Search

The CardioMEMS™ HF system (Abbott, Chicago, IL), a wireless pulmonary artery (PA) pressure sensor, was approved by the FDA after demonstration of reduction of heart failure hospitalization in New York Heart Association class III patients. These devices are implanted into the desired PA branch via either common femoral or jugular vein access. However, in some patients who cannot undergo the procedure via these routine access sites for various reasons, alternative access is needed. We describe, to our knowledge, the first case of successful CardioMEMS™ implantation via brachial vein access.

Las agro exportaciones peruanas crecerán 10,6% en el año 2018 con respecto al 2017, que cerró en US$5 203 millones, según fuente de ADEX. Al 2021, se estima alcanzar los US$10 000 millones, lo que representa una tasa crecimiento anual de 18% en el periodo 2017-2021. Dentro del marco de las frutas, las bayas han sido introducidas como un nuevo producto en la cartera agroexportadora con excelentes resultados, de acuerdo a las estadísticas del Banco Central de Reserva del Perú, el arándano fue el producto que registró el mayor crecimiento en valor exportado, en el orden del 49%, con un monto de US$580 millones al cierre del 2017. El impacto sobre el empleo y la especialización laboral fue relevante ya que generó 200 000 nuevos puestos de trabajo de acuerdo a las cifras expresadas en el Seminario Internacional de Berries – Regiones 2017. En el actual mercado global, la demanda de los consumidores es cada vez más exigente en aspectos de calidad sensorial, nutricional y sanitaria, que se traduce en un consumo de frutas frescas y de productos procesados mínimos. Esta tendencia orienta el avance tecnológico en la conservación de frutas a tecnologías en donde el congelamiento, el ultra congelamiento y la refrigeración, han logrado desarrollar una fruta congelada adecuada a las exigencias del consumidor final tanto en calidad, oportunidad, presentación y precio. Esta investigación busca aprovechar esta ventana comercial de oportunidad de negocios, con la finalidad de instalar una planta de congelado de frambuesa para su exportación a Alemania, que es el primer importador de bayas congeladas en el mundo. Se determinó que el proyecto, cuya inversión asciende a US$801 337 es viable y rentable obteniendo buenos indicadores: el VAN y TIR económico resultan en US$116 346 y 15,11% respectivamente; mientras que el VAN y TIR financiero en US$55 428 y 23,25%. Asimismo, se presentó dos escenarios alternativos para aumentar la rentabilidad del mismo. Por otro lado, la macro-localización del proyecto, en el departamento de Cajamarca, generará un impacto social positivo y un excelente relacionamiento sectorial minería, agricultura y ambiente; en la que actualmente la población está descontenta con la actividad de la minería y el escaso apoyo que le otorga el gobierno. According to Adex, Peruvian agroexports will increase 10,6% by the end of the year 2018 in comparison of 2017, which closed at US$5 203 millions. It is estimated that it will reach US$10 000 million by 2021, which represents an annual growth rate of 18% from 2017-2021. Among fruits, berries have been introduced as a new product to Peru’s agro export portfolio with excellent results. According to the Central Reserve Bank’s statistics, blueberries registered the largest growth at 49%, with a total of US$580 million by the end of 2017. This last year, its impact in employment and work specialization was relevant as well: blueberries’ productive outcome generated 200 000 new jobs, according to the Seminario Internacional de Berries – Regiones 2017. In the global market, consumer demand is increasingly stringent in aspects such as sensorial, nutritional, and sanitary quality, which translate in the need of fresh and minimum process fruit. This trend is leading the conservation technology in a way in which freezing, ultra-freezing, and refrigeration have been able to satisfy consumer demand in quality, opportunity and price. This investigation aims to seize this business opportunity and install an Individual Quick Freezing plant to export frozen raspberries to Germany, the number one importer in the world. It will be demonstrated that this project, which is worth US$801 337 is both viable and profitable thanks to two good indicators: the economic NPV and IRR are US$116 346 and 15,11%, respectively; while the financial NPV and IRR are US$55 428 and 23,25%, respectively. Finally, given the macro localization of the project, there will be a very positive social impact in the Cajamarca region; wherein the current population is unhappy with the mining activity as well as the poor options the government gives them.

Objective\ud \ud Numerous studies have proposed that smooth metal surfaces reduce initial bacterial attachment in the establishment of an early biofilm formation. However, these studies have largely examined single bacterial species, which are not always relevant as pathogens identified as initiators of inflammatory peri-implantitis. This study investigated the adherence of four periodontally-relevant bacterial species to implant and abutment surfaces in current clinical use.\ud Methods\ud \ud Discs of polished cobalt chromium (CoCr-polished) and milled titanium (Ti-milled), representing two clinically relevant surfaces, were prepared and surfaces were characterised. Bacterial species Porphyromonas gingivalis, Fusobacterium nucleatum, Prevotella intermedia and Aggregatibacter actinomycetemcomitans were cultured to mid-log or stationary growth phase. Co-cultures of P. gingivalis, F. nucleatum and P. gingivalis, F. nucleatum, Pr. intermedia were similarly prepared. Bacteria were inoculated onto discs for 2 h, stained with a live/dead fluorescent stain and percentage bacterial coverage was calculated by confocal microscopy and image analysis.\ud Results\ud \ud CoCr-polished discs had smooth surfaces with gentle valley structures, whilst Ti-milled discs had sharp edged peaks. Both discs demonstrated a partial wetting ability capable of initiating bacterial adhesion. P. gingivalis, F. nucleatum and co-cultures, at both mid-log and stationary concentrations, demonstrated equally high coverage of both the smooth CoCr-polished and the rougher Ti-milled metal surfaces. Pr. intermedia and A. actinomycetemcomitans demonstrated lower surface coverage which was slightly higher for Ti-milled.\ud Conclusion\ud \ud Variability was noted in the adherence potential for the respective periodontal pathogens examined. Particularly high adherence was noted for P. gingivalis and F. nucleatum, despite the manufacture of a smooth surface.\ud Clinical significance\ud \ud Both surfaces studied may be used at implant-abutment junctions and both possess an ability to establish a bacterial biofilm containing a periodontally-relevant species. These surfaces are thus able to facilitate the apical migration of bacteria associated with peri-implantitis.

Objectives To compare morbidity and mortality of patients with ST-elevation myocardial infarction (MI) undergoing coronary artery bypass graft (CABG) surgery within 24 hours with those who had surgery delayed >24 hours. Background Patients with ST-elevation MI are currently managed by emergency percutaneous coronary intervention (PCI). If PCI is unsuccessful, or if there is severe coronary artery disease not amenable to PCI, CABG is considered. If the patient is clinically stable, surgeons wait several days before performing surgery, as very early surgery carries a prohibitive risk. Methods One hundred and eighty-four patients with acute ST elevation MI (STEMI) who had undergone CABG were divided into two groups based on their surgery timing ( 24 hours). Mortality and complication rates were studied between the two groups by Fischer test. Time-to-event analyses were performed for five primary variables: all-cause mortality, cardiac events, congestive heart failure, stroke, and renal failure. Results At one month post-CABC, all-cause mortality was noted in 10.6% of patients who had CABG within 24 hours of STEMI diagnosis, compared with 8.9% in patients who had CABG after 24 hours (P = 0.3). Cardiac events including re-exploration, atrial fibrillation, graft occlusion, and arrhythmias requiring shock occurred in 17.1% versus 13.9% between the two groups, respectively (P = 0.68). One year post-coronary artery bypass surgery, there was no difference in individual or combined events between the two groups. Conclusions In patients with ST-elevation myocardial infarction who required emergency coronary artery bypass surgery, there was no difference in procedure complications or mortality between early (within 24 hours) or later (more than 24 hours). That was noted at one month and one year after the index myocardial infarction. (J Interven Cardiol 2015;28:14–23)

In a recent paper (1) Bramwell and A. V. Hill showed that the velocity of the pulse wave is a measure of the elasticity of the arteries, according to the formula: Velocity = 3.57 / √ Percentage increase in volume per (in metres per sec.) mm. Hg. increase of pressure. They showed also, both from the data of Roy (2), and by direct measurement on an isolated artery, that the pressure of fluid inside an artery plays an important part in modifying the velocity of the pulse wave, the velocity increasing as a function of the rise in pressure. In other words, the extensibility of an artery decreases as the pressure inside it is increased, a phenomenon analogous to the well-known fact that the extensibility of a muscle decreases as the tension on it is increased. This fact is of some importance in man, since, the more extensible the arteries are, the less is the work required of the heart and the more regular is the flow of blood in the capillaries. The velocity of the pulse wave may be measured with accuracy in man by the use of a hot wire sphygmograph (3) (4) and the relative extensibility of the arteries then calculated from the above formula.