Grossmanfrom7809

Atrial fibrillation (AF) has become a major health and economic burden. Pulmonary veins isolation (PVI) based ablation for rhythm control of AF is well established. Furthermore, recent studies show its superiority over anti-arrhythmic therapy. However, most of these studies were performed in highly experienced centers, that may not necessarily reflect real world outcomes. We evaluated the outcome (success rate and complications) of 300 consecutive procedures, performed on 291 patients (during 2014-2015) of a major HMO. All had undergone PVI for AF by experienced electrophysiologists in 8 medical centers (85% RF technique). Data were retrospectively collected using computerized medical records. Variables included demographic and clinical characteristics, acute procedural success and complications, long term success rate based on multiple ECGs and Holter monitoring. The average age was 63 years, 61% were male, 79% had paroxysmal AF. Sinus rhythm at 2 years was considered success. The overall success rate of maintaining sinus rhythm at 2 years was 56%. Success rate correlated significantly with age and standard risk factors. Those patients in whom the index procedure was the first ablation, success rate was 78%. Sixty-one patients underwent a second ablation with success rate of 64%, 32 underwent a 3rd/4th procedure with success rate of 56%. The probability to be in sinus rhythm after 2 years regardless of the number of ablations was 78%. Thirty-five percent of the patients were still on anti-arrhythmic therapy at 2 years post procedure. Complication rate was 6.6% (2.5% serious), among them 2 deaths, 1 procedure related. PVI in a real-world large unselected population is a valid therapeutic option for AF with an overall 2-year success rate of 56%. In our group higher complication rate was observed compared to the reported rate in the literature. The use of cryo-ablation for PVI and further improvements in both technique and experience may improve both efficacy and safety profile.Cardiovascular disease is the greatest health care burden and one of the most common causes of death worldwide. Less is known about the genetic factors that are responsible for predisposition to cardiovascular disease thus; the molecular and genetic mechanisms underlying cardiovascular diseases remain obscure. One important regulator of blood pressure homeostasis is the renin-angiotensin system. The protease renin cleaves angiotensinogen into the inactive decameric peptide angiotensin I (Ang I). Angiotensin-converting enzyme (ACE) catalyzes the cleavage of the Ang I into the active octomer angiotensin II (Ang II). In humans, can ACE polymorphism has been associated with determinants of renal and cardiovascular function and pharmacological inhibition of ACE and Ang II receptors are effective in lowering blood pressure and preventing kidney disease. In addition, inhibition of ACE and Ang II receptors has beneficial effects in heart failure. A homologue of ACE, termed ACE2, has been identified; it is predominantly expressed in the vascular endothelial cells of the kidney and heart. Unlike ACE, ACE2 functions as a carboxypeptidase, cleaving a single residue from AngI, generating Ang1-9, and a single residue from AngII to generate Ang1-7. Nevertheless, the in vivo role of ACE2 in the cardiovascular system and the renin-angiotensin system is not known.Classical symptoms of chronic mesenteric ischemia include postprandial pain referred to as "intestinal angina", food fear and weight loss. Here we present a case of chronic mesenteric ischemia treated by endovascular stenting in a patient with chronic heart failure and left ventricular assist device.

The purpose of the study was to describe the ischemic changes occurring during percutaneous transluminal coronary angioplasty (PTCA) using a new method based on Precordial Bipolar Leads (PBL) and Precordial Unipolar Leads (PUL).

Ischemic ECG changes have been attributed to both systolic and diastolic injury currents. The relation between ST-segment shift and QRS changes is unclear and there is a discussion about its significance.

Twelve-lead electrocardiograms (ECGs) were performed in 16 patients before PTCA balloon inflation and immediately after balloon deflation in the proximal left anterior descending coronary artery (LAD). Also, ECG data was used to generate V2-V1 PBL, average V1+V2 lead, and the correspondent loop to explore ECG and spatial vector changes.

(1) The V2-V1 Vs Average V1+V2 loop rotation changed from counterclockwise (CCW) to clockwise (CW) in 14 of 15 patients (93%). (2) In 12 of 16 patients (75%), there was an abrupt change of QRS vector direction, producing a "folding" of the looanymore to the isoelectric point. (3) Alterations of myocardial activation appear to be responsible for ST elevation in hyperacute ischemia.The cleaning efficiencies of fouled multibore ultrafiltration membrane (UFMB) operated from a pilot-scale UF process for surface water treatment were systemically investigated according to the sequences of two different cleaning solutions. The experimental results decisively confirmed that HPI DOM and HPO DOM/multivalent ions complexation significantly resulted in the fouling formations on UFMB due to their neutral charge characteristic. The basic cleaning agent effectively extracted the organic foulants attached on UFMB, indicating that the type of cleaning agent was a critical factor influencing on the cleaning efficiency of fouled UFMB. However, the cleaning sequence 1 (CS-1 0.1 M NaOH >0.1 M HCl; the total DOC = 725.77 mgC∙m-2; the total TN = 146.35 mgN∙m-2, total inorganic contents = 132.62 mg m-2) much more effectively extracted the foulants on the UFMB surfaces than the cleaning sequence 2 (CS-2 0.1 M HCl >0.1 M NaOH; the total DOC = 604.49 mgC∙m-2; the total of TN = 121.79 mgN∙m-2, total inorganic contents = 73.43 mg m-2). The morphological results also clearly showed that the cleaned UFMB surface using CS-1 were effectively recovered, as compared with those using CP-2. Overall, this study implied that the hydroxide ions from the basic cleaning agent promoted the infiltration of the acidic cleaning agent into the densely formed fouling layers on the UFMB surfaces and demonstrated that the cleaning sequences strategy could significantly govern the restoration of UFMB performance during the pilot-scale surface water treatment system operation.It is important to develop a catalyst that can maintain good activity in alkaline environment for Fenton or Fenton-like reactions. In order to achieve stable Fenton catalytic degradation in a wide pH range, this study reports Cu-doped MnFe2O4 heterogeneous catalysts still has excellent effect when the pH is extended to 11 for removing organic pollutants, such as tetracycline hydrochloride (TC-HCl). The synergistic effect among Fe, Mn and Cu ions has been proved to enhanced the catalytic activity in this work. When the molar ratio of Cu/Mn = 41, the porous Cu0·8Mn0·2Fe2O4 materials had the highest photo-Fenton catalytic activity compared with pure MnFe2O4, CuFe2O4 and other CuxMn1-xFe2O4. The XPS showed that Cu0·8Mn0·2Fe2O4 formed oxygen vacancies, which exposed more active sites to attract more H2O2 for TC-HCl degradation. Results indicated 94.3% of TC-HCl was efficiently degraded by 0.1 g/L Cu0·8Mn0·2Fe2O4 with 50 mM H2O2 at pH = 11 under 30 min visible light irradiation, and the corresponding apparent rate constant was 0.08286 min-1. With free radicals quenching experiment, O2- was responsible for the high catalytic degradation and OH was participated in the photo-Fenton reaction. To sum up, Cu0·8Mn0·2Fe2O4 exhibited high activity, great stability and easily recyclable, which eliminated the pH limitation of the Fenton reaction and provided practical application performance for water purification.Traditional high-throughput methods for identification of chemicals with liver tumor promotion potentials are based on established cancer cell lines, and rapid and cost-effective high-throughput screening assays in whole organisms are presently lacking. In this study, a transgenic zebrafish liver cancer model was employed to develop a method that could be used to identify chemicals with liver tumor promotion effect quickly and accurately. The method consisted of three parts, including exposure preparation, exposure process and image acquisition. In brief, after chemical exposure for 7 days, 96-well plate exposure system for zebrafish larvae was assessed by microplate reader. Then, the liver cancer promoting potential chemicals were evaluated by field area and field average intensity of fluorescence. The results were further validated by conducting histopathological examination. Our data demonstrated that the high-throughput screening assay developed in this study was reproducible and could be used to rapidly screen chemicals with liver tumor promoting potentials by using tris-(2-chloropropyl)-phosphate (TDCIPP) as a positive control. see more Furthermore, some other positive chemicals found in previous studies and environmental compounds were assessed using the established method. Results indicated that 86.7% of the positive chemicals and five environmental compounds out of seventeen compounds could enhance liver tumor progression.Bimetallic oxy(hydroxides) have gain great interest in water treatment systems based on adsorption processes. Their high OH groups density, in addition to inheriting the oxides properties make them highly promising adsorbents of anions. In this work, highly affine and selective bimetallic oxyhydroxides of cerium and iron (CeFe-P's) for arsenic(V) were synthesized by implementing an assisted microwave methodology. The CeFe-P's were characterized by various techniques (SEM, FTIR, XRD and XPS) and the As(V) adsorption capacity and kinetics as well as the effect of pH and the presence of coexisting anions were determined. The results showed that CeFe-P's have an outstanding As(V) adsorption capacity (179.8 mg g-1 at Ce = 3 mg L-1) even at low concentrations (120 mg g-1 at Ce = 37 μg L-1). Moreover, the adsorption equilibrium was reached very fast, just in 3 min, with an adsorption rate of 0.123 mg min-1, that is, 80% of the initial As(V) concentration of 5 mg L-1 was removed in the first 3 min. The arsenic adsorption capacity decreased only up to 20% at pH above 7, attributed to electrostatic repulsions due to the adsorbent's pHPZC, which was 6.8. On the other hand, the arsenic adsorption capacity of CeFe-P's decreased just 21% in the presence of 10 mg L-1 of each of the following competing anions F-, Cl-, SO42-, NO3-, PO43- and CO32-, which usually coincide in contaminated water with As(V). CeFe-P's has proven to be one of the most promising As(V) adsorbent materials reported so far in the literature, because it presented an outstanding adsorption capacity and at the same time a very fast adsorption speed. Furthermore, the pH and the concentration of coexisting anions caused little interference in the adsorption processes. Due to the above, the CeFe-P's is already in the process of intellectual protection.Volcanoes are currently to be regarded as natural sources of air pollutants. Climatic and environmental forcing of large volcanic eruptions are well known, although gases emitted through passive degassing during periods of quiescence or hydrothermal activity can also be highly dangerous for the environment and public health. Based on compositional and isotopic data, a survey on the spatial distribution in air of the main volatile compounds of carbon (CO2 and CH4) and sulfur (H2S and SO2) emitted from the fumarolic field of Pisciarelli (Campi Flegrei, Pozzuoli, Naples), a hydrothermal area where degassing activity has visibly increased since 2009, was carried out. The main goals of this study were (i) to evaluate the impact on air quality of these natural manifestations and (ii) inquire into the behavior of the selected chemical species once released in air, and their possible use as tracers to distinguish natural and anthropogenic sources. Keeling plot analysis of CO2 and CH4 isotopes revealed that the hydrothermal area acts as a net source of CO2 in air, whilst CH4 originated mainly from anthropogenic sources.