First genome sequence of St. Louis encephalitis virus (SLEV) isolated from a human in Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Productivity, stability and adaptability in open pollination progenies of Eucalyptus urophylla ST Blake

Prediction of genetic gains within breeding programs is not always compatible with those observed in practice. One reason for this inconsistency is the lack of knowledge of genotype-environment interaction (GxE). The aim of this study was to estimate genetic variation, evaluate the GxE, investigate the genetic correlation between pairs of environments and for the set, and to study the productivity, stability and adaptability at 2 years of age for diameter at breast height (DBH) in five progenies trials of Eucalyptus urophylla, used in a randomized complete block design, with the number of progenies ranging from 138 to 167, four to eight blocks and five to six plants per plot. Estimates of variance components and genetic parameters were obtained using the REML/BLUP method. For analysis of productivity, stability and adaptability, the HMRPGV method was used. The highest DBH growth was observed in Anhembi (10.52 cm) and Uberaba (10.20 cm). Estimates considered high were obtained for the coefficient of individual additive genetic variation (>13.3%) and average heritability among progenies (>0.40), indicating the possibility of obtaining genetic gains by selection among progenies. The coefficient of determination of the GxE was 1.7%, a fact that led to a high value of genotypic correlation between the performance of the progenies and environments (78.1%), indicating that the interaction is simple. The first six progenies showed a coincidence of 100% in the order of stability (HMGV), adaptability (RPGV) and productivity (HMRPGV), being 13% higher than the overall mean of five experiments (9.21 cm). When ordering the progenies, the selection of the 20 best in growth led to an increase in gain ranging of from 10.4 to 70%. Anhembi is the ideal place to have a breeding population which will be good in the other places as well.

Extrafloral nectary morphology and the role of environmental constraints in shaping its traits in a common Cerrado shrub (Maprounea brasiliensis A. St.-Hill: Euphorbiaceae)

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Population trends of the red palm mite, raoiella indica hirst (acari: tenuipalpidae) and associated entomopathogenic fungi in trinidad, antigua, st kitts and nevis and dominica

A survey to determine population trends and entomopathogenic fungi associated with the red palm mite (RPM), Raoiella indica, was conducted in Trinidad, Antigua, St. Kitts and Nevis and Dominica. RPM population density was evaluated by sampling a total of ten coconut palms per site in Antigua, St. Kitts and Nevis, Dominica, and Trinidad (Manzanilla and Icacos). Mites from the four islands were either surface sterilized or left unsterilized before being cultured on Tap Water Agar (TWA). A total of 318 fungal colonies were retrieved. A further 96 mites from Dominica were kept on sterile moist filter paper in a humidity chamber and a further 85 colonies were isolated. Based on morphological observations of all 403 isolates, a sample consisting of 32 colonies (8 %) was sent for identification at CABI-UK. Of the 27 fungi positively identified, 15 isolates belonged to the genera Cladosporium, three to Simplicillium spp., and one to Penicillium. Other fungi genera with limited or no entomopathogenic potential included: Aspergillus, Cochliobolus, Fusarium, Pestalotiopsis and Pithomyces. The results show a potential use of entomopathogenic fungi for population management of the red palm mite in the Caribbean region.

BNP and Admission Glucose as In-Hospital Mortality Predictors in Non-ST Elevation Myocardial Infarction

Objectives. Admission hyperglycemia and B-type natriuretic peptide (BNP) are associated with mortality in acute coronary syndromes, but no study compares their prediction in-hospital death. Methods. Patients with non-ST-elevation myocardial infarction (NSTEMI), in-hospital mortality and two-year mortality or readmission were compared for area under the curve (AUC), sensitivity (SEN), specificity (SPE), positive predictive value (PPV), negative predictive value (NPV), and accuracy (ACC) of glycemia and BNP. Results. Respectively, AUC, SEN, SPE, PPV, NPV, and ACC for prediction of in-hospital mortality were 0.815, 71.4%, 84.3%, 26.3%, 97.4%, and 83.3% for glycemia = 200 mg/dL and 0.748, 71.4%, 68.5%, 15.2%, 96.8% and 68.7% for BNP = 300 pg/mL. AUC of glycemia was similar to BNP (P = 0.411). In multivariate analysis we found glycemia >= 200mg/dL related to in-hospital death (P = 0.004). No difference was found in two-year mortality or readmission in BNP or hyperglycemic subgroups. Conclusion. Hyperglycemia was an independent risk factor for in-hospital mortality in NSTEMI and had a good ROC curve level. Hyperglycemia and BNP, although poor in-hospital predictors of unfavorable events, were independent risk factors for death or length of stay >10 days. No relation was found between hyperglycemia or BNP and long-term events.

ST Elevation Myocardial Infarction in the elderly

Acute coronary syndromes (ACS) are the leading causes of death in the elderly. The suspicion and diagnosis of ACS in this age group is more difficult, since typical angina is less frequent. The morbidity and mortality is greater in older age patients presenting ACS. Despite the higher prevalence and greater risk, elderly patients are underrepresented in major clinical trials from which evidence based recommendations are formulated. The authors describe, in this article, the challenges in the diagnosis and management of ST elevation myocardial infarction in the elderly, and discuss the available evidence.

Prediction of enzymatic infarct size in ST-segment elevation myocardial infarction

Objectives Predictors of adverse outcomes following myocardial infarction (MI) are well established; however, little is known about what predicts enzymatically estimated infarct size in patients with acute ST-elevation MI. The Complement And Reduction of INfarct size after Angioplasty or Lytics trials of pexelizumab used creatine kinase (CK)-MB area under the curve to determine infarct size in patients treated with primary percutaneous coronary intervention (PCI) or fibrinolysis. Methods Prediction of infarct size was carried out by measuring CK-MB area under the curve in patients with ST-segment elevation MI treated with reperfusion therapy from January 2000 to April 2002. Infarct size was calculated in 1622 patients (PCI=817; fibrinolysis=805). Logistic regression was used to examine the relationship between baseline demographics, total ST-segment elevation, index angiographic findings (PCI group), and binary outcome of CK-MB area under the curve greater than 3000 ng/ml. Results Large infarcts occurred in 63% (515) of the PCI group and 69% (554) of the fibrinolysis group. Independent predictors of large infarcts differed depending on mode of reperfusion. In PCI, male sex, no prior coronary revascularization and diabetes, decreased systolic blood pressure, sum of ST-segment elevation, total (angiographic) occlusion, and nonright coronary artery culprit artery were independent predictors of larger infarcts (C index=0.73). In fibrinolysis, younger age, decreased heart rate, white race, no history of arrhythmia, increased time to fibrinolytic therapy in patients treated up to 2 h after symptom onset, and sum of ST-segment elevation were independently associated with a larger infarct size (C index=0.68). Conclusion Clinical and patient data can be used to predict larger infarcts on the basis of CK-MB quantification. These models may be helpful in designing future trials and in guiding the use of novel pharmacotherapies aimed at limiting infarct size in clinical practice. Coron Artery Dis 23:118-125 (C) 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Combined Evaluation of ST-segment Elevation in lead AVR and ST-segment Depression in other Leads Enhances Prediction of in-hospital Cardiovascular Death in Patients with Non ST-segment Elevation Acute Coronary Syndrome

Objective: To investigate the prognostic significance of ST-segment elevation (STE) in aVR associated with ST-segment depression (STD) in other leads in patients with non-STE acute coronary syndrome (NSTE-ACS). Background: In NSTE-ACS patients, STD has been extensively associated with severe coronary lesions and poor outcomes. The prognostic role of STE in aVR is uncertain. Methods: We enrolled 888 consecutive patients with NSTE-ACS. They were divided into two groups according to the presence or not on admission ECG of aVR STE≥ 1mm and STD (defined as high risk ECG pattern). The primary and secondary endpoints were: in-hospital cardiovascular (CV) death and the rate of culprit left main disease (LMD). Results: Patients with high risk ECG pattern (n=121) disclosed a worse clinical profile compared to patients (n=575) without [median GRACE (Global-Registry-of-Acute-Coronary-Events) risk score =142 vs. 182, respectively]. A total of 75% of patients underwent coronary angiography. The rate of in-hospital CV death was 3.9%. On multivariable analysis patients who had the high risk ECG pattern showed an increased risk of CV death (OR=2.88, 95%CI 1.05-7.88) and culprit LMD (OR=4.67,95%CI 1.86-11.74) compared to patients who had not. The prognostic significance of the high risk ECG pattern was maintained even after adjustment for the GRACE risk score (OR = 2.28, 95%CI:1.06-4.93 and OR = 4.13, 95%CI:2.13-8.01, for primary and secondary endpoint, respectively). Conclusions: STE in aVR associated with STD in other leads predicts in-hospital CV death and culprit LMD. This pattern may add prognostic information in patients with NSTE-ACS on top of recommended scoring system.

Geochronological and structural evolution of the western and central Kaoko Belt in NW Namibia

This thesis focusses on the tectonic evolution and geochronology of part of the Kaoko orogen, which is part of a network of Pan-African orogenic belts in NW Namibia. By combining geochemical, isotopic and structural analysis, the aim was to gain more information about how and when the Kaoko Belt formed. The first chapter gives a general overview of the studied area and the second one describes the basis of the Electron Probe Microanalysis dating method. The reworking of Palaeo- to Mesoproterozoic basement during the Pan-African orogeny as part of the assembly of West Gondwana is discussed in Chapter 3. In the study area, high-grade rocks occupy a large area, and the belt is marked by several large-scale structural discontinuities. The two major discontinuities, the Sesfontein Thrust (ST) and the Puros Shear Zone (PSZ), subdivide the orogen into three tectonic units: the Eastern Kaoko Zone (EKZ), the Central Kaoko Zone (CKZ) and the Western Kaoko Zone (WKZ). An important lineament, the Village Mylonite Zone (VMZ), has been identified in the WKZ. Since plutonic rocks play an important role in understanding the evolution of a mountain belt, zircons from granitoid gneisses were dated by conventional U-Pb, SHRIMP and Pb-Pb techniques to identify different age provinces. Four different age provinces were recognized within the Central and Western part of the belt, which occur in different structural positions. The VMZ seems to mark the limit between Pan-African granitic rocks east of the lineament and Palaeo- to Mesoproterozoic basement to the west. In Chapter 4 the tectonic processes are discussed that led to the Neoproterozoic architecture of the orogen. The data suggest that the Kaoko Belt experienced three main phases of deformation, D1-D3, during the Pan-African orogeny. Early structures in the central part of the study area indicate that the initial stage of collision was governed by underthrusting of the medium-grade Central Kaoko zone below the high-grade Western Kaoko zone, resulting in the development of an inverted metamorphic gradient. The early structures were overprinted by a second phase D2, which was associated with the development of the PSZ and extensive partial melting and intrusion of ~550 Ma granitic bodies in the high-grade WKZ. Transcurrent deformation continued during cooling of the entire belt, giving rise to the localized low-temperature VMZ that separates a segment of elevated Mesoproterozoic basement from the rest of the Western zone in which only Pan-African ages have so far been observed. The data suggest that the boundary between the Western and Central Kaoko zones represents a modified thrust zone, controlling the tectonic evolution of the Kaoko belt. The geodynamic evolution and the processes that generated this belt system are discussed in Chapter 5. Nd mean crustal residence ages of granitoid rocks permit subdivision of the belt into four provinces. Province I is characterised by mean crustal residence ages <1.7 Ga and is restricted to the Neoproterozoic granitoids. A wide range of initial Sr isotopic values (87Sr/86Sri = 0.7075 to 0.7225) suggests heterogeneous sources for these granitoids. The second province consists of Mesoproterozoic (1516-1448 Ma) and late Palaeo-proterozoic (1776-1701 Ma) rocks and is probably related to the Eburnian cycle with Nd model ages of 1.8-2.2 Ga. The eNd i values of these granitoids are around zero and suggest a predominantly juvenile source. Late Archaean and middle Palaeoproterozoic rocks with model ages of 2.5 to 2.8 Ga make up Province III in the central part of the belt and are distinct from two early Proterozoic samples taken near the PSZ which show even older TDM ages of ~3.3 Ga (Province IV). There is no clear geological evidence for the involvement of oceanic lithosphere in the formation of the Kaoko-Dom Feliciano orogen. Chapter 6 presents the results of isotopic analyses of garnet porphyroblasts from high-grade meta-igneous and metasedimentary rocks of the sillimanite-K-feldspar zone. Minimum P-T conditions for peak metamorphism were calculated at 731±10 °C at 6.7±1.2 kbar, substantially lower than those previously reported. A Sm-Nd garnet-whole rock errorchron obtained on a single meta-igneous rock yielded an unexpectedly old age of 692±13 Ma, which is interpreted as an inherited metamorphic age reflecting an early Pan-African granulite-facies event. The dated garnets survived a younger high-grade metamorphism that occurred between ca. 570 and 520 Ma and apparently maintained their old Sm-Nd isotopic systematics, implying that the closure temperature for garnet in this sample was higher than 730 °C. The metamorphic peak of the younger event was dated by electronmicroprobe on monazite at 567±5 Ma. From a regional viewpoint, it is possible that these granulites of igneous origin may be unrelated to the early Pan-African metamorphic evolution of the Kaoko Belt and may represent a previously unrecognised exotic terrane.

Acute coronary syndromes in young patients: Presentation, treatment and outcome

Background: Acute coronary syndromes (ACS) in very young patients have been poorly described. We therefore evaluate ACS in patients aged 35 years and younger. Methods: In this prospective cohort study, 76 hospitals treating ACS in Switzerland enrolled 28,778 patients with ACS between January 1, 1997, and October 1, 2008. ACS definition included ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina (UA). Results: 195 patients (0.7%) were 35 years old or younger. Compared to patients N35 years, these patients were more likely to present with chest pain (91.6% vs. 83.7%; P=0.003) and less likely to have heart failure (Killip class II to IV in 5.2% vs. 23.0%; Pb0.001). STEMI was more prevalent in younger than in older patients (73.1% vs. 58.3%; Pb0.001). Smoking, family history of CAD, and/or dyslipidemia were important cardiovascular risk factors in young patients (prevalence 77.2%, 55.0%, and 44.0%). The prevalence of overweight among young patients with ACS was high (57.8%). Cocaine abuse was associated with ACS in some young patients. Compared to older patients, young patients were more likely to receive early percutaneous coronary interventions and had better outcome with fewer major adverse cardiac events. Conclusions: Young patients with ACS differed from older patients in that the younger often presented with STEMI, received early aggressive treatment, and had favourable outcomes. Primary prevention of smoking, dyslipidemia and overweight should be more aggressively promoted in adolescence.

Relationship between the logistic EuroSCORE and the Society of Thoracic Surgeons Predicted Risk of Mortality score in patients implanted with the CoreValve ReValving system--a Bern-Rotterdam Study

Background Surgical risk scores, such as the logistic EuroSCORE (LES) and Society of Thoracic Surgeons Predicted Risk of Mortality (STS) score, are commonly used to identify high-risk or “inoperable” patients for transcatheter aortic valve implantation (TAVI). In Europe, the LES plays an important role in selecting patients for implantation with the Medtronic CoreValve System. What is less clear, however, is the role of the STS score of these patients and the relationship between the LES and STS. Objective The purpose of this study is to examine the correlation between LES and STS scores and their performance characteristics in high-risk surgical patients implanted with the Medtronic CoreValve System. Methods All consecutive patients (n = 168) in whom a CoreValve bioprosthesis was implanted between November 2005 and June 2009 at 2 centers (Bern University Hospital, Bern, Switzerland, and Erasmus Medical Center, Rotterdam, The Netherlands) were included for analysis. Patient demographics were recorded in a prospective database. Logistic EuroSCORE and STS scores were calculated on a prospective and retrospective basis, respectively. Results Observed mortality was 11.1%. The mean LES was 3 times higher than the mean STS score (LES 20.2% ± 13.9% vs STS 6.7% ± 5.8%). Based on the various LES and STS cutoff values used in previous and ongoing TAVI trials, 53% of patients had an LES ≥15%, 16% had an STS ≥10%, and 40% had an LES ≥20% or STS ≥10%. Pearson correlation coefficient revealed a reasonable (moderate) linear relationship between the LES and STS scores, r = 0.58, P < .001. Although the STS score outperformed the LES, both models had suboptimal discriminatory power (c-statistic, 0.49 for LES and 0.69 for STS) and calibration. Conclusions Clinical judgment and the Heart Team concept should play a key role in selecting patients for TAVI, whereas currently available surgical risk score algorithms should be used to guide clinical decision making.

Cell-based therapy for myocardial repair in patients with acute myocardial infarction: rationale and study design of the SWiss multicenter Intracoronary Stem cells Study in Acute Myocardial Infarction (SWISS-AMI)

Recent studies report that intracoronary administration of autologous bone marrow mononucleated cells (BM-MNCs) may improve remodeling of the left ventricle after acute myocardial infarction (AMI). Subgroup analysis suggest that early treatment between days 4 and 7 after AMI is probably most effective; however, the optimal time point of intracoronary cell administration has never been addressed in clinical trials. Furthermore, reliable clinical predictors are lacking for identifying patients who are thought to have most benefit from cellular therapy.

Postpartal recurrent non-ST elevation myocardial infarction in essential thrombocythaemia: case report and review of the literature

ABSTRACT: Normal pregnancy corresponds to a procoagulant state. Acute myocardial infarction during pregnancy is rare, yet considering the low non-pregnant risk score of childbearing women it is still surprisingly frequent. We report a case of postpartum recurrent non-ST elevation myocardial infarction in a 40-year-old caucasian woman with essential thrombocythaemia in the presence of a positive JAK-2 mutation and an elevated anti-cardiolipin IgM antibody titer. In the majority of cases of myocardial infarction in pregnancy or in the peripartal period, atherosclerosis, a thrombus or coronary artery dissection is observed. The combination of essential thrombocythaemia and elevated anti-cardiolipin IgM antibody titer in the presence of several cardiovascular risk factors seems to be causative in our case. In conclusion, with the continuing trend of childbearing at older ages, rare or unlikely conditions leading to severe events such as myocardial infarction must be considered in pregnant women.

Strategies for subacute/chronic type B aortic dissection: the Investigation Of Stent Grafts in Patients with type B Aortic Dissection (INSTEAD) trial 1-year outcome

Endovascular stent grafting represents a novel concept for type B aortic dissection both in the acute and subacute/chronic setting, with an unknown effect on outcomes.