Infrared Spectroscopic Study and Mathematical Simulations of Carotid Atherosclerosis.

BACKGROUND/AIM: The pathogenesis, treatment and prevention of atherosclerosis continue to be the subject of intensive research and study by the scientific community. Based on Fourier-transform infrared spectra and 3D-Doppler echogram, we attempted to develop a computational simulation model for predicting the association of atherosclerotic risk factors with pathogenic molecular structural changes. MATERIALS AND METHODS: Atheromatic carotid arteries from 56 patients (60-85 years old) were used as samples. Color 3D-Doppler echogram screening was performed on all patients preoperatively. Each infrared spectrum consisted of 120 co-added spectra at a spectral resolution of 4 cm-1 Results: The infrared spectral analysis reveals 'marker bands', such as the 1,744 cm-1 band assigned to aldehyde formation and to the 'fingerprint' digital spectral region of 1,050-1,169 cm-1, characteristic of the presence of advanced glycation end products (C-O-C). The accumulation of calcium phosphate salts increases the formation rate of stenosis. The critical point of stenosis risk starts at about 45%, while when stenosis is over 60-70%, the risk of ischemic stroke or other major adverse cardiovascular events increases dramatically. CONCLUSION: Fourier-transform infrared spectroscopy and mathematical simulation models showed that carotid artery stenosis over 45% reduces the blood flow rate, while stenosis over 65% dramatically increases the hemodynamic disturbance, with a parallel increase the rate of ischemic stroke or other major adverse cardiovascular events.

Multiple Late Complications After Takeuchi Repair of Anomalous Left Coronary Artery From the Pulmonary Artery.

Takeuchi repair is a unique surgical approach in anomalous left coronary artery from the pulmonary artery. We present an adult patient with anomalous left coronary artery from the pulmonary artery with multiple late structural complications after Takeuchi repair who was evaluated using multimodality imaging, including newly developed cardiac fusion imaging with computed tomography and echocardiography. (Level of Difficulty: Advanced.).

Ecobiological context of home visits from the perspective of users in the municipality of Aracaju, state of Sergipe - SE, Brazil / Contexto ecobiológico da visita domiciliar sob a perspectiva dos usuários no município de Aracaju/SE

A quantitative study was conducted in the municipality of Aracaju/State of Sergipe - SE, Brazil, to construct and analyse the ecomap of users (216 users) who received a home visit from the Family Health Teams (Equipes de Saúde da Família). The study showed that half of the users (50.5%) were over 60 years old, 77.8% were female, 68.0% had a low educational level, 49.1% were retired, 83.3% reported being bedridden, 53.2% reported a chronic injury as the reason for having the visit, 62.5% did not know the nursing assistant professional, 58.8% had a family caregiver, 94.4% considered the visit important, and 75.9% were informed about their right to a visit but considered it a privilege. The home visit is perfectly feasible, humanising and welcoming; it is a unique opportunity to immerse into and get to know the environment of families, delivering services in a more humane and welcoming space.

Estudo quantitativo realizado no município de Aracaju/Se que objetivou a construção e análise de ecomapa do universo de usuários (216 usuários) que receberam visita domiciliar das Equipes de Saúde da Família. O estudo revelou que metade dos usuários (50,5%) tinham mais de 60 anos, 77,8% eram do gênero feminino, 68,0% com baixa escolaridade, 49,1% aposentados; 83,3% relataram o fato de estarem acamados e 53,2% referiram agravo crônico como motivo para receber a visita, 62,5% desconheciam o profissional auxiliar de enfermagem, 58,8% tinham cuidador familiar, 94,4% consideravam a visita importante e 75,9% foram informados do direito a visita, mas a consideravam um privilégio. A visita domiciliar é perfeitamente exeqüível, humanizadora e acolhedora; é uma oportunidade ímpar de imergir e conhecer o ambiente das famílias, prestando atendimento em espaço mais humano e acolhedor.

High Echogenicity with Thickening on Coronary Echogram of Proximal Coronary Artery Predicts the Severe Atherosclerosis

BACKGROUND: Coronary atherosclerosis is a pathologic process that produces thickening of the wall of the coronary arteries. but coronary angiography does not examine the wall but only the lumen of the vessels. IVUS has confirmed autopsy data that coronary atheroslerosis is diffuse and almost always involve the proximal portion of coronary arteries. We assess the meaning of the high echogenicity with thickening (HET) on transthoracic coronary echogram of proximal coronary arteries and to evaluate whether HET predicts the severity of coronary artery disease on coronary angiogram. METHODS: 112 patients (M:F=73:39, mean age=57+/-12 years) referred for coronary angiography were included in this study. We detected proximal coronary artery using transthoracic echocardiogram (3.5 MHz transducer, H-P Sonos 5500). We defined that high echogenicity with thickening (HET) is more than 1.5 mm in thickness with high echogenicity and persistence. Coronary angiography were performed in all patients. Of these patients, 29 vessels were examined by IVUS (Intravascular Ultrasound, 30 MHz) and 122 vessels by Fluoroscopy. RESULTS: 1) HET on coronary echogram had sensitivity of 80% and 88% and specificity of 79% and 82% for identifying calcification on IVUS and fluoroscopy, respectively. 2) HET on coronary echogram had sensitivity of 74% and specificity of 86% for identifying the significant stenosis of proximal left coronary artery. 3) HET on coronary echogram was observed more frequently in 3 vessel diseases compared to normal coronary arteries and 1 or 2 vessel diseases (p<0.05, respectively). 4) HET on coronary echogram was observed in vessels with more complex lesions. CONCLUSION: High echogenicity with thickening on coronary echogram may be related to the presence of calcification and predict far advanced coronary atherosclerosis. Technique using echocardiographic tissue characterization of proximal coronary arteries may become a sensitive means of screening for coronary atherosclerosis in asymptomatic patients.