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In addition to many other functions, the placenta is a source of a vast number of autocrine, paracrine and endocrine factors. However, the spectrum of placental regulatory factors, their concentrations, gestational profiles and roles may differ considerably even between phylogenetically closely related species. Depending on the species, placental regulatory factors of a broad range of molecule classes have been found including (glyco-)proteins, peptides, steroids and prostaglandins. Local placental regulatory factors are especially important for the dialogue between the fetal and the maternal compartment immediately at the feto-maternal borderline and for the control of growth, differentiation and functions of the placenta itself. Moreover, placental hormones in a proper sense may also have effects in more remote targets within the maternal compartment, serving functions such as pregnancy-specific adaptations of maternal circulation, provision of hemotrophe to the fetus or the development and function of the mammary gland. Functions of placental hormones in the fetus proper are less clear but may be especially important before the establishment of a functional fetal endocrine system and near term within the highly species-specific networks of signals preparing and initiating parturition. This review takes a comparative view on the situation in different domestic animals focusing on ruminants and on placental hormones occurring at significant concentrations in the maternal circulation.

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OBJECTIVES: The purpose of this study was to evaluate the efficacy and long-term outcomes of a novel polymer/carrier-free drug-coated stent (DCS) in patients with de novo coronary lesions.BACKGROUND: The BioFreedom (BFD) DCS incorporates a low-profile, stainless-steel platform, with a surface that has been modified to create a selectively microstructured abluminal surface that allows adhesion and further release of Biolimus A9 (Biosensors Europe SA, Morges, Switzerland). METHODS: A total of 182 patients (183 lesions) were randomized into a 1:1:1 ratio for treatment with BFD "standard dose" (BFD) or BFD "low dose" (BFD-LD) versus first-generation paclitaxel-eluting stents (PES) at 4 sites in Germany.RESULTS: Baseline and procedural characteristics were well matched. At 4-month angiographic follow-up (Cohort 1, n = 75), in-stent late lumen loss (LLL) was significantly lower with BFD and BFD-LD versus PES (0.08 and 0.12 mm vs. 0.37 mm, respectively; p < 0.0001 for BFD vs. PES, and p = 0.002 for BFD-LD vs. PES). At 12 months (Cohort 2, n = 107), in-stent LLL (primary endpoint) was 0.17 mm in BFD versus 0.35 mm in PES (p = 0.001 for noninferiority; p = 0.11 for superiority)...

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La estrategia óptima de reperfusión en pacientes atendidos rápidamente luego del inicio de los síntomas de infarto agudo de miocardio con elevación del segmento ST (IAMEST) es aún materia de debate. El objetivo de esta revisión fue evaluar el alcance de la resolución completa del segmento ST (RST) temprana y el pronóstico de las diferentes estrategias de reperfusión. Encontramos 14 investigaciones de pacientes con IAMEST que tenían información sobre RST, a los que se les realizó fibrinólisis prehospitalaria, intervención percutánea coronaria facilitada (IPC) o IPC directa entre 2000 y 2008. Los 14 estudios aleatorizados incluyeron 6.621 pacientes (3.605 recibieron IPC facilitada, 2.934 IPC directa, y 182, fibrinólisis prehospitalaria). Los agentes facilitadores fueron: inhibidores de la glucoproteína Ib/IIIa plaquetaria en nueve estudios (1.589 pacientes), fibrinólisis en tres (1.037 pacientes), y la combinación de inhibidores de la glucoproteína IIb/IIIa plaquetaria más dosis reducidas de fibrinolíticos en tres (979 pacientes)...(AU)

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La estrategia óptima de reperfusión en pacientes atendidos rápidamente luego del inicio de los síntomas de infarto agudo de miocardio con elevación del segmento ST (IAMEST) es aún materia de debate. El objetivo de esta revisión fue evaluar el alcance de la resolución completa del segmento ST (RST) temprana y el pronóstico de las diferentes estrategias de reperfusión. Encontramos 14 investigaciones de pacientes con IAMEST que tenían información sobre RST, a los que se les realizó fibrinólisis prehospitalaria, intervención percutánea coronaria facilitada (IPC) o IPC directa entre 2000 y 2008. Los 14 estudios aleatorizados incluyeron 6.621 pacientes (3.605 recibieron IPC facilitada, 2.934 IPC directa, y 182, fibrinólisis prehospitalaria). Los agentes facilitadores fueron: inhibidores de la glucoproteína Ib/IIIa plaquetaria en nueve estudios (1.589 pacientes), fibrinólisis en tres (1.037 pacientes), y la combinación de inhibidores de la glucoproteína IIb/IIIa plaquetaria más dosis reducidas de fibrinolíticos en tres (979 pacientes)...

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The objective of the present study was to describe ovarian activity in 11 adult non-mated guanacos, evaluated every second day for 40 days by transrectal ultrasonography and by plasma estradiol-17beta and progesterone concentrations. An inverse relationship (r = -0.29, P < 0.001) was observed between the diameter of the largest ovarian follicle and the total number of follicles indicating that follicular growth in guanacos occurs in waves. The mean duration of follicular wave was 15.1 +/- 4.2 days with a range from 9 to 26. The follicular growth phase was 7.0 +/- 2.4 days, the static phase 3.0 +/- 1.2 days, the regression phase 5.2 +/- 2.1 days and the inter-wave interval was 12.6 +/- 5.6 days. The maximum follicular diameter in each follicular wave was 10.2 +/- 2.1 mm with a range from 7.2 to 16.1 mm. Inter-wave intervals of longer duration were associated with a larger maximum follicle diameter (P < 0.001). Follicular activity alternated between ovaries in 93% of the waves with 48% of dominant follicles occurring in the left and 52% in the right ovary without differences (P > 0.05). Plasma estradiol-17beta concentrations showed a wave-like pattern, varying from 20.0 to 92.1 pmol/L. Plasma progesterone concentrations remained below 1 nmol/L without any ultrasonic evidence of ovulation during the study. These results in guanacos suggest a follicular wave pattern more similar to the llama (Lama glama) than previously described in other South American and Old World camelid species.

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Plasma concentrations of progesterone (P4), estradiol-17beta (E2), estrone (E1) and estrone sulfate (E1S) were measured during gestation in eight guanacos kept in captivity. Gestational length was 346.1+/-9.8 days. P4 plasma concentrations increased after ovulation and remained elevated until parturition. However, during the last 4 weeks of gestation, a gradual decrease from 4.17x1.17(+/-1)nmol/L to 2.02x1.95(+/-1)nmol/L on day 5 before parturition was observed, followed by a more abrupt final decline to baseline concentrations which were reached on the day after parturition. Mean E2 plasma concentrations started to increase during the eighth month of gestation, and were significantly elevated up to maximum concentrations of 484.7x1.21(+/-1)pmol/L during the last 2 months of pregnancy. Concentrations returned to baseline during the last 2 days of gestation. An increase of E1S concentrations (p<0.01) was observed in the eleventh month of gestation. Mean E1S concentrations remained rather constant during the last 3 weeks of gestation between 4 to 8nmol/L until parturition, when a steep precipitous decline was observed. E1 concentrations were slightly elevated during the last 4 weeks of gestation, however, maximum concentrations did not exceed 1.5nmol/L. The results show distinct species specific features of gestational steroid hormone profiles in the guanaco in comparison to domestic South American camelids, such as a more pronounced gradual prepartal decrease of P4 concentrations prior to the final decline to baseline, and clearly lesser E1S concentrations during the last 4 weeks of gestation, which lack a continuous prepartal increase.

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O diabetes mellitus é um dos maiores fatores de risco para a doenca arterial coronariana. A doenca progride mais rápido em pacientes diabéticos e está associada com pior prognóstico. Embora a cirurgia de revascularizacão ou intervencão percutânea com a implantacão de stent garanta rápido alívio dos sintomas em pacientes com doenca arterial coronariana estabelecida, não existe substancial benefício prognóstico. Uma intervencão multifatorial incluindo medidas dietéticas, controle glicêmico, tratamento anti-hipertensivo e exercícios físicos regulares tem influência positiva nos fatores de risco modificáveis, na melhora de outras funcões cardiovasculares e na tolerância ao exercício livre de angina.

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Background—Our aims were to compare coronary artery bypass grafting (CABG) and stenting for the treatment of diabetic patients with multivessel coronary disease enrolled in the Arterial Revascularization Therapy Study (ARTS) trial and to determine the costs of these 2 treatment strategies. Methods and Results—Patients (n51205) were randomly assigned to stent implantation (n5600; diabetic, 112) or CABG (n5605; diabetic, 96). Costs per patient were calculated as the product of each patient’s use of resources and the corresponding unit costs. Baseline characteristics were similar between the groups. At 1 year, diabetic patients treated with stenting had the lowest event-free survival rate (63.4%) because of a higher incidence of repeat revascularization compared with both diabetic patients treated with CABG (84.4%, P,0.001) and nondiabetic patients treated with stents (76.2%, P50.04). Conversely, diabetic and nondiabetic patients experienced similar 1-year event-free survival rates when treated with CABG (84.4% and 88.4%). The total 1-year costs for stenting and CABG in diabetic patients were $12 855 and $16 585 (P,0.001) and in the nondiabetic groups, $10 164 for stenting and $13 082 for surgery. Conclusions—Multivessel diabetic patients treated with stenting had a worse 1-year outcome than patients assigned to CABG or nondiabetics treated with stenting. The strategy of stenting was less costly than CABG, however, regardless of diabetic status.

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Our aims were to compare coronary artery bypass grafting (CABG) and stenting for the treatment of diabetic patients with multivessel coronary disease enrolled in the Arterial Revascularization Therapy Study (ARTS) trial and to determine the costs of these 2 treatment strategies.Patients (N= 1205) were randomly assigned to stent implantation (n= 600; diabetic, 112) or CABG (n=605; diabetic, 96). Costs per patient were calculated as the product of each patient's useof resources and the corresponding unit costs.Baseline charcteristics were similar between the groups. At 1 year , diabetic patient treated with stenting had the lowest event-free survival rate (63,4%) because of a higher incidence of repeat revascularization compared with both diabetics patients...

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