When is the Best Time for the Second Antiplatelet Agent in Non-St Elevation Acute Coronary Syndrome?

Abstract Dual antiplatelet therapy is a well-established treatment in patients with non-ST elevation acute coronary syndrome (NSTE-ACS), with class I of recommendation (level of evidence A) in current national and international guidelines. Nonetheless, these guidelines are not precise or consensual regarding the best time to start the second antiplatelet agent. The evidences are conflicting, and after more than a decade using clopidogrel in this scenario, benefits from the routine pretreatment, i.e. without knowing the coronary anatomy, with dual antiplatelet therapy remain uncertain. The recommendation for the upfront treatment with clopidogrel in NSTE-ACS is based on the reduction of non-fatal events in studies that used the conservative strategy with eventual invasive stratification, after many days of the acute event. This approach is different from the current management of these patients, considering the established benefits from the early invasive strategy, especially in moderate to high-risk patients. The only randomized study to date that specifically tested the pretreatment in NSTE-ACS in the context of early invasive strategy, used prasugrel, and it did not show any benefit in reducing ischemic events with pretreatment. On the contrary, its administration increased the risk of bleeding events. This study has brought the pretreatment again into discussion, and led to changes in recent guidelines of the American and European cardiology societies. In this paper, the authors review the main evidence of the pretreatment with dual antiplatelet therapy in NSTE-ACS.

III - Contribuição para o estudo biológico e ecológico das Podostemaceae do salto do Piracicaba

1 - The Author, in this 3 thd. contribution, concludes the study of the biology and ecology of the species Tristicha trifaria (Willd.) Spreng. and Mourera aspera (Bong.) Tul., both of the Piracicaba Fall. 2 - According to the results of Dr. Peter van Royen (State Herbarium of Leiden, Holland), who made a complete revision of Podostemaceae of the Piracicaba Fall, the species Tristicha hypnoides (St. Hil.) Spreng. var. Hilarii Tul. and Mnioppsis Glazioviana Warm, correspond, respectively, to theTristicha trifaria (Willd.) Spreng. and Mniopsis weddelliana Tul. Apinagia Accorsii Toledo was transferred by Royen to the genus Wettsteiniola. So, its new name is Wettsteiniola accorsii (Toledo) v. Royen. 3 - Propagation by seeds may occur in the following places: a) placenta of partially open fruits; b) external and internal walls of the open capsules; c) pedicels of the fruits; d) remains of rhizomes, branches, etc. e) organic residues accumulated in water holes in the fall; f) clean rocks, in which the little groups of seedlings seems to be a colony of algae. Seeds adhere to the substrata above by means, of a mucilage produced by the transformation of the external integuments in contact with water. 4 - In the growth of the four species below it was found in Piracicaba Fall conspicuous zoning so scattered: a) Wettsteiniola accorsii (Toledo) v. Royen, in rocks situated just within the water fall, where velocity of the current and aeration of the water are very high. b) Tristicha trifaria (Willd.) Spreng. and Mniopsis weddelliana Tul., in rocks at some distance (100 m more or less) upstream until near the bridge across the river. c) Mourera aspera (Bong.) Tul., 300 m upwards the bridge. 5- During 1949, the ecological conditions of the Piracicaba Fall were changed due to the following factors: a) dry season very long, begining from last period of June until 30 november; b) stopping, during four months, of water from the Atibaia river (one of the components of Piracicaba river) near to the city of Americana, in the place where a new station of the Companhia Paulista de Força e Luz was build. In consequence, most of the Podostemaceae died. On the dry rocks there were only fruits and dried plants. 6 - Tristicha trifaria has the same biological and ecological behavior as the Mniopsis weddelliana,. 7 - The vegetative propagation of Tristicha trifaria is made by increasing of its branches, production of stolons with vegetatives buds and regeneration of old parts in especial conditions of water and aeration. 8 - Mourera aspera has the same vegetative propagation as the Wettsteiniola accorsii; it produces stolons (in very little percentage) with vegetative buds, branches of the rhizomes and regeneration of active old parts. 9 - Frequently, there is, on the plants an accumulation of sand, silt, loam, organic substances, and so on. The quantity of material stored depends of the purity of the water, of the morphology of the plants and of the situation on the fall. 10 - In extrem conditions of dry heat, the surviving of the species in its habitat depends exclusively from germination of seeds in the mentioned substrata. Exceptionally, some plants survive in a few water pockets full with the weak remaining current.

Plantae Utowanae. Plants collected in Bermuda, Porto Rico, St. Thomas, Culebras, Santo Domingo, Jamaica, Cuba, The Caymans, Cozumel, Yucatan and the Alacran shoals. Dec. 1898-Mar. 1899. The Antillean cruise of the yacht Utowana. Mr. Allison V. Armour, owner and master.

v.2:no.1(1900)

Plantae Utowanae. Plants collected in Bermuda, Porto Rico, St. Thomas, Culebras, Santo Domingo, Jamaica, Cuba, The Caymans, Cozumel, Yucatan and the Alacran shoals. Dec. 1898-Mar. 1899. The Antillean cruise of the yacht Utowana. Mr. Allison V. Armour, owner and master.

v.2:no.2(1900)

Efeitos da aplicação de P, B, Zn e calagem no teor de boro e zinco das folhas de mudas de Eucalyptus grandis (Hill, Ex-Maiden) cultivadas em solo de cerrado

Foi desenvolvido em casa de vegetação, na E. S.A."Luiz de Queiroz", em Piracicaba (SP), um experimento, utilizando-se Latossol Vermelho Amarelo, fase arenosa, originalmente sob vegetação de cerrado, do município de Itirapina (SP), cujo objetivo foi estudar os efeitos de níveis de fósforo (0, 16 e 32 ppm), boro (0, 2 e 4 ppm), zinco (0, 3 e 6 ppm) e calagem (0 e 6,0 g CaCO3 + 2,5 g MgCO3) por vaso no teor de micronutrientes de folhas de Eucalyptus grandis (Hill, Ex-Maiden). O delineamento experimental utilizado foi inteiramente casualizado num esquema fatorial 3³ na presença e ausência de calagem. Cada parcela foi constituída de um vaso contendo 8,0 kg de terra e duas plantas. As adubações com boro e zinco aumentaram as concentrações desses micronutrientes nas folhas das plantas. Verificou-se acúmulo de boro nos tecidos das folhas, em níveis considerados tóxicos, quan do se adicionou ao solo 2 e 4 ppm de boro. A calagem diminuiu as concentrações de zinco das folhas das plantas.

Efeitos da aplicação de fósforo, boro, zinco e calagem na altura e na produção de matéria seca em mudas de Eucalyptus grandis (Hill, Ex-Maiden) cultivadas em um solo de cerrado

Foi desenvolvido um experimento em casa de vegetação na Escola Superior de Agricultura "Luiz de Queiroz", em Piracicaba (SP) utilizando-se Latossol Vermelho Amarelo, fase arenosa, originalmente sob vegetação de cerrado, do município de Itirapina (SP), com o objetivo de estudar o efeito de três níveis de P (0, 16 e 32 ppm), três níveis de B (0, 2 e 4 ppm), tres níveis de Zn (0, 3 e 6 ppm) e dois níveis de calagem (0 e 6,0 g CaCO3 + 2,5 g MgC0(3)) por cada vaso no crescimento em altura e na produção de matéria seca de mudas de Eucalyptus grandis (Hill, Ex-Maiden). A adubação fosfatada, provocou aumento no crescimento em altura e na produção de matéria seca das plantas. A adição de 2 e 4 ppm de boro ao solo, provocou efeitos de interação com calagem, fósforo e zinco, ocasionando alterações no crescimento em altura das plantas. A adição de 3 e 6 ppm de zinco ao solo, ocasionou interação com o boro e fósforo adicionados, diminuindo o crescimento em altura das plantas.

Efeitos da aplicação de fósforo, boro, zinco e calagem no teor de macronutrientes das folhas de mudas de Eucalyptus grandis (Hill, Ex-Maiden) Cultivadas em solo de cerrado

Utilizando-se um Latossol Vermelho Amarelo fase arenosa, originalmente sob vegetação de Cerrado do município de Itirapina (SP), foi desenvolvido um experimento em vasos, em casa de vegetação, na E. S.A. "Luiz de Queiroz", em Piracicaba (SP), com a finalidade de se verificar o efeito da aplicação de níveis de P (0, 16 e 32 ppm), níveis de B (0, 2 e 4 ppm), níveis de Zn (0, 3 e 6 ppm) e níveis de calagem (0 e 6,0 g CaCO3 + 2,5 g MgCO3) por cada vaso, na concentração de N, P, K, Ca e Mg das folhas de mudas de Eucalyptus grandis (Hill, Ex-Maiden), A calagem e as adubações fosfatadas, com boro ou com zinco, alteraram as concentrações dos macronutrientes dos tecidos foliares das plantas.

Ripening of mango fruits. Competition of methods

Mangoes, cv. Imperial, were exposed, in post harvest, to the following methods of ripening: 1) sawdust burning; 2) alcohol vaporization; 3) calcium carbide (acetylene), 4) vapour of ethylene; and, 5) immersion in ethefon. All methods resulted in acceleration of ripening, when compared to controls. Calcium carbide, ethelene and ethefon were the best, methods. Alcohol vaporization also showed good results sawdust burning method showing low efficiency.

Effects of ethephon and urea on ripening of fruits and leaf abscission of coffee (Coffea arábica L.)

A field experiment was carried out to investigate the effects of ethephon and urea on ripening of fruits and leaf abscission of coffee plant. Ethephon (2-chloroethane phosphonic acid) sprays were applied to green Coffea arábica berries 26 days before counting date in concentrations of 0.5 and 0.25 ml/1 from Ethrel (240 a.i./l). The chemical accelerated the onset of fruit ripening at both concentrations. The efficacy of ethephon was increased adding urea. Ethephon 0.5 ml/1 promoted abscission of leaves and low concentration reduced shedding of leaves. The treatments did not affect the growth and production on the next harvest.

Growth and exportation of nutrients by apple fruits

In order to obtain informations concerning the dry matter production and extraction of nutrients by the fruits of the varieties 'Ohio Beauty' and 'Brasil', a trial was conducted on a Latossol Vermelho Escuro-Orto (USTOX) at Buri , State of São Paulo, Brazil. The fruits were collected from trees grafted on 'Doucin' being 1-2; 3-4; 4-5, and 6-7 years old. Chemical analysis were run on the fruits for: N, P, K, Ca, Mg, S, B, Cu, Fe, Mn, Zn, and Mo; as well for the dry mat ter production. The main conclusions are as follows: a) differences were observed on dry matter production of fruits by the two varieties at the different stages of growth; b) differences were observed on exportation of nutrients between the two varieties concerning the fruit growth period- the nutrient exportation by the fruits obeyed following order: K>N>P>S>Ca>Mg>Fe>B > Cu > Mn > Zn > Mo.

Concentration of nutrients in the apple fruits at different ages

On an apple grove situated at Buri, State of São Paulo, fruits were collected from trees 1-2; 3-4; 4-5, and 6 - 7 years old. The fruits were analysed for N, P, K, Ca, Mg, S, B, Cu, Fe, Mn and Zn. The authors concluded: a) the concentrations of the nutrients in the fruits differ according to the variety, age of the tree and age of the fruit; b) the concentrations of nutrients decrease with aging of the fruits; c) the concentrations of the macronutrients obey the following order: N>K>P>Ca>S> Mg; d) for the micronutrients, the following order was ob -served: Fe > B > Mn > Cu > Zn.

Biologia de Glena unipennaria unipennaria (Guenée, 1857) (Lepidoptera, Geometridae) em folhas de Eucalyptus grandis (Hill) Maiden

Este trabalho trata do estudo da biologia de Glena unipennaria unipennaria (Guenée, 1857) (Lepidoptera, Geometridae), cujas lagartas são desfolhadoras e consideradas como praga de grande importância econômica, em povoamentos homogêneos e implantados de Eucalyptus spp. (Myrtaceae), no Brasil. Os insetos foram criados em condições de laboratório (temperatura 25±3°C; UR:70±10; fotoperíodo de 12 horas), no Laboratório de Controle Biológico, do Departamento de Entomologia, da Escola Superior de Agricultura "Luiz de Queiroz"-USP, em Piracicaba, SP, em 1978. As lagartas foram alimentadas, exclusivamente, com folhas de Eucalyptus grandis (Hill) Maiden. Foram estudados os seguintes parâmetros: período e viabilidade das fases de ovo, lagarta (exceto viabilidade), pré-pupa; número e duração dos ínstares larvais e consumo foliar na fase larval; longevidade dos a dultos e proporção quanto ao sexo. Medidas lineares foram tomadas das cápsulas cefálicas das lagartas, comprimento e maior largura das pupas e envergadura das asas anteriores dos adultos. Aspectos relacionados com o comportamento e morfologia externa também foram observados.

Autumn flowers and fruits / by J. Francis Macbride, Asst. Curator, Taxonomy, Dept. of Botany.

no.10(1924)

Tropical and subtropical fruits / by B. E. Dahlgren, Curator Emeritus, Dept. of Botany, Drawings by Albert Frey.

no.26(1947)