Intervenção coronária percutânea utilizando Full Metal Jacket com stents farmacológicos: eventos cardíacos adversos maiores em um ano

FUNDAMENTO: O benefício clínico de intervenção coronária percutânea (ICP) para lesões coronárias longas é incerto; além disso, foram levantadas dúvidas questões sobre a sua segurança. OBJETIVO: Avaliar os preditores de eventos cardíacos adversos maiores (ECAM) associados à ICP utilizando Full Metal Jacket (FMJ), definido como a sobreposição de stents farmacológicos (SF) medindo >60 mm de comprimento, para lesões muito longas. MÉTODOS: Foram incluídos 136 pacientes consecutivos com lesões coronárias longas, requerendo FMJ em nosso cadastro de centro único. O desfecho primário incluiu a ocorrência combinada de todas as causas de morte, infarto do miocárdio (IM) e revascularização do vaso alvo (RVA). Variáveis demográficas, clínicas, angiográficas e de procedimento foram avaliadas por meio de análise de regressão de Cox para determinar os preditores independentes de desfecho. RESULTADOS: O comprimento médio do stent por lesão foi de 73,2 ± 12,3 mm e o diâmetro médio do vaso de referência foi de 2,9 ± 0,6 mm. O sucesso angiográfico foi de 96,3%. A ausência de ECAM foi de 94,9% em 30 dias e 85,3% em um ano. No acompanhamento de um ano, a taxa de mortalidade por todas as causas foi de 3,7% (1,5% por mortes cardíacas), a taxa de IM foi de 3,7%, e a incidência de trombose de stent (TS) definitiva ou provável foi de 2,9%. O gênero feminino [risco relativo (RR), 4,40; intervalo de confiança de 95% (IC), 1,81-10,66, p = 0,001) e ICP de artéria coronária não direita (RR, 3,49; p = 0,006; IC 95%, 1,42-8,59) foram preditores independentes de ECAM em um ano. A ausência de eventos adversos em um ano foi maior em pacientes com angina estável submetidos à ICP (RR, 0,33; IC 95% 0,13-0,80, p = 0,014). CONCLUSÕES: A ICP utilizando FMJ com SF para lesões muito longas foi eficaz, mas associada a uma alta taxa de TS em acompanhamento de um ano. No entanto, a taxa de mortalidade cardíaca, IM não relacionado a procedimento, e ECAM foi relativamente baixa. ICP de vaso coronário alvo, apresentação clínica, e gênero feminino são novos fatores clínicos contemporâneos que parecem apresentar efeitos adversos sobre o resultado da ICP utilizando FMJ para lesões longas.

On boundary value problems for Willmore surfaces and Hartree-Fock theory of pseudo-relativistic atoms

Magdeburg, Univ., Fak. für Mathematik, kumulative Habil.-Schr., 2011

Long-term Outcomes of Drug-eluting versus Bare-metal stent for ST-elevation Myocardial Infarction

Background:Long-term outcomes of drug-eluting stents (DES) versus bare-metal stents (BMS) in patients with ST-segment elevation myocardial infarction (STEMI) remain uncertain.Objective:To investigate long-term outcomes of drug-eluting stents (DES) versus bare-metal stents (BMS) in patients with ST-segment elevation myocardial infarction (STEMI).Methods:We performed search of MEDLINE, EMBASE, the Cochrane library, and ISI Web of Science (until February 2013) for randomized trials comparing more than 12-month efficacy or safety of DES with BMS in patients with STEMI. Pooled estimate was presented with risk ratio (RR) and its 95% confidence interval (CI) using random-effects model.Results:Ten trials with 7,592 participants with STEMI were included. The overall results showed that there was no significant difference in the incidence of all-cause death and definite/probable stent thrombosis between DES and BMS at long-term follow-up. Patients receiving DES implantation appeared to have a lower 1-year incidence of recurrent myocardial infarction than those receiving BMS (RR = 0.75, 95% CI 0.56 to 1.00, p= 0.05). Moreover, the risk of target vessel revascularization (TVR) after receiving DES was consistently lowered during long-term observation (all p< 0.01). In subgroup analysis, the use of everolimus-eluting stents (EES) was associated with reduced risk of stent thrombosis in STEMI patients (RR = 0.37, p=0.02).Conclusions:DES did not increase the risk of stent thrombosis in patients with STEMI compared with BMS. Moreover, the use of DES did lower long-term risk of repeat revascularization and might decrease the occurrence of reinfarction.

Spectral Analysis Related to Bare-Metal and Drug-Eluting Coronary Stent Implantation

Background: The autonomic nervous system plays a central role in cardiovascular regulation; sympathetic activation occurs during myocardial ischemia. Objective: To assess the spectral analysis of heart rate variability during stent implantation, comparing the types of stent. Methods: This study assessed 61 patients (mean age, 64.0 years; 35 men) with ischemic heart disease and indication for stenting. Stent implantation was performed under Holter monitoring to record the spectral analysis of heart rate variability (Fourier transform), measuring the low-frequency (LF) and high-frequency (HF) components, and the LF/HF ratio before and during the procedure. Results: Bare-metal stent was implanted in 34 patients, while the others received drug-eluting stents. The right coronary artery was approached in 21 patients, the left anterior descending, in 28, and the circumflex, in 9. As compared with the pre-stenting period, all patients showed an increase in LF and HF during stent implantation (658 versus 185 ms2, p = 0.00; 322 versus 121, p = 0.00, respectively), with no change in LF/HF. During stent implantation, LF was 864 ms2 in patients with bare-metal stents, and 398 ms2 in those with drug-eluting stents (p = 0.00). The spectral analysis of heart rate variability showed no association with diabetes mellitus, family history, clinical presentation, beta-blockers, age, and vessel or its segment. Conclusions: Stent implantation resulted in concomitant sympathetic and vagal activations. Diabetes mellitus, use of beta-blockers, and the vessel approached showed no influence on the spectral analysis of heart rate variability. Sympathetic activation was lower during the implantation of drug-eluting stents.

Simulation of metal quenching processes for the minimization of distortion and stresses

Quenching process, TRIP, J2-plasticity theory, phase transition, distortion

Influence of water quality and kind of metal in the secondary cooling zone of casting process

Magdeburg, Univ., Fak. für Verfahrens- und Systemtechnik, Diss., 2012

Growth of semi-polar GaN on high index silicon (11h) substrates by metal organic vapor phase epitaxy

Magdeburg, Univ., Fak. für Naturwiss., Diss., 2014

Cytochemical characterization of gill and hepatopancreatic cells of the crab Ucides cordatus (Crustacea, Brachyura) validated by cell metal transport

Ucides cordatus (Linnaeus, 1763) is a hypo-hyper-regulating mangrove crab possessing gills for respiratory and osmoregulatory processes, separated in anterior and posterior sections. They also have hepatopancreas, which is responsible for digestion and absorption of nutrients and detoxification of toxic metals. Each of these organs has specific cells that are important for in vitro studies in cell biology, ion and toxic metals transport. In order to study and characterize cells from gills and hepatopancreas, both were separated using a Sucrose Gradient (SG) from 10 to 40% and cells in each gradient were characterized using the vital mitochondrial dye DASPEI (2-(4-dimethylaminostyryl)-N- ethylpyridinium iodide) and Trichrome Mallory's stain. Both in 20 and 40% SG for gill cells and 30% SG for hepatopancreatic cells, a greater number of cells were colored with DASPEI, indicating a larger number of mitochondria in these cells. It is concluded that the gill cells present in 20% and 40% SG are Thin cells, responsible for respiratory processes and Ionocytes responsible for ion transport, respectively. For hepatopancreatic cells, the 30% SG is composed of Fibrillar cells that possess larger number of membrane ion and nutrient transporters. Moreover, the transport of toxic metal cadmium (Cd) by isolated hepatopancreatic cells was performed as a way of following cell physiological integrity after cell separation and to study differences in transport among the cells. All hepatopancreatic cells were able to transport Cd. These findings are the first step for further work on isolated cells of these important exchange epithelia of crabs, using a simple separation method and to further develop successful in vitro cell culture in crabs.

On an upper bound for the arithmetic self-intersection number of the dualizing sheaf on arithmetic surfaces

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Intersection Pairing and intersection motive of surfaces

We construct the Chow motive modelling intersection co-homology of a proper surface. We then study its functoriality properties. Using Murre's decompositions of the motive of a desingularization into KÄunneth components [Mr1], we show that such decompositions exist also for the intersection motive.

Pure motives, mixed motives and extensions of motives associated to singular surfaces

We first recall the construction of the Chow motive modelling intersection cohomology of a proper surface X and study its fundamental properties. Using Voevodsky's category of effective geometrical motives, we then study the motive of the exceptional divisor D in a non-singular blow-up of X. If all geometric irreducible components of D are of genus zero, then Voevodsky's formalism allows us to construct certain one-extensions of Chow motives, as canonical subquotients of the motive with compact support of the smooth part of X. Specializing to Hilbert-Blumenthal surfaces, we recover a motivic interpretation of a recent construction of A. Caspar.

Random graphs on surfaces

Counting labelled planar graphs, and typical properties of random labelled planar graphs, have received much attention recently. We start the process here of extending these investigations to graphs embeddable on any fixed surface S. In particular we show that the labelled graphs embeddable on S have the same growth constant as for planar graphs, and the same holds for unlabelled graphs. Also, if we pick a graph uniformly at random from the graphs embeddable on S which have vertex set {1, . . . , n}, then with probability tending to 1 as n → ∞, this random graph either is connected or consists of one giant component together with a few nodes in small planar components.

A simple method for assessing the binding of concanavalin A to mononuclear cell surfaces: no interference of visceral leishmaniasis serum on this binding

We report a simple method for evaluating the binding of concanavalin A (ConA) to human peripheral blood mononuclear cells (PBMC). The binding is evidenced by an immunoenzymic assay using peroxidase-conjugated immunoglobulins of a rabbit anti-ConA serum. Using the method we show that sera from patients with American leishmaniasis do not interfere with binding of ConA to PBMC.

Role of secretory immunoglobulin A and secretory component in the protection of mucosal surfaces.

The contribution of secretory immunoglobulin A (SIgA) antibodies in the defense of mucosal epithelia plays an important role in preventing pathogen adhesion to host cells, therefore blocking dissemination and further infection. This mechanism, referred to as immune exclusion, represents the dominant mode of action of the antibody. However, SIgA antibodies combine multiple facets, which together confer properties extending from intracellular and serosal neutralization of antigens, activation of non-inflammatory pathways and homeostatic control of the endogenous microbiota. The sum of these features suggests that future opportunities for translational application from research-based knowledge to clinics include the mucosal delivery of bioactive antibodies capable of preserving immunoreactivity in the lung, gastrointestinal tract, the genito-urinary tract for the treatment of infections. This article covers topics dealing with the structure of SIgA, the dissection of its mode of action in epithelia lining different mucosal surfaces and its potential in immunotherapy against infectious pathogens.

A computational and geometric approach to phase resetting curves and surfaces

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