Resultados iniciais e tardios de pacientes tratados com stent híbrido eluidor de sirolimus ou stent eluidor de everolimus

ResumoIntroduçãoO stent Orsiro é um stent híbrido que possui revestimentos passivo (carbeto de silício amorfo) e ativo (ácido poli‐L‐lático, PLLA). O primeiro encapsula as hastes do stent, promovendo menor inflamação local, e o segundo libera o sirolimus por meio de matriz biodegradável. Nosso objetivo foi comparar os resultados das intervenções coronárias percutâneas (ICP) dos stents Orsiro e Xience® V (eluidor de everolimus) na prática clínica diária.MétodosEstudo observacional em que os pacientes foram alocados em dois grupos: os que receberam exclusivamente um ou mais stents Orsiro e os que receberam exclusivamente stents Xience® V. Desfechos iniciais e tardios foram prospectivamente coletados.ResultadosEntre setembro de 2012 e março de 2014, incluímos 92 e 108 pacientes tratados com stent Orsiro e Xience® V, respectivamente. Características clínicas, angiográficas e do procedimento foram, em sua maioria, semelhantes entre os grupos. As taxas de sucesso do procedimento (98,9% vs. 95,4%; p = 0,22), mortalidade (1,1% vs. 0%; p = 0,40) e trombose do stent (0% vs. 0,9%; p = 0,30) hospitalares não diferiram entre os grupos. O tempo de seguimento foi de 434 ± 111 e 477 ± 66 dias (p = 0,23), respectivamente, não sendo observadas diferenças na mortalidade (0,9% vs. 0%; p = 0,30), trombose do stent (0% vs. 0,9%; p = 0,30) e nem na necessidade de revascularização da lesão alvo (0% vs. 0,9%; p = 0,30).ConclusõesOs stents Orsiro e Xience® V apresentaram desempenho semelhante, com baixas taxas de eventos clínicos e angiográficos iniciais e tardios.AbstractBackgroundThe Orsiro is a hybrid stent which has passive (amorphous silicon carbide) and active (poly‐L‐lactic acid, PLLA) coatings. The first layer encapsulates the stent struts, promoting lower local inflammation, whereas the second layer releases sirolimus through a biodegradable matrix. This study's aim was to compare the results of percutaneous coronary interventions (PCI) with Orsiro and Xience™ V stents (everolimus‐eluting stent) in daily clinical practice.MethodsObservational study in which patients were divided into two groups: those who received only one or more Orsiro stents, and those who received only XienceTM V stents. Early and late outcomes were prospectively collected.ResultsBetween September 2012 and March 2014, this study included 92 and 108 patients treated with Orsiro and Xience™ V stents, respectively. Clinical, angiographic, and procedure characteristics were mostly similar between groups. Rates of procedure success (98.9% vs. 95.4%; p = 0.22), in‐hospital mortality (1.1% vs. 0%; p = 0.40) and stent thrombosis (0% vs. 0.9%, p = 0.30) did not differ between groups. Time of follow‐up was 434 ± 111 and 477 ± 66 days (p = 0.23), respectively, and differences in mortality (0.9% vs. 0%, p = 0.30), stent thrombosis (0% vs. 0.9%; p = 0.30), or need for repeat revascularization of the target lesion (0% vs. 0.9%; p = 0.30) were not observed.ConclusionsOrsiro and Xience™ V stents showed similar performance, with low rates of early and late clinical and angiographic events

Enhanced Photoelectrochemical Detection of Bioaffinity Reactions by Vertically Oriented Au Nanobranches Complexed with a Biotinylated Polythiophene Derivative

Four nanostructured Au electrodes were prepared by a simple and templateless electrochemical deposition technique. After complexing with a biotinylated polythiophene derivative (PTBL), photocurrent generation and performance of PTBL/Au-nanostructured electrodes as photoelectrochemical biosensors were investigated. Among these four nanostructured Au electrodes, vertically oriented nanobranches on the electrode significantly improved the photoelectric conversion, because the vertically oriented nanostructures not only benefit light harvesting but also the transfer of the photogenerated charge carriers. Owing to this advantaged nanostructure, the PTBL/Au-nanobranch electrode showed higher sensitivity and faster response times in the photoelectrochemical detection of a streptavidin-biotin affinity reaction compared to a PTBL/Au-nanoparticle electrode

The Structural Complexity of the Human BORIS Gene in Gametogenesis and Cancer

BORIS/CTCFL is a paralogue of CTCF, the major epigenetic regulator of vertebrate genomes. BORIS is normally expressed only in germ cells but is aberrantly activated in numerous cancers. While recent studies demonstrated that BORIS is a transcriptional activator of testis-specific genes, little is generally known about its biological and molecular functions.Here we show that BORIS is expressed as 23 isoforms in germline and cancer cells. The isoforms are comprised of alternative N- and C-termini combined with varying numbers of zinc fingers (ZF) in the DNA binding domain. The patterns of BORIS isoform expression are distinct in germ and cancer cells. Isoform expression is activated by downregulation of CTCF, upregulated by reduction in CpG methylation caused by inactivation of DNMT1 or DNMT3b, and repressed by activation of p53. Studies of ectopically expressed isoforms showed that all are translated and localized to the nucleus. Using the testis-specific cerebroside sulfotransferase (CST) promoter and the IGF2/H19 imprinting control region (ICR), it was shown that binding of BORIS isoforms to DNA targets in vitro is methylation-sensitive and depends on the number and specific composition of ZF. The ability to bind target DNA and the presence of a specific long amino terminus (N258) in different isoforms are necessary and sufficient to activate CST transcription. Comparative sequence analyses revealed an evolutionary burst in mammals with strong conservation of BORIS isoproteins among primates.The extensive repertoire of spliced BORIS variants in humans that confer distinct DNA binding and transcriptional activation properties, and their differential patterns of expression among germ cells and neoplastic cells suggest that the gene is involved in a range of functionally important aspects of both normal gametogenesis and cancer development. In addition, a burst in isoform diversification may be evolutionarily tied to unique aspects of primate speciation

De-identifying a public use microdata file from the Canadian national discharge abstract database

<p>Abstract</p> <p>Background</p> <p>The Canadian Institute for Health Information (CIHI) collects hospital discharge abstract data (DAD) from Canadian provinces and territories. There are many demands for the disclosure of this data for research and analysis to inform policy making. To expedite the disclosure of data for some of these purposes, the construction of a DAD public use microdata file (PUMF) was considered. Such purposes include: confirming some published results, providing broader feedback to CIHI to improve data quality, training students and fellows, providing an easily accessible data set for researchers to prepare for analyses on the full DAD data set, and serve as a large health data set for computer scientists and statisticians to evaluate analysis and data mining techniques. The objective of this study was to measure the probability of re-identification for records in a PUMF, and to de-identify a national DAD PUMF consisting of 10% of records.</p> <p>Methods</p> <p>Plausible attacks on a PUMF were evaluated. Based on these attacks, the 2008-2009 national DAD was de-identified. A new algorithm was developed to minimize the amount of suppression while maximizing the precision of the data. The acceptable threshold for the probability of correct re-identification of a record was set at between 0.04 and 0.05. Information loss was measured in terms of the extent of suppression and entropy.</p> <p>Results</p> <p>Two different PUMF files were produced, one with geographic information, and one with no geographic information but more clinical information. At a threshold of 0.05, the maximum proportion of records with the diagnosis code suppressed was 20%, but these suppressions represented only 8-9% of all values in the DAD. Our suppression algorithm has less information loss than a more traditional approach to suppression. Smaller regions, patients with longer stays, and age groups that are infrequently admitted to hospitals tend to be the ones with the highest rates of suppression.</p> <p>Conclusions</p> <p>The strategies we used to maximize data utility and minimize information loss can result in a PUMF that would be useful for the specific purposes noted earlier. However, to create a more detailed file with less information loss suitable for more complex health services research, the risk would need to be mitigated by requiring the data recipient to commit to a data sharing agreement.</p