Search Results (9)

Background/Objectives: According to the guidelines established by the European Society of Vascular Surgery (ESVS), a minimum 2 mm diameter is advised for both the radial artery (RA) and cephalic vein (CV) to perform a radio-cephalic arteriovenous fistula (RC-AVF). However, studies have suggested that larger vein diameters, over 2.5 or 3 mm, or even smaller vessel diameters, above 1.6 mm, can yield satisfactory outcomes in both the medium and long term. This study aims to analyze how preoperative vascular mapping influences the long-term RC-AVF failure, considering adherence to guidelines. Methods: This retrospective, monocentric, and observational study enrolled 110 patients with ESKD who were admitted, between 2018 and 2024, to the Vascular Surgery Department at the Emergency County Hospital of Târgu Mureș for the creation of an RC-AVF. Demographic characteristics, comorbidities, preoperative vascular mapping data, and laboratory data were meticulously collected from the hospital’s electronic databases. Patients enrolled in the current study were categorized into two groups based on their adherence to guideline recommendations. Results: Patients whose RC-AVF was created outside guideline recommendations demonstrated smaller arterial (p < 0.001) and venous (p < 0.001) diameters. Additionally, a higher percentage of these patients were on hemodialysis via CVC at the time of RC-AVF creation (p = 0.041), as well as a higher incidence of 6-week AVF maturation failure (p = 0.012) and long-term AVF failure (p = 0.016). In ROC Curve analysis, a threshold of 2.75 mm was established for the RA (AUC: 0.647, p = 0.005) and 2.52 mm for the CV (AUC: 0.677, p = 0.001). Additionally, patients whose RC-AVF procedures adhered to guideline recommendations had a significantly lower risk of long-term RC-AVF failure (HR: 0.44, p = 0.012). This association lost significance after adjusting for cardiovascular risk factors and the presence of CVC at admission (HR: 0.69, p = 0.328). After full adjustment, only the CV remained an independent predictor of long-term successful RC-AVF (HR: 0.68, p = 0.026). In contrast, RA lost significance after adjusting for cardiovascular risk factors and the presence of CVC at admission (HR: 0.71, p = 0.086). Conclusions: In conclusion, this study reveals that only the diameter of the CV is correlated with the long-term failure of RC-AVF, independent of age, gender, diabetes, hypertension, active smoking, and the presence of a CVC at the time of AVF creation. Therefore, while adhering to the threshold diameters of the AR and CV, as recommended by the ESVS guidelines, facilitates the creation of a functional RC-AVF, we assert that additional cofactors, such as demographic data, usual cardiovascular risk factors, or CVC presence, must also be considered to achieve optimal long-term AVF. Full article

Background: Atrial fibrillation is the most common human heart rhythm disorder, yet its underlying causes remain largely unknown. Trimethylamine N-oxide (TMAO), a by-product derived from the gut microbiota contributed by red meat, has been linked to numerous cardiovascular and metabolic diseases. Aims: This study aimed to evaluate the impact of serum TMAO levels on the occurrence of atrial fibrillation in patients with cardiovascular disease. Results: Utilizing a cross-sectional study design, fasting serum TMAO levels were measured and compared between 153 patients without cardiovascular disease and patients hospitalized for cardiovascular disease, stratified by the presence or absence of atrial fibrillation. While patients with more comorbidities had higher TMAO overall, the TMAO levels were not significantly different between cardiovascular disease patients with and without atrial fibrillation (p = 0.57). Moreover, there was no difference between atrial fibrillation progression phenotypes (p = 0.27). In multivariate analysis, a significant association was found with atherosclerotic cardiovascular disease (p = 0.04) and chronic kidney disease (p < 0.001), but there was no significant association between TMAO and atrial fibrillation (p = 0.9). Conclusions: Serum TMAO levels are not associated with the occurrence of atrial fibrillation and disease progression phenotypes in patients with cardiovascular disease, but are associated with ASCVD and CKD. Full article

Background/Objectives: The autologous arteriovenous fistula (AVF) is the preferred choice for vascular access in patients with end-stage kidney disease (ESKD) undergoing maintenance hemodialysis. However, in the long term, the primary patency of AVF is suboptimal, with an AVF failure of approximately 30% in one year. The aim of this study is to examine how the pre-operative baseline levels of interleukin-6 (IL-6) affect long-term AVF failure. Methods: This retrospective, observational study involves ESKD patients admitted to the Vascular Surgery Clinic for AVF creation from January 2020 to December 2023. Ultimately, a total of 91 patients whose AVFs matured and began dialysis were enrolled. Prior to surgery, each patient underwent a thorough blood sample collection, with IL-6 levels assessed. The patients were categorized into two groups: those with functioning AVFs and those with dysfunctional AVFs. Their progress was monitored via a review of medical records, telephone interviews, or direct contact. Following the surgery, patients were observed for an average of 1.53 ± 0.94 years. Results: During the follow-up, patients who experienced AVF failure had a higher incidence of diabetes mellitus (p = 0.019) and active smoking (p = 0.012), as well as higher levels of IL-6 (p < 0.001). At ROC analysis, we found a strong association between IL-6 value and AVF failure (AUC: 0.814, p < 0.001), with an optimal cut-off value of 7.08 (76.5% Sensitivity and 79.7% Specificity). Furthermore, at the survival curve Kaplan-Meier analysis, we observed a higher occurrence of AVF failure in patients with baseline IL-6 values above the median (p = 0.004), in tertile 3 (p = 0.002), and above the optimal cut-off value (p < 0.001). At cox-regression analysis, elevated baseline IL-6 levels are associated with AVF Failure (HR: 2.23, p < 0.001). Conclusions: In the current study, we demonstrated that elevated IL-6 levels at baseline are associated with long-term AVF failure, independent of age, sex, and cardiovascular risk factors. Full article

The aim of this study was to assess the impact of WWTP effluents on the sediment microbial communities throughout the Mureș River. This study shows the existence of an ecological equilibrium between the WWTP effluent disruptors and the resilience of the Mureș River sediment microbiomes, a fact that suggests the river’s stable/balanced ecological status in this regard, partly due to the microbial communities’ resilience to the local impact of WWTP effluents. High-throughput 16S bacterial metabarcoding was used to evaluate the bacterial communities in the sediment. Due to the lotic system’s sediment microbial communities’ sensitivity to environmental changes, we assumed the dependency of these community structures and functions on environmental abiotic and abiotic parameters. The study results show that, although bacterial communities are equally diverse in the three locations (upstream WWTP, WWTP effluents, and downstream WWTP), there is a difference in community structure between the upstream samples and the WWTP samples, while the downstream samples contain a mixture of the upstream and WWTP effluent communities. Just downstream of the WWTP sediment, microbial communities are influenced by the specific input from the WWTP effluents; nevertheless, the river sediment microbiome is resilient and able to further recover its natural microbial composition, as evidenced by the similarity in bacterial community structures at all upstream river locations. This study demonstrates the ecological equilibrium between the WWTP effluent disruptors and the resilience capacity of the Mureș River sediment microbiomes, a fact that indicates the river’s stable/balanced ecological status, in part due to the microbial communities’ resilience to the local impact of WWTP effluents. Based on these findings, a monitoring system should be implemented here in the future. Full article

Every year, the global food industry produces a significant number of wastes and by-products from a variety of sources. By-products from the food-processing sector are produced in large quantities, and because of their undesirable qualities, they are frequently wasted, losing important resources. In order to pursue a circular economy that refers to waste reduction and effective waste management, by-products valorization recently received increased interest. By-products are rich in bioactive compounds and can be used in various industrial applications for health promotion and nutritional benefits. A novel step in its sustainable application is the use of these inexpensive waste agri-food by-products to create the value-added products. The present review intended to summarize the different types of agro-industrial by-products and their properties and highlight their nutritional composition and potential health benefits. Applications of agri-food by-products in foods as well as the potential health and sustainability implications of by-products in food products were also covered. According to research, agri-food by-products can be added to a variety of food to increase their bioactive profile, fiber content, and antioxidant capacity while maintaining good sensory acceptability. Overall, the sustainability of the agri-food chain and consumer health can both benefit from the use of agri-food by-products in food formulation. Full article

The adoption of remote assisted care was accelerated by the COVID-19 pandemic. This type of system acquires data from various sensors, runs analytics to understand people’s activities, behavior, and living problems, and disseminates information with healthcare stakeholders to support timely follow-up and intervention. Blockchain technology may offer good technical solutions for tackling Internet of Things monitoring, data management, interventions, and privacy concerns in ambient assisted living applications. Even though the integration of blockchain technology with assisted care is still at the beginning, it has the potential to change the health and care processes through a secure transfer of patient data, better integration of care services, or by increasing coordination and awareness across the continuum of care. The motivation of this paper is to systematically review and organize these elements according to the main problems addressed. To the best of our knowledge, there are no studies conducted that address the solutions for integrating blockchain technology with ambient assisted living systems. To conduct the review, we have followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology with clear criteria for including and excluding papers, allowing the reader to effortlessly gain insights into the current state-of-the-art research in the field. The results highlight the advantages and open issues that would require increased attention from the research community in the coming years. As for directions for further research, we have identified data sharing and integration of care paths with blockchain, storage, and transactional costs, personalization of data disclosure paths, interoperability with legacy care systems, legal issues, and digital rights management. Full article

Aim: Although the association between left ventricular dilation and mitral annulus dilation is well understood, the potential variation in the size of the mitral annulus during dilation of the left atrium is currently unknown. In order to investigate the link between the two variables, we used multidetector computed tomography (MDCT) and looked at patients who had a dilated left atrium, assessing if the mitral valve also dilates. Materials and Methods: The study included 107 patients with paroxysmal and persistent atrial fibrillation, in whom catheter ablation was performed using pulmonary vein isolation ± atrial substrate modification. Eighty patients were male (74.8%), with a mean age of 55.8 years (±9.87 with a minimum age of 26 years and a maximum age of 79 years), of which 57.1% had paroxysmal AF and the rest had persistent fibrillation. All the patients underwent multiple-detector CT (MDCT) with contrast medium before the ablation. CT images were integrated into the three-dimensional mapping system CARTO 3, after which the diameters of the mitral annulus, area, and circumference were measured. Left atrial size was evaluated by measuring the diameters, area, and volume. Results: The left atrial area was 247 ± 65.7 cm2 and the left atrial volume was 139 ± 56.3 mL. The transverse mitral annulus (MA) was 29.9 ± 5.3 mm and the longitudinal diameter was 41.9 ± 7.6 mm. The MA circumference and area were 15.0 ± 3.5 cm and 14.2 ± 4.6 cm², respectively. The following statistically significant correlation was identified between the dimensions of the mitral annulus and the diameters of the left atrium: the transverse mitral annulus correlates with the antero-posterior (AP) LA diameter (R = 0.594, p < 0.01) and the longitudinal MA diameter correlates with the latero-lateral (LL) LA diameter (R = 0.576, p < 0.01). Furthermore, the MA area correlates with the LA volume (R = 0.639, p < 0.001). Conclusions: The volume of the left atrium correlates with the area of the mitral annulus. In patients with paroxysmal and persistent AF, an increase in left atrial dimensions is further associated with an increase in mitral valve dimensions. Full article

In this work, (Ba_0.75Sr_0.25) (Ti_0.95Co_0.05) O₃ perovskite nanostructured material, denoted subsequently as Co-doped BaSrTiO₃, was synthesized in a one-step process in hydrothermal conditions. The obtained powder was heat-treated at 800 °C and 1000 °C, respectively, in order to study nanostructured powder behavior during thermal treatment. The Co-doped BaSrTiO₃ powder was pressed into pellets of 5.08 cm (2 inches) then used for thin film deposition onto commercial Al₂O₃ substrates by RF sputtering method. The microstructural, thermal, and gas sensing properties were investigated. The electrical and thermodynamic characterization allowed the evaluation of thermodynamic stability and the correlation of structural features with the sensing properties revealed under real operating conditions. The sensing behavior with respect to the temperature range between 23 and 400 °C, for a fixed CO₂ concentration of 3000 ppm, highlighted specific differences between Co-doped BaSrTiO₃ treated at 800 °C compared to that treated at 1000 °C. The influence of the relative humidity level on the CO₂ concentrations and the other potential interfering gases was also analyzed. Two possible mechanisms for CO₂ interaction were then proposed. The simple and low-cost technology, together with the high sensitivity when operating at room temperature corresponding to low power consumption, suggests that Co-doped BaSrTiO₃ has a good potential for use in developing portable CO₂ detectors. Full article

There is a strong drive worldwide to discover and exploit the therapeutic potential of a large variety of plants. In this work, an alcoholic extract of Helleborus purpurascens (family Ranunculaceae) was investigated for the identification of amino acids and peptides with putative antiproliferative effects. In our work, a separation strategy was developed using solvents of different polarity in order to obtain active compounds. Biochemical components were characterized through spectroscopic (mass spectroscopy) and chromatographic techniques (RP-HPLC and GC-MS). The biological activity of the obtained fractions was investigated in terms of their antiproliferative effects on HeLa cells. Through this study, we report an efficient separation of bioactive compounds (amino acids and peptides) from a plant extract dependent on solvent polarity, affording fractions with unaffected antiproliferative activities. Moreover, the two biologically tested fractions exerted a major antiproliferative effect, thereby suggesting potential anticancer therapeutic activity. Full article