Coronary artery anomalies

Coronary artery anomalies (CAAs) are a rare entity but their true incidence in the general population has yet to be determined. Most CAAs are asymptomatic, but they are nevertheless the second leading cause of sudden death in apparently healthy young athletes. The new imaging methods available to cardiologists, including CT angiography and MRI, now enable noninvasive diagnosis and characterization of these anomalies. The authors review the literature and present a retrospective study of 360 consecutive patients who underwent cardiac CT angiography. Demographic, clinical and angiographic characteristics were studied. The incidence of CAAs in this population was 2.69%. In order to better characterize this disorder, including diagnostic strategy, screening, treatment and prognosis, the authors suggest the establishment of a national registry of cardiac CT angiography. Such a registry would fill the existing gap in information on exams performed in the country, enriching current knowledge about this disease and noninvasive cardiac imaging in Portugal.     

Outpatient evaluation and management of patients with ventricular premature beats or non-sustained ventricular tachycardia

In this survey, European physicians who deal with arrhythmia patients gave their opinions about diagnostic work up when they see patients with ventricular premature beats (VPBs) or non-sustained ventricular tachycardia (NSVT). In general, similar work-up regimens were used for these two arrhythmias except for coronary angiography, which was considered by one in four physicians when dealing with NSVT but by almost none for VPBs. The majority of physicians believe that it is acceptable to abstain from pharmacological therapy in an asymptomatic patient with VPBs. When considering second-line therapy almost half of the respondents would consider amiodarone in patients with NSVT whereas almost none would when dealing with VPBs. When the effect of therapy was evaluated, its influence on symptoms and arrhythmia burden were ranked highest.     

A novel variant in plakophilin-2 gene detected in a family with arrhythmogenic right ventricular cardiomyopathy

Aims  

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is characterized by fibrofatty replacement of muscular fibers predominantly in the right ventricle and with ventricular arrhythmias as the main clinical manifestation. Mutations in several components of the desmosome genes have been identified and mutations of the plakophilin-2 (PKP-2) gene are a common cause of ARVC. The aim of this study is to investigate the correlation between genotype and phenotype in a family with a novel PKP-2 variant.     

Synthetic non-classical luminescence generation by enhanced silica nanophotonics based on nano-bio-FRET

Fluorescent silica nanoparticles (NPs–(SiO₂–Fluo)) were synthesized based on the classical Störber method for cyanobacteria labelling. Modified mono-coloured SiO₂ NPs with fluorescein (Fl) and rhodamine B (RhB) were obtained (NPs–(SiO₂–Fl) and NPs–(SiO₂–RhB)). Moreover, multi-coloured SiO₂ NPs, via the incorporation of both emitters (NPs–(SiO₂–RhB–Fl)), were tuned for optimal emissions and the biodetection of cyanobacteria. NPs–(SiO₂–Fl) and NPs–(SiO₂–RhB–Fl) were optimized for detection via laser fluorescence microscopy and in-flow cytometry with laser excitation and fluorescence detection. By TEM, homogeneous SiO₂ NPs of 180.0 nm in diameter were recorded. These sizes were slightly increased due to the covalent linking incorporation of fluorescent dye emitters to 210.0 nm with mono-coloured fluorescent modified amine-organosilanes, and to 340.0 nm in diameter with multi-coloured dye incorporation. NPs–(SiO₂–Fluo) showed variable emission depending on the dye emitter concentration, quantum yield and applied luminescent pathway. Thus, mono-coloured NPs–(SiO₂–Fl) and NPs–(SiO₂–RhB) showed diminished emissions in comparison to multi-coloured NPs–(SiO₂–RhB–Fl). This enhancement was explained by fluorescence resonance energy transfer (FRET) between Fl as a fluorescent energy donor and RhB as an energy acceptor produced within the nanoarchitecture, produced only in the presence of both fluorophores with the appropriate laser excitation of the energy donor. The depositions of the nano-emitters on cyanobacteria by non-covalent interactions were observed by TEM and laser fluorescence microscopy. For multi-coloured NPs–(SiO₂–RhB–Fl) labelling, bio-FRET was observed between the emission of the nano-labellers and the natural fluorophores from the cyanobacteria that quenched the emission of the whole nano-biostructure in comparison to mono-coloured NPs–(SiO₂–Fl) labelling. This fact was explained and discussed in terms of different fluorescence energy transfer from the nanolabellers towards different natural chromophore coupling. In the presence of NPs–(SiO₂–RhB–Fl) and NPs–(SiO₂–RhB), the emission was coupled with lower quantum yield chromophores; while upon the application of NPs–(SiO₂–Fl), it was coupled with higher quantum yield chromophores. In this manner, for enhanced luminescent nanoplatform tracking, the multi-coloured NPs–(SiO₂–RhB–Fl) showed improved properties; but more highly luminescent bio-surfaces were generated with mono-coloured NPs–(SiO₂–Fl) that permitted faster cyanobacteria detection and counting by laser fluorescence microscopy, and by in-flow cytometry with laser excitation and fluorescence detection.

Fluorescent silica nanophotonics for cyanobacteria labelling.     

The Value of Predischarge ICD Tests in Patients with a Successful Peroperative Test

An internal cardioverter defibrillator (ICD) is normally extensively tested during implantation. The necessity of retesting prior to discharge of the patient is a matter of debate. In our material of 30 patients undergoing first-time implantation of a transvenous internal defibrillator system, we retrospectively compare the predischarge defibrillation test with the peroperative test. A successful peroperative defibrillation test with no failed shocks at 10 J below maximal energy level was followed by a successful predischarge test with the same safety margin in 18/19 patients, while one patient required a maximal energy ICD shock for conversion at the predischarge test. We conclude that the predischarge defibrillation test can be omitted if the peroperative test was successful, with no failed shocks at 10 J below maximal energy level and if the shock therapy is set to maximal energy level.     

Revascularisation of costochondral grafts: an experimental study in domestic pigs

Mandibular condyles are reconstructed immediately with costochondral grafts (CCGs) in children for several temporomandibular conditions, including ankylosis, benign neoplasia, and chronic arthritis. A prerequisite for growth of CCGs is that they are properly revascularised, but the revascularisation process has not to our knowledge so far been examined. The aim of the present study was therefore to investigate the revascularisation of CCGs when they were used for immediate reconstruction of the mandibular condyle in juvenile domestic pigs. Eleven mandibular condyles were experimentally resected and immediately reconstructed with CCGs. Microangiograms with an Indian ink solution were done 2, 4, 8, and 12 weeks after the reconstructions. The density of vessels was higher in measurement zones facing soft tissues than in those facing mandibular bone at all time points. Revascularisation of the growth plate originated from the surrounding recipient soft tissues and not from an endosteal blood supply from the host mandible ramus.     

Radixin expression in microglia after cortical stroke lesion

Stroke induces extensive tissue remodeling, resulting in the activation of several cell types in the brain as well as recruitment of blood‐borne leucocytes. Radixin is part of a cytoskeleton linker protein family with the ability to connect transmembrane proteins to the actin cytoskeleton, promoting cell functions involving a dynamic cytoskeleton such as morphological changes, cell division and migration which are common events of different cell types after stroke. In the healthy adult brain radixin is expressed in Olig2⁺ cells throughout the brain and in neural progenitor cells in the subventricular zone. In the current study, we detected a 2.5 fold increase in the number of radixin positive cells in the peri‐infarct cortex two weeks after the induction of cortical stroke by photothrombosis. Similarly, the number of Olig2⁺ cells increased in the peri‐infarct area after stroke; however, the number of radixin⁺/Olig2⁺ cells was unchanged. Neural progenitor cells maintained radixin expression on their route to the infarct. More surprising however, was the expression of radixin in activated microglia in the peri‐infarct cortex. Seventy percent of Iba1⁺ cells expressed radixin after stroke, a population which was not present in the control brain. Furthermore, activation of radixin was predominantly detected in the peri‐infarct region of oligodendrocyte progenitors and microglia. The specific location of radixin⁺ cells in the peri‐infarct region and in microglia suggests a role for radixin in microglial activation after stroke.     

Adjunctive azithromycin in the treatment of aggressive periodontitis: microbiological findings of a 12-month randomized clinical trial

Objectives

To compare the subgingival microbiological outcomes of azithromycin or placebo as adjuncts to scaling and root planing (SRP) in the treatment of aggressive periodontitis (AgP), and to secondarily evaluate the microbiological effect of supragingival scaling in AgP patients.

Methods

Twenty-four AgP subjects 13–26 years of age received a 15-day programme of supragingival scaling (SC) and were then randomly assigned to SRP with systemic azithromycin or placebo. Subgingival samples were taken with sterile paper points at baseline, 15 days after SC, and at 3, 6 and 12 months following SRP. Microbiological analysis was performed by the checkerboard DNA–DNA hybridization.

Results

Changes in bacterial levels from baseline to 15 days after SC were similar in the 2 groups. When subjects were analysed as a single group, significant reductions after SC were observed for Actinomyces gerencseriae, Capnocytophaga ochracea, and Treponema denticola. During the 12-month follow-up, levels of most of the bacteria decreased in both groups in a similar pattern. For instance, Actinomyces israelli, Veillonella parvula, Streptococcus gordonii, C. ochracea, Eikenella corrodens, Eubacterium nodatum, Fusobacterium periodonticum and Fusobacterium nucleatum ssp. polymorphum decreased significantly within the groups.

Conclusions

Azithromycin was ineffective in lowering the subgingival levels of important putative periodontal pathogens in young AgP subjects compared to placebo.

Clinical significance

Scaling and root planing with adjunctive systemic azithromycin provides little additional benefit compared to placebo in reductions of major subgingival periodontal pathogens.