Percutaneous revascularization in late-presenting STEMI with absence of viability: effects on left ventricular remodeling and scar

INTRODUCTION: In patients with ST-elevation myocardial infarction (STEMI), percutaneous coronary intervention (PCI) should be conducted within 12 hours of symptom onset. The potential benefits attributable to late reperfusion in STEMI fall under the "open artery hypothesis" where the stunned peri-infarction zone after revascularization would restore blood supply and contractility. PURPOSE: To estimate the differences on the LV ejection fraction (LVEF), indexed LV end-systolic volume (iLVESV) and scar in patients with STEMI without viabilitity randomized to optimal medical therapy (OMT) alone or OMT and a late percutaneous coronary intervention (PCI) performed between 24 hours and 30 days after the event. METHODS: Patients with non-reperfused STEMI were evaluated from September 2021 to June 2022 at a tertiary cardiology hospital. The patients underwent Cardiac Magnetic Resonance (CMR) to assess myocardial viability and were classified as non-viable if they had only 1 wall segment with less than fifty percent thickness of the affected wall with late gadolinium enhancement. The patients were randomized to PCI or OMT alone. CMR was repeated at 6 months to evaluate LVEF, iLVESV and fibrosis. This summary presents a planned partial analysis of the 6-month results (N=51). Descriptive statistics analysis included central and dispersion estimators, or absolute and relative frequencies. To explore the differences between groups and time, Mann-Whitney and Wilcoxon tests were run, and results were given as point-estimates and confidence intervals at 95% (95% CI). A significance level of 5% was adopted for inferential analysis. RESULTS: 51 patients (60±11 years, 71% male) were included in the analysis. Of this total, 24 were randomized to PCI + OMT, and 27 to isolated OMT. The groups showed balanced distribution regarding clinical characteristics and initial CMR parameters (LVEF, iLVESV, and fibrosis). The difference in LVEF at the end of 6 months between the OMT and PCI groups was 2.07%, favoring the OMT group; however, this difference was not significant (p= 0.677, 95% CI: -5 to 10). Between the groups, the difference at the end of 6 months in iLVESV was -6.82 ml/m², also without statistical significance (p= 0.858, 95% CI: -19 to 11). There was a significant reduction in the amount of fibrosis in both PCI group with -14.68g (p= 0.011) and in the OMT group with -12.57g (p= 0.009). Detailed results are presented in Table 1. CONCLUSION: Despite a significant reduction in fibrosis in both groups, there was no superiority observed in late PCI compared to isolated OMT in reducing reverse remodeling and fibrosis in patients with non-viable STEMI when compared to isolated OMT.

Determinação do perfil fitoquímico de extrato com atividade antioxidante da espécie medicinal Cordia verbenacea DC. por HPLC-DAD / Phytochemical profile determination from extracts with antioxidant activity of the medicinal species of Cordia verbenacea DC. by HPLC-DAD

O presente trabalho teve por objetivo investigar a atividade antioxidante dos extratos das folhas de Cordia verbenacea obtido por maceração em etanol e partição em solventes orgânicos. O infuso das folhas também foi investigado. O teor de fenóis totais foi avaliado pelo método de Folin-Ciocalteau e o de flavonoides totais pela formação de complexo com cloreto de alumínio. O extrato etanólico, as subfrações e o infuso foram testados em diversas concentrações para determinar a atividade sequestradora de DPPH expressa em termos de sua CE50. A melhor atividade antioxidante encontrada foi para o extrato em acetato de etila, EA, CE50 15,0 ± 0,5 µg.mL-1. Os ensaios espectrofotométricos revelaram altas concentrações de fenóis e de flavonoides no extrato EA. A análise por HPLC-DAD foi realizada para se obter o perfil de UV-Vis dos picos cromatográficos do extrato EA. As características espectrais foram relacionadas a compostos fenólicos e flavonoídicos.

The objective of the present study was to investigate the antioxidant activity of extracts from Cordia verbenacea leaves obtained by maceration in ethanol and partitioned with organic solvents. The infusion of leaves was also investigated. The total phenolic and total flavonoid content was evaluated by the Folin-Ciocalteau method and by the aluminum chloride complex method, respectively. The ethanol extract, the subfractions and the infusion were assayed at various concentrations to determine the DPPH scavenging activity expressed in terms of CE50. The best antioxidant activity was found on the ethyl acetate extract, EA, CE50 15.0 ± 0.5 µg.mL-1. The spectrophotometric assays revealed high phenol and flavonoid concentrations on the EA extract. The HPLC-DAD analysis was performed to reveal the UV-Vis profile of the chromatographic peaks of the EA extract. The UV spectral characteristics were related to phenol and polyphenol compounds.

Comparative analysis of six different antibodies against Her2 including the novel rabbit monoclonal antibody (SP3) and chromogenic in situ hybridisation in breast carcinomas.

AIMS: To compare the sensitivity and specificity of new rabbit monoclonal antibody SP3 with those of mouse monoclonal and rabbit polyclonal antibodies using HER2 amplification defined by chromogenic in situ hybridisation (CISH) as the gold standard. METHODS: Serial sections from tissue microarrays (TMAs) containing 84 breast carcinomas were submitted to CISH (Zymed HER2 Spot-Light kit) and immunohistochemistry, using NeoMarkers SP3 (rabbit monoclonal), DAKO A0485 and DAKO HercepTest (polyclonal), Novocastra NCL-CB11, Cell Marque CM-CB11, and Genentech 4D5 (mouse monoclonal). RESULTS: The best antibody concordance was between SP3 and HercepTest (kappa = 0.74). SP3, A0485 and HercepTest detected all HER2 amplified tumours, but were less specific than mouse monoclonal antibodies. 3/38 (7.9%) and 8/38 (21.0%) non-amplified tumours were scored as 3+ using SP3 and A0485, respectively. 3/46 (6.5%) amplified tumours were negative for NCL-CB11. SP3, HercepTest and A0485 showed no gene amplification on 55%, 62.5% and 92.3% of the 2+ scored tumours, but most of the 2+ scored tumours using monoclonal antibodies were amplified by CISH (80-92.3%). CONCLUSIONS: SP3 is more sensitive than mouse monoclonal antibodies for Her2 assessment. However, HercepTest, CB11 and 4D5 show higher specificity than SP3 for the identification of HER2 gene amplification. Mouse monoclonal antibodies show less Her2 2+ tumours; most are amplified by CISH.

Microbiological analysis of water used in hydrotherapy

Water used in hydrotherapy units of Nova Iguaçu and Nilópolis, Rio de Janeiro State, Brazil, was microbiologically analyzed. Thirty samples (5ml each) were weekly collected from September 2001 to June 2002 before the beginning and after the end of activities in the units. For analysis, routine techniques were used, which showed the presence of Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Klebsiella spp, Candida spp, Penicillium spp, Epidermophyton spp, Aspergillus fumigatus, Aspergillus niger, Aspergillus spp, Cephalosporium spp, Cladosporium spp, Trichophyton rubrum, and Trichophyton spp. Results indicated a need for improving hygienic conditions, suggesting that water might be a contamination source in the evaluated units

Microbiological analysis of water used in hydrotherapy

Water used in hydrotherapy units of Nova Iguaçu and Nilópolis, Rio de Janeiro State, Brazil, was microbiologically analyzed. Thirty samples (5ml each) were weekly collected from September 2001 to June 2002 before the beginning and after the end of activities in the units. For analysis, routine techniques were used, which showed the presence of Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Klebsiella spp, Candida spp, Penicillium spp, Epidermophyton spp, Aspergillus fumigatus, Aspergillus niger, Aspergillus spp, Cephalosporium spp, Cladosporium spp, Trichophyton rubrum, and Trichophyton spp. Results indicated a need for improving hygienic conditions, suggesting that water might be a contamination source in the evaluated units.

Listeria monocytogenes in HIV-infected patients in a Hospital of Nova Iguaçu, Rio de Janeiro, Brazil

A survey was carried out in a hospital of Nova Iguaçu, Rio de Janeiro, Brazil, in the period from July 1999 to March 2002, to determine the infection rate of Listeria monocytogenes in HIV+ patients with diarrhea symptoms; 134 samples were processed by microbiological methods. The results demonstrated 12.68% of positive samples. However, no statistical differences were observed for age or sex in the studied group, suggesting that this microorganism should be regarded in the differential diagnosis of infectious processes in HIV+ patients in the area

Listeria monocytogenes in HIV-infected patients in a hospital of Nova Iguaçu, Rio de Janeiro, Brazil

A survey was carried out in a hospital of Nova Iguaçu, Rio de Janeiro, Brazil, in the period from July 1999 to March 2002, to determine the infection rate of Listeriamonocytogenes in HIV+ patients with diarrhea symptoms; 134 samples were processed by microbiological methods. The results demonstrated 12.68% of positive samples. However, no statistical differences were observed for age or sex in the studied group, suggesting that this microorganism should be regarded in the differential diagnosis of infectious processes in HIV+ patients in the area.

Snake envenomations in northwest counties of the Rio de Janeiro State, Brazil

The frequency of envenoming in Northwest counties of the Rio de Janeiro State, Brazil, from 1995 to 2000 was evaluated. Reports from the Municipal Secretariat of Health of these counties were used. The results demonstrated that, from 1997 to 1999, there was a shortage of notification, and 40 cases of envenomations caused by Bothrops snakes were registered. These cases were more common from February to October, and the lower limbs of male peasants were the mainly affected areas.(AU)

Listeria monocytogenes in HIV-infected patients in a hospital of Nova Iguaçu, Rio de Janeiro, Brazil

A survey was carried out in a hospital of Nova Iguaçu, Rio de Janeiro, Brazil, in the period from July 1999 to March 2002, to determine the infection rate of Listeriamonocytogenes in HIV+ patients with diarrhea symptoms; 134 samples were processed by microbiological methods. The results demonstrated 12.68% of positive samples. However, no statistical differences were observed for age or sex in the studied group, suggesting that this microorganism should be regarded in the differential diagnosis of infectious processes in HIV+ patients in the area.

Snake envenomations in northwest counties of the Rio de Janeiro State, Brazil

The frequency of envenoming in Northwest counties of the Rio de Janeiro State, Brazil, from 1995 to 2000 was evaluated. Reports from the Municipal Secretariat of Health of these counties were used. The results demonstrated that, from 1997 to 1999, there was a shortage of notification, and 40 cases of envenomations caused by Bothrops snakes were registered. These cases were more common from February to October, and the lower limbs of male peasants were the mainly affected areas.