Is the variation in monocyte to high-density lipoprotein cholesterol ratio a predictor of major cardiovascular events after acute coronary syndrome?

In clinical practice, we need to develop new tools to identify the residual cardiovascular risk after acute coronary syndrome (ACS). This study aimed to evaluate whether the monocyte to high-density lipoprotein cholesterol ratio (MHR) variation (ΔMHR) obtained during hospital admission (MHR1) and repeated in the first outpatient evaluation (MHR2) is a predictor of major adverse cardiovascular events (MACE) after ACS. One hundred ninety-one patients admitted for ACS were prospectively included. The ΔMHR was calculated by subtracting MHR1 from MHR2. Patients were followed for 166±38 days in which the occurrence of MACE was observed. The best cutoff for ΔMHR was zero (0), and individuals were divided into two groups: ΔMHR<0 (n=113) and ΔMHR≥0 (n=78). The presence of MACE was higher in the ΔMHR≥0 (22%) than in the ΔMHR<0 (7%), with a hazard ratio (HR) of 3.96 (95% confidence interval [CI]: 1.74-8.99; P=0.0004). After adjusting for confounders, ΔMHR≥0 remained an independent MACE predictor with an adjusted HR of 3.13 (95%CI: 1.35-7.26, P=0.008). In conclusion, our study showed that ΔMHR was an independent MACE predictor after ACS. Thus, ΔMHR is a potential marker of residual cardiovascular risk after ACS.

SWAN-Venule: An Optimized MRI Technique to Detect the Central Vein Sign in MS Plaques

BACKGROUND AND PURPOSE

Multiple sclerosis lesions develop around small veins that are radiologically described as the so-called central vein sign. With 7T MR imaging and magnetic susceptibility-based sequences, the central vein sign has been observed in 80%-100% of MS lesions in patients' brains. However, a lower proportion ∼50% has been reported at 3T using susceptibility-weighted angiography (SWAN). Our aim was to assess a modified version of SWAN optimized at 3T for sensitive detection of the central vein sign.

MATERIALS AND METHODS

Thirty subjects with MS were scanned on a 3T clinical MR imaging system. 3D T2-weighted FLAIR and optimized 3D SWAN called SWAN-venule, were acquired after injection of a gadolinium-based contrast agent. Patients showing >3 focal white matter lesions were included. The central vein sign was recorded by 2 trained raters on SWAN-venule images in the supratentorial brain.

RESULTS

Twenty patients showing >3 white matter lesions were included. A total of 380 white matter lesions (135 periventricular, 144 deep white matter, and 101 juxtacortical) seen on both FLAIR and SWAN-venule images were analyzed. Overall, the central vein sign was detected in 86% of the white matter lesions (periventricular, 89%; deep white matter, 95%; and juxtacortical, 78%).

CONCLUSIONS

The SWAN-venule technique is an optimized MR imaging sequence for highly sensitive detection of the central vein sign in MS brain lesions. This work will facilitate the validation and integration of the central vein sign to increase the diagnostic certainty of MS and further prevent misdiagnosis in clinical practice.

What do tiger-fly larvae (Diptera: Muscidae) eat?

Coenosia attenuata, usually known as tiger-fly, is a generalist predator of agricultural and forest pests in both larval and adult stages; it has potential to be an effective biocontrol agent in protected crops. To contribute for the knowledge of which prey this predator larvae potentially consumes, and of the occurrence and the conditions that promote cannibalism by tiger-fly larvae, intact alive specimens and portions of the earthworm Lumbricus terrestris were tested as prey and the cannibalism was evaluated in the presence or in absence of fungus gnat larvae. The tiger-fly larvae fed on the bisected earthworm portions but seem to have difficulty to penetrate in the cuticle of the alive and moving L. terrestris. However, the time to start feeding on the portions of L terrestris was shorter than on fungus gnats. Cannibalism by C. attenuato was not detected, but mortality occurred in several modalities. Nevertheless, escaping from the Petri dishes was the dominant behaviour of the larvae in the cannibalism evaluation assay.

Annotated catalogue of the flowering plants of São Tomé and Príncipe

A catalogue of the flowering plants of the islands of São Tomé and Príncipe (Gulf of Guinea) is presented. Flowering plant diversity figures are updated to: 135 families (20 introduced), 624 genera (172 introduced), 1 104 species (301 introduced) plus 15 additional infraspecific taxa. At present 119 taxa (107 species and 12 infraspecific taxa) are known to be endemic to the two islands. The catalogue includes accepted names, synonyms used in recent literature, common names, voucher specimens and information on habit and habitat and on plant uses, particularly medicinally.

Aloe in Angola (Asphodelaceae: Alooideae). ACTA ACUST UNITED AC 2009. [DOI: 10.4102/abc.v39i1.228]

Botanical exploration of Angola was virtually impossible during the almost three-decade-long civil war. With more areas becoming accessible, there is, however, a revived interest in the flora of this country. A total of 27 members of the genus Aloe L. have been recorded for Angola. It is not unlikely that new taxa will be discovered, and that the distribution ranges of others will be expanded now that botanical exploration in Angola has resumed. This manuscript provides a complete taxonomic treatment of the known Aloe taxa in Angola. It includes, amongst other information, identification keys, descriptions and distribution maps.

The effect of crop protection strategy on pest and beneficials incidence in protected crops

This study took place in the Oeste region from 1996-1999 and it intended to analyse if the crop protection strategy followed by the farmer influenced the arthropod incidence and the natural control in protected vegetable crops under Mediterranean conditions. The observations were made fortnightly (Autumn/Winter) or weekly (Spring/Summer) in 30-60 plants/parcel (1 plant/35 m2) in order to evaluate incidences. Samples of pests and natural enemies were collected for systematic identification in two greenhouses for each protection strategy (traditional chemical control (TCC), integrated pest management (IPM) and pest control allowed in organic farming (OF)) in lettuce, tomato, green beans and cucumber. Data on incidence of mites, aphids, caterpillars, leafminers, whiteflies, thrips and respective natural enemies were registered as well as phytosanitary treatments performed (farmers' information and/or in loco traces). The leafminers were the pest whose incidence more often presented significant statistical differences between the studied protection strategies. In relation to this pest, the main results obtained were: a higher feeding punctures incidence in TCC than in IPM; higher incidence of adults, mines and feeding punctures in TCC than in OF; and a higher mines' incidence in IPM than in OF. Both in TCC and IPM high percentages of plants with mines were found although without an adult proportional presence. In the first case this was due to the repeatedly phytosanitary treatments applied; in the second case it was due to the natural control, since in IPM and OF greenhouses the collected larvae were mostly parasitized or dead. In spite of the fact these two strategies have as final result a similar mines and adults incidence, their production and environmental costs are quite different. Significant differences at the beneficials' population level between TCC greenhouses and IPM or OF greenhouses were found. As the farmers did no biological treatments these differences are related to different levels of beneficial populations due to different secondary effects of the pesticides applied.

Comparative incidence of depression in women and men, during pregnancy and after childbirth. Validation of the Edinburgh Postnatal Depression Scale in Portuguese mothers

BACKGROUND

Comparing women's and men's emotional reactions to childbirth can clarify the impact on mental health of childbirth as a life event.

METHOD

Fifty-four first-time mothers attending obstetric services in Oporto, Portugal, and 42 of their husbands or partners participated in a longitudinal study of their mental health. All subjects were given a semi-structured clinical interview (SADS) at 6 months antenatally and at 12 months postnatally and sub-samples were interviewed at 3 months postnatally. At all these times all the mothers and fathers also completed a translated version of a self-rating scale for depression, the Edinburgh Postnatal Depression Scale (EPDS).

RESULTS

More women than men had past histories of depression but their rates of depression did not differ significantly during pregnancy. In the first 3 months postnatally, nearly a quarter of the women at risk were found to have become depressed (major, minor and intermittent) in contrast with less than 5% of the men. In the next nine months men were more prone to become depressed than previously and their conditions tended to follow an earlier onset of depression in their spouses.

CONCLUSION

Comparisons of EPDS and SADS ratings showed that the translated EPDS was a valid instrument for women but it was less satisfactory when applied to men.

Correlates of postnatal depression in mothers and fathers

BACKGROUND

We compare and contrast some correlates of paternal and maternal depression after the live birth of a first child, as part of a longitudinal study.

METHOD

Fifty-four first-time mothers attending obstetric services in Oporto, Portugal, and 42 of their husbands or partners participated in a longitudinal study of their mental health. All subjects were given a semi-structured clinical interview (SADS) at six months antenatally and at 12 months postnatally and sub-samples were interviewed at three months postnatally. At all these times all the mothers and fathers also completed a translated version of a self-rating scale for depression, the Edinburgh Postnatal Depression Scale (EPDS) and a series of other questionnaires and interviews to measure different psychosocial variables. Profiles of risk factors associated with depression in the first postnatal year were analysed by means of logistic regressions.

RESULTS

In the mothers, aside from a history of depression, the only other powerful predictor of postnatal depression was the mean objective negative impact score of life events. 'Postnatal' depression in fathers was associated with a history of depression in themselves and with the presence of depression in their wives or partners during pregnancy and soon after delivery.

CONCLUSION

Prevention and early treatment of depression in fathers may benefit not only themselves but also their spouses and their children.

Post-natal depression in an urban area of Portugal: comparison of childbearing women and matched controls

The point prevalence of depression measured on one occasion between 2 and 5 months after childbirth was estimated to be 13.1% in 352 mothers living in urban Portugal; the criterion was a score of 13 or more on a translated version of the Edinburgh Post-natal Depression Scale (EPDS). More detailed comparisons were made between a subgroup of 118 mothers and 118 matched controls who had not borne a child in the previous 2 years. Post-natal women were twice as likely as non-childbearing controls to meet the EPDS criterion for depression In comparison with controls, they were also more severely depressed as judged by their total scores on another questionnaire, the Zung Scale. Comparisons of individual symptom scores (Zung Scale) showed that childbearing women, as a whole, reported more somatic symptoms than controls, but when only those women judged to be depressed or dysphoric by the EPDS were compared, this difference disappeared. Stepwise logistic analyses of symptoms contributing to the categorization of a 'case' of post-natal versus non-post- natal depression did not reveal any very clear divergences in self-reported psychopathology. In childbearing women, two factors were found significantly to contribute to higher depression scores; women with more children and those from lower socio-economic groups were most at risk.

[Preferential projections for mapping and ablation of tachycardia of the right ventricle outflow. Anatomoradiological study]

PURPOSE

To select ideal radiologic projections for mapping and ablation of tachycardias of right ventricular outflow tract (RVOT).

METHODS

Ten hearts from human corpses were studied utilizing radiopaque material to identify the pulmonary valve and three distinct sites on this valve: septal anterior (A), septal posterior (P) and free-wall (L). Next, the hearts were filmed in the frontal plane and in oblique projections with 15 degrees increments to the right and to the left. The projections in which the sites were lateralized on the valve, eased radiologic interpretation and were considered ideal for mapping and ablation. Depending on the proximity of the sites to the lateral extremes of the pulmonary valve, the projections were considered ideal ( ), intermediary (++) and inadequate (+).

RESULTS

Projections [table: see text]

CONCLUSION

The A site of RVOT was best indicated in the 60 and 45 degrees left anterior oblique projections; the 0 degree postero anterior projection was best for mapping the P site; the L region was best explored in the 60 degrees right anterior oblique projection.

[Analysis of the junctional rhythm characteristics in patients with nodal reentry tachycardia treated with slow pathway radiofrequency ablation]

PURPOSE

To study the quantitative and qualitative aspects of junctional rhythm (JR) during radiofrequency (RF) catheter ablation of slow pathway in atrioventricular nodal reentrant tachycardia.

METHODS

Twenty five patients, 5 males, ages ranging from 15 to 76 years, with recurrent atrioventricular nodal reentrant tachycardia, underwent to RF catheter ablation of slow pathway. During RF applications (40V, duration 60s) electrocardiographic was continuously recorded. The recordings were posteriorly used to study the presence and characteristics of JR (number of episodes, frequency and time of onset) at the effective and ineffective RF sessions. All variables were expressed as median and mean +/- SD. Univariate analysis of the effects of each variable on success or failure of ablation were performed using x2 test. A p value < 0.05 was considered significant.

RESULTS

One hundred forty nine RF sessions were performed, 25 effective and 124 ineffective (mean per patient 6, range 1 to 22). JR was present in 18 of 25 effective and 44 of 124 ineffective sessions (p < 0.05). Mean time of appearance was 12s, occurring later this time in 9 of 18 effective and in 10 of 44 ineffective sessions (p < 0.05). Mean number of episodes was 3, occurring higher number in 7 of 18 effective and in 4 of 44 ineffective sessions (p < 0.05). Median of frequency of JR was 100bpm; 11 of 18 effective and 15 of 44 ineffective sessions presented higher frequencies (p < 0.05).

CONCLUSION

JR during slow pathway ablation is a sensitive marker of ablation success. JR predictor of success has higher number of episodes, higher frequency and later time of appearance than that one of ineffective sessions.

Identification, purification and partial characterization of a carboxypeptidase from the matrix of rat liver mitochondria: a novel metalloenzyme

A novel carboxypeptidase has been purified to apparent homogeneity from the matrix fraction of rat liver mitochondria by using a procedure mainly based on immobilized-metal-affinity chromatography (IMAC). This carboxypeptidase has been named mCP-III, since it represents the third major peak of carboxypeptidase activity after the IMAC step of purification. mCP-III hydrolyses a number of N-blocked dipeptides, with preference for Cbz-Phe-Ala, and shows no degrading activity towards 125I-casein. The optimal pH of its activity is 7.6, the apparent Km for Cbz-Phe-Ala is 0.12 mM and the specific activity is 145.5 mumol/min per mg of protein. The enzyme is a typical metalloproteinase, is inhibited by 1,10-phenanthroline and carboxypeptidase inhibitor and re-activated by added Zn2+ and Co2+. The molecular mass estimated by molecular-sieve h.p.l.c. was approx. 115 kDa with two protein bands of 61 and 50 kDa shown by SDS/PAGE analysis, indicating that the enzyme is active as a dimer. This is the first clearly identified carboxypeptidase within mitochondria.

Effect of dose of GnRH analog on ovulation in mares

Proper timing of insemination for optimal conception is accomplished by frequent palpations per rectum, by ultrasonography of the preovulatory follicle and/or by treatment with hCG or GnRH. Sustained release of GnRH from implants has been shown to hasten ovulation. Therefore, 2 studies were conducted to evaluate the efficacy of a GnRH analog, deslorelin, for hastening ovulation in nonlactating cyclic mares. The GnRH implant was 2.3x3.7 mm and released deslorelin for 2 to 3 days. In Experiment 1, 60 nonlactating, cycling mares were assigned to 1 of 5 doses: 0, 1.2, 1.7, 2.2 and 2.7 mg per implant. Mares were assigned sequentially on the first day of estrus (Day 1). Ovaries were examined per rectum and with ultrasonography every 12 h until ovulation. Once the mares obtained a follicle>30 mm, they were injected subcutaneously with a GnRH implant. The mares were inseminated every other day during estrus with semen from 1 of 3 stallions. Pregnancy was determined with ultrasonography. Experiment 2, 40 nonlactating, cyclic mares were assigned to 1 of 5 treatments (same treatments as in Experiment 1). Data were obtained on interval to ovulation, duration of estrus and pregnancy rates at 12, 18 and 35 d after ovulation. Time to ovulation was shorter (P<0.05) in GnRH-treated mares than in control mares in the Experiment 1. Mean time to ovulation was 68, 49, 48, 47, 44 h in Experiment 1, and 91, 66, 58, 46, 58 h in Experiment 2 for mares given 0, 1.2, 1.7, 2.2 and 2.7 mg/mare in the 2 trials. Averaged for both experiments, the proportion of mares ovulating within 48 h of treatment was 40, 75, 85, 90 and 90% for 0, 1.2, 1.7, 2.2 and 2.7 mg/mare. For both experiments, there was no effect of GnRH on pregnancy rate. In summary, a subcutaneous implant containing GnRH analog induced ovulation in most mares by 48 h of injection, and there was no advantage of doses higher than 2.2 mg/mare.

[Contribution to the pathogenesis and treatment of post-partum schizophrenic episodes. A collective and family therapy in a day care unit]

We tried to summarise our personal experience showing that a high percentage of psychotic post-partum breaks may be treated in a day unit using tritherapy. We described the advantages for a collective institutional therapy, the tritherapy, especially regarding to the treatment of schizophrenic crises. The treatment we propose for the post-partum psychotic crises in a day unit would ease: 1) The preservation of part of the patient's autonomy which would valorise her. 2) The facility for supervising the institutional work, especially for nursing care so import in the institutional casing of the mother-baby pair. 3. Possibility to integrate the husband in the treatment. We did notice in post-partum schizophrenic breaks the influence of the husband's attitude on the mother's illness at least in a certain amount of cases he puts on the mother's back his own ambivalency regarding to the child. This attitude in the natural dependency of mother hood has the same destructurating effect as a double blind.

[Characteristics of psychiatric day care units: a tentative clarification]

For more than 20 years now, an important literature has informed us of the advantages and disadvantages of Day Units, but sometimes in a way which is not always impartial. In the same view the delimitation of the aspects of Day Units and the appreciation of their great field of application are sometimes not all that clear. These component units associated with the conservative outlook of health politic planners and the majority of psychiatrists are promoting factors for the use of psychiatric hospitalizations instead of the use of Day Units and Out-patient facilities on the whole. In this paper, we will start by outlining the frame of the "Day Unit", in its specificity in regard to full time hospitalizations and other modes of psychiatric assistance. We would like to point out the extreme diversity of Day Units according to the type of patients treated, the age, the aims of the institution, the connections with other psychiatric units, the modality of admission etc. Following this, we will try to show what the intrinsic characteristics of Day Units are, especially in comparing them to those of full time hospitalizations; treatment during the day, reduced costs, greater feeling of the outside world, greater automony of the patient, less accent on the fear of madness, less humiliation, reduced fear of psychiatric institutions. Using these intrinsic characteristics, we have tried to define the potential characteristics which are derived directly from the above, but which, to be fully developed, implicate a therapeutic option: better quality of team work, facility for the use of non-directive psychotherapies, prevalence of psycho-medical treatments and sociotherapeutic treatments over the administrative and bureaucratic orders. Finally, we point out that many characteristics of the Day Units, often called intrinsic or potential, issue from conjunctural factors such as the small size of the unit, the convenient geographical situation, the facility for utilization of new therapeutic technics etc. The development of the Day Unit movement was able to profit from the ongoing critic of the usual psychiatric hospital practices and experiences. We do hope that this paper will help to make clear the frame, the different way of application and particularly the characteristics of Day Units which deserve to be well known, well utilized, so that the different psychatric facilities will be able to profit from their use and through this, all those for whom we are asked to care for.