Twelve-month clinical outcomes after coronary stenting with the Genous Bio-engineered R Stent in patients with a bifurcation lesion: from the e-HEALING (Healthy Endothelial Accelerated Lining Inhibits Neointimal Growth) registry

Background The e-Healthy Endothelial Accelerated Lining Inhibits Neointimal Growth (e-HEALING) registry was designed to capture clinical data on the use of the endothelial progenitor cell capture stent (ECS) in routine clinical practice. In this analysis, we investigated the 12-month clinical outcomes in patients treated with an ECS for a bifurcation lesion. Methods The worldwide, prospective, nonrandomized e-HEALING registry aimed to enrol 5000 patients treated for coronary artery disease with one or more ECS between October 2005 and October 2007. Clinical follow-up was obtained at 1, 6, and 12 months. The primary endpoint was target vessel failure (TVF), defined as the composite of cardiac death, myocardial infarction, and target vessel revascularization at 12 months. Results A total of 573 patients were treated for at least one bifurcation lesion and were assessed in the current analysis. Baseline characteristics showed a median age of 65 years; 21% were diabetic patients and 36% had unstable angina. A total of 63% of the bifurcation lesions were located in the left artery descending and the mean stent length was 20.7 +/- 12.6 mm. At 12 months, TVF was 12.7% and target lesion revascularization was 7.5%. Definite or probable stent thrombosis occurred in 1.7% of the patients. Moreover, one or more stents per lesion [hazard ratio (HR): 2.79, 95% confidence interval (CI): 1.60-4.86, P < 0.001], predilatation (HR: 0.39, 95% CI: 0.17-0.87, P = 0.023), and lesions located in the right coronary artery (HR: 4.56, 95% CI: 1.07-19.5, P = 0.041) were independent predictors of TVF. Conclusion In the e-HEALING registry, coronary bifurcation stenting with the ECS results in favorable clinical outcomes and low incidences of repeat revascularization and stent thrombosis. Coron Artery Dis 23:201-207 (C) 2012 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.

Duration of dual antiplatelet therapy and outcomes after coronary stenting with the genous (TM) bio-engineered R stent (TM) in patients from the e-healing registry

Objective: We investigated the relation between duration of dual antiplatelet therapy (DAPT) and clinical outcomes up to 12 months after Genous (TM) endothelial progenitor cell capturing R stent (TM) placement in patients from the e-HEALING registry. Background: Cessation of (DAPT) has been shown to be associated with the occurrence of stent thrombosis (ST). After Genous placement, 1 month of DAPT is recommended. Methods: Patients were analyzed according to continuation or discontinuation of DAPT at a 30-day and 6-month landmark, excluding patients with events before the landmark. Each landmark was a new baseline, and outcomes were followed up to 12 months after stenting. The main outcome for our current analysis was target vessel failure (TVF), defined as target vessel-related cardiac death or myocardial infarction and target vessel revascularization. Secondary outcomes included ST. (Un)adjusted hazard ratios (HR) for TVF were calculated with Cox regression. Results: No difference was observed in the incidence of TVF [HR: 1.03; 95% confidence intervals (CI): 0.651.65, P = 0.89] in patients continuing DAPT (n = 4,249) at 30 days versus patients stopped (n = 309), and HR: 0.82 (95% CI: 0.551.23, P = 0.34) in patients continuing DAPT (n = 2,654) at 6 months versus patients stopped [n = 1,408] DAPT). Furthermore, no differences were observed in ST. Even after addition of identified independent predictors for TVF, adjusted TVF hazards were comparable. Conclusions: In a post-hoc analysis of e-HEALING, duration of DAPT was not associated with the occurrence of the outcomes TVF or ST. The Genous stent may be an attractive treatment especially in patients at increased risk for (temporary) cessation of DAPT or bleeding. (C) 2011 Wiley Periodicals, Inc.

Applying the National Institute for Clinical Excellence criteria to patients treated with the Genous (TM) Bio-engineered R stent (TM): a sub-study of the e-HEALING (Healthy Endothelial Accelerated Lining Inhibits Neointimal Growth) worldwide registry

The National Institute for Clinical Excellence (NICE) guidelines recommend the use of bare-metal stents (BMS) in non-complex lesions with a low risk of restenosis (diameter a parts per thousand yen3 mm and lesion length a parts per thousand currency sign15 mm) and the use of drug-eluting stents (DES) in more complex lesions with a high risk of restenosis (diameter < 3.0 mm or lesion length > 15 mm). However, the guidelines were created based on studies evaluating BMS and DES only. We performed an analysis of patients undergoing non-urgent percutaneous coronary intervention with the novel endothelial cell capturing stent (ECS). The ECS is coated with CD34(+) antibodies that attract circulating endothelial progenitor cells to the stent surface, thereby accelerating the endothelialization of the stented area. We analyzed all patients enrolled in the worldwide e-HEALING registry that met the NICE criteria for either low-risk or high-risk lesions and were treated with a parts per thousand yen1 ECS. The main study outcome was target vessel failure (TVF) at 12-month follow-up, defined as the composite of cardiac death or MI and target vessel revascularization (TVR). A total of 4,241 patients were assessed in the current analysis. At 12-month follow-up, TVF occurred in 7.0% of the patients with low-risk lesions and in 8.8% of the patients with high-risk lesions (p = 0.045). When evaluating the diabetic patients versus the non-diabetic patients per risk group, no significant differences were found in TVF, MI or TVR in either risk group. The ECS shows good clinical outcomes in lesions carrying either a high or a low risk of restenosis according to the NICE guidelines with comparable rates of cardiac death, myocardial infarction, and stent thrombosis. The TVF rate with ECS was slightly higher in patients with high-risk lesions, driven by higher clinically driven TLR. The risk of restenosis with ECS in patients carrying high-risk lesions needs to be carefully considered relative to other risks associated with DES. Furthermore, the presence of diabetes mellitus did not influence the incidence of TVF in either risk group.

Broad Bean Stain Virus: Identification, Detectability with ELISA in Faba Bean Leaves and Seeds, Occurrence in West Asia and North Africa and Possible Wild Hosts

Abstract During a survey of faba bean viruses in West Asia and North Africa a virus was identified as broad bean stain virus (BBSV) based on host reactions, electron microscopy, physical properties and serology. An antiserum to a Syrian isolate was prepared. With this antiserum both the direct double antibody sandwich ELISA (DAS-ELISA) and dot-ELISA were very sensitive in detecting BBSV in leaf extracts, ground whole seeds and germi nated embryos. Sens it i vity was not reduced when the two-day procedure was replaced by a one-day procedure. us i ng ELISA the vi rus was detected in 73 out of 589 faba bean samples with virus-like symptoms collected from Egypt (4 out of 70 samples tested), Lebanon (6/44) , Morocco (017), Sudan (19/254), Syria (36/145) and Tunisia (8/69). This is the first report of BBSV infection of faba bean in Lebanon, Sudan, Syria and Tunisia. speci es i ndi genous to Syri a were Fourteen wild legume susceptible to BBSV infection, with only two producing obvious symptoms. The virus was found to be seed transmitted ~n Vicia palaestina.

Uso das ondas de Lamb e Scholte para caracterização de líquidos

Pós-graduação em Engenharia Elétrica - FEIS

Studio delle proprietà oncotiche e non incotiche dell'albumina nel paziente con cirrosi epatica e ascite

L’albumina umana (HA) è usata per le sue proprietà oncotiche per ricostituire il volume circolante in pazienti critici e nella cirrosi epatica avanzata. Tuttavia, l’albumina non è solo semplice espansore plasmatico, ma è provvista anche di proprietà non oncotiche, quali, la capacità di legare e trasportare molecole insolubili in acqua, come metalli e farmaci, il suo potere antiossidante e di detossificazione di sostanze sia endogene che esogene. Il nostro studio, è stato progettato da un lato per dimostrare che il trattamento in cronico con albumina umana nei pazienti cirrotici con ascite è in grado di ridurre l’incidenza di ascite refrattaria, delle complicanze legate all’uso dei diuretici e la ricorrenza delle ospedalizzazioni (studio randomizzato), dall’altro per determinare se le alterazioni delle proprietà non oncotiche dell’albumina, possono rappresentare degli indicatori di un aumentato rischio di complicanze cliniche e di una prognosi sfavorevole di questi pazienti (studio di coorte). METODI Studio multicentrico, prospettico, randomizzato, in 440 pts cirrotici con ascite: due bracci di trattamento: t. medica standard vs t. medica standard + albumina; Studio di coorte con 110 cirrotici vs 50 individui sani, valutati mediante -analisi proteomica per individuare con le modifiche post-trascrizionali; - Cobalt Binding Albumina (ACB) per quantificare la quota di albumina modificata dall’ischemia e IMA-Ratio. RISULTATI Studio randomizzato: non è possibile trarre conclusioni, ma emerge un dato incoraggiante, cioè i pazienti del braccio standard hanno una maggiore tendenza a chiudere lo studio per tre paracentesi / mese; Studio Coorte:-IMA e IMA-R sono aumentati in cirrosi, ma non associate a complicanze della cirrosi, l'infezione batterica è associata ad un aumento IMA e IMA-R in cirrosi. CONCLUSIONE: Lo studio randomizzato è in corso ma i dati preliminari sono incoraggianti. Lo studio coorte, ha dimostrato che la cirrosi è associata da alterazioni post-trascrizionali che coinvolgono il N-terminale ed i siti di legame Cys-34.