Introduction: Myocardial bridge (MB) is a congenital anomaly in which a segment of a coronary artery is surrounded by myocardium. In our study, we want to use conventional coronary angiography (CCA) to describe morphologic characteristics of MB (unidentified or identified) in the patients with documented evidence of MB in coronary computed tomography angiography (CCTA). Methods: The present study was designed as cross-sectional and was conducted on 47 patients with documented evidence of MB in CCTA, who were referred to Nemazee and Faghihi hospitals for performing coronary angiography during a one year period. We compared the morphologic characteristics of tunneled segments, which were missed at CCA (unidentified), and the tunneled segments which were identified with CCA. Results: In sum, MB was found in 16 (34%) patients at CCA (identified), and it was not found in 31 (66%) patients (unidentified) based on compression sign. No significant correlation was found between the percentage of systolic compression and the length and depth of the tunneled segment in identified group (r=0.73, P = 0.18; r=1.09, P = 0.15; respectively). Degree of atherosclerotic plaque formation (diameter stenosis, percentage) (mean, 0.25 (25%) ±0.29; range, 0-0.98) of the tunneled segments in unidentified group was significantly more than the same degree (mean, 0.07 (7%) ±0.13; range, 0-0.41) of the identified group (P = 0.03). The measurement of the trapezoid area under the tunneled segment with this formula [(MB length+ intramyocardial segment) ×depth/2] had significant relation with systolic compression (r=0.304, P = 0.03) and defined the cut-off value of 250 mm2 as the value of significant difference in detecting myocardial bridging with CCA. Conclusion: Our results showed that in most of identified MBs in CCA the tunneled segment area was equal and more than 250 mm2. In addition, the degree of atherosclerotic plaque of the tunneled segments at CCA was significantly more in unidentified group.
afforded by nanoscale technologies are expected to have substantial impacts on almost all industries and areas of society (e.g., medicine, plastics, energy, electronics, and aerospace) [1][2][3][4][5]. The recent advancement of bioanalytical techniques involving the development of highly sensitive or selective analytical methods based on nanoscale materials/molecules have progressed with remarkable success. In this regard, silver nanoparticles (AgNPs) have received significant attention in constructing analytical and bioanalytical sensors. This relevance arises from their unusual optical, electronic, and chemical properties [6][7][8]. They have a high surface area, very small size (<20 nm) and high dispersion ability, spectrally selective coating [9, 10], surface-enhanced Raman scattering [11,12], and antibacterial activity [13]. Moreover, AgNPs exhibit optical properties which could not be observed either in molecular or in bulk metallic form [14][15][16][17].Fluorescence spectroscopy as a sensitive, simple, diverse, and nondestructive method can provide real time, in situ, and dynamic analytical information [18]. However, utilizing nanoparticles in fluorescence analysis has provided significant improvement in this area [19][20][21][22][23]. It should be mentioned that the fluorescence of metal clusters and thin films is well established based on Mooradian's observation of photoluminescence from bulk copper and gold [24]. Also several reports are available related to the fluorescence of silver nanoclusters [25,26].Glucose, a simple sugar (monosaccharide), is an important carbohydrate in biology. Cells use it as a source of energy and a metabolic intermediate and its lack or excess can produce detrimental influence on cellular functions. The glucose level in blood is considered as a clinical indicator for diabetes. Therefore, the monitoring of glucose level in blood with faster and more accurate methods is in great demand and a great deal of effort has been focused Abstract A nanosensor was designed for the enzymatic determination of glucose based on the fluorescence enhancement of silver nanoparticles (AgNPs). This enhancement is the result of the glucose oxidase-catalyzed oxidation of glucose. Silver nanoparticles were prepared through a chemical reduction by using trisodium citrate as the reducing agent and were characterized with UV-visible spectroscopy, Fourier transform infrared spectroscopy and transmission electron microscopy. The experimental results showed that the increase of the AgNP fluorescence was linearly proportional to the concentration of glucose within its concentration ranges of 2.50 × 10 −5 -7.50 × 10 −3 M and 7.50 × 10 −3 -7.50 × 10 −2 M with a detection limit of 5.53 × 10 −7 M under the optimized experimental conditions. To evaluate the applicability of the nanobiosensor, determination of glucose in real samples was performed according to the developed procedure.
Introduction: Considering the increased expenditure in public health sector, especially the increased cost in hospitals and clinics, there is an urgent need to control these costs mainly by ensuring adherence to clinical guidelines for diagnostic procedures. In this study we aim to investigate the adherence of heart clinics to guideline for exercise tolerance test. Methods: This cross-sectional study was performed on 308 patients who were referred for ECG exercise test in 3 clinics located in the city of Shiraz, Iran in 2018. Demographic and clinical data were recorded and the indications of exercise test for each patient was reviewed according to the ACC/AHA guideline for exercise tolerance test. Results: Exercise tests were found to be inappropriately done in 121 (39.3%) participants. Among the patients for whom the test was done without indication 79 (65.3%) were women and the gender difference was statistically significant (P < 0.01); women were 18.5% more likely to undergo exercise test without indication. There was more inappropriate tests among nonanginal pain subsets comparing to other presenting symptoms (P < 0.001). Age, coronary risk factors, reason for performing exercise tests and private health system were not predictors of inappropriate use (P > 0.05). Conclusion: This study confirms that more than one third of exercise tests done in the participants are inappropriate. Wide availability of exercise test makes it vulnerable to overuse and additional unnecessary cost to health care systems.
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