Search

Objectives: We sought to assess the feasibility and safety of same-day discharge (SDD) after complex percutaneous coronary intervention (PCI) using a forearm approach., Background: SDD has been shown to be safe after elective, low-risk PCI. However, the feasibility and safety of SDD in more complex patients and lesions has received limited study., Methods: We retrospectively reviewed 1190 elective PCIs that were performed between January 2013 and December 2015 at the Red Cross General Hospital., Results: Of the 1190 PCIs, 166 (13.9%) were complex (bifurcations, vein and arterial grafts, unprotected left main, last remaining vessel, chronic total occlusions, or with utilization of rotational atherectomy or hemodynamic support). As compared with non-complex cases, complex cases were associated with older age, male gender, higher prevalence of diabetes mellitus and prior coronary artery bypass graft surgery, lower prevalence of smoking, higher utilization of femoral access and 7F guiding catheters, higher contrast utilization and fluoroscopy dose, longer fluoroscopy time, more stents per lesion, more frequent single vessel treatment and non-complete revascularization, and treatment with ticagrelor and bivalirudin. Among the patients who underwent complex PCI (n=166), twenty eight (16.9%) were discharged the same day. SDD after complex PCI was associated with younger age and more frequent use of forearm access. The 30-day incidence of major adverse cardiac events after complex PCI was 0% vs 3.6% (p=0.59) in patients with SDD vs. overnight hospitalization., Conclusions: SDD is feasible and safe in selected patients undergoing elective complex PCI using the forearm approach., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Objectives: The aim of this study is to identify possible predictors for same day discharge (SDD) after percutaneous coronary interventions (PCI)., Background: Same day discharge after PCI is becoming more and more appealing and patient's selection criteria are being formulated., Methods: A retrospective analysis was performed in all PCI procedures from January 2013 until December 2015. Patients were discharged the same day (SDD group) or had at least one overnight stay (non-SDD group). The decision of SDD or not was on treating physician discretion. We evaluated predictors of SDD decision by a logistic regression analysis., Results: One thousand one hundred sixty eight procedures were performed from our department during the study period: 308 patients (26.4%) were discharged the same day (SDD group) and the rest 860 procedures (73.6%) had at least one overnight stay (non-SDD group). Multivariate analysis revealed that forearm approach (OR=5.498, CI: 2.067-14.629; p=<0.001), patient's residency proximal to the hospital (OR=4.543, CI: 2.406-8.580; p<0.001), completion of the procedure before 13,00p.m. (OR=3.437, CI: 1.789-0.6.601; p<0.001) and the success of the performed procedure (OR=1.125, CI 1.043-2.135; p=0.044) were positive predictors of SDD, while presentation with non-ST elevation myocardial infarction or unstable angina (OR=0.542, CI: 0.268-0.872; p<0.010) and amount of contrast used (OR=0.910, CI: 0.852-0.969; p<0.030) were negative predictors of SDD., Conclusion: In retrospect, both procedural and demographic details play a crucial role in patient selection for same day discharge post coronary percutaneous intervention., (Copyright © 2017 Elsevier Inc. All rights reserved.)

The frequency of dicentric chromosomes in human peripheral blood lymphocytes at metaphase is considered as the "gold-standard" method for biological dosimetry and, presently, it is the most widely used for dose assessment. Yet, it needs lymphocyte stimulation and a 2-day culture, failing the requirement of rapid dose estimation, which is a high priority in radiation emergency medicine and triage biodosimetry. In the present work, we assess the applicability of cell fusion mediated premature chromosome condensation (PCC) methodology, which enables the analysis of radiation-induced chromosomal aberrations directly in non-stimulated G0-lymphocytes, without the 2-day culture delay. Despite its advantages, quantification of an exposure by means of the PCC-method is not currently widely used, mainly because Giemsa-staining of interphase G0-lymphocyte chromosomes facilitates the analysis of fragments and rings, but not of dicentrics. To overcome this shortcoming, the PCC-method is combined with fluorescence in situ hybridization (FISH), using simultaneously centromeric/telomeric peptide nucleic acid (PNA)-probes. This new approach enables an accurate analysis of dicentric and centric ring chromosomes, which are formed within 8h post irradiation and will, therefore, be present in the blood sample by the time it arrives for dose estimation. For triage biodosimetry, a dose response curve for up to 10Gy was constructed and compared to that obtained using conventional metaphase analysis with Giemsa or centromeric/telomeric PNA-probes in metaphase. Since FISH is labor intensive, a simple PCC-method scoring Giemsa-stained fragments in excess of 46 was also assessed as an even more rapid approach for triage biodosimetry. First, we studied the rejoining kinetics of fragments and constructed a dose-response curve for 24h repair time. Then, its applicability was assessed for four different doses and compared with the PCC-method using centromeric/telomeric PNA-probes, through the evaluation of speed of analysis and minimum number of cells required for dose estimation and categorization of exposed individuals., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Comprehensive two-dimensional gas chromatography (GC×GC) is used widely to separate and measure organic chemicals in complex mixtures. However, approaches to quantify analytes in real, complex samples have not been critically assessed. We quantified 7 PAHs in a certified diesel fuel using GC×GC coupled to flame ionization detector (FID), and we quantified 11 target chlorinated hydrocarbons in a lake water extract using GC×GC with electron capture detector (μECD), further confirmed qualitatively by GC×GC with electron capture negative chemical ionization time-of-flight mass spectrometer (ENCI-TOFMS). Target analyte peak volumes were determined using several existing baseline correction algorithms and peak delineation algorithms. Analyte quantifications were conducted using external standards and also using standard additions, enabling us to diagnose matrix effects. We then applied several chemometric tests to these data. We find that the choice of baseline correction algorithm and peak delineation algorithm strongly influence the reproducibility of analyte signal, error of the calibration offset, proportionality of integrated signal response, and accuracy of quantifications. Additionally, the choice of baseline correction and the peak delineation algorithm are essential for correctly discriminating analyte signal from unresolved complex mixture signal, and this is the chief consideration for controlling matrix effects during quantification. The diagnostic approaches presented here provide guidance for analyte quantification using GC×GC., (Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.)

Acute toxicity studies, using two organotin compounds, tributyltin chloride (TBTCl) and triphenyltin chloride (TPhTCl), were performed on gilthead seabream, Sparus aurata, fertilized eggs. The tests were static and run for 24 h (temperature = 19 +/- 1 degrees C, salinity = 39.5 g/L). Three replicate egg groups were incubated in solutions containing different concentrations of the toxicants. The (24h)LC(50) value for TBTCl was 28.3 microg/L and for TPhTCl was 34.2 microg/L, when the embryos were at the morula and late blastula stage at the start of the experiment. The value for TBTCl was 38.6 microg/L, when the embryos were at the gastrula stage at the start of the experiment. The results reconfirm the expected toxicity of TBT to this euryhaline fish species and introduce TPhT as a toxicant of potentially similar impact on teleosts., (Copyright 2002 Elsevier Science (USA))