Characteristics and Outcome of Acute Heart Failure in Infective Endocarditis: Focus on Cardiogenic Shock

Spanish Collaboration on Endocarditis—Grupo de Apoyo al Manejo de la Endocarditis Infecciosa en España (GAMES).[Background] Studies investigating the impact of cardiogenic shock (CS) on endocarditis are lacking.[Methods] Prospectively collected cohort from 35 Spanish centers (2008-2018). Logistic regression analyses were performed to identify risk factors for developing CS and predictors of mortality.[Results] Among 4856 endocarditis patients, 1652 (34%) had acute heart failure (AHF) and 244 (5%) CS. Compared with patients without AHF and AHF but no CS, patients with CS presented higher rates of surgery (40.5%, 52.5%, and 68%; P < .001) and in-hospital mortality (16.3%, 39.1%, and 52.5%). Compared with patients with septic shock, CS patients presented higher rates of surgery (42.5% vs 68%; P < .001) and lower rates of in-hospital and 1-year mortality (62.3% vs 52.5%, P = .008, and 65.3% vs 57.4%, P = .030). Severe aortic and mitral regurgitation (OR [95% CI], 2.47 [1.82-3.35] and 3.03 [2.26-4.07]; both P < .001), left-ventricle ejection fraction <60% (1.72; 1.22-2.40; P = .002), heart block (2.22; 1.41-3.47; P = .001), tachyarrhythmias (5.07; 3.13-8.19; P < .001), and acute kidney failure (2.29; 1.73-3.03; P < .001) were associated with higher likelihood of developing CS. Prosthetic endocarditis (2.03; 1.06 -3.88; P = .032), Staphylococcus aureus (3.10; 1.16 -8.30; P = .024), tachyarrhythmias (3.09; 1.50-10.13; P = .005), and not performing cardiac surgery (11.40; 4.83-26.90; P < .001) were associated with a higher risk of mortality.[Conclusions] AHF is common among patients with endocarditis. CS is associated with high mortality and should be promptly identified and assessed for cardiac surgery.This work was supported by the Ministerio de Sanidad y Consumo of Spain (grant number FIS NCT00871104; Instituto de Salud Carlos III). Institut d’Investigacions Biomèdiques Pi i Sunyer (IDIBAPS) provided J. M. M. with a persobal IDIBAPS 80:20 research grant during 2017–2021. M. H. M. held a Rio Hortega Research Grant (CM17/00062) from the Instituto de Salud Carlos III” and the Ministerio de Economia y Competitividad, Madrid (Spain) in 2018–2020.Peer reviewe

Revista española de orientación y psicopedagogía

Título, resumen y palabras clave también en inglésResumen basado en el de la publicaciónSe presenta los resultados obtenidos en una investigación sobre la orientación académica y profesional que se lleva a cabo en los centros educativos de Vitoria-Gasteiz y cómo la perciben tanto el profesorado como el alumnado y sus familias. Asimismo pretende identificar los factores que influyen en las decisiones estereotipadas de chicas y chicos. Para la recogida de la información se han realizado grupos de discusión con representantes del profesorado, alumnado y familias de los centros. También se han pasado dos cuestionarios diferenciados para el profesorado y equipos directivos participantes. Los resultados indican que, a pesar de los avances legales alcanzados en los últimos años, la orientación no sexista no es un tema prioritario entre las familias y que existen una serie de factores, como la socialización diferencial de chicas y chicos, la edad temprana a la que deben elegir un camino u otro, las expectativas de las familias, la falta de referentes y la realidad del mundo laboral, que hacen que alumnos y alumnas sigan eligiendo en función de los roles esperados para ellos y ellas.ES

TGF- /SMAD Pathway is modulated by miR-26b-5p: another piece in the puzzle of chronic lymphocytic leukemia progression

Material complementario: https://www.mdpi.com/article/10.3390/cancers14071676/s1Clinical and molecular heterogeneity are hallmarks of chronic lymphocytic leukemia (CLL), a neoplasm characterized by accumulation of mature and clonal long-lived CD5 + B-lymphocytes.Mutational status of the IgHV gene of leukemic clones is a powerful prognostic tool in CLL, and it is well established that unmutated CLLs (U-CLLs) have worse evolution than mutated cases. Nevertheless, progression and treatment requirement of patients can evolve independently from the mutational status. Microenvironment signaling or epigenetic changes partially explain this different behavior. Thus, we think that detailed characterization of the miRNAs landscape from patients with different clinical evolution could facilitate the understanding of this heterogeneity. Since miRNAs are key players in leukemia pathogenesis and evolution, we aim to better characterize different CLL behaviors by comparing the miRNome of clinically progressive U-CLLs vs. stable U-CLLs. Our data show up-regulation of miR-26b-5p, miR-106b-5p, and miR-142-5p in progressive cases and indicate a key role for miR-26b-5p during CLL progression. Specifically, up-regulation of miR-26b-5p in CLL cells blocks TGF-B/SMAD pathway by down-modulation of SMAD-4, resulting in lower expression of p21Cip1 kinase inhibitor and higher expression of c-Myc oncogene. This work describes a new molecular mechanism linking CLL progression with TGF-B modulation and proposes an alternative strategy to explore in CLL therapy.ANII: FSGSK_ 1_2017_1_14666