In-hospital course of early invasive strategy in acute coronary syndromes

Unstable angina is emerging as a major public health problem worldwide. Two approaches - an early invasive strategy or a conservative strategy - are used of the management of non-ST elevation acute coronary syndrome [MSTE-ACS]. An early invasive strategy involves the use of early coronary angiography and revascularization with percutaneous coronary intervention [PCI] or coronary artery bypass graft surgery [CABG]. A conservative strategy involves initial treatment with aggressive pharmacologic treatment, and coronary angiography with revascularization is used if there is evidence of spontaneous or provoked ischemia within the hospital stay. Two hundred sixty-one patients coronary syndrome were enrolled in this study for early invasive strategy. Patients received aspirin, heparin, clopidogrel, and lipid-lowering therapy. The primary endpoint was a composite of death, non-fatal myocardial infarction, cerebrivascular accident, and recurrent chest pain. Angiograms were assessed qualitatively by two expert invasive cardiologists. Sixty-seven percent of the patients underwent percutaneous [33%] or surgical [34%] revascularization. The overall death rate was 1.1%. In-hospital major adverse cardiac event [MACE] rate was 3.2% in the revascularization groups. According to the favorable in-hospital course in patients referred for PCI or CABG, it seems that accurate selection of patients who may be candidates for early invasive strategies is of paramount importance. We found that diabetes, cardiac enzyme elevations [Troponin T], ST/T changes, and the presence of two or more risk factors besides diabetes are powerful predictors of the patients who will undergo revascularization. Proper selection of patients admitted with ACS for invasive strategy is warranted. Positive cardiac enzymes [Troponin T], diabetes mellitus, and presence of two or more major CAD risk factors are helpful for patient selection

Vinorelbine, 5 fluorouracil and folinic acid [fufol-nav] versus paclitaxel [p] as first line treatment in metastatic breast cancer patients pre-treated with anthracycline

The aim of this study was to investigate the efficacy and safety of Vinorelbine, 5 Fluorouracil and Folinic acid [Fu Fol-Nav] versus Paclitaxel [P] in patients with metastatic breast cancer [MBC] previously treated with Anthracycline. Between January 2001 and September 2003, 50 eligible patients with MBC were randomized to either Folinic acid 3Omg/m2 followed by 5Fu 600 mg/m2 given as intravenous holus injection then Vinorelbine 25 mglm2 [10 minute-infusion] q3 weeks [group A], or Paclitaxel 175 mg/m2 [3 hour infusion] q3 weeks [group B]. Eligibility criteri included: measurable MBC previous treatment with Anthracycline in [neo] adjuvant setting. The two randomized arms were well balanced for FuFol-Nav vs. P, median age [44 vs. 51], nearly three quarter of patients in each group had ECOG performance status 0,1. Hormonal receptor positivity for group A was 60% vs. 72% for group B, about half the patients had one metastatic site [56% vs. 47%] with predominant visceral sites in 68% vs. 60% in groups A and B respectively. Overall, both regimens were relatively well tolerated, grade 314 toxicities for group A vs. B: neutropenia and alopecia were significantly higher in group B: [28% vs. 8, 24% vs. 0] hut neurosensory [4% vs. 8%] and mucositis [8% vs. 4%] were not significantly different between the 2 groups. Other toxicities were mild and manageable and no treatment related mortality has been reported in both arms. Overall response rate was 44% [95% CI 42.1 to 45.9] for group A versus 48% [95% CI 46.9 to 50.1] in group B [P> 0.05]. Median time to progression TTP was 7.5 ms vs. 8ms in groups A and B respectively, median duration of response was comparable in both groups [8.5 vs 9ms]. Notably the median OS was similar in both arms [l3ms]. The present study failed to demonstrate a significant difference in response rate, median time to progression and overall survival between the two regimens, so FuFol-Nav is a well tolerated regimen with comparable efficiency as Paclitaxel hut with less cost burden in the treatment of MBC patients

Production and evaluation of dehydrated buffalo meat

Buffalo meat slices were brined in 5, 10 or 15% NaCl solutions or in combination with NaNO2 [100 ppm] and ascorbic acid [400 ppm], then sun- or freeze-dried and stored at room temperature for 6 months. The dehydrated slices were evaluated for their chemical composition, rehydration ratio and color changes during storage. It was found that total protein, fat, essential and nonessential amino acids content were lower in the sun-dried samples than those of the freeze- dried ones. Moreover, increasing NaCl concentrations in the brine solutions caused more loss of such components. On the other hand, freeze-drying revealed a great reduction in TBA values for the dried and stored samples when compared with the sun-dried ones. Sodium chloride at 10 or 15% for sun-dried and 5% for freeze-dried meats was found to be effective in reducing fat rancidity. Moreover, incorporation of NaNO2 with or without ascorbic acid, showed the lowest fat oxidation possibilities. Freeze-dried meat samples had also better rehydration ratios than sun-dried ones