Detecting drug-induced prolongation of the QRS complex: new insights for cardiac safety assessment.

BACKGROUND: Drugs slowing the conduction of the cardiac action potential and prolonging QRS complex duration by blocking the sodium current (I(Na)) may carry pro-arrhythmic risks. Due to the frequency-dependent block of I(Na), this study assesses whether activity-related spontaneous increases in heart rate (HR) occurring during standard dog telemetry studies can be used to optimise the detection of class I antiarrhythmic-induced QRS prolongation. METHODS: Telemetered dogs were orally dosed with quinidine (class Ia), mexiletine (class Ib) or flecainide (class Ic). QRS duration was determined standardly (5 beats averaged at rest) but also prior to and at the plateau of each acute increase in HR (3 beats averaged at steady state), and averaged over 1h period from 1h pre-dose to 5h post-dose. RESULTS: Compared to time-matched vehicle, at rest, only quinidine and flecainide induced increases in QRS duration (E(max) 13% and 20% respectively, P<0.01-0.001) whereas mexiletine had no effect. Importantly, the increase in QRS duration was enhanced at peak HR with an additional effect of +0.7 ± 0.5 ms (quinidine, NS), +1.8 ± 0.8 ms (mexiletine, P<0.05) and +2.8 ± 0.8 ms (flecainide, P<0.01) (calculated as QRS at basal HR-QRS at high HR). CONCLUSION: Electrocardiogram recordings during elevated HR, not considered during routine analysis optimised for detecting QT prolongation, can be used to sensitise the detection of QRS prolongation. This could prove useful when borderline QRS effects are detected. Analysing during acute increases in HR could also be useful for detecting drug-induced effects on other aspects of cardiac function.

Long-term performance of passive materials for removal of ozone from indoor air.

The health effects associated with exposure to ozone range from respiratory irritation to increased mortality. In this paper, we explore the use of three green building materials and an activated carbon (AC) mat that remove ozone from indoor air. We studied the effects of long-term exposure of these materials to real environments on ozone removal capability and pre- and post-ozonation emissions. A field study was completed over a 6-month period, and laboratory testing was intermittently conducted on material samples retrieved from the field. The results show sustained ozone removal for all materials except recycled carpet, with greatest ozone deposition velocity for AC mat (2.5-3.8 m/h) and perlite-based ceiling tile (2.2-3.2 m/h). Carbonyl emission rates were low for AC across all field sites. Painted gypsum wallboard and perlite-based ceiling tile had similar overall emission rates over the 6-month period, while carpet had large initial emission rates of undesirable by-products that decayed rapidly but remained high compared with other materials. This study confirms that AC mats and perlite-based ceiling tile are viable surfaces for inclusion in buildings to remove ozone without generating undesirable by-products. PRACTICAL IMPLICATIONS The use of passive removal materials for ozone control could decrease the need for, or even render unnecessary, active but energy consuming control solutions. In buildings where ozone should be controlled (high outdoor ozone concentrations, sensitive populations), materials specifically designed or selected for removing ozone could be implemented, as long as ozone removal is not associated with large emissions of harmful by-products. We find that activated carbon mats and perlite-based ceiling tiles can provide substantial, long-lasting, ozone control.

Immunotherapy in oncology: a new challenge for radiologists. / Inmunoterapia en oncología: un nuevo desafío radiológico.

OBJECTIVE: In patients with oncologic disease, immunotherapy has become established as an alternative or complementary therapy to traditional treatment options (surgery, radiotherapy, and chemotherapy). Currently available immunotherapy modes can be divided into two types: passive and active. The active type strengthens the immune system's response to tumor cells by activating both humoral immunity and cell-mediated immunity, using the adaptive response. This article aims to analyze the radiologic patterns of the response to immunotherapy through immune-response-related criteria and to describe the main adverse effects associated with this treatment approach. CONCLUSION: Imaging tests play a fundamental role in the follow-up of oncologic patients and in the assessment of their response to treatment. Immunotherapy represents a challenge for radiologists both in the evaluation of the response to immunotherapy and in the detection of the adverse effects associated with this treatment approach.