Registro Multicêntrico de Takotsubo (REMUTA) – Aspectos Clínicos,Desfechos Intra-Hospitalares e Mortalidade a Longo Prazo

BackgroundTakotsubo syndrome (TTS) is an acquired form of cardiomyopathy. National Brazilian data on this condition are scarce. The Takotsubo Multicenter Registry (REMUTA) is the first to include multicenter data on this condition in Brazil.ObjectiveTo describe the clinical characteristics, prognosis, in-hospital treatment, in-hospital mortality, and mortality during 1 year of follow-up.MethodsThis is an observational, retrospective registry study including patients admitted to the hospital with diagnosis of TTS and patients admitted for other reasons who developed this condition. Evaluated outcomes included triggering factor, analysis of exams, use of medications, complications, in-hospital mortality, and mortality during 1 year of follow-up. A significance level of 5% was adopted.ResultsThe registry included 169 patients from 12 centers in the state of Rio de Janeiro, Brazil. Mean age was 70.9 ± 14.1 years, and 90.5% of patients were female; 63% of cases were primary TTS, and 37% were secondary. Troponin I was positive in 92.5% of patients, and median BNP was 395 (176.5; 1725). ST-segment elevation was present in 28% of patients. Median left ventricular ejection fraction was 40 (35; 48)%. We observed invasive mechanical ventilation in 25.7% of cases and shock in 17.4%. Mechanical circulatory support was used in 7.7%. In-hospital mortality was 10.6%, and mortality at 1 year of follow-up was 16.5%. Secondary TTS and cardiogenic shock were independent predictors of mortality.ConclusionThe results of the REMUTA show that TTS is not a benign pathology, as was once thought, especially regarding the secondary TTS group, which has a high rate of complications and mortality. (Arq Bras Cardiol. 2020; 115(2):207-216)     

Antimicrobial activities of novel bipyridine compounds produced by a new strain of Saccharothrix isolated from Saharan soil

The actinobacterium strain ABH26 closely related to Saccharothrix xinjiangensis, isolated from an Algerian Saharan soil sample, exhibited highly antagonist activity against Gram-positive bacteria, yeasts and filamentous fungi. Its ability to produce antimicrobial compounds was investigated using several solid culture media. The highest antimicrobial activity was obtained on Bennett medium. The antibiotics secreted by strain ABH26 on Bennett medium were extracted by methanol and purified by reverse-phase HPLC using a C18 column. The chemical structures of the compounds were determined after spectroscopic (¹H NMR, ¹³C NMR, ¹H-¹H COSY and ¹H-¹³C HMBC spectra), and spectrometric (mass spectrum) analyses. Two new cyanogriside antibiotics named cyanogriside I (1) and cyanogriside J (2), were characterized along with three known caerulomycins, caerulomycin A (3), caerulomycin F (4) and caerulomycinonitrile (5). This is the first report of cyanogrisides and caerulomycins production by a member of the Saccharothrix genus. The minimum inhibitory concentrations (MIC) of these antibiotics were determined against pathogenic microorganisms.     

Design and preliminary results of FRENSHOCK 2016: A prospective nationwide multicentre registry on cardiogenic shock

Central illustration: geographic distribution of the 49 centres participating in the FRENSHOCK registry (35 academic hospitals, 10 general hospitals and four private clinics). Inclusion per centre varied from 1 to 72 patients.

     

免疫检查点抑制剂治疗少见突变非小细胞肺癌疗效的研究进展

驱动基因的发现及针对驱动基因的靶向治疗已显著提高了肺癌患者的生存质量和时间，但目前对于BRAF、HER2、MET、RET等少见驱动基因改变肺癌患者的靶向药物的选择仍然较少。近年来免疫检查点抑制剂在肺癌治疗中取得了一定的疗效，但因为少见驱动基因突变的肺癌患者本身样本量少，开展大规模临床随机对照试验尚存在一定的困难，目前此类患者接受免疫检查点抑制剂治疗的疗效情况仍不明确。本文将对目前已掌握的免疫检查点抑制剂治疗BRAF、HER2、MET、RET等少见驱动基因改变肺癌患者的临床研究结果进行综述，以期在一定程度上为临床工作提供一些依据和参考。     

Faut-il être adventiste du 7 Jour pour être en bonne santé ?

Many health-related research studies among Seventh-day Adventists (SDA) were published since 1958. Californian and Norwegian studies have shown that SDA have lower coronary mortality rates than the general population. This finding is usually attributed to the lifestyle advocated by the Seventh-day Adventist church with greater physical activity, lower median BMI, abstention from use of alcohol and tobacco, food habits characterized by a large intake of fruits, vegetables, cereal fiber, unsaturated fatty acids and a low consumption of saturated fats. The results about cancer incidence were discussed. Californian studies have shown significantly decreased relative risk in SDA than in the general population. Japanese studies have also reported lower risk of cancers in men with lifestyles similar to those of SDA. By contrast the Norwegian study of SDA has shown that the risk of cancer seems to be similar to that of the general population. Some studies reported a greater prevalence of type 2 diabetes in the non vegetarian SDA than the vegetarian. Compared with vegetarian, non vegetarian SDA reported more medication use, more chronic diseases, more hospitalizations and surgeries. Lifestyle choices of SDA as above described could prevent a great many coronary artery disease and type 2 diabetes. This lifestyle is now emphasized by French PNNS.     

顽固性下颌磨牙根尖周炎患者的治疗和护理讨论

目的治疗顽固性下颌磨牙根尖周炎。并尽量减少对牙周膜的机械性损伤。方法采用下牙槽神经阻滞麻醉,并配合局部麻醉。拔牙钳的尖置放于釉牙骨质界以上,采用颊舌向摆动的方式将患牙拔下。在不断滴有生理盐水的条件下,立即用高速车针磨除患牙根尖2￣3mm的牙体组织,根管内3￣5mm深的充填物要用圆钻将其清除,再用牙胶尖和氢氧化钙糊剂充填。将患牙再植入牙槽窝之前,务必用生理盐水将牙槽窝冲洗干净,要求严格控制在15分钟内完成再植,并尽量减少对牙周膜的机械性损伤。再植牙齿一般不需要夹板固定,必要时可采用缝线缝合固定。结果我们选择的5例患者,术后随访1￣2年,1例患者再植失败,4例患者再植成功。结论特异性再植术治疗顽固性下颌磨牙根尖周炎疗效理想,而且较易掌握。