MRI Discriminates Thrombus Composition and ST Resolution after Percutaneous Coronary Intervention in Patients with ST-Elevation Myocardial Infarction

Histological composition of material obtained by thrombus aspiration during percutaneous coronary intervention (PCI) in patients with ST-segment elevation acute myocardial infarction (STEMI) is highly variable. We aimed to characterize this material using magnetic resonance imaging (MRI) and to correlate MRI findings with the success of PCI in terms of ST-segment resolution. Thrombus aspiration during primary or rescue PCI was attempted in 100 consecutive STEMI patients, of whom enough material for MRI was obtained in 59. MR images were obtained at 9.4T and T1 and T2 values were measured. Patients with (n = 31) and without (n = 28) adequate ST resolution 120 min after PCI (≥70% of pre-PCI value) had similar baseline characteristics except for a higher prevalence of diabetes mellitus in the latter (10 vs. 43%, p = 0.003). T1 values were similar in both groups (1248±112 vs. 1307±85 ms, respectively, p = 0.7). T2 values averaged 31.2±10.3 and 36.6±12.2 ms; in thrombus from patients with and without adequate ST resolution (p = 0.09). After adjusting for diabetes and other baseline characteristics, lower T2 values were significantly associated with inadequate ST resolution (odds ratio for 1 ms increase 1.08, CI 95% 1.01–1.16, p = 0.027). Histology classified thrombus in 3 groups: coagulated blood (n = 38), fibrin rich (n = 9) and lipid-rich (n = 3). Thrombi composed mostly of coagulated blood were characterized as being of short (n = 10), intermediate (n = 15) or long evolution (n = 13), T2 values being 34.0±13.2, 31.9±8.3 and 31.5±7.9 ms respectively (p = NS). In this subgroup, T2 was significantly higher in specimens from patients with inadequate perfusion (35.9±10.3 versus 28.6±6.7 ms, p = 0.02). This can be of clinical interest as it provides information on the probability of adequate ST resolution, a surrogate for effective myocardial reperfusion

Genetic diversity and paternity of Brycon orbignyanus offspring obtained for different reproductive systems

The objective of this study was to estimate the genetic diversity and the paternity of Brycon orbignyanus offspring's obtained with the extrusion and semi-natural reproductive systems, by microsatellites markers. The four loci used produced 11 alleles, being observed three alleles (BoM1, BoM5 and BoM7) and two alleles (BoM2) for locus present in the parental and in the offspring of both reproductive systems. In the offspring of the extrusion system low frequency alleles was observed for the locus BoM5 (allele B = 0.095) and BoM7 (allele C = 0.059) and there was a decrease of genetic variability (observe heterozygosity-Ho = 0.900 and 0.823; Shannon index-IS = 0.937 and 0.886; Nei genetic diversity-DGN = 0.604 and 0.566, respectively). For the offspring of the semi-natural system the allele frequencies stayed stable being verified an unequal frequency for each locus. The genetic variability in the offspring was preserved, being corroborated by the Ho values (0.975 and 0.945), IS (0.927 and 0.924) and DGN (0.593 and 0.581) for parental and offspring, respectively. Deviations were observed (P <0.01) in the Hardy-Weinberg equilibrium and linkage disequilibrium for the two reproductive systems. The inbreeding coefficient (Fis) it showed deficit of heterozygote in the offspring of the extrusion system. Multiple paternity and differed reproductive contributions in the composition of the families in the offspring in the two reproductive systems was observed, with the presence of reproductive dominance in the semi-natural system.O objetivo do presente estudo foi avaliar a diversidade genética e a paternidade de progênies de Brycon orbignyanus obtidas pelos sistemas reprodutivos por extrusão e seminatural, através do marcador microssatélite. Os quatro loci utilizados produziram 11 alelos, sendo observados três alelos (BoM1, BoM5 e BoM7) e dois alelos (BoM2) por locus presentes nos parentais e na progênie de ambos sistemas reprodutivos. Na progênie do sistema por extrusão foram observados alelos de baixa frequência para os locus BoM5 (alelo B = 0,095) e BoM7 (alelo C = 0,059) e houve uma diminuição da variabilidade genética (Heterozigosidade observada-Ho = 0,900 e 0,823; Índice de Shannon-IS = 0,937 e 0,886; diversidade genética de Nei-DGN = 0,604 e 0,566, respectivamente). Na progênie do sistema seminatural as frequências dos alelos se mantiveram estáveis, sendo verificada uma frequência desigual para cada locus. A variabilidade genética foi preservada, sendo corroborado pelos valores de Ho (0,975 e 0,945), IS (0,927 e 0,924) e DGN (0,593 e 0,581) para parentais e progênie, respectivamente. Observaramse desvios (P&lt;0.01) no equilíbrio de Hardy-Weinberg e desequilíbrio de ligação nos dois sistemas reprodutivos. O coeficiente de endogamia (Fis) mostrou déficit de heterozigotos na progênie do sistema por extrusão. Observou-se paternidade múltipla e contribuição reprodutiva diferenciada na composição das famílias na progênie nos dois sistemas reprodutivos, com a presença de dominância reprodutiva no sistema seminatural.Facultad de Ciencias Exacta

Effect of a serogroup A meningococcal conjugate vaccine (PsA-TT) on serogroup A meningococcal meningitis and carriage in Chad: a community study [corrected].

BACKGROUND: A serogroup A meningococcal polysaccharide-tetanus toxoid conjugate vaccine (PsA-TT, MenAfriVac) was licensed in India in 2009, and pre-qualified by WHO in 2010, on the basis of its safety and immunogenicity. This vaccine is now being deployed across the African meningitis belt. We studied the effect of PsA-TT on meningococcal meningitis and carriage in Chad during a serogroup A meningococcal meningitis epidemic. METHODS: We obtained data for the incidence of meningitis before and after vaccination from national records between January, 2009, and June, 2012. In 2012, surveillance was enhanced in regions where vaccination with PsA-TT had been undertaken in 2011, and in one district where a reactive vaccination campaign in response to an outbreak of meningitis was undertaken. Meningococcal carriage was studied in an age-stratified sample of residents aged 1-29 years of a rural area roughly 13-15 and 2-4 months before and 4-6 months after vaccination. Meningococci obtained from cerebrospinal fluid or oropharyngeal swabs were characterised by conventional microbiological and molecular methods. FINDINGS: Roughly 1·8 million individuals aged 1-29 years received one dose of PsA-TT during a vaccination campaign in three regions of Chad in and around the capital N'Djamena during 10 days in December, 2011. The incidence of meningitis during the 2012 meningitis season in these three regions was 2·48 per 100,000 (57 cases in the 2·3 million population), whereas in regions without mass vaccination, incidence was 43·8 per 100,000 (3809 cases per 8·7 million population), a 94% difference in crude incidence (p<0·0001), and an incidence rate ratio of 0·096 (95% CI 0·046-0·198). Despite enhanced surveillance, no case of serogroup A meningococcal meningitis was reported in the three vaccinated regions. 32 serogroup A carriers were identified in 4278 age-stratified individuals (0·75%) living in a rural area near the capital 2-4 months before vaccination, whereas only one serogroup A meningococcus was isolated in 5001 people living in the same community 4-6 months after vaccination (adjusted odds ratio 0·019, 95% CI 0·002-0·138; p<0·0001). INTERPRETATION: PSA-TT was highly effective at prevention of serogroup A invasive meningococcal disease and carriage in Chad. How long this protection will persist needs to be established. FUNDING: The Bill & Melinda Gates Foundation, the Wellcome Trust, and Médecins Sans Frontères