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1.
ACS Energy Lett ; 8(10): 4371-4379, 2023 Oct 13.
Article in English | MEDLINE | ID: mdl-37854053

ABSTRACT

Metal halide perovskites (MHPs) are disruptive materials for a vast class of optoelectronic devices. The presence of electronic trap states has been a tough challenge in terms of characterization and thus mitigation. Many attempts based on electronic spectroscopies have been tested, but due to the mixed electronic-ionic nature of MHP conductivity, many experimental results retain a large ambiguity in resolving electronic and ionic charge contributions. Here we adapt a method, previously used in highly resistive inorganic semiconductors, called photoinduced current transient spectroscopy (PICTS) on lead bromide 2D-like ((PEA)2PbBr4) and standard "3D" (MAPbBr3) MHP single crystals. We present two conceptually different outcomes of the PICTS measurements, distinguishing the different electronic and ionic contributions to the photocurrents based on the different ion drift of the two materials. Our experiments unveil deep level trap states on the 2D, "ion-frozen" (PEA)2PbBr4 and set new boundaries for the applicability of PICTS on 3D MHPs.

2.
Rev. argent. cardiol ; 89(2): 107-114, abr. 2021. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1356856

ABSTRACT

RESUMEN Introducción: La demora a la reperfusión del síndrome coronario agudo con elevación del segmento ST es un factor determinante en el pronóstico. Su reducción podría disminuir la morbimortalidad. Objetivo: Identificar y modificar las barreras detectadas en 20 años de tratamiento del síndrome coronario agudo con elevación del segmento ST en un centro de tercer nivel de una ciudad de alta densidad demográfica para evaluar su efecto en el resultado del procedimiento. Material y métodos: Incluimos prospectiva y consecutivamente del 01/01/2000 al 31/12/2019, 3007 pacientes con síndrome coronario agudo con elevación del segmento ST dentro de las 12 h de iniciados los síntomas para realizar angioplastia primaria. Se dividió el tiempo desde el comienzo de los síntomas hasta la insuflación del balón en intervalos. Luego de identificar las barreras (2000-2009) se incorporaron cambios al procedimiento. Se organizó a la población en 2 grupos (G) G1: preimplementación de cambios (2000-2009) y G2: posimplementación (2010- 2019). Resultados: Se incluyeron en G1 1409 pacientes y en G2 1598. Sin diferencias demográficas, excepto por el tipo de angioplastia. Se identificaron demoras al realizar el diagnóstico, de comunicación entre médicos, del traslado y del ingreso del paciente a hemodinamia. Con los cambios, disminuimos el intervalo consulta-contacto con el hemodinamista [G1: 90 min (36-168) vs. G2: 77 min (36-144) p -0,01] y el intervalo contacto hemodinamista-ingreso a Hemodinamia [G1: 75 min (55-100) vs. G2: 51 min (34-70) p -0,01]. Se redujo la mortalidad intrahospitalaria (G1: 9,2% vs. G2:6,7% p -0,01) y al 6to mes (G1: 13,1% vs. G2: 7,5% p -0,01). Conclusiones: El retraso al diagnóstico, la dificultad en la comunicación y la forma de traslado fueron las principales causas de demora. La implementación de un protocolo de procedimientos permitió reducir las demoras. La evaluación continua de resultados y la educación permanente, constituyen los pilares fundamentales para la optimización de programas de atención en red.


ABSTRACT Background: The delay to reperfusion of ST-segment elevation acute coronary syndrome (STEACS) is a key factor in its prognosis, and its reduction could reduce morbidity and mortality. Objective: The aim of this study was to identify and modify the barriers detected in 20 years of STEACS treatment in a tertiary care center of a densely populated city to evaluate their effect on the outcome of the procedure. Methods: A total of 3007 patients with STEACS within 12 hours of symptoms onset were prospectively and consecutively included to undergo primary percutaneous coronary intervention (PCI) from January 1, 2000 to December 31, 2019. Time from symptoms onset to balloon inflation was divided into intervals. After barriers were identified (2000-2009), the procedure was changed. The population was divided into two groups (G) G1: pre-implementation (2000-2009) and G2: post-implementation (2010-2019) of changes. Results: G1 included 1409 and G2 1598 patients with no demographic differences except for the type of PCI. Delays were identified in diagnosis, communication between physicians, transfer and admission of the patient to the hemodynamics lab. Procedural changes decreased first medical contact-hemodynamic team contact interval [G1: 90 min (36-168) vs. G2: 77 min (36-144) p -0.01] and hemodynamic team contact-hemodynamics lab admission interval [G1: 75 min (55-100) vs. G2: 51 min (34-70) p -0.01] and reduced in-hospital (G1: 9,2% vs. G2: 6,7% p -0,01) and 6-month (G1: 13.1% vs. G2: 7.5% p -0. 01) mortality. Conclusions: Delay in diagnosis, difficulty in communication and type of transfer were the most important causes of delay. Implementing a procedural protocol reduced delays. Continuous evaluation of results and permanent education constitute the fundamental cornerstones for optimizing network care programs.

3.
Catheter Cardiovasc Interv ; 80(2): 267-72, 2012 Aug 01.
Article in English | MEDLINE | ID: mdl-22422735

ABSTRACT

OBJECTIVES: The aim of the study was to evaluate if the left radial approach (LRA) confers any additional advantage compared to the right radial approach (RRA) in octogenarian patients who undergo a coronary diagnostic procedure. BACKGROUND: Octogenarians, an increasing segment of patients in our society, present a higher risk of access-site complications related to invasive coronary catheterization. Transradial approach has been shown to be an effective alternative to reduce vascular complications. Although some studies have suggested that elderly people might benefit from a LRA, the advantages of using the left or right radial access remain not clear. METHODS: One hundred octogenarian patients undergoing a transradial coronary angiogram with normal Allen test and without previous history of coronary artery by-pass grafting were randomized to either LRA (n = 50) or RRA (n = 50). The primary end-points of the study were procedural and fluoroscopy times. RESULTS: Mean age was 82.6 years (80-88) and 59% were males. Procedural and fluoroscopy times were similar among study groups. Crossover was required in two patients (4%) with RRA and five patients (10%) with LRA (P = 0.24). Subclavian tortuosity was more frequent in the right side (32% vs. 6% in the left side; P = 0.002) but this difference did not translate into longer procedural or fluoroscopy times or higher cross-over, procedural difficulty or wire manipulation. CONCLUSIONS: In our series of octogenarian patients, the LRA was a valid alternative for diagnostic procedures but its usage was not associated with a significant reduction in procedural and fluoroscopy times compared to the RRA.


Subject(s)
Cardiac Catheterization/methods , Coronary Angiography/methods , Radial Artery , Age Factors , Aged, 80 and over , Cardiac Catheterization/adverse effects , Cardiac Catheterization/instrumentation , Cardiac Catheters , Chi-Square Distribution , Coronary Angiography/adverse effects , Coronary Angiography/instrumentation , Equipment Design , Female , Humans , Male , Predictive Value of Tests , Prospective Studies , Risk Assessment , Risk Factors , Spain , Time Factors
4.
Rev. esp. cardiol. Supl. (Ed. impresa) ; 11(supl.C): 6c-8c, 2011. ilus, mapas
Article in Spanish | IBECS | ID: ibc-166665

ABSTRACT

El objetivo de Stent for Life en España es mejorar el acceso de los pacientes con infarto agudo de miocardio a la intervención coronaria percutánea primaria y conseguir una tasa de reperfusión mediante esta técnica con el fin de reducir la morbilidad y la mortalidad de los pacientes que sufren esta enfermedad aguda. En octubre del año 2009, la Dra. Fina Mauri, expresidenta de la Sección de Hemodinámica y Cardiología Intervencionista de la Sociedad Española de Cardiología, en el Congreso PCR en Barcelona, firmó el certificado de adhesión de la Sociedad Española de Cardiología a la iniciativa europea Stent for Life. Para conseguir el éxito de este programa, es de vital importancia contar con todos los actores participantes en el sistema de salud. A continuación se detallan los principales objetivos de esta iniciativa en España para el periodo comprendido entre junio de 2010 y junio de 2013 (AU)


The mission of the Stent-for-Life (SFL) Initiative is to improve the delivery of and access to the life-saving indication of primary percutaneous coronary intervention, thereby reducing mortality and morbidity in patients with acute coronary syndrome. In October 2009, Dr. Fina Mauri signed the SFL Initiative certificate and committed the Spanish Society of Cardiology to this European program. Between June 2010 and June 2013, a range of projects will be developed under the SFL Initiative in Spain. Their success crucially depends on the involvement of all sectors of the health-care system. The aim of this article was to describe the projects planned under the SFL Initiative for Spain over the next 3 years (AU)


Subject(s)
Humans , Myocardial Infarction/surgery , Percutaneous Coronary Intervention/methods , Myocardial Reperfusion , National Health Strategies , Health Planning Guidelines , Health Services Accessibility/organization & administration
5.
Rev. esp. cardiol. Supl. (Ed. impresa) ; 11(supl.C): 15c-20c, 2011. graf, tab
Article in Spanish | IBECS | ID: ibc-166667

ABSTRACT

A partir de los datos del Registro Nacional de Hemodinámica y Cardiología Intervencionista de 2009, se presenta la situación de la intervención coronaria percutánea primaria en España. Se analiza la actividad por comunidades autónomas, con énfasis en los principales condicionantes que inciden en la implantación de la intervención coronaria percutánea primaria. En 2009 se realizaron 216 (65-427) intervenciones coronarias percutáneas primarias/millón de habitantes. La utilización de la intervención coronaria percutánea primaria no parece condicionada por el número de laboratorios con alerta las 24 h ni el presupuesto por persona de cada comunidad. Sin embargo, se advierte cierta influencia del grado de desarrollo del intervencionismo en cada comunidad (intervención es coronarias percutáneas totales/millón habitantes) y, fundamentalmente, de la implantación de programas centralizados de ámbito comunitario que implican a la administración sanitaria (AU)


This article describes the current status of primary percutaneous coronary intervention in Spain by using data from the national cardiac catheterization and interventional cardiology registry. Activity in individual Spanish autonomous regions was analyzed, and special attention was paid to the main factors that influenced the implementation of primary percutaneous coronary intervention in each region. In 2009, 216 (range, 65-427) primary percutaneous coronary interventions per million inhabitants were performed. The use of primary percutaneous coronary intervention did not appear to be influenced by the number of emergency facilities that operated on a 24-hour basis or by per capita expenditure in a region. However, the level of development of coronary intervention provision (i.e. the number of percutaneous coronary interventions per million inhabitants) in a particular region and, especially, the introduction of centralized community programs that involved health-care authorities were observed to have some influence (AU)


Subject(s)
Humans , Myocardial Infarction/surgery , Percutaneous Coronary Intervention/methods , Myocardial Revascularization/methods , Acute Coronary Syndrome/surgery , Spain/epidemiology , Diseases Registries/statistics & numerical data , Health Planning Guidelines
6.
Rev. argent. cardiol ; 77(1): 60-62, ene.-feb. 2009. ilus
Article in Spanish | LILACS | ID: lil-634060

ABSTRACT

La miocarditis de células gigantes (MCG) es una entidad rara, de causa desconocida, de probable etiología autoinmune. Puede presentarse como insuficiencia cardíaca refractaria, asociarse con arritmias ventriculares y en otras ocasiones simular un infarto agudo de miocardio. Su pronóstico con frecuencia es ominoso, salvo que se realicen tratamiento inmunosupresor o trasplante cardíaco, este último con elevada recurrencia.


The giant cell myocarditis (GCM) is a rare disease, of unknown origin, and probably of autoimmune etiology. It can occur as refractory heart failure, associate with ventricular arrhythmias, and mimicking an acute myocardial infarction in certain cases. Its prognosis is usually ominous, unless immunosupressive therapy or cardiac transplant is performed, the latter with a high recurrence.

7.
Rev. argent. cardiol ; 75(5): 353-359, sep.-oct. 2007. tab
Article in Spanish | LILACS | ID: lil-633945

ABSTRACT

La angioplastia coronaria (ATC) es una técnica para el tratamiento de la enfermedad coronaria que se encuentra en constante evolución. El registro CONAREC V relevó características de pacientes sometidos a angioplastia durante el año 1996. Diez años después publicamos los resultados del estudio CONAREC XIV. Objetivo Comparar las características demográficas y clínicas, la utilización de dispositivos y de pruebas funcionales, los resultados y las complicaciones de la ATC en el estudio CONAREC V con el estudio CONAREC XIV. Material y métodos Se unificaron las bases de datos de ambos protocolos. Se compararon las variables continuas por medio de la prueba de la t y las categóricas con la prueba de chi cuadrado. Se construyó un modelo de regresión logística para determinar si disminuyó la tasa de complicaciones en el año 2005, ajustando por confundidores. Resultados Los pacientes del CONAREC XIV fueron más añosos (62,8 ± 10,8 versus 60,6 ± 10,9 años), con mayor prevalencia de hipertensión arterial (72,4% versus 61,3%; p < 0,001) y diabetes (19,2% versus 16,9%; p = 0,017) y menor de tabaquismo (22% versus 38%; p < 0,001); presentaron enfermedad de tres vasos (20,2% versus 14,8%; p < 0,001) y ATC de más de un vaso con mayor frecuencia (25,3% versus 11,8%; p < 0,001); se incrementaron el uso de stents (94,5% versus 48%; p < 0,001) y la indicación por cuadros estables (36,3% versus 18,2%; p < 0,001). El uso de pruebas funcionales en este contexto fue menor en el año 2005 (54% versus 65%; p < 0,001). En pacientes con infarto agudo de miocardio, en el CONAREC XIV se observó una prevalencia menor de infarto anterior (46% versus 57,8%; p < 0,005) y de shock cardiogénico (7,3% versus 13,5%; p = 0,017). La tasa de complicaciones mayores fue menor en el último protocolo, CONAREC XIV (3,1% versus 8,9%; p < 0,001). En el modelo multivariado, pertenecer al último estudio disminuyó el riesgo de padecer eventos (OR 0,41, IC 95% 0,26-0,64; p < 0,001). Conclusiones En el relevamiento del año 2005, la ATC se realizó en pacientes con más factores de riesgo y mayor compromiso angiográfico. Se incrementó la indicación en cuadros estables. La tasa de complicaciones, como infarto, cirugía y muerte, se redujo en forma independiente.


Introduction Percutaneous coronary intervention (PCI) is a constantly evolving procedure for the treatment of coronary disease. The CONAREC V registry assessed the characteristics of patients that underwent an angioplasty during 1996. Ten years later the results of the CONAREC XIV study were published. Objective To compare the demographic and clinical characteristics, use of devices and functional tests, and PCI results and complications in the CONAREC V versus the CONAREC XIV registries. Material and methods Both protocols databases were unified. The continuum variables were compared by means of the t test and the categorical with the chi square test. A logistic regression model, adjusted by confounders, was built in order to determine if the events rate from 2006 had decreased. Results The patients from CONAREC XIV were older (62.8±10.8 versus 60.6±10.9 years), with higher prevalence of arterial hypertension (72.4% versus 61.3%; p<0,001) and diabetes (19.2% versus 16.9%; p=0.017) and less tobacco consumption (22% versus 38%; p<0,001); they showed three vessel disease (20.2% versus 14.8%; p<0,001) and PCI to more than one vessel (25.3% versus 11.8%; p<0.001) more frequently; stent use was increased (94.5% versus 48%; p<0.001) as well as the indication in stable conditions (36,3% versus 18,2%; p<0,001). Use of functional tests in this context was lesser in the year 2005 (54% versus 65%; p<0.001). In patients with acute myocardial infarction (AMI), in the CONAREC XIV a lesser prevalence of anterior infarction (46% versus 57.8%; p<0.005) and cardiogenic shock (7.3% versus 13.5%; p=0.017) were observed. The rate of major events was lower in the last CONAREC XIV protocol (3.1% versus 8.9%; p<0.001). In the multivariate model, the patients included in the last study had decreased risk of events (OR 0.41, IC 95% 0.26-0.64; p<0,001). Conclusions The 2005 registry showed that PCI was performed in patients with more risk factors and increased angiographic risk. Indication under stable conditions increased. The rate of events such as infarction, surgery and death was reduced independently.

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