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1.
Cardiol J ; 2021 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-34671968

RESUMO

BACKGROUND: The Rotapro study was conducted to evaluate the safety and feasibility of the new Rotapro rotational atherectomy system (RAS) for lesion preparation in calcified coronary artery stenosis. METHODS: Between 2015 and 2019 consecutive patients undergoing rotational atherectomy (RA) with the new Rotapro system and the conventional rotablator (Rotablator) were included from the Bad Krozingen Rotablation Registry. The primary endpoint was the incidence of in-hospital major adverse cardiovascular and cerebral event rate (MACCE). RESULTS: Rotablation was performed in 3.6% of all patients (n = 597) treated by percutaneous coronary intervention. Procedural outcomes were compared according to the applied RAS (n = 246 Rotapro vs. n = 351 Rotablator). Overall technical success was achieved in 98.3% of patients. The primary endpoint of in-hospital MACCE was comparable between the Rotapro- and the Rotablator-group (3.7% vs. 5.7%, respectively, p = 0.254). The Rotapro group was associated with significant reductions of fluoroscopy time (30 vs. 38 min, p < 0.0001), procedural time (82.5 vs. 96 min, p = 0.0003), applied contrast volume (210 vs. 290 mL, p < 0.0001) and radiation dose (6129 vs. 9827 cGy*cm², p < 0.0001) compared to the Rotablator group. CONCLUSIONS: The present study demonstrates the safety and efficacy of the new Rotapro system. In-hospital MACCE rates were comparable between both RAS, whereas Rotapro was associated with less fluoroscopy time, radiation dose as well as contrast use.

2.
Cardiol J ; 2021 08 12.
Artigo em Inglês | MEDLINE | ID: mdl-34231874

RESUMO

BACKGROUND: The aim of this study was to describe the mechanism of subintimal shift (SIS), standardise diagnostic criteria and sensitise the interventional community to this phenomenon. The treatment of chronic total occlusions (CTO) by means of percutaneous coronary intervention (PCI) is complicated by bifurcation lesions involved in the CTO segment or adjacent to it. Extraplaque expansion of intracoronary devices during CTO PCI may extend the dissection plane over the bifurcation with the consequential side or main branch compression by an intimo-medial flap. This phenomenon is hereby described for the first time and named subintimal shift. METHODS: Experienced CTO operators from 3 international high volume centers for CTO PCI retrospectively searched their personal records for paradigmatic cases of SIS, summarising key features and proposing diagnostic criteria. RESULTS: The series comprised 7 demonstrative cases, illustrating SIS by intravascular imaging (2 cases) or indirect angiographic signs during CTO PCI (5 cases). Five cases were triggered by stent expansion, 1 by balloon inflation and 1 case was aborted after angiographic warning signs. In 4 cases, SIS resulted in total occlusion of a branch, refractory to ballooning whenever attempted. Four cases required bailout intervention and in 2 cases the branch was left occluded, resulting in a rise of cardiac markers. CONCLUSIONS: Subintimal shift is a noteworthy complication in CTO bifurcations, potentially resulting in occlusion of the relevant side or even the main branch. Intracoronary imaging prior to stenting is recommended to understand the tissue planes. Some counterintuitive peculiarities of this phenomenon, like its refractoriness to ballooning, must be known by CTO operators for its efficient resolution.

3.
J Clin Med ; 10(7)2021 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-33916666

RESUMO

BACKGROUND: In percutaneous coronary interventions (PCI), the impact of prolonged fluoroscopy time (FT) on procedural outcomes is poorly studied. METHODS AND RESULTS: We analyzed the outcomes of 12,538 consecutive elective PCIs. The primary endpoint was procedure failure (PF), the composite of technical failure, and adverse in-hospital events including all-cause death, myocardial infarction, stroke, and target vessel revascularization (MACCE), as well as pericardial tamponade. We stratified the procedures as PCI for chronic total occlusion (CTO, n = 2720) and PCI for non-CTO (n = 9818). Logistic regression demonstrated a significant association between fluoroscopy time and procedural failure with a significant interaction with PCI type (both p < 0.001). The odds ratios (OR) of procedural failure for a 10-min increment in FT were 1.15 (confidence interval (CI) 95% 1.12-1.18, p < 0.001) in non-CTO PCI and 1.05 (CI 95% 1.03-1.06, p < 0.001) in CTO PCI. The optimal cut-point for prediction of PF was 21.1 min in non-CTO PCI (procedural success in 98.4% versus 95.3%, adjusted OR for PF 2.79 (CI 95% 1.93-4.04), p < 0.001) and 41 min in CTO PCI (procedural success in 92.3% versus 83.8%, adjusted OR for PF 2.18 (CI 95% 1.64-2.94), p < 0.001). In CTO PCI, the increase in PF with FT was largely driven by technical failure (adjusted OR 2.25 (CI 95% 1.65-3.10), p < 0.001), whereas in non-CTO PCI, it was driven by major complications (adjusted OR 2.94 (CI 95% 1.93-4.53), p < 0.001). CONCLUSIONS: Prolonged FT is strongly associated with procedural failure in both non-CTO and CTO PCI. In CTO PCI, this relation is shifted towards longer FT. The mechanisms of procedural failure differ between CTO and non-CTO PCI.

5.
Cardiovasc Revasc Med ; 28S: 208-211, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33397603

RESUMO

BACKGROUND/OBJECTIVE: Microcatheters and dedicated guidewires for both chronic total occlusion (CTO) and non-CTO percutaneous coronary intervention (PCI) are increasingly being used to overcome complex coronary anatomy with severe tortuosity and calcification. In extremely resistant lesions, a potential over-rotation and device fatigue may result in entrapment or even fracture causing abrupt vessel closure and hinder successful revascularization. METHOD/RESULT: We demonstrate two consecutive cases complicated with dislodged microcatheter tip which was rescued uniquely with coronary laser atherectomy. We describe an algorithmic approach for management of microcatheter fracture which are increasingly occur in contemporary practice of complex PCI. CONCLUSION: In summary, our cases illustrate the feasibility of using coronary excimer laser system to release fractured and entrapped intracoronary MC tips when other conventional percutaneous techniques fail.


Assuntos
Aterectomia Coronária , Oclusão Coronária , Intervenção Coronária Percutânea , Aterectomia Coronária/efeitos adversos , Doença Crônica , Angiografia Coronária , Oclusão Coronária/diagnóstico por imagem , Oclusão Coronária/cirurgia , Humanos , Lasers de Excimer/uso terapêutico , Intervenção Coronária Percutânea/efeitos adversos , Resultado do Tratamento
6.
EuroIntervention ; 17(6): 481-488, 2021 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-33258774

RESUMO

BACKGROUND: The comparative efficacy of balloon-based techniques to prepare severely calcified coronary lesions before stenting remains poorly studied. AIMS: We sought to compare stent expansion following preparation of severely calcified coronary lesions with either a super high-pressure balloon or a scoring balloon. METHODS: In this randomised, open-label trial, patients with severely calcified coronary lesions were enrolled at five centres in Germany and Switzerland. After unsuccessful lesion preparation with a standard non-compliant balloon (<30% reduction of baseline diameter stenosis), participants were randomised to predilation with either a super high-pressure balloon or a scoring balloon before drug-eluting stent (DES) implantation. The primary endpoint of the study was stent expansion index as assessed by optical coherence tomography (OCT). The key secondary endpoints included angiographic, strategy and procedural success. RESULTS: OCT data after DES implantation were available for 70 out of 74 patients (94.6%) enrolled. Lesion preparation with a super high-pressure balloon versus a scoring balloon led to a comparable stent expansion index (0.72±0.12 vs 0.68±0.13; p=0.22). Compared with the scoring balloon, the super high-pressure balloon increased the minimum lumen diameter (2.83±0.34 mm vs 2.65±0.36 mm; p=0.03) and reduced the diameter stenosis (11.6±4.8% vs 14.4±5.6%; p=0.02) without difference in terms of angiographic success (100% vs 97.3%; p>0.99). Strategy success (91.9% vs 83.8%; p=0.48) and procedural success (100% vs 89.2%; p=0.12) were numerically more frequent with the super high-pressure balloon versus the scoring balloon. CONCLUSIONS: In patients with severely calcified coronary artery lesions, preparation with a super high-pressure balloon versus a scoring balloon was associated with comparable stent expansion on intravascular imaging and a trend towards improved angiographic performance. Visual summary. A ComparIson of Strategies to PrepAre SeveRely CALCified Coronary Lesions: the ISAR-CALC randomised trial.


Assuntos
Angioplastia Coronária com Balão , Doença da Artéria Coronariana , Reestenose Coronária , Stents Farmacológicos , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/cirurgia , Humanos , Stents , Resultado do Tratamento
7.
J Clin Med ; 9(4)2020 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-32235416

RESUMO

BACKGROUND: Concomitant left main coronary artery (LMCA) disease in patients with chronic total occlusions (CTO) commonly results in referral for coronary artery bypass grafting, although the impact of LMCA in CTO patients remains largely unknown. Nevertheless, patient selection for percutaneous coronary intervention of CTOs (CTO-PCI) or alternative revascularization strategies should be based on precise evaluation of the coronary anatomy to anticipate those patients that most likely benefit from a procedure and not on strict adherence to perpetual clinical practice. Therefore, the aim of this study was to assess the impact of LMCA disease on long-term outcomes in patients undergoing percutaneous coronary intervention for CTO. METHODS: We enrolled 3860 consecutive patients undergoing PCI for at least one CTO lesion and investigated the predictive value of concomitant LMCA disease. All-cause mortality was defined as the primary study endpoint. RESULTS: We observed that LMCA disease is significantly associated with mortality. In the Cox regression analysis, we observed a crude hazard ratio (HR) 1.59 (95% confidence interval (CI) 1.23-2.04, p < 0.001) for patients with LMCA disease as compared to patients without. Results remained unchanged after bootstrap- or clinical confounder-based adjustment. CONCLUSION: LMCA disease is associated with excess mortality in CTO patients. Specifically, anatomical features such as CTO of the circumflex artery represent a high risk patient population.

8.
Zygote ; 28(3): 233-240, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32151301

RESUMO

This study aimed to: (i) characterize cultured granulosa cells (GCs) from different follicle sizes morphologically and molecularly; and (ii) select a suitable model according to follicular size that maintained GC function during culture. Buffalo ovaries were collected from a slaughterhouse and follicles were classified morphologically into: first group ≤ 4 mm, second group 5-8 mm, third group 9-15 mm and fourth group 16-20 mm diameter. GC pellets were divided into two portions. The first portion served as the control fresh pellet, and the secondwas used for 1 week for GC culture. Total RNA was isolated, and qRT-PCR was performed to test for follicle-stimulating hormone receptor (FSHR), cytochrome P450 19 (CYP19), luteinizing hormone/choriogonadotropin receptor (LHCGR), proliferating cell nuclear antigen (PCNA), apoptosis-related cysteine peptidase (CASP3), anti-Müllerian hormone (AMH), and phospholipase A2 group III (PLA2G3) mRNAs. Estradiol (E2) and progesterone (P4) levels in the culture supernatant and in follicular fluids were measured using enzyme-linked immunosorbent assay (ELISA). Basic DMEM-F12 medium maintained the morphological appearance of cultured GCs. The relative abundance of FSHR, CYP19, and LHCGR mRNAs was 0.001 ≤ P ≤ 0.01 and decreased at the end of culture compared with the fresh pellet. There was a fine balance between expression patterns of the proliferation marker gene (PCNA) and the proapoptotic marker gene (CASP3). AMH mRNA was significantly increased (P < 0.001) in cultured GCs from small follicles, while cultured GCs from other three categories (5-8 mm, 9-15 mm and 16-20 mm) showed a clear reduction (P < 0.001). Interestingly, the relative abundance of PLA2G3 mRNA was significantly (P < 0.001) increased in all cultured GCs. E2 and P4 concentrations were significantly (P < 0.001) decreased in all cultured groups. Primary cultured GCs from small follicles could be a good model for better understanding follicular development in Egyptian buffaloes.


Assuntos
Perfilação da Expressão Gênica/métodos , Células da Granulosa/metabolismo , Folículo Ovariano/metabolismo , RNA Mensageiro/genética , Animais , Aromatase/genética , Búfalos , Caspase 3/genética , Tamanho Celular , Células Cultivadas , Estradiol/metabolismo , Feminino , Líquido Folicular/metabolismo , Células da Granulosa/citologia , Folículo Ovariano/citologia , Progesterona/metabolismo , Antígeno Nuclear de Célula em Proliferação/genética , Receptores do FSH/genética , Receptores do LH/genética
9.
Eur J Intern Med ; 77: 97-104, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32184031

RESUMO

BACKGROUND: The percutaneous coronary intervention (PCI) for chronic total occlusions (CTO) remains debated. Therefore the aim of this large-scale observational multi-center registry was to compare the long-term outcome of CTO patients undergoing different therapeutic approaches comparing successful CTO revascularization either by PCI or coronary artery bypass graft (CABG), failed CTO-PCI and optimal medical therapy (OMT) alone. METHODS AND RESULTS: A total of 6630 CTO patients were enrolled from two high-volume centers to compare different treatment strategies. All procedures were performed by high-volume CTO operators in tertiary university hospital. Successful CTO-PCI was performed in 3906 patients, failed CTO-PCI in 1479 patients, 412 patients underwent CABG surgery and 833 patients were treated with OMT. During the 5-year follow-up period, 1019 (15%) patients died. Kaplan-Meier analysis unveiled a significantly improved long-term outcome for CTO patients undergoing revascularization either by PCI or by CABG compared to patients with failed CTO-PCI or OMT alone (log-rank P < 0.001). In the multivariate Cox-regression analysis successful CTO-PCI was associated with significantly improved long-term outcome compared to patients under OMT (adj. HR 0.39, 95%CI 0.33-0.45, P < 0.001) or CABG (adj. HR 0.68, 95%CI 0.53-0.86, P = 0.002) independent of clinical confounders encompassing age, BMI, diabetes, kidney function and left ventricular function. CONCLUSIONS: This study showed an improved long-term outcome for CTO revascularization compared to optimal medical therapy, independent from revascularization mode, with the highest survival rate in patients undergoing successful CTO-PCI.


Assuntos
Oclusão Coronária , Intervenção Coronária Percutânea , Doença Crônica , Angiografia Coronária , Oclusão Coronária/cirurgia , Humanos , Sistema de Registros , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
10.
Catheter Cardiovasc Interv ; 96(1): E45-E52, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-31596537

RESUMO

OBJECTIVES: To evaluate the incidence of vascular complication and major bleeding in patients undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI) with a fully trans-wrist access (TWA) approach versus a conventional approach based on trans-femoral access (TFA). BACKGROUND: TFA is the preferred vascular access in CTO PCI, but it has been associated with a non-negligible risk of complications. METHODS: This retrospective registry included all patients undergoing CTO PCI at five institutions between July 2011 and October 2018. Patients were divided into two groups: Conventional (patients treated with at least one TFA) and Fully TWA (subjects exclusively treated with one or two TWA). The primary safety endpoint was a composite of vascular complications and major bleeding. The primary efficacy endpoint was procedural success. RESULTS: We included 1,900 patients (Conventional n = 1,496 and Fully TWA n = 404). Conventional patients showed higher occlusion complexity (J-CTO score 2.1 ± 1.2 vs. 1.5 ± 1.1, p < .001). Procedural success showed no significant difference between both groups (85.7 vs. 83.0%, p = .17). The primary safety endpoint occurred more frequently in the Conventional group (10.3 vs. 4.5%, p < .001), driven by vascular complications (9.4 vs. 3.7%, p < .001). On multivariate analysis, not using a Fully TWA approach was an independent predictor of the study endpoint, after adjusting for age, sex, diabetes, body mass index, chronic kidney disease, prior coronary artery bypass graft, and J-CTO score. CONCLUSIONS: Embracing a Fully TWA approach for CTO PCI might be associated with lower incidence of a composite endpoint of vascular complications and major bleeding, compared with a Conventional approach.


Assuntos
Cateterismo Periférico , Oclusão Coronária/terapia , Artéria Femoral , Intervenção Coronária Percutânea , Punho/irrigação sanguínea , Idoso , Cateterismo Periférico/efeitos adversos , Doença Crônica , Oclusão Coronária/diagnóstico por imagem , Europa (Continente) , Feminino , Hemorragia/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Intervenção Coronária Percutânea/efeitos adversos , Intervenção Coronária Percutânea/instrumentação , Punções , Sistema de Registros , Estudos Retrospectivos , Stents , Resultado do Tratamento , Doenças Vasculares/etiologia
11.
JACC Cardiovasc Interv ; 12(19): 1915-1923, 2019 10 14.
Artigo em Inglês | MEDLINE | ID: mdl-31601387

RESUMO

OBJECTIVES: The aim of this study was to assess the prognostic impact of post-procedural troponin T increase and mortality in patients undergoing percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) to define the threshold at which procedure-related myocardial injury drives mortality. BACKGROUND: Coronary CTO recanalization represents the most technically challenging PCI. The complexity harbors a significant increased risk for complications with CTO PCI with compared with non-CTO PCI. However, there are evidenced biomarker cutoff levels that help identify those patients at risk for unfavorable clinical outcomes. METHODS: A total of 3,712 consecutive patients undergoing PCI for at least 1 CTO lesion were enrolled, and comprehensive troponin T measurements were performed 6, 8, and 24 h after the procedure. All-cause mortality was defined as the primary study endpoint. RESULTS: Using spline curve analysis, a more than 18-fold increase of troponin above the upper reference limit was significantly associated with mortality. In a Cox regression analysis, the crude hazard ratio was 2.32 (95% confidence interval: 1.83 to 2.93; p < 0.001) for a ≥18-fold increase compared with patients with post-procedural troponin increase <18-fold of the upper reference limit. Results remained virtually unchanged after bootstrap- or clinical confounder-based adjustment. CONCLUSIONS: This large-scale outcome study demonstrates for the first time the prognostic value of post-procedural troponin T elevation after PCI in patients with CTOs. A threshold was defined for procedure-related myocardial injury in patients with CTOs to differentiate them from those without CTOs that may help guide post-procedural clinical care in this high-risk patient population.


Assuntos
Oclusão Coronária/terapia , Cardiopatias/diagnóstico , Intervenção Coronária Percutânea/efeitos adversos , Troponina T/sangue , Idoso , Biomarcadores/sangue , Doença Crônica , Oclusão Coronária/diagnóstico por imagem , Oclusão Coronária/mortalidade , Feminino , Cardiopatias/sangue , Cardiopatias/etiologia , Cardiopatias/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Intervenção Coronária Percutânea/mortalidade , Valor Preditivo dos Testes , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Regulação para Cima
12.
EuroIntervention ; 15(9): e804-e811, 2019 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-31217142

RESUMO

AIMS: The aim of this study was to describe the epidemiology, mechanisms, management, and outcomes of coronary artery perforation during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS AND RESULTS: We included 1,811 consecutive patients undergoing CTO PCI at five centres between 2011 and 2018. Coronary perforation was observed in n=99 (5.5%). Patients with perforation were older, had a higher J-CTO score, more often required antegrade dissection/re-entry and the retrograde approach, and had lower success rates. The frequency of Ellis type I, II, III and III "cavity spilling" perforations was 11%, 46%, 28%, and 14%, respectively. In 48% of cases, perforation involved the CTO vessel, while the retrograde approach was responsible for 46% of cases. In 53% of cases perforations required intervention. The most frequently applied management strategies included clinical observation (47%), covered stent implantation (25%), balloon occlusion (9%), and coil/fat embolisation (9%). Tamponade was observed in 20/99 (20%) perforation cases. Ellis type III perforations were most frequently observed at the CTO site. These were accountable for 16/20 tamponades and 3/5 deaths. In-hospital mortality was 5.1% vs 0.3% in patients with versus those without perforation (p<0.001). Older age, occlusion length >20 mm, rotational atherectomy, antegrade dissection/re-entry, and the retrograde approach were independently associated with coronary perforation. Patients with perforation suffered an increased incidence of target vessel failure on short-term follow-up. CONCLUSIONS: Coronary perforation is observed in a non-negligible proportion of CTO PCIs, often requires intervention, and is associated with tamponade and mortality in a minority of patients. CTO vessel-related perforations are associated with the highest burden of morbidity and mortality.


Assuntos
Oclusão Coronária/cirurgia , Vasos Coronários/lesões , Intervenção Coronária Percutânea/efeitos adversos , Lesões do Sistema Vascular/epidemiologia , Idoso , Doença Crônica , Angiografia Coronária , Oclusão Coronária/diagnóstico , Oclusão Coronária/epidemiologia , Vasos Coronários/diagnóstico por imagem , Feminino , Humanos , Complicações Intraoperatórias/epidemiologia , Masculino , Intervenção Coronária Percutânea/métodos , Derrame Pericárdico , Fatores de Tempo , Resultado do Tratamento , Lesões do Sistema Vascular/diagnóstico
13.
Cryobiology ; 79: 14-20, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-28986135

RESUMO

The aim of the present study was to evaluate the effects of supplementation of semen extender with various non-enzymatic antioxidants on the quality of cooled or cryopreserved Arabian stallion spermatozoa. Semen collected from four pure Arabian stallions was centrifuged at 600g for 15 min. Spermatozoa were then diluted in INRA-82 extender supplemented with bovine serum albumin (BSA; 0, 10, 15 and 20 mg/mL) or trehalose (0, 75, 100 and 150 mM) or zinc sulphate (0, 100, 150 and 200 µM). The diluted semen was then either cooled at 5 °C or cryopreserved in 0.5-ml plastic straws. After cooling or thawing, sperm motility, viability, sperm abnormalities, viability index, and plasma membrane integrity were evaluated. The results showed that supplementation of semen extender with 150 mM trehalose or with 200 µM zinc sulphate significantly (P < 0.05) improved motility, viability, sperm membrane integrity and acrosome status in Arabian stallion spermatozoa after cooling or after freezing and thawing compared with controls (non-supplemented media) or with those supplemented with other concentrations of trehalose or zinc sulphate. Supplementation of semen extender with BSA did not improve sperm motility or cryosurvival of Arabian stallion spermatozoa after cooling or after freezing and thawing. In conclusion, supplementation of semen extender with non-enzymatic antioxidants (trehalose or zinc sulphate) improved the quality of chilled and frozen/thawed Arabian stallion spermatozoa. The most beneficial effects occur when semen diluent was supplemented with 150 mM trehalose or 200 µM zinc sulphate.


Assuntos
Antioxidantes/farmacologia , Criopreservação/métodos , Crioprotetores/farmacologia , Preservação do Sêmen/métodos , Motilidade Espermática/efeitos dos fármacos , Trealose/farmacologia , Sulfato de Zinco/farmacologia , Acrossomo/efeitos dos fármacos , Albuminas/farmacologia , Animais , Membrana Celular/efeitos dos fármacos , Membrana Celular/fisiologia , Congelamento , Cavalos , Masculino , Sêmen/fisiologia , Análise do Sêmen , Espermatozoides/fisiologia
14.
Microb Pathog ; 105: 74-80, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28192222

RESUMO

In the attempt to reduce the negative impacts of chemical pesticides on environment and consumer's health, a new plant treatment practice minimizing the amount of pesticides needed during pests and diseases treatments has been developed. Our approach is based on combining the biocide effects of fungicide with the peroxyacetic acid (PAA) one. In this paper, we focused on the in vitro study of the antifungal activity of this combination against Botrytis cinerea, the most redoubtable threat of tomatoes plants in Morocco. First, different concentrations of a peroxyacetic acid product (PERACLEAN®5) and two commercially available fungicides SWITCH and SIGNUM were tested separately for their inhibitory effects on the mycelial growth and spores germination of B. cinerea. 100% inhibition of fungal growth was achieved using 16.77 and 14.47 µg/ml of SIGNUM and SWITCH respectively and 1.5% of PERACLEAN®5. When combined with 0.5% of the peroxyacetic acid mixture (PERACLEAN®5), the pesticides 100% effective concentrations decreased to 0.5 µg/ml for both pesticides. Hence, this approach allowed us to suppress the pathogen while minimizing the amounts of applied fungicides by more than 95%.


Assuntos
Botrytis/efeitos dos fármacos , Botrytis/crescimento & desenvolvimento , Sinergismo Farmacológico , Fungicidas Industriais/farmacologia , Ácido Peracético/farmacologia , Lycopersicon esculentum/microbiologia , Marrocos , Micélio/efeitos dos fármacos , Micélio/crescimento & desenvolvimento , Doenças das Plantas/microbiologia , Esporos Fúngicos/efeitos dos fármacos , Esporos Fúngicos/crescimento & desenvolvimento
15.
Water Sci Technol ; 74(2): 516-23, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27438258

RESUMO

Alum recovery from water treatment sludge is a promising technique applied to decrease usage of fresh coagulants in the water treatment industry. In addition, alum recovery reduces sludge volume for easy handling. The undertaken work investigated the parametric conditions for alum recovery procedure by acidification. The results show that alum recovery reaches up to 69.03%, and the reduction of sludge volume reaches its highest level at 90%. Moreover, results of the parametric investigation reveal that the mixing time of 60 minutes and mixing intensity of 150 rpm are the optimum conditions of mixing for alum recovery from water treatment sludge. The optimum pH level is 1.50 for alum recovery as indicated by maximum aluminum releasing, maximum reduction of sludge volume, and reasonable dosages of added sulfuric acid.


Assuntos
Compostos de Alúmen/análise , Esgotos/análise , Eliminação de Resíduos Líquidos/métodos , Poluentes Químicos da Água/análise , Purificação da Água/métodos , Concentração de Íons de Hidrogênio
16.
EuroIntervention ; 11(8): 856-9, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26696453

RESUMO

AIMS: Previously, we reported that the nine-month angiographic result after treatment of coronary bifurcation lesions with provisional T-stenting was not significantly different from that with routine T-stenting. To compare long-term clinical outcomes of the two stenting strategies, we extended the follow-up of our study on bifurcation stenting. METHODS AND RESULTS: One hundred and one patients with coronary bifurcation lesions had been randomly assigned to provisional T-stenting and 101 to routine T-stenting, using sirolimus-eluting stents. We performed complete five-year follow-up. The primary efficacy endpoint was the incidence of target lesion revascularisation (TLR), and the primary safety endpoint was the incidence of definite/probable stent thrombosis (ST). We also monitored death, myocardial infarction (MI) and MACE (composite of death, MI and TLR). The cumulative five-year incidence of TLR in the provisional T-stenting arm was not significantly different from that in the routine T-stenting arm (16.2% vs. 16.3%, p=0.97). The same was true for MACE (22.8% vs. 22.9%, p=0.91), the composite of death and MI (9.9% vs. 13.9%, p=0.40), and ST (2.0% vs. 5.1%; p=0.25). CONCLUSIONS: During five-year follow-up, routine T-stenting offered no advantage over provisional T-stenting with respect to TLR or MACE. ClinicalTrials.gov Identifier: NCT00288535


Assuntos
Doença da Artéria Coronariana/terapia , Stents Farmacológicos , Intervenção Coronária Percutânea/instrumentação , Idoso , Idoso de 80 Anos ou mais , Fármacos Cardiovasculares/administração & dosagem , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/mortalidade , Reestenose Coronária/etiologia , Trombose Coronária/etiologia , Feminino , Alemanha , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/etiologia , Intervenção Coronária Percutânea/efeitos adversos , Intervenção Coronária Percutânea/mortalidade , Desenho de Prótese , Fatores de Risco , Sirolimo/administração & dosagem , Fatores de Tempo , Resultado do Tratamento
17.
Risk Manag Healthc Policy ; 7: 19-24, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24403846

RESUMO

BACKGROUND: Self-medication and acquisition of over-the-counter (OTC) medications are emerging community health issues. Besides being a cheap alternative for treating common illnesses, the behavior entails serious ramifications, such as medication wastage, increasing pathogen resistance, and adverse drug reactions. The present study was conducted to explore the extent of OTC medications in households in Sharjah, United Arab Emirates (UAE), including native UAE and expatriate families. METHODS: The study employed a population-based, cross-sectional, analytical study design. The study population included native and expatriate households residing in the Emirate of Sharjah, UAE. The snowball sampling technique was used, and the sample included a total of 335 households. RESULTS: Expatriate households acquired more OTC medications than did native households (adjusted odds ratio [aOR]=1.7). The demographic determinants for expatriate households were number of family members (aOR=1.6), age of children in the family (aOR=1.8), and annual income (aOR=0.5). Expatriate households purchased more OTC medication practices than did native households (aOR=2.2). In the statistical sense, expatriate household practices were buying medication upon relatives' advice (aOR=0.3), storage condition of medication (aOR=2.4), and disposal of expired medication (aOR=0.6). The highest percentages of OTC medications in native and expatriate households were those related to gastric and ear, nose, and throat illnesses. CONCLUSION: The presence of OTC medications in expatriate households was two-fold more common than in native households in Sharjah, UAE. There were significant associations for behaviors related to the reasons why OTC medications were purchased and stored within the household for both native and expatriate families.

18.
J Biomed Nanotechnol ; 7(2): 255-62, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21702363

RESUMO

Preparation of biodegradable nanoparticles containing active molecule is now taking much attention of researchers. The aim of the present work is to achieve the nanosize particles for the first time by double emulsion (W1/O/W2,) evaporation method to encapsulate hydrophilic substance using high performance stirring apparatus. A fluorescent stable hydrophilic agent (Stilbene derivative) was used as a model drug to be encapsulated. For this purpose, PCL (polycaprolactone) was chosen as polymer in this study. Several kinds of stabilizers [triton-405, tween 80, poloxamer, PVP (polyvinylpyrrolidone), PEG (poly ethylene glycol) & PVA (poly vinyl alcohol)] were investigated and the results indicate that the PVA (0.5% concentration) leads to the most stable double emulsion with the particle size in nano range. Different parameters affecting the size of particles have been studied such as stirring time (for 1st and 2nd emulsion), stirring speed (for 1st and 2nd emulsion), polymer and stabilizer concentrations etc. After duration of one month, the encapsulation efficiency of obtained particles was estimated using U.V. analysis. Transmission Electron Microscopy (TEM) showed that the prepared particles were spherical in shape. The size and size distribution were found to be submicron and ranging from 150 to 400 nm.


Assuntos
Química Farmacêutica/métodos , Emulsões/química , Nanopartículas/química , Estabilidade de Medicamentos , Corantes Fluorescentes/química , Interações Hidrofóbicas e Hidrofílicas , Microscopia Eletrônica de Transmissão , Nanopartículas/ultraestrutura , Tamanho da Partícula , Poliésteres/química , Álcool de Polivinil/química
19.
BMC Clin Pathol ; 11: 4, 2011 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-21366912

RESUMO

BACKGROUND: Odontogenic cysts are those which arise from the epithelium associated with the development of teeth. Some odontogenic cysts were found to have special biological features that make them distinct from other lesions. This study was conducted to detect the immunoepxression of laminin-1 and Ki-67 in both radicular cysts (RCs) and keratocystic odontogenic tumors (KCOTs) and to examine the possible predictive value of these markers. METHODS: Thirteen cases of RCs and twelve cases of KCOTs were included in this study. Antibodies against laminin-1 and Ki-67 were used as primary antibodies. RESULTS: ten cases out of thirteen cases of RCs were immunopositive to laminin-1. The immunonegative cases of RCs showed high degree of inflammation inside the connective tissue wall. One case out of twelve cases of KCOTs was immunopositive to laminin-1 and the rest were immunonegative. Seven cases out of thirteen cases of RCs showed immunopositivity for Ki-67 with increased numbers of immunopositive cells when the inflammation was severe in the connective tissue wall. All KCOTS were immunopositive to Ki-67. CONCLUSIONS: The benign nature of radicular cysts and the aggressive behavior of keratocystic odontogenic tumors could be explained by the expression of laminin and Ki-67. Laminin-1 and Ki-67 could be valuable markers for the prediction of the biologic behavior of cystic lesions.

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