Development of a New Microextraction Fiber Combined to On-Line Sample Stacking Capillary Electrophoresis UV Detection for Acidic Drugs Determination in Real Water Samples

A new analytical method coupling a (off-line) solid-phase microextraction with an on-line capillary electrophoresis (CE) sample enrichment technique was developed for the analysis of ketoprofen, naproxen and clofibric acid from water samples, which are known as contaminants of emerging concern in aquatic environments. New solid-phase microextraction fibers based on physical coupling of chromatographic supports onto epoxy glue coated needle were studied for the off-line preconcentration of these micropollutants. Identification and quantification of such acidic drugs were done by capillary zone electrophoresis (CZE) using ultraviolet diode array detection (DAD). Further enhancement of concentration sensitivity detection was achieved by on-line CE “acetonitrile stacking” preconcentration technique. Among the eight chromatographic supports investigated, Porapak Q sorbent showed higher extraction and preconcentration capacities. The screening of parameters that influence the microextraction process was carried out using a two-level fractional factorial. Optimization of the most relevant parameters was then done through a surface response three-factor Box-Behnken design. The limits of detection and limits of quantification for the three drugs ranged between 0.96 and 1.27 µg∙L⁻¹ and 2.91 and 3.86 µg∙L⁻¹, respectively. Recovery yields of approximately 95 to 104% were measured. The developed method is simple, precise, accurate, and allows quantification of residues of these micropollutants in Genil River water samples using inexpensive fibers.

Induction of the Phenylpropanoid Pathway by Acibenzolar-S-Methyl and Potassium Phosphite Increases Mango Resistance to Ceratocystis fimbriata Infection

This study used both microscopic and biochemical analyses to investigate the possible defense responses induced by acibenzolar-S-methyl (ASM) and potassium phosphite (Phi) in mango plants inoculated with Ceratocystis fimbriata. Disease development was evaluated in the stems of inoculated mango plants and these were examined using fluorescence and light microscopy. High-performance liquid chromatography (HPLC) was used to quantify secondary metabolites in the stem sections. Spraying the plants with ASM and Phi reduced internal necrosis and disease development. The ASM and Phi induced many microscopic defense responses in the stem tissues against C. fimbriata infection. HPLC analysis revealed that the concentrations of two alkaloids (theobromine and 7-methylxanthine) and 10 phenolic compounds (catechin, epicatechin, epigallocatechin, gallic acid, myricetin, p-coumaric acid, p-hydroxybenzoic acid, phloridzin, sinapinic acid, and salicylhydroxamic acid) were higher in the stem tissues of plants sprayed with ASM or Phi than in inoculated control treatment. The concentrations of phenolic compounds were higher in the stem tissues of inoculated plants than in noninoculated plants, while the inverse was observed for alkaloids. Higher concentrations of secondary metabolites in the stem tissues were detected in the early stages of fungal infection, especially in plants treated with inducers. Taken together, the results from the present study clearly support the concept that the phenylpropanoid pathway in the stem tissues of mango plants infected by C. fimbriata can be induced by ASM and Phi.

Single drop microextraction and gas chromatography-mass spectrometry for the determination of diflufenican, mepanipyrim, fipronil, and pretilachlor in water samples

An analytical method for the determination of diflufenican, mepanipyrim, pretilachlor, and fipronil in water samples was developed using single drop microextraction in the direct immersion mode and gas chromatography-mass spectrometry. A factorial fractionated design of type 2(6-1) at two levels was performed, to study the influence of experimental variables such as ionic strength, pH, agitation speed, extraction time, drop volume, and sample volume. To establish the optimal conditions for the variables that were significant, a Doehlert design was performed. The optimum conditions of extraction were 1 μL of heptane immersed in 4.0 mL of sample with continuous agitation at 500 rpm for 30 min at room temperature. The developed method proved to have good linearity for the range studied. The detection limits were 0.07 μg L(-1) for diflufenican, 0.03 μg L(-1) for mepanipyrim, 0.08 μg L(-1) for pretilachlor, and 1.39 μg L(-1) for fipronil. The method was validated on river water samples, showing the absence of matrix effect and recoveries ranged from 90.1 to 107.8 %. The results show that the method developed is accurate, sensitive, rapid, simple, and low cost, so it is recommended for application in the analysis of these different classes of pesticides in water samples.

Spheroidal Fabry-Perot microcavities in optical fibers for high-sensitivity sensing

All-optical-fiber Fabry-Perot interferometers (FPIs) with microcavities of different shapes were investigated. It was found that the size and shape of the cavity plays an important role on the performance of these interferometers. To corroborate the analysis, FPIs with spheroidal cavities were fabricated by splicing a photonic crystal fiber (PCF) with large voids and a conventional single mode fiber (SMF), using an ad hoc splicing program. It was found that the strain sensitivity of FPIs with spheroidal cavities can be controlled through the dimensions of the spheroid. For example, a FPI whose cavity had a size of ~10x60 μm exhibited strain sensitivity of ~10.3 pm/με and fringe contrast of ~38 dB. Such strain sensitivity is ~10 times larger than that of the popular fiber Bragg gratings (~1.2 pm/με) and higher than that of most low-finesse FPIs. The thermal sensitivity of our FPIs is extremely low (~1pm/°C) due to the air cavities. Thus, a number of temperature-independent ultra-sensitive microscopic sensors can be devised with the interferometers here proposed since many parameters can be converted to strain. To this end, simple vibration sensors are demonstrated.

Burnout syndrome and Brazilian civil aviation: a short essay on the focus on prevention

INTRODUCTION

At the same time that there are increased demands we have become more sedentary, increasing risk factors for new diseases. All this reflects on our quality of life with special emphasis upon a particular syndrome called Burnout. Aviation is no exception and packed into its processes each day more expeditious, promotes a perfect environment for the development and spread of the syndrome.

AIM

To evaluate the quality of life, organizational climate, and the level of physical activity among employees of a Brazilian airline.

METHODS

A cross-sectional design was conducted with 8 subjects.

RESULTS

Total score on the WHOQOL quality of life questionnaire was 64.7 (SD 10.8), and the environmental field showed the lowest score. Nevertheless, the sedentary risk factor was performed in 25% of the sample. About the organizational climate, it can be seen that 6.12% of the sample was framed in "Professional Exhaustive", 29.60% in the condition of "Warning", and 64.37% in the condition of "Professional Efficiency".

CONCLUSION

the study found a low quality of life, especially in the environmental category, sedentary people and a large proportion of employees in this Brazilian airline with negative scores on the Organizational Climate.

Umbilical cord transection in twin-reverse arterial perfusion syndrome with the use of a coaxial bipolar electrode (Versapoint®)

Umbilical-cord occlusion has been proposed for the treatment of twin-reverse arterial perfusion syndrome (TRAP). Transection of the umbilical cord is necessary in patients with monoamniotic or 'pseudomonoamniotic' TRAP to avoid subsequent cord entanglement and demise of the pump twin. We present a case of TRAP in which the umbilical cord was successfully ligated with suture and transected with the Versapoint electrode.

Clinical outcomes and predictive factors in patients with liver metastasis from breast cancer treated with gemcitabine and cisplatin (GC) salvage regimen

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Background: Liver metastasis (mets) from breast cancer is typically associated with poor prognosis. GC is a good option, since patients (pts) have often failed anthracycline and taxane therapy and liver dysfunction may preclude these regimens. Methods: Retrospective study designed to evaluate the clinical outcomes and predictive factors in pts with metastatic breast cancer treated with GC, with special interest for liver mets. Results: From 2004 to 2007, 56 pts were treated with GC. Median age was 52.1 years, 33 pts had PS 0–1, 26 were hormone receptor (HR) negative, 32 had been treated with 3 or more chemotherapy (CT) regimens and 34 had liver mets. The median overall survival (OS) was 7,1 mo (95% CI; 4.3–9.7), the progression free survival was 3.3 mo (95% CI; 2.2–5.5) and the clinical response rate was 25%. OS was 4.0 mo (95% CI; 2.3–8.9) for pts with liver mets and 9.7 mo (95% CI; 6.9–12.9) for pts without liver mets (p = 0.03). No factor showed correlation with OS in pts with liver mets, including age < 45 years (median OS [95% CI]: 2.8 mo [1.8–11.5] versus 4.5 mo [2.5–8.9]; p = 0.74), PS 0–1 (median OS [95% CI]: 7.3 mo [2.5–11.5] versus 2.8 mo [0.8–9.7]; p = 0.55), HR positivity (median OS [95% CI]: 7.3 mo [2.0–11.5] versus 5.9 mo [1.9–9.7]; p = 0.87), bilirubin level ≥ 5 times the superior limit of the normality (median OS [95% CI]: 5.9 mo [0.5–16.7] versus 4.5 mo [2.5–9.7]; p = 0.45), progression free interval after the previous CT ≤ 1 mo (median OS [95% CI]: 4.0 mo [2.0–9.7] versus 7.1 mo [2.5–14.7]; p = 0.93) and previous treatment with ≥ 3 CT regimens (median OS [95% CI]: 7.3 mo [1.0–11.0] versus 4.0 mo [2.0–9.7]; p = 0.93). Conclusions: These data is in accordance with the literature concerning the dismal prognosis in liver mets from breast cancer and the clinical activity of GC. We could not define predictive factors in this cohort, which was probably due to the relatively small number of pts.

No significant financial relationships to disclose.

[Composition and antioxidant capacity of the guava (Psidium guajava L.) fruit, pulp and jam]

Guava (Psidium guajava L.) is a tropical fruit widely relished in the tropics, consumed fresh and processed. In this work, free acidity, pH, ash, nitrogen and water contents were measured, besides the total polyphenol content and the antioxidant capacity of the peel, the shell and the pulp of the fresh fruit and the processed guava pulp and jam. The highest phenolic content was found in the guava skin la (10.36 g/100 g skin) and the lowest in the jam (1.47 g/ 100 g jam), in dry weight. The antioxidant capacity of the skin was 10 times higher than that of the pulp, and the jam was twice that of the shell.

Drug allergy claims in children: from self-reporting to confirmed diagnosis

BACKGROUND

Poorly documented self-reported drug allergy (DAll) is a frequent problem in daily clinical practice and has a considerable impact on prescription choices. The diagnostic work-up of drug hypersensitivity (DHs) allows a better classification of the reactions and provides patients with more reliable information and recommendations for future treatments.

OBJECTIVE

To assess the prevalence of self-reported adverse drug reactions (ADRs) and DAll in a paediatric population and to investigate children reporting suspected DAll in order to achieve a firm diagnosis.

DESIGN

The first phase was based on a cross-sectional survey assessing the life occurrence of ADRs and self-reported DAll carried out at the outpatient clinic of a paediatric hospital. The second phase was based on the diagnostic work-up in children with parent-reported DAll, including detailed anamnesis and in vitro and in vivo investigations (skin and provocation tests). Participants One thousand four hundred and twenty-six parents responded to the initial survey. Sixty of the 67 patients with reported DAll were evaluated at the allergy clinic.

RESULTS

The prevalences of self-reported ADRs and DAll were 10.2% and 6.0%, respectively. Most of the suspected allergic reactions were non-immediate cutaneous events attributable to beta-lactam antibiotics and occurred in very young children. Thirty-nine of the 60 patients consulting for evaluation had a plausible clinical history and were recommended further investigation. DHs was diagnosed in three children only, based on positive responses in skin (n=1) and oral provocation (n=2) tests.

CONCLUSION

ADRs are frequently reported in children, and many children are classified as having a DAll. After complete evaluation, only a few of these reactions can be attributed to DHs and DAll. Most of the patients (94% in this study) could actually tolerate the initially suspected drug.

Effect of haemin on growth, protein content and the antioxidant defence system inTrypanosoma cruzi

A nutritional characteristic of trypanosomatid protozoa is thatin vitrothey need a haem-compound as a growth factor, which is supplied as haemoglobin, haematin or haemin. Because haemin and related porphyrins are an important source of oxidative stress in biological systems, the effect of haemin on growth, protein content and the antioxidant defence system inTrypanosoma cruziwas evaluated. We have observed that, in epimastigotes grown under different haemin concentrations in the culture medium (0–30 mg/l), 5 mg/l was the haemin concentration yielding optimum growth. Above 15 mg/l there was a clear decrease in growth rate, producing the epimastigote to amastigote transformation. Such morphological change was observed together with a marked injury of the enzymatic machinery of the parasite, leading to diminished protein synthesis as well as lower activity of the antioxidant enzymes (superoxide dismutase, ascorbate peroxidase and trypanothione reductase), reduced total thiol content and a marked increase in the HaemOx-1 activity and expression. The current work demonstrates that there is a correlation between higher haemin concentrations in the culture medium and oxidative damage in the cells. Under these conditions induction of HaemOx-1 would indicate the important role of this enzyme as an antioxidant defence response inTrypanosoma cruzi.

Determination of pyrimethanil and kresoxim-methyl in soils by headspace solid-phase microextraction and gas chromatography-mass spectrometry

A method using headspace solid-phase microextraction (HS-SPME) then gas chromatography-mass spectrometry with selected ion monitoring (GC-MS, SIM) has been developed for determination of trace amounts of the fungicides pyrimethanil and kresoxim-methyl in soil and humic materials. Both fungicides were extracted on to a fused-silica fibre coated with 85 microm polyacrylate (PA). Response-surface methodology was used to optimise the experimental conditions. For soil samples the linear dynamic range of application was 0.004-1.000 microg g(-1) for pyrimethanil and 0.013-1.000 microg g(-1) for kresoxim-methyl. The detection limits were 0.001 microg g(-1) and 0.004 microg g(-1) for pyrimethanil and kresoxim-methyl, respectively. HP-SPME-GC-MS analysis was highly reproducible-relative standard deviations (RSD) were between 6.7 and 12.2%. The method was validated by analysis of spiked matrix samples and used to investigate the presence of pyrimethanil and kresoxim-methyl above the detection limits in soil and humic materials.

Determination of the antibacterial trovafloxacin by differential-pulse adsorptive stripping voltammetry

A differential-pulse adsorptive stripping voltammetric method for the determination of trace amounts of the antibacterial trovafloxacin (TRFLX) is proposed. The optimal experimental parameters for the drug assay were: accumulation potential=-0.30 V (vs. Ag/AgCl), accumulation time=120 s, pulse amplitude=50 mV and scan rate=5 mV s(-1) in Britton-Robinson buffer (pH 4.5). The linear concentration range of application was 2.0-20.0 ng ml(-1) of TRFLX, with a relative standard deviation of 3.6% (for a level of 5.0 ng ml(-1)) and a detection limit of 0.6 ng ml(-1). The method was applied to determination of TRFLX in human urine and serum samples. It was validated using HPLC as a reference method. Recovery levels of the method reached 100% in all cases

Hyaluronidase inhibitory activity from the polyphenols in the fruit of blackberry (Rubus fruticosus B.)

The hyaluronidase inhibitory activity of different fractions obtained from aqueous extract of blackberry fruits was evaluated. We found that only fractions F3 and F7 inhibit the tested enzyme.

Determination of pyrimethanil and kresoxim-methyl in green groceries by headspace solid-phase microextraction and gas chromatography-mass spectrometry

A method for determination of trace amounts of the fungicides pyrimethanil and kresoxim-methyl in green groceries, previous headspace solid-phase microextraction (HSSPME), was developed using gas chromatography-mass spectrometry and selected ion monitoring (GC-MS, SIM). Both fungicides were extracted with a fused-silica fiber coated with 85 microm polyacrylate. The effects of pH, ionic strength, extraction and desorption times as well as the extraction temperature were studied. The linear concentration range of application was 12.5-250 ng g(-1) for both compounds, with detection limits of 1.8-2.0 ng g(-1) for pyrimethanil and 2.8-3.1 ng g(-1) for kresoxim-methyl. SPME/GC-MS analysis yielded good reproducibility (RSD between 7.4 and 15.0%). It was applied to check the eventual existence of pyrimethanil and kresoxim-methyl above the detection limits on grapes, strawberries, tomatoes and ketchup samples. The method validation was completed with spiked matrix samples. It can be applied as a monitoring tool in grapes, strawberries, tomatoes and ketchup samples.

Determination of grepafloxacin and clinafloxacin by capillary zone electrophoresis

A simple and rapid capillary zone electrophoresis determination method with UV detection of grepafloxacin and clinafloxacin has been developed. The separation was performed in 35 mM borate-35 mM phosphate buffer solution (pH 8.6), containing 6% (v/v) of acetonitrile. Analyses were realised using fused-silica capillaries (57 cm length x 75 microm I.D.) and the operating conditions were: 15 kV applied voltage, 30 degrees C and detection at 279 nm. Piromidic acid was used as an internal standard. The linear concentration range of application was 1.0-120.0 microg ml(-1) for both compounds, with a detection limit of 0.2 microg ml(-1) for grepafloxacin and 0.3 microg ml(-1) for clinafloxacin. The analysis yielded good reproducibility (RSD between 3.37 and 1.74%). It was applied to the determination of grepafloxacin and clinafloxacin in human and rat urine samples. The method was validated using HPLC as a reference method. Recovery levels were between 94.5 and 103%.

Determination of oxadiazon residues by headspace solid-phase microextraction and gas chromatography-mass spectrometry

A method for the determination of trace amounts of the herbicide oxadiazon was developed using headspace solid-phase microextraction (HS-SPME), gas chromatography-mass spectrometry (GC-MS) and selected ion monitoring. It was applied to determine oxadiazon in ground water, agricultural soil, must, wine and human urine samples. To determine oxadiazon in liquid samples, a response surface methodology generated with a Doehlert design was applied to optimize the HS-SPME conditions using a 100 microm polydimethylsiloxane fibre. For the analysis of soil samples, they were mixed with water and the SPME fibre suspended in the headspace above the slurry. Ground water, human urine and must show linear concentration range of application of 0.5-50 ng ml(-1)' with detection limits < or =0.02 ng ml(-1). HS-SPME-GC-MS analysis yielded good reproducibility (RSD values between 6.5 and 13.5%). The method validation was completed with spiked matrix samples. The developed analytical procedure is solvent free, cost effective and fast.

Differential-pulse adsorptive stripping voltammetric determination of the antibacterial lomefloxacin

A differential-pulse adsorptive stripping voltammetric method for the determination of trace amounts of the antibacterial lomefloxacin is proposed. By using an accumulation potential of -0.30 V and a 2 min accumulation time, the linear concentration range of application was 1.0-10.0 ng ml(-1) of lomefloxacin, with a relative standard deviation of 3.8% (for a level of 5.0 ng ml(-1)) and a detection limit of 0.3 ng ml(-1). The method was applied to determination of lomefloxacin in human urine and serum samples. It was validated using HPLC as a reference method. Recovery levels of the method reached 100% in all cases.

Determination of fipronil by solid-phase microextraction and gas chromatography-mass spectrometry

A method for the determination of trace amounts of the insecticide fipronil was developed using solid-phase microextraction-gas chromatography-mass spectrometry and selected ion monitoring. Fipronil was extracted with a fused-silica fiber coated with 85 microm polyacrylate. The effects of pH, ionic strength, sample volume, extraction and desorption times as well as the extraction temperature were studied. Lindane was used as an internal standard. The linear concentration range of application was 0.3-100 ng ml(-1) of fipronil, with a relative standard deviation of 9.5% (for a level of 50 ng ml(-1)) and a detection limit of 0.08 ng ml(-1). The method was applied to check the eventual existence of fipronil above this limit in water and soil samples from Granada (Spain) as well as in human urine samples. The method validation was completed with spiked matrix samples. The method can be applied as a monitoring tool for water, soil and urine, in the investigation of environmental and occupational exposure to fipronil.

Influence of the surfactant concentration on the body distribution of nanoparticles

The rapid reticuloendothelial system (RES) uptake of nanoparticles after i.v. injection, especially by the liver, can be reduced and the body distribution can be altered by coating them with non-ionic surfactants. In the present work 2-14C-poly(methyl methacrylate) nanoparticles were coated with poloxamine 908 and polysorbate 80, and the influence of different surfactant concentrations on the body distribution was investigated. These surfactants were chosen because earlier studies showed that poloxamine 908 was very effective in decreasing the liver uptake and keeping the nanoparticles in circulation, whereas polysorbate 80 was the most effective surfactant to direct the particles to organs that do not belong to the RES. Above nanoparticles were injected i.v. to rats and the animals were sacrificed after 30 min. Below a surfactant concentration of 0.1% the nanoparticle preparations behaved like uncoated particles. At a 0.1% concentration a very sudden and significant change in the body distribution occurred with poloxamine 908. The liver concentration decreased from about 75% of the dose to 13% and stayed at this level at higher surfactant concentrations. This decrease was combined with a similar sudden complementary increase in blood and other organ and tissue concentrations. With polysorbate 80 the decrease in liver concentration and increase in the blood and the other organ levels was gradual and became important only above 0.5% surfactant concentration. The results indicate that the type of interaction and the strength of the adsorptive binding to the nanoparticles are different with different surfactants. This in turn leads to different body distribution patterns after i.v. injection of surfactant coated nanoparticles.

Analysing organophosphorus pesticides in wines using graphitized carbon black extraction cartridges

A quick and simple method was developed to determine the residues of 15 organophosphorus pesticides of different polarity in grape wine, based on liquid-solid extraction with graphitized carbon black cartridges and capillary gas chromatography. Aliquots of diluted wine (10 ml wine + 40 ml deionized water) and 250 mg graphitized carbon black cartridges were used to extract the analytes. The pesticides were eluted with 2 x 0.5 ml acetone and 3 x 2.5 ml ethyl acetate/acetone (80:20). The eluates were then dried with anhydrous sodium sulphate and concentrated to 1 ml under a nitrogen current. After adding triphenylphosphate internal standard (i.s.), this extract was analysed by capillary gas chromatography using a nitrogen-phosphorus detector (GC-NPD). Pesticide recovery percentages at levels of 0.01 and 0.02 microgram/ml were between 74% and 111%, with a 2-13% relative standard deviation interval. The chromatograms of extracts had few co-extracted species peaks, with no analytical interference. Dilution of the grape wine samples removed most of the pigments, thus producing clear extracts. The results indicate that liquid-solid extraction from wine samples using graphitized carbon is fast (25 min per sample), efficient and reproducible for analysing organophosphorus pesticides of different polarity.

Odontogenic myxomas are not associated with activating mutations of the Gs alpha gene

BACKGROUND

Myxoma is a rare bone tumor of the mandible and maxillary sinus whose etiology and underlying molecular mechanisms remain unknown. Mutations that inhibit the GTPase activity of the a subunit of the stimulating G protein (Gsa) have been demonstrated in the myocardium of patients with McCune-Albright syndrome. The histopathological similarities shared by cardiac and jaw myxomas coupled with the paucity of reported candidate genes involved in jaw tumor pathogenesis, prompted us to investigate for the presence of gsp mutations in 23 sporadic jaw myxomas.

MATERIALS AND METHODS

We used the polymerase chain reaction (PCR) to amplify the appropriate genomic fragments, followed by denaturing gradient gel electrophoresis (DGGE) analysis.

RESULTS

No gsp mutations could be demonstrated in any of tumors analyzed, while the technique has a proven capability to detect these specific mutations.

CONCLUSIONS

We conclude that mutations of the Gs alpha gene rarely, if ever, are associated with sporadic jaw myxomas tumorigenesis.

Body distribution of azidothymidine bound to hexyl-cyanoacrylate nanoparticles after i.v. injection to rats

Cells of the reticuloendothelial system (RES e.g. macrophages) play an important role in the immunopathogenesis of AIDS. The objective of the present study was to investigate the possibility of specifically targeting antiviral drugs such as azidothymidine (AZT) to macrophages using nanoparticles as colloidal drug carriers. In a first series of experiments the body distribution of 14C-labelled AZT bound to nanoparticles and a similarly prepared control solution with unbound AZT were studied in rats after intravenous injection. In a second series of experiments polysorbate 80-coated nanoparticles and a solution of AZT in saline were tested. 14C-labelled AZT was bound to nanoparticles using the surfactant bis(2-ethylhexyl) sulphosuccinate sodium (DOSS). The radioactivity in several organs, including those containing large numbers of macrophages, was measured after intravenous injection of the AZT-nanoparticles and the AZT-control solutions. AZT concentrations were up to 18 times higher in organs belonging to the RES if the drug was bound to nanoparticles compared with unbound AZT. These results demonstrate that nanoparticles are a potential drug targeting system for anti-AIDS drugs. The increase in drug concentration at the sites containing abundant macrophages may allow a reduction in dosage to reduce systemic toxicity.

"Mixed dementia": adequate or antiquated? A critical review

Despite its importance and widespread usage, the term mixed dementia, referring to the coexistence of Alzheimer's disease (AD) and vascular dementia (VsD), has been ill-defined and poorly conceptualized. The authors review the use of the term mixed dementia in neuropathological and clinical research. As a result of recent developments in the categorization of dementias, they recommend discarding the term mixed dementia in favor of a more precise terminology based on AD and VsD concurrently meeting established criteria for each diagnosis.

Prognostic value of simultaneous perfusion and function assessment using technetium-99m sestamibi

This study examines the prognostic value of simultaneous perfusion and function assessment in 412 patients. The exercise perfusion pattern was a stronger predictor of events (mostly acute nonfatal myocardial infarcts) than resting ejection fraction.