The obesity paradox: effect of body mass index on 2-years clinical outcome after primary percutaneous coronary intervention in Indonesia.

OBJECTIVE: Several studies demonstrated that a high body mass index (BMI) might actually benefit patients with cardiovascular disease, including coronary heart disease. However, other studies were unable to confirm this paradoxical phenomenon in all populations. Therefore, this study aims to determine the association between BMI and long-term clinical outcomes in ST-segment elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI). PATIENTS AND METHODS: This was a retrospective cohort study of 400 STEMI patients undergoing PCI. Clinical outcome evaluation was done by face-to-face or phone interview and collecting objective data. Statistical analysis was performed to compare the outcomes between underweight-normal group with overweight-obese group. RESULTS: The incidence of major adverse cardiovascular events (MACE) was lower in patients with higher BMI group in 2-years evaluation (24.1% vs. 39.9%; p < 0.001). Multivariate analysis showed that BMI was an independent predictor of MACE and the incidence of recurrent infarction (OR 2.322 [CI 95% 1.505-3.584; p < 0.001]). The risk of MACE reduces as the weight increases, with a nadir of risk reduction for MACE at 28 to 29.0 kg/m2, in which the curve rises after, but remained below the risk associated with BMI of 23 kg/m2. CONCLUSIONS: In our population, patients with high BMI have a lower incidence of long-term MACE, especially recurrent myocardial infarction, in patients with STEMI undergoing PCI.

Survival analysis of patients with rheumatic MS after PBMV compared with MVS in a low-to-middle-income country.

INTRODUCTION: Rheumatic mitral stenosis continues to be prevalent in developing countries, notably in endemic areas. Over the last few decades, percutaneous balloon mitral valvuloplasty (PBMV) has been established as a lower-cost alternative treatment for mitral stenosis (MS) in low-to-middle-income countries. PBMV has also been suggested to be an effective and safe alternative treatment modality. This study aims to analyse the survival of rheumatic MS patients treated with PBMV compared with those treated with mitral valve surgery (MVS). METHODS: This study was a national, single-centre, longitudinal study using a survival analysis method in 329 consecutive patients suffering from rheumatic heart disease with severe MS who underwent PBMV compared with 142 consecutive patients with similar characteristics who underwent MVS between January 2011 and December 2016. Survival analysis and event-free duration were determined over a median follow-up of 24 months in the PBMV group and 27 months in the MVS group. RESULTS: The results showed that of the 329 consecutive patients in the PBMV group, 61 patients (18.5) had an event (6 patients died and 55 patients were hospitalised), and of the 142 consecutive patients in the MVS group, 19 patients (13.4%) had an event (5 patients died, and 14 patients were hospitalised). The hazard ratio was 0.631 (95% confidence interval, 0.376-1.058; P = 0.081). Longer short-term survival was found in the MVS group but was not statistically significant. Event-free survival was significantly longer in the MVS group (P = 0.002), by 5 months. CONCLUSIONS: In this study, the efficacy and safety of PBMV was reconfirmed, as PBMV proved to be non-inferior to MVS in survival prognosis, but sustained event-free duration was significantly better in the MVS group than in the PBMV group.

Highly-repeatable generation of very small nanoparticles by pulsed-laser ablation in liquids of a high-speed rotating target.

By irradiating a cylindrical silver target rotated at a high-speed within the range 300-2400 rpm (lateral speed 0.16-1.25 m s-1) in pure water, we prepare ligand-free Ag nanoparticles (NPs) with a size of 4 ± 2 nm which are likely to be primary particles. Usually, the generation of NPs showing such a small size requires either a laser post-treatment and/or chemical additives. As the rotation rate of the target is increased, calculated 3D flow patterns revealed different hydrodynamic regimes which clearly influence the ablation rate and repeatability of the process as well as the colloidal properties. In addition to revealing the importance of fluid dynamics in pulsed-laser ablations in liquids, this study provides a way for producing in one step pure NPs with sizes below 5 nm which are suitable for applications in catalysis.

New procedure to measure simultaneously the surface tension and contact angle.

This paper proposes a new procedure to simultaneously measure the static contact angle and the surface tension of a liquid using a spherical geometry. Unlike the other existing methods, the knowledge of one of both previous parameters and the displacement of the sphere are not mandatory. The technique is based on the measurement of two simple physical quantities: the height of the meniscus formed on a sphere at the very contact with a liquid bath and the resulting vertical force exerted on this object at equilibrium. The meniscus height, whose exact value requires the numerical resolution of the Laplace equation, is often estimated with an approximate 2D model, valid only for very large spheres compared to the capillary length. We develop instead another simplified solution of the Young-Laplace equation based on the work of Ferguson for the meniscus on a cylinder and adapted for the spherical shape. This alternative model, which is less restrictive in terms of the sphere size, is successfully compared to numerical solutions of the complete Young-Laplace equation. It appears to be accurate for sphere radii larger than only two capillary lengths. Finally the feasibility of the method is experimentally tested and validated for three common liquids and two "small" steel spheres.

Levitating spherical particle in a slightly tapered tube at low Reynolds numbers: application to the low-flow rate rotameters.

In this study, a theoretical framework is developed to predict the equilibrium conditions of a non-neutrally buoyant sphere placed in a vertical conical tube as encountered in liquid rotameters. The analysis presented herein is applicable for a sphere heavier than the surrounding fluid, situated on the axis of a slightly tapered tube. The sphere is subject to the laminar flow conditions with the Reynolds numbers ranging between the Stokes type regimes up to values corresponding to slightly inertial regimes. In this work, we assume that the aperture angle of the tube is small and that the drag force is mainly due to the dissipation located in the gap between the tube and the sphere. Under these conditions, it is possible to consider the tube as locally cylindrical and we can use the results previously obtained for the correction factor of the Stokes force on a sphere subject to a Poiseuille flow in a tube of constant cross-section. We obtain an equation relating the flow rate to the vertical position of the sphere in the tube and the validity of this analysis is demonstrated by applying it to a commercially available rotameter. The present study provides a simple but sound theoretical method to calibrate such flowmeters.