Feasibility, safety and tolerability of accelerated dobutamine stress echocardiography

A continuous infusion of a single high dose of dobutamine has been, recently, suggested as a simple and effective protocol of stress echocardiography. The present study assesses the feasibility, safety, and tolerability of an accelerated dobutamine stress protocol performed in patients with suspected or known coronary artery disease. Two hundred sixty five consecutive patients underwent accelerated dobutamine stress echocardiography: the dobutamine was administered at a constant dose of 50 μg/kg/min for up to 10 minutes. The mean weight-adjusted cumulative dose of dobutamine used was 330 ± 105.24 μg/kg. Total duration of dobutamine infusion was 6.6 ± 2.1 min. Heart rate rose from 69.9 ± 12.1 to 123.1 ± 22.1 beats/min at peak with a concomitant change in systolic blood pressure (127.6 ± 18.1 vs. 167.6 ± 45.0 mmHg). Dobutamine administration produced a rapid increase in heart rate (9.4 ± 5.9 beats/min2). The side effects were similar to those described with the standard protocol; the most common were frequent premature ventricular complexes (21.5%), frequent premature atrial complexes (1.5%) and non sustained ventricular tachycardia (1.5%); among non cardiac symptoms the most frequent were nausea (3.4%), headache (1.1%) and symptomatic hypotension (1.1%). No major side effects were observed during the test. Our data demonstrate that a continous infusion of a single high dose of dobutamine is a safe and well tolerated method of performing stress echocardiography in patients with suspected or known coronary artery disease. This new protocol requires the administration of lower cumulative dobutamine dose than standard protocol and results in a significant reduction in test time

AML1/ETO Oncoprotein Is Directed to AML1 Binding Regions and Co-Localizes with AML1 and HEB on Its Targets

A reciprocal translocation involving chromosomes 8 and 21 generates the AML1/ETO oncogenic transcription factor that initiates acute myeloid leukemia by recruiting co-repressor complexes to DNA. AML1/ETO interferes with the function of its wild-type counterpart, AML1, by directly targeting AML1 binding sites. However, transcriptional regulation determined by AML1/ETO probably relies on a more complex network, since the fusion protein has been shown to interact with a number of other transcription factors, in particular E-proteins, and may therefore target other sites on DNA. Genome-wide chromatin immunoprecipitation and expression profiling were exploited to identify AML1/ETO-dependent transcriptional regulation. AML1/ETO was found to co-localize with AML1, demonstrating that the fusion protein follows the binding pattern of the wild-type protein but does not function primarily by displacing it. The DNA binding profile of the E-protein HEB was grossly rearranged upon expression of AML1/ETO, and the fusion protein was found to co-localize with both AML1 and HEB on many of its regulated targets. Furthermore, the level of HEB protein was increased in both primary cells and cell lines expressing AML1/ETO. Our results suggest a major role for the functional interaction of AML1/ETO with AML1 and HEB in transcriptional regulation determined by the fusion protein

Tratamento cirúrgico do câncer colorretal: série histórica de três anos de um serviço em Salvador, Bahia Surgical treatment of colorectal cancer: three-year historical series of a health service in Savador, Bahia, Brazil

O reduzido número de registro de câncer colorretal no Brasil tem demonstrado a dificuldade para o conhecimento da epidemiologia dessa patologia, levando a um mau planejamento dos governos para o diagnóstico precoce. O objetivo desse trabalho foi relatar a casuística de um serviço, em Salvador (BA), durante um período de três anos e compará-la com a literatura nacional. Os dados obtidos foram analisados, sendo observada semelhança com a literatura brasileira. Ocorreu maior incidência dessa neoplasia entre indivíduos do sexo feminino (53,7%), com média de idade de 57 anos ao diagnóstico. Nota-se estádio III em 40,4% dos pacientes, sendo a retossigmoidectomia a cirurgia mais realizada (54%). Este estudo demonstrou um conhecimento epidemiológico da poplação baiana, na qual foi observado um atraso do diagnóstico da doença, bem como a necessidade de investimentos na descoberta precoce.<br>The low number of registration of colorectal cancer cases in Brazil has shown the difficulty in understanding the epidemiology of this disease, thus leading to a poor government planning for early diagnosis. The aim of this study was to report the cases of a service in Salvador during three years and compare it with the national literature data. The data were analyzed, and we found similarity to the Brazilian literature: higher incidence among females (53.7%), mean age of 57 years at diagnosis. Stage III was observed in 40.4% of patients, and retossigmoidectomy surgery was most often performed (54%). This study showed epidemiological characteristics of the population of Bahia, being observed late diagnosis of the disease and the need for investment in early detection