An interactive assistant for patients with cardiac implantable electronic devices: A study protocol of the LUCY trial.

Patients with chronic heart failure (CHF) and reduced left ventricle ejection fraction benefit from cardiac resynchronization therapy (CRT) and implantable cardioverter defibrillator (ICD). However, increasing numbers of patient with CRT and ICD devices produce overload of cardiology centers where patients are admitted to ambulatory visits. This study aims to find multivariate model predicting the requirement for ambulatory follow-up of cardiac implantable electronic devices (CIEDs).The LUCY study is an observational, cohort, prospective, 2-stage trial. As equal number of patients (300) will be included in the first and the second part of the study, finally, 600 patients will be included in the study. The inclusion criteria will be: age between 18 and 90 years, CHF (New York Heart Association classes I-III) and implanted ICD or CRT at least 30 days before study inclusion. The exclusion criteria will be dementia and other conditions impeding cooperation during the study. All patients included in the study will undergo standard ambulatory visit. Primary endpoint will be defined as any ambulatory visit qualified as necessary due to patient's condition or device malfunction diagnose by the cardiologist: any change in pharmacotherapy related to patient's clinical status assessed during the visit, any change in tachyarrythmia counter or discriminator status, any change in tachyarrythmia threshold, presence of ventricular undersensing or oversensing, presence of atrial or ventricular ineffective pacing, or device's pocket infection. Secondary endpoint will be defined as any ambulatory visit qualified as necessary due to the alarm identified via Medtronic CareLink Express (MCLE): sustained or treated ventricular tachyarrythmia, any not previously diagnosed supraventricular tachyarrythmia, or elective replacement indicator.Our study is the first attempt of implementation of the machine learning and elements artificial intelligence in health care optimization of patients with CIED. The LUCY will be an open product, available for additional testing and improvement with supplementary functionalities: quality of life assessment, teleconsultation, video-streaming, automated imagine recognizing.

An in vitro evaluation of the effect of fluoride products on white spot lesion remineralization.

PURPOSE: To compare the effect of combinations of fluoride (F) products on remineralization of caries-like lesions. METHODS: Demineralized human enamel specimens were assessed by surface microhardness (SMH), stratified and allocated to five treatments groups: (1) Toothpaste containing 1% nano hydroxyapatite (HAP) + 1,450 ppm F; (2) Tooth mousse containing 10% casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) + 900 ppm F plus F toothpaste (1,450 ppm F as NaF); (3) F varnish containing 22,600 ppm F plus F toothpaste (1,450 ppm F as NaF); (4) F toothpaste (1,450 ppm F as NaF); and (5) placebo--distilled water (P). Each group was treated in a 21-day pH-cycling model. Groups 1, 4 and 5 were treated 2x/day. In Group 3, the tooth mousse was administered 1x/day plus 2x/day F toothpaste treatment. In Group 4, F varnish was administered 1x/week plus 2x/day treatment with F toothpaste. After cycling, SMH was re-measured and cross-sectional microhardness measurements were taken. RESULTS: Groups 1-4 produced significant rehardening of enamel. In the superficial layer (25-50 µm deep) significantly higher mineralization (up to 83%, by Volume (V), P < 0.0001) was achieved for Groups 2 and 3. In the area of 75-100 µm deep, the highest mineralization was observed for Groups 1 and 4 (V% = 68-83%).

The effect of nano-hydroxyapatite toothpaste on enamel surface remineralization. An in vitro study.

PURPOSE: To compare, in vitro, the surface remineralization effect of two fluoride dentifrices. METHODS: 90 human enamel specimens, embedded in cylindrical acrylic blocks, washed and polished, served as a study material. The specimens were randomly assigned in equal numbers to the three groups (two test and one control). Initially the microhardness of the enamel surface (SMH) was assessed by Vickers method, while a profilometer was used to evaluate the surface roughness (Ra value). The enamel specimens were subjected to the preliminary demineralization, simulating the initial carious lesion formation. Subsequently, mean SMH and Ra values were re-assessed. Upon demineralization, one half of each specimen was covered with a protective varnish. The exposed fragment underwent the 3-week cycle of pH changes, according to the protocol. The groups were as follows: NHAPF group--toothpaste containing nanohydroxyapatite (nano HAP) and 1,450 ppm F; F group--toothpaste containing 1,450 ppm; and P group (placebo)--distilled water. Upon completion of the treatment period, the enamel microhardness and roughness profile were re-measured. RESULTS: The demineralization procedure resulted in statistically significant reduction of SMH level in all the groups, and the mean post demineralization values were in the range of 49.7 VHN to 51.2 VHN. Remineralization therapies led to statistically significant increase of enamel SMH value (P < 0.0001). None of the groups reached their original baseline level of SMH following the remineralization therapy.

[Study on the potential use of baculoviruses to eradicate insects in pest control]. / Badania mozliwosci wykorzystania bakulowirusów do zwalczania owadów szkodników sanitarnych.

The biological activity of baculovirus AcMNPV and its recombinant SPX were determined on cockroaches Blattella germanica, pharaoh's ants Monomorium pharaonis and flies Musca domestica--species very difficult to eradicate. Baculovirus AcMNPV is one of the best known viruses of wide host range. Its recombinant SPX contained the gene for natural toxin. It is known that this toxin paralyses nervous system of insects by blocking sodium channels. The studies on the influences of baculoviruses showed in the case of cockroaches Blattella germanica L. the disturbances of development. The result of using high concentration baculoviruses SPX 2 x 10(7) pfu/ml for a long time of exposition 8 weeks it was.

Poneratoxin, a neurotoxin from ant venom. Structure and expression in insect cells and construction of a bio-insecticide.

Poneratoxin is a small neuropeptide found in the venom of the ant Paraponera clavata. It is stored in the venom reservoir as an inactive 25-residue peptide. Here we describe both chemically synthesized poneratoxin and poneratoxin obtained by expression in insect cells. When expressed in insect cells, poneratoxin was observed attached to cell membranes. Both synthetic and recombinant ponerotoxins were soluble below pH 4.5. The structure of synthetic poneratoxin was characterized by circular dichroism and solved by nuclear magnetic resonance. In an environment imitating a lipid bilayer, at pH within the range of insect hemolymph, synthetic poneratoxin has a V shape, with two alpha-helices connected by a beta-turn. Insect larvae were paralyzed by injection of either of the purified toxins, with the recombinant one acting faster. The recombinant toxin-producing baculovirus reduced the average survival time of the insect host by 25 h compared with unmodified virus. Mass spectrometry analysis showed that the recombinant toxin has an N-terminal 21-residue extension, possibly improving its stability and/or stabilizing the membrane-bound state. The potential use of poneratoxin for the construction of biological insecticide is discussed.

(99m)Tc human IgG radiolabelled by HYNIC. Biodistribution and scintigraphy of experimentally induced inflammatory lesions in animal model.

BACKGROUND: Our goal was the efficient labelling of highly purified human gammaglobulin. This radioactive protein fraction can be used as a basic compound of radiopharmaceutical formulation for inflammation lesion diagnosis. This application was experimentally illustrated in animal models with artificially induced inflammatory lesions after turpentine oil injection into mouse leg muscle. MATERIALS AND METHODS: Hydrazine nicotinamine derivative of human gammaglobulin (IgG-HYNIC) was synthesized according to Abrams method. The radionuclide: technetium (99m)Tc has been introduced into protein molecules by indirect method incorporation in phosphate buffer, pH 7.4, in the presence of stannous chloride as a reducing agent for sodium pertechnetate, and EDTA as a coligand. Radiochemical purity was estimated by thin layer chromatography. The stability of labelled IgG-HYNIC derivative in human serum in presence of copper, cobalt, iron and manganum salts was analyzed by HPLC method (BioSEP SEC 4000, eluent: 0.1 mol/L phosphate). Inflammation lesions were induced in Balb/3 mice muscles by injection of 0.2 ml turpentine oil into the leg muscle. Five days later, inflammation lesions were visualized by hIgG-HYNIC- (99m)Tc injections. The tracer accumulation in tissue was evaluated by gamma camera at 1 to 24 hour intervals. RESULTS: Efficiency of technetium99m Tc human gammaglobulin labelling (pH 7.4, temp. 37 degrees C) was strictly dependant on ligand and coligand presence in the reaction mixture. Labelling of IgG molecules without any supplements resulted in very low efficiency, never exceeding the range of 5%. Presence of EDTA or hydrazine nicotinamide (HYNIC) conjugated with IgG increased radiolabelling efficiency to 50%. IgG-HYNIC derivative in EDTA presence enables us to reach value above 95% radiochemical purity. Stability of IgG-HYNIC derivative labelled with technetium (99m) Tc decreased rapidly in serum in time--up to 70% of initial value in 30 minutes and only 20% during further 4 hr incubation. This means that as much as 80% of radiotracer present in IgG molecules has been dissociated during incubation with serum. This forced us to find proper conditions for improving the stability of radioactive IgG-HYNIC conjugate in circulating serum for at least six hours. It was achieved by using a reaction medium supplement with divalent metal cations in the following compounds: MgCl2, CoSO4, Cu (NO3)2 and FeCl2 in equimolar ratio to EDTA. Scintigraphy of (99m)Tc gammaglobulin in artificially induced inflammatory lesions of mouse thigh muscle showed a 4 times higher accumulation of the tracer after 6 hours post injection, and 6 times higher after 24 hours. CONCLUSIONS: A human gammaglobulin derivative (hIgG-HYNIC) labelled with technetium (99m)Tc by indirect method with high radiochemical purity can be a basic compound of formulation for infection/inflammation scintigraphy.

[Acute invasive fungal rhinosinusitis--case report]. / Grzybica inwazyjna zatok przynosowych o piorunujacym przebiegu--opis przypadku.

A case report of acute invasive fungal rhinosinusitis in 28 year old woman with acute myeloid leukemia is described in this paper. The diagnosis of the fungal disease was based on clinical presentation, endoscopic evaluation of nasal cavity, computed tomography and magnetic resonance imaging of the paranasal sinuses and histopathological findings. An aggressive treatment including antifungal therapy (amphotericin B), antibiotics and the surgery of paranasal sinuses was implemented. Unfortunately the underlying disease and the fungal invasion progressed rapidly and the patient died on the forth week post-op due to cardiorespiratory failure.