This population-based registry was designed to provide robust and updated information on the characteristics and the epidemiology of chronic myeloid leukemia (CML). All cases of newly diagnosed ...Philadelphia positive, BCR-ABL1+ CML that occurred in a sample of 92.5 million adults living in 20 European countries, were registered over a median period of 39 months. 94.3% of the 2904 CML patients were diagnosed in chronic phase (CP). Median age was 56 years. 55.5% of patients had comorbidities, mainly cardiovascular (41.9%). High-risk patients were 24.7% by Sokal, 10.8% by EURO, and 11.8% by EUTOS risk scores. The raw incidence increased with age from 0.39/100,000/year in people 20-29 years old to 1.52 in those >70 years old, and showed a maximum of 1.39 in Italy and a minimum of 0.69 in Poland (all countries together: 0.99). The proportion of Sokal and Euro score high-risk patients seen in many countries indicates that trial patients were not a positive selection. Thus from a clinical point of view the results of most trials can be generalized to most countries. The incidences observed among European countries did not differ substantially. The estimated number of new CML cases per year in Europe is about 6370.
The European Treatment and Outcome Study (EUTOS) population-based registry includes data of all adult patients newly diagnosed with Philadelphia chromosome-positive and/or BCR-ABL1+ chronic myeloid ...leukemia (CML) in 20 predefined countries and regions of Europe. Registration time ranged from 12 to 60 months between January 2008 and December 2013. Median age was 55 years and median observation time was 29 months. Eighty percent of patients were treated first line with imatinib, and 17% with a second-generation tyrosine kinase inhibitor, mostly according to European LeukemiaNet recommendations. After 12 months, complete cytogenetic remission (CCyR) and major molecular response (MMR) were achieved in 57% and 41% of patients, respectively. Patients with high EUTOS risk scores achieved CCyR and MMR significantly later than patients with low EUTOS risk. Probabilities of overall survival (OS) and progression-free survival for all patients at 12, 24 and 30 months was 97%, 94% and 92%, and 95%, 92% and 90%, respectively. The new EUTOS long-term survival score was validated: the OS of patients differed significantly between the three risk groups. The probability of dying in remission was 1% after 24 months. The current management of patients with tyrosine kinase inhibitors resulted in responses and outcomes in the range reported from clinical trials. These data from a large population-based, patient sample provide a solid benchmark for the evaluation of new treatment policies.
The aim of this study was to evaluate the post-legislation change in tributyltin (TBT) pollution at Croatian Adriatic coast. Gastropod Hexaplex trunculus and sediments were collected, nearly 10years ...after TBT based antifouling paints were banned, at 12 locations along the coast where a previous study was conducted in 2005. The study showed a decline of TBT levels over the investigated period, although all gastropods populations were highly affected by imposex meaning that prohibition did not result in the recovery of populations. The further aim was to propose the Ecological Quality Ratio (EQR) boundaries for potential use of H. trunculus as a principal bioindicator in the assessment of the ecological status of the Mediterranean regarding TBT pollution, under the Water Framework Directive (WFD). According to the proposed EQR classes, the WFD target for achieving the Good ecological status of the marine environment by 2015 was not reached.
•TBT pollution is present along the Croatian coast in 2015 despite the TBT global ban in 2008.•Imposex parameter RPLI indicates decrease in TBT levels from the year 2005 to 2015.•Decrease in TBT levels was not sufficient to result in the recovery of H. trunculus.•H. trunculus is proposed as biomonitor in WFD monitoring programme in the Mediterranean.•Good ecological status, evaluated by biomonitoring of H. trunculus, was not reached in 2015.
Background
The present analysis aimed to estimate the penetration of cardiac resynchronization therapy (CRT) on the basis of the prevalence and incidence of eligible patients in selected European ...countries and in Israel.
Methods and Results
The following countries were considered: Italy, Slovakia, Greece, Israel, Slovenia, Serbia, the Czech Republic, Poland, Romania, Hungary, Ukraine, and the Russian Federation. CRT penetration was defined as the number of patients treated with CRT (CRT patients) divided by the prevalence of patients eligible for CRT. The number of CRT patients was estimated as the sum of CRT implantations in the last 5 years, the European Heart Rhythm Association (EHRA) White Book being used as the source. The prevalence of CRT indications was derived from the literature by applying three epidemiologic models, a synthesis of which indicates that 10% of heart failure (HF) patients are candidates for CRT. HF prevalence was considered to range from 1% to 2% of the general population, resulting in an estimated range of prevalence of CRT indication between 1000 and 2000 patients per million inhabitants. Similarly, the annual incidence of CRT indication, representing the potential target population once CRT has fully penetrated, was estimated as between 100 and 200 individuals per million. The results showed the best CRT penetration in Italy (47–93%), while in some countries it was less than 5% (Romania, Russian Federation, and Ukraine).
Conclusion
CRT penetration differs markedly among the countries analyzed. The main barriers are the lack of reimbursement for the procedure and insufficient awareness of guidelines by the referring physicians.
Polymer-dispersed liquid crystal elastomers have been recently introduced as a thermomechanically active composite material, consisting of magnetically oriented liquid crystal elastomer particles ...incorporated in a cured polymer matrix. Their thermomechanical properties are largely governed by the degree of imprinted particle alignment, which can be assessed by means of deuterium perturbed
2
H-NMR. Spectra of samples with various degrees of imprinted particle alignment were recorded and the results simulated using the discrete reorientational exchange model developed for determining the dispersion of liquid crystal elastomer's domain orientational distribution. We show that the model can be applied to measure the orientational distribution of embedded liquid crystal microparticles and successfully determine the orientational order parameter in the composite system. Thermomechanical measurements correlate well with the obtained results, thus additionally confirming the validity of the applied method.
Orientational order parameter of magnetically aligned liquid crystal elastomer particles suspended in a cured silicone matrix is assessed using
2
H-NMR spectroscopy. Obtained results correspond well with the composite's thermomechanical response.
Abstract
Background
Atrioventricular (AV) node ablation with biventricular (BiV) pacemaker implantation is a feasible rate control strategy for symptomatic permanent atrial fibrillation (AF) with ...rapid ventricular response and tachycardia-induced heart failure (HF). However, certain controversy exists since BiV pacing delivers non-physiological ventricular resynchronization and does not return left ventricular (LV) activation times to those seen in individuals with intrinsically narrow QRS. Permanent His bundle pacing (HBP) is a physiological alternative to conventional and BiV pacing. By capturing the native conduction system, depolarization of the ventricles through the His-Purkinje system induces normal synchronous ventricular activation.
Purpose
The aim of the study was to compare short-term outcomes between BiV pacing and HBP after AV node ablation in HF patients with symptomatic permanent AF and narrow QRS.
Methods
A total of 25 consecutive HF patients with permanent AF and narrow QRS (≤110 ms) who underwent AV node ablation in conjunction with BiV pacing or HBP in our centre were enrolled. Post-implant QRS duration, echocardiographic data, and New York Heart Association (NYHA) functional class were assessed in short-term follow-up.
Results
Among 25 HF patients (aged 68 ± 7 years, 52% female, QRS 96 ± 9 ms, LVEF 37 ± 7%, NYHA II-IV), 13 received BiV pacing and 12 HBP. Implant and ablation procedures were acutely successful in both groups. In BiV group 1 patient had a LV lead dislodgement and 1 patient in the HBP group had an acute HB lead threshold increase after AV node ablation. In HBP group post-implant QRS duration was shorter compared to BiV (103 ± 15 ms vs. 177 ± 13 ms, p < 0.001). At a median follow-up of 6 months, patients treated with HBP had greater increase in LV ejection fraction compared to BiV (44 ± 10 vs. 37 ± 6, p = 0.045). A trend toward greater reduction of LV volumes (EDV 119 ± 54 ml vs. 153 ± 33 ml, p = 0.07; ESV 75 ± 34 ml vs. 97 ± 26 ml, p = 0.09) and improvement of NYHA class (2.1 ± 0.7 vs. 2.7 ± 0.8, p = 0.08) was also observed in HBP group compared to BiV group.
Conclusion
In rate control refractory HF patients with permanent AF and narrow QRS atrioventricular node ablation in conjunction with HBP demonstrated superior electrical resynchronization and greater increase in LV ejection fraction compared to BiV pacing. Larger prospective studies are warranted to address clinical outcomes between both pace and ablate strategies.
The s-triazine herbicide atrazine (2-chloro-4-ethylamino-6-isopropyl-amino-s-triazine) is one of the most used pesticides in the world. The greatest quantity of atrazine is used for weed control in ...corn, sorghum, sugarcane and other crops. It is one of the most frequently detected pesticides in surface- and ground waters in Europe and North America due to its widespread use, low chemical reactivity, relative mobility and high persistence in the environment. The highest concentrations were detected in streams and rivers in agricultural regions, after applications in spring and early summer. Such frequent appearance of atrazine in natural waters has generated a lot of research into its toxicity in aquatic systems, especially on green alga and macrophita. The effects of atrazine in environmentally realistic concentrations on freshwater animals are less studied. The best known are the effects on fishes. The concentrations of 1.5, 3.0 and 6.0 mg/L of atrazine inhibit biochemical activity of alkaline phosphatase in carp liver, kidneys and heart. In higher concentrations atrazine caused vacuolisation of hepatocytes with fibrosis and necrosis of surrounding tissues. Gill damages were also noted. Depending on the concentration, atrazine induced progressive degradation of kidney tubular and intertubular tissue and interferes with electrolyte balance in fishes. The concentration of 0.1 mg/L of atrazine during 10 days causes significant irreversible lysis of kidney cells in the snail Physa acuta. In environmentally realistic concentrations it also affects biochemical processes in the freshwater snail Lymnaea palustris, while in Physa acuta and Ancylus fluviatilis, it causes changes in feeding behaviour. It is known that environmentally realistic concentrations of atrazine have negative impact on feeding, growth and egg production in freshwater molluscs, cladoceran and leeches.
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