Sixty-minute alteplase protocol: a new accelerated recombinant tissue-type plasminogen activator regimen for thrombolysis in acute myocardial infarction

OBJECTIVES: Our aim was to design and evaluate a new and easily administered recombinant tissue-type plasminogen activator (rt-PA) regimen for thrombolysis in acute myocardial infarction (AMI) based on established pharmacokinetic data that improve the reperfusion success rate. BACKGROUND: Rapid restoration of Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow is a primary predictor of mortality after thrombolysis in AMI. However, TIMI grade 3 patency rates 90 min into thrombolysis of only 50% to 60% indicate an obvious need for improved thrombolytic regimens. METHODS: Pharmacokinetic simulations were performed to design a new rt-PA regimen. We aimed for a plateau tissue-type plasminogen activator (t-PA) plasma level similar to that of the first plateau of the Neuhaus regimen. These aims were achieved with a 20-mg rt-PA intravenous (i.v.) bolus followed by an 80-mg i.v. infusion over 60 min (regimen A). This regimen was tested in a consecutive comparative trial in 80 patients versus 2.25 10(6) IU of streptokinase/60 min (B), and 70 mg (C) or 100 mg (D) of rt-PA over 90 min. Subsequently, a confirmation trial of regimen A in 254 consecutive patients was performed with angiographic assessment by independent investigators of patency at 90 min. RESULTS: The comparative phase of the trial yielded, respectively, TIMI grade 3 and total patency (TIMI grades 2 and 3) of 80% and 85% (regimen A), 35% and 50% (B), 50% and 55% (C) and 60% and 70% (D). In the confirmation phase of the trial, regimen A yielded 81.1% TIMI grade 3 and 87.0% total patency. At follow-up angiography 7 (4.1%) of 169 vessels had reoccluded. In-hospital mortality rate was 1.2%. Nadir levels of fibrinogen, plasminogen and alpha2-antiplasmin were 3.6 +/- 0.8 mg/ml, 60 +/- 21% and 42 +/- 16%, respectively (mean +/- SD). Fifty-seven patients (22.4%) suffered from bleeding; 3.5% needed blood transfusions. CONCLUSIONS: The 60-min alteplase thrombolysis in AMI protocol achieved a TIMI grade 3 patency rate of 81.1% at 90 min with no indication of an increased bleeding hazard; it was associated with a 1.2% overall mortality rate. These results are substantially better than those reported from all currently utilized regimens. Head to head comparison with established thrombolytic regimens in a large-scale randomized trial is warranted

Sunflower Lecithin: Application of a Fractionation Process with Absolute Ethanol

Native or modified lecithins are widely used as a multifunctional ingredient in the food industry. A fractionation process of sunflower lecithin (a non GMO product) with absolute ethanol was used for obtaining enriched fractions in certain phospholipids under different experimental conditions (temperature 35-65 °C, time of fractionation 30-90 min, ethanol/lecithin ratio 2:1, 3:1). Phospholipid enrichment in PC and PI fractions was obtained and analyzed by 31P NMR determinations. The percent extraction coefficients for different phospholipids (%EPC, %EPE and %EPI) in both fractions were calculated. Values of %EPC in PC fractions significantly increased (p < 0.05) from 12.8 (35 °C, 30 min, 2:1) to 57.7 (65 °C, 90 min, 3:1) at increasing temperature and incubation time. %EPE varied from 3.0 to 18.3 in the same fraction while %EPI presented lower values (<3%) under all the conditions assayed. The study of the effect of the operating conditions on the fractionation process evidenced a relevant influence of temperature, incubation time and to a minor extent of the ethanol/lecithin ratio on the enriched fraction yield% and selectivity of the main phospholipids (PC, PI, PE) estimated by %EPL. Response surface methodology (RSM) was utilized to explain the influence of the different parameters to optimize this process.Fil: Cabezas, Dario Marcelino. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas. Centro de Investigación y Desarrollo en Criotecnología de Alimentos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Investigación y Desarrollo en Criotecnología de Alimentos. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Centro de Investigación y Desarrollo en Criotecnología de Alimentos; ArgentinaFil: Diehl, Bernd W. K.. Spectral Service GmbH Laboratorium für Auftragsanalytik; AlemaniaFil: Tomás, Mabel Cristina. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas. Centro de Investigación y Desarrollo en Criotecnología de Alimentos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Investigación y Desarrollo en Criotecnología de Alimentos. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Centro de Investigación y Desarrollo en Criotecnología de Alimentos; Argentin

3D-Integrated Multi-Sensor Demonstrator System for Environmental Monitoring

This paper summarizes the outcome of the EC FP7 project MSP - Multi Sensor Platform for Smart Building Management (Grant Agreement No. 611887). The MSP consortium comprising 17 partners from 6 European countries developed a full manufacturing chain for 3D system integration, which has never been realized before. It enables 3D-integration of highly sophisticated components and sensor devices on a CMOS electronic platform chip. The final multi-sensor system comprises a variety of gas sensors as well as optical sensors for ultraviolet, visible and infrared light. The MSP demonstrator system implemented in a wearable wristband device integrates a total of 57 sensors - this is a worldwide unique sensor system