Histopathological effects of silver nanoparticles in Rhamdia quelen after oral exposure

The studies about silver nanoparticles (AgNP) increased in the last years but few is known about their effects in Brazilian neotropical freshwater fish species. The current study investigated the effects of AgNP on adult silver catfish Rhamdia quelen after subchronic oral exposure. After nanoparticle (NP) size and area characterization fish were administrated with three different doses for 15 days (0.03, 0.3 and 3 µg g-1). The concentration of silver in liver and kidney was measured to evaluate the bioaccumulation and discuss its effects in the target organs. Liver bioaccumulated 15, 1.7 and 0.2 % of administered doses while kidney bioaccumulated 1.33, 0.33 and 0.9 % (respectively for 0.03, 0.3 and 3 µg g-1). The histopathological findings were considered in both organs to evaluate the effects of AgNP, according to Bernet’s Lesion Index (BLI). Also were included the melano-macrophages center (MMC) and new nephrons (NN) counting respectively in liver and posterior kidney. The results revealed morphological injuries as inflammation in both studied organs and vascular congestion and steatosis in liver, in a concentration dependent way. The presence of AgNP in the tissues revealed the bioavailability of the nanoparticle while the damages and morphological disturbs showed the potential risk of exposure in R. quelen, even under environmental relevant concentrations.

LSI guided-high power short duration is safe and improves pulmonary vein isolation efficiency

Introduction High-power short-duration (HPSD) is an increasingly used ablation strategy for pulmonary vein isolation (PVI) procedures, but Lesion Index (LSI)-guided HPSD radio-frequency (RF) application has not been described in this clinical setting. Purpose We evaluated the procedural efficiency and safety of an LSI-guided HPSD strategy for atrial fibrillation (AF) ablation. Methods Paroxysmal and persistent AF patients scheduled for AF ablation were prospectively enrolled and divided in two groups, according to the ablation power used. The LSI-HP Group included patients ablated with a RF power of 50 Watts and the LSI-LP Group included patients ablated with 35 Watts. All patients underwent only PVI under LSI guidance (LSI between 5.5 and 6 anteriorly; LSI between 4.5 and 5 posteriorly) with a point by point strategy and an inter-lesion distance <6 mm. Procedural efficiency parameters were compared between groups. Results Forty-six patients with AF (60% paroxysmal) were prospectively enrolled, 25 in the LSI-HP Group and 21 in the LSI-LP Group. They were usually male (78%) with a low-intermediate CHA2DS2-Vasc score (1.8±1.1), a preserved ejection fraction (60±6%) and moderate left atrial dilatation (45±6 mm). Baseline clinical characteristics resulted comparable between groups (p=NS). PVI was successful in all patients. RF time (30.22±9.04 vs 47.85±11.87 min, p<0.0001), total procedure time (138.7±33.2 vs 177.6±49.77, p=0.006) and fluoroscopy time (13.92±5.34 vs 23.14±10.97 min, p=0.006) were significantly lower in the LSI-HP Group. No complication or steam pops was seen in either group. Conclusions LSI-HP AF ablation significantly improves procedural efficiency, reducing ablation time, total procedural duration and fluoroscopy use, while maintaining a comparable safety profile as lower powers. FUNDunding Acknowledgement Type of funding sources: None. Figure 1 Figure 2

Wirkung eines homöopathischen Arzneimittels auf die klinische Symptomatik von Hunden mit atopischer Dermatitis

Zusammenfassung Gegenstand und Ziel Ein kommerziell erhältliches Arzneimittel mit homöopathischen Inhaltsstoffen zeigte erste Erfolge bei Hunden mit atopischer Dermatitis. Ziel dieser Fallserie war, die Wirkung des Arzneimittels bei einer größeren Anzahl von Hunden mit dieser Erkrankung zu bewerten. Material und Methoden Zehn Hunde mit atopischer Dermatitis erhielten das homöopathische Kombinationsarzneimittel täglich oral über 3 Wochen nach Herstellerangabe. Die Diagnose der atopischen Dermatitis wurde zuvor anhand von Anamnese, klinischer Untersuchung und Ausschluss von Differenzialdiagnosen gestellt. Ein Ausschluss von bakteriellen und mykotischen Hautinfektionen erfolgte durch die klinische Untersuchung und die zytologische Evaluierung von Abklatschpräparaten der Haut. Patienten mit zusätzlicher Futtermittel-allergie erhielten ab mindestens 2 Monate vor Beginn sowie während der gesamten Dauer der Studie eine Eliminationsdiät. Bei Hunden mit vermuteter oder bestätigter Flohspeichelallergie fand mindestens 1 Monat vor sowie während der Studie eine Flohprophylaxe statt. Die klinische Symptomatik wurde anhand eines validierten Juckreizscores (Pruritus Visual Analogue Scale, PVAS) und eines validierten Läsionsscores (Canine Atopic Dermatitis Lesion Index, CADLI) vor und nach der Therapie evaluiert. Zusätzlich beurteilten die Tierbesitzer die Fellqualität. Potenzielle Nebenwirkungen wurden bei dem Kontrolltermin vermerkt. Ergebnisse Im Verlauf der Behandlung ergaben sich keine signifikanten Veränderungen der Läsionen (Wilcoxon-Test, p = 1,0), des Pruritus (gepaarter t-Test, p = 0,34) und der Fellqualität (gepaarter t-Test, p = 0,34). Nur ein Patient zeigte eine geringgradige Verbesserung des Juckreizes und der Fellqualität. Nebenwirkungen traten nicht auf. Schlussfolgerung und klinische Relevanz In dieser Fallserie zeigte das getestete homöopathische Arzneimittel keinen positiven Einfluss auf die klinischen Anzeichen von kaniner atopischer Dermatitis.

1249Acute efficacy and safety of pulmonary vein isolation for atrial fibrillation in patients alternatively assigned to high power short duration (70W, 8s) vs lesion index guided (35W) ablation

Background permanent trans-mural lesions not affecting surrounding anatomical structures is the goal of safe and effective wide antral pulmonary vein (PV) isolation in patients with paroxysmal and persistent atrial fibrillation (AF) undergoing catheter ablation (CA). Time, energy and contact force are parameters related to lesion goodness and incorporated in a complex formula (i.e. the lesion index, LSI™, Abbott). This parameter is emerging as the gold standard for PV isolation. Recently, the shallower but wider lesions created by high power short duration (HPSD) ablation has came to attention. Purpose to compare acute reconnection rate, procedural parameters, and complication rates in patients with paroxysmal or persistent AF undergoing CA. Methods one-hundred patients with paroxysmal and 100 with persistent AF will be alternatively assigned to undergo PV isolation with the FlexAbility™ (HPSD group, 70W, 41°, 8 seconds) or the TactiCath™ (LSI-group: 35W, 41°, LSI: 5-5.5 posterior wall, up to ≥6 anywhere else) catheter. A 3-D mapping system (Ensite Precision™) and a steerable sheath (Agilis™, both Abbott) were always used. Adenosine (30mg) is given after PV isolation and ≥ 20 minutes waiting time. Posterior wall isolation was added in all, and patients with persistent AF were additionally treated with mitral and cavotricuspid isthmus ablation. Results: between June and October 2019, 71 patients (68 ± 10 years old, 32 (45%) female, 44 (60%) paroxysmal AF, AF duration 58 ± 81 months) were alternatively assigned to HPSD (36, 51%) or LSI-guided (35, 49%) ablation. No difference in clinical characteristics was found between groups. After 44 ± 18 and 30 ± 14min of procedural and RF time, all PVs were isolated, and all 17 (24%) reconnections treated with an additional 4 ± 3 and 3 ± 2min, respectively. In 8 ± 3 and 7 ± 3 min of procedural and RF time, the PW was successfully isolated in all. PV isolation (34 ± 12min vs. 56 ± 16min; P<.0001), RF (18 ± 5min vs. 41 ± 9min; P<.0001), and total procedural (138 ± 34min vs. 162 ± 34min; P=.0026) time were shorter in the HPSD group. X-Ray time and effective dose did not differ. A similar rate of acute reconnections (9, 25% vs. 8 23%) was found when HPSD and LSI were compared. A higher, although statistically not significant, number of steam pops was observed in the HPSD (14, 39%) vs. LSI (8, 23%) group, possibly related to the higher incidence of moderate pericardial effusion (>0.5mm, <20mm) found the day following the ablation (10, 28% vs. 2, 6%; P=.0238). No further complications related to CA were detected. Conclusions in patients with paroxysmal and persistent AF undergoing their first CA, HPSD ablation is faster than an LSI-guided approach. Acute efficacy (reconnection rate) is similar. Although a higher rate of haemodynamically non-relevant pericardial effusions were seen in the HPSD group, these were all treated medically and the general safety profile of this approach is excellent and comparable to LSI ablation.

Calcium Hydroxide as Intracanal Medicament in Pulp Necrosis with Periapical Lesion : A Case Report

Calcium hydroxide [Ca(OH)2] has been widely used as an intracanal medicament especially in treatment of periapical lesion. This case report will discuss about calcium hydroxide as intracanal medicament in a periapical lesion of an upper left central incisor. This case describes about treatment of periapical lesion with suspect of infected cyst with symptoms and root resorption. Root canal preparation was done by crown down technique using protaper hands universal from S1/27mm until F5/27mm. Calcium hydroxide paste was continuously applicated every 2 weeks as intracanal medicament until the periapical index (PAI) of lesion decrease, in this case PAI decreased from scale 5 until scale 2 during three months recall. Calcium hydroxide supports tissue repair, stimulates fibroblast formation and damage the cytoplasmic membrane of bacteria, denature their proteins or damage the DNA by its alkaline property. As conclusion, the use of calcium hydroxide successfully decrease the periapical lesion index in the periapical radiograph examination and can be considered as a simple and effective medicament for endodontic infection.