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1.
Cardiol Young ; : 1-9, 2024 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-38439642

RESUMO

BACKGROUND: There is limited data on the organisation of paediatric echocardiography laboratories in Europe. METHODS: A structured and approved questionnaire was circulated across all 95 Association for European Paediatric and Congenital Cardiology affiliated centres. The aims were to evaluate: (1) facilities in paediatric echocardiography laboratories across Europe, (2) accredited laboratories, (3) medical/paramedical staff employed, (4) time for echocardiographic studies and reporting, and (5) training, teaching, quality improvement, and research programs. RESULTS: Respondents from forty-three centres (45%) in 22 countries completed the survey. Thirty-six centres (84%) have a dedicated paediatric echocardiography laboratory, only five (12%) of which reported they were European Association of Cardiovascular Imaging accredited. The median number of echocardiography rooms was three (range 1-12), and echocardiography machines was four (range 1-12). Only half of all the centres have dedicated imaging physiologists and/or nursing staff, while the majority (79%) have specialist imaging cardiologist(s). The median (range) duration of time for a new examination was 45 (20-60) minutes, and for repeat examination was 20 (5-30) minutes. More than half of respondents (58%) have dedicated time for reporting. An organised training program was present in most centres (78%), 44% undertake quality assurance, and 79% perform research. Guidelines for performing echocardiography were available in 32 centres (74%). CONCLUSION: Facilities, staffing levels, study times, standards in teaching/training, and quality assurance vary widely across paediatric echocardiography laboratories in Europe. Greater support and investment to facilitate improvements in staffing levels, equipment, and governance would potentially improve European paediatric echocardiography laboratories.

2.
Eur J Public Health ; 31(1): 23-30, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33169169

RESUMO

BACKGROUND: To stop the spread of the new coronavirus disease in 2019 (COVID-19), many countries had completely locked down. This lockdown restricted the everyday life of the affected residents and changed their mobility pattern, but its effects on sleep pattern were largely unknown. METHODS: Here, utilizing one of the largest crowdsourced database (Sleep as Android), we analyzed the sleep pattern of 25 217 users with 1 352 513 sleep records between 1 January and 29 April 2020 in the US and 16 European countries (Germany, UK, Spain, France, Italy, The Netherlands, Belgium, Hungary, Denmark, Finland, Norway, Czech, Sweden, Austria, Poland and Switzerland) with more than 100 records in all days of 2020. RESULTS: During the COVID-19 pandemic, the sleeping pattern before and after the country-level lockdown largely differed. The subjects increased their sleep duration by an average of 11.3 to 18.6 min on weekday nights, except Denmark (4.9 min) and Finland (7.1 min). In addition, subjects form all 16 European countries delayed their sleep onset from 10.7 min (Sweden) to 29.6 min (Austria). CONCLUSION: During the COVID-19 pandemic, residents in the US and 16 European countries delayed their bedtime and slept longer than usual.


Assuntos
COVID-19/psicologia , Crowdsourcing , Surtos de Doenças/prevenção & controle , Saúde Mental , SARS-CoV-2 , Sono/fisiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/complicações , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Europa (Continente)/epidemiologia , Humanos , Masculino , Pandemias , Quarentena/psicologia , Transtornos do Sono-Vigília/epidemiologia , Smartphone
3.
Int J Mol Sci ; 22(22)2021 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-34830361

RESUMO

The iontophoresis delivery of insulin (INS) remains a serious challenge due to the low permeability of the drug through the skin. This work aims to investigate the potential of water-soluble polypyrrole nanoparticles (WS-PPyNPs) as a drug donor matrix for controlled transdermal iontophoresis of INS. WS-PPyNPs have been prepared via a simple chemical polymerization in the presence of sodium dodecyl sulfate (SDS) as both dopant and the stabilizing agent. The synthesis of the soluble polymer was characterized using field emission scanning electron microscopy (FESEM), dynamic light scattering (DLS), fluorescence spectroscopy, and Fourier transform infrared (FT-IR) spectroscopy. The loading mechanism of INS onto the WS-PPyNPs is based on the fact that the drug molecules can be replaced with doped dodecyl sulfate. A two-compartment Franz-type diffusion cell was employed to study the effect of current density, formulation pH, INS concentration, and sodium chloride concentration on anodal iontophoresis (AIP) and cathodal iontophoresis (CIP) of INS across the rat skin. Both AIP and CIP delivery of INS using WS-PPyNPs were significantly increased compared to passive delivery. Furthermore, while the AIP experiment (60 min at 0.13 mA cm-2) show low cumulative drug permeation for INS (about 20.48 µg cm-2); the CIP stimulation exhibited a cumulative drug permeation of 68.29 µg cm-2. This improvement is due to the separation of positively charged WS-PPyNPs and negatively charged INS that has occurred in the presence of cathodal stimulation. The obtained results confirm the potential applicability of WS-PPyNPs as an effective approach in the development of controlled transdermal iontophoresis of INS.


Assuntos
Insulina/farmacologia , Iontoforese/métodos , Nanopartículas/química , Pele/efeitos dos fármacos , Administração Cutânea , Animais , Portadores de Fármacos/química , Portadores de Fármacos/farmacologia , Humanos , Microscopia Eletrônica de Varredura , Polímeros/química , Polímeros/farmacologia , Pirróis/química , Pirróis/farmacologia , Coelhos , Pele/ultraestrutura , Dodecilsulfato de Sódio/química , Dodecilsulfato de Sódio/farmacologia , Solubilidade , Espectroscopia de Infravermelho com Transformada de Fourier , Água/química
4.
Dement Geriatr Cogn Disord ; 49(6): 544-556, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33508841

RESUMO

PURPOSE: Due to the variety of clinical symptoms that occur in rare neurodegenerative diseases and difficulties in the correct diagnosis, there is a need to learn their characteristic imaging findings by using conventional MRI. That knowledge helps to determine the appropriate differential diagnosis and avoid misdiagnosis. The aim of this review is to present the typical neuroimaging signs of the selected neurodegenerative disorders and to create a practical approach to imaging findings useful in everyday clinical practice. Images: Images of progressive supranuclear palsy (PSP), multiple system atrophy (MSA), corticobasal degeneration (CBD), Creutzfeldt-Jakob disease (CJD), Wilson's disease (WD), and cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) are provided to visualize and distinguish the typical features of those diseases and therefore to assist neurologists and neuroradiologists in decision-making process. CONCLUSIONS: It is important to know the characteristic MRI features of rare neurodegenerative diseases and to use them in everyday clinical practice. MRI is a valuable tool when considering the initial diagnosis because it is proven to be very useful in the differentiation of more advanced stages of the rare neurodegenerative diseases but also from other neurodegenerative disorders.


Assuntos
Imageamento por Ressonância Magnética , Doenças Neurodegenerativas/diagnóstico por imagem , Neuroimagem , Diagnóstico Diferencial , Humanos
5.
Cardiol Young ; 30(9): 1374-1375, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32513330

RESUMO

This article is to commemorate and celebrate achievements of Professor Milan Samánek who passed away on 29 April, 2020. Milan was an excellent and visionary paediatric cardiologist who helped to establish paediatric cardiology as a speciality in Czechoslovakia and several other east European countries in the late 1970s. Milan was also paramount for connecting the East and West, helping in no small way to establish the Association for European Paediatric Cardiology (AEPC) as the leading learned society in Europe.


Assuntos
Cardiologia , Criança , Europa (Continente) , Humanos
6.
Cardiol Young ; 30(4): 511-520, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32172702

RESUMO

INTRODUCTION: Infants with isolated atrial septal defects are usually minimally symptomatic, and repair is typically performed after infancy. Early repair may be considered if there is high pulmonary blood flow and reduced respiratory reserve or early signs of pulmonary hypertension. Our aim was to review the characteristics and outcomes of a cohort of patients who underwent infant repair at our institute. METHODS: The study included 56 infants (28 female, 19 trisomy 21) with isolated atrial septal defect (age: 8 months (1.5-12), weight: 6 kg (2.8-7.5), echo Qp/Qs: 1.9 ± 0.1) who underwent surgical closure (20 fenestrated). Three groups were identified: 1) chronic lung disease and pulmonary hypertension (group A: n = 28%); 2) acutely unwell infants with pulmonary hypertension but no chronic lung disease (group B: n = 20, 36%); and 3) infants with refractory congestive heart failure without either pulmonary hypertension or chronic lung disease (group C: n = 9, 16%). RESULTS: Post-operatively, pulmonary hypertension infants (47/56) showed improvement in tricuspid annular plane systolic excursion z-score (p < 0.001) and right ventricular systolic/diastolic duration ratio (p < 0.05). All ventilator (14.3%) or oxygen-dependent (31.6%) infants could be weaned within 2 weeks after repair. One year later, weight z-score increased in all patients and by +1 in group A, +1.3 in group B and +2 in group C. Over a median follow-up of 1.4 years, three patients died, four patients continued to have pulmonary hypertension evidence and two remained on targeted pulmonary hypertension therapy. CONCLUSION: Atrial septal defect repair within the first year may improve the clinical status and growth in infants with early signs of pulmonary hypertension or those requiring respiratory support and facilitate respiratory management.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Comunicação Interatrial/cirurgia , Hipertensão Pulmonar/fisiopatologia , Pneumopatias/etiologia , Circulação Pulmonar/fisiologia , Cateterismo Cardíaco , Progressão da Doença , Ecocardiografia , Feminino , Seguimentos , Comunicação Interatrial/complicações , Humanos , Hipertensão Pulmonar/etiologia , Lactente , Pneumopatias/fisiopatologia , Masculino , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
7.
Molecules ; 25(9)2020 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-32403238

RESUMO

Nosocomial infections, which greatly increase morbidity among hospitalized patients, together with growing antibiotic resistance still encourage many researchers to search for novel antimicrobial compounds. Picolinium salts with different lengths of alkyl chains (C12, C14, C16) were prepared by Menshutkin-like reaction and evaluated with respect to their biological activity, i.e., lipophilicity and critical micellar concentration. Picolinium salts with C14 and C16 side chains achieved similar or even better results when in terms of antimicrobial efficacy than benzalkoniums; notably, their fungicidal efficiency was substantially more potent. The position of the methyl substituent on the aromatic ring does not seem to affect antimicrobial activity, in contrast to the effect of length of the N-alkyl chain. Concurrently, picolinium salts exhibited satisfactory low cytotoxicity against mammalian cells, i.e., lower than that of benzalkonium compounds, which are considered as safe.


Assuntos
Antibacterianos/farmacologia , Anti-Infecciosos/farmacologia , Antivirais/farmacologia , Ácidos Picolínicos/química , Ácidos Picolínicos/farmacologia , Compostos de Amônio Quaternário/química , Animais , Células CHO , Candida/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Cricetulus , Fungos/efeitos dos fármacos , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Positivas/efeitos dos fármacos , Herpesvirus Humano 3/efeitos dos fármacos , Testes de Sensibilidade Microbiana , Ácidos Picolínicos/síntese química , Compostos de Amônio Quaternário/farmacologia , Relação Estrutura-Atividade , Tensoativos/química , Tensoativos/farmacologia
8.
Molecules ; 25(3)2020 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-31991816

RESUMO

The increasing risk of radiation exposure underlines the need for novel radioprotective agents. Hence, a series of novel 1-(2-hydroxyethyl)piperazine derivatives were designed and synthesized. Some of the compounds protected human cells against radiation-induced apoptosis and exhibited low cytotoxicity. Compared to the previous series of piperazine derivatives, compound 8 exhibited a radioprotective effect on cell survival in vitro and low toxicity in vivo. It also enhanced the survival of mice 30 days after whole-body irradiation (although this increase was not statistically significant). Taken together, our in vitro and in vivo data indicate that some of our compounds are valuable for further research as potential radioprotectors.


Assuntos
Piperazinas/química , Piperazinas/farmacologia , Protetores contra Radiação/química , Protetores contra Radiação/farmacologia , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos da radiação , Relação Dose-Resposta a Droga , Humanos , Dose Máxima Tolerável , Modelos Moleculares , Conformação Molecular , Estrutura Molecular , Piperazinas/administração & dosagem , Piperazinas/efeitos adversos , Radiação Ionizante , Protetores contra Radiação/administração & dosagem , Protetores contra Radiação/efeitos adversos , Relação Estrutura-Atividade , Análise de Sobrevida
9.
J Cardiovasc Magn Reson ; 21(1): 34, 2019 06 27.
Artigo em Inglês | MEDLINE | ID: mdl-31242903

RESUMO

BACKGROUND: Once surgical management is indicated, variation of Ebstein valve morphology affects surgical strategy. This study explored practical, easily measureable, cardiovascular magnetic resonance (CMR)-derived attributes that may contribute to the complexity and risk of cone reconstruction. METHODS: A retrospective assessment was performed of Ebstein anomaly patients older than 12 years age, with pre-operative CMR, undergoing cone surgical reconstruction by one surgeon. In addition to clinical data, the CMR-derived Ebstein valve rotation angle (EVRA), area ratios of chamber size, indexed functional RV (RVEDVi) and left ventricular (LV) volumes, tricuspid valve regurgitant fraction (TR%) and other valve attributes were related to early surgical outcome; including death, significant residual TR% or breakdown of repair. RESULTS: Of 26 operated patients older than 12 years age, since program start, 20 had pre-op CMR and underwent surgery at median (range) age 20 (14-57) years. TR% was improved in all patients. Four of the 20 CMR patients (20%) experienced early surgical dehiscence of the paravalve tissue, with cone-shaped tricuspid valve intact; one of whom died. A larger EVRA correlated with Carpentier category and was significantly related to dehiscence. If EVRA >60o, relative risk of dehiscence was 3.2 (CI 1.3-4.9, p = 0.03). Those with dehiscence had thickened, more tethered anterior leaflet edges (RR 17, CI 3-100, p < 0.01), smaller pre-operative functional RVEDVi; (132 vs 177 mL/m2, p = 0.04), and were older (median 38 vs 19 years, p = 0.01). TR %, chamber area ratios and LV parameters were not different. CONCLUSIONS: Comprehensive CMR assessment characterizes patients prior to cone surgical reconstruction of Ebstein anomaly. Pragmatic observation of larger EVRA, smaller RVEDVi and leaflet thickening, suggests risk of repair tension and dehiscence, and may require specific modification of cone surgical technique, such as leaflet augmentation.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Anomalia de Ebstein/diagnóstico por imagem , Anomalia de Ebstein/cirurgia , Imagem Cinética por Ressonância Magnética , Procedimentos de Cirurgia Plástica , Valva Tricúspide/diagnóstico por imagem , Valva Tricúspide/cirurgia , Adolescente , Adulto , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Procedimentos Cirúrgicos Cardíacos/mortalidade , Tomada de Decisão Clínica , Anomalia de Ebstein/mortalidade , Anomalia de Ebstein/fisiopatologia , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/mortalidade , Valor Preditivo dos Testes , Procedimentos de Cirurgia Plástica/efeitos adversos , Procedimentos de Cirurgia Plástica/mortalidade , Recuperação de Função Fisiológica , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento , Valva Tricúspide/anormalidades , Valva Tricúspide/fisiopatologia , Adulto Jovem
11.
Pol Merkur Lekarski ; 47(282): 212-216, 2019 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-31945021

RESUMO

Epidemiological investigations regarding the incidence of thyroid diseases reveal that in the Silesia thyroid diseases constitute 13.5% of all illnesses in Poland. AIM: The aim of this study was to analyze the structure of thyroid diseases in Piekary Slaskie in the years 2006-2011 and evaluate the effectiveness of the implemented Thyroid Disease Prevention Programme. MATERIALS AND METHODS: The material comprised the thyroid test results of 1137 patients who consented to take part in the Thyroid Disease Prevention Program in the years 2006-2011. The patients who underwent the examination constituted 2.04% of the whole population residing in Piekary Slaskie. Assessment of thyroid function was based on hormonal measurements (thyroid-stimulating hormone, TSH), thyroid ultrasound, ultrasound-guided fine needle aspiration biopsy of thyroid. RESULTS: The examinations conducted in 1137 participants of the Thyroid Disease Prevention Programme in the years 2006-2011 prove that the program allowed to diagnose thyroid nodular lesions in 44.1% of examined people, thyroiditis in 57.5% of patients, increased thyroid volume in 27.1% of subjects, hypothyroidism or hyperthyroidism in 26.9% of examined patients, and neoplastic disease in 1.1% of patients. CONCLUSIONS: The Thyroid Disease Prevention Program being the subject of assessment has met its objective aimed at prophylaxis in Piekary Slaskie, as thanks to the conducted diagnostic procedures, it allowed to provide treatment of thyroid diseases at their different stadiums.


Assuntos
Doenças da Glândula Tireoide , Biópsia por Agulha Fina , Humanos , Polônia/epidemiologia , Prevalência , Doenças da Glândula Tireoide/epidemiologia , Doenças da Glândula Tireoide/prevenção & controle
12.
Circulation ; 135(11): 1045-1055, 2017 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-28143885

RESUMO

BACKGROUND: The study analyzed the impact of first-trimester screening on the spectrum of congenital heart defects (CHDs) later in pregnancy and on the outcome of fetuses and children born alive with a CHD. METHODS: The spectrum of CHDs, associated comorbidities, and outcome of fetuses, either diagnosed with a CHD in the first trimester (Group I, 127 fetuses) or only in the second-trimester screening (Group II, 344 fetuses), were analyzed retrospectively between 2007 and 2013. Second-trimester fetuses diagnosed with a CHD between 2007 and 2013 were also compared with Group III (532 fetuses diagnosed with a CHD in the second trimester from 1996 to 2001, the period before first-trimester screening was introduced). RESULTS: The spectrum of CHDs diagnosed in the first and second trimesters in the same time period differed significantly, with a greater number of comorbidities (P<0.0001), CHDs with univentricular outcome (P<0.0001), intrauterine deaths (P=0.01), and terminations of pregnancy (P<0.0001) in Group I compared with Group II. In Group III, significantly more cases of CHDs with univentricular outcome (P<0.0001), intrauterine demise (P=0.036), and early termination (P<0.0001) were identified compared with fetuses diagnosed with CHDs in the second trimester between 2007 and 2013. The spectrum of CHDs seen in the second-trimester groups differed after first-trimester screening was implemented. CONCLUSIONS: First-trimester screening had a significant impact on the spectrum of CHDs and the outcomes of pregnancies with CHDs diagnosed in the second trimester. Early detection of severe forms of CHDs and significant comorbidities resulted in an increased pregnancy termination rate in the first trimester.


Assuntos
Cardiopatias Congênitas/diagnóstico , Aberrações Cromossômicas , Comorbidade , República Tcheca , Ecocardiografia , Feminino , Feto/diagnóstico por imagem , Cardiopatias Congênitas/epidemiologia , Cardiopatias Congênitas/genética , Humanos , Gravidez , Primeiro Trimestre da Gravidez , Segundo Trimestre da Gravidez , Estudos Retrospectivos , Ultrassonografia Pré-Natal
13.
Cutan Ocul Toxicol ; 37(1): 77-83, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28724312

RESUMO

The aim of this study was to determine optimal conditions for in vitro skin decontamination using water and detergents as decontamination agents and to test the cleansing efficiency of selected detergents. Experiments were performed using a peristaltic pump for showering of pig skin in modified static diffusion cells. Several conditions were tested including different flow rates (from 5 to 33 ml s-1), quantity of rinsing fluid (from 40 to 400 ml) and concentration of detergents (2; 5; 10%). Further, several types of detergents/commercial decontamination agents were evaluated under the selected conditions to find the most effective means of decontamination. The amount of paraoxon removed from the skin surface following wet-type decontamination was detected in the rinsing fluid spectrophotometrically after hydrolysis of paraoxon - a model contaminant. The efficacy of rinsing by water/Spolapon AES 253 increased with flow rate up to 25 ml s-1 and a rinsing volume of 200 ml. Lutensol AT 25 achieved maximum efficacy at the lowest tested concentration (2%). A flow rate of 16 ml s-1, rinsing volume of 100 ml (values from the middle part of the sigmoid curve) and 5% concentration of decontaminant solution were used for further evaluation of detergents as cleansing agents under the selected conditions. Cetylpyridinium bromide (cationic surfactant), carbethopendecinii bromidum (cationic surfactant) and polyoxyethylene-10-tridecyl ether (non-ionic surfactant), SDS (anionic surfactant), althosan MB (cationic surfactant), sodium dodecylbenzene sulphonate (anionic surfactant), neodekont (mixture), tergitol NPX (non-ionic surfactant), Korynt P (non-ionic surfactant) were found to be the most effective. These decontaminants were able to wash away more than 92% of paraoxon from the contaminated skin.


Assuntos
Descontaminação/métodos , Inseticidas/análise , Paraoxon/análise , Animais , Detergentes/química , Feminino , Inseticidas/química , Paraoxon/química , Pele , Tensoativos/química , Suínos , Água/química
14.
Bioorg Med Chem ; 24(4): 841-8, 2016 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-26774252

RESUMO

In the present paper, we describe the synthesis of a new group of 5-hydroxyisoquinolinium salts with different lengths of alkyl side-chain (C10-C18), and their chromatographic analysis and biological assay for in vitro activity against bacterial and fungal strains. We compare the lipophilicity and efficacy of hydroxylated isoquinolinium salts with the previously published (non-hydroxylated) isoquinolinium salts from the point of view of antibacterial and antifungal versatility and cytotoxic safety. Compound 11 (C18) had to be excluded from the testing due to its low solubility. Compounds 9 and 10 (C14, C16) showed only moderate efficacy against G+ bacteria, notably with excellent potency against Staphyloccocus aureus, but no effect against G- bacteria. In contrast, non-hydroxylated isoquinolinium salts showed excellent antimicrobial efficacy within the whole series, particularly 14 (C14) against G+ strains and 15 (C16) against fungi. The electronic properties and desolvation energies of 5-hydroxyisoquinolinium and isoquinolinium salts were studied by quantum-chemistry calculations employing B3LYP/6-311++G(d,p) method and an implicit water-solvent simulation model (SCRF). Despite the positive mesomeric effect of the hydroxyl moiety reducing the electron density of the quaternary nitrogen, it is probably the higher lipophilicity and lower desolvation energy of isoquinolinium salts, which is responsible for enhanced antimicrobial versatility and efficacy.


Assuntos
Antibacterianos/síntese química , Antifúngicos/síntese química , Isoquinolinas/síntese química , Antibacterianos/farmacologia , Antifúngicos/farmacologia , Fungos/efeitos dos fármacos , Fungos/crescimento & desenvolvimento , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Negativas/crescimento & desenvolvimento , Bactérias Gram-Positivas/efeitos dos fármacos , Bactérias Gram-Positivas/crescimento & desenvolvimento , Isoquinolinas/farmacologia , Testes de Sensibilidade Microbiana , Modelos Moleculares , Teoria Quântica , Relação Estrutura-Atividade
15.
Cardiol Young ; 26(7): 1373-82, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26842969

RESUMO

BACKGROUND: In the era of multi-modality imaging, this study compared contemporary, pre-operative echocardiography and cardiac MRI in predicting the need for intervention on additional lesions before surgical bidirectional cavopulmonary connection. METHODS: A total of 72 patients undergoing bidirectional cavopulmonary connection for single-ventricle palliation between 2007 and 2012, who underwent pre-operative assessment using both echocardiography and MRI, were included. The pre-determined outcome measure was any additional surgical or catheter-based intervention within 6 months of bidirectional cavopulmonary connection. Indices assessed were as follows: indexed dimensions of right and left pulmonary arteries, coarctation of the aorta, adequacy of interatrial communication, and degree of atrioventricular valve regurgitation. RESULTS: Median age at bidirectional cavopulmonary connection was 160 days (interquartile range 121-284). The following MRI parameters predicted intervention: Z score for right pulmonary artery (odds ratio 1.77 (95% confidence interval 1.12-2.79, p=0.014)) and left pulmonary artery dimensions (odds ratio 1.45 (1.04-2.00, p=0.027)) and left pulmonary artery report conclusion (odds ratio 1.57 (1.06-2.33)). The magnetic resonance report predicted aortic arch intervention (odds ratio 11.5 (3.5-37.7, p=0.00006)). The need for atrioventricular valve repair was associated only with magnetic resonance regurgitation fraction score (odds ratio 22.4 (1.7-295.1, p=0.018)). Echocardiography assessment was superior to MRI for predicting intervention on interatrial septum (odds ratio 27.7 (6.3-121.6, p=0.00001)). CONCLUSION: For branch pulmonary arteries, aortic arch, and atrioventricular valve regurgitation, MRI parameters more reliably predict the need for intervention; however, echocardiography more accurately identified the adequacy of interatrial communication. Approaching bidirectional cavopulmonary connection, the diagnostic strengths of MRI and echocardiography should be acknowledged when considering intervention.


Assuntos
Aorta/diagnóstico por imagem , Técnica de Fontan , Cardiopatias Congênitas/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , Artéria Pulmonar/diagnóstico por imagem , República Tcheca , Ecocardiografia , Feminino , Cardiopatias Congênitas/cirurgia , Humanos , Lactente , Modelos Logísticos , Imageamento por Ressonância Magnética , Masculino , Análise Multivariada , Estudos Retrospectivos
16.
Cardiol Young ; 26(2): 340-6, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25739970

RESUMO

We report three cases of an abnormal finding of duplicated left pulmonary artery: two of these occurring in children with Kabuki syndrome and configuring the setting of a pseudo-pulmonary sling without any clinical or cardiac cross-sectional evidence of tracheal compression. The other case instead represents duplicated left pulmonary artery with pulmonary sling caused by the retro-tracheal course of the lower left pulmonary artery associated with "Christmas Tree" arrangement of the tracheo-bronchial system. In both patients with pseudo-pulmonary sling and Kabuki syndrome, the abnormal finding was incidental during echocardiographic examination and neither of the patients required surgical repair for the condition. To the best of our knowledge, they represent the third and fourth cases in which such an anomaly of the pulmonary artery branches not forming a sling is seen in association with Kabuki syndrome. Another case represents our second experience and the second case reported in literature with duplicated left pulmonary artery in the setting of a complex tracheal anatomy. In this symptomatic patient, surgical repair of atrial septal defect and relief of the vascular ring were indicated, and the surgical repair was performed successfully at the age of 3 years.


Assuntos
Anormalidades Múltiplas/diagnóstico , Face/anormalidades , Doenças Hematológicas/diagnóstico , Artéria Pulmonar/anormalidades , Malformações Vasculares/diagnóstico , Doenças Vestibulares/diagnóstico , Angiografia , Criança , Pré-Escolar , Diagnóstico Diferencial , Ecocardiografia , Humanos , Masculino
17.
Klin Mikrobiol Infekc Lek ; 22(2): 75-85, 2016 Jun.
Artigo em Tcheco | MEDLINE | ID: mdl-27450526

RESUMO

Studies focused on arbovirus diseases transmitted by invasive species of mosquitoes have become increasingly significant in recent years, due to the fact that these vectors have successfully migrated to Europe and become established in the region. Mosquitoes, represented by more than 3 200 species, occur naturally worldwide, except in Antarctica. They feed on the blood of warm-blooded animals and by this route, they are capable of transmitting dangerous diseases. Some species can travel a distance of 10 km per night and can fly continuously for up to 4 hours at a speed of 1-2 km/h. Most species are active at night, in the evening or morning. It usually takes a mosquito female about 50 seconds to penetrate the skin of mammals and the subsequent blood meal usually takes about 2.5 minutes. Mosquitoes live for several weeks or months, depending on the environmental conditions. The VectorNet project is a European network of information exchange and sharing of data relating to the geographical distribution of arthropod vectors and transmission of infectious agents between human populations and animals. It aims at the development of strategic plans and vaccination policies which are the main tasks of this time, as well as the development and application of new disinfectants to control vector populations.


Assuntos
Doenças Transmissíveis/transmissão , Culicidae , Insetos Vetores , Espécies Introduzidas , Animais , Fatores Biológicos , Humanos , Vacinação
18.
Bioorg Med Chem ; 23(1): 174-83, 2015 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-25438883

RESUMO

Substitution of chlorine in 5-chloro-N-phenylpyrazine-2-carboxamide (1) with simple n-alkylamines yielded a series of 5-alkylamino-N-phenylpyrazine-2-carboxamides (propylamino to octylamino derivatives), which possessed similar or increased activity against Mycobacterium tuberculosis H37Rv compared to parent 5-chloro derivative (1), with MIC ranging from 2.5 to 12.2 µM. 5-Butylamino to 5-heptylamino derivatives exerted similar activity also against Mycobacterium kansasii. Importantly, the substitution led also to significant decrease of in vitro cytotoxicity in HepG2 cell line. 5-Heptylamino-N-phenylpyrazine-2-carboxamide (1e) exerted MIC=2.5 µM (M.tbc) and IC50 >250 µM (HepG2). Further modification of alkylamino chain with terminal methoxy or hydroxy group lead to compounds with decreased or none activity, the decrease was proportional to the decrease of lipophilicity. 5-(2-Phenylethylamino) and 5-(3-phenylpropylamino) derivatives were also of decreased activity. On contrary to alkylamino derivatives derived from 1, alkylamino derivatives derived from 5-chloro-N-2-chlorophenylpyrazine-2-carboxamide (2) possessed substantially decreased or none activity. None of the prepared compounds was active against Mycobacterium avium.


Assuntos
Amidas/química , Amidas/farmacologia , Pirazinamida/química , Pirazinamida/farmacologia , Tuberculose/tratamento farmacológico , Amidas/síntese química , Antibacterianos/síntese química , Antibacterianos/farmacologia , Antituberculosos/síntese química , Antituberculosos/farmacologia , Humanos , Pirazinamida/síntese química , Relação Estrutura-Atividade
19.
Molecules ; 20(3): 3681-96, 2015 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-25719739

RESUMO

A set of new quaternary ammonium compounds based on pyridine-4-aldoxime was synthesized, characterized with analytical data (NMR, EA, HPLC, MS) and tested for in vitro antimicrobial activity (antibacterial, antifungal) and cytotoxicity. Quaternary pyridinium-4-aldoxime salts with length of alkyl side chain from C8 to C20 and belonging to the group of cationic surfactants were investigated in this work. An HPLC experimental protocol for characterization of mixtures of all homologues has been found. Antimicrobial evaluation found that yeast-type fungi were most sensitive towards C14 and C16 analogues, whereas the C16 analogue was completely ineffective against filamentous fungi. Antibacterial assessment showed versatility of C14 and relatively high efficacy of C16 against G+ strains and C14 against G- strains. Notably, none of the studied compounds exceeded the efficacy and versatility of the benzalkonium C12 analogue, and benzalkonium analogues also exhibited lower cytotoxicity in the cell viability assay.


Assuntos
Antibacterianos/farmacologia , Antifúngicos/farmacologia , Bactérias/efeitos dos fármacos , Fungos/efeitos dos fármacos , Oximas/química , Compostos de Amônio Quaternário/síntese química , Compostos de Amônio Quaternário/farmacologia , Animais , Antibacterianos/síntese química , Antifúngicos/síntese química , Células CHO , Sobrevivência Celular/efeitos dos fármacos , Cricetulus , Testes de Sensibilidade Microbiana , Relação Estrutura-Atividade
20.
Molecules ; 20(5): 8687-711, 2015 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-26007174

RESUMO

A series of N-alkyl-3-(alkylamino)pyrazine-2-carboxamides and their N-alkyl-3-chloropyrazine-2-carboxamide precursors were prepared. All compounds were characterized by analytical methods and tested for antimicrobial and antiviral activity. The antimycobacterial MIC values against Mycobacterium tuberculosis H37Rv of the most effective compounds, 3-(hexylamino)-, 3-(heptylamino)- and 3-(octylamino)-N-methyl-pyrazine-2-carboxamides 14‒16, was 25 µg/mL. The compounds inhibited photosystem 2 photosynthetic electron transport (PET) in spinach chloroplasts. This activity was strongly connected with the lipophilicity of the compounds. For effective PET inhibition longer alkyl chains in the 3-(alkylamino) substituent in the N-alkyl-3-(alkylamino)pyrazine-2-carboxamide molecule were more favourable than two shorter alkyl chains.


Assuntos
Antituberculosos/farmacologia , Cloroplastos/metabolismo , Transporte de Elétrons/efeitos dos fármacos , Pirazinamida/farmacologia , Pirazinas/farmacologia , Antituberculosos/síntese química , Proteínas de Bactérias/antagonistas & inibidores , Proteínas de Bactérias/metabolismo , Ácido Graxo Sintases/antagonistas & inibidores , Ácido Graxo Sintases/metabolismo , Testes de Sensibilidade Microbiana , Mycobacterium tuberculosis/efeitos dos fármacos , Mycobacterium tuberculosis/metabolismo , Pirazinamida/síntese química , Pirazinamida/química , Pirazinas/síntese química , Spinacia oleracea/metabolismo , Relação Estrutura-Atividade
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