First- Versus Second-Generation Drug-Eluting Stents in Acute Coronary Syndromes (Katowice-Zabrze Registry)

Abstract Background: There are sparse data on the performance of different types of drug-eluting stents (DES) in acute and real-life setting. Objective: The aim of the study was to compare the safety and efficacy of first- versus second-generation DES in patients with acute coronary syndromes (ACS). Methods: This all-comer registry enrolled consecutive patients diagnosed with ACS and treated with percutaneous coronary intervention with the implantation of first- or second-generation DES in one-year follow-up. The primary efficacy endpoint was defined as major adverse cardiac and cerebrovascular event (MACCE), a composite of all-cause death, nonfatal myocardial infarction, target-vessel revascularization and stroke. The primary safety outcome was definite stent thrombosis (ST) at one year. Results: From the total of 1916 patients enrolled into the registry, 1328 patients were diagnosed with ACS. Of them, 426 were treated with first- and 902 with second-generation DES. There was no significant difference in the incidence of MACCE between two types of DES at one year. The rate of acute and subacute ST was higher in first- vs. second-generation DES (1.6% vs. 0.1%, p < 0.001, and 1.2% vs. 0.2%, p = 0.025, respectively), but there was no difference regarding late ST (0.7% vs. 0.2%, respectively, p = 0.18) and gastrointestinal bleeding (2.1% vs. 1.1%, p = 0.21). In Cox regression, first-generation DES was an independent predictor for cumulative ST (HR 3.29 [1.30-8.31], p = 0.01). Conclusions: In an all-comer registry of ACS, the one-year rate of MACCE was comparable in groups treated with first- and second-generation DES. The use of first-generation DES was associated with higher rates of acute and subacute ST and was an independent predictor of cumulative ST.

Fertilizer policy in the developing countries: the case of Brazil

This paper deals initially with the role of mineral fertilizers in increasing agricultural production: the relationship between the two variables is illustrated within global, regional national and local contexts. The pattern and trends in fertilizer usage in Brazil are presented next, namely: increase in consumption in the period 1950/72; regional distribution; consumption as related to crops and cultivated land. It is shown that in less than a quarter or century fertilizer use has increased in the country nearly 12 fold, whereas world consumption was raised 7 fold, thus exceeding estimates based in several criteria. Steps taken to secure the raise in fertilizer consumption above the historical trend are discussed: research experience for outlining fertilization recomendations; the transfer of the knowledge to the farmer by the extension work both official and private; the credit policy and special incentives for the purchase of fertilizer; the national policy for minumum proces of agricultural products; the implantation of a national fertilizer industry. It is considered that the Brazilian experience adapted to similar local conditions in other developing countries, presents a possibility for achieving beneficial results without inflationary reflexes in the economy.

Taxonomy of Epyris (Hymenoptera, Bethylidae) from Paraná, Brazil

Epyris rotundus sp. nov. and Epyris cochlear sp. nov., from southern Brazil, are described and illustrated. Epyris longus Corrêa & Azevedo, 2002, E. argentinicus Evans, 1969, E. angustatus Evans, 1969, E. perpolitus Evans, 1969, E. parallelus Evans, 1969, E. distinctus Corrêa & Azevedo, 2002, E. variatus Corrêa & Azevedo, 2002, E. jugatus Evans, 1969, E. intermedius Evans, 1969 and E. depressigaster Evans, 1966 are recorded for the first time to Paraná, Brazil.

Trophic ecology of Lontra longicaudis (Carnivora, Mustelidae) in lotic and semilotic environments in southeastern Brazil

Lontra longicaudis (Olfers, 1818) (Carnivora, Mustelidae) is a semi-aquatic animal spread through the Central and South America, except in Chile. The implantation of a hydroelectric power plant along a river alters the dynamics of the watercourse, transforming a lotic environment into a lentic or semilotic one, what can damage the otter's feeding. From April 2008 to March 2009 we analysed the otter's food habits in lotic (streamlet) and semilotic (hydroelectric reservoir) environments of Paranapanema Valley, in southeastern Brazil. Aiming to compare the otter's diet of these two environments, we analyzed statistically the frequency of occurrence of main items in the scats. Fishes represent the base of the diet both in the reservoir and in the streamlet and, despite of the total otter's diet showing up similarities in the two environments, the results evidenced modifications on the fish species consumed between them. In the reservoir the otters ate more exotic fish Oreochromis niloticus (Linnaeus, 1758) probably because it is an easy capture prey in this place. The fact that the otters get established and feed in the reservoir doesn't mean that this structure is benefic to the species because the food supplied for it consists mainly of exotic fish species.

Influence of mucin on the metabolism of pnemococcus

1. The appearance of meta-hemoglobin in pneumococcus cultures in blood media must be consequential to the formation of hydogen peroxide, according to the observation of several authors as well as of our own. 2. We emphasize the rôle of mucin in the production of hydrogen peroxide by pneumococcus, a circumstance which has been neglected by the authors who dealt with the matter. 3. In the metabolism of pneumococcus, the existence or formation of mucin is necessary for the maintenance of certain biological properties of the germ. 4. In cultures media containing blood and mucin, the production of meta-hemoglobin by pneumococcus is much larger than in those which contain no mucin. 5. We venture the hypothesis that mucin plays a very important rôle in the implantation of pneumonia, as in the periods preceeding this disease theres is an increase of bronchial secretion, and this secretion is almost entirely constintuted by mucin. 6. Mucin increases the pathogenic power of pneumococcus in mice according to the studies of several authors, which comes to favour our hypothesis.

Evolution of sarcoma 180 in mice treated with hyperchlorinated water

Mice treated with hyperchlorinated water (50 ppm of chlorine) and control mice, drinking tap water (1-3 ppm of chlorine) were inoculated with 2.5 x 10 [raised to the power of 6] sarcoma 180 cells, by intraperitoneal route. Tumor evolution was measured by enumeration of tumor cells in peritoneal cavity and by evaluation of weight gain at different time intervals after tumor implantation. In mice treated with excessive amounts of chlorine there was enhancement of tumor growth demonstrated by: (a) shorter incubation period and increased weight gain (ascites formation) after tumor implantation; (b) increased number of tumor cells in the peritoneal cavity 2, 3 and 4 days after tumor challenge. The number of peritoneal cells exsudated after tumor implantation was lower in mice treated with hyperchlorinated water than in controls. The tumor enhancement observed after excessive chlorine ingestion would be due to: (a) reduction of the number of peritoneal macrophages that migrate to the peritoneal cavity and (b) reduction of the tumoricidal capacity of peritonela macrophages induced by the direct effect of chlorine or by the reduction of the amount of endogenous endotoxins due to the bactericidal effect of chlorine.

Helmintofauna de cavalas, Scomber japonicus Houtt, do Rio de Janeiro

Os autores identificaram as seguintes espécies de helmintos, coletados de 50 cavalas, Scomber japonicus, no Rio de Janeiro: Kuhnia scombri (Kuhn, 1829) e Grubea cochlear (Diesing, 1858) (Monogenea); Opechona orientalis (Layman, 1930), Lecithocladium harpodontis Srivastava, 1942 e Nematobothrium scombri (Taschenberg, 1879) (Digenea); plerocercos de Trypanorhyncha Scolex pleuronectis Müller, 1788 e Rhinebothrium sp. (Cestoda); Bolbosoma sp. (Acanghocephala) e Anisakidae larvares (Nematoda), identificados aos tipos larvares Raphidascaris, Phocanema, Contracaecum e Anisakis tipo 1. Os digenéticos foram os de maior incidência, 84% dos peixes mostraram-se parasitados por uma ou mais espécies. Quanto às espécies, a de maior incidência foi Nematobothrium scombri (Digenea, Didymozoidae), em 46% dos peixes. São pela primeria vez assinalados Scomber japonicus larvas de Phillobothiidae, possivelmente Rhinebothrium, além de larvas de Anisakis do tipo 1. São pela primeira vez assinaladas no Brasil as espécies, Grubea cochlear, Kuhnia scombri, Nematobothrium scombri e Opechona orientalis.

Helminofauna da sarda (Scomber scombrus L. ) peixe da Costa Continental Portuguesa

Dos primerios 80 espécimens da sarda examinados (de janeiro a maio de 1982), apenas seis (7,5%) estavam livres de helmintos, apresentando os demais as espécies de parasitos seguintes, por ordem de freqüência dentro de cada grupo taxonômico: Kuhnia scombri (Kuhn, 1829) e Grubea cochlear (Diesing, 1858) (classe Monogenea); Lecithocladium excisum (Rudolph, 1819) e Opechona basillaris (Molin, 1859)(classe Digenea); pelrocercoides de Lacistrorhynchus tenuis (Beneden, 1858) de Scolex pleuronectis (Muller, 1788) e de Echeneibothrium sp. (classe Cestoda); Rhadinorhynchus tenuicornis (Linton, 1891) (filo Acanthocephala); formas dos tipos larvares Anisakis e Contracaecum e ainda, larvas de Goezia sp. (classe Nematoda). São referidas, pela primeira vez, neste hospedeiro, formas larvares do cestóide Echeneibothrium sp. e do nematóide Goezia sp.

Laboratory and Field Evaluation of Biodegradable Polyesters for Sustained Release of Isometamidium and Ethidium

An overview is presented of the results obtained with biodegradable sustained release devices (SRDs) containing a mixture of polymers and either isometamidium (ISMM) or ethidium. Under controlled laboratory conditions (monthly challenge with tsetse flies infected with Trypanosoma congolense) the protection period in SRD treated cattle could be extended by a factor 2.8 (for ethidium) up to 4.2 (for ISMM) as compared to animals treated intramuscularly with the same drugs. Using a competitive drug ELISA ISMM concentrations were detected up to 330 days after the implantation of the SRDs, whereas after i.m. injection the drug was no longer present three to four months post treatment. Two field trials carried out in Mali under heavy tsetse challenge showed that the cumulative infection rate was significantly lower in the ISMM-SRD implanted cattle than in those which received ISMM intramuscularly. Using ethidium SRD, however, contradictory results were obtained in field trials in Zambia and in Mali. The potential advantages and inconvenients of the use of SRDs are discussed and suggestions are made in order to further improve the currently available devices.

Surgical hepatosplenic mansonic schistosomiasis in adolescents: repercussions of the post-treatment schistosomotic burden on the hepatic functional reserve

Schistosomiasis mansoni affects the hepatic functional reserve. Clinical treatment with oxamniquine is not 100% effective and there has been found strain of this parasite resistant to this drug. The aims of this investigation were: (1) to examine the presence of residual parasite burden after medical and surgical treatment on adolescents with surgical schistosomiasis mansoni and (2) to assess the effect on the hepatic functional reserve in patients with and without residual infection. Twenty nine children with hepatosplenic schistosomiasis mansoni and bleeding esophageal varices were treated with oxamniquine. They underwent splenectomy, ligature of the left gastric vein and autologous implantation of spleen tissue into the greater omentum. After a mean post-operative follow up of five years they underwent rectal biopsy for schistosomotic egg search. They were divided in patients with and without infection. In 20 patients the submucosal egg search was negative, however, in 9 it was positive. The hepatic functional reserve in the patients without infection was as follows: 17 were Child-Pugh A and 3 Child-Pugh B. In the patients who were still infected 6 were Child-Pugh A and 3 Child-Pugh B. The chi2 analysis of the hepatic functional reserve showed chi2 = 3.19 - p= 0.07. From the results the following conclusion can be drawn: residual infection or reinfection in the follow up period had not interfered with the distribution of the hepatic functional reserve of the patients in this series. However, there was a trend for a decrease of this parameter in patients with residual infection.

Autotransplant of spleen tissue in children with schistosomiasis: evaluation of splenic function after splenosis

Autotransplantation of spleen tissue has been done, in the past ten years, in children with schistosomiasis mansoni with bleeding varices. The purposes of this investigation were: (1) to study the morphology and function of the remnant spleen tissue; (2) to quantify the production of tuftsin; and (3) to assess the immune response to pneomococcal vaccine of these patients. Twenty three children, who underwent splenectomy and autologous implantation of spleen tissue into the greater omentum were included in this investigation. The average postoperative follow-up is five years. Splenosis was proved by colloid liver-spleen scans. Search for Howell-Jolly bodies assessed the filtration function. Tuftsin and the titer of pneumococcal antibodies were quantified by ELISA. Splenosis was evident in all children; however, it was insufficient in two. Howell-Jolly bodies were found only in these two patients. The mean tuftsin serum concentration (335.0 ± 29.8 ng/ml) was inside the normal range. The immune response to pneumococcal vaccination was adequate in 15 patients; intermediate in four; and inadequate in four. From the results the following conclusions can be drawn: splenosis was efficient in maintaining the filtration splenic function in more than 90% and produced tuftsin inside the range of normality. It also provided the immunologic splenic response to pneumococcal vaccination in 65% of the patients of this series.