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1.
Environ Pollut ; 316(Pt 2): 120553, 2023 Jan 01.
Article in English | MEDLINE | ID: mdl-36347410

ABSTRACT

This study comprises a critical review of modeling of pesticides in surface waters. The aim was to update the status of the use of models to simulate the fate of pesticides from diffuse sources. ISI papers were selected on Scopus and the information concerning the study areas, type of pesticides (herbicides, fungicides and insecticides), the model, and the methodology adopted (i.e., calibration and/or validation, spatial and temporal scales) were analyzed. The studies were carried out in Europe (55.5%), North America (22.3%), Asia (13.9%) and South America (8.3%). The Soil and Water Assessment Tool proved to be the most used model (45.95%). Herbicides were the most modeled pesticides (71.4%), followed by insecticides (18.2%) and fungicides (10.4%). The main herbicides modeled were atrazine, metolachlor, isoproturon, glyphosate, and acetochlor. Insecticides such as chlorpyrifos and metaldehyde. Chlorothalonil, and fungicides (i.e., tebuconazole) were the most widely investigated. Based on published studies, it was found that modeling approaches for assessing the fate of pesticides are constantly evolving and the model algorithms work well with diverse watershed conditions, management strategies, and pesticide properties. Several papers reported concentrations of pesticides exceeding ecotoxicological thresholds revealing that water contamination with pesticides used in agriculture and urban areas is a priority issue of current global concern.


Subject(s)
Fungicides, Industrial , Herbicides , Insecticides , Pesticides , Water Pollutants, Chemical , Pesticides/analysis , Fungicides, Industrial/analysis , Insecticides/analysis , Environmental Monitoring/methods , Fresh Water , Herbicides/analysis , Agriculture , Water , Water Pollutants, Chemical/analysis
2.
Ann R Coll Surg Engl ; 103(4): 296-301, 2021 Apr.
Article in English | MEDLINE | ID: mdl-33682470

ABSTRACT

INTRODUCTION: Superior vena cava (SVC) syndrome (SVCS) is a life-threatening occurrence that necessitates prompt treatment. At present, endovascular stenting is proposed as a first-line treatment to relieve symptoms. We assessed the effectiveness, safety and outcome of SVC stent positioning in patients affected with advanced cancer. METHODS: Forty-two patients undergoing stent positioning in the SVC for neoplasms from January 2002 to December 2018 form the basis of this retrospective study. Demographic data, risk factors, associated diseases, symptoms at presentation according to the score proposed by Kishi and the type of SVCS according to Sanford and Doty were collected. Minor and major complications were recorded. Suspected stent occlusion was confirmed by means of recurrence of symptoms followed by a confirmatory computed tomography (CT). RESULTS: Thirty-four (81%) patients had a nonresectable lung tumour invading or compressing the SVC. Five (12%) patients had a non-Hodgkin's lymphoma, and three (7%) had metastatic lymphadenopathies. Nitinol stents (Memotherm®) were employed in 19 (45%) patients, and steel stents (Wallstent™) in the remaining 23 (55%) patients. Thirty-five (85%) patients died during follow up for disease progression and the overall survival rate at 24 months was 11% (standard error (SE)=0.058). Thirteen patients (32%) had a recurrence of SVCS because of stent thrombosis in three (23%) and extrinsic compression from uncontrolled cancer progression in ten (77%). The overall symptom-free interval at 24 months was 57% (SE=0.095). CONCLUSIONS: We recommend the use of the endovascular procedure as a first-line treatment in locally advanced or metastatic tumour in the presence of SVCS.


Subject(s)
Carcinoma/complications , Endovascular Procedures/instrumentation , Lung Neoplasms/complications , Lymphoma, Non-Hodgkin/complications , Self Expandable Metallic Stents , Superior Vena Cava Syndrome/therapy , Adult , Aged , Aged, 80 and over , Endovascular Procedures/methods , Female , Follow-Up Studies , Humans , Kaplan-Meier Estimate , Lymphatic Metastasis , Male , Middle Aged , Retrospective Studies , Superior Vena Cava Syndrome/etiology , Treatment Outcome
3.
J Musculoskelet Neuronal Interact ; 20(4): 610-613, 2020 12 01.
Article in English | MEDLINE | ID: mdl-33265090

ABSTRACT

Spinal muscular atrophy (SMA) refers to a group of genetic neuromuscular disorders affecting lower motor neurons causative of numerous phenotypes. To date, according to the age of onset, maximum muscular activity achieved, and life expectation four types of SMA are recognized, all caused by mutations in the SMN1 gene with SMN2 copy number influencing disease severity. Herein, we describe the case of a 31-year-old young male with normal psychomotor development who has experienced fatigue, cramps, and muscle fasciculations in the lower limbs for a period of 2 months. Based on electrophysiological and clinical findings we performed SMA genetic, clinical exome and RNA expression of candidate genes which led us to suggest SMN1-SMN2 genes [(2+0) and (0+0)] combination as possibly being implicated in the phenotype.


Subject(s)
Muscular Atrophy, Spinal/genetics , Survival of Motor Neuron 1 Protein/genetics , Adult , Electromyography , Genotype , Humans , Male , Mutation , Survival of Motor Neuron 2 Protein/economics
4.
Environ Res ; 166: 363-376, 2018 10.
Article in English | MEDLINE | ID: mdl-29935449

ABSTRACT

In this study, the simulations generated by two of the most widely used hydrological basin-scale models, the Annualized Agricultural Non-Point Source (AnnAGNPS) and the Soil and Water Assessment Tool (SWAT), were compared in a Mediterranean watershed, the Carapelle (Apulia, Southern Italy). Input data requirements, time and efforts needed for input preparation, strength and weakness points of each model, ease of use and limitations were evaluated in order to give information to users. Models were calibrated and validated at monthly time scale for hydrology and sediment load using a four year period of observations (streamflow and suspended sediment concentrations). In the driest year, the specific sediment load measured at the outlet was 0.89 t ha-1 yr-1, while the simulated values were 0.83 t ha-1 yr-1 and 1.99 t ha-1 yr-1 for SWAT and AnnAGNPS, respectively. In the wettest year, the specific measured sediment load was 7.45 t ha-1 yr-1, and the simulated values were 8.27 t ha-1 yr-1 and 6.23 t ha-1 yr-1 for SWAT and AnnAGNPS, respectively. Both models showed from fair to a very good correlation between observed and simulated streamflow and satisfactory for sediment load. Results showed that most of the basin is under moderate (1.4-10 t ha-1 yr-1) and high-risk erosion (> 10 t ha-1 yr-1). The sediment yield predicted by the SWAT and AnnAGNPS models were compared with estimates of soil erosion simulated by models for Europe (PESERA and RUSLE2015). The average gross erosion estimated by the RUSLE2015 model (12.5 t ha-1 yr-1) resulted comparable with the average specific sediment yield estimated by SWAT (8.8 t ha-1 yr-1) and AnnAGNPS (5.6 t ha-1 yr-1), while it was found that the average soil erosion estimated by PESERA is lower than the other estimates (1.2 t ha-1 yr-1).


Subject(s)
Environmental Monitoring , Models, Theoretical , Rivers , Soil , Geologic Sediments , Italy , Water
5.
Food Chem ; 192: 1083-9, 2016 Feb 01.
Article in English | MEDLINE | ID: mdl-26304451

ABSTRACT

The effect of nixtamalization on the content of fumonisins (FBs), hydrolysed (HFBs) and partially hydrolysed (PHFBs) fumonisins in maize was investigated at laboratory-scale. Maize naturally contaminated with FBs and PHFBs was cooked with lime. Starting raw maize, steeping and washing waters and final masa fractions were analysed for toxin content. Control-cooking experiments without lime were also carried out. The nixtamalization reduced the amount of FBs and PHFBs in masa and converted them to HFBs. However, the three forms of fumonisins collected in all fractions amounted to 183%, indicating that nixtamalization made available forms of matrix-associated fumonisins that were then converted to their hydrolysed forms. Control-cooking enhanced FBs and PHFBs reduction, due to the solubility of fumonisins in water during the steeping process, but did not form HFBs. These findings indicate that benefits associated with enhancing the nutritional value of nixtamalized maize are also associated with a safer product in terms of fumonisin contamination.


Subject(s)
Cooking/methods , Food Contamination/analysis , Fumonisins/analysis , Zea mays/chemistry , Calcium Compounds , Fumonisins/chemistry , Hydrogen-Ion Concentration , Hydrolysis , Nutritive Value , Oxides , Water
6.
Toxicol In Vitro ; 29(5): 1140-5, 2015 Aug.
Article in English | MEDLINE | ID: mdl-25956791

ABSTRACT

Fumonisins (FBs), Fusarium mycotoxins common food contaminant, are a potent inducer of oxidative stress and lipid peroxidation in intestinal cells. In order to verify this toxic effect in intestine tract, the aim was to assess lipid peroxidation (as malondialdehyde MDA increased levels) on intestine rat samples exposed to chyme samples from in vitro digestion of FBs contaminated corn samples. Naturally (9.61±3.2 µg/gr), artificially (726±94 µg/gr) and spiked corn samples at EU permitted FBs levels were digested and added to luminal side of Ussing chamber for 120 min. Fumonisins-free corn sample was used as control. The MDA increase was observed just in 83% of intestine samples exposed at EU FBs levels and the digestion process seems to reduce this incidence (50% of samples). Malondialdehyde levels were FBs dose- and subject-related and ranged from 0.07±0.01 to 3.59±0.6 nmol/mg. Highest incidence and MDA % increment (I) were found when intestine tracts were exposed to chymes from artificially corn sample. The induction of lipid peroxidation induced by FBs could be due to interactions between FBs and intestinal membranes, with consequent modifications in membrane permeability and oxygen diffusion-concentration, as suggested by other authors.


Subject(s)
Complex Mixtures/toxicity , Fumonisins/toxicity , Intestinal Mucosa , Intestines , Zea mays , Animals , Female , Food Contamination , Intestinal Mucosa/metabolism , Lipid Peroxidation/drug effects , Malondialdehyde/metabolism , Rats, Wistar
7.
Food Chem Toxicol ; 66: 166-72, 2014 Apr.
Article in English | MEDLINE | ID: mdl-24480040

ABSTRACT

The gut is a possible target toward mycotoxin fumonisins (FBs) exposure. The study aims to investigate the effects induced by FBs contaminated-corn chyme samples on functional parameters of human and rat intestine by using Ussing chamber. Fumonisins-contaminated corn and processed corn samples were undergone to in vitro digestion process and then added to luminal side. A reduction (about 90%) of short circuit current (Isc µA/cm(2)) during exposure of human colon tissues to fumonisins-free corn chyme samples was observed, probably related to increased chyme osmolality. This hyperosmotic stress could drain water towards the luminal compartment, modifying Na(+) and Cl(-) transports. The presence of FBs in corn chyme samples, independently to their concentration, did not affect significantly the Isc, probably related to their interference towards epithelial Na(+) transport, as assessed by using a specific inhibitor (Amiloride). The rat colon tract represents a more accessible model to study FBs toxicity showing a similar functional response to human. In the rat small intestine a significant reduction (about 15%) of Isc parameter during exposure to uncontaminated or FBs contaminated corn chyme samples was observed; therefore such model was not suitable to assess the FBs toxicity, probably because the prevalent glucose and amino acids electrogenic absorption overwhelmed the FBs influence on ionic transport.


Subject(s)
Fumonisins/toxicity , Intestine, Small/drug effects , Zea mays/chemistry , Adult , Aged , Aged, 80 and over , Animals , Female , Humans , Male , Middle Aged , Rats
8.
J Am Vet Med Assoc ; 243(9): 1291-7, 2013 Nov 01.
Article in English | MEDLINE | ID: mdl-24134578

ABSTRACT

OBJECTIVE: To determine efficacy of a single intra-articular injection of an autologous platelet concentrate for treatment of osteoarthritis in dogs. DESIGN: Randomized, controlled, 2-center clinical trial. ANIMALS: 20 client-owned dogs with osteoarthritis involving a single joint. PROCEDURES: Dogs were randomly assigned to a treatment or control group. In all dogs, severity of lameness and pain was scored by owners with the Hudson visual analog scale and the University of Pennsylvania Canine Brief Pain Inventory, respectively, and peak vertical force (PVF) was determined with a force platform. Dogs in the treatment group were then sedated, and a blood sample (55 mL) was obtained. Platelets were recovered by means of a point-of-use filter and injected intra-articularly within 30 minutes. Control dogs were sedated and given an intra-articular injection of saline (0.9% NaCl) solution. Assessments were repeated 12 weeks after injection of platelets or saline solution. RESULTS: Dogs weighed between 18.3 and 63.9 kg (40.3 and 140.6 lb) and ranged from 1.5 to 8 years old. For control dogs, lameness scores, pain scores, and PVF at week 12 were not significantly different from pretreatment values. In contrast, for dogs that received platelet injections, lameness scores (55% decrease in median score), pain scores (53% decrease in median score), and PVF (12% increase in mean PVF) were significantly improved after 12 weeks, compared with pretreatment values. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that a single intra-articular injection of autologous platelets resulted in significant improvements at 12 weeks in dogs with osteoarthritis involving a single joint.


Subject(s)
Dog Diseases/therapy , Osteoarthritis/veterinary , Platelet Transfusion/veterinary , Animals , Blood Platelets , Dogs , Female , Male , Osteoarthritis/therapy
9.
Tissue Eng Part C Methods ; 17(10): 993-8, 2011 Oct.
Article in English | MEDLINE | ID: mdl-21609305

ABSTRACT

INTRODUCTION: We created the first tissue-engineered vascular graft (TEVG) to be successfully used in humans. The TEVG is made by seeding autologous bone marrow-derived mononuclear cells (BM-MNCs) onto a biodegradable tubular scaffold fabricated from polyglycolic-acid mesh coated with a 50:50 copolymer of poly-L-lactide and-ɛ-caprolactone. In the initial clinical study, the BM-MNCs were isolated using a Ficoll density centrifugation method. Use of this cell isolation technique is problematic in that it is performed using an open system and therefore is susceptible to contamination. As a first step toward creating a closed system for assembling a TEVG, we evaluated the use of a filter-based method for isolating BM-MNCs and compared it to density centrifugation in Ficoll. METHODS: BM-MNCs were isolated from human BM using density centrifugation in Ficoll or a filter-based method. BM-MNCs were seeded onto biodegradable tubular scaffold and incubated for 24 h before implantation. The TEVG were implanted as inferior vena cava interposition grafts in SCID/bg mice (n=24) using microsurgical technique. Grafts were followed with ultrasonography and computed tomography-angiography. Ten weeks after implantation the TEVG were explanted and examined using histology and immunohistochemistry. RESULTS: Both methods isolated similar number of cells (Ficoll: 8.5±6.6×10(6)/mL, Filter: 6.6±3.5×10(6)/mL; p=0.686) with similar viability as assayed using fluorescence-activated cell sorting (FACS) (Ficoll: 97.0%±1.5%, Filter: 95.9%±3.0%; p=0.339). FACS analysis demonstrated that the fraction of lymphocytes and monocytes to total cells was lower in the filter group (CD4 in Ficoll: 8.9%±1.1%, CD4 in Filter: 3.5%±0.8%; p=0.002, CD8 in Ficoll: 9.4%±2.1%, CD8 in Filter: 3.9%±1.4%; p=0.021, Monocyte in Ficoll: 6.9%±1.0%, Monocyte in Filter: 2.7%±1.0%; p=0.008), consistent with granulocyte contamination (Ficoll: 46.6±2.7×10(6)/mL, Filter: 58.1±5.2×10(6)/mL; p<0.001). The ratio of stem cells to BM-MNCs was comparable between groups. There were no statistically significant differences with regard to TEVG patency and morphology between groups. Both methods of cell isolation produced neovessels with similar histology. CONCLUSION: Filter-based BM-MNC isolation is comparable to BM-MNC isolation using density centrifugation in Ficoll for TEVG assembly. The filter-based cell isolation technique has the added advantage of the potential to create a closed disposable system.


Subject(s)
Blood Vessel Prosthesis , Bone Marrow Cells/cytology , Cell Separation/methods , Centrifugation, Density Gradient/methods , Filtration/instrumentation , Leukocytes, Mononuclear/cytology , Tissue Engineering/methods , Animals , Blood Vessels/diagnostic imaging , Blood Vessels/pathology , Flow Cytometry , Humans , Mice , Mice, SCID , Time Factors , Tomography, X-Ray Computed , Ultrasonography
10.
Article in English | MEDLINE | ID: mdl-21400323

ABSTRACT

A comparison study of different extraction and clean-up procedures for the liquid chromatographic analysis of fumonisins B(1) (FB(1)) and B(2) (FB(2)) in corn masa flour was performed. The procedures included extraction (heat or room temperature) with acidic conditions or EDTA-containing solvents, and clean-up by immunoaffinity or C18 solid-phase extraction columns. Thereafter an analytical method was optimised using extraction with an acidic mixture of methanol-acetonitrile-citrate/phosphate buffer, clean-up through the immunoaffinity column and determination of fumonisins by liquid chromatography with automated pre-column derivatisation with o-phthaldialdehyde reagent. Recovery experiments performed on yellow, white and blue masa flours at spiking levels of 400, 800 and 1200 µg kg(-1) FB(1) and of 100, 200 and 300 µg kg(-1) FB(2) gave overall mean recoveries of 99% (±6%) for FB(1) and 88% (±6%) for FB(2). Good recoveries (higher than 90% for both FB(1) and FB(2)) were also obtained with corn tortilla chips. The limits of quantification of the method (signal-to-noise ratio of 10) were 25 µg kg(-1) for FB(1) and 17 µg kg(-1) for FB(2). The method was tested on different commercial corn masa flours as well as on white and yellow corn tortilla chips, showing fumonisin contamination levels (FB(1) + FB(2)) up to 1800 µg kg(-1) (FB(1) + FB(2)) in masa flour and 960 µg kg(-1) in tortilla chips. Over 30% of masa flours originating from Mexico exceeded the European Union maximum permitted level.


Subject(s)
Edible Grain/chemistry , Fast Foods/analysis , Food Contamination , Food Inspection/methods , Fumonisins/analysis , Zea mays/chemistry , Analytic Sample Preparation Methods , Carcinogens/analysis , Carcinogens/isolation & purification , Chromatography, High Pressure Liquid , Edible Grain/economics , Edible Grain/standards , Europe , European Union , Fast Foods/economics , Fast Foods/standards , Food Handling/methods , Fumonisins/isolation & purification , Humans , Legislation, Food , Limit of Detection , Reproducibility of Results , Seeds/chemistry , Temperature , Time
11.
J AOAC Int ; 93(2): 611-21, 2010.
Article in English | MEDLINE | ID: mdl-20480909

ABSTRACT

An interlaboratory validation study was conducted to establish the method performance characteristics of an immunoaffinity column (IAC) cleanup procedure followed by LC/MS for the determination of fumonisins B1 (FB1) and B2 (FB2) and combined FB1 + FB2 in corn. The test portion is extracted with acetonitrile-methanol-water (25 + 25 + 50). The extract is filtered, diluted with phosphate-buffered saline solution, and applied to an IAC. FB1 and FB2 are removed with methanol, followed by water, then directly determined by RPLC with MS detection using selected-ion monitoring of two characteristic ions in each case. Naturally contaminated corn samples were milled to a fine powder and mixed to produce three samples with target levels of combined FB1 + FB2 ranging from 350 to 4000 microg/kg. Of 15 initially participating laboratories, two failed to report results and another did not follow the prescribed method. Thus, valid results were obtained from 12 participants located in 11 countries. Statistical analysis of the results produced RSDr values of 4.6-11.9, 1.9-12.6, and 1.4-11.5% for FB1, FB2, and combined FB1 + FB2, respectively; the corresponding RSDR values were 19.8-23.8, 18.2-25.5, and 18.8-23.2%. The three concentration levels of combined FB1 + FB2 were 534, 1194, and 1954 microg/kg. HorRat values for r and R were all < 2.0, indicating that the method is suitable as a regulatory method for the enforcement of European Union limits for fumonisins in corn.


Subject(s)
Fumonisins/analysis , Zea mays/metabolism , Acetonitriles/chemistry , Calibration , Chemistry Techniques, Analytical , Chromatography, High Pressure Liquid/methods , Chromatography, Liquid/methods , Food Analysis/methods , Food Contamination , Hydrogen-Ion Concentration , International Cooperation , Mass Spectrometry/methods , Methanol/chemistry , Reproducibility of Results , Water/chemistry
12.
Am J Infect Control ; 38(1): 69-71, 2010 Feb.
Article in English | MEDLINE | ID: mdl-19709779

ABSTRACT

Infections with Pseudomonas aeruginosa and other waterborne pathogens (WBPs) are major contributors to serious morbidity and mortality in hospitals. We sought to determine whether point-of-use (POU) water filtration might result in decreased risk of infection in the subacute care unit (SACU) of a 208-bed medical center. Our findings indicate that POU water filtration can significantly and cost-effectively reduce colonization of and infection with WBPs, including ventilator-associated pneumonia, in an SACU.


Subject(s)
Filtration/economics , Filtration/methods , Point-of-Care Systems/economics , Pseudomonas Infections/prevention & control , Subacute Care , Water Purification/economics , Water Purification/methods , Cost-Benefit Analysis , Humans , Prevalence
13.
Am J Hum Genet ; 85(3): 394-400, 2009 Sep.
Article in English | MEDLINE | ID: mdl-19716111

ABSTRACT

Submicroscopic copy-number variations make a considerable contribution to the genetic etiology of human disease. We have analyzed subjects with idiopathic mental retardation (MR) by using whole-genome oligonucleotide-based array comparative genomic hybridization (aCGH) and identified familial and de novo recurrent Xp11.22-p11.23 duplications in males and females with MR, speech delay, and a peculiar electroencephalographic (EEG) pattern in childhood. The size of the duplications ranges from 0.8-9.2 Mb. Most affected females show preferential activation of the duplicated X chromosome. Carriers of the smallest duplication show X-linked recessive inheritance. All other affected individuals present dominant expression and comparable clinical phenotypes irrespective of sex, duplication size, and X-inactivation pattern. The majority of the rearrangements are mediated by recombination between flanking complex segmental duplications. The identification of common clinical features, including the typical EEG pattern, predisposing genomic structure, and peculiar X-inactivation pattern, suggests that duplication of Xp11.22-p11.23 constitutes a previously undescribed syndrome.


Subject(s)
Chromosomes, Human, X/genetics , Electroencephalography , Gene Duplication , Intellectual Disability/complications , Intellectual Disability/genetics , Language Development Disorders/complications , Language Development Disorders/genetics , Female , Humans , Male , Pedigree
14.
Article in English | MEDLINE | ID: mdl-19680966

ABSTRACT

Fourier transform near-infrared spectroscopy (FT-NIR) was used for rapid and non-invasive analysis of deoxynivalenol (DON) in durum and common wheat. The relevance of using ground wheat samples with a homogeneous particle size distribution to minimize measurement variations and avoid DON segregation among particles of different sizes was established. Calibration models for durum wheat, common wheat and durum + common wheat samples, with particle size <500 microm, were obtained by using partial least squares (PLS) regression with an external validation technique. Values of root mean square error of prediction (RMSEP, 306-379 microg kg(-1)) were comparable and not too far from values of root mean square error of cross-validation (RMSECV, 470-555 microg kg(-1)). Coefficients of determination (r(2)) indicated an "approximate to good" level of prediction of the DON content by FT-NIR spectroscopy in the PLS calibration models (r(2) = 0.71-0.83), and a "good" discrimination between low and high DON contents in the PLS validation models (r(2) = 0.58-0.63). A "limited to good" practical utility of the models was ascertained by range error ratio (RER) values higher than 6. A qualitative model, based on 197 calibration samples, was developed to discriminate between blank and naturally contaminated wheat samples by setting a cut-off at 300 microg kg(-1) DON to separate the two classes. The model correctly classified 69% of the 65 validation samples with most misclassified samples (16 of 20) showing DON contamination levels quite close to the cut-off level. These findings suggest that FT-NIR analysis is suitable for the determination of DON in unprocessed wheat at levels far below the maximum permitted limits set by the European Commission.


Subject(s)
Mycotoxins/analysis , Trichothecenes/analysis , Triticum/chemistry , Food Contamination/analysis , Reproducibility of Results , Spectroscopy, Fourier Transform Infrared/methods
16.
Radiol Med ; 114(5): 692-704, 2009 Aug.
Article in English, Italian | MEDLINE | ID: mdl-19551341

ABSTRACT

PURPOSE: Myocardial viability was evaluated by magnetic resonance imaging (MRI) in patients with chronic total coronary occlusion (CTO) treated with a drug-eluting stent. Change in left ventricular ejection fraction (LVEF) was analysed. MATERIALS AND METHODS: Twenty-three patients with CTO underwent delayed-enhancement (DE) and low-dose dobutamine MRI (LD). Diastolic wall thickness (DWT), dobutamine-induced systolic wall thickening (SWT) and DE transmural extension were quantitatively assessed in vessel-related segments, calculating the contribution of viable tissue to SWT, expressed as viability index (VI)=[SWTx(100 - DE)]/100. Patients with transmural enhancement were excluded from revascularisation. At 6 months follow-up, patients underwent coronary angiography (CA) and MRI. Functional recovery was defined as a 2-mm increase in SWT. RESULTS: Transmural enhancement (mean DE 62.88+/-37.18] was present in three patients. Mean DWT, SWT, VI and DE of recanalised patients were 8.03+/-2.35, 2.64+/-1.56, 1.77+/-1.48 mm and 41.97+/-30.32. Revascularisation was successful in 14/16. Follow-up CA showed patency of treated vessels. Functional recovery was achieved in 13 patients. Functional recovery showed significant correlation with SWT (beta 1,779, p=0.015), and even higher correlation with VI (beta 2.032, p=0.011). LVEF improved significantly [Delta 95% confidence interval (CI) -4.47, p=0.0203). CONCLUSIONS: Invasive CTO treatment has beneficial effects on myocardial contractility that can be predicted by VI, and on LVEF.


Subject(s)
Cardiotonic Agents , Coronary Stenosis/therapy , Dobutamine , Drug-Eluting Stents , Magnetic Resonance Imaging/methods , Aged , Chronic Disease , Contrast Media , Coronary Stenosis/physiopathology , Female , Heterocyclic Compounds , Humans , Linear Models , Male , Myocardial Revascularization , Organometallic Compounds , Predictive Value of Tests , Recovery of Function , Treatment Outcome
17.
Eur J Vasc Endovasc Surg ; 37(3): 311-8, 2009 Mar.
Article in English | MEDLINE | ID: mdl-19111480

ABSTRACT

OBJECTIVES: Definitive evidence that red blood cell transfusion improves outcome after vascular surgery is lacking. The aims of the study were to determine, among stable consecutive patients who underwent elective major vascular surgery, (1) the association between postoperative transfusion and 30-day death, myocardial infarction, and both, and (2) and if this association differs according to the presence of postoperative anaemia (haemoglobin value less than 9.0 g/dL within 7 days after surgery). METHODS: A retrospective observational study was conducted on 359 patients prospectively screened according to the ACC/AHA guidelines for preoperative risk in non-cardiac surgery. Main outcome was 30-day death; secondary outcomes 30-day myocardial infarction, and composite of 30-day myocardial infarction or death. RESULTS: Of the patients included, 95 (26.5%) received at least one unit of red blood cells. Patients who received transfusion had a significantly increased hazard of 30-day death (hazard ratio [HR] 11.72, 95% confidence interval [CI] 3.92-35.10; p<0.0001), myocardial infarction (HR 3.3, 95% CI 1.7-6.1; p=0.0003), and both (HR 4.0 95% CI 2.2-7.3; p<0.0001). Such associations held even after adjusting for baseline characteristics, surgical risk, bleeding, and propensity to receive transfusion. There was a significant interaction between transfusion and postoperative anaemia (p=0.012). In patients without anaemia, transfusion was associated with higher risk of 30-day death (HR 19.20, 95% CI 3.99-92.45; p=0.007), myocardial infarction (HR 5.05, 95% CI 2.23-11.44; p=0.0001), and both. Conversely, in patients with anaemia this association was not significant. CONCLUSIONS: In patients who underwent elective major vascular surgery, perioperative transfusion was associated with a significantly increased risk of 30-day events which was more attributable to patients with lesser degree of anaemia. Our data caution against the use of liberal transfusion in stable vascular surgery patients.


Subject(s)
Elective Surgical Procedures , Erythrocyte Transfusion/mortality , Outcome Assessment, Health Care , Perioperative Care , Vascular Surgical Procedures , Aged , Anemia/mortality , Anemia/therapy , Female , Hemoglobins/analysis , Humans , Male , Myocardial Infarction/epidemiology , Postoperative Complications/epidemiology , Postoperative Hemorrhage/therapy , Proportional Hazards Models , Prospective Studies , Renal Insufficiency/epidemiology , Retrospective Studies
18.
Int J Cardiol ; 137(2): 123-9, 2009 Oct 02.
Article in English | MEDLINE | ID: mdl-18694607

ABSTRACT

BACKGROUND: Seasonal peaks in acute myocardial infarction (AMI) incidence have been widely reported. Weather has been postulated to be one of the elements at the basis of this association. The aim of our study was to determine the influence of seasonal variations and weather on AMI hospital admissions. METHODS: We correlated the daily number of AMI cases admitted to a western Sicily hospital over twelve years and weather conditions on a day-to-day basis. Information on temperature, humidity, wind force and direction, precipitation, sunny hours and atmospheric pressure was obtained from the local Birgi Air Force base. A total of 3918 consecutive patients were admitted with AMI over the period 1987-1998 (2822 men, 1096 women; M/F: 2,58). RESULTS AND CONCLUSIONS: A seasonal variation was found with a significant winter peak. The results of multivariate Poisson analysis show in both sexes a significant association as regards the incidence relative ratio between the daily number of AMI hospital admission and minimal daily temperature and maximal daily humidity. The incidence relative ratios (95% confidence intervals) were, in males, 0.95 (0.92-0.98) (p<0.001) as regards minimal temperature and 0.97 (0.94-0.99) (p=0.017) as regards maximal humidity. The corresponding values in females were respectively 0.91 (0.86-0.95) (p<0.001) and 0.94 (0.90-0.98) (p=0.009). Environmental temperature, and also humidity, may play an important role in the pathogenesis of AMI. These data may help in understanding the mechanisms whereby AMI events are triggered and in organizing better the assistance to ischemic patients throughout the year.


Subject(s)
Myocardial Infarction/epidemiology , Myocardial Infarction/etiology , Patient Admission , Seasons , Weather , Aged , Aged, 80 and over , Climate , Cold Temperature/adverse effects , Female , Hospitalization/trends , Humans , Humidity/adverse effects , Italy/epidemiology , Male , Middle Aged , Patient Admission/trends , Retrospective Studies
20.
Dalton Trans ; (5): 596-601, 2008 Feb 07.
Article in English | MEDLINE | ID: mdl-18217114

ABSTRACT

A comparative kinetic study of anomerization between the four main forms (alpha/beta-pyranosides and alpha/beta-furanosides) of D-galacturonic acid (GalAH(2), 1) and tin(IV) complexed D-galacturonate ([Sn(CH(3))(2)(GalA)(H(2)O)(2)], 2) in D(2)O, is reported. Important differences are shown by pD vs. mutarotation rate profiles of 1 and 2. Coordination, in fact, causes: i) a spectacular increase of the rate due to kinetic template assistance of the carboxylic tail holding the metal in close proximity to the reactive centre and ii) a change in the dependence of the rate on the pD. Entropic and enthalpic factors contribute to the huge activation energy decrease in 2. Anomerization rates of the complexed ligand are determined by 2D-EXSY cross-peak integration. Analysis of up to twelve direct and reverse rate constants in the pD range 7.0-2.5 evidences ring size memory, and at least one reaction path which bypasses the aldehydo open chain intermediate. Solvent oxygen atom incorporation into the ligand is, at pH 4.5, about ten fold faster when catalyzed by the metal, and proves that the metal-assisted nucleophilic attack of water on the anomeric carbon atom cannot significantly contribute to mutarotation rates that are thousands of times faster.


Subject(s)
Hexuronic Acids/chemistry , Tin Compounds/chemistry , Catalysis , Kinetics , Magnetic Resonance Spectroscopy , Rotation , Stereoisomerism
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