Trends in primary percutaneous coronary intervention for the treatment of acute coronary ST-elevation myocardial infarction in Latin American countries: insights from the CECI consortium.

Background: ST-elevation myocardial infarction (STEMI) requires revascularization treatment, preferably via primary percutaneous coronary interventions (pPCI). There is a lack of data about contemporary management of STEMI in Latin America. Methods: This was a multicenter, multinational, prospective, and dynamic registry of patients undergoing pPCI in Latin America for STEMI (STEMI/LATAMI Registry) that was carried out in nine centers from five countries (Argentina, Ecuador, Venezuela, Bolivia, and the Dominican Republic) between June 2021 and June 2023. All interventionalists involved in the study were originally trained at the same institution (Centro de Estudios en Cardiología Intervencionista, Buenos Aires, Argentina). The primary objective was to evaluate procedural and in-hospital outcomes of pPCI in STEMI and in-hospital outcome in the Latin America (LATAM) region; as secondary endpoints, we analyzed the following subgroups: differences between pPCI vs. pharmaco-invasive or late presenters, gender, elderly and very elderly patients, cardiogenic shock outcomes, and causes of STEMI. Results: In total, 744 STEMI patients who underwent PCI between June 2021 and June 2023 in five countries (nine centers) in our continent were included; 76.3% had a pPCI, 8.1% pharmaco-invasive PCI, and 15.6% had late STEMI PCI. There were no differences in region or center when we evaluated in-hospital and 30 days of death. The rate of procedural success was 96.2%, and the overall in-hospital mortality rate was 2.2%. In the subgroup of pPCI, mean symptom onset-to-balloon time was 295.3 ± 246 min, and mean door-to-balloon time was 55.8 ± 49.9 min. The femoral approach was chosen in 60.5%. In 3.0% of patients, the left main disease was the culprit artery, with 1.63 ± 1.00 stents per patient (564 drug-eluting stents and 652 bare metal stents), with 34 patients receiving only plain optimal balloon angioplasty. Definitive stent thrombosis was related to the infarct artery as the primary cause of STEMI in 7.5% of patients. The use of assistant mechanical devices was low, at 2.1% in the pPCI group. Women were older, with large numbers in very elderly age (≥90 years), greater mortality, and incidence of spontaneous coronary dissection as a cause of STEMI (p < 0.001, p < 0.001, p < 0.001, and p < 0.003, respectively). Conclusion: In suitable LATAM Centers from low/medium-income countries, this prospective registry in patients with STEMI, PCI performed by well-trained operators has comparable results to those reported in well-developed countries.

Norfloxacin adsorption on montmorillonite and carbon/montmorillonite hybrids: pH effects on the adsorption mechanism, and column assays.

The presence of norfloxacin antibiotic (NFX) in drinking water raises significant scientific concern due to the health and environmental problems that may cause. This study aimed to evaluate the NFX removal: 1) in batch adsorption at different pH values on montmorillonite (M) and montmorillonite-carbon hybrids (M-HC); 2) in continuous columns experiments, to assess the technological application of these hybrids as domestic filters, using one M-HC as adsorbent material ranging from 1% to 5%. Batch experiments showed that adsorption occurred in all the samples, being M the material with the highest adsorption capacity (95% of adsorption for cationic NFX). For the M-HC the adsorption seemed to be not strongly dependent of the pH (20%- 41% of adsorption). The characterization of adsorbents and NFX adsorption products (FTIR, XRD, and zeta potential analysis) disclosed that adsorption occurs at both the external surface and the interlayer space of M. For the M-HC synthesized without activation, the interlayer space seemed to be predominantly responsible; while for the activated M-HC the adsorption occurred at the external surface (its interlayer was destroyed). The column experiments revealed that the best adsorption capacity and highest flow were attained using 1% of adsorbent material in the column packing.

Some aspects of the adsorption of glyphosate and its degradation products on montmorillonite.

The most worldwide used herbicide is glyphosate, phosphonomethylglycine (PMG). Consequently, a significant amount of PMG, its metabolites (sarcosine, SAR, and aminomethylphosphonic acid, AMPA) and the degradation product, methylphosphonic acid (MPA), reaches the soil, which acts as final sink. Because clays are one of the most reactive components of soils, expansive clays such as montmorillonite (Mt) are used to retain agriculture contaminants with some success. In this work, as a preliminary step for the evaluation of the risk that PMG, SAR, AMPA, and MPA occurrence could have on the environment, their adsorption on Mt surface was performed. The adsorption process was analyzed at constant adsorbate concentrations and two pH values to take into account the different protonation states of the amino group. DTA, XRD, zeta potential measurements, and XPS were used to identify the interactions or association mechanisms with the clay surface, the entry of adsorbates into the Mt interlayer, and electric charge changes on the Mt surface, and evaluate the acid-base surface complex constants, respectively. The interlayer thickness in acid media indicated that adsorbates are able to enter the interlayer in planar form. Besides, for the Mt-PMG sample, some PMG molecules could be also inserted as a bilayer or with a tilt angle of 52.4° in the interlayer. However, in alkaline media, the interlayer thickness indicated that the adsorbate arrangement differed from that of acidic media where PMG and MPA could have more than one orientation. The surface complex deprotonation constants were determined for the =NH+2 â‡† =NH+H+ process, being 3.0, 5.0, and 7.3 for PMG, AMPA, and SAR, respectively.

Technological applications of organo-montmorillonites in the removal of pyrimethanil from water: adsorption/desorption and flocculation studies.

Pyrimethanil (2-aniline-4, 6-dimethylpyrimidine, PRM) is used in fruit packing plants to control fungal infections and diseases. The effluents greatly polluted with this fungicide, as a point source contamination, need to be technologically treated for their regeneration before they reach water bodies. This work evaluates the use of organo-montmorillonites, synthetized in our laboratory, for their application in adsorption and coagulation/flocculation processes for the removal of PRM from water. The adsorption-desorption performance of PRM in a raw montmorillonite (Mt) and several organo-montmorillonites (organo-Mt) obtained by different amounts and types of exchanged surfactants (octadecyltrimethylammonium (ODTMA) and didodecyldimethylammonium (DDAB) bromides and benzyltrimethylammonium chloride (BTMA)) was studied. The PRM adsorption on raw Mt was assigned mainly to an interlayer occupancy, while hydrophobic interactions between PRM and the surfactants in the exchanged samples increased PRM adsorption, which was correlated with the surfactant loading. PRM desorption showed irreversible behavior in raw Mt, which changed to reversible for organo-Mt samples, and was also correlated with the increase of surfactant loading.Two of the organo-Mt with high surfactant loading (twice the CEC) were assayed for the removal of commercial PRM in coagulation/flocculation tests, and their performance was compared to that of the native clay (Mt). The use of the organo-Mt produced flocculation at a very low ratio (0.5 g L-1), whereas no flocculation was observed with Mt. These results proved the feasibility of the use of organo-Mt for the treatment of wastewater contaminated with PRM using a low organo-Mt/liquid ratio.

Satisfacción de los usuarios externos(as), atendidos en la unidad de emergencia del Hospital Regional Santa Teresa Comayagua, Honduras: julio 2004

Identifica los principales factores y posibles causas que inciden en una satisfacción positiva o negativa de los usuarios externos (pacientes y acompañantes) que son atendidos en el servicio de emergencia de dicha unidad.

Actividad reproductiva de la yegua y la burra durante los días con menor cantidad de horas luz / Ovarian activity in the mare and the febale donkey during the days with less light

Con el propósito de conocer la actividad ovárica de la yegua y burra durante los días con menor cantidad de horas luz, se realizó un estudio en hembras de rastro. El 60.1 porciento y el 64.9 porciento de las yeguas gestantes y no gestantes, respectivamente, presentaron crecimiento folicular. De éstas, en el 34.5 porciento y el 50.3 porciento, en el mismo orden, el crecimiento se localizó en los 2 ovarios. El 71.1 porciento de las burras gestantes y el 82.4 porciento de las no gestantes, presentaron crecimiento folicular. Crecimiento que se localizó en los 2 ovarios en el 38.3 porciento y 60.7 porciento de los casos, respectivamente. El 87.1 porciento y el 81.1 porciento de las yeguas y burras, respectivamente, concibieron de mayo a septiembre. Los cuerpos lúteos desaparecieron de los ovarios en los animales con gestación avanzada. Los fetos, en el 55.6 porciento de las yeguas y en el 60.4 porciento de las burras se encontraron en el cuerno uterino contralateral al ovario que presentó el cuerpo lúteo.