Effectiveness of vaccines in preventing hospitalization due to COVID-19: A multicenter hospital-based case-control study, Germany, June 2021 to January 2022

We included 852 patients in a prospectively recruiting multicenter matched case-control study in Germany to assess vaccine effectiveness (VE) in preventing COVID-19-associated hospitalization during the Delta-variant dominance. The two-dose VE was 89 % (95 % CI 84-93 %) overall, 79 % in patients with more than two comorbidities and 77 % in adults aged 60-75 years. A third dose increased the VE to more than 93 % in all patient-subgroups.

Dinuclear Gold(I) Chloride Complexes of 1,4-Bis(diphenylphosphinyl)butane and 1,5-Bis(diphenylphosphinyl)pentane: A Conformational Study

[1,4-Bis(diphenylphosphinyl)butane]digold dichloride 1 and [1,5-bis(diphenylphosphinyl)-pentane]digold dichloride 2 have been prepared from R2SAuCl (R = CH2CH2OH) and the corresponding bidentate phosphines Ph2P(CH2)nPPh2 (n = 4 or 5) in good yields. The structures of the compounds have been determined by single crystal X-ray diffraction (1 · CH2C12: space group P1̅, Z = 2; 2·0.5 CH2Cl2: space group C 2/c, Z = 8). While the monomers [Ph2P(CH2)5PPh2] (AuCl)2 are associated through intermolecular Au···Au contacts (3.323 Å) to form a chain-like structure, the crystal lattice of 1· CH2Cl2 features independent [Ph2P(CH2)4PPh2](AuCl)2 molecules which show no intra- or intermolecular Au···Au interactions. This exceptional behaviour can be rationalized on the basis of efficient packing of solvent molecules and molecules 1 with a particularly favourable conformation, which cannot be altered by weak Au(d10)—Au(d10) interactions.

Modellsysteme für die Gallium-Extraktion, II / Model Systems for Gallium Extraction, II

The introduction of a methyl substituent in the 2-position of 8-oxy-quinoline strongly alters its ligand properties in the complex formation with gallium(III). From aqueous solutions (ammonium acetate buffer, acetic acid, gallium nitrate) a pale-green complex (2-MeOx)2GaOAc is precipitated instead of the tris(oxinate) chelate. According to a single crystal X-ray diffraction study, the gallium atom is pentacoordinate in this complex, with two chelating 2-MeOx and one monocoordinate acetate ligands. Similar acetato complexes were generated with equally hindered 2,4-dimethyl- and 2,5,7-trimethylquinoline, as well as with 2-ethyl- and 2-n-propylquinoline ligands. Retaining the 2-MeOx ligand, acetate OAc could be exchanged for trifluoroacetate, propionate, cyanoacetate, and (in binuclear complexes) equivalents of succinic, maleic, fumaric, and acetylenedicarboxylic acid. From this series, crystal and molecular structures have also been determined for (2-MeOx)2GaOC(O)CH2CN and [(2-MeOx)2GaOC(O)CHJ2]2 (with crystal nitrobenzene). In the cyanoacetate, the nitrile function is not involved in intra/intermolecular metal coordination. In the binuclear succinate the molecule has a crystallographical center of inversion. As in the cyanoacetate, the environment of the two equivalent gallium centers of the succinate is very similar to that of the acetate complex.

Size Exclusion Chromatography of Microliter Volumes for On-Line Use in Low-Pressure Microfluidic Systems

We have developed a new cartridge format for on-line size exclusion processing in low-pressure, portable microfluidic devices. The described system allows size exclusion chromatography of microliter volumes (termed muL-SEC) to be performed with ready integration in complex protocols for continuous-flow sample processing and analysis. The refillable cartridge format was employed for the preparation of Bacillus subtilus spores lysed in the presence of a strong reducing agent. While the reducing agent is known to interfere with subsequent fluorescent labeling of the solubilized proteins, the described continuous-flow size exclusion processing allowed complete isolation of interferences from a 10-muL sample in 70 s. Following efficient labeling, the protein sample was injected and separated on-chip using gel electrophoresis. To increase the resolution, speed, and sample capacity of buffer exchange under low-pressure operation (40 psi), parameters such as the size exclusion resin, load volumes, flow rates, buffer composition, and cartridge geometry were optimized and are presented here. The muL-SEC analysis is compatible with automated sample preparation for microfluidic systems and has resulted in significantly increased analysis speed and throughput over benchtop methods. The presented technique has the potential to improve capabilities such as buffer exchange, size fractionation, and high-abundance protein removal-steps that are frequently required prior to on-chip, point-of-care, and mass spectrometric analyses.

[Functional mitral insufficiency: a neglected vascular lesion?]

Functional mitral regurgitation is usually neglected during the course of dilated cardiomyopathies. However, functional mitral regurgitation is a sensitive marker of decreased survival. Recent development of treatments such as new surgical approach, permanent biventricular pacing and beta-blockade therapy lead to assess and treat more specifically the accompanying functional mitral regurgitation in congestive heart failure.

Mitral ring annuloplasty: an incomplete correction of functional mitral regurgitation associated with left ventricular remodeling

Functional mitral regurgitation (FMR) occurs commonly in patients undergoing left ventricular (LV) remodeling. It is ubiquitous in patients referred to cardiac transplantation for LV systolic dysfunction and predicts a poor prognosis. The LV remodeling that is responsible for FMR is well understood and involves regional LV dysfunction Mitral annular dilatation is present in patients with idiopathic dilated cardiomyopathy but most often absent in patients with ischemic cardiomyopathy. Nonrandomized observations indicate that implantation of a mitral undersized flexible mitral ring reduces the amount of FMR, reverses LV remodeling, and improves symptoms in patients with end-stage cardiomyopathy and severe FMR. Whether a surgical procedure that does not correct the major LV alterations leading to FMR can have long-lasting effects on the amount of FMR and the reversal of LV remodeling remains to be demonstrated in randomized trials.

Protruding aortic arch atheromas: risk of stroke during heart surgery with and without aortic arch endarterectomy

BACKGROUND

Stroke occurs in 1% to 7% of heart surgery. Aortic arch atherosclerosis is a risk factor for intraoperative stroke, and endarterectomy has been proposed to prevent stroke during heart surgery in patients with arch atheromas.

METHODS AND RESULTS

Intraoperative transesophageal echocardiography was performed in 3404 patients undergoing heart surgery between 1990 and 1996. Use of transesophageal echocardiography was unselected and based on equipment availability. Aortic arch atheromas (>/=5 mm, or mobile) were seen in 268 (8%) patients. They were evaluated for intraoperative stroke (confirmed by a neurologist and cerebral infarction on computed tomography or magnetic resonance imaging). Arch endarterectomy was performed in 43 patients as an adjunct to their cardiac procedure in an attempt to prevent intraoperative stroke. The intraoperative stroke rate in all 268 patients with atheromas was high (15.3%). On univariate analysis, age, previous stroke, and arch endarterectomy were significantly associated with intraoperative stroke. On multivariate analysis, age (odds ratio 3.9, P =.01) and arch endarterectomy (odds ratio 3.6, P =.001) were independently predictive of intraoperative stroke. Mortality rate in all 268 patients was high (14.9%). These patients with atheromas also had a long recovery room, intensive care unit, and total hospital length of stay (48 days).

CONCLUSIONS

Patients with protruding aortic arch atheromas are at high risk for intraoperative stroke, significant and multiple morbidity, prolonged hospital stay, and death resulting from heart surgery. Aortic arch endarterectomy is strongly associated with intraoperative stroke; its use should be carefully considered in light of these results.