Inflammation and genetics are both prominent mechanisms in the pathogenesis of atherosclerosis and arterial thrombosis. Accordingly, a number of population studies have explored the association of ...ischaemic heart disease with gene polymorphisms of the inflammatory molecules tumour necrosis factors (TNF) α and β, transforming growth factors (TGF) β1 and 2, interleukin (IL) 1 and its receptor antagonist (IL 1ra), CD14 (the receptor for lipopolysaccharide), P and E selectins, and platelet endothelial cell adhesion molecule (PECAM) 1. Although they are very preliminary and partly conflicting, the data provide some evidence that alterations in the genetics of the inflammatory system may modify the risk of ischaemic heart disease.
Abstract Objective Previous studies have shown a high cardiovascular risk in patients with autoimmune diseases, such as type 1 diabetes mellitus (T1DM). Conversely, few data are available about ...patients with celiac disease (CD). The aim of our study was to assess carotid intima–media thickness (c-IMT), in patients with T1DM, CD or both (T1DM + CD) as compared with age- and sex-matched healthy individuals (H). Methods We enrolled 120 patients, 30 with T1DM, 30 with CD, 30 with T1DM + CD and 30 H. Clinical, metabolic and anthropometric data were collected. All T1DM patients were on insulin while all CD patients were on a gluten-free diet. c-IMT was evaluated by high frequency linear digital ultrasound. Results c-IMT was significantly greater in patients with T1DM + CD than in patients with T1DM or CD ( P < 0.001 for both), while no difference was found between T1DM and CD. Moreover, c-IMT was greater in CD than in H ( P < 0.001). Glycemic control and disease duration were similar between T1DM + CD and T1DM. Lipid and anthropometric parameters were similar among groups. Furthermore, in a pooled multivariate analysis, only age and disease type were significantly correlated with c-IMT ( P < 0.001 for both). Conclusion Our study demonstrates that celiac patients have greater c-IMT as compared with healthy individuals. Thus, non-invasive monitoring of c-IMT in CD might be useful in preventing cardiovascular disease. Moreover, patients with T1DM + CD show more severe subclinical atherosclerosis as compared with those presenting T1DM or CD only, suggesting that the association of these autoimmune diseases might accelerate the atherosclerotic process.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, SAZU, SBCE, UL, UM, UPCLJ, UPUK
Myocardial infarction (MI) with no obstructive coronary atherosclerosis (MINOCA) is a syndrome with different causes. Its prevalence ranges between 5 and 25% of all MIs. The prognosis is extremely ...variable, depending on the causes of MINOCA. Clinical history, echocardiography, coronary angiography, and left ventriculography represent the first-level diagnostic investigations. Nevertheless, additional tests are required in order to establish its specific cause, thus allowing an appropriate risk stratification and treatment. We review pathogenesis, diagnosis, prognosis, and therapy of MINOCA and propose an algorithm for its management.
Ventricular septal defect (VSD) is an uncommon but frequently fatal complication following acute myocardial infarction. In medically treated patients, mortality rates exceed 90%, while the surgical ...repair is associated with better outcomes, even though optimal surgical timing is still under debate.
We present the case of a 78-years-old man with no previous remarkable cardiological history admitted to our Emergency Department with the diagnosis of anterior ST-elevation myocardial infarction and significant reduction of left ventricular ejection fraction. The emergency coronary angiography showed sub-occlusion of the left anterior descending coronary artery, treated with stent implantation. The post-procedural echocardiography unveiled the presence of an apical VSD with a large left-to-right shunt, significant right ventricular overload and dysfunction. An intra-aortic balloon pump (IABP) was positioned and, after Heart Team evaluation, a delayed surgical approach was planned. As a bridge to the intervention Levosimendan infusion was administered, on top of IABP support, and a significant improvement in bi-ventricular function and pressure profiles was obtained. Cardiac surgery was successfully performed 9 days after the admission without periprocedural complications.
This unique case supports the use of Levosimendan as a valid pharmacological strategy for perioperative management of VSD.
Abstract Objective To investigate the effects of N -acetylcysteine (NAC) and high-dose atorvastatin (ATOR) in reducing oxidative stress in a rat kidney model of ischemia-reperfusion injury. Methods ...Forty female rats underwent clamping of the left renal artery for 30 minutes, followed by reperfusion. The effects of pre-ischemic administration of NAC and/or ATOR were evaluated within 4 groups: a) control (no NAC, no ATOR); b) NAC (intraperitoneal NAC administration); c) ATOR (oral ATOR administration); and d) NAC+ATOR (both drugs). Oxidative stress was assessed by measuring the activity of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and myeloperoxidase (MPO). Post–ischemia-reperfusion injury was evaluated by means of renal histology. Results NAC, ATOR, and NAC+ATOR in rats showed lower MPO ( P < .05) and higher GPx activity ( P < .05) versus control; SOD activity was lower in NAC versus ATOR ( P < .05). No difference among groups was found at histology. However, a lower rate of tubular ischemic lesions was evident in NAC+ATOR versus control ( P = .07). Conclusions Atorvastatin pretreatment provides protection against oxidative stress in a rat kidney model of ischemia-reperfusion injury, reinforcing the evidence of a beneficial effect of statins beyond their cholesterol-lowering properties.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Key properties of magnesium alloys, such as the high strength-to-density ratio, are driving the production of lightweight structural components in the automotive and aeronautical industries. Many ...efforts have been carried out on various aspects of processing and fabrication, but the
joining of Mg alloys to dissimilar materials is a subject which attracted much research interest in the last decades. In the present work a preliminary investigation on the strength of Al/Mg (AA6082/AZ31B) single-lap epoxy bonded joints was carried out. To this aim, Mg and Al substrates were
laser irradiated using a pulsed ytterbium fiber laser. For comparison, and in order to estimate the beneficial action of the laser surface treatment, single lap joints with grit-blasted substrates were prepared and tested. The interaction between laser treated surfaces and two different epoxy
adhesives was also analyzed. Finally, the results and discussion were supported by scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS) executed on treated and post-failure sample surfaces.
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BFBNIB, DOBA, GIS, IJS, IZUM, KILJ, KISLJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Ferrierite type (FER) zeolite layers have been successfully synthesized on a porous cordierite support from clear solutions, using ethylenediamine as structure directing agent. The use of a clear ...solution avoids the support channel plugging and promotes a stable and homogeneous zeolitic layer, without any pre-treatments of the support surface. The amount of deposited zeolite has been quantified by the increasing weight of the sample and it is around 70% and calculated layer thickness value is 23µm. The adherence of zeolite layer has been evaluated measuring the weight losses of samples, caused by exposing them to repeated air flows and heating cycles. The different post-synthesis thermal treatments affect the homogeneity of the zeolitic layer.
Pure FER-zeolite layer on porous cordierite, with high support coverage, high surface homogeneity and strong adhesion, has been obtained by clear solution. Display omitted
•FER type zeolitic layer has been obtained for the first time by clear solutions using ethylenediamine as structure direct agent.•The layers obtained are firmly attached on support because the in situ synthesis method allows a chemical bonding between the support and the zeolitic layer.•Post-synthesis thermal treatments of zeolitic layer can affect its surface homogeneity, thus influencing the permeability of single gas, such as H2, N2, and C3H8.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Many patients undergoing coronary angiography because of chest pain syndromes, believed to be indicative of obstructive atherosclerosis of the epicardial coronary arteries, are found to have normal ...angiograms. In the past two decades, a number of studies have reported that abnormalities in the function and structure of the coronary microcirculation may occur in patients without obstructive atherosclerosis, but with risk factors or with myocardial diseases as well as in patients with obstructive atherosclerosis; furthermore, coronary microvascular dysfunction (CMD) can be iatrogenic. In some instances, CMD represents an epiphenomenon, whereas in others it is an important marker of risk or may even contribute to the pathogenesis of cardiovascular and myocardial diseases, thus becoming a therapeutic target. This review article provides an update on the clinical relevance of CMD in different clinical settings and also the implications for therapy.
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