1.Physics, chemistry, and Hirshfeld surface analyses of gamma-irradiated thalidomide to evaluate behavior under sterilization doses
Mussel A.F.S.N. VALNER ; Ferreira P. MAX ; Marques B.F. MARIA ; Yoshida I. MARIA ; Almeida R. MARIANA ; Rodrigues L. BERNARDO ; Mussel N. WAGNER
Journal of Pharmaceutical Analysis 2018;8(3):194-201
Thalidomide was indicated as a sedative and antiemetic and prescribed for pregnant women. Its tragic teratogenic effects culminated in withdrawal from the market. Since the discovery of its anti-angiogenic and anti-inflammatory actions, thalidomide has been used in the treatment of leprosy and multiple myeloma, which justify studies of its stability. We investigated the effects of irradiation of thalidomide up to 100 kGy (fourfold the usual sterilizing dose for pharmaceutics). The β polymorph of thalidomide was obtained in an isothermal experiment at 270 °C. All samples underwent gamma irradiation for specific times. At different doses, decomposition of the pharmaceutical was not observed up to 100 kGy. The observed effect was angle turning between the phthalimide and glutarimide rings modulated by repulsion towards the carbonyl group, leading to a stable energetic configuration, as measured by the equilibrium in the torsion angle after irra-diation. The thalidomide molecule has a center of symmetry, so a full turn starting from 57.3° will lead to an identical molecule. Further irradiation will start the process again. Samples irradiated at 30 and 100 kGy have more compact unit cells and a lower volume, which leads to an increase in the intermolecular hydrogen interaction within the unit cel , resulting in higher thermal stability for polymorph α.
2.Left ventricular thrombus routine screening with contrast echocardiography in patients with anterior ST‑elevation myocardial infarction:is it worth it?
Joana Laranjeira CORREIA ; Gonçalo R. M. FERREIRA ; João Gouveia FIUZA ; Mariana Duarte ALMEIDA ; Joana COELHO ; Emanuel CORREIA ; José Miguel CORREIA ; Davide MOREIRA ; Nuno CRAVEIRO ; Maria Luísa GONÇALVES ; Vanda Devesa NETO
Journal of Cardiovascular Imaging 2024;32(1):21-
Background:
Left ventricular (LV) thrombus has a higher incidence among patients with anterior ST-elevation myocardial infarction (STEMI) when compared to other types of acute myocardial infarction and is associated with worse prognosis. The management of LV thrombus diagnosis remains challenging. Contrast echocardiography (transthoracic echocardiography, TTE) has shown potential in improving the accuracy for its diagnosis, thereby influencing treatment strategies concerning antithrombotic/anticoagulation therapy. The aim of this study was to assess the effectiveness of contrast TTE as a routine screening method for detecting LV thrombus in the acute phase of anterior STEMI.
Methods:
A prospective, single center, randomized controlled trial was conducted among patients with anterior STEMI. The study group underwent contrast TTE, while the control group received a conventional approach. Demographical, clinical, and diagnostic data were collected. Thrombus detection rates were compared between groups.
Results:
A total of 68 patients were included (32 in the study group and 36 in the control group). No substantial baseline differences were observed between groups. Thrombus detection rate was 25.0% in the study group and 13.9% in the control group, however these results did not reach statistical significance (P = 0.24). The prevalence of anterior/ apical aneurysm was higher in the study group (46.9% vs. 22.2%, P = 0.03).
Conclusions
Conventional TTE may be adequate for diagnosing LV thrombus in the acute phase of anterior STEMI; however, further larger-scale and multicenter studies are necessary to obtain more robust and conclusive results. Ultrasound contrast may play a significant role in the detection of anterior/apical aneurysms, which are known risk factors for the subsequent development of thrombus.
3.Left ventricular thrombus routine screening with contrast echocardiography in patients with anterior ST‑elevation myocardial infarction:is it worth it?
Joana Laranjeira CORREIA ; Gonçalo R. M. FERREIRA ; João Gouveia FIUZA ; Mariana Duarte ALMEIDA ; Joana COELHO ; Emanuel CORREIA ; José Miguel CORREIA ; Davide MOREIRA ; Nuno CRAVEIRO ; Maria Luísa GONÇALVES ; Vanda Devesa NETO
Journal of Cardiovascular Imaging 2024;32(1):21-
Background:
Left ventricular (LV) thrombus has a higher incidence among patients with anterior ST-elevation myocardial infarction (STEMI) when compared to other types of acute myocardial infarction and is associated with worse prognosis. The management of LV thrombus diagnosis remains challenging. Contrast echocardiography (transthoracic echocardiography, TTE) has shown potential in improving the accuracy for its diagnosis, thereby influencing treatment strategies concerning antithrombotic/anticoagulation therapy. The aim of this study was to assess the effectiveness of contrast TTE as a routine screening method for detecting LV thrombus in the acute phase of anterior STEMI.
Methods:
A prospective, single center, randomized controlled trial was conducted among patients with anterior STEMI. The study group underwent contrast TTE, while the control group received a conventional approach. Demographical, clinical, and diagnostic data were collected. Thrombus detection rates were compared between groups.
Results:
A total of 68 patients were included (32 in the study group and 36 in the control group). No substantial baseline differences were observed between groups. Thrombus detection rate was 25.0% in the study group and 13.9% in the control group, however these results did not reach statistical significance (P = 0.24). The prevalence of anterior/ apical aneurysm was higher in the study group (46.9% vs. 22.2%, P = 0.03).
Conclusions
Conventional TTE may be adequate for diagnosing LV thrombus in the acute phase of anterior STEMI; however, further larger-scale and multicenter studies are necessary to obtain more robust and conclusive results. Ultrasound contrast may play a significant role in the detection of anterior/apical aneurysms, which are known risk factors for the subsequent development of thrombus.
4.Left ventricular thrombus routine screening with contrast echocardiography in patients with anterior ST‑elevation myocardial infarction:is it worth it?
Joana Laranjeira CORREIA ; Gonçalo R. M. FERREIRA ; João Gouveia FIUZA ; Mariana Duarte ALMEIDA ; Joana COELHO ; Emanuel CORREIA ; José Miguel CORREIA ; Davide MOREIRA ; Nuno CRAVEIRO ; Maria Luísa GONÇALVES ; Vanda Devesa NETO
Journal of Cardiovascular Imaging 2024;32(1):21-
Background:
Left ventricular (LV) thrombus has a higher incidence among patients with anterior ST-elevation myocardial infarction (STEMI) when compared to other types of acute myocardial infarction and is associated with worse prognosis. The management of LV thrombus diagnosis remains challenging. Contrast echocardiography (transthoracic echocardiography, TTE) has shown potential in improving the accuracy for its diagnosis, thereby influencing treatment strategies concerning antithrombotic/anticoagulation therapy. The aim of this study was to assess the effectiveness of contrast TTE as a routine screening method for detecting LV thrombus in the acute phase of anterior STEMI.
Methods:
A prospective, single center, randomized controlled trial was conducted among patients with anterior STEMI. The study group underwent contrast TTE, while the control group received a conventional approach. Demographical, clinical, and diagnostic data were collected. Thrombus detection rates were compared between groups.
Results:
A total of 68 patients were included (32 in the study group and 36 in the control group). No substantial baseline differences were observed between groups. Thrombus detection rate was 25.0% in the study group and 13.9% in the control group, however these results did not reach statistical significance (P = 0.24). The prevalence of anterior/ apical aneurysm was higher in the study group (46.9% vs. 22.2%, P = 0.03).
Conclusions
Conventional TTE may be adequate for diagnosing LV thrombus in the acute phase of anterior STEMI; however, further larger-scale and multicenter studies are necessary to obtain more robust and conclusive results. Ultrasound contrast may play a significant role in the detection of anterior/apical aneurysms, which are known risk factors for the subsequent development of thrombus.
5.Left ventricular thrombus routine screening with contrast echocardiography in patients with anterior ST‑elevation myocardial infarction:is it worth it?
Joana Laranjeira CORREIA ; Gonçalo R. M. FERREIRA ; João Gouveia FIUZA ; Mariana Duarte ALMEIDA ; Joana COELHO ; Emanuel CORREIA ; José Miguel CORREIA ; Davide MOREIRA ; Nuno CRAVEIRO ; Maria Luísa GONÇALVES ; Vanda Devesa NETO
Journal of Cardiovascular Imaging 2024;32(1):21-
Background:
Left ventricular (LV) thrombus has a higher incidence among patients with anterior ST-elevation myocardial infarction (STEMI) when compared to other types of acute myocardial infarction and is associated with worse prognosis. The management of LV thrombus diagnosis remains challenging. Contrast echocardiography (transthoracic echocardiography, TTE) has shown potential in improving the accuracy for its diagnosis, thereby influencing treatment strategies concerning antithrombotic/anticoagulation therapy. The aim of this study was to assess the effectiveness of contrast TTE as a routine screening method for detecting LV thrombus in the acute phase of anterior STEMI.
Methods:
A prospective, single center, randomized controlled trial was conducted among patients with anterior STEMI. The study group underwent contrast TTE, while the control group received a conventional approach. Demographical, clinical, and diagnostic data were collected. Thrombus detection rates were compared between groups.
Results:
A total of 68 patients were included (32 in the study group and 36 in the control group). No substantial baseline differences were observed between groups. Thrombus detection rate was 25.0% in the study group and 13.9% in the control group, however these results did not reach statistical significance (P = 0.24). The prevalence of anterior/ apical aneurysm was higher in the study group (46.9% vs. 22.2%, P = 0.03).
Conclusions
Conventional TTE may be adequate for diagnosing LV thrombus in the acute phase of anterior STEMI; however, further larger-scale and multicenter studies are necessary to obtain more robust and conclusive results. Ultrasound contrast may play a significant role in the detection of anterior/apical aneurysms, which are known risk factors for the subsequent development of thrombus.