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Europace : European Pacing,... Dec 2023Single-connector (DF4) defibrillator leads have become the predominantly implanted transvenous implantable cardioverter-defibrillator lead. However, data on their... (Review)
Review
AIMS
Single-connector (DF4) defibrillator leads have become the predominantly implanted transvenous implantable cardioverter-defibrillator lead. However, data on their long-term performance are derived predominantly from manufacturer product performance reports.
METHODS AND RESULTS
We reviewed medical records in 5289 patients with DF4 leads between 2011 and 2023 to determine the frequency of lead-related abnormalities. We defined malfunction as any single or combination of electrical abnormalities requiring revision including a sudden increase (≥2×) in stimulation threshold, a discrete jump in high-voltage impedance, or sensing of non-physiologic intervals or noise. We documented time to failure, predictors of failure, and management strategies. Mean follow-up after implant was 4.15 ± 3.6 years (median = 3.63), with 37% of leads followed for >5 years. A total of 80 (1.5%) leads demonstrated electrical abnormalities requiring revision with an average time to failure of 4 ± 2.8 years (median = 3.5). Of the leads that malfunctioned, 62/80 (78%) were extracted and replaced with a new lead and in the other 18 cases, malfunctioned DF4 leads were abandoned, and a new lead implanted. In multivariable models, younger age at implant (OR 1.03 per year; P < 0.001) and the presence of Abbott/St. Jude leads increased the risk of malfunction.
CONCLUSION
DF4 defibrillator leads demonstrate excellent longevity with >98.3% of leads followed for at least 5 years still functioning normally. Younger age at implant and lead manufacturer are associated with an increased risk of DF4 lead malfunction. The differences in lead survival between manufacturers require further investigation.
Topics: Humans; Defibrillators, Implantable; Equipment Failure; Retrospective Studies
PubMed: 38000900
DOI: 10.1093/europace/euad347 -
Environmental Monitoring and Assessment Nov 2023This investigation examines the transport of metal- and pesticide-polluted dust emitted by one of the most relevant agricultural areas of Northwestern Mexico. In the...
This investigation examines the transport of metal- and pesticide-polluted dust emitted by one of the most relevant agricultural areas of Northwestern Mexico. In the contaminated area, an excessive water extraction of the aquifer and seawater intrusion caused the abandonment of fields, which are pollutant-loaded dust emitters. We used air mass forward trajectories (HYSPLIT) model to obtain particle trajectories in the wind and the use of banned pesticides as geochemical tracers for dust transported by wind. Fifty dust samples from 10 agriculture fields and 26 roof dust of a city close to the agricultural area were analyzed for their contents of zirconium, lead, arsenic, zinc, copper, iron, manganese, vanadium, and titanium, by portable X-ray fluorescence. Nine pesticides were analyzed in the roof dust and agricultural soil samples by gas chromatography. Results show that the distribution of metals was significantly different between active and abandoned fields. Arsenic-lead-copper was mainly concentrated in abandoned fields, while zinc-iron-manganese-titanium was dominant in active fields. Two potential sources of metal contamination were found by principal component analysis (PCA): (I) a mixture of traffic and agricultural sources and (II) a group related to agricultural activities. The occurrence of banned pesticides in dust deposited on roofs collected at nearby cities confirms the atmospheric transport from the agricultural area. The HYSPLIT results indicated that the dust emitted from agricultural fields can reach up to the neighboring states of Sonora, Mexico, and the USA. The impacts that these emissions can have on human health should be studied in future research.
Topics: Humans; Pesticides; Copper; Manganese; Titanium; Arizona; Arsenic; Environmental Monitoring; Agriculture; Metals; Zinc; Iron; Dust
PubMed: 37982889
DOI: 10.1007/s10661-023-12086-9 -
Environmental Pollution (Barking, Essex... Jan 2024Groundwater pollution is a recurrent problem in abandoned non-ferrous metal smelting sites, and its severity is influenced by topsoil contamination, hydrogeological...
Groundwater pollution is a recurrent problem in abandoned non-ferrous metal smelting sites, and its severity is influenced by topsoil contamination, hydrogeological characteristics, and hydrogeochemical conditions. In such unique areas, traditional methods for evaluating groundwater pollution risk are biased, as the long production history of these sites have led to highly polluted and heterogeneous soil and groundwater. Herein, based on a typical lead-zinc smelting site, As, Pb, Zn, Cd, Mn, and Ni were found to be the predominant heavy metal (loid)s in groundwater, with respective exceedance rates of 44.4%, 50.0%, 72.2%, 88.9%, 88.9%, and 61.1%. Combined with the groundwater pollution characteristics, the representative hydrogeochemical factors were screened out to optimize the following aquifer vulnerability evaluation using the AHP-DRASTICH method. A comprehensive evaluation model (DI-NCPI) for groundwater pollution risk was established by combining the DRASTICH index (DI) obtained after optimization and the Nemerow comprehensive contamination index (NCPI) of topsoil. The fit between DI-NCPI and groundwater heavy metal (loid) pollution index reached 0.956, which laterally confirms that the model has some reference value. In terms of distribution, the high-risk and very high-risk zones were mainly concentrated in the zinc smelting system, located in the southeastern and central-western parts of the site. These areas have relatively high levels of topsoil contamination and aquifer vulnerability and require focused attention in site remediation. This research highlights the importance of combining topsoil contamination and aquifer vulnerability to evaluate groundwater pollution risk in smelting areas. It provides a more targeted reference for groundwater remediation strategies in abandoned smelting sites, as well as severely polluted industrial areas.
Topics: Zinc; Soil Pollutants; Environmental Monitoring; Risk Assessment; Metals, Heavy; Soil; Groundwater; China
PubMed: 37981182
DOI: 10.1016/j.envpol.2023.122939 -
Environmental Science and Pollution... Dec 2023Pistacia lentiscus L. is an excluder metallophyte proposed for the revegetation and phytostabilization of metal-contaminated sites in the Mediterranean area. The present...
Pistacia lentiscus L. is an excluder metallophyte proposed for the revegetation and phytostabilization of metal-contaminated sites in the Mediterranean area. The present study aims at evaluating the linking between bacterial communities and plants spontaneously growing in ecosystems chronically impacted by mining activities. Environmental properties and metal accumulation into hypogeal and epigeal tissues were analyzed in wild plants of two contrasting habitats with extreme metal contamination (> 2300 mg/kg for Zn, > 1100 mg/kg for Pb, > 10 mg/kg for Cd). The community structures of rhizospheric and root endophytic bacteria were fingerprinted by terminal restriction fragment length polymorphism of the 16S rRNA gene. The wild shrubs efficiently restrict the accumulation of the three major contaminants to the epigeal tissues in the two habitats under study (249 ± 68 mg/kg dw for Zn, 43 ± 21 mg/kg dw for Pb, and 1.4 ± 0.5 mg/kg dw for Cd). Evidence was provided that the combined but not individual effect of environmental conditions (moisture, inorganic carbon, pH) and proportion between Zn and Cd in the mine substrate play a role in structuring rhizosphere bacterial communities. The observed changes in community structures of root endophytes were found to be strongly associated with Pb level in roots and substrate properties (inorganic carbon and Zn/Cd ratio). Overall, our study highlights the importance of the analysis of multifactorial interactions among mine substrate, plant, and microbes for understanding how the environmental context affects phytoremediation under real conditions.
Topics: Ecosystem; Cadmium; Pistacia; Lead; RNA, Ribosomal, 16S; Plants; Biodegradation, Environmental; Bacteria; Carbon; Soil Pollutants; Soil; Metals, Heavy
PubMed: 37964146
DOI: 10.1007/s11356-023-30776-2 -
Journal of Pediatric Surgery Feb 2024Birth Defects are accountable for the substantial surgical burden of disease worldwide. It can bring upon death, chronic illness, disability [physical or mental or... (Review)
Review
Birth Defects are accountable for the substantial surgical burden of disease worldwide. It can bring upon death, chronic illness, disability [physical or mental or both], financial burden, social stigma, abandonment, feticide and Infanticide. Availing timely and safe surgery can minimize the potential fatalities and sufferings caused by birth defects. Yet surgery is not treated as essential for the management of birth defects, especially in lower middle-income countries. It causes potentially correctable conditions to exacerbate, which can lead to death or lifelong disabilities. Surgical care cannot only correct birth defects but also can avert potential Disability Adjusted Life Years (DALYs) and financial burden. Furthermore, surgical correction facilitates social inclusion. Such transformation can be equated to "Revising Destiny". A "whole of society" approach focused on surgical care is instrumental for addressing the health, financial, and social implications of birth defects. LEVEL OF EVIDENCE V: Expert Opinion.
Topics: Humans; Quality-Adjusted Life Years; Disabled Persons; Global Health; Chronic Disease; Cost of Illness
PubMed: 37953161
DOI: 10.1016/j.jpedsurg.2023.10.006 -
Environmental Science and Pollution... Dec 2023The study shows how the statistical approach can provide information on the factors and processes that control the geochemical distribution of elements at the surface of...
The study shows how the statistical approach can provide information on the factors and processes that control the geochemical distribution of elements at the surface of an abandoned tailings pond. In this regard, the case study of a waste deposit resulting from the ore processing plant of Fundu Moldovei was carried out. The facility was concentrating Cu, Pb, and Zn from the polymetallic sulfide ores of the Fundu Moldovei-Leșu Ursului mining district (Romania). The statistics indicate three types of waste, showing specific properties: (i) Waste of the beach, rich in soluble fraction (14.4%) and secondary minerals (e.g., jarosite, ferricopiapite, magnesiocopiapite, pickeringite, and clay minerals). The latter and the related high contents of Al, K, Fe, Co, Ni, Cu, Pb, and Zn are controlled by the water evaporation and subsequent transient pH (2.6-3.5) of the leachates accumulated as puddles. The lower pH and scarce soluble fraction favor a rise in the Cu and Zn contents, while Al, K, Fe, and Co are noticeable at a higher pH when the soluble fraction is abundant. (ii) Waste of the upper dam slope, marked by intense oxidation and a meager occurrence of secondary minerals precipitated from highly acidic pore leachates (average pH of 2.55), namely, jarosite, ferricopiapite, magnesiocopiapite, and coquimbite. The surface waste contains more pyrite and is coarser because of the fine particle removal during rainfall. Unlike the beach waste, in the upper dam tailings, Al, K, Fe, Co, Cu, Pb, and Zn seem to relate mainly to the primary minerals (muscovite, chlorite, and pyrite). (iii) Downslope dam waste is less acidic (average pH of 3.75) than that of the upper slope; it contains secondary minerals stable at a higher pH (e.g., gypsum, apjohnite, dietrichite, clay minerals, and schwertmannite). Calcium, Mn, and Cd are more abundant in the dam waste. They originate from both primary and secondary minerals (e.g., muscovite, chlorite, gypsum, ferricopiapite, and magnesiocopiapite) and correlate with the coarser waste.
Topics: Ponds; Calcium Sulfate; Clay; Lead; Minerals; Environmental Monitoring
PubMed: 37947936
DOI: 10.1007/s11356-023-30357-3 -
Environmental Science and Pollution... Dec 2023The mining and metallurgical industry sector activities often release potential toxic elements (PTE) surrounding exploitation area. We evaluated the addition of...
The mining and metallurgical industry sector activities often release potential toxic elements (PTE) surrounding exploitation area. We evaluated the addition of phosphate and lime using the dosage of 0.5:1, 1:1, and 2:1 molar ratio of PO and CO to the sum of PTE, respectively, and also, biochar and biosolids using the dosage of 2.5, 5, and 10% (m:m) to immobilize PTE in contaminated forest soil (Pb (270 mg kg) and Zn (858 mg kg)) near an abandoned mine site in Brazil. The desorption by stirred flow kinetics revealed that 15% of the total Zn and 12% Pb contents are mobile before any amendment application. Phosphate amendment decreased Pb desorption but increased Zn desorption. Biochar and biosolids immobilize high amounts of Zn and Pb because of their high cation exchange capacities and alkaline properties; however, 20% biosolid dose increased Pb desorption. X-ray absorption spectroscopy suggested Zn-kerolite as the major species in the contaminated soil, likely from mine dust. The change in Zn speciation after soil amendment addition indicated that biochar and lime kept a high proportion of Zn-Al species, whereas phosphate and biosolids led to more Zn-Fe species. Our results pointed out that lime might reduce both Pb and Zn mobilities; however, field trials are crucial to confirm the immobilization efficiency of lime and other amendments over long term.
Topics: Biosolids; Lead; Phosphates; Charcoal; Soil; Zinc; Soil Pollutants; Metals, Heavy
PubMed: 37940822
DOI: 10.1007/s11356-023-30643-0 -
Heart Rhythm O2 Oct 2023Existing data on the impact of sex differences on transvenous lead extraction (TLE) outcomes in cardiac device patients are limited.
BACKGROUND
Existing data on the impact of sex differences on transvenous lead extraction (TLE) outcomes in cardiac device patients are limited.
OBJECTIVE
The purpose of this study was to evaluate the safety and efficacy of mechanical TLE in female patients.
METHODS
A retrospective evaluation was performed on 3051 TLE patients (group 1: female; group 2: male) from a single tertiary referral center. All individuals received treatment using single sheath mechanical dilation and various venous approaches as required.
RESULTS
Our analysis included 3051 patients (group 1: 750; group 2: 2301), with a total of 5515 leads handled with removal. Female patients were younger, had a higher left ventricular ejection fraction, and lower prevalences of coronary artery disease and diabetes mellitus. Infection was more common in male patients, whereas lead malfunction or abandonment were more frequent in female patients. Radiologic success was lower in female patients (95.8% vs 97.5%; = .003), but there was no significant difference in clinical success between groups (97.2% vs 97.5%; = .872). However, major complications (1.33% vs 0.60%; <.001) and procedural mortality (0.4% vs 0.1%; <.001) were higher in females compared to male patients. After multivariate analysis, female sex emerged as the only predictor of major complications, including deaths (odds ratio 3.96; 95% confidence interval 1.39-11.24).
CONCLUSION
TLE using unpowered simple mechanical sheaths in female patients is safe and effective, but is associated with lower radiologic success and higher complication rates and mortality than in males. This finding underscores the importance of recognizing sex differences in TLE outcomes.
PubMed: 37936665
DOI: 10.1016/j.hroo.2023.09.002 -
Frontiers in Plant Science 2023Mercury (Hg) is a global environmental concern due to its toxicity (especially high in methylated form) and the long-range distribution of its gaseous elemental form...
Mercury (Hg) is a global environmental concern due to its toxicity (especially high in methylated form) and the long-range distribution of its gaseous elemental form (GEM). Hg-contaminated areas, such as abandoned mining sites, pose intrinsic difficulties for their management and heavy monitoring costs. In these environments, plant-based solutions may play a key role in the ecosystem quality assessment and support remediation strategies, combining reliability and cost-effectiveness. In this study, we adopted a biomonitoring approach by using tree rings of four different species collected in the proximity of the mining-metallurgical area of Abbadia San Salvatore, central Italy, a major former Hg mining district whose reclamation is currently in progress. Our dendrochemical analysis was aimed at identifying the historical changes of local atmospheric Hg contamination and at singling out, for the first time in the study area, other potentially toxic elements (PTEs) associated with the past mining activity. Collected cores dated back to early as 1940 and provided the temporal patterns of atmospheric Hg emission vs the produced liquid quantities, so reconstructing the historical impact of the mining site on nearby terrestrial ecosystems and resident human population. Current GEM contamination was found about twenty times lower than that of the fully operational mine periods. From a first survey on other PTEs, thallium (Tl) and lead (Pb) appeared to be potentially associated with the mining activity, thus suggesting new working assumptions for further dendrochemical analyses and for the inclusion of Pb in human biomonitoring surveys of the Mt. Amiata area, actually not present in the control list. The results prompt a more thorough assessment by tracking for a longer time span a critical site that is an ideal open-field lab to study the ecophysiology of different tree species in relation to environmental behavior of PTEs for better-assessing wildlife and human exposures.
PubMed: 37900738
DOI: 10.3389/fpls.2023.1260431 -
Scandinavian Journal of Trauma,... Oct 2023Autoresuscitation is the phenomenon of spontaneous return of circulation after cessation of CPR, also known as the Lazarus phenomenon. Most of the evidence is based on...
BACKGROUND
Autoresuscitation is the phenomenon of spontaneous return of circulation after cessation of CPR, also known as the Lazarus phenomenon. Most of the evidence is based on case reports and a few systematic reviews. The occurrence of autoresuscitation may lead to self-reproach and dismay in affected emergency personnel and may rise questions about the correct procedure after terminating resuscitative efforts. In contrast to existing cardiac arrest guidelines there is no standardized approach to terminating resuscitative attempts.
CASE
We report a case of out of hospital autoresuscitation in a 67-year-old female after 60 min of advanced cardiac life support. After shock refractory shockable rhythm, we recorded pulseless electrical activity and fixed pupils, consequently resuscitation was terminated. About 50 min later the patient surprisingly showed signs of life. Due to the suggestive history a coronary angiography was performed, showing severe coronary heart disease which necessitated surgical intervention. After ACBP surgery and intensive care followed by treatment on the cardiological ward, she was finally discharged to neurological rehabilitation.
CONCLUSION
As already proposed by existing literature, there should be at least a 10-min interval of close monitoring after abandoning CPR. Transport of a deceased patient should only take place after secure signs of death can be detected. Further investigation is needed to determine which patients are most likely to benefit from an extended observation period. Our case reports highlights the difficulties in death declaration and the importance of close monitoring after abandoning CPR.
Topics: Female; Humans; Aged; Cardiopulmonary Resuscitation; Return of Spontaneous Circulation; Heart Arrest; Hospitals; Time Factors; Out-of-Hospital Cardiac Arrest
PubMed: 37884989
DOI: 10.1186/s13049-023-01137-2