Abstract
Funding Acknowledgements
Type of funding sources: None.
Aims
To safely perform angioplasties in acute coronary syndromes with very low contrast volume using Cordis diagnostic catheters and ...thereby improve the cardiovascular and renal outcomes.
Methods and results
In 1432 patients (1857 lesions/ 2148 stents) with acute coronary syndromes, angioplasty was performed with Cordis 6F diagnostic catheters. Primary angioplasty was performed in 457 cases. In 76% of cases, iodixanol was used. All contrast injections were given by hand. A regular follow-up of the patients was performed 30 days after the procedure. All the procedures were performed through the femoral route. Tirofiban was used in 99% cases with adjusted dosages based on the creatinine values. The mean contrast volume used per patient was 28 ml (±6 ml) including the angiogram prior to the angioplasty. Ninety one patients had creatinine more than 2mg/dl before the angioplasty procedures. Left main angioplasty was performed in 37 patients using single stents. 70 patients had cardiogenic shock at presentation. 76% of the cases had diabetes. IVUS was used in only two patients. A variety of coronary stents from various companies were used. Buddy wires were used in 36 cases. Ticagrelor was used in 92 cases, and in other cases clopidogrel was used. Mild reversible nephropathy (CIN) was observed in six patients. Four patients were already on dialysis, and dialysis was continued thereafter. Switch-over of angioplasty to the radial route was performed in five cases due to associated aortic/iliac obstructive lesions. 26 deaths in total were observed in this series; 16 of these patients had cardiogenic shock (7 late presenters), and three patients expired after discharge due to possible acute stent thrombosis. Groin haematoma was seen in five cases requiring one unit of blood transfusion. Proximal mild edge dissection in the deployed stent was seen in 3 cases which were treated with stents. Wire breakages were not seen. Acute in-hospital stent thrombosis was seen in 6 cases, which were managed with balloon dilatations and stents. Covid19 was positive in 16 cases by RT PCR.
Conclusions
Angioplasty and stenting can be performed safely in patients with acute coronary syndromes using Cordis diagnostic catheters and a very low volume of contrast with improved clinical outcomes.
Contrast-induced nephropathy is a commonly encountered problem in clinical practice. The purpose of the study was to design and develop a novel contrast agent, which could be used to prevent ...contrast-induced nephropathy in the future.
In total, 20–220nm magnetic nanoparticles were conjugated with iodixanol, and their radio-opacity and magnetic properties were assessed thereafter. Scanning electron microscopy pictures were acquired. Thereafter, the nanoparticles conjugate was tested in cell culture (HUVEC cells), and Quantibody® assay was studied after cell treatment in 1:5 dilutions for 48h, compared with control.
The conjugate preparation had an adequate radio-opacity. A 4mm magnetic bubble was attached to a bar magnet and the properties were studied. The magnetic bubble maintained its structural integrity in all angles including antigravity position. Scanning electron microscopy showed magnetic nanoparticles in all pictures and the particles are of 100–400nm agglomerates with primary particle sizes of roughly 20nm. 1:5 diluted particles had no effect on secretion of IL-1a, IL-1b, IL-4, IL-10, IL-13 and TNFa. Particles increased secretion of IL-8 from 24h and 48h. Secretion of IFNg was also increased when particles were added to the cells as early as 1h. Likewise, IL-6 was strongly secreted by HUVEC treated with particles from 24h incubation time. In contrast, the secretion of MCP-1 was slightly reduced on HUVEC treated with particles.
There is potential for a novel iodixanol-magnetic nanoparticle conjugate to be used in cineradiography. Further investigations need to be performed to study its performance in vitro and in vivo.
La néphropathie induite par les produits de contraste est un problème fréquemment rencontré en pratique clinique. L’objectif de cette étude est de présenter un nouvel agent de contraste, le conjugué iodixanol-nanoparticules magnétiques, qui ne serait pas associé à cette complication iatrogène.
Des nanoparticules magnétiques de 20 à 220nm ont été conjuguées à de l’iodixanol. La radio-opacité du conjugué a été étudiée en comparaison à l’iodixanol seul. Des images de microscopie électronique à balayage ont été acquises. Le conjugué de nanoparticules a été étudié en culture cellulaire endothéliale. La sécrétion de cytokines inflammatoires a été mesurée par test ELISA à 1h, 24h et 48h dans la culture cellulaire traitée avec le conjugué à une dilution de 1/5, en comparaison à une culture cellulaire non traitée.
Le conjugué de nanoparticules a présenté une radio-opacité adéquate et a maintenu son intégrité structurelle. La microscopie électronique à balayage a mis en évidence des agglomérats de nanoparticules magnétiques de 100 à 400nm avec des particules primaires d’environ 20nm. Le conjugué de nanoparticules dilué à 1/5 n’a pas eu d’effet sur la sécrétion d’IL-1a, d’IL-1b, d’IL-4, d’IL-10, d’IL-13 et de TNFa. La sécrétion d’IL-8 a augmenté à 24h et 48h. La sécrétion d’IFNγ a également augmenté lorsque le conjugué a été ajouté à la culture de cellules endothéliales dès 1h. De même, l’IL-6 a été fortement sécrétée par les cellules endothéliales traitées avec le conjugué de nanoparticules à partir de 24h d’incubation. En revanche, la sécrétion de MCP-1 par les cellules a été légèrement réduite.
Le conjugué iodixanol-nanoparticules pourrait potentiellement être utilisé en imagerie. Des études complémentaires sont nécessaires pour étudier ses propriétés in vitro et in vivo.
We report a rare case of primary postpartum haemorrhage due to a traumatic cause following spontaneous vaginal delivery in which surgical intervention failed. It was successfully treated by ...transcatheter embolisation of the uterine artery. This technique, although well known, is still underused in such conditions. S Afr J Obstet Gynaecol 2015; 21(2):46-47. DOI: 10.7196.SAJOG.906
General Electronics for TPCs (GET) is a generic, reconfigurable and comprehensive electronics and data-acquisition system for nuclear physics instrumentation of up to 33792 channels. The system ...consists of a custom-designed ASIC for signal processing, front-end cards that each house 4 ASIC chips and digitize the data in parallel through 12-bit ADCs, concentration boards to read and process the digital data from up to 16 ASICs, a 3-level trigger and master clock module to trigger the system and synchronize the data, as well as all of the associated firmware, communication and data-acquisition software. An overview of the system including its specifications and measured performances are presented.
Aims The study was initiated to analyse and characterize application of graphene on to heart valves, and also to evaluate the morphology of graphene after accelerated wear test in saline.
Methods ...Monolayer graphene was transferred to four bi-leaflet mechanical mitral valves. Three valves were subjected to accelerated wear test to 40M cycles in saline. Subsequently, after completion of the test, all the valves were evaluated by scanning electron microscopy. One bi-leaflet valve coated with graphene and another one which was not coated with graphene served as control.
Results A definite presence of graphene by SEM analysis was observed in various locations in 2 out of 3 valves analysed by accelerated wear test. As the valve surface was relatively rough, and the magnification was very high though graphene traces were not seen on the third valve, its presence cannot be ruled out. The surface morphology of the mitral valves was not changed at the completion of the study, by application of graphene.
Conclusion Graphene could be applied to mechanical bi-leaflet heart valves, and its presence was seen in 2 out of 3 valves after an accelerated wear test of 40M test cycles in saline.
Crossing the blood-brain barrier in primates is a major obstacle for gene delivery to the brain. Adeno-associated viruses (AAVs) promise robust, non-invasive gene delivery from the bloodstream to the ...brain. However, unlike in rodents, few neurotropic AAVs efficiently cross the blood-brain barrier in non-human primates. Here we report on AAV.CAP-Mac, an engineered variant identified by screening in adult marmosets and newborn macaques, which has improved delivery efficiency in the brains of multiple non-human primate species: marmoset, rhesus macaque and green monkey. CAP-Mac is neuron biased in infant Old World primates, exhibits broad tropism in adult rhesus macaques and is vasculature biased in adult marmosets. We demonstrate applications of a single, intravenous dose of CAP-Mac to deliver functional GCaMP for ex vivo calcium imaging across multiple brain areas, or a cocktail of fluorescent reporters for Brainbow-like labelling throughout the macaque brain, circumventing the need for germline manipulations in Old World primates. As such, CAP-Mac is shown to have potential for non-invasive systemic gene transfer in the brains of non-human primates.
The nuclei below lead but with more than 126 neutrons are crucial to an understanding of the astrophysical r process in producing nuclei heavier than A∼190. Despite their importance, the structure ...and properties of these nuclei remain experimentally untested as they are difficult to produce in nuclear reactions with stable beams. In a first exploration of the shell structure of this region, neutron excitations in ^{207}Hg have been probed using the neutron-adding (d,p) reaction in inverse kinematics. The radioactive beam of ^{206}Hg was delivered to the new ISOLDE Solenoidal Spectrometer at an energy above the Coulomb barrier. The spectroscopy of ^{207}Hg marks a first step in improving our understanding of the relevant structural properties of nuclei involved in a key part of the path of the r process.
The ACtive TARget and Time Projection Chamber (ACTAR TPC) is a novel gas-filled detector that has recently been constructed at GANIL. This versatile detector is a gaseous thick target that allows the ...tracking of charged particles in three dimensions and provides a precise reaction energy reconstruction from the vertex position. A commissioning experiment using resonant scattering of a 3.2MeV/nucleon 18O beam on an isobutane gas (proton) target was performed. The beam and the heavy scattered ions were stopped in the gas volume, while the light recoil left the active volume and were stopped in auxiliary silicon detectors. A dedicated tracking algorithm was applied to determine the angle of emission and the length of the trajectory of the ions, to reconstruct the reaction kinematics used to built the excitation functions of the 1H(18O, 18O)1H and 1H(18O, 15N)4He reactions. In this article, we describe the design of the detector and the data analysis, that resulted in center of mass reaction energy resolutions of 38(4)keV FWHM and 54(9)keV FWHM for the proton and alpha channels, respectively.
The presence of a neutron halo in 15C has been demonstrated in several reaction experiments at intermediate energies. In the present study, the dynamical effects of this structure are observed for ...the first time at Coulomb barrier energies in the 15C + 208Pb quasi-elastic scattering at Elab=65 MeV, measured at the HIE-ISOLDE facility, CERN using the high-granularity detector array GLORIA. A combined continuum discretised coupled channels and coupled reaction channels calculation describes the data well and significant coupling effects due both to breakup and single-neutron stripping are identified.
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