Abstract Background Although outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary interventions (PCI) have improved, women show higher mortality. Objectives To assess gender differences in presentation, management and in-hospital mortality, at 30-days, 6-months and 1-year after STEMI. Methods We retrospectively collected data from 809 consecutive patients treated with primary PCI and compared the females versus males at the local intervention cardiology database. The level of significance used was p<0.05. Results Women were older than man (69,1±14,6 vs. 58,5±12,7 years; p<.001) with higher prevalence of age over 75 years (36.7% vs. 11.7%; p<.001), diabetes (30,6% vs. 18,5%; p=.001), hypertension (60.5% vs. 45.9%; p=.001), chronic kidney disease (3.4% vs. 0.6%; p=.010) and acute ischemic stroke (6.8% vs. 3.0%; p=.021). At presentation, women had more atypical symptoms, less chest pain (p=.014) and were more frequently in cardiogenic shock (p=.011)). Women had longer time until reperfusion (p=.001) and were less likely to receive optimal medical therapy (p<0.05). In-hospital mortality (p=.001), at 30-days (p<.001), 6-months (p<.001) and 1-year (16.4% vs. p<.001) was higher in women. The multivariate analysis identified age over 75 years (HR=4.25; 95% CI[1.67-10.77];p=.002), Killip class II (HR=8.80; 95% CI[2.72-28.41];p<.001), III (HR=5.88; 95% CI [0.99-34.80]; p=.051) and IV (HR=9.60; 95% CI[1.86-48.59];p=.007), Acute Kidney Injury (HR=2.47; 95% CI[1.00-6.13];p=.051) and days of hospitalization (HR=1.04; 95% CI[1.01-1.08];p=.030) but not female gender (HR=0.83; 95% CI[0.33-2.10];p=.690) as independent prognostic factors of mortality. Conclusions Compared to men, women with STEMI undergoing primary PCI have higher mortality rates. Women admitted for STEMI have a worse risk profile, are treated with a higher reperfusion time related with system delays and are less likely to receive the recommended therapy. Female gender was not an independent prognostic factor for mortality in the studied population.

Resumo Fundamento Embora os resultados em pacientes com infarto do miocárdio com supradesnivelamento do segmento ST (IAMCSST) submetidos a intervenções coronárias percutâneas (ICP) primárias tenham melhorado, as mulheres apresentam maior mortalidade. Objetivos: Avaliar as diferenças de gênero na apresentação, manejo e mortalidade hospitalar, em 30 dias, 6 meses e 1 ano após IAMCSST. Métodos Coletamos retrospectivamente dados de 809 pacientes consecutivos tratados com ICP primária e comparamos mulheres versus homens no banco de dados de cardiologia de intervenção local. O nível de significância utilizado foi p<0,05. Resultados As mulheres eram mais velhas que os homens (69,1±14,6 vs. 58,5±12,7 anos; p<0,001) com maior prevalência de idade acima de 75 anos (36,7% vs. 11,7%; p<0,001), diabetes (30,6% vs. 18,5%; p=0,001), hipertensão (60,5% vs. 45,9%; p=0,001), doença renal crônica (3,4% vs. 0,6%; p= 0,010) e acidente vascular cerebral isquêmico agudo (6,8% vs. 3,0%; p=0,021). Na apresentação, as mulheres apresentavam mais sintomas atípicos, menos dor torácica (p=0,014) e estavam mais frequentemente em choque cardiogênico (p=0,011)). As mulheres tinham mais tempo até a reperfusão (p=0,001) e eram menos propensas a receber terapia médica ideal (p<0,05). A mortalidade intra-hospitalar (p=0,001), em 30 dias (p<0,001), 6 meses (p<0,001) e 1 ano (16,4% vs. p<0,001) foi maior nas mulheres. A análise multivariada identificou idade acima de 75 anos (HR=4,25; IC 95%[1,67-10,77];p=0,002), classe Killip II (HR=8,80; IC 95%[2,72-28,41];p<0,001), III (HR=5,88; IC95% [0,99-34,80]; p=0,051) e IV (HR=9,60; IC 95%[1,86-48,59];p=0,007), Lesão Renal Aguda (HR=2,47; IC 95% [1,00-6,13];p=0,051) e dias de hospitalização (HR=1,04; IC 95%[1,01-1,08];p=0,030), mas não o sexo feminino (HR=0,83; IC95% [0,33-2,10];p=0,690) como fatores prognósticos independentes de mortalidade. Conclusões Comparadas aos homens, as mulheres com IAMCSST submetidas à ICP primária apresentam maiores taxas de mortalidade. Mulheres hospitalizadas por IAMCSST têm pior perfil de risco, são tratadas com maior tempo de reperfusão relacionado a atrasos do sistema e têm menor probabilidade de receber a terapia recomendada. O sexo feminino não foi fator prognóstico independente para mortalidade na população estudada.

Abstract One of the major health security challenges of the 21st century is the occurrence of microbial infections and bacterial complications that could affect 10 million people by 2050. On the biomaterial field, implant metallic currently replaces partial or total body parts and can fail to be integrated into the body due to infections. This study performs two combined surface modifications on Ti-30Ta alloy, in order to obtain an infection-resistance and osseointegration surface on metallic implants to be tested within bacterial biofilm. The Group 1 investigated surface modifications by the anodization process in the electrolyte glycerol + NH4F 0.25% at 30V- 9 hours and annealed in 530°C (5°C/min). The Group 2 underwent the same process as Group 1 and, additionally, the samples were immersed in 0.3 M CaCl2 and 0.5 M Na2HPO4 solutions for hydroxyapatite growth. The substrate was characterized using scanning electron microscopy (SEM), X-ray diffractometer (XRD) and dynamic contact angle. S. epidermidis bacterial adhesion and biofilm formation. The results indicated that the Group 1 shows a higher antimicrobial activity, hydrophilic behavior and potential to be used for metallic implant applications. The Group 2 with the hydroxyapatite film coating did not have an improvement in the antimicrobial response.

Several studies have been carried out to develop new materials for biomedical applications. Material surfaces that present biomimetic morphology like nanotubes or nanofibers that provides nanoscale architectures have been shown to alter cell/biomaterial interactions. The coated surface biomaterial with biocompatible polymers and nanotubes of TiO2 is an alternative to improve osseointegration. The anodization process was performed to obtain nanotubes of TiO2 covering the Ti-30Ta alloy surface and the electrospinning process has been used for producing polymer fibers. Characterization techniques such as scanning electron microscopy (SEM - FEG), X-ray diffraction analysis (X-rays), thermogravimetric analysis (TGA), Differential Scanning Calorimetry (DSC) and contact angle were used for samples analyses. Adult human adipose-derived stem cells (ADSCs) were used to investigate the cellular response and S. aureus antimicrobial activity on these coated surfaces. The results indicated that both surface modification treatment showed a favorable micro-environment for cells growth and proliferation such as adhesion, viability and morphology which is a desire property for an implant. In addition, the antimicrobial activity study presented both materials with similar growth of S. aureus. So, it can conclude nanotubes and nanofibers can be used at biomedical field and both present similar cell evaluation and antimicrobial activity results.