[An independent observatory in Vendée on ST-elevated acute myocardial infarction (the OVISCA Register). A Departmental evaluation of demographic trends, mortality and delays before treatment]

AIM

Mortality from acute myocardial infarction has been falling during the past 30 years. The aim of the study was to evaluate the temporal trends of demographics, mortality rates, and time to treatment in patients admitted for acute ST elevation myocardial infarction (STEMI) in Vendée.

PATIENTS AND METHODS

From 2008 to 2016, 1994 patients hospitalised in CHD Vendée for STEMI <48hours were included. Two groups were compared, 838 patients admitted between 2008 and 2011 (group 1), and 1156 admitted between 2013 and 2016 (group 2).

RESULTS

Between the 2 periods, mean age was comparable (63.8 vs. 64.4 years), the gender ratio decreased (from 3.15 to 2.79 ; P=0.25). The mean duration of hospital stay was 0.8 day shorter (P=0.008). Treatment at discharge was optimum in 97.5% patients versus 92% (P<0.001). Left ventricular ejection fraction was comparable (50.6% vs. 50.2%). There was a non-significant trend to a decrease in hospital mortality (from 6.3% to 4.4%; p=0.12), and 6-month mortality (from 6.9% to 5.9%; P=0.51). There was a reduction in the use of emergency call-outs (74.9% to 68.9%; P<0.01), but an increase in direct presentations from 44% to 48.7% (P<0.05). The time before calling was comparable (2.5hours vs. 2.3hours; P=04.7). The "door-to-balloon" time decreased (0.71 vs. 0.55hour; P<0.001). The mean time between pain and angioplasty increased (5.7 vs. 6.8hours; P<0.05).

CONCLUSIONS

In vendee, from 2011 to 2016, hospital and 6-month mortality of STEMI trend to decrease non-significantly. The door to balloon time decreased, although emergency call-out rates and delays did not. Considerable efforts are still required with respect to patient information and education. Our registry offers an excellent tool to improve practices, the aim being to ensure its integration in the CRAC-France PCI registry.

Liver and kidney concentrations of vanadium in oiled seabirds after the Erika wreck

Vanadium was measured by atomic absorption spectrophotometry in the liver and kidney of several oiled seabirds that were stranded on the French Atlantic coasts after the Erika wreck and died in wildlife care Centers. Estimated averages were 30 to 77 ng g(-1) wet weight (ww) in the liver and 52 to 72 ng g(-1) wet weight in the kidney. These concentrations were not higher in oiled birds than in dead birds found later, without visible traces of petroleum on beaches not affected by the Erika pollution. Vanadium hepatic and renal concentrations do not seem to be appropriate biomarkers for recent exposure to fuel in seabirds.

Determination of residues of oxolinic acid and flumequine in freeze-dried salmon muscle and skin by HPLC with fluorescence detection

A procedure for the determination of residues of oxolinic acid (OA) and flumequine (FLU) in freeze-dried salmon muscle with attached skin, using reversed-phase high-performance liquid chromatography, is described. OA and FLU were extracted by a solid-liquid extraction procedure: after addition of hydrochloric acid, extraction used successively ethyl acetate, sodium hydroxide and chloroform. Liquid chromatography was performed on a 5 microm PuroSpher RP-18E cartridge using acetonitrile and 0.02 M aqueous orthophosphoric acid solution as mobile phase, with fluorescence detection. The performance of the method was established by spiking tissues with OA and FLU before the freeze-drying step. The method was linear over the concentration range 50-2000 ng/g freeze-dried tissue. Limits of detection and quantitation were 3.2 and 16 ng/g wet weight tissue respectively both for OA and FLU. Mean extraction recoveries of OA and FLU from freeze-dried tissue were 85.5 and 85.2% respectively. The method is suitable as a regulatory one for determination of residues of OA and FLU in freeze-dried salmon tissue.

Determination of oxolinic acid in faeces and urine of turbot (Scophthalmus maximus) by high-performance liquid chromatography using fluorescence detection

A procedure for the determination of oxolinic acid (OA) in faeces and urine of turbot (Scophthalmus maximus), using reversed-phase high-performance liquid chromatography is described. Liquid chromatography was performed on a 5-microm PuroSpher RP-18E cartridge using acetonitrile and 0.001 M aqueous orthophosphoric acid solution as mobile phase, with fluorescence detection. After the addition of an internal standard, oxolinic acid was extracted by using a liquid-liquid extraction procedure. Linearity and precision were checked over the concentration ranges 1.0-1000 microg/g (faeces) and 0.06-10.00 microg/ml (urine). Limits of detection of OA in faeces and urine were 0.20 microg/g and 0.02 microg/ml respectively. Mean extraction recoveries of OA from faeces and urine were 102.0 and 91.6% respectively.

Preliminary assays to elucidate the structure of oxytetracycline's degradation products in sediments. Determination of natural tetracyclines by high-performance liquid chromatography-fast atom bombardment mass spectrometry

A very specific high-performance liquid chromatography-mass spectrometric method for the determination of natural tetracyclines was developed in order to characterise the degradation products of oxytetracycline in sediments. First, extraction used a clean up step with a Bond Elut Certify LRC cartridge. A 3 microm Spherisorb ODS1 column was then used with a methanol, acetonitrile and oxalic acid mobile phase gradient. Chromatographic resolution in these conditions was 3.31 between oxytetracycline and tetracycline. Two liquid chromatography-mass spectrometry methodologies based on a particle beam and a frit fast atom bombardment interface were developed. In the first approach, ionisation was performed in the negative chemical mode using methane as reacting gas. In the other case, glycerol-thioglycerol mixture was used as matrix to ensure good sensitivity. MS-MS experiment was performed to determinate oxytetracycline fragmentation pattern in the perspective of degradation product study.

Residues depletion in egg after warfarin ingestion by laying hens

Accidental ingestion of anticoagulant rodenticide bait by poultry rarely leads to clinical signs of poisoning, but represents a risk for the consumer because of potential residues in the laid eggs. An assay was conducted for a better risk assessment. Three groups of laying hens were given a single oral dose of 10, 30 or 90 mg warfarin/kg BW. Eggs were collected for 14 d, and warfarin was analyzed by reversed-phase high-performance liquid chromatography. Warfarin was present in the white for 3 to 4 d following anticoagulant ingestion, while concentration increased in the yolk until the 5th or 6th d, and then gradually decreased. At the end of experimentation, warfarin was still detected at below 100 ng/g in the yolk of eggs in each group.

Rapid and simple determination of oxolinic acid and oxytetracycline in the shell of the blue mussel (Mytilus edulis) by high-performance liquid chromatography

A simple procedure for the determination of oxolinic acid (OA) and oxytetracycline (OTC), two antibacterial agents, in the shell of the blue mussel (Mytilus edulis), using reversed-phase high-performance liquid chromatography is described. Liquid chromatography was performed on a 5-microm LiChroSpher 100 RP-18E column using acetonitrile and a 0.02 M orthophosphoric acid solution as the mobile phase, with ultraviolet detection. After roughly grinding the shell, drugs were extracted using a methanolic oxalic acid solution. Linearity and precision were checked over the concentration range 0.04-0.32 microg/g. Limits of detection of OA and OTC were 0.012 and 0.008 microg/g, respectively. Mean extraction recoveries of OA and OTC from mussel shell were 72.9 and 65.4%, respectively. To demonstrate the usefulness of the analytical procedure, an experimental study was performed in blue mussels exposed to the drugs for eight days.

Determination of warfarin in the yolk and the white of hens' eggs by reversed-phase high-performance liquid chromatography

A procedure for the determination of warfarin, an anticoagulant rodenticide, in the white and the yolk of hens' eggs, using reversed-phase high-performance liquid chromatography is described. Liquid chromatography was performed on an octadecylsilane cartridge using methanol and ammonium acetate triethylamine buffer as the mobile phase, with UV detection at 281 nm. Samples (5 g) were analysed after liquid-phase extraction using a mixture of acetone and diethyl ether. Linearity, precision and accuracy of the method were determined in the range of 0.5-8.0 microg. Limits of quantitation for warfarin in the white and the yolk were 0.020 and 0.015 microg/g, respectively. Mean recoveries of warfarin from spiked white and yolk samples were 84.6 and 87.4%, respectively. The analytical method was applied to a fourteen-day experimental study conducted in laying hens that had been orally dosed with warfarin.

Reversed-phase HPLC determination of eight anticoagulant rodenticides in animal liver

A reversed-phase high-performance liquid chromatographic method was developed for the analysis of eight anticoagulant rodenticides in animal liver. Coumarinic anticoagulant rodenticides (brodifacoum, bromadiolone, coumachlor, coumatetralyl, difenacoum, and warfarin) were detected by using a gradient elution and a fluorimetric detection. Indanedione anticoagulant rodenticides (chlorophacinone and diphacinone) were detected by using an isocratic elution and an UV detection. Anticoagulants were extracted from liver with mixtures of acetone/diethylether and acetone/chloroform. Extracts were applied to solid-phase extraction cartridges. Linearity was checked over the concentration range 0.1-0.6 microgram/g. Relative standard deviations of within-run and between-run variability were all between 5.7 and 10.3%. Recoveries from spiked liver samples were between 51.7 (difenacoum) and 78.2% (warfarin). Limits of detection were between 0.01 (difenacoum and warfarin) and 0.11 microgram/g (chlorophacinone).

High-performance liquid chromatographic determination of oxolinic acid in the plasma of seabass (Dicentrarchus labrax) anaesthetized with 2-phenoxyethanol

A high-performance liquid chromatographic (HPLC) method for the determination of oxolinic acid (OA) in the plasma of seabass (Dicentrarchus labrax) anaesthetized with 2-phenoxyethanol is described. The samples were extracted and cleaned up by a solid-phase extraction procedure using C18 extraction cartridges. After the eluent was evaporated, the dry residue was dissolved in 1/15 M phosphate buffer. OA was determined by using an isocratic HPLC method with UV detection at 340 nm. Seabass drug-free plasma samples were spiked with OA at 0.2, 1.0, 5.0 and 25.0 microg/ml. Validation of the method showed good precision and accuracy. The mean recovery was 92.2%, with a relative standard deviation lower than 5%. The quantification limit was 0.2 microg/ml. The method was tested on 300 plasma samples of OA-treated seabass.

Acute toxicity of fluorescein to turbot (Scophthalmus maximus)

Some land-based marine fish-farms situated on the Atlantic coastline of France use high volumes of underground sea water. Studies of the available quantities and movements of this underground resource became necessary, using fluorescent dyes such as fluorescein. As fluorescein may reach reared fish, it became important to assess its toxicity to fish. Acute fluorescein toxicity to turbot (Scophthalmus maximus) was investigated by exposing fish to different fluorescein concentrations (0.5, 0.7, 0.9, 1.1 and 1.3 milligrams) at 14.0 C for 24, 48 or 96 h. The lethal concentration inducing 50% fish mortality (LC50) was 997.1 +/- 11.4 mg/l (mean +/- standard deviation) after a 24, 48 or 96 h exposure. Toxicity affected the central nervous system. Early postmortem findings were a brown-green coloring of some tissues and encephalon congestion. The fluorescein LC50 was much higher than the recommended concentration in field applications (1 mg/l), indicating that fluorescein toxicity to turbot will not be expected when used at the recommended concentration.

Determination of oxytetracycline in marine shellfish (Crassostrea gigas, Ruditapes philippinarum and Scrobicularia plana) by high-performance liquid chromatography using solid-phase extraction

A reversed-phase high-performance liquid chromatographic method was developed to detect oxytetracycline (OTC) in three species of marine shellfish (Crassostrea gigas, Ruditapes philippinarum and Scrobicularia plana). Shellfish tissues were analysed after solid-phase extraction by using a mobile phase containing acetonitrile and 0.02 M orthophosphoric acid solution. The linearity and precision of the method were checked over the concentration range 0.100-1.500 micrograms/g. The limits of detection and determination of OTC were 0.040 and 0.100 microgram/g, respectively. The recovery of OTC from spiked shellfish tissues was 79.8%. The OTC concentration in oyster (Crassostrea gigas) spiked at 0.500 microgram/g and stored at -20 degrees C was stable for 6 weeks. The method was applied to a 21-day experimental study performed with oysters.