Proximal Optimization Technique and Kissing Balloon Inflations With the Bioresorbable Vascular Scaffold for Coronary Bifurcation Percutaneous Coronary Intervention

Proximal optimization technique and final kissing balloon inflations with noncompliant balloons facilitate success with coronary bifurcation intervention. The use of bioresorbable vascular scaffolds has been postulated to reduce the risk of in-stent restenosis, a particular problem with bifurcation intervention. We present a case of bifurcation intervention in a 49-year-old woman, using for the first time, proximal optimization and kissing balloon inflation within bioresorbable vascular scaffolds, using optical coherence tomography guidance.     

Pr3+ doping at the A-site of La0.67Ba0.33MnO3 nanocrystalline material: assessment of the relationship between structural and physical properties and Bean–Rodbell model simulation of disorder effects

Bulk nanocrystalline samples of (La_1−xPr_x)_0.67Ba_0.33MnO₃ (0.075 ≤ x ≤ 0.30) manganites with a fixed carrier concentration are prepared by the sol–gel based Pechini method. Rietveld refinement of the X-ray diffraction patterns, shows the formation of single-phase compositions with rhombohedral symmetry. Upon Pr³⁺ doping at the A-site, the unit cell volume and the B–O–B bond angles are reduced. FTIR spectra present a prominent absorption peak of the in-phase stretching mode (B_2g mode) rising from the vibration of the Mn–O bond. Raman spectra at room temperature reveal a gradual shift toward lower frequencies in (E_g) phonon mode with increasing Pr³⁺ concentration. The M(T) measurements shows a clear ferromagnetic (FM)–paramagnetic (PM) phase transition with increasing temperature. An increase in resistivity and activation energy and a decrease in the metal–semiconductor transition (T_M–SC) and Curie temperatures (T_C) was observed as a consequence of Pr³⁺ doping. The results are discussed according to the change of A-site-disorder effect caused by the systematic variations of the A-site average ionic radius 〈r_A〉 and A-site-cation mismatch σ², resulting in the narrowing of the bandwidth and the decrease of the mobility of e_g electrons. The magneto-transport behavior in the whole measured temperature and a magnetic field can be described by a percolation model, which is in agreement with the limited experimental data of the samples for x = 0.075, 0.15 and 0.30. The experimental results confirm that A-site substitution with Pr³⁺ destroys the Mn³⁺–O²⁻–Mn⁴⁺ bridges and weakens the double exchange (DE) interaction between the Mn³⁺ (t³_2ge¹_g, S = 2) and Mn⁴⁺ (t³_2ge⁰_g, S = 3/2) ions. On the other hand, the Bean and Rodbell model has been successfully used to simulate the magnetization data of the samples with x = 0.15 and x = 0.22. The random replacement of La³⁺ by Pr³⁺ is shown to induce more disorder in the system, which is reflected in the increase of the fitted disorder parameter and spin value fluctuation. At a temperature close to room temperature, the maximum magnetic entropy change (ΔS_Max) and the relative cooling power (RCP) of La_0.52Pr_0.15Ba_0.33MnO_2.98 are found to be, respectively, 1.34 J kg⁻¹ K⁻¹ and 71 J kg⁻¹ for a 1.5 T field change.

Bulk nanocrystalline samples of (La_1−xPr_x)_0.67Ba_0.33MnO₃ (0.075 ≤ x ≤ 0.30) manganites with a fixed carrier concentration are prepared by the sol–gel based Pechini method.     

Analysis of Metal Contamination and Bioindicator Potential of Predatory Fish Species Along Contas River Basin in Northeastern Brazil

Samples of two carnivore fish species (Hoplias malabaricus and Serrasalmus brandtii) were collected along Contas River, northeastern Brazil, to determine the levels of Co, Cr, Cu, Fe, Mn, Ni and Pb in edible and non-edible tissues of these important local fisheries resources. Lead could not be quantified in most of the samples, while the other metals were detected in both species. In edible parts, Cr levels were above Brazilian threshold limits in all specimens and Ni was at high concentration in S. brandtii individuals from one collection site. In non-edible parts (viscera), besides Cr, Cu concentration was higher than that recommended by Brazilian laws. Both fish species proved to be sensitive to environmental contamination. Despite the different ecological characteristics, such as vagility and feeding strategy, these fish showed that aquatic predators are efficient bioindicators of water quality and biomagnification.     

Participation of adolescents in the Family Health Strategy from the theoretical-methodological structure of an enabler to participation

Objective

to evaluate the participation of adolescents in the Family Health Strategy, from the theoretical-methodological structure of an enabler to participation.

Method

a quantitative study, conducted from December of 2010 to March of 2011, with 213 professionals in the FHS in the region of Cariri-Ceará-Brazil. Data were collected through a questionnaire and organized in SPSS 18.0.

Results

the level of normative participation becomes manifest beginning with the adolescent search for health services, motivated by disease (77.9%). Normative participation + independence appear when they seek prenatal care and family planning. Emancipatory participation was identified by the frequency of adolescents in group activities, in the schools, and a move in the direction of the level of transformative participation was observed.

Conclusion

in this context, it is understood that there exists a need to stimulate the participatory process of the adolescents for a change in health promotion in this group.     

Histopathology and immunohistochemistry of tissues outside central nervous system in bovine rabies

We performed a histopathological and immunohistochemical study of tissues outside the central nervous system in 48 cases of bovine rabies confirmed by direct immunofluorescence and/or immunohistochemistry (IHC) of the central nervous system. In the bovines of this study, mononuclear inflammation in all ganglia (trigeminal, spinal, stellate, and celiac) and adrenal medulla was observed. This injury also occurred in 85 % of neuro-pituitaries in 55 % of pars intermediate and 15 % of the pars distalis of pituitary evaluated. IHC was positive in 92.31 % of lumbar spinal ganglia, 90.9 % of trigeminal ganglia, stellate ganglia of 41.67 and 16.67 % of the celiac ganglia. One of the evaluated adrenal (1/17) showed strong immunohistochemical labeling in the cytoplasm of pheochromocytes. The pituitary IHC was positive in one case in the neurohypophysis (1/20) and in one case in the pars intermedia of the adenohypophysis (1/20). Data from this study indicate that in suspected cases of rabies, besides the complex pituitary rete mirabile and trigeminal ganglion, the evaluation of other ganglia, particularly the lumbar spinal, and adrenal may also contribute to the diagnosis and understanding of the clinical presentation and pathogenesis of the disease in bovines.     

Biomechanical Evaluation of Platform Switching: Different Mismatch Sizes,Connection Types,and Implant Protocols

Background: It is not yet well understood to what extent different implant–abutment mismatch sizes and implant–abutment connection types may influence the peri‐implant biomechanical environment of implants in different clinical situations. Methods: Computed tomography–based finite element models comprising a maxillary central incisor socket and 4.5 × 13 mm outer‐diameter implants with external and internal hex connection types were constructed. The abutments were designed with diameters of 3.5 mm (platform switching [PS] with 1 mm of diametral mismatch [PS ? 1]), 4.0 mm (PS with 0.5 mm of diametral mismatch [PS ? 0.5]), and 4.5 mm (conventional matching implant–abutment design [CD]). Analysis of variance at the 95% confidence interval was used to evaluate peak equivalent strain (EQV strain) in the bone, bone volume affected by a strain >4,000 με (EQV strain >4,000 με), the peak von Mises stress (EQV stress) in abutment screw, and the bone–implant relative displacement. Results: Similar bone strain levels (EQV strain and EQV strain >4,000 με) were encountered in PS ? 1, PS ? 0.5, and CD models for immediately placed implants, independent of the connection type. For immediately loaded implants, slightly smaller peak EQV strain and EQV strain >4,000 με were found for PS ? 1. However, for both connection types in osseointegrated models, the higher the mismatch size, the lesser the amount of strain found. Conclusions: The increase in mismatch size of PS configuration results in a significant decrease of strain levels in bone for osseointegrated implants, principally for external hex connections. No significant effect of PS could be noted in immediately placed implants.     

Cellular and Molecular Tissue Response to Triple Antibiotic Intracanal Dressing

Introduction

The aim of this study was to characterize the response of mouse subcutaneous tissue to triple antibiotic paste (TAP) using conventional light microscopy and real-time PCR (qRT-PCR).

Methods

Polyethylene tubes containing TAP or calcium hydroxide (CH) (ie, the control group) were implanted in mouse subcutaneous tissue. Animals that received empty tubes or no tubes were used as additional controls. After periods of 7, 21, and 63 days postimplantation, the specimens were removed and subjected to histologic processing. The number of inflammatory cells and vessels, vessel areas, vascular density, and relative percentage of collagen were evaluated. Gene expression of proinflammatory (interleukin-1 beta, tumor necrosis factor alpha, and interleukin 17) and anti-inflammatory (transforming growth factor beta) cytokines and angiogenic factors (vascular endothelial growth factor and hypoxia-inducible factor-1 alpha) was quantified by 7 and 21 days postimplantation. Results were analyzed using the Student t test, analysis of variance, and the Tukey test (α = 0.05).

Results

TAP induced an exuberant inflammatory and angiogenic response, with higher numbers of inflammatory cells, higher vascular area and density, and lower relative percentage of collagen compared with CH. In general, the expression of genes involved in inflammation and angiogenesis was higher in the TAP group compared with animals that received CH or empty tubes.

Conclusions

The response of mouse subcutaneous tissue to TAP was characterized by exuberant and persistent inflammatory and angiogenic responses with no repair and high gene expression of biomarkers associated with inflammation and angiogenesis.     

Moderate acute exercise (70% VO2 peak) induces TGF‐β, α‐amylase and IgA in saliva during recovery

Strenuous exercise promotes changes in salivary IgA and can be associated with a high incidence of upper respiratory tract Infections. However, moderate exercise enhances immune function. The effect of exercise on salivary IgA has been well studied, but its effect on other immunological parameters is poorly studied. Thus, this study determined the effect of moderate acute exercise on immunological salivary parameters, such as the levels of cytokines (TGF‐β and IL‐5), IgA, α‐amylase and total protein, over 24 h. Ten male adult subjects exercised for 60 min at an intensity of 70% VO₂ peak. Saliva samples were collected before (‘basal’) and 0, 12 and 24 h after an exercise session. The total salivary protein was lower after 12 and 24 h than immediately after exercise, whereas α‐amylase increased at 12 and 24 h after exercise compared with basal levels. The IgA concentration was increased at 24 h after exercise relative to immediately after exercise, and there was no difference in the IL‐5 while TGF‐β concentration increased in recovery. In conclusion, 70% VO₂ peak exercise does not induce changes immediately after exercise, but after 24 h, it produces an increase in salivary TGF‐β without changing IL‐5.     

Distribuição Espacial de Mortalidade por Insuficiência Cardíaca no Brasil, 1996-2017

BackgroundHeart failure (HF) is a leading cause of mortality and morbidity worldwide, and is associated with the high use of resources and healthcare costs. In Brazil, the HF prevalence is around 2 million patients, and its incidence is of approximately 240,000 new cases per year.ObjectiveThe present investigation aimed to analyze the spatiotemporal trend of mortality caused by HF in Brazil, from 1996 to 2017.MethodsThis is an ecological study developed with secondary data on HF mortality in Brazil. During the period, 1,242,014 cases of death caused by heart failure were analyzed. The existence of spatial autocorrelation of cases was calculated using the Global Moran Index (GMI) and, when significant, the Local Moran Index, considering p<0.05. The relative risk of the clusters was calculated.ResultsThe mortality rate due to HF was diversified in all Brazilian regions, with an emphasis in the South, Southeast, and Northeast. The GMI indicated positive spatial autocorrelation (p=0.01) in all periods. Municipalities located in the South, Southeast, Northeast, and Midwest showed a higher Relative Risk for mortality from HF, and most municipalities in the North were classified as a protective factor against this cause of death.ConclusionsThe study showed a decline in mortality rates across the national territory. The highest concentration of mortality rates is in the North and Northeast regions, highlighting priority vulnerable areas in the planning and controlling strategies of health services.