A comparative analysis of primary stenting and optimal balloon coronary angioplasty in acute myocardial infarction. Six month results from the STENT PAMI trial

OBJECTIVE: To compare the outcome of balloon PTCA with final coronary stenosis diameter (SD) <=30%, with elective coronary stenting. METHODS: We performed a comparative analysis of the 6 month outcomes in patients treated with primary stenting and those who obtained an optimal balloon PTCA result treated during the first 12 hours of AMI onset included in the STENT PAMI randomized trial. RESULTS: The results were analysed into 3 groups: primary stenting (441 patients, SD=22±6%), optimal PTCA (245 patients), and nonoptimal PTCA (182 patients, SD= 37±5%). At the end of the 6 months primary stent group presented with the lowest restenosis(23 vs. 31 vs. 45%, p=0.001, respectively). Ischemia-driven target vessel revascularization rate (TVR) (7 vs. 15.5 vs. 19%, p=0.001, respectively). CONCLUSION: At the 6 month follow-up, primary stenting offered the lowest restenosis and ischemia-driven TVR rates. Compared to optimal balloon PTCA. Nonoptimal primary balloon PTCA pts (SD=31-50%), had the worst late angiographic outcomes and should be treated more actively with coronary stent implantation.

The use of primary stenting or balloon percutaneous transluminal coronary angioplasty for the treatment of acutely occluded saphenous vein grafts. Results from the Brazilian National Registry - CENIC

OBJECTIVE: We conducted a comparative analysis of the in-hospital outcomes of patients who underwent primary percutaneous transluminal angioplasty (PTCA) or stent implantation because of an acute myocardial infarction (AMI) related to an acute vein graft occlusion. METHODS: Since 1991 the Brazilian Society of Hemodynamic and Interventional Cardiology has maintained a large database (CENIC). From these, we selected all consecutive patients, who underwent primary PTCA or stenting in the first 24 hours of AMI, with the target vessel being an occluded vein graft. Immediate results and major coronary events occurring up until hospital discharge were analyzed. RESULTS: During this period, 5,932 patients underwent primary PTCA or stenting; 158 (3%) of the procedures were performed because of an acute vein graft occlusion. Stenting was performed in 74 (47%) patients. Patients treated with stents had a higher success rate and lower mean residual stenosis compared with those who underwent primary balloon PTCA. The incidence of reinfarction and death were similar for stenting and balloon PTCA. CONCLUSION: Primary percutaneous treatment of AMI related to acute vein graft occlusion is still an uncommon practice. Primary stenting improved luminal diameter and offered higher rates of success; however, this strategy did not reduce the in-hospital reinfarction and death rate, compared with that occurring with PTCA treatment.

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery: Report of an Adult Case

We report the clinical findings, pathophysiology, diagnostic characteristics, and surgical repair of anomalous origin of the left coronary artery from the pulmonary artery in a 26-year-old female patient with a clinical diagnosis of coronary heart disease.

Anomalous origin of the left pulmonary artery from the ascending aorta: successful surgical correction in an infant with fallot's tetralogy

We describe the case of a 40-day-old female patient with a history of breathlessness since birth who was referred to our hospital for surgical correction of common arterial trunk. The invasive investigation disclosed a Fallot¢s tetralogy anatomy associated with an anomalous origin of the left pulmonary artery from the ascending aorta. Immediately after diagnosis, the patient underwent a successful total surgical correction of the defect, including simultaneous anastomosis of the left pulmonary artery to the pulmonary trunk.

Anomalous origin of the left coronary artery from the pulmonary trunk in a 45-year-old woman

We report a rare case of anomalous origin of the left coronary artery from the pulmonary trunk in a 45-year-old woman. The approach and technique used for selective catheterization of an anomalous left coronary artery arising from the pulmonary trunk are described. Six years after diagnosis, echocardiography showed left ventricular disfunction, and surgical treatment was indicated again. The origin of the left coronary artery from the pulmonary trunk was closed, and the postoperative period was uneventful, with recovery of left ventricular function and disappearance of ischemic features on stress myocardial perfusion imaging with 99m Tc-sestamibi, performed 4 weeks after surgery.

Acute Coronary Syndrome Treatment Costs from the Perspective of the Supplementary Health System

AbstractBackground:Acute coronary syndrome (ACS) is defined as a “group of clinical symptoms compatible with acute myocardial ischemia”, representing the leading cause of death worldwide, with a high clinical and financial impact. In this sense, the development of economic studies assessing the costs related to the treatment of ACS should be considered.Objective:To evaluate costs and length of hospital stay between groups of patients treated for ACS undergoing angioplasty with or without stent implantation (stent+ / stent-), coronary artery bypass surgery (CABG) and treated only clinically (Clinical) from the perspective of the Brazilian Supplementary Health System (SHS).Methods:A retrospective analysis of medical claims of beneficiaries of health plans was performed considering hospitalization costs and length of hospital stay for management of patients undergoing different types of treatment for ACS, between Jan/2010 and Jun/2012.Results:The average costs per patient were R$ 18,261.77, R$ 30,611.07, R$ 37,454.94 and R$ 40,883.37 in the following groups: Clinical, stent-, stent+ and CABG, respectively. The average costs per day of hospitalization were R$ 1,987.03, R$ 4,024.72, R$ 6,033.40 and R$ 2,663.82, respectively. The average results for length of stay were 9.19 days, 7.61 days, 6.19 days and 15.20 days in these same groups. The differences were significant between all groups except Clinical and stent- and between stent + and CABG groups for cost analysis.Conclusion:Hospitalization costs of SCA are high in the Brazilian SHS, being significantly higher when interventional procedures are required.

The phosphate fixing capacities of two soils from the Piracicaba municipality: latosol and sands

An essay was carried out under laboratory conditions in order to know the phosphate fixing capcity of a Latosol and a Sands from the municipality of Piracicaba, State of São Paulo, Brazil. The results showed that they were able to fix about 1,588 and 274 kg/ha of P2O5> respectively.

A new species of Ibitermes (Isoptera, Termitidae) from the Atlantic forest, northeastern Brazil

The sterile castes of Ibitermes inflatus sp. nov. from Rio Tinto, State of Paraíba, Brazil are described and illustrated. This is the first record of a species of Ibitermes from the Brazilian northeast and from the Atlantic Forest biome. The absence of ridges in the molar plate of the left mandible and the presence of granules of sand and silt mixed with organic matter in advanced stage of decomposition in the digestive tube of workers suggest that the species is a typical humus feeding termite.

Planktonic ciliates Choreotrichida and Strombidiida from the inner zone of Bahía Blanca Estuary, Argentina

Seven species of aloricate planktonic ciliates were identified using protargol staining. Choreotrichida: Strombidinopsidae, Strombidinopsis elongata Song & Bradbury, 1998; Strobiliidae, Strobilidium epacrum Lynn & Montagnes, 1988 and Strombidiida: Strombidiidae, Strombidium capitatum (Leegaard, 1915) Kahl, 1932; S. emergens (Leegaard, 1915) Kahl, 1932; S. acutum Leegaard, 1915; S. dalum Lynn, Montagnes & Small, 1988 and Cyrtostrombidium longisomum Lynn & Gilron, 1993; they were collected from the inner zone of the Bahía Blanca estuary in the southern region of the Buenos Aires province, Argentina. These species represent new records to South America (Argentina).

Abundance and species composition of planktonic Ciliophora from the wastewater discharge zone in the Bahía Blanca Estuary, Argentina

The specific composition and abundance variation of the ciliate community from a wastewater discharge zone in the Bahía Blanca estuary, Argentina, were studied all throughout a year, from June 1995 to May 1996. The polluted area exhibited high values of particulate organic matter and nutrients, particularly phosphates. Aloricate ciliates were represented by 15 species belonging to the genera Strombidium Claparède & Lachmann, 1859; Strombidinopsis Kent, 1881; Cyrtostrombidium Lynn & Gilron, 1993; Strobilidium Schewiakoff, 1983; Lohmmanniella Leegaard, 1915 and Tontonia Fauré-Fremiet, 1914. Tintinnids were represented by nine species belonging to the genera Tintinnidium Kent, 1881, Tintinnopsis Stein, 1867 and Codonellopsis Jörgensen, 1924. The total abundance of aloricate ciliates reached a peak of 1,800 ind. 1-1 and the total abundance of tintinnids reached a peak of 9,400 ind. 1-1. Tintinnidium balechi Barría de Cao, 1981 was the most abundant ciliate in the community. Considerations on the presence and abundance of ciliates are made in relation to physicochemical and biochemical parameters.

Species of Terebellides (Polychaeta, Terebellidae, Trichobranchinae) from the Brazilian coast

Terebellides sepultura sp. nov. is described from the continental shelf bottoms off southern Brazil. Terebellides carmenensis Solis-Weiss, Fauchald & Blankensteyn, 1991 is newly recorded for the Brazilian coast and notes on T. anguicomus F. Müller, 1858 and T. klemani Kinberg, 1867 are provided. A key to 28 species of Terebellides is given.