Ping-pong guide catheter technique for facilitating antegrade crossing of a chronic total occlusion

A 60-year-old man was referred for percutaneous coronary intervention of a proximal left circumflex (Cx) chronic total occlusion (CTO) with distal filling via epicardial collaterals from the left anterior descending (LAD) artery.

Triple-Access Retrograde Chronic Total Occlusion Intervention Through Vein Graft and Epicardial Collaterals

Based on the patient's symptoms and examination, a decision was made to recanalize his totally occluded RCA via retrograde approach through the SVG to the OM. Due to inadequate visualization of the epicardial collaterals and distal RCA via SVG, triple-access was used and injection via left main. In selected CTO cases, triple access may facilitate the retrograde approach, allowing optimal collateral visualization.

Assessment of the Incidence of Human Adenovirus in Surface Waters of Southwest Greece: Vouraikos River as a Case Study

The purpose of this study is to assess the overall impact of different anthropogenic activities in the Vouraikos River basin (southwestern Greece, Natura 2000 area). Virological quality of river water samples was investigated. Positive samples for human adenoviruses were found occasionally, while porcine adenoviruses and bovine polyoma viruses were not detected. It is the first time that virological data are collected in the study area.

Dissection Re-entry Technique: How is it Really Looking?

Dissection re-entry is a widely used technique in many chronic total occlusion centers. This account of a failed re-entry attempt provides in vivo photographic evidence of how the vessel looked after such an attempt. Operators are advised to keep dissection of subintimal space and hematoma limited and use dedicated materials and techniques for controlled re-entry.

Results of the simultaneous measurements of radon around the Black Sea for seismological applications

Results of measurements of radon around of the Black Sea are shown. Radon stations in zones of active faults were placed. Simultaneous hourly measurements of soil radon in 2005 were carried out in the Sivrice Fault Zone that is a segment of East Anatolian Fault System, in the town of Tbilisi (Georgia) and in the South Russia. In 2008 simultaneously hourly measurements of soil radon were carried out in the Western Caucasus (Russia) and in the Mytilene Island (Greece). In 2013 radon in underground waters simultaneously in midday was measuring in Crete (Greece), in the Pamukkale geothermal region (Southwest Turkey) and in the Western Caucasus. Measurements of radon concentration in the points located around of the Black Sea have shown identical regularities in changes of the data. Influence of meteorological, tidal and solar factors on changes of water radon concentrations and soil radon concentrations was observed in all researches points. But this influence was insignificant. Seismological application of observed results also was considered. Various mathematical methods of definition of anomaly in the radon data during earthquakes were considered. During researches in the Black Sea region basically earthquakes with M from 2.0 up to 5.0 and in a depth about 10 km were occurred. For these earthquakes method of daily subtraction of the data of the next and previous day was used. This method has allowed solving a problem with a choice of average value. Probability up to 0.69 (number of earthquakes with radon anomalies/total number of earthquakes) of detection of radon anomalies before earthquakes was achieved applying this method. Changes of radon maps before regional earthquakes were also observed. The frequency analysis of variations of the radon data on the basis of the Wavelet analysis was carried out. Occurrence of the short periods (about 2 days) was observed during regional earthquakes.

Distal Versus Traditional Radial Approach for Coronary Angiography

PURPOSE

The aim of this study was to evaluate the efficacy and safety of distal radial (DR) versus traditional radial (TR) approach during coronary angiography.

METHODS

Two hundred patients scheduled to undergo transradial coronary angiography were randomized between the two approaches. Primary endpoint of the study was switching to another access site due to inability of successful target artery cannulation. Secondary endpoints were time to cannulation, total procedure duration, number of attempts, number of skin punctures and duration of manual hemostasis. Secondary safety endpoints were the rate of moderate or severe spasm, arm hematoma EASY class III or more and radial artery occlusion at discharge. Quality of life endpoint was the patient's preference of cannulation method at 30 days.

RESULTS

The primary endpoint was met in 30 patients (30%) from the DR group and 2 patients (2%) from the TR group (p < 0.001). The time of cannulation was longer in the DR group compared to the TR group (269 ± 251 s vs 140 ± 161 s, p < 0.001), but this did not affect the total procedural duration (925 ± 896 s vs 831 ± 424 s, p = 0.494). The number of attempts and the number of skin punctures were more in the DR group compared to the TR group (6.8 ± 6.2 vs 3.4 ± 4.5, p < 0.001 and 2.4 ± 1.7 vs 1.6 ± 1.2, p < 0.001, respectively). However, DR treated patients had faster manual hemostasis time compared to TR treated patients (568 ± 462 s vs 841 ± 574 s, p = 0.002). There were no differences recorded in the safety endpoints of moderate or severe spasm, EASY grade III or more radial hematomas or the incidence of radial artery occlusion after the procedure. Patients' preference to the randomized puncture sites was the same (79% vs 85%, p = 0.358).

CONCLUSION

Distal radial approach is associated with lower successful cannulation rates and shorter manual hemostasis time compared to the traditional radial approach.

Compartment Syndrome: A Rare and Frightening Complication of Transradial Catheterization

The compartment syndrome is a severe complication of transradial approach and can be prevented by prompt treatment of forearm hematoma; otherwise, fasciotomies are urgent.

Determination of water-soluble and insoluble elements in PM2.5 by ICP-MS

The elemental composition of water-soluble and acid-soluble fractions of PM2.5 samples from two different Greek cities (Patras and Megalopolis) was investigated. Patras and Megalopolis represent different environments. Specifically, Patras is an urban environment with proximity to a large port, while Megalopolis is a small city located close to lignite power plants. Both cities can serve as a representative example of European cities with similar characteristics. The concentration of 14 elements (As, Cd, Co, Cr, Cu, Fe, Mn, Ni, Pb, Fe, Sr, Ti, V and Zn) was determined in each fraction by ICP-MS. Microwave assisted digestion was used to digest the samples using a mixture of HNO3 and HF. For the determination of the water soluble fraction, water was chosen as the simplest and most universal extraction solvent. For the validation of the extraction procedure, the recoveries were tested on two certified reference materials (NIST SRM 1648 Urban Particulate Matter and NIST 1649a Urban Dust). Results showed that Zn has the highest total concentration (273 and 186 ng/m(3)) and Co the lowest (0.48 and 0.23 ng/m(3)) for Patras and Megalopolis samples, respectively. Nickel with 65% for Patras and As with 49% for Megalopolis displayed the highest solubility, whereas Fe (10%) and Ti (2%) the lowest ones, respectively.

Geochemical controls on fluoriferous groundwaters of the Pliocene and the more recent aquifers: the case of Aigion region, Greece

High fluoride concentrations (>8 mg/L) in the groundwater of the Plio-Pleistocene sediments are rare; however, this is the case around Aigion town, where teeth fluorosis has been detected since the 80s. Aiming to investigate the origin and the mobility mechanism of fluorine in groundwater and sediments a hydrogeological and geochemical research has been conducted. The hydrogeological research revealed that the Na-HCO3 water type of boreholes aligned along a fault and hosted in the confined aquifers display the higher fluoride content. The unconfined aquifer is mostly dominated by Na-Ca-Mg-HCO3-SO4 water, which displays much lower fluoride concentrations. The most permeable sectors of this aquifer host fresh water of Ca-HCO3 type. The geochemical research revealed significant amount of fluorine in the base of a lignite sequence hosted in the Plio-Pleistocene sediments. The Na-HCO3 water type represents a deep water circulation, proved by its elevated temperature and isotopic composition, carrying a significant load of fluorine and trace elements. During its uprise through faults and the Plio-Pleistocene sediments, part of its load is being deposited on the base of the lignite beds. Leaching experiments and mineralogical determinations in lignite samples revealed enrichment in fluorine at the bottom of the studied lignite sequence, where silicate minerals are dominant. This is due to either, the presence of F-bearing minerals or the presence of organic matter which can also absorb/adsorb fluorine. At the upper part of the sequence, where carbonates prevail, calcite is the major phase indicating the circulation of Ca-ΗCO3-rich fresh water. The Na-Ca-Mg-HCO3-SO4 water type could be considered as mixed water spending longer time in sediments of relatively low permeability and thus, dissolving fluorine and trace elements from clay minerals and organic matter.