Impact of primary percutaneous coronary intervention on ST-segment elevation myocardial infarction patients: A comprehensive analysis.

BACKGROUND: Myocardial infarction, particularly ST-segment elevation myocardial infarction (STEMI), is a key global mortality cause. Our study investigated predictors of mortality in 96 STEMI patients undergoing primary percutaneous coronary intervention at Erbil Cardiac Center. Multiple factors were identified influencing in-hospital mortality. Significantly, time from symptom onset to hospital arrival emerged as a decisive factor. Consequently, our study hypothesis is: "Reducing time from symptom onset to hospital arrival significantly improves STEMI prognosis." AIM: To determine the key factors influencing mortality rates in STEMI patients. METHODS: We studied 96 consecutive STEMI patients undergoing primary percutaneous coronary intervention (PPCI) at the Erbil Cardiac Center. Their clinical histories were compiled, and coronary evaluations were performed via angiography on admission. Data included comorbid conditions, onset of cardiogenic shock, complications during PPCI, and more. Post-discharge, one-month follow-up assessments were completed. Statistical significance was set at P < 0.05. RESULTS: Our results unearthed several significant findings. The in-hospital and 30-d mortality rates among the 96 STEMI patients were 11.2% and 2.3% respectively. On the investigation of independent predictors of in-hospital mortality, we identified atypical presentation, onset of cardiogenic shock, presence of chronic kidney disease, Thrombolysis In Myocardial Infarction grades 0/1/2, triple vessel disease, ventricular tachycardia/ventricular fibrillation, coronary dissection, and the no-reflow phenomenon. Specifically, the recorded average time from symptom onset to hospital arrival amongst patients who did not survive was significantly longer (6.92 ± 3.86 h) compared to those who survived (3.61 ± 1.67 h), P < 0.001. These findings underscore the critical role of timely intervention in improving the survival outcomes of STEMI patients. CONCLUSION: Our results affirm that early hospital arrival after symptom onset significantly improves survival rates in STEMI patients, highlighting the critical need for prompt intervention.

A new evaluation framework for the assessment of wastewater heat recovery potential coupled with wastewater reuse.

The integration of wastewater heat recovery (WWHR) and wastewater reuse offers a numerous advantage, making its application possible in various sectors. Nevertheless, this concept faced challenges to the identification of appropriate location. Existing research lacks comprehensive evaluation methods that encompass a various factor for effective decision-making. This study introduces a new evaluation framework that involves different aspects, including thermal energy potential and spatial distribution analysis. The novelty of this research lies in its unique focus on the combination of WWHR and wastewater reuse. Moreover, it introduces a structured evaluation framework that considers multiple criteria and expert opinions, enhancing decision-making precision. Multi-criteria decision analysis (MCDA) was applied to select assessment criteria, which were categorized into three aspects: water-energy supplier, water-energy consumers, and water-energy station. The relative importance of criteria was determined using the analytical hierarchical process (AHP). The results of the AHP highlight significance of factors: treated wastewater flow rate; treated wastewater temperature; water-energy supply distance, and type of water-energy consumer. These factors were assigned weight values of 0.297, 0.186, 0.123, and 0.096, respectively. It is emphasizing their influence in the decision-making process that potential locations depend on the water-energy supplier and water-energy consumer as supply and demand sources.

Using Musical Feedback Increases Stride Frequency in Recreational Runners.

The number of participants in popular races has increased in recent years, with most of them being amateurs. In addition, it has been observed that there is a high percentage of injuries among them, and some of these injuries may be related to a low stride frequency. The aim of this research was to check if a continuous running training program with a musical base improves the stride frequency of popular runners. For this purpose, the effect of a 6 week continuous running training program with the help of a musical track with a constant rhythm that was 10% higher than the preferred stride frequency of the subjects was analyzed and compared to a control group that performed the continuous running training without sound stimuli. Significant increases were found in the evolution of stride frequency in the experimental group between the pre- and post-test (p = 0.002). No significant changes were observed in the stride frequency of the control group. These results show that training with music feedback helps to improve stride frequency in recreational runners. Future research should study the evolution of the improvement obtained in time as it is unknown if the increase in stride rate has been integrated in the runner's technique, making the improvement obtained permanent. Future research is needed to confirm these results by enlarging the sample and carrying out an exhaustive biomechanical study.

Emerging challenges of air pollution and particulate matter in China, India, and Pakistan and mitigating solutions.

This study examines point and non-point sources of air pollution and particulate matter and their associated socioeconomic and health impacts in South Asian countries, primarily India, China, and Pakistan. The legislative frameworks, policy gaps, and targeted solutions are also scrutinized. The major cities in these countries have surpassed the permissible limits defined by WHO for sulfur dioxide, carbon monoxide, particulate matter, and nitrogen dioxide. As a result, they are facing widespread health problems, disabilities, and causalities at extreme events. Populations in these countries are comparatively more prone to air pollution effects because they spend more time in the open air, increasing their likelihood of exposure to air pollutants. The elevated level of air pollutants and their long-term exposure increases the susceptibility to several chronic/acute diseases, i.e., obstructive pulmonary diseases, acute respiratory distress, chronic bronchitis, and emphysema. More in-depth spatial-temporal air pollution monitoring studies in China, India, and Pakistan are recommended. The study findings suggest that policymakers at the local, national, and regional levels should devise targeted policies by considering all the relevant parameters, including the country's economic status, local meteorological conditions, industrial interests, public lifestyle, and national literacy rate. This approach will also help design and implement more efficient policies which are less likely to fail when brought into practice.

Serum Copper Level and Its Relation with Blood Pressure and Urinary Protein Level in Preeclampsia.

Preeclampsia is a multifactorial disease of unknown etiology and is associated with oxidative stress. Some studies observed that alteration of essential trace element may contribute to the development of preeclampsia. The aim of the study was to assess the serum copper (Cu) level and its relation with blood pressure and urinary protein level in preeclampsia. This cross sectional study was conducted in the Department of Physiology, Dhaka Medical College, Dhaka, Bangladesh from July 2016 to June 2017. Thirty subjects with preeclampsia age ranging from 18 to 40 years were considered as the study group and 30 aged matched healthy pregnant women were considered as control group for comparison. The subjects were selected from Department of Obstetrics and Gynecology of Dhaka Medical College hospital, Dhaka. Serum copper (Cu) level was estimated in the Department of Soil, Water and Environment of University of Dhaka. For statistical analysis, unpaired Students "t" test and Pearson's correlation coefficient (r) test were performed. In this study serum Copper level was significantly (p<0.001) higher in preeclampsia patients as compared to controls. Serum copper level showed positive correlations with systolic & diastolic blood pressure and urinary protein level. This study concluded that serum copper level increases and is positively related with blood pressure and urinary protein level. Therefore, estimation of serum copper level in early pregnancy might be useful for prediction of future risk of developing preeclampsia.

Phlogiellus bundokalbo spider venom: Its neuroactive, phospholipase a2 and cytotoxic components against human breast adenocarcinoma (MCF-7)

@#Spider venoms and toxins are valuable sources of lead compounds for drug development due to their essential role in cellular and physiological processes targeting various receptors. Here, we present the protein profile of the venom of Phlogiellus bundokalbo, an endemic Philippine tarantula, to screen and characterize its cytotoxicity against MCF-7 cells, secretory phospholipase a2 (sPLA2), and neurotoxicity to evaluate its potential anticancer properties. Spider venom was extracted via electrical stimulation. Venom components were fractionated by reversed-phase high-performance liquid chromatography and characterized through liquid chromatography-mass spectrometry (LC-MS) and SDS-PAGE analysis before assay. The resulting five venom fractions were amphiphilic peptides showing cytotoxicity against MCF-7 cells in a concentrationdependent manner (IC50 ranging from 52.25μg/ml to 110.20μg/ml) after 24-hour incubation. Cells appeared detached, rounded, and shrunk with cytoplasmic condensation upon overnight incubation with venom fractions. The sPLA2 was observed in all the venom fractions tested for cytotoxicity. Venom fractions revealed a predominant mass of ~3-5 kDa with LC-MS analysis. Results showed distinct similar mass as μ- theraphotoxin-Phlo1a, an Australian tarantula, Phlogiellus sp. toxin with inhibitor cystine knot motif. The venom fractions exhibit excitatory neurotoxins that might activate presynaptic voltage-gated ion channels, such as an agonist or gating modifier toxins that slow down the channel inactivation similar to spider toxins. In conclusion, the spider venom of P. bundokalbo exhibits cytotoxic, phospholipase A2, and neuroactive properties suggesting that its venom components, upon further purification and structure-function analysis, can be potential tools in the development of targeted breast chemotherapeutics.

Comparison of three diagnostic tests in detecting vestibular deficit in patients with peripheral vestibulopathy.

OBJECTIVES: This study aimed to evaluate the results of the video head impulse test and of the caloric and rotatory chair tests in patients with dizziness. Agreement between test results was assessed and the best protocol for detecting peripheral vestibulopathy was identified. METHODS: Participants comprised 116 patients, 75 with a peripheral vestibulopathy and 41 with non-peripheral vestibulopathy. The main outcome measures were classified as normal or abnormal according to our laboratory data. RESULTS: Agreement between tests was low. Vestibulopathy testing that required all three results to be abnormal had a sensitivity of 0.547, a specificity of 0.878, and positive and negative predictive values of 0.891 and 0.514, respectively. Vestibulopathy testing that required just one result to be abnormal had a sensitivity of 0.933, a specificity of 0.292, and positive and negative predictive values of 0.701 and 0.705, respectively. CONCLUSION: In peripheral vestibulopathy, there was weak concordance in the assessment of horizontal semicircular canal function among the different tests. However, the video head impulse test had sufficient statistical power to be recommended as the first-line test.

Normal Gain of VOR with Refixation Saccades in Patients with Unilateral Vestibulopathy.

OBJECTIVE: To characterize the response in the video head-impulse test for the assessment of the vestibulo-ocular reflex (VOR) in patients because of vertigo and dizziness. MATERIALS AND METHODS: After rightward and leftward head impulses, the following results evaluated were: gain of the reflex and appearance of refixation saccades. A particular type of response (normal gain VOR and refixation saccades) was evaluated in a group of patients. RESULTS: In patients with a unilateral abnormality consisting of normal gain and refixation saccades, there was a close concordance with the diseased side and the side to which head impulses elicited the abnormal result. CONCLUSION: In the assessment of patients with dizziness, finding a normal gain VOR with refixation saccades indicates the existence of a peripheral vestibulopathy and localizes to the side of the lesion.

A practical system for recording instrument interactions during live robotic surgery.

We have developed a system for measuring and recording the high-frequency vibrations that characterize instrument interactions during minimally invasive robotic surgery. Consisting of simple circuitry and a DVD recorder, this system is low-cost and easily implementable, requires no sterilization, and enables measurement of a validated, objective technical skill metric in both the simulated setting and the operating room. The vibration recordings of fourteen sleeve gastrectomies were processed by segmenting the operation into seven phases and calculating the root mean square (RMS) vibration within each phase. Statistical analysis showed that the observed differences match expectations drawn from knowledge of the operation, substantiating the premise that RMS vibration provides a good measure of the intensity of instrument interactions during live robotic surgery.

Prevalence and risk factors for encephalomyocarditis virus infection in Peru.

Although encephalomyocarditis virus (EMCV) infection has been commonly documented among domestic animals, less is known about EMCV transmission among humans. Recently, we described the isolation of EMCV from two febrile patients in Peru. To further investigate EMCV transmission in Peru, we screened febrile patients reporting to health clinics in Peru for serological evidence of recent EMCV infection. We also conducted a serological survey for EMCV-neutralizing antibodies in the city of Iquitos, located in the Amazon basin department of Loreto, Peru. Additionally, we screened serum from rodents collected from 10 departments in Peru for evidence of EMCV exposure. EMCV infection was found to be only rarely associated with acute febrile disease in Peru, accounting for <1% of febrile episodes analyzed. Despite the low acute disease burden associated with the virus, human exposure was quite common, as prevalence of EMCV-neutralizing antibodies ranged between 6.0% in the coastal city of Tumbes and >17% in cities in the tropical rainforest of northeastern Peru (Iquitos and Yurimaguas). On the basis of the serological survey conducted in Iquitos, risk factors for past infection include increased age, socioeconomic indicators such as residence construction materials and neighborhood, and swine ownership. Evidence from the rodent survey indicates that EMCV exposure is common among Murinae subfamily rodents in Peru (9.4% EMCV IgG positive), but less common among Sigmodontinae rodents (1.0% positive). Further studies are necessary to more precisely delineate the mode of EMCV transmission to humans, other potential disease manifestations, and the economic impact of EMCV transmission among swine in Peru.

Epidemiology of spotted fever group and typhus group rickettsial infection in the Amazon basin of Peru.

A seroprevalence study for IgG antibodies against spotted fever group (SFGR) and typhus group (TGR) Rickettsia among humans and domestic pets was conducted in the city of Iquitos, located in the Amazon basin of Peru. Of 1,195 human sera analyzed, 521 (43.6%) and 123 (10.3%) were positive for SFGR and TGR antibodies, respectively. District of residence and participant age were associated with antibody positivity for both groups, whereas rodent sightings in the home were associated with TGR antibody positivity. Of the 71 canines tested, 42 (59.2%) were positive for SFGR antibodies, and two (2.8%) were positive for TGR antibodies; one active SFGR infection was detected by polymerase chain reaction. An uncharacterized SFGR species was detected in 95.9% (71/74) of Ctenocephalides felis pools collected from domestic pets. These data suggest that rickettsial transmission is widespread in Iquitos. Rickettsia species should be further explored as potential causes of acute febrile illnesses in the region.

Otosclerosis among patients with dizziness.

OBJECTIVE: The objective of this study was to identify patients with otosclerosis and to characterize its clinical presentation among patients examined at our hospital with vertigo as the primary and most distressing symptom. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary medical center. PATIENTS: This study involved 40 patients suffering from dizziness and diagnosed with otosclerosis. METHODS: At inclusion, the clinical status, as well as auditory (pure tone hearing level and speech audiometry, impedancemetry) and vestibular function (bedside, nystagmography, caloric test and rotator chair testing) were assessed. The results were analyzed using parametric and non-parametric tests, and the chi2 test. RESULTS: The clinical presentation was diverse: 12 patients with Menière's syndrome (30%); 11 patients with spontaneous recurrent vertigo without hearing fluctuation (27.5%); 13 patients with positional vertigo (32.5%); 3 patients with chronic unrelapsing imbalance (7.5%); and 1 patient with acute unilateral vestibulopathy (2.5%). There was a lag between the detection of hearing loss and the beginning of vertigo attacks or imbalance in all patients. When measured through bone conduction, hearing loss was significantly different in patients with Menière's disease, spontaneous recurrent vertigo and positional vertigo. CONCLUSIONS: Dizziness, although frequent in patients with otosclerosis is rarely a cause for specific clinical assessment. There is a lag between the patient's perception of hearing loss and the initiation of vestibular symptoms, and it is not associated with any specific clinical disorder Otosclerosis can be found as any one of the most common vestibular disorders and in general, vestibular function tests reveal a more severe vestibular dysfunction than in the idiopathic forms. LEVEL OF EVIDENCE: 2A.

Microstructures formation in a seemingly ideal homogeneous mixture of ethanol and methanol: An experimental evidence and two-dimensional correlation spectroscopy approach.

An anomalous solution behavior at the molecular scale was observed for macroscopically homogeneous mixtures of methanol and ethanol. Two-dimensional Raman correlation spectroscopy was used to elucidate the possible existence of microstructures formed in the mixture. The result suggests that separate methanol and ethanol clusters are formed without heterohydrogen bonding between different alcohol species. Supramolecular structures seem to be formed by the interaction of such clusters with each other through cohesion and dispersion forces, but not through direct hydrogen bonding connections.

High dietary taurine reduces apoptosis and atherosclerosis in the left main coronary artery: association with reduced CCAAT/enhancer binding protein homologous protein and total plasma homocysteine but not lipidemia.

We sought to determine whether taurine could specifically protect against coronary artery disease during an atherogenic diet and whether taurine affects the lipid profile, metabolites of methionine, and endothelial atherogenic systems. Rabbits were fed one of the following diets for 4 weeks: (1) control diet; (2) 0.5% cholesterol+1.0% methionine; or (3) 0.5% cholesterol+1.0% methionine+2.5% taurine. Endothelial function was examined, and the left main coronary artery atherosclerosis was quantified by stereology and semiquantitative immunohistochemistry to determine the endothelial expression of proteins related to the NO, renin-angiotensin, endoplasmic reticulum, and oxidative stress systems, as well as apoptosis. Taurine normalized hyperhomocysteinemia (P<0.05) and significantly reduced hypermethioninemia (P<0.05) but not lipidemia. The intima:media ratio was reduced by 28% (P=0.034), and atherosclerosis was reduced by 64% (P=0.012) and endothelial cell apoptosis by 30% (P<0.01). Endothelial cell CCAAT/enhancer binding protein homologous protein was normalized (P<0.05). Taurine failed to improve hyperlipidemia, endothelial function, or endothelial proteins related to the NO, renin-angiotensin, and oxidative stress systems. Taurine reduces left main coronary artery wall pathology associated with decreased plasma total homocysteine, methionine, apoptosis, and normalization of CCAAT/enhancer binding protein homologous protein. These results elucidate the antiapoptotic and antiatherogenic properties of taurine, possibly via normalization of endoplasmic reticulum stress.

Venezuelan equine encephalitis virus in Iquitos, Peru: urban transmission of a sylvatic strain.

Enzootic strains of Venezuelan equine encephalitis virus (VEEV) have been isolated from febrile patients in the Peruvian Amazon Basin at low but consistent levels since the early 1990s. Through a clinic-based febrile surveillance program, we detected an outbreak of VEEV infections in Iquitos, Peru, in the first half of 2006. The majority of these patients resided within urban areas of Iquitos, with no report of recent travel outside the city. To characterize the risk factors for VEEV infection within the city, an antibody prevalence study was carried out in a geographically stratified sample of urban areas of Iquitos. Additionally, entomological surveys were conducted to determine if previously incriminated vectors of enzootic VEEV were present within the city. We found that greater than 23% of Iquitos residents carried neutralizing antibodies against VEEV, with significant associations between increased antibody prevalence and age, occupation, mosquito net use, and overnight travel. Furthermore, potential vector mosquitoes were widely distributed across the city. Our results suggest that while VEEV infection is more common in rural areas, transmission also occurs within urban areas of Iquitos, and that further studies are warranted to identify the precise vectors and reservoirs involved in urban VEEV transmission.

Pila de botón en esófago / Button battery in oesophagus

No disponible

No disponible