We describe the adoption of high sensitive troponin I (hsTnI) in clinical practice in two hospital settings in Italy. Samples from 426 consecutive patients (mean age 68.8 ± 17.0) admitted to the Emergency Department with a suspected acute coronary syndrome (ACS) have been tested at admittance and after 3 and 6 hours by contemporary TnI and hsTnI. Results have been compared to the final clinical diagnosis. Troponin was detectable in 68.6% by TnI and 89.9% by hsTnI. Since hsTnI has a lower threshold for females, 38/41 patients with positive values only by hsTnI were women. The correlation between the assays was very high (r = 0.92). A diagnosis of acute myocardial infarction (AMI) was made in 45 cases (10.5%). The negative and positive predictive values for a 50% troponin variation at 3 hours were 95.8% and 66.7% for hsTnI and 95.0% and 52.6% for TnI and at 6 hours 90.3% and 100% for hsTnI and 88.9% and 78.9% for TnI, respectively. Receiver operating characteristic (ROC) curve analysis demonstrated a greater efficiency by hsTnI at 3 hours versus 6 hours (AUC = 0.91 versus 0.72). The main benefits of hsTnI are the adoption of gender-specific 99th percentile and the shortening of time to decision.
The Auger Muon Infill Ground Array (AMIGA) is part of the AugerPrime upgrade of the Pierre Auger Observatory. It consists of particle counters buried 2.3 m underground next to the water-Cherenkov stations that form the 23.5 km2 large infilled array. The reduced distance between detectors in this denser area allows the lowering of the energy threshold for primary cosmic ray reconstruction down to about 1017 eV. At the depth of 2.3 m the electromagnetic component of cosmic ray showers is almost entirely absorbed so that the buried scintillators provide an independent and direct measurement of the air showers muon content. This work describes the design and implementation of the AMIGA embedded system, which provides centralized control, data acquisition and environment monitoring to its detectors. The presented system was firstly tested in the engineering array phase ended in 2017, and lately selected as the final design to be installed in all new detectors of the production phase. The system was proven to be robust and reliable and has worked in a stable manner since its first deployment.
Funding Acknowledgements Type of funding sources: None. Introduction The association between nocturia and hypertension has been widely reported yet remains poorly characterized, precluding a more refined understanding of blood pressure as it relates to the cardiovascular setting. Nocturia is associated with significant morbidity and mortality (1,2,3) which is thought to be mediated in large part by the fact that nocturia is a potential manifestation of systemic disease (4). Previous studies have reported that heart failure and uncontrolled hypertension were responsible for clinically significant nocturia (5,6). However, it remains unclear the relationship with any hypertension mechanism and the effect on circadian blood pressure rhythm. Purpose To investigate characteristics of hypertensive patients in who complain for nocturia. Methods We prospectively recruit 49 patients among outpatients attending the Hypertension Centre of Hospital San Luca, Istituto Auxologico Italiano. Physical examination, standard routine blood tests, urine analysis for microalbuminuria, 24-hour sodium excretion, 24-hour urinary cortisol levels, 24-hour urinary metanephrine/normetanephrine and a standard 24h ABPM has been performed. We asses in every patients the presence of nocturia (≥2 nightly voids) then we compare sub mentioned features between patients with nocturia or not. Results The population recruited demonstrate a mean age of 62 years old, it is made by a majority of men (M 61%, F 39%). We found nocturia in 13 patients on the 49 recruited. Demographic, anthropometrical and hematochemical features of the population recruited is described in Table 1. We compare patients who complain nocturia with patients with a normal number of nocturnal voids. Only height and hemoglobin demonstrate significative difference in the population. In a second analysis we compare ABPM results of patients with nocturia with patients who don’t have this symptom. The results are described in Table 2. Differently to what we expect no difference is demonstrated between the two group in dipping status, we found a significative difference in overall heart rate, this difference is evident only the day period but not in the night period. Conclusion These preliminary data suggest that patients with nocturia than patient with normal number of nocturnal voids i) have lower height and hemoglobin level, this in support to nocturia is a potential manifestation of systemic disease (4);) have both a lower overall and diurnal cardiac frequency. No dipping correlation have been found in our study, more study are needed to clarify a potential relationship with sleep disorder.
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