Transcatheter aortic valve implantation with a self-expanding nitinol bioprosthesis: Prediction of the Need for Permanent Pacemaker Using Simple Baseline and Procedural Characteristics

Objective: To ascertain incidence and predictors of new permanent pacemaker (PPM) following transcatheter aortic valve implantation (TAVI) with the self-expanding aortic bioprosthesis. Background: TAVI with the Medtronic Corevalve (MCV) Revalving System (Medtronic, Minneapolis, MN) has been associated with important post-procedural conduction abnormalities and frequent need for PPM. Methods: Overall, 73 consecutive patients with severe symptomatic AS underwent TAVI with the MCV at two institutions; 10 patients with previous pacemaker and 3 patients with previous aortic valve replacement were excluded for this analysis. Clinical, echocardiographic, and procedural data were collected prospectively in a dedicated database. A standard 12-lead ECG was recorded in all patients at baseline, after the procedure and predischarge. Decision to implant PPM was taken according to current guidelines. Logistic multivariable modeling was applied to identify independent predictors of PPM at discharge. Results: Patients exhibited high-risk features as evidenced by advanced age (mean = 82.1 +/- 6.2 years) and high surgical scores (logistic EuroSCORE 23.0 +/- 12.8%, STS score 9.4 +/- 6.9%). The incidence of new PPM was 28.3%. Interventricular septum thickness and logistic Euroscore were the baseline independent predictors of PPM. When procedural variables were included, the independent predictors of PPM were interventricular septum thickness (OR 0.52; 95% CI 0.320.85) and the distance between noncoronary cusp and the distal edge of the prosthesis (OR 1.37; 95% CI 1.031.83). Conclusions: Conduction abnormalities are frequently observed after TAVI with self-expandable bioprosthesis and definitive pacing is required in about a third of the patients, with a clear association with depth of implant and small interventricular septum thickness. (c) 2011 Wiley Periodicals, Inc.

Alveolar hemorrhage: distinct features of juvenile and adult onset systemic lupus erythematosus

We compared outcomes of alveolar hemorrhage (AH) in juvenile (JSLE) and adult onset SLE (ASLE). From 263 JSLE and 1522 ASLE, the AH occurred in 13 (4.9%) and 15 (1.0%) patients, respectively (p < .001). Both groups had comparable disease duration (2.6 +/- 3.0 vs. 5.6 +/- 7.0 years, p = .151) and median SLEDAI scores [17.5 (2 to 32) vs. 17.5 (3 to 28), p = 1.000]. At AH onset, a higher frequency of JSLE were already on a high prednisone dose ( > 0.5 mg/kg/day) compared to ASLE (54% vs. 15%, p = .042). The mean drop of hemoglobin was significantly lower in JSLE (2.9 +/- 0.9 vs. 5.5 +/- 2.9 g/dL, p = .006). Although treatments with methylprednisolone, plasmapheresis, intravenous immunoglobulin and cyclophosphamide were similar in both groups (p > .050), regarding outcomes, there was a trend in high frequency of mechanical ventilation use (85% vs. 47%, p = .055) and also significant mortality (69% vs. 13%, p = .006) in JSLE compared to ASLE. The sepsis frequency was comparable in both groups (50% vs. 27%, p = .433). We have identified that AH in JSLE has a worse outcome most likely related to respiratory failure. The AH onset in JSLE already treated with high-dose steroids raises the concern of inadequate response to this treatment and reinforces the recommendation of early aggressive alternative therapies in this group of patients. Lupus (2012) 21, 872-877.

Duration of dual antiplatelet therapy and outcomes after coronary stenting with the genous (TM) bio-engineered R stent (TM) in patients from the e-healing registry

Objective: We investigated the relation between duration of dual antiplatelet therapy (DAPT) and clinical outcomes up to 12 months after Genous (TM) endothelial progenitor cell capturing R stent (TM) placement in patients from the e-HEALING registry. Background: Cessation of (DAPT) has been shown to be associated with the occurrence of stent thrombosis (ST). After Genous placement, 1 month of DAPT is recommended. Methods: Patients were analyzed according to continuation or discontinuation of DAPT at a 30-day and 6-month landmark, excluding patients with events before the landmark. Each landmark was a new baseline, and outcomes were followed up to 12 months after stenting. The main outcome for our current analysis was target vessel failure (TVF), defined as target vessel-related cardiac death or myocardial infarction and target vessel revascularization. Secondary outcomes included ST. (Un)adjusted hazard ratios (HR) for TVF were calculated with Cox regression. Results: No difference was observed in the incidence of TVF [HR: 1.03; 95% confidence intervals (CI): 0.651.65, P = 0.89] in patients continuing DAPT (n = 4,249) at 30 days versus patients stopped (n = 309), and HR: 0.82 (95% CI: 0.551.23, P = 0.34) in patients continuing DAPT (n = 2,654) at 6 months versus patients stopped [n = 1,408] DAPT). Furthermore, no differences were observed in ST. Even after addition of identified independent predictors for TVF, adjusted TVF hazards were comparable. Conclusions: In a post-hoc analysis of e-HEALING, duration of DAPT was not associated with the occurrence of the outcomes TVF or ST. The Genous stent may be an attractive treatment especially in patients at increased risk for (temporary) cessation of DAPT or bleeding. (C) 2011 Wiley Periodicals, Inc.

GALAXIES BEHIND THE GALACTIC PLANE: FIRST RESULTS AND PERSPECTIVES FROM THE VVV SURVEY

VISTA Variables in the Via Lactea (VVV) is an ESO variability survey that is performing observations in near-infrared bands (ZY JHK(s)) toward the Galactic bulge and part of the disk with the completeness limits at least 3 mag deeper than Two Micron All Sky Survey. In the present work, we searched in the VVV survey data for background galaxies near the Galactic plane using ZY JHK(s) photometry that covers 1.636 deg(2). We identified 204 new galaxy candidates by analyzing colors, sizes, and visual inspection of multi-band (ZY JHK(s)) images. The galaxy candidate colors were also compared with the predicted ones by star count models considering a more realistic extinction model at the same completeness limits observed by VVV. A comparison of the galaxy candidates with the expected one by Millennium simulations is also presented. Our results increase the number density of known galaxies behind the Milky Way by more than one order of magnitude. A catalog with galaxy properties including ellipticity, Petrosian radii, and ZY JHK(s) magnitudes is provided, as well as comparisons of the results with other surveys of galaxies toward the Galactic plane.

A cross-sectional study on canine Leishmania (L.) infantum chagasi infection in Amazonian Brazil ratifies a higher prevalence of specific IgG-antibody response than delayed-type hypersensitivity in symptomatic and asymptomatic dogs

This was a cross-sectional study which analyzed the prevalence and the clinical and immunological spectrum of canine Leishmania (L.) infantum chagasi infection in a cohort of 320 mongrel dogs living in an endemic area of American visceral leishmaniasis in the Amazonian Brazil by using, mainly, the indirect fluorescence antibody test (IFAT-IgG) and the delayed-type hypersensitivity (DTH), and the parasite research by the popliteal lymph node aspiration. The IFAT and DTH reactivity recognized three different immune response profiles: (1) IFAT((+))/DTH(-) (107 dogs), (2) IFAT((-))/DTH(+) (18 dogs), and (3) IFAT((+))/DTH(+) (13 dogs), providing an overall prevalence of infection of 43 % (138/320). Thus, the specific prevalence of IFAT ((+)) /DTH ((-)) 33.4 % (107/320) was higher than those of IFAT ((-)) /DTH ((+)) 5.6 % (18/320) and IFAT ((+)) /DTH ((+)) 4.0 % (13/320). Moreover, the frequency of these profiles among 138 infected dogs showed that the IFAT ((+)) /DTH ((-)) rate of 77.5 % (107/138) was also higher than those of 13.0 % (18/138) of IFAT ((-)) /DTH ((+)) and 9.5 % (13/138) of IFAT ((+)) /DTH ((+)) rates. The frequency of asymptomatic dogs (76 %-105) was higher than those of symptomatic (16.6 %-23) and oligosymptomatic ones (7.4 %-10). A total of 16 (11.6 %) L. (L.) i. chagasi isolates were obtained from infected dogs, all from the IFAT ((+)) /DTH ((-)) profile: 41 % (9/22) from symptomatic, 33.3 % (3/9) from oligosymptomatic, and 5.2 % (4/76) from asymptomatic dogs. These findings strongly suggested that despite the higher frequency of asymptomatic dogs (76 %-105), the majority (72.4 %-76) was characterized by the IFAT ((+)) /DTH ((-)) profile with a doubtful immunogenetic resistance against infection.

A LED Based Photometer for Solid Phase Photometry: Zinc Determination in Pharmaceutical Preparation Employing a Multicommuted Flow Analysis Approach

In this work, a LED (light emitting diode) based photometer for solid phase photometry is described. The photometer was designed to permit direct coupling of a light source (LED) and a photodiode to a flow cell with an optical pathlength of 4 mm. The flow cell was filled with adsorbing solid phase material (C-18), which was used to immobilize the chromogenic reagent 1-(2-thiazolylazo)-2-naphthol (TAN). Aiming to allow accuracy assessment, samples were also analyzed employing ICP OES (inductively coupled plasma optical emission spectrometry) methodology. Applying the paired t-test at the 95% confidence level, no significant difference was observed. Other useful features were also achieved: linear response ranging from 0.05 to 0.85 mg L-1 Zn, limit of detection of 9 mu g L-1 Zn (3 sigma criterion), standard deviation of 1.4% (n = 10), sampling throughput of 36 determinations per h, and a waste generation and reagent consumption of 1.7 mL and of 0.03 mu g per determination, respectively.

Qualitative study of young, adult, and aged wistar rats temporomandibular synovial membrane employing light, scanning, and transmission electron microscopy

The aim of this study was to analyze the rat temporomandibular joint (TMJ) synovial membrane at different ages using light, scanning, and transmission electron microscopy. Under light microscopic analysis, the TMJ structures were observed such as condyle, capsule, disk, the synovial membrane collagen type, and cells distribution. In the scanning electron microscopy, the synovial membrane surface exhibited a smooth aspect in young animals and there was an increase with ageing in the number of folds. The transmission electron microscopic analysis showed more synoviocytes in the synovial layer in the young group and still a great number of vesicles and cisterns dilation of rough endoplasmic reticulum in the aged group. In the three groups, a dense layer of collagen fibers in the synovial layer and cytoplasmic extensions were clearly seen. It was possible to conclude that synovial membrane structures in aged group showed alterations contributing to the decrease in joint lubrication and in the sliding between disk and joint surfaces. These characteristic will reflect in biomechanics of chewing, and may cause the TMJ disorders, currently observed in clinical processes. Microsc. Res. Tech. (c) 2012 Wiley Periodicals, Inc.

Self-bound interacting QCD matter in compact stars

The quark gluon plasma (QGP) at zero temperature and high baryon number is a system that may be present inside compact stars. It is quite possible that this cold QGP shares some relevant features with the hot QGP observed in heavy ion collisions, being also a strongly interacting system. In a previous work we have derived from the QCD Lagrangian an equation of state (EOS) for the cold QGP, which can be considered an improved version of the MIT bag-model EOS. Compared to the latter, our EOS reaches higher values of the pressure at comparable baryon densities. This feature is due to perturbative corrections and also to nonperturbative effects. Here we apply this EOS to the study of neutron stars, discussing the absolute stability of quark matter and computing the mass-radius relation for self-bound (strange) stars. The maximum masses of the sequences exceed two solar masses, in agreement with the recently measured values of the mass of the pulsar PSR J1614-2230, and the corresponding radii of around 10-11 km.

A LED based photometer for solid phase photometry: zinc determination in pharmaceutical preparation employing a multicommuted flow analysis approach

Neste trabalho é proposto um fotômetro baseado em LED (diodo emissor de luz) para fotometria em fase sólida. O fotômetro foi desenvolvido para permitir o acoplamento da fonte de radiação (LED) e do fotodetector direto na cela de fluxo, tendo um caminho óptico de 4 mm. A cela de fluxo foi preenchida com material sólido (C18), o qual foi utilizado para imobilizar o reagente cromogênico 1-(2-tiazolilazo)-2-naftol (TAN). A exatidão foi avaliada empregando dados obtidos através da técnica ICP OES (espectrometria de emissão por plasma indutivamente acoplado). Aplicando-se o teste-t pareado não foi observada diferença significativa em nível de confiança de 95%. Outros parâmetros importantes encontrados foram faixa de resposta linear de 0,05 a 0,85 mg L-1 Zn, limite de detecção de 9 µg L-1 Zn (n = 3), desvio padrão de 1,4 % (n = 10), frequência de amostragem de 36 determinações por h, e uma geração de efluente e consumo de reagente de 1,7 mL e 0,03 µg por determinação, respectivamente.