harmonisation of processes and staff support have been identified as priorities to ameliorate this impact, and develop a more sustainable clinical trial ecosystem.

19.
Kardiologiia ; 62(3): 40-48, 2022 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-35414360

RESUMO

Aim    The objective was to assess the correlation of fasting plasma glucose (FPG), HbA1c, and the duration of type 2 diabetes mellitus (T2DM) with SYNTAX score (SS) II in patients with non-ST elevation myocardial infarction (NSTEMI).Material and methods    FPG and HbA1C were measured in 398 patients presenting with NSTEMI at admission. SS II was calculated using an online calculator. Patients were stratified according to SS II (≤21.5, 21.5-30.6, and ≥30.6), defined as SS II low, mid, and high, respectively.Results    37.7 % of subjects were diabetic. Correlations of FPG (R=0.402, R2=0.162, p<0.001) and HbA1c (R=0.359, R2=0.129, p<0.001) with SS II were weak in the overall population. Duration of T2DM showed very strong correlation with SS II (R=0.827, R2=0.347). For the prediction of high SS II in the study population, FPG≥98.5 mg / dl demonstrated a sensitivity of 58 % and a specificity of 60 %, and HbA1c ≥6.05 demonstrated a sensitivity of 63 % and a specificity of 69 %. Duration of T2DM (adjusted odds ratio (OR): 1.182; 95 % confidence interval (CI): 1.185-2.773) and FPG (OR: 0.987; 95 % CI: 0.976-0.9959) were significantly associated with high SS II after controlling for other risk factors. Duration of T2DM (Beta=0.439) contributed strongly to variance of SS II, whereas HbA1c (Beta=0.063) contributed weakly.Conclusion    Duration of T2DM is a very important risk factor for severity of coronary artery disease.


Assuntos
Doença da Artéria Coronariana , Diabetes Mellitus Tipo 2 , Infarto do Miocárdio sem Supradesnível do Segmento ST , Glicemia , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/etiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/diagnóstico , Hemoglobinas Glicadas , Humanos , Infarto do Miocárdio sem Supradesnível do Segmento ST/diagnóstico , Infarto do Miocárdio sem Supradesnível do Segmento ST/etiologia , Fatores de Risco
20.
J Nucl Cardiol ; 29(2): 581-589, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-32748278

RESUMO

BACKGROUND: Accurate diagnostic tools to identify patients at risk of cancer therapy-related cardiac dysfunction (CTRCD) are critical. For patients undergoing cardiotoxic cancer therapy, ejection fraction assessment using radionuclide ventriculography (RNVG) is commonly used for serial assessment of left ventricular (LV) function. METHODS: In this retrospective study, approximate entropy (ApEn), synchrony, entropy, and standard deviation from the phase histogram (phase SD) were investigated as potential early markers of LV dysfunction to predict CTRCD. These phase parameters were calculated from the baseline RNVG phase image for 177 breast cancer patients before commencing cardiotoxic therapy. RESULTS: Of the 177 patients, 11 had a decline in left ventricular ejection fraction (LVEF) of over 10% to an LVEF below 50% after treatment had commenced. This patient group had a significantly higher ApEn at baseline to those who maintained a normal LVEF throughout treatment. Of the parameters investigated, ApEn was superior for predicting the risk of CTRCD. Combining ApEn with the baseline LVEF further improved the discrimination between the groups. CONCLUSIONS: The results suggest that RNVG phase analysis using approximate entropy may aid in the detection of sub-clinical LV contraction abnormalities, not detectable by baseline LVEF measurement, predicting a subsequent decline in LVEF.


Assuntos
Neoplasias da Mama , Cardiopatias , Disfunção Ventricular Esquerda , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/tratamento farmacológico , Cardiotoxicidade , Feminino , Humanos , Ventriculografia com Radionuclídeos , Estudos Retrospectivos , Medição de Risco , Volume Sistólico , Disfunção Ventricular Esquerda/induzido quimicamente , Disfunção Ventricular Esquerda/diagnóstico por imagem , Função Ventricular Esquerda
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