Quantitative contrast-enhanced ultrasound for the differentiation of kidney allografts with significant histopathological injury.

OBJECTIVE: To identify specific quantitative contrast-enhanced ultrasound (CEUS) parameters that could distinguish kidney transplants with significant histopathological injury. METHODS: Sixty-four patients were enrolled in this prospective observational study. Biopsies were performed following CEUS and blood examination. RESULTS: 28 biopsy specimens had minimal changes (MC group), while 36 had significant injury (SI group). Of these, 12 had rejection (RI group) and 24 non-rejection injury (NRI group). In RI and NRI groups, temporal difference in time to peak (TTP) between medulla and cortex (ΔTTPm-c) was significantly shorter compared to the MC group (5.77, 5.92, and 7.94 s, P = 0.048 and 0.026, respectively). Additionally, RI group had significantly shorter medullary TTP compared to the MC group (27.75 vs. 32.26 s; P = 0.03). In a subset of 41 patients with protocol biopsy at 1-year post-transplant, ΔTTPm-c was significantly shorter in the SI compared to the MC group (5.67 vs. 7.67 s; P = 0.024). Area under receiver operating characteristic curves (AUROCs) for ΔTTPm-c was 0.69 in all patients and 0.71 in patients with protocol biopsy. CONCLUSIONS: RI and NRI groups had shorter ΔTTPm-c compared to the MC group. AUROCs for both patient groups were good, making ΔTTPm-c a promising CEUS parameter for distinguishing patients with significant histopathological injury.

Immediate, lag and time window effects of meteorological factors on ST-elevation myocardial infarction incidence.

The influence of several meteorological parameters on acute myocardial infarction (AMI) incidences with immediately and/or delayed effects has been widely reported. It remains unknown whether the individual AMI subtypes reveal similar patterns. To date, generally seasonal variation in ST elevation MI (STEMI) has been investigated. However, these approaches couldn't detect the effects of changes in multiple meteorological variables on STEMI incidence within a specific season. Therefore, the aim of our study is to explore immediate, delayed and cumulative effects of average daily temperature, atmospheric pressure and humidity on nation-wide STEMI hospital admissions. We linked daily hospitals' STEMI admission data with meteorological stations' data according to the patient's permanent residence. Subsequently, a multivariate analysis based on a main effect generalised linear model, assuming a log-link function with a Poisson distribution, was conducted. With the help of lags, we were able to analyse delayed effects, while the cumulative effects of specific meteorological variables were analysed utilising time windows. As a result, we confirmed immediate and delayed negative effect of low temperature and low relative humidity for all observed lags as well as cumulative average effects of low temperature and low relative humidity for all observed time windows. However, no delayed, single-day effect for atmospheric pressure was detected. Nevertheless, the cumulative average effect was confirmed in all time windows suggesting that prolonged low pressure influences the incidence of STEMI. A novelty of our approach is the comparative examination of immediate, delayed and cumulative effect of specific meteorological variables on the incidence of STEMI. This approach enables us to gain a new insight into the phenomenon studied.

Influence of daily individual meteorological parameters on the incidence of acute coronary syndrome.

BACKGROUND: A nationwide study was conducted to explore the short term association between daily individual meteorological parameters and the incidence of acute coronary syndrome (ACS) treated with coronary emergency catheter interventions in the Republic of Slovenia, a south-central European country. METHOD: We linked meteorological data with daily ACS incidence for the entire population of Slovenia, for the population over 65 years of age and for the population under 65 years of age. Data were collected daily for a period of 4 years from 1 January 2008 to 31 December 2011. In line with existing studies, we used a main effect generalized linear model with a log-link-function and a Poisson distribution of ACS. RESULTS AND CONCLUSIONS: Three of the studied meteorological factors (daily average temperature, atmospheric pressure and relative humidity) all have relevant and significant influences on ACS incidences for the entire population. However, the ACS incidence for the population over 65 is only affected by daily average temperature, while the ACS incidence for the population under 65 is affected by daily average pressure and humidity. In terms of ambient temperature, the overall findings of our study are in line with the findings of the majority of contemporary European studies, which also note a negative correlation. The results regarding atmospheric pressure and humidity are less in line, due to considerable variations in results. Additionally, the number of available European studies on atmospheric pressure and humidity is relatively low. The fourth studied variable-season-does not influence ACS incidence in a statistically significant way.