Identification of Histopathological Criteria for the Diagnosis of Canine Cutaneous Progressive Angiomatosis.

The term angiomatosis is used to denote a group of well-known to poorly characterized proliferative vascular entities. In animals, cutaneous progressive angiomatosis (CPA) is a disorder with variable prognosis related to the extension and depth of infiltration of the surrounding tissues by vessels. CPA may share some microscopical features with other vascular proliferations such as low-grade well-differentiated capillaritic hemangiosarcoma (HS), making the diagnosis not always straightforward, especially in small biopsies. The aim of this study is to retrospectively assess the most common diagnostic microscopical features of CPA in dogs. In this work, 11 histopathological criteria were analyzed on 31 CPA and 11 primary cutaneous HS in dogs. Features significantly associated with CPA included: lobular growth, interposition of connective tissue and adnexa between the vascular proliferation, presence of nerve fibers, and a mixed vascular proliferative component. Absence of plump/prominent endothelial cells, lack of atypia, and lack of mitoses were also significant factors differentiating CPA from HS. Additional distinctive findings in CPA, although with no statistical association to CPA diagnosis, were vascular shunting, absence of necrosis, and endothelial cell piling up. In conclusion, the combined use of different microscopical clues allowed for the distinction of CPA from HS and was considered useful for the diagnosis of CPA.

Footpad peripheral ganglioneuroblastoma in a dog.

BACKGROUND: Peripheral neuroblastic tumours arising from primitive cells of the cranial and spinal ganglia and from sympathetic ganglion cells of the autonomic nervous system include, from most to least differentiated, ganglioneuroma, ganglioneuroblastoma and neuroblastoma. Canine ganglioneuroblastoma has been described in the mediastinum, nasal and oral cavities, as well as in the brain. OBJECTIVE: To describe the clinical and histopathological findings, treatment and follow-up of a primary cutaneous ganglioneuroblastoma affecting the footpad of a dog. ANIMAL: An 8-year-old male German shepherd dog, referred for left forelimb lameness and licking of the footpad, showed thickening of the footpad of digit V with a central nodular lesion. METHODS AND RESULTS: Histopathological and immunohistochemical examination on a surgical skin biopsy specimen showed an infiltrative and highly cellular neoplasm in the deep dermis. The neoplasm was composed of large polyhedral cells with abundant cytoplasm containing Nissl substance that reacted strongly with neuron-specific enolase and neuronal nuclei antigen, spindle cells with indistinct cell borders suggestive of Schwann cells, with a mild S-100 and GFAP immunoreactivity, and rare nests of neuroblasts. The owner agreed to digit amputation. Histologically, a neoplastic multinodular proliferation with morphological findings like those detected in the biopsy was observed, not extended to the surgical margins and without involvement of skeletal bone. No recurrence or metastasis was observed over a period of one year. CONCLUSIONS AND CLINICAL IMPORTANCE: To the best of the authors' knowledge, this is the first report of a primary cutaneous ganglioneuroblastoma in a dog. Ganglioneuroblastoma should be included in the differential diagnoses of canine footpad neoplastic diseases.

Pathology and Distribution of Trombiculosis in Northern Chamois ( Rupicapra rupicapra rupicapra) in the Italian Alps.

Trombiculosis has been reported in some wild ruminant species. We investigated the occurrence of trombiculosis in the northern chamois ( Rupicapra rupicapra rupicapra) in the Western Italian Alps, and we describe the related histopathologic changes. Superficial scrapes and skin samples were taken from 191 chamois from the Lombardy and Piedmont regions during the hunting season in September-December 2015. Numbers of eosinophils, mast cells, cluster of differentiation (CD)3-, CD79α-, CD68-positive cells were determined on immunohistochemically stained skin sections using a semiautomatic analysis system. Forty (20.9, 40/191) chamois were positive for trombiculid larvae on skin scrapings. Of the positive animals, 15 were from Lombardy and 25 from Piedmont, with similar prevalences. Macroscopic lesions were light with involvement of body regions that had contact with the ground, especially head (pinnae and areas around eyes and mouth) and limbs, where stylostome was easily formed due to thin skin. Histologically, trombiculosis caused a focal moderate dermatitis with epidermal necrosis, thin crusts, and hyperkeratosis. Inflammatory infiltrates were suggestive of a granulomatous reaction centered on a stylostome, formed by mite saliva and necrotic host tissue debris. However, we detected some difference in cutaneous immune response with some chamois showing a prevalent T-cell response and others having an increased B-cell count associated with a higher number of eosinophils, mast cells and a lower number of T cells.

Effects of Electrochemotherapy with Cisplatin and Peritumoral IL-12 Gene Electrotransfer on Canine Mast Cell Tumors: a Histopathologic and Immunohistochemical Study.

BACKGROUND: The study was aimed to characterize tumor response after combined treatment employing electrochemotherapy with IL-12 gene electrotransfer in dogs with spontaneous mast cell tumors (MCT). MATERIALS AND METHODS: Eleven dogs with eleven MCTs were included in the study. Histological changes were investigated in biopsy specimens collected before the treatment (T0), and 4 (T1) and 8 weeks (T2) later. Cellular infiltrates were characterized immunohistochemically by using anti CD3, CD20, Foxp3 (Treg), CD68 and anti MHC-class II antibodies. Proliferation and anti-apoptotic activity of neoplastic cells were assessed using anti Ki-67 and Bcl-2 antibodies. Angiogenetic processes were investigated immunohistochemically by using anti Factor VIII and anti CD31 antibodies and micro vessel density quantification. RESULTS: Histopathological examination of samples at T0 confirmed the diagnosis and the presence of scanty infiltrates consisted mainly of T-lymphocytes and macrophages. At T1 and T2 neoplastic cells were drastically reduced in 7/11 cases, small clusters of neoplastic cells were detected in 3/11 cases and 1/11 cases neoplastic cells were still evident. Proliferation activity of neoplastic cells was significantly reduced at T1 and T2 and expression of anti-apoptotic protein at T1. Microvessel density was drastically reduced in all samples after treatment. The number of T-lymphocytes increased at T1, although not significant, while Treg were significant higher at T1 and macrophages at T2. CONCLUSIONS: The combined electrochemotherapy and IL-12 gene electrotransfer effectively induced a cellular response against neoplastic cells characterized mainly by the recruitment of T-lymphocytes and macrophages and a fibrotic proliferation with reduction of microvessels.

Antimicrobial resistance in Enterococcus strains isolated from healthy domestic dogs.

Enterococci are opportunistic bacteria that cause severe infections in animals and humans, capable to acquire, express, and transfer antimicrobial resistance. Susceptibility to 21 antimicrobial agents was tested by the disk diffusion method in 222 Enterococcus spp. strains isolated from the fecal samples of 287 healthy domestic dogs. Vancomycin and ampicillin minimum inhibitory concentrations (MICs) and high-level aminoglycoside resistance (HLAR) tests were also performed. Isolates showed resistance mainly to streptomycin (88.7%), neomycin (80.6%), and tetracycline (69.4%). Forty-two (18.9%) isolates showed an HLAR to streptomycin and 15 (6.7%) to gentamicin. Vancomycin and ampicillin MIC values showed 1 and 18 resistant strains, respectively. One hundred and thirty-six (61.2%) strains were classified as multidrug resistant and six (2.7%) strains as possibly extensively drug-resistant bacteria. Enterococcus faecium and Enterococcus faecalis were the most prevalent antimicrobial resistant species. Companion animals, which often live in close contact with their owners and share the same environment, represent a serious source of enterococci resistant to several antibiotics; for this reason, they may be a hazard for public health by providing a conduit for the entrance of resistance genes into the community.

Histological Lesions and Cellular Response in the Skin of Alpine Chamois (Rupicapra r. rupicapra) Spontaneously Affected by Sarcoptic Mange.

Population dynamics of chamois (genus Rupicapra, subfamily Caprinae) can be influenced by infectious diseases epizootics, of which sarcoptic mange is probably the most severe in the Alpine chamois (Rupicapra rupicapra rupicapra). In this study, skin lesions and cellular inflammatory infiltrates were characterized in 44 Alpine chamois affected by sarcoptic mange. Dermal cellular responses were evaluated in comparison with chamois affected by trombiculosis and controls. In both sarcoptic mange and trombiculosis, a significantly increase of eosinophils, mast cells, T and B lymphocytes, and macrophages was detected. Moreover, in sarcoptic mange significant higher numbers of T lymphocytes and macrophages compared to trombiculosis were observed. Lesions in sarcoptic mange were classified in three grades, according to crusts thickness, correlated with mite counts. Grade 3 represented the most severe form with crust thickness more than 3.5 mm, high number of mites, and severe parakeratosis with diffuse bacteria. Evidence of immediate and delayed hypersensitivity was detected in all three forms associated with diffuse severe epidermal hyperplasia. In grade 3, a significant increase of B lymphocytes was evident compared to grades 1 and 2, while eosinophil counts were significantly higher than in grade 1, but lower than in grade 2 lesions. An involvement of nonprotective Th2 immune response could in part account for severe lesions of grade 3.

Demodicosis in Chamois ( Rupicapra rupicapra subsp. rupicapra) in the Italian Alps, 2013-14.

We report demodicosis in five alpine chamois ( Rupicapra rupicapra subsp. rupicapra) from the Italian Alps that showed moderate crusts on the head and dorsal aspect of the trunk. We detected intramural folliculitis, moderate dermatitis, and T-lymphocytes and macrophages associated with Demodex spp. in follicles and sebaceous glands.

The influence of mesh topology in the abdominal wall repair process.

The tissue integration and the formation of adhesions in the repair of abdominal wall defects are principally led to the topology and the mechanical properties of implanted prosthesis. In this study we analyzed the influence of the topology of the meshes for abdominal wall repair, made of polypropylene (PP), evaluating its ability to prevent and to minimize the formation of adhesions, and to promote tissue ingrowth. Two series of in vivo studies were performed. In the first, two types of PP meshes, a lightweight macroporous mesh (LWM) and a heavyweight microporous mesh (HWM) were compared with determine the optimal porosity for tissue integration. In the second, a composite mesh, Clear Mesh Composite (CMC), made of a LWM sewn on a PP planar smooth film, was compared with a PP planar film, to demonstrate how two different topologies of same material are able to induce different tissue integration with the abdominal wall and different adhesion with internal organs. In both studies, the prostheses were implanted in Wistar rats and histological analysis and mechanical characterization of tissue coupled with the implants were performed. LWM showed better host tissue ingrowth in comparison to HWM. CMC prosthesis showed no adhesions to the viscera and no strong foreign body reaction, moreover its elasticity and anisotropy index were more similar to that of natural tissue. These results demonstrated that the surface morphology of PP surgical meshes allowed to modulate their repair ability. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1220-1228, 2016.

Antimicrobial resistance in Enterococcus spp. isolated from laying hens of backyard poultry floks.

INTRODUCTION AND OBJECTIVE: Enterococci belonging to human and animal gastrointestinal flora are widely-distributed in the environment. They are opportunistic bacteria that can cause severe infections, with the ability to acquire, express and transfer antimicrobial resistance. The aim of the present study was to investigate antimicrobial resistance profiles of Enterococcus spp. strains isolated from cloacal swabs of laying hens of small backyard flocks. MATERIALS AND METHODS: Susceptibility to 21 antimicrobial agents was tested by the disc diffusion method in 115 Enterococcus spp. strains. Vancomycin and ampicillin minimum inhibitory concentrations and high-level aminoglycoside resistance tests were also performed. RESULTS: Isolates showed resistance mainly to aminoglycosides, eritromycin, fluoroquinoles, tetracycline and nitrofurantoin. 19 (16.5%) isolates showed a high level of resistance to streptomycin, but no high level resistance to gentamycin. No significant resistance was detected for vancomycin. Several strains (45; 39.1%) showed combined resistance to macrolides, lincosamides and streptogramin B. 61 (53%) isolates were classified as multidrug-resistant (MDR) and 6 (5.2%) strains as possibly extensively drug-resistant (XDR). E. faecium was the most prevalent antimicrobial resistant species, followed by E. faecalis and E. durans. CONCLUSIONS: The results show that the risk of dissemination of antimicrobial resistant enterococci is related not only to the birds of large commercial flocks, but also to the birds of small backyard flocks. Thus, laying hens of hobby flocks, which share the outside environment with people, could represent a hazard for public health by providing a conduit for the entrance of resistance genes into the community.

Primary cutaneous undifferentiated round cell tumor with concurrent polymyositis in a dog.

A cutaneous poorly differentiated round cell tumor with concurrent, non-suppurative, polymyositis was diagnosed in a hovawart dog. Histochemical staining, immunohistochemistry, and transmission electron microscopy findings suggested that the tumors cells were of myeloid, or possibly natural killer cell origin. The possibility that the concurrent polymyositis may represent a pre-neoplastic or paraneoplastic process is discussed.

[Epidemiology of Tako-tsubo cardiomyopathy: the Tuscany Registry for Tako-tsubo Cardiomyopathy ]. / Epidemiologia della sindrome di tako-tsubo nel mondo reale: dati del Registro Toscano della Miocardiopatia da stress tipo Tako-tsubo.

BACKGROUND: Tako-tsubo (stress) cardiomyopathy (TTC) is a recently described acute cardiac syndrome that mimics ST-segment elevation myocardial infarction. The TTC Tuscany Registry is an observational prospective multicenter registry established to define the prevalence, epidemiology and prognosis of TTC in the Tuscany area. METHODS: From January 1 to December 31, 2009, 105 consecutive patients hospitalized in the 14 Cardiology Units of the Tuscany Region with a diagnosis of TTC, were enrolled in the registry. TTC diagnosis was made using the Mayo Clinic modified criteria. Clinical, instrumental, laboratory and 6-month follow-up data were collected. Results. TTC represented 1.2% of all myocardial infarctions in the Tuscany Region during 2009, and it was diagnosed in 0.6% of the angiographic exams performed during the same year. The data collected showed that TTC affects mainly the female gender (91%) in the post-menopausal period (70 ± 11 years), though 5% of patients were ≤50 years old. An antecedent stressful event was frequently detected (74%). The main clinical presentation was chest pain (86%), associated with ST-segment elevation (59%). Mean left ventricular ejection fraction on admission was 40 ± 9%, and was associated with apical (37%), midapical (49%) or midventricular (5%) wall motion abnormalities. Left ventricular ejection fraction recovered to 51 ± 9% in 7 ± 9 days. Heart failure was the most common complication in the acute phase (14%), and 4 patients presented with cardiogenic shock. No patient died during the index hospitalization. At 6-month follow-up, no patient had TTC recurrence, 9 patients were rehospitalized (7 for noncardiac disease) and 2 patients died of noncardiac causes. CONCLUSIONS: Our data, which represent the largest prospective series of patients with a diagnosis of TTC, show that the prevalence of TTC in Tuscany is similar that described in other national and international studies. Moreover, the data highlight that TTC may occur also in male patients and in patients aged <50 years. The mid-term prognosis is good, but the risk of acute complications related to heart failure cannot be neglected.

Microcystic meningioma of the fourth ventricle in a dog.

A 5-year-old female cross-breed dog was presented with a 1-month history of progressive changes in the posture of the head and in the gait. At neurological examination the dog showed a central vestibular syndrome lateralized to the left. MRI showed a space occupying lesion within the fourth ventricle, characterized by iso- to hypointensity in T1 and hyperintensity in T2 with a heterogeneous contrast uptake. Histologically, a neoplasia composed of meningothelial cells forming compact whorls with slight atypia, and stellate cells delimitating microcysts containing eosinophilic fluid was observed. Neoplastic cells were positive for vimentin and negative for GFAP and FVIII. A diagnosis of intraventricular microcystic meningioma was achieved. Intraventricular meningiomas in dogs are rarely encountered and reports of meningiomas within the fourth ventricle have not yet been described. Although choroid plexus tumor is the most frequent neoplasia localized in the fourth ventricle, intraventricular meningioma should be included in the differential diagnoses.

Amiodarone-induced pulmonary toxicity mimicking acute pulmonary edema.

Amiodarone is a highly effective antiarrhythmic drug. Its long-term use may, however, lead to several adverse effects, with pulmonary toxicity being the most serious. The article presents the case of a 78-year-old woman with a history of cardiac surgery, who after 2 years of amiodarone therapy for prophylactic treatment of atrial fibrillation developed amiodarone pneumonitis mimicking an acute pulmonary edema. The patient failed to respond to diuretic therapy and several courses of anti-infective therapy. Differential diagnosis of different causes of pulmonary infiltrates did not demonstrate any other abnormality. Lung biopsy findings were consistent with the diagnosis of amiodarone pneumonitis. Given the widespread use of amiodarone as an antiarrhythmic agent, pneumologists and cardiologists should consider this important adverse effect as a differential diagnosis of pulmonary distress refractory to therapy in all patients treated with amiodarone who present with respiratory symptoms and pneumonia-like illness.

Poly(ester urethane) guides for peripheral nerve regeneration.

A biocompatible and elastomeric PU was synthesized from low-molecular-weight PCL as macrodiol, CMD as chain extender and HDI as chain linker for applications in the field of peripheral nerve repair. PU cast films supported in vitro attachment and proliferation of NOBEC. The in vitro adhesion and proliferation of S5Y5 neuroblastoma cells on the inner surface of uncoated, gelatin- and PL-coated PU guides were compared. Due to their superior in vitro performance, PL-coated PU guides were tested in vivo for the repair of 1.8 cm-long defects in rat sciatic nerves. The progressive regeneration was confirmed by EMG and histological analysis showing the presence of regenerating fibers in the distal stumps.

Left bundle branch block as an electrocardiographic pattern at presentation of patients with Tako-tsubo cardiomyopathy.

BACKGROUND: Tako-tsubo cardiomyopathy (TTC) is a recently described clinical condition that may mimic acute myocardial infarction. The presence or new onset of left bundle branch block (LBBB) is associated with adverse outcome in patients with acute myocardial infarction. OBJECTIVE: We sought to assess the incidence, clinical profile, and outcome of patients with TTC and LBBB at presentation. METHODS AND RESULTS: From July 2003 to December 2006, 84 consecutive patients met the diagnostic criteria for TTC. LBBB was present in eight (9%) patients at presentation. Patients with LBBB tended to be older (77 +/- 11 years versus 72 +/- 10 years; P=0.186), and with a more frequent, but not statistically significant, history of hypertension (75 versus 53%; P=0.227), and chronic renal failure (25 versus 8%, P=0.117). Moreover, patients with LBBB showed a higher peak creatine kinase-MB value (76 +/- 32 U/I versus 21 +/- 31 U/I; P=0.005), and a lower, but not significantly, baseline left ventricular ejection fraction (30 +/- 13% versus 36 +/- 9%; P=0.107), as compared with patients without LBBB. Follow-up length was 12 +/- 10 months. The mortality rate was higher in patients with LBBB as compared with those without (25 and 3%; P=0.005). However, at Cox analysis the only independent predictor of death was age (P=0.042). CONCLUSION: LBBB was documented at presentation in 9% of TTC patients. At long-term follow-up, TTC patients with LBBB showed increased unadjusted mortality. However, when adjusted for age, baseline characteristics, and concomitant diseases, LBBB did not appear to be an independent predictor of poor outcome in patients with TTC.

Abnormal coronary reserve and left ventricular wall motion during cold pressor test in patients with previous left ventricular ballooning syndrome.

AIMS: To investigate whether and how cold pressor test (CPT) could affect myocardial perfusion and left ventricular (LV) function in patients with previous LV ballooning syndrome (LVBS). METHODS AND RESULTS: Cold pressor test (3 min hand immersion in ice-water) was performed in 17 women with previous LVBS and in 7 age- and risk factor-matched women with chest pain and normal coronary arteries. At baseline and peak CPT, global and regional LV function, and myocardial perfusion were quantitatively assessed by real-time three-dimensional echocardiography (RT3DE) and myocardial contrast (SonoVue, Bracco) 2D echocardiography (MCE), respectively (Philips iE33 machine, X3-1 and S5-1 probes). Data were analysed off-line (QLab 6.0 software). Peripheral venous catecholamines were assayed by high performance liquid chromatography with electrochemical detection. Cold pressor test induced similar haemodynamic changes and catecholamine increase in controls and LVBS patients. Left ventricular ejection fraction decreased and transient new mid-ventricular and apical motion abnormalities developed in LVBS patients only (quantitative RT3D analysis), without corresponding perfusion defects (MCE). At peak CPT, coronary blood flow and velocity increased (quantitative MCE analysis) in control subjects only. CONCLUSION: Cold pressor test induced LV wall motion abnormalities unmatched to regional coronary flow reduction in LVBS patients only. The reduced coronary reserve in response to CPT suggests microvascular dysfunction in LVBS patients.

Melt-extruded guides for peripheral nerve regeneration. Part I: poly(epsilon-caprolactone).

Melt-extruded guides for peripheral nerve repair based on poly(epsilon-caprolactone) (PCL) were realised and their physico-chemical properties were evaluated. Preliminarily, PCL cast films were found to support the attachment and proliferation of Neonatal Olfactory Bulb Ensheating Cells (NOBEC). S5Y5 neuroblastoma cells were cultured inside PCL guides in their uncoated form or coated with a non-specific adhesion protein (gelatin) and a specific peptide for nerve regeneration (poly(L-lysine)). Coating increased cell density (gelatin) and/or the cell density rate on substrates (poly(L-lysine); gelatin) as compared to uncoated guides. Various in vivo tests were carried out for the repair of small (0.5 cm), medium (1.5 cm) and long (4.5 cm) size defects in the peripheral nerves of Wistar rats. For the small nerve defects, uncoated and coated PCL guides were tested. Results from in vivo tests were subjected to histological examination after 45 days, 6 and 8 months postoperative for small, medium and large defects, respectively. Regeneration was found for small and medium size defects. For 0.5 cm defects, the coating did not affect regeneration significantly. Grip-tests also evidenced functional recovery for the 1.5 cm-long defects treated with PCL guides, after 6 months from implantation. On the other hand, mechanical stiffness of PCL conduits impaired the repair of 4.5 cm-long defects in 8-month period: the lack of flexibility of the guide to rat movements caused its detachment from the implant site. The research showed that PCL guides can be used for the successful repair of small and medium size nerve defects, with possible improvements by suitable bio-mimetic coatings.

Time of onset and outcome of cardiogenic shock in acute coronary syndromes.

BACKGROUND AND METHODS: The aim of our study was to evaluate the incidence, timing of the onset and outcome of cardiogenic shock in a group of 865 patients with acute coronary syndromes who were consecutively admitted to our Intensive Cardiac Care Unit (ICCU) from January 2004 to December 2005. RESULTS: Eighty-seven patients had cardiogenic shock; 65 (74.7%, 65/87) on ICCU admission ('early' cardiogenic shock) and 22 (25.3%, 22/87) during ICCU stay ('delayed' cardiogenic shock). Left ventricular systolic dysfunction was the cause of cardiogenic shock in 90.7% of patients (59/65) with early cardiogenic shock and in 50% of patients (11/22) with delayed cardiogenic shock (P < 0.001). Patients with early shock exhibited higher serum levels of troponin I (P = 0.029), higher serum levels of glucose on admission (P = 0.009), lower ejection fraction (=0.003), whereas latency (time from symptoms onset to percutaneous coronary intervention) was higher in patients with delayed shock (P = 0.032). Intra-ICCU mortality was comparable in the two subgroups of patients. At multivariable logistic regression analysis, age, percutaneous coronary intervention failure, glycemia on admission and the development of mechanical complications were independent predictors of intra-ICCU mortality. CONCLUSION: Primary percutaneous coronary intervention has reduced the number of patients who develop cardiogenic shock after ICCU admission. According to our results, cardiogenic shock in patients with ST-elevation myocardial infarction developed early after symptoms' onset and, despite optimal treatment, mortality in these patients remains high (about 50%). Delayed cardiogenic shock is mainly due to mechanical complications as well as due to PCI complications.

Effectiveness and safety of routine primary angioplasty in patients aged > or =85 years with acute myocardial infarction.

BACKGROUND: Although octogenarians constitute a fast growing portion of cardiovascular patients, few data are available on the outcome of very old patients (age >80 years) with ST-segment elevation myocardial infarction (STEMI) undergoing primary angioplasty. METHODS AND RESULTS: Short- and long-term outcomes of 88 consecutive very old (age > or =85 years) patients with STEMI undergoing primary angioplasty were evaluated. In-hospital mortality was 17%, significantly higher in patients with cardiogenic shock (90%; p<0.001), with failure of percutaneous coronary intervention (PCI; p=0.016), with Killip class > or =III on admission (p=0.018), or with chronic renal failure (p=0.033). Major bleeding complications occurred in 11 patients (12%). Multivariable logistic regression analysis identified 3 independent predictors of in-hospital death: age > or =90 years (p=0.018), Killip > or =III on admission (p=0.018), and PCI failure (p=0.025). Multivariable logistic regression analysis identified age > or =90 years (p=0.008), Killip > or =III on admission (p=0.015), and time from symptoms to PCI >12 h (p=0.04) as independent predictors of mortality at long-term follow-up. CONCLUSIONS: The low incidence of procedural complications, together with good long term survival, suggest that primary PCI in STEMI patients > or =85 years is safe and efficacious, with a low rate of PCI failure in the presence of a low Killip class on admission, whereas primary PCI is unable to affect the poor prognosis for very old patients with cardiogenic shock.

PAM-microfabricated polyurethane scaffolds: in vivo and in vitro preliminary studies.

Polymeric scaffolds were realised with linear degradable PU in the form of square, hexagonal and octagonal grids. They were characterised in terms of their mechanical properties. Analysis shows that the mechanical properties of the scaffolds depend on their geometries which are easily modulated using PAM. In vitro biological assays showed that PU promotes the adhesion and proliferation of fibroblast cells and that cell activities are better on PU scaffolds than on PU films. In vivo implantation of PU and PLGA scaffolds and PU films demonstrated that the scaffolds are completely resorbed after three months with a slight inflammatory response, while the PU film was still present after six months with an intense granulomatous reaction.