Abstract Funding Acknowledgements None. Background/Introduction Bioresorbable vascular scaffolds (BVS) were considered promising alternatives to drug-eluting stents in percutaneous coronary interventions (PCI). They would restore the normal vasomotor tone and allow positive remodeling, reducing the trigger for inflammation and facilitating further interventions. Although randomized trials showed beneficial outcomes up to 1 year of follow-up, longer-term results have been disappointing, with increased rates of events, leading to its discontinuation. Purpose This study aims to evaluate our center’s 5-year follow-up of the BVS implantations, in terms of safety and efficacy. Methods Retrospective cohort of 46 patients submitted to PCI with a BVS was evaluated. The outcomes assessed were composite endpoint of death, myocardial infarction (MI), and revascularization (DMR), target vessel failure (TVF) and cardiovascular death, and each endpoint individually. Data analysis was done with SPSS software. Results The cohort was a total of 46 patients, with a mean age 69,5±1,5 years, and 23,9% women (n=11). The mean follow-up time was 5,6±0,2 years. BVS were implanted 74% (n=34) of the times in acute coronary syndromes, and 68% (n=31) were PCI on previous stent failure. Total of 24% (n=11) had an episode in the follow-up. Regarding each individual outcome, there was 9% (n=4) of MI, 0% (n=0) of cardiovascular deaths and 15,2% (n=7) of BVS re-stenosis requiring revascularization. Only 4% (n=2) of patients had complete BVS resorption on reassessment coronary angiography. Conclusions In the 5-year follow-up, there was a high rate of events, with 24% (n=11) of events, of which the most common was BVS re-stenosis, with 15,2% cases (n=7), and MI in 9% (n=4). Despite theoretical benefits with the resorption of BVS, it was only verified in 4% of the cases (n=2). According to the recent data, from the longer-term follow-up, BVS have been associated with a higher number of events, with the intended benefit not being verified.

Abstract Funding Acknowledgements None. Background Percutaneous coronary intervention (PCI) has undergone rapid evolution over the last years and is currently a widely generalized therapeutic option. In the past, it was associated with a significant rate of complications, yet, with the improvement of new generation drug eluting stents, and the radial access (RA) development, PCI has become safer and simpler, with a minimum rate of complications. This allows patient’s faster discharge. Besides the pressure from the limited number of beds in wards, the improvement of PCI has given the confidence to urge outpatient PCI programs. However, there are still centers where there is no ambulatory PCI. Purpose This study aims to describe our center experience of ambulatory PCI program, in terms of safety and efficacy. Methods We analyzed our center’s retrospective cohort of 723 PCI, in 2022. Ambulatory PCI was defined as PCI with same day hospital discharge. Our inclusion criteria were patients submitted to PCI. We excluded patients with acute coronary syndromes and patients needing hospital admission for other non-coronary reasons. Results 467 (65%), of the 723 PCI were performed in ambulatory setting. Patients mean age was 67,8±11 years and 23% (n=107) were female. In 12% (n=55) of the cases, the coronary anatomy was previously known, from a differed procedure. 63% (n=298) had a normal left ventricle ejection fraction (LVEF), 6% (n=26) had a moderate depression of LVEF and 3% (n=13) had LVEF severe depression. RA was possible in 82% of the cases (n=384), and 18% (n=83) of PCI was done by femoral access (FA). The access size was 6 Fr in 77% (n=359) of the cases, 7Fr in 22% (n=105) and 8Fr in 1% (n=2). The RA hemostasis was by compression (either manually or by external device) and FA hemostasis was first intended by closing device, however in 17% of the transfemoral PCI (n=14) had to be compressed, due to device hemostasis failure. PCI was successful in 97% of the cases (n=449), with revascularization of the goal lesion. The unsuccessful PCI (3% n=18) were because uncrossable lesion in 2% (n=14), and no reflow after PCI in 1% (n=4). 6 patients had to be admitted, after planned outpatient PCI, 5 due to peripheral access complication with hemorrhage of FA (after closing device and manual compression failure) and 1 due to PCI complication, with small coronary perforation. There was a higher probability of admission in patients submitted to transfemoral PCI (p<0,05), and there was no statistically significant relation between unplanned admission and patient’s LVEF. There were no episodes of death, MACE, non-planned hospital readmission and stent failure in the ambulatory PCI population. PCI has become a predictable and reliable technique, capable to treat outpatients. Patients undergoing successful non-complex PCI, without events, can safely be discharged on the same day. Outpatient PCI helps with the functioning of inpatient care, allowing beds to be freed up for other situations.

Porcine circovirus type 2 (PCV-2) is the agent of one of the most important diseases in the swine industry. Although it has been controlled through vaccination, viremic piglets at birth may represent a risk by reducing vaccination efficacy. Since there are few reports on the viremic status of pre-suckling piglets regarding PCV-2 infection, we assessed the PCV-2 frequency in sows housed in 18 breeding farms with no history of clinical PCVAD in Brazil, using placental umbilical cord serum (PUCS). The selection criteria were: breeding farms with more than 1,000 sows; sows not vaccinated for PCV-2 at least for 2 years prior to the study; farms with no history of PCV-2 clinical disease in the last 12 months; and production systems with a maximum of two sites. Blood from the umbilical cords in sow placenta or directly from piglet’s immediately after birth was collected from 30 litters on each farm for PCR. In addition, blood from 538 sows was collected for PCV-2 antibody detection. A total of 17.29% of the PUCS tested positive. The PCV-2 DNA was detected in PUCS from 94.4% of all farms. A total of 94.8% of the sows was positive for PCV-2 antibodies. However, seronegative sows were detected in 44.4% of farms. All 18 farms had at least 46.9% seropositive dams. A higher percentage of seronegative sows was observed for farms with more than 10% of PCV-2-positive litters compared to those with ≤10% of PCV-2 positive litters (8.9 +/−1.7% vs. 1.5 +/− 0.7%, p < 0.01, respectively).

Abstract Funding Acknowledgements None. Background/Introduction Severe aortic stenosis is the most common valve disease requiring intervention. It has very poor prognosis, and early intervention is recommended. Either surgical or percutaneous transcatheter intervention is possible. According to European guidelines, surgical aortic valve replacement (SAVR) is usually indicated for patients younger than 75 years old. However, some patients are refused surgery, and transcatheter aortic valve implantation (TAVI) might be an option of treatment for these patients, however medium-long term results are still uncertain. Purpose This study intends to evaluate the efficacy and safety of TAVI in younger patients with severe symptomatic aortic stenosis. Methods Retrospective cohort of 224 patients were submitted to TAVI in the last 3 years, of which 21 patients were younger than 75 years old. The primary endpoints are mortality, major adverse cardiovascular events (MACE) and rehospitalization (related to the procedure, valve, or heart failure). Efficacy and safety were evaluated during a follow-up of at least 6 months, compared with the traditional group. Results A total of 224 patients underwent TAVI during the last 3 years at our center. Of these, 21 patients (9%) were younger than 75 years. The mean age was 72,1±3 [62-75] years old and 33% were female (n=7). 95% (n=20) of the TAVI procedures were due to degenerative severe aortic stenosis and 5% (n=1) due to degenerative aortic surgical valve prothesis. The mean euroscore risk value was 6,2±1,3%, and 18 patients were refused for surgery (86%) and 3 patients refused surgery (14%). All procedures were performed by transfemoral access, with 2 peripheral access complications (9,5%), 1 hemorrhagic (4%), solved with covered stent, and 1 closure device occlusion solved with wire crossing and balloon inflation (4%). It was necessary to implant 3 temporary pacemakers, however, only 2 patients required a definitive pacemaker implantation (9,5%). There were no cases intraprocedural death, MACE or aortic severe complications. There was a statistically significant reduction of risk of peripheral complications and pacemaker implantation on younger patients comparing with older patients (p=0,04 and p=0,05 respectively). Mean follow-up time was 14±8,3 months [6-39 months]. During follow-up there were no deaths, MACE or episodes of rehospitalization due to heart failure recorded. Regarding echocardiographic evaluation, there were no cases of significant valve degeneration, with mean aortic gradient of 13±4,1mmHg, no significant leakage or other echocardiographic findings. In younger patients, TAVI appears to be also valid therapeutic option, with less risk of peripheral access complication or need of permanent pacemaker implantation. During the follow-up there was no cases of prothesis degeneration, proving to be a reliable option for the medium to long term.

Abstract Funding Acknowledgements None. Background/Introduction Coronary manual thrombectomy is not routinely recommended, due to the risk of stroke, as supported by some dedicated clinical trials. It is, however, a simple and delicate technique that gives the opportunity to improve angioplasty results by decreasing thrombus burden and potentially improving stent apposition and decreasing no-reflow phenomenon, protecting coronary microcirculation. Purpose To describe a single-centre experience on coronary manual thrombectomy, regarding clinical context, anatomic/technical features, procedure success and in-hospital occurrence of stroke. Methods Retrospective study of procedures in which coronary manual thrombectomy was performed from 2009 to 2021. Procedure and patient characteristics were analyzed and related with hospital records of new stroke diagnosis. Results Manual thrombectommy was performed on 1136 procedures, in 1111 patients (77% male). As expected, the vast majority of cases were acute coronary syndromes: STEMI (1031 cases; 90,8%) and NSTEMI (78; 6,9%). The device used was predominantly 6F (81,7%). Most frequent reference diameters were 3,0mm (529; 46,6%) and 3,5mm (244; 21,5%). The vessel was initially completely occluded in about two thirds of the cases (747; 65,8%) and the left anterior descending artery was the most frequent culprit (541; 47,7%), followed by the right coronary (386; 33,9%). Revascularization was considered completely successful in 1017 (89,5%) of cases. There were no cases of new stroke diagnosis during admission in these patients. Conclusions Coronary manual thrombectomy should not be routinely performed, as recommended by international guidelines. However, fear of stroke should not hamper its use whenever the benefits seem clear, such as the presence of a flow-limiting thrombus in a culprit artery, with a retrievable size and good catheter engagement of the coronary artery. In this relatively large sample, we report a good single centre experience with this technique, with no clinical stroke occurrence during admission.

Abstract Funding Acknowledgements None. Background/Introduction Antiplatelet therapy is the cornerstone treatment for ST-segment elevation myocardial infarction (STEMI). Dual antiplatelet therapy (DAPT) including aspirin and a potent P2Y12 inhibitor (P2Y12i) is recommended as the default strategy. However, the timing of DAPT remains controversial: European Cardiology Society (ESC) guidelines ceased recommending pretreatment with P2Y12i in STEMI, based on ATLANTIC trial results. Purpose This study aims to evaluate the effect of DAPT with potent P2Y12i pretreatment DAPT in STEMI patients, comparing with DAPT with clopidogrel and aspirin only pretreatment. Methods We have analyzed the antiplatelet pretreatment strategy results of a retrospective cohort of 2283 STEMI patients, from a multicenter national registry, from 2011 till 2019. We compared 3 groups: DAPT with potent P2Y12i, DAPT with clopidogrel and aspirin only. Primary endpoints were death, major adverse cardiovascular events (MACE), including reinfarction, heart failure, sustained ventricular arrhythmia, cardiogenic shock, mechanical complication and stroke, and successful PCI. Safety endpoint was major hemorrhagic events between different strategies. Results A total of 2283 STEMI patients where included, with a mean age of 66±13 years and 27% (n=627) were female. The population was divided in 3 groups, according with pretreatment strategy: DAPT with potent P2Y12i, DAPT with clopidogrel and aspirin only. 334 patients undergone DAPT with potent P2Y12i, and 86% (n=296) had a successful PCI, 21% (n=69) had a MACE and 9% (n=31) died in hospital. The group of patients submitted to DAPT with clopidogrel were 1815, and 80% (n=1448) had a successful PCI, 29% (n=527) had a MACE and 11,5% (n=209). The group pretreated only with aspirin were 124 patients, of which, only 14% (n=17) had a successful PCI, 38% (n=47) had a MACE and 39% (n=49) died. Regarding safety outcomes, 1,5% (n=5) patients with DAPT with potent P2Y12i had a significant hemorrhage, comparing with 3% (n=53) of patients with DAPT with clopidogrel and 3% (n=4) of aspirin only group of patients. There was a statistically significant higher rate of successful PCI with DAPT with potent P2Y12i (p<0,05 OR 2), a statistically significant lower number of MACE (p<0,05 OR 0,6) and in hospital deaths (p=0,04 OR 0,67), comparing with DAPT with clopidogrel and aspirin only groups. There was no statistically significant difference between groups in terms of hemorrhagic events (p=0,7). According to our retrospective multicenter national registry, pretreatment with potent P2Y12i is associated with better results, namely higher rate of successful PCI, less MACE and in hospital death, contrary to recent trials. Our study has some bias: the pretreatment with DAPT was standard of care during the registry, and the choice for aspirin only strategy might be due to higher risk patients, as the choice was not randomized.Antiplatelet treatment comparison

The objective of this study was to characterize the Mycoplasma hyopneumoniae (M. hyopneumoniae) detection and seroconversion patterns in recently acclimated gilts to be introduced to endemically infected farms using different types of replacement management. Three gilt developing units (GDUs) belonging to sow farms were included in this investigation: two farms managed gilts in continuous flow, and one farm managed gilts all-in/all-out. Two replicates of 35 gilts each were selected per GDU and sampled approximately every 60 days for a total of four or five samplings, per replicate and per GDU. Detection of M. hyopneumoniae was evaluated by PCR, while antibodies were measured using a commercial ELISA assay. Also, M. hyopneumoniae genetic variability was evaluated using Multiple-Locus Variable number tandem repeat Analysis. Detection of M. hyopneumoniae was similar across GDUs. Although a significant proportion of gilts was detected positive for M. hyopneumoniae after acclimation, an average of 30.3 % of gilts was negative at any point during the study. Detection of M. hyopneumoniae antibodies was similar among GDUs regardless of flow type or vaccination protocol. The genetic variability analysis revealed a limited number of M. hyopneumoniae types within each GDU. Results of this study showed a similar pattern of M. hyopneumoniae detection by PCR and seroconversion by ELISA among GDUs, regardless of the type of flow management strategies applied to gilts.

Abstract Background Ischaemic heart disease is the single most common cause of death and its frequency is increasing. The mortality in patients presenting with an acute coronary syndrome with ST-elevation (STEMI) is associated with many factors such as the time delay to treatment, which comprises primary angioplasty (pPCI) or fibrinolysis. Therefore, treatment delays should be recorded systematically and audited, so as to improve standard of care. Purpose To analyse the response time and delays in the emergent coronary referral pathway for our centre, taking into consideration the place of first contact. Methods Primary data for this study was obtained by evaluating consecutive patients from the year 2015 to 2021, admitted for pPCI in our centre in the context STEMI. Time variables were collected for all patients – schematically represented in Figure 1. Statistical analyses were performed using IBM SPSS Statistics for Windows Version 27.0. Results We included a total of 1452 cases of pPCI with a median patient age of 64 years and 75,3% male. Over 7 years of pPCI were analysed and median times are displayed in table 1. We found that ECG median delays were significantly lower in the emergency first responders (EFR) group when comparing to PCI Centre group (11,0 vs 22,0; p<0,001), primary care physicians group(11,0 vs 23,0; p<0,001) and non-PCI Centre group (11,0 vs 28,0; p<0,001). Futhermore, median diagnostic delay was significantly lower in the EFR group compared to non-PCI centre group (28,0 vs 62,0; p<0,001) and primary care physician group (28,0 vs 59,0; p<0,001), as well as in the PCI Centre group compared to the non-PCI Centre group (30,0 vs 62,0; p<0,001) and to primary care physician group (30,0 vs 59,0; p<0,001). Conclusions Our data displays a clear heterogeneity in care which has an impact in the ischaemic time of STEMI patients. There seems to be a significant difference between the primary point of contact being the primary care physicians or a non-PCI centre when compared to our centre or the EFR, especially when it comes to the diagnostic timings. Hence, strategies must be developed to increase diagnostic sensibility and accuracy of STEMI patients throughout our geographical region.Time variable schemeTime according to groups

Context Mycoplasma hyopneumoniae causes enzootic pneumonia, predisposing pigs to infections with other respiratory pathogens. The main control measure is to reduce piglet exposure at lactation, which can be achieved by gilts’ acclimation prior to their entrance to the farms. One of the acclimation strategies is aerosol exposure with a positive inoculum by using a fogger. However, studies on its efficacy in gilts and their litters are lacking in the literature. Aim The aim of this case study was to assess the efficacy fogging with a positive inoculum of M. hyopneumoniae to expose negative gilts in an acclimation program. Moreover, the infection dynamics of M. hyopneumoniae were assessed in their piglets from lactation to slaughter. Methods The trial was performed in two phases. In Phase 1, a total of 34 and 107 gilts was selected from Farms A and B respectively, and then exposed to the inoculum through a fogger. In Phase 2, a subsample of 74 gilts from Farm B was followed to their first farrowing and 263 piglets born to those gilts were sampled from 15 to 170 days of age, and at slaughter, lung lesions were evaluated. Key results In Phase 1, the prevalence of positive gilts at 28 days post-exposure (dpe) was 100% and 98.1% in Farms A and B respectively. In Phase 2, 10.8% of gilts remained positive at 180 dpe and 0.8% of piglets were positive at 15 days of age (day) and 28.1% at 60 days, suggesting a possible vertical transmission. Conclusion The use of fogging with a lung homogenate positive for M. hyopneumoniae successfully acclimated negative gilts. However, it did not avoid the presence of positive gilts at farrowing and the detection of the bacterium in their progeny by polymerase chain reaction. Implications The exposure of gilts to M. hyopneumoniae at 150 days of age was successfully achieved by fogging. However, consideration should be given to exposing replacement gilts of a younger age in order to reduce the odds of detecting positive gilts at first farrowing.

Influenza A virus (IAV) active surveillance in pigs prior to weaning is commonly conducted by collecting individual samples, mostly nasal swabs. Recently, the use of udder skin wipes collected from lactating sows was identified as an effective sampling method to indicate IAV status of suckling piglets prior to weaning. However, there is limited information on the effect of pooling multiple udder wipes on the ability to detect IAV. We evaluated the effect of pooling 3, 5, or 10 udder wipes on the sensitivity of detecting IAV and compared the results with testing the wipes individually. The likelihood of detecting positive udder wipes decreased with pooling when the initial positive cycle threshold value was ≥31.5; pooling of up to 3 samples could be performed without affecting sensitivity significantly. Our results support pooling of udder skin wipes to conduct surveillance of IAV in pigs prior to weaning.

The aim of this study was to evaluate genetic diversity, distribution, evolution and population structure of Brazilian Brachyspira hyodysenteriae strains isolated from swine. Multilocus Sequence Typing (MLST) analysis using seven housekeeping genes was applied to 46 isolates obtained from outbreaks of swine dysentery that occurred between 2011 and 2015 in the states of Minas Gerais, São Paulo, Mato Grosso, Rio Grande do Sul and Santa Catarina. Historical isolates from Rio Grande do Sul obtained in 1998 were also included in the study. An independent international profile of the global sequences deposited in the B. hyodysenteriae database was used for comparisons with the Brazilian strains. All isolates from 2011 to 2015 were classified into nine sequence type (STs) and divided into four clonal complexes. These findings indicated genetic relationships among the B. hyodysenteriae from different Brazilian states, among historical strains isolated in 1998 and from recent outbreaks, and relatedness with global isolates. Seven STs were unique and, to date, only reported in Brazil.

Pneumonia caused by Mycoplasma (M.) hyopneumoniae is one of the major respiratory diseases in swine production. Commercial vaccines for M. hyopneumoniae are widely used in weaned piglets to reduce lung lesions and clinical signs in the downstream flow; however, no information regarding the effect of mass immunization of the breeding herd is available. The aim of this work was to evaluate a mass vaccination protocol for M. hyopneumoniae on the humoral response of sows and their offspring 24 h post-partum (trial registration number 40156). A total of 52 sows from two different farms (13 primiparous and 13 multiparous sows on each farm), one with mass vaccination (MVF) and one without mass vaccination against M. hyopneumoniae (control farm (CF)) were enrolled in this study. Five piglets from each litter were selected, resulting in 260 piglets. Blood was collected from sows and piglets 24 h post-partum for M. hyopneumoniae antibody detection by ELISA. The results showed that primiparous sows from MVF had higher antibody titers compared to multiparous sows of the same farm, and multiparous and primiparous sows from the CF. Similar results were evidenced in their offspring. The findings of this study suggest that mass vaccination results in a more robust serologic response on primiparous sows, which could be the main target of vaccination strategies for the breeding herd.

ABSTRACT: Gilts represent a group risk for Mycoplasma hyopneumoniae vertical transmission in swine herds. Therefore, parity segregation can be an alternative to control M. hyopneumoniae infections. The study evaluated the effect of parity segregation on M. hyopneumoniae infection dynamics and occurrence and severity of lung lesions at slaughter. For that, three multiple site herds were included in the study. Herd A consisted of the farm where gilts would have their first farrowing (parity order (PO) 1). After the first farrowing PO 1 sows were transferred to herd B (PO2-6). Herd C was a conventional herd with gilt replacement (PO1-6). Piglets born in each herd were raised in separated nursery and finishing units. Sows (n = 33 (A), 37 (B), 34 (C)) in all herds were sampled prior to farrowing and piglets (n = 54 (A), 71 (B), 66 (C)) were sampled longitudinally at 21, 63, 100, 140 days of age and at slaughter for M. hyopneumoniae detection by PCR and lung lesions scoring. M. hyopneumoniae prevalence in sows did not differ among herds. Prevalence of positive piglets was higher at weaning in the PO1 herd (A) (P < 0.05). However, prevalence of positive pigs from 100 days of age to slaughter age was higher in the PO2-6 herd (B) (P < 0.05). Lung lesion occurrence and severity were higher in herd B. The authors suggested that the lack of a proper gilt acclimation might have influenced the results, leading to sows being detected positive at farrowing, regardless of the parity.

Staphylococcus hyicus is the causative agent of porcine exudative epidermitis. This disorder affects animals in all producing countries and presents a widespread occurrence in Brazil. This study evaluated strains from a historical collection in order to detect the presence of exfoliative-toxin-encoding genes (SHETB, ExhA, ExhB, ExhC, ExhD), characterize the strains using PFGE, and determine their respective antimicrobial resistance profiles. The results obtained from the evaluation of 77 strains from 1982 to 1987 and 103 strains from 2012 reveal a significant change in resistance profiles between the two periods, especially regarding the antimicrobial classes of fluoroquinolones, amphenicols, lincosamides, and pleuromutilins. The levels of multidrug resistance observed in 2012 were significantly higher than those detected in the 1980s. It was not possible to correlate the resistance profiles and presence of genes encoding toxins with the groups obtained via PFGE. Only 10.5% of the strains were negative for exfoliative toxins, and different combinations of toxins genes were identified. The changes observed in the resistance pattern of this bacterial species over the 30-year period analyzed indicate that S. hyicus could be a useful indicator in resistance monitoring programs in swine production. In a country with animal protein production such as Brazil, the results of this study reinforce the need to establish consistent monitoring programs of antimicrobial resistance in animals, as already implemented in various countries of the world.

ABSTRACT: The aim of this study was to access the efficacy of four disinfectants to inactivate influenza A [H1N1] 0 hour and 72 hours after disinfectant dilution. A pandemic H1N1 influenza virus isolated from a pig with respiratory disease was used to obtain inoculums containing 6.4log10 EID50/mL; 5.4log10 EID50/mL; 4.4log10 EID50/mL and 3.4log10 EID50/mL. Suspension test was composed of 400μL of viral inoculum, 100μL of organic load and 500μL of each individually diluted disinfectant and incubated for ten minutes of contact time. After a neutralizing step, each mixture was filtered on a 0.22μm membrane and 0.2mL was inoculated in six 9-day-old embryo chicken egg through allantoic route. The allantoic fluid from eggs was harvest for RT-PCR and hemagglutination test. The experiment was repeated 72 hours after disinfectant dilution. On the first assessment with fresh disinfectant, influenza virus was inactivated by oxidizing compost disinfectant and phenolic disinfectant in all virus concentrations, the quaternary ammonium compound (QAC) and glutaraldehyde association inactivated the virus up to a concentration of 5.4log10 EID50/mL. QAC disinfectant did not eliminate virus viability. Seventy-two hours after disinfectants were diluted, oxidizing compost disinfectant and QAC and glutaraldehyde association disinfectant demonstrated the same result as the evaluation with fresh disinfectant solution. Phenolic disinfectant inactivated viral inoculum up to a concentration of 5.4log10 EID50/mL. QAC had no effect on inactivating 3.4log10 EID50/mL of influenza virus. In conclusion, three of the four disinfectants tested were effective to inactivate pandemic H1N1 influenza virus in the presence of organic load. Test result performed 72hours after disinfectant dilution suggest a decrease in the effectiveness of one disinfectant.

The aim of this study was to compare the sensitivity of different in vivo and post-mortem samples collected from finishing pigs under field conditions on Mycoplasma hyopneumoniae detection by PCR. Results suggested that tracheobronchial secretions and bronchial swabs conferred the highest sensitivity in vivo and post-mortem, respectively.

Abstract Introduction Iron deficiency was shown to affect functional capacity and ejection fraction in patients with heart failure and reduced ejection fraction. Myocardial infarction is an important cause of reduced left ventricular ejection fraction (LVEF). Moreover, there is some evidence of the iron deficiency as a factor to predict cardiovascular and non-cardiovascular mortality. Purpose Evaluate the presence of iron deficiency in patients with acute coronary syndromes (ACS) admitted to the intensive cardiac care unit and its eventual association with LVEF and mortality. Population and methods We performed a prospective study in which ACS patients were divided into groups according to the presence or absence of iron deficiency. We collected demographic data, comorbidities, as well as determination of troponin I, haemoglobin and criteria for absolute and functional iron deficiency (ID) and other data related to the use of mechanical ventilation, need for aminergic support, LVEF and death. Results From 148 patients we included 78 patients who met the criteria for being analysed. 49 patients had iron deficiency (51% had absolute iron deficiency and 49% had relative iron deficiency). There were no differences between groups in terms of myocardial infarction with or without ST segment elevation (p=0.609 and p=0.329, respectively), hypertension (p=0.926), diabetes (p=0.882), obesity (p=0.343), dyslipidaemia (p=0.482), smoking (p=0.876), valvular heart disease (p=0.888), acute and chronic renal failure (p=0.800 and p=0.888, respectively) and LVEF (p=0.886). There were no differences in need for aminergic support (p=0.984), ventilation (p=0.315) and death (p=0.704). We found that in the sub-population of patients without anaemia (Hb>12g/dL), the proportion of patients with depressed LVEF (inferior to 50%) and relative iron deficiency was significantly higher than those with preserved LVEF (48.1 vs 13.8%, p=0.005). Furthermore, we also found that in this sub-population, patients with myocardial infarction without ST segment elevation had higher proportion of absolute iron deficiency (45.0 vs 19.4%, p=0.043). Conclusion Our study showed that the prevalence of iron deficiency in ACS patients is 62.9% (n=49). Moreover, in patients without anaemia, this results seems to point out that the presence of iron deficiency may be related with LVEF, at least during the acute event. Further studies with a higher sample size are warranted to either establish or discard this association. Furthermore, a follow-up of this patients can further enlighten us as to the role of iron deficiency in long term LVEF and mortality. Funding Acknowledgement Type of funding sources: None.

Abstract Introduction Absence of obstructive coronary disease does not imply absence of acute myocardial infarction (AMI). Hence, it can be designated as Myocardial Infarction with Non-obstructive Coronary Arteries (MINOCA). Performing Cardiac Magnetic Resonance (CMR) can be essential for establishing a final diagnosis, according to the presence and pattern of late gadolinium enhancement (LGE). Purpose The aim of this study is to evaluate the diagnostic and prognostic impact of CMR in patients with a possible diagnosis of MINOCA. Methods A 7-year prospective study, which included all patients proposed to CMR with a presumptive diagnosis of MINOCA due to acute chest pain, troponin raise and absence of angiographically significant coronary disease (luminal stenosis of <50%). All patients performed functional, anatomical evaluation and LGE assessment. We analysed clinical characteristics, electrocardiographic presentation, echocardiographic and invasive coronary angiography results. A presumptive diagnosis was elaborated after invasive coronary angiography and comparison was made with the definitive one after CMR. Results A total of 96 patients were included, 50% were male, with a mean age of 48±20 years old. Clinical history of hypertension was observed in 51.0% patients, 35.4% had dyslipidaemia, 7.3% with diabetes, obesity was present in 22.9% of patients and smoking habits in 30.2%. At admission, 44.8% had ST segment elevation, so emergent invasive coronary angiography was performed. The mean highest troponin I was 7.34±9.18 ng/mL. Late gadolinium enhancement was observed in 53 (55.2%) of patients. After CMR realization a final diagnosis of MINOCA was made in only 8 patients (8.4%) and in 51 patients (53.1%) CMR evaluation allowed a diagnosis modification, with impact on patients' management and prognosis. A definitive diagnosis of myocarditis was seen in 46.9% (n=45) of cases, of Takotsubo's myocardiopathy in 13.5% (n=13), and hypertrophic cardiomyopathy in 3.1% (n=3). In 27 (28.1%) of patients, late gadolinium enhancement was not found. This diagnosis adjustment had an impact on treatment in 34.4% (n=33). Conclusion CMR is a pivotal technique on MINOCA patients' management. Our study portrayed the importance of performing CMR, allowing initial diagnosis modification in half of the cases, with important therapeutic in one third of patients and prognostic implications, related to diagnosis and target treatment adverse effects. Funding Acknowledgement Type of funding sources: None.

ABSTRACT: A high prevalence of pneumonic lesions has been reported to affect slaughtered pigs in southern Brazil. In order to identify which microorganisms have been causing those lesions, 30 pig lungs presenting pneumonic gross lesions were collected from five different slaughterhouses, totaling 150 lungs. Samples for bacterial isolation, molecular, histopathologic and immunohistochemistry (IHC) evaluation were taken from each lung. The pneumonic lesion scoring ranged from 1.53 to 2.83. The most frequent histopathological lesions found was the concomitant Influenza A virus (IAV) and Mycoplasma hyopneumoniae infection, corresponding to 55.3% (83/150), and Pasteurella multocida type A was isolated in 54.2% (45/83) of these cases. In 102 samples (68%), there was histopathologic suggestion of involvement of more than one infectious agent. M. hyopneumoniae was the most frequent agent associated with pneumonic lesions, being present in 92.1% (94/102) of the lungs with coinfections, followed by IAV in 89.2% (91/102). Besides the coinfections, IAV lesions were observed also in six samples without another pathogenic microorganism detected. A total of 46 samples with acute and subacute IAV suspected lesions in histopathological examination were assessed for IHC and real time RT-PCR for IAV. A total of 35% (16/46) of them were positive by IHC and 13% (6/46) by real time RT-PCR. Regarding M. hyopneumoniae, 79.3% (119/150) of samples were positive by qPCR and 84.9% (101/119) of them also presented M. hyopneumoniae suspected lesions in the histopathological examination. The results of this study suggest the importance of IAV in respiratory diseases in finishing pigs, even though this virus is more frequently reported in the nursery phase. In addition, our results emphasize the importance of lung coinfections in finishing pigs.

Background: Respiratory diseases are one of the major health issues described in intensive pig production, causing important economic losses. However, there is little information on the prevalence, etiology and clinical-pathological presentation of these diseases in wild boars. For this reason, this work investigated the presence in captive wild boars of pneumonic lesions and bacterial pathogens commonly detected and associated with respiratory diseases in domestic pigs.Materials, Methods & Results: A total of 226 captive wild boar lungs from two farms were examined in a slaughterhouse in Southern Brazil. The pneumonic lesions were classified as cranioventral, dorsocaudal, and disseminated, and the quantification of lesions was calculated. From the total of 226 lungs, 121 were collected for laboratory examination. Lungs with macroscopic lesions suggestive of pneumonia were collected for histological, bacteriological and molecular analysis. The molecular analysis was performed to detect the presence of Actinobacillus (A.) pleuropneumoniae, Glaesserella (G.) parasuis, Mycoplasma (M.) hyopneumoniae, Mycoplasma (M.) hyorhinis and Streptococcus (S.) suis serotype 2. The percentages of histological lesions and bacterial agents and their association were calculated. Cranioventral consolidation (75.2%) was the most prevalent macroscopic lung lesion, followed by disseminated (21.5%) and dorsocaudal (3.3%) distribution. Microscopically, chronic lesions were the most prevalent, representing 70.2% of the lungs. Moreover, BALT hyperplasia was present in 86.5% of the lungs, suppurative bronchopneumonia in 65.7%, and alveoli infiltrate in 46.8%. Six bacterial pathogens commonly described as agents of pig pneumonia were identified by bacterial or molecular methods: Pasteurella (P.) multocida, S. suis, M. hyopneumoniae, A. pleuropneumoniae, G. parasuis and M. hyorhinis. Twenty-eight different combinations of pathogens were identified in 84 samples (69.4%). The most common combinations were: M. hyopneumoniae and A. pleuropneumoniae (13.1%), M. hyopneumoniae, G. parasuis and M. hyorhinis (10.7%), and M. hyopneumoniae, A. pleuropneumoniae and G. parasuis (8.3%). Additionally, M. hyopneumoniae was the most frequent pathogen detected in this study, representing 58.7% of the samples. The detection of M. hyopneumoniae and M. hyorhinis by PCR was associated with the presence of BALT hyperplasia (P < 0.05) and there was also an association between the detection of M. hyopneumoniae by PCR and suppurative bronchopneumonia (P < 0.05). In addition, a significant association (P < 0.05) between the detection of M. hyopneumoniae and A. pleuropneumoniae by PCR and the histological classification (acute, subacute or chronic lesions) was observed.Discussion: The results of this study were similar to those observed in slaughtered domestic pigs, although, the detection of opportunist pathogens was less frequent than that usually described in pig pneumonia. The high prevalence of pneumonia in captive wild boars at slaughter and the similar characteristics of pneumonia in captive wild boars and domestic pigs suggest that the close phylogenetic relationship between pigs and wild boars could influence the susceptibility of both species to the colonization of the same pathogens, indicating that captive wild boars raised in confined conditions could be predisposed to respiratory diseases, similar to domestic pigs. Keywords: Mycoplasma hyopneumoniae, lung consolidation, slaughter, Sus scrofa, swine.