Complications after elective percutaneous coronary interventions: A comparison between public and private hospitals

Objective: Complications after percutaneous coronary interventions (PCI) are associated with significant morbidity and mortality, although institutional discrepancies can occur when public and private hospitals coexist within the healthcare system. The aim of this study was to compare the in-hospital complication rates and mortality in addition to long-term survival following elective PCI in two reference public and private cardiology hospitals in Rio de Janeiro, Brazil. Methods: From January 1st 2013 to December 31st 2014, a total of 440 procedures were identified in both hospitals (public: 328 vs. private: 112) and retrospectively analyzed by chart review. Results: There were no significant differences between the two hospitals regarding the total number of procedures with at least one complication (public: 23.8 vs. private: 17.9%, p = 0.2) or in-hospital mortality rates (public: 0.6% vs. private: 0%, p = 0.5). Post-procedural renal insufficiency was more frequent in the private hospital, whereas coronary-related complications were more prevalent in the public hospital. After a mean follow up of 30.3 months (SD ± 9.2), the survival rate was also similar. Conclusions: Clinical complications after elective PCI are common both in public and private hospitals. Meticulous pre-procedural clinical assessment and patient selection as well as adherence to guideline-based practices could minimize the risk of PCI-related adverse events

Effect of growth hormone on fatty acid synthase gene expression in porcine adipose tissue cultures

We describe an efficient in vitro assay to test growth hormone effects on mRNA levels and fatty acid synthase (FAS, EC. 2.3.1.85) activity. Swine adipose tissue explants were long-term cultured in medium containing growth hormone and FAS mRNA levels and enzyme activity were measured. We quantified FAS transcripts by competitive reverse transcriptase PCR (RT-PCR) using total RNA from cultured adipose tissue explants and RT-PCR standard-curves were constructed using a cloned 307 bp segment of native FAS cDNA and a shorter fragment from which a 64 bp (competitor, 243 bp) internal sequence had been deleted. A known amount of competitor was added to each PCR as an internal control and µ-actin transcripts were also measured to correct for differences in total RNA extraction and reverse transcription efficiency. In cultures with added growth hormone FAS mRNA levels decreased 70% (p < 0.01) and FAS enzyme activity decreased 22% (p < 0.05). These in vitro growth hormone effects were consistent with those observed in vivo, showing that in vitro adipose tissue culture combined with RT-PCR is a useful and accurate tool for studying growth hormone modulation of adipose tissue metabolism. This technique allowed the diagnosis of lower levels of FAS mRNA in the presence of growth hormone and these low levels were associated with decreased FAS activity in the adipose tissue explants

Percutaneous Coronary Interventions and Post-Procedural Enzyme Elevation

In the last 30 years, the number of cardiovascular diagnostic and therapeutic invasive procedures has progressively increased in many countries around the world. According to the American Heart Association, almost 1,03 million coronary angiographies, 955 thousand percutaneous coronary interventions (PCI) and 397 thousand heart surgeries were performed in the United States (US) alone in the year 2010 [1]. Although since the year 2006 the number of angioplasties seems to be stable in the US, in other countries such as Brazil the procedure count continues to rise [2]. This trend underscores the importance of concurrently analyzing the behavior of intervention related complications, particularly because PCI associated in hospital mortality remains at around 1.31%, notwithstanding the total complication rate which is even more significant. [1] In this context, post-procedural enzyme elevation is a frequently overlooked complication that has an important independent prognostic value

The 18S rRNA from Odontophrynus americanus 2n and 4n (Amphibia, Anura) reveals unusual extra sequences in the variable region V2

The nucleotide sequence of the rDNA 18S region isolated from diploid and tetraploid species of the amphibian Odontophrynus americanus was determined and used to predict the secondary structure of the corresponding 18S rRNA molecules. Comparison of the primary and secondary structures for the 2n and 4n species confirmed that these species are very closely related. Only three nucleotide substitutions were observed, accounting for 99% identity between the 18S sequences, whereas several changes were detected by comparison with the Xenopus laevis 18S sequence (96% identity). Most changes were located in highly variable regions of the molecule. A noticeable feature of the Odontophrynus 18S rRNA was the presence of unusual extra sequences in the V2 region, between helices 9 and 11. These extra sequences do not fit the model for secondary structure predicted for vertebrate 18S rRNA

Troponin I elevation after elective percutaneous coronary interventions: Prevalence and risk factors

Troponin elevation after coronary angioplasty is a prognostic marker associated with significant morbidity and mortality, although its prevalence varies according to clinical and procedural characteristics. We analyzed the frequency of post-procedural enzyme elevation among 112 elective interventions between 2013 and 2014 in a private hospital in Brazil. Troponin increase was observed in 62.5% of the procedures, and was related to age, female sex, low pre-procedural hemoglobin, prior angiotensin converting enzyme inhibitor or angiotensin receptor blocker use and multivessel angioplasty. PCI is not a risk free procedure and these results underscore the importance of a careful clinical assessment before its utilization