Activity

Polymer-free biolimus A9-coated coronary stent (DCS) has novel features which lead to the expectation of better arterial healing. However, comparisons of intravascular status between DCS and drug-eluting stents (DES), and robust real-word clinical assessments of DCS have been lacking to date.

From September 2017 to September 2018, we evaluated the intra-vascular status of 74 DCS implanted in 55 lesions from 43 patients using coronary angioscopy (CAS) approximately one year after implantation from a cohort of 219 lesions in 158 patients. We set 239 second-generation durable-polymer DES (DP-DES) implanted in 211 lesions from 180 patients from a cohort of 2652 lesions in 1914 patients as the control. Angioscopic images were analyzed to determine (1) the dominant degree of neointimal coverage (NIC) over the stent; (2) the heterogeneity of NIC; (3) yellow color grade of the stented segment; and (4) the presence of intra-stent thrombus. The primary outcome was the incidence of thrombus and secondary outcomes weDP-DES. DCS can thus be used with similar safety and efficacy as DP-DES.

Restoration of anterograde blood flow leads to alterations in vascular wall stress that may influence lumen size distal to chronic total occlusion (CTO) lesions. We sought to assess changes in lumen diameter of segments distal to the stent segment of successfully recanalized CTO.

We analyzed 507 consecutive CTO cases with stent implantation that underwent follow-up angiography at a single high-volume center (mean follow-up of 13.5 months). Segments ≤40 mm distal to the stent edge were analyzed using quantitative coronary angiography.

At follow-up, lumen diameters significantly increased; diameter changes of 0.26 ± 0.47 (percent diameter change of 18.2%) at 5 mm distal, mean lumen diameter changes of 0.23 ± 0.35 (14.3%) and minimal lumen diameter changes of 0.22 ± 0.80 (24.7%) (all p < 0.001). Lumen enlargement was similar between visually shrunken and stenosed vessels (degree of stenosis ≥20% with luminal irregularities) distal to stents; 5 mm distal (0.32 ± 0.48 vs. 0.30 ± 0.48, p = 0.76), mean lumeistal to CTO lesions significantly increased following successful revascularization, regardless of diseased status of the distal bed or degree of in-stent narrowing. These findings implicate appropriate determination of stent size, stent coverage length, as well as management strategies of distal vessels.

We aimed to examine the relationship between the difficulty of activity using the arms and mild cognitive impairment (MCI), the relationship between the difficulty of activity using the arms and manual function, and cognitive function in patients with coronary artery disease (CAD).

We conducted a cross-sectional study of 263 non-dementia patients who met the study criteria from 2328 CAD patients. MCI was estimated with the Japanese version of the Montreal Cognitive Assessment (MoCA-J). check details The difficulty of activity using the arms was evaluated using the Disability of the Arm, Shoulder, Disability of the Arm, Shoulder and Hand and Hand (DASH) questionnaire. Manual function was evaluated by pinch strength and handgrip strength.

Age (odds ratio, 1.10), three-fingered pinch strength (odds ratio, 0.69), and DASH score (odds ratio, 1.03) were independently associated with MCI in the multivariable logistic regression analysis. Hemoglobin (β=-0.15), handgrip strength (β=-0.37), and MoCA-J score (β=-0.15) were independently associated with DASH score (Model 1 p<0.001, adjusted R

=0.33); hemoglobin (β=-0.17), eGFR (β=-0.14), three-fingered pinch strength (β=-0.25), and MoCA-J score (β=-0.14) were independently associated with DASH score in the multivariate regression analysis (Model 2 p<0.001, adjusted R

=0.31).

The difficulty of activity using the arms was independently associated with manual and cognitive function and MCI in CAD patients.

The difficulty of activity using the arms was independently associated with manual and cognitive function and MCI in CAD patients.

Ophthalmologic care needings increase whereas the numbers of ophthalmologist decrease. Oldest people who are often vulnerable and dependent populations are particularly affected in difficulty to access to health services. To resolve the problem, the use of telemedicine in ophthalmology could be an alternative.

From June 2018to November 2018, patients from Janzé Hospital (Ille et Vilaine) did an ophthalmologic teleconsultation during their stay. Teleconsultation was based on visual acuity, intraocular pressure measurement, wild-field retinophotography and optical coherence tomography performed by an orthoptist and a videoconference with an ophthalmologist.

Sixty-seven patients underwent teleconsultation (60% women, 40% men). Mean age was 83 (standard deviation±8). Fifty-four percent (36) of consultations were complete. Retinophotography was missing in 45% of cases (30) and optical coherence tomography in 53% of cases (35). Ophtalmologic pathologies were detected in 37patients (55%) and we start medical cs an alternative to classical consultation especially in dependent population. This experiment could be a starting point to the development of this solution in social health-care institutions.Energy consumption, water use and carbon emission targets are important for promoting sustainable development. This study presents a multi-goal analytical framework based on an environmental input-output analysis, structural path analysis and correspondence analysis to identify the key sectors for energy, water and carbon footprints. Using Guangdong Province as a case study, the energy, water and carbon footprints are modelled from production-based, consumption-based and network (betweenness)-based perspectives. The results show that (1) the construction sector is a key sector for energy use/water use/carbon emissions from the three perspectives. The electricity and heat power production and supply sector emitted the most production-based CO2 (283.4 Mt), accounting for 52.3% of the total CO2 emissions. (2) The key sectors in terms of energy, water and carbon differ. The transport, storage and post sector is an important sector for energy consumption, and the agriculture sector and food and tobacco sector are important sectors for freshwater withdrawal.