The ESC ACCA EAPCI EORP acute coronary syndrome ST-elevation myocardial infarction registry

Aims 

The Acute Cardiac Care Association (ACCA)–European Association of Percutaneous Coronary Intervention (EAPCI) Registry on ST-elevation myocardial infarction (STEMI) of the EurObservational programme (EORP) of the European Society of Cardiology (ESC) registry aimed to determine the current state of the use of reperfusion therapy in ESC member and ESC affiliated countries and the adherence to ESC STEMI guidelines in patients with STEMI.

Methods and results 

Between 1 January 2015 and 31 March 2018, a total of 11 462 patients admitted with an initial diagnosis of STEMI according to the 2012 ESC STEMI guidelines were enrolled. Individual patient data were collected across 196 centres and 29 countries. Among the centres, there were 136 percutaneous coronary intervention centres and 91 with cardiac surgery on-site. The majority of centres (129/196) were part of a STEMI network. The main objective of this study was to describe the demographic, clinical, and angiographic characteristics of patients with STEMI. Other objectives include to assess management patterns and in particular the current use of reperfusion therapies and to evaluate how recommendations of most recent STEMI European guidelines regarding reperfusion therapies and adjunctive pharmacological and non-pharmacological treatments are adopted in clinical practice and how their application can impact on patients’ outcomes. Patients will be followed for 1 year after admission.

Conclusion 

The ESC ACCA-EAPCI EORP ACS STEMI registry is an international registry of care and outcomes of patients hospitalized with STEMI. It will provide insights into the contemporary patient profile, management patterns, and 1-year outcome of patients with STEMI.

Twelve years of Lyell's Syndrome in the burn unit of São João Hospital Centre

Stevens-Johnson syndrome (SSJ) and toxic epidermal necrolysis (TEN) correspond to an acute and rare life-threatening mucocutaneous reaction. We describe the etiology, length of stay, comorbidities and mortality of TEN in our hospital in a retrospective study of 12 years. Twenty-one patients were included in the study. The mean age was 66 years: 57.1% were females. One third had mucosal surface involvement. Median TBSA of epidermal detachment was 66% on day 1. Forty-two per cent had a SCORTEN at admission of 3 and 28.6% had a SCORTEN of 4, which performs 70.6% with SCORTEN ≥5. The most common causes of SJS/TEN in this study were antibiotics. There were a total of 15 deaths (71.4%). All the patients in the antibiotic group died. Patients who needed invasive ventilation had higher mortality (91%) than the non-invasive ventilation group (50%) and the group on spontaneous ventilation (42.8%). The most common complications were sepsis (53%) and renal failure (23%). Highest mortality due to sepsis was in the antibiotic group. When SCORTEN score was calculated for each patient, statistical evaluation showed an increase in mortality with increasing final score. The most crucial interventions are discontinuation of the causative drug and immediate referral to a burn unit, which helps in early diagnosis and decreases mortality. Our study provides insights into the confirmation of the risk of SJS/TEN as well as its treatment. When SSJ/TEN is caused by antibiotics, the suspicion of developing fatal sepsis should be high regardless of the patient's medical condition.

Classifying different Iberian pig genetic lines by applying chemical-instrumental parameters of dry-cured Iberian shoulders

Iberian pigs are an autochthonous porcine breed mainly bred in southwestern of Iberian Peninsula, this herd traditionally feeds on acorn and pasture, in an extensive production system. In this study, the main objective was for classifying Iberian shoulders from different genetic lines of pigs and their crossed genetic lines. For that, morphology parameters, fatty acid profile and volatile compounds were determined on two batches of dry-cured Iberian shoulders. The samples were acquired from the same place of the dry-cured Iberian shoulders. From these data, two databases were created, for training and validation purpose. Results on this study, firstly demonstrate the capability of data mining techniques in order to classify shoulder as function as Iberian pig genetic lines by using of different quality characteristics. Four classification models were developed and tested in the training database and all models achieved a percentage of correct classification higher than 75%. Then, the same four classification models were performed in the validation database and the model of J48 decision tree and fatty acid profile reached the highest correct classification percentage (91.67%), and from Retinto genetic line (95.65%). From this classification model, a software application was developed in order to determine in a semi-automatic way the genetic line of the dry-cured Iberian shoulder. This application could be used in the meat industries for determining relationships between genetic line and meat quality or performance of noble parts.

Papilar topografy and morphology of the tongue in the E. sexcinctus

Introduction: The Six-banded armadillo (Euphractussexcintus) belongs to Cigunlata order, has diverse feeding habits and masticatory apparatus developed. The tongue, one of the major components of this equipment, has the mucosa papillae, taste buds and tongue glands. Materials and Methods: Six-banded armadillo were submitted to an anesthetic protocol with Tiletamine and zolazepan (Telazol®, Fortdotge, Brazil) and Sodium Thiopental (Thiopentax®, Cristália, Brazil), we proceeded to euthanasia using Potassium Chloride 19.1%, to then fix them in a 10% formaldehyde solution. The tongues were dissected and identified structures. For microscopic processing, segments from different parts of the tongue were subjected to histological routine and stained with hematoxylin-eosin and Masson. Results: The tongue of the six-banded armadillo presents three types of papillae: filiform, fungiform and vallate, with no conical buds and foliate. Still in the tongue mucosa, was observed mucous glands and various taste corpuscles. Some data differ from those same found in other wild animals that have been studied, but are similar to those of the same phylogenetic. Conclusion: The morphological characteristics of the six-banded armadillo's tongue are adapted to the difficulties faced by him during chewing, requiring the tongue, structures that provide you mobility, strength and sensitivity.

JET diagnostic enhancements testing and commissioning in preparation for DT scientific campaigns

In order to optimize the scientific exploitation of JET (Joint European Torus) during the upcoming deuterium-tritium experiments, a set of diagnostic systems is being enhanced. These upgrades focus mainly on the experimental and operational conditions expected during tritium campaigns. It should be stressed that measurements relevant for burning plasmas are specifically targeted. Previously non-available capabilities, such as a current measurement system fully covering all poloidal field circuits, are described in detail. Instrument descriptions, performance prediction, testing, and initial commissioning results of these systems are presented.

Testing of the ITER plasma position reflectometry high-field side in-vessel antenna assembly prototype

The ITER plasma position reflectometry diagnostic aims to provide measurements of the edge plasma to correct or supplement the magnetics for plasma position control. It consists of five reflectometers, two of which have components installed inside the vessel. One of these systems probes the plasma from the high-field side using a bistatic array of small pyramidal horns located in the gap between two blankets. Electromagnetic simulations have shown that the blankets shape the radiation pattern and need to be considered as part of the antenna. Full-wave plasma simulations have confirmed these results and have also shown that the first-wall geometry may induce measurement errors above the required margin. To further address these issues, we manufactured a prototype of the high-field side antenna, which includes a mock-up of the blanket modules. Here, we present the results of the prototype tests, with and without the blankets, using a metallic mirror as a target. The signals reflected from the mirror are used to derive the mirror distance and assess the precision of the measurements under different arrangements. The sensitivity to the blankets' installation tolerances is also assessed by changing the antennas' position with respect to the blankets' surfaces and cut-outs.