Percutaneous peripheral interventions in patients with non-ST elevation acute coronary syndromes performed by interventional cardiologists: rationale and results

BACKGROUND: The coexistence of peripheral artery disease (PAD) and multilevel atherosclerosis increases death and stroke rates in patients with coronary artery disease (CAD). Due to many comorbidities these patients are often treated conservatively without revascularisation. AIM: To investigate whether complex percutaneous cardiovascular interventions for CAD and PAD may improve prognosis and long-term outcome in this group of patients. METHODS: We studied consecutive patients treated for symptomatic CAD who also had chronic PAD. The primary cause of hospital admission for all our patients was non-ST elevation acute coronary syndrome (NSTE ACS). All percutaneous peripheral interventions were performed during one hospital stay (index hospitalisation). Major adverse cardio- and cerebrovascular events (MACCE) during follow-up were defined as follows: death (cardiac and non-cardiac), myocardial infarction (MI), urgent revascularisation (surgical or repeat PCI, peripheral percutaneous intervention), stroke/TIA or amputation. RESULTS: We performed 109 interventions in 78 consecutive patients with chronic peripheral artery stenoses and occlusions. The average age was 61.5+/-8.6 years and the majority were males (80%). Preinterventional angiography showed occlusions that involved the common iliac artery in 28 (36%) patients, the external iliac artery in 16 (21%) patients, internal iliac artery in 2 (3%) patients, and superficial femoral artery in 63 (81%) patients. Stenting was performed in half of the patients with a mean stent length of 69.6+/-50.3 mm. An average number of 1.24+/-0.55 stents was used for each lesion. During a mean follow-up of 18 months (range 4 to 42), there were 4 deaths, 3 MIs, 13 repeated percutaneous peripheral interventions due to restenosis in previously treated peripheral lesions, two urgent coronary interventions, two ischaemic strokes, two TIAs and one amputation. The combined follow--up MACCE end-point occurred in 32% of patients. CONCLUSIONS: Patients with concomitant CAD and PAD could safely undergo percutaneous cardiovascular and peripheral interventions. Multilevel intervention is associated with a promising long-term follow-up.     

Characterization of W–Cr Metal Matrix Composite Coatings Reinforced with WC Particles Produced on Low-Carbon Steel Using Laser Processing of Precoat

The paper presents the study results of laser processing of precoat applied on C30 steel. The precoat consisted of powder mixtures with a binder in the form of water glass. Tungsten powder, chromium, and tungsten carbide (WC) were used to produce the precoat. The laser processing was carried out using a Yb:YAG disc laser with a rated power of 1 kW. Constant producing parameters (power of laser beam, 600 W; laser beam scanning rate, 400 mm/min) were applied. Chemical composition of the precoat was a variable parameter in coating production. A mixture consisting of 50% W and 50% Cr as a metal matrix was prepared. Subsequently, WC particles in weight ratios of 25%, 50%, and 75% were added to matrix. As a result, W–Cr metal matrix composite coatings reinforced with WC particles were formed. This study focused on investigation of microstructure, microhardness, phase, and chemical composition as well as corrosion and wear resistance, of the newly formed W–Cr/WC coatings. An instrumented nanoindentation test was also used in this study. As a result of laser beam action, the newly formed coatings had an interesting microstructure and good properties which were improved in comparison to substrate material. It is anticipated that the resulting coatings, depending on the treatment parameters (e.g., W–Cr/WC powder mixture) used, can be successfully applied to metal forming or foundry tools.     

The Shear Stress Determination in Tubular Specimens under Torsion in the Elastic–Plastic Strain Range from the Perspective of Fatigue Analysis

The comparison of shear stress determination methods in tubular specimens under torsion is presented in this paper. Four methods were analyzed: purely elastic solutions, purely plastic solutions, the midsection approach, and the Chaboche nonlinear kinematic hardening model. Using experimental data from self-designed and conducted fatigue experiments, an interesting insight on this problem was obtained that is not often tackled in the literature. It was shown that there are differences in determined shear stress values, and their level depends on a few factors. The midsection approach and purely plastic solution gave values of surface shear stress very close to the values obtained using the Chaboche nonlinear kinematic hardening model for high strain levels. The purely elastic solution gave proper results for the low strain ranges, close to the cyclic yield limit. Since none of the methods can be trusted in the full range of loading, an important conclusion from these analyses regards the formulated ranges of their applicability. It was also shown that the calculated values of shear stress and plastic and elastic strain energy density determined on this basis have a strong impact on fatigue life predictions. Finally, the influence of predicted values of shear stresses on the interpretation of cyclic hardening phenomena was also presented.     

Induction of immediate early genes expression in the mouse striatum following acute administration of synthetic cathinones

BackgroundSynthetic cathinones (SCs) form one of the most prominent group of the New Psychoactive Substances. SCs enhance central dopaminergic and noradrenergic neurotransmission, and are used as substitutes for illicit psychostimulants, namely cocaine, amphetamine, and methamphetamine. Changes in the expression of immediate early genes (IEGs) in the striatum underlie the addictive potential of drugs of abuse belonging to distinct pharmacologic groups. This work was aimed to assess the impact of acute administration of the prominent SCs on the mRNA levels of IEGs in the mouse striatum.MethodsEffects of 3,4-MDPV, 2,3-MDPV, α-PVP, PV8, PV9, methcathinone (MC) and 3-fluoromethcathinone (3-FMC) on the mRNA levels of ten IEGs, one and two hours after exposure, were measured in the mouse striatum using the quantitative RT-PCR technique.ResultsAll SCs used in the study produced increased mRNA levels of the following IEGs: Areg, c-fos, Csrnp1, Dusp1, Dusp14, Egr2, Egr4 and FosB. Additionally, the majority of SCs increased the expression of Homer1 and c-jun. The magnitude of observed changes varied by the drug, analyzed gene and, in many cases, by time after administration.ConclusionsThis study demonstrates that SCs increase the expression of IEGs in the mouse striatum, which may lead to a plethora of effects, as proteins encoded by the analyzed genes are involved in diverse actions, including an acute response to the drug and the neuroplasticity underlying the development of addiction.     

Can adipokine visfatin be a novel marker of pregnancy‐related disorders in women with obesity?

Overweight and obesity have become a dangerous disease requiring multiple interventions, treatment and preventions. In women of reproductive age, obesity is one of the most common medical conditions. Among others, obese state is characterized by low‐grade systemic inflammation and enhanced oxidative stress. Increased maternal body mass index might amplify inflammation and reactive oxygen species production, which is associated with unfavourable clinical outcomes that affect both mother and child. Intrauterine growth retardation, preeclampsia, or gestational diabetes mellitus are examples of the hampered maternal and foetoplacental unit interactions. Visfatin is the obesity‐related adipokine produced mainly by the visceral adipose tissue. Visfatin affects glucose homeostasis, as well as the regulation of genes related to oxidative stress and inflammatory response. Here, we review visfatin interactions in pregnancy‐related disorders linked to obesity. We highlight the possible predictive and prognostic value of visfatin in diagnostic strategies on gravidas with obesity.