Inhalation of NO at 80 ppm for 4 h in STEMI was safe but did not reduce infarct size relative to absolute LVmass at 48-72h. The observed functional recovery and clinical event rates at follow-up and possible interaction with nitroglycerine warrant further studies of iNO in STEMI.

A b s t r a c tBackground: Clinical outcomes of patients with ST-segment elevation myocardial infarction (STEMI) disqualified from an invasive strategy (InvS) are poorly understood.Aim: To investigate the short-term result of a conservative strategy (ConS) in a real-life population of patients with STEMI. Material and methods: 1031 patients with STEMI were retrospectively analyzed. Of these, 194 (18.8%) patients were initially qualified to the ConS. For the remaining 837 (81.2%) patients the InvS was applied.Results: The most frequent reasons for disqualification from an InvS in STEMI patients were the duration of ischemia > 12 h (81.4%), aborted STEMI (9.8%) and anticipated transportation time > 2 h (3.1%). On admission, in the group of InvS, cardiogenic shock was noted in 45 (5.4%) patients. Death within 30 days was more frequently observed in STEMI patients who underwent ConS vs. InvS (13.9% vs. 9.0%, p = 0.037). During initial hospitalization 22 (11.3%) patients who underwent ConS and 34 (4.1%, p < 0.001) with InvS developed symptoms of heart failure (Killip class 2-4). Age (OR 1.07 per year, 95% CI 1.04-1.11, p < 0.0001) and conservative strategy (OR 1.55, 95% CI 0.73-4.86, p = 0.035) were the independent predictors of death within 30 days. Moreover, in patients with InvS cardiogenic shock on admission (OR 52.4, 95% CI 18.7-134.1, p < 0.0001) and in patients with ConS heart failure during hospitalization (OR 10.8, 95% CI 3.2-36.7, p = 0.0002) independently influenced the 30-day mortality (c-statistics 0.83).Conclusions: Duration of ischemia of more than 12 h was the main reason for disqualification from InvS. Applied ConS was associated with higher 30-day mortality when compared to InvS. The symptoms of heart failure were an independent predictor of death within 30 days in patients with ConS.Key words: ST-segment elevation myocardial infarction, conservative strategy, percutaneous coronary intervention S t r e s z c z e n i e Wstęp: Wyniki leczenia pacjentów z zawałem serca z uniesieniem odcinka ST (STEMI) niezakwalifikowanych do strategii inwazyjnej (invasive strategy, InvS) są słabo poznane.Cel: Ocena bezpośredniego wyniku klinicznego strategii zachowawczej (conservative strategy, ConS) zastosowanej w grupie kolejnych pacjentów ze STEMI niezakwalifikowanych do leczenia inwazyjnego.Materiał i metody: Retrospektywnie przeanalizowano dane 1031 pacjentów ze STEMI leczonych zgodnie z obowiązującymi wytycznymi. Spośród tej grupy 194 (18,8%) chorych zostało pierwotnie zakwalifikowanych do ConS, pozostałych 837 (81,2%) poddano InvS.Wyniki: Głównymi czynnikami wykluczającymi z InvS w grupie STEMI były: czas niedokrwienia > 12 godz. (81,4%), ustąpienie bólu i zmian w EKG (9,8%) i przewidywany czas transportu > 2 godz. (3,1%). Przy przyjęciu 45 (5,4%) pacjentów poddanych InvS miało objawy wstrząsu kardiogennego. Śmiertelność 30-dniowa wśród pacjentów STEMI w grupach InvS i ConS wyniosła odpowiednio 9,0% i 13,9% (p = 0,037). Podczas pierwotnej hospitalizacji u 22 (11,3%) pacjentów poddanych ConS i 34 (4,1%, p < 0,001...

Cocaine- and amphetamine-regulated transcript peptide (CART) is widely distributed within the central and peripheral nervous system. In the brain, CART is considered as the main anorectic peptide involved in the regulation of food intake. Contrary to the central nervous system, a lot of aspects connected with the distribution and functions of CART within the enteric nervous system (ENS) still remain unknown. The aim of the present study was to investigate, for the first time, the population of CART-like immunoreactive (CART-LI) neurons within the porcine esophagus and the denotation of their neurochemical coding. During this experiment, the distribution of CART-LI neurons and the colocalization of CART with other neuronal active substances were examined using standard double- and triple-immunofluorescence techniques in enteric plexuses of cervical, thoracic, and abdominal esophagus fragments. The obtained results showed that CART is present in a relatively high percentage of esophageal neurons (values fluctuated from 45.2±0.9% in the submucous plexus of the thoracic esophagus to 58.1±5.0% in the myenteric plexus of the same fragment of the esophagus). Moreover, CART colocalized with a wide range of other active neuronal substances, mainly with the vesicular acetylcholine transporter (VAChT, a marker of cholinergic neurons), neuronal isoform of nitric oxide synthase (nNOS, a marker of nitrergic neurons), vasoactive intestinal polypeptide (VIP) and galanin (GAL). The number of CART-positive neuronal cells and their neurochemical coding clearly depended on the fragment of esophagus studied and the type of enteric plexus. The obtained results suggest that CART may play important and multidirectional roles in the neuronal regulation of esophageal functions.

Bisphenol A (BPA) is used in the production of plastics approved for contact with feed and food. Upon entering living organisms, BPA, as a potent endocrine disruptor, negatively affects various internal organs and regulatory systems, especially in young individuals. Although previous studies have described the neurotoxic effects of BPA on various tissues, it should be underlined that the putative influence of this substance on the chemical architecture of the urinary bladder intrinsic innervation has not yet been studied. One of the most important neuronal substances involved in the regulation of urinary bladder functions is vasoactive intestinal polypeptide (VIP), which primarily participates in the regulation of muscular activity and blood flow. Therefore, this study aimed to determine the influence of various doses of BPA on the distribution pattern of VIP-positive neural structures located in the wall of the porcine urinary bladder trigone using the double-immunofluorescence method. The obtained results show that BPA influence leads to an increase in the number of both neurons and nerve fibres containing VIP in the porcine urinary bladder trigone. This may indicate that VIP participates in adaptive processes of the urinary bladder evoked by BPA.