Cardiac magnetic resonance outperforms echocardiography to predict subsequent implantable cardioverter defibrillator therapies in ST-segment elevation myocardial infarction patients

Altres ajuts: Conselleria de Educación-Generalitat Valenciana (PROMETEO/2021/008); Sociedad Española de Cardiología (Grant SEC/FEC-INVCLI 21/024)Implantable cardioverter defibrillators (ICD) are effective as a primary prevention measure of ventricular tachyarrhythmias in patients with ST-segment elevation myocardial infarction (STEMI) and depressed left ventricular ejection fraction (LVEF). The implications of using cardiac magnetic resonance (CMR) instead of echocardiography (Echo) to assess LVEF prior to the indication of ICD in this setting are unknown. We evaluated 52 STEMI patients (56.6 ± 11 years, 88.5% male) treated with ICD in primary prevention who underwent echocardiography and CMR prior to ICD implantation. ICD implantation was indicated based on the presence of heart failure and depressed LVEF (≤ 35%) by echocardiography, CMR, or both. Prediction of ICD therapies (ICD-T) during follow-up by echocardiography and CMR before ICD implantation was assessed. Compared to echocardiography, LVEF was lower by cardiac CMR (30.2 ± 9% vs. 37.4 ± 7.6%, p < 0.001). LVEF ≤ 35% was detected in 24 patients (46.2%) by Echo and in 42 (80.7%) by CMR. During a mean follow-up of 6.1 ± 4.2 years, 10 patients received appropriate ICD-T (3.16 ICD-T per 100 person-years): 5 direct shocks to treat very fast ventricular tachycardia or ventricular fibrillation, 3 effective antitachycardia pacing (ATP) for treatment of ventricular tachycardia, and 2 ineffective ATP followed by shock to treat ventricular tachycardia. Echo-LVEF ≤ 35% correctly predicted ICD-T in 4/10 (40%) patients and CMR-LVEF ≤ 35% in 10/10 (100%) patients. CMR-LVEF improved on Echo-LVEF for predicting ICD-T (area under the curve: 0.76 vs. 0.48, p = 0.04). In STEMI patients treated with ICD, assessment of LVEF by CMR outperforms Echo-LVEF to predict the subsequent use of appropriate ICD therapies

Impact of Inflammatory Response Modifiers on the Incidence of Hospital-Acquired Infections in Patients with COVID-19.

The study aim was to assess the influence of inflammatory response modifiers, including anti-interleukin-6 (IL-6) biologics and corticosteroids, on the incidence of hospital-acquired infections in patients with coronavirus disease 2019 (COVID-19). METHODS: Case-control study performed at a university hospital from February 26 to May 26, 2020. Cases were defined as patients with COVID-19 who developed hospital-acquired infections. For each case, two controls were selected among patients without infections. Cases and controls were matched obeying three criteria in a hierarchical sequence: length of hospital stay up until the first infection; comorbidity; and need for Intensive care unit (ICU) admission. Conditional logistic regression analysis was used to estimate the association of exposures with being a case. RESULTS: A total of 71 cases and 142 controls were included. Independent predictors for acquiring a hospital infection were chronic liver disease [odds ratio (OR) 16.56, 95% CI 1.87-146.5, p = 0.012], morbid obesity (OR 6.11, 95% CI 1.06-35.4, p = 0.043), current or past smoking (OR 4.15, 95% CI 1.45-11.88, p = 0.008), exposure to hydroxychloroquine (OR 0.2, 95% CI 0.041-1, p = 0.053), and invasive mechanical ventilation (OR 61.5, 95% CI 11.08-341, p ≤ 0.0001). CONCLUSIONS: Inflammatory response modifiers had no influence on acquisition of nosocomial infections in admitted patients with COVID-19. Hospital-acquired infections primarily occurred in the critically ill and invasive mechanical ventilation was the main exposure conferring risk

EFETIVIDADE DA HIDROTERAPIA E DA CINESIOTERAPIA NA REABILITAÇÃO DE IDOSOS COM HISTÓRICO DE QUEDAS

A fisioterapia tem um papel fundamental na reabilitação funcional de idosos com histórico de quedas. O objetivo deste estudo foi avaliar a efetividade do protocolo de hidroterapia e cinesioterapia no equilíbrio, na agilidade e na estatura em idosos que costumam cair. Foram avaliados 14 idosos por meio de estadiômetro, escala de equilíbrio de Berg e Timed Up & Go. Os idosos foram alocados em dois grupos: G1, tratados com hidroterapia, e G2, tratados com cinesioterapia. O protocolo teve duração de 2 meses, sendo duas vezes por semana e sessões de 40 minutos, totalizando 16 atendimentos. Após 16 sessões, os participantes foram reavaliados. Os dados foram analisados estatisticamente pelos testes Kruskal-Wallis e Wilcox-Mann-Whitney. Comparando-se os dois grupos, verificou-se que ambos os grupos apresentaram maior pontuação na escala de equilíbrio de Berg, menor tempo na realização do Timed Up & Go e uma tendência à significância na estatura corporal após a aplicação do protocolo No entanto, não houve diferenças estatisticamente entre os grupos. Pode-se concluir que a hidroterapia e a cinesioterapia são efetivas para a melhora do equilíbrio e agilidade dos participantes, amenizando o declínio da capacidade funcional inerente ao envelhecimento

El cultivo del caqui

En este libro se escribe del caqui en toda su amplitud, los mejores investigadores en las diferentes especialidades nos explican los resultados de la investigación y experiencias en fertirrigación, pies y variedades, sanidad vegetal, poda y postcosecha; acompañado y documentado de una amplia bibliografía de los investigadores de los principales países productores del mundo: China, Japón e Israel, e Italia, más que por su producción, por su continua y avanzada investigación. Este libro, fruto del trabajo de las diferentes líneas de investigación del producto, coordinada por el magnífico equipo de investigadores del IVIA, pone a disposición de la producción, postcosecha y comercialización todos los avances conocidos a nivel nacional e internacional

Multidisciplinary practice guidelines for the diagnosis, genetic counseling and treatment of pheochromocytomas and paragangliomas

Altres ajuts: The Spanish Societies of Endocrinology and Nutrition (SEEN), Medical Oncology (SEOM), Medical Radiology (SERAM), Nuclear Medicine and Molecular Imaging (SEMNIM), Otorhinolaryngology (SEORL), Pathology (SEAP), Radiation Oncology (SEOR), and Surgery (AEC) equally funded this project.Pheochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumors that arise from chromaffin cells of the adrenal medulla and the sympathetic/parasympathetic neural ganglia, respectively. The heterogeneity in its etiology makes PPGL diagnosis and treatment very complex. The aim of this article was to provide practical clinical guidelines for the diagnosis and treatment of PPGLs from a multidisciplinary perspective, with the involvement of the Spanish Societies of Endocrinology and Nutrition (SEEN), Medical Oncology (SEOM), Medical Radiology (SERAM), Nuclear Medicine and Molecular Imaging (SEMNIM), Otorhinolaryngology (SEORL), Pathology (SEAP), Radiation Oncology (SEOR), Surgery (AEC) and the Spanish National Cancer Research Center (CNIO). We will review the following topics: epidemiology; anatomy, pathology and molecular pathways; clinical presentation; hereditary predisposition syndromes and genetic counseling and testing; diagnostic procedures, including biochemical testing and imaging studies; treatment including catecholamine blockade, surgery, radiotherapy and radiometabolic therapy, systemic therapy, local ablative therapy and supportive care. Finally, we will provide follow-up recommendations

Gestão Adaptativa na Etapa de Acompanhamento da Avaliação de Impacto Ambiental

O emprego de abordagens baseadas em Gestão Adaptativa representa uma oportunidade para o aperfeiçoamento da Etapa de Acompanhamento da Avaliação de Impacto, considerando as afinidades conceituais que existem entre suas estruturas. Na prática, há casos que demonstram o aumento da capacidade adaptativa baseado em aprendizado experiencial, o que requer arranjos de governança que sejam capazes de garantir o efetivo envolvimento das diversas partes da sociedade no próprio processo de tomada de decisão. De toda forma, a Gestão Adaptativa é uma abordagem promissora, o que não pode significar o desrespeito aos princípios da precaução e da prevenção que fundamentam os processos de Avaliação de Impacto Ambiental, servindo de mero paliativo para situações cujos impactos ambientais poderiam ter sido previstos e evitados.&nbsp;Approaches based on adaptive management are an opportunity to improve the Environmental Impact Assessment (EIA) follow-up, considering the conceptual affinities between their structures. Some cases demonstrate an increase in adaptive capacity, based on experiential learning, despite a lack of governance arrangements able to guarantee the effective involvement of different parts of society in the decision-making process. Finally, adaptive management is a promising approach for EIA follow-up, which does not mean abrogating the principles of precaution and prevention that underlie EIA processes, serving as a mere palliative for situations whose environmental impacts might have been predicted and prevented.&nbsp

Residual ST-segment elevation to predict long-term clinical and CMR-derived outcomes in STEMI

[EN] Residual ST-segment elevation after ST-segment elevation myocardial infarction (STEMI) has traditionally been considered a predictor of left ventricular (LV) dysfunction and ventricular aneurism. However, the implications in terms of long-term prognosis and cardiac magnetic resonance (CMR)-derived structural consequences are unclear. A total of 488 reperfused STEMI patients were prospectively included. The number of Q wave leads with residual ST-segment elevation> 1 mm (Q-STE) at pre-discharge ECG was assessed. LV ejection fraction (LVEF, %) and infarct size (IS, % of LV mass) were quantifed in 319 patients at 6-month CMR. Major adverse cardiac events (MACE) were defned as all-cause death and/or re-admission for acute heart failure (HF), whichever occurred frst. During a mean follow-up of 6.1 years, 92 MACE (18.9%), 39 deaths and 53 HF were recorded. After adjustment for baseline characteristics, Q-STE (per lead with> 1 mm) was independently associated with a higher risk of long-term MACE (HR 1.24 [1.07¿1.44] per lead, p = 0.004), reduced (< 40%) LVEF (HR 1.36 [1.02¿1.82] per lead, p = 0.04) and large (> 30% of LV mass) IS (HR 1.43 [1.11¿1.85] per lead, p = 0.006) at 6-month CMR. Patients with Q-STE¿ 2 leads (n= 172, 35.2%) displayed lower MACE-free survival, more depressed LVEF, and larger IS at 6-month CMR (p< 0.001 for all comparisons). Residual ST-segment elevation after STEMI represents a universally available tool that predicts worse longterm clinical and CMR-derived structural outcomes.This work was supported by the Instituto de Salud Carlos III and co-funded by Fondo Europeo de Desarrollo Regional (FEDER) (Grants PI20/00637 and CIBERCV16/11/00486, postgraduate contract FI18/00320 to C.R.-N. and CM21/00175 to V.M.-G.), Generalitat Valenciana (Grant PROMETEO/2021/008), and by Sociedad Espanola de Cardiologia (Grant SEC/FECINV-CLI 21/024). J. G. acknowledges financial support from the Agencia Estatal de Investigacion (Grant FJC2020-043981-I/AEI/).Merenciano-Gonzalez, H.; Marcos-Garces, V.; Gavara-Doñate, J.; Pedro-Tudela, A.; Lopez-Lereu, MP.; Monmeneu, JV.; Pérez, N.... (2022). Residual ST-segment elevation to predict long-term clinical and CMR-derived outcomes in STEMI. Scientific Reports. 12(1):1-12. https://doi.org/10.1038/s41598-022-26082-511212

IBER-XYFAS - Ibero-American network for the surveillance of Xylella fastidiosa

Trabajo presentado en el Congress of Microbiology and Biotechnology (Microbiotec 19), celebrado en Coimbra del 5 al 7 de diciembre de 2019.Xylella fastidiosa is the causal agent of various plant diseases that continuously challenge agroforestry production causing significant losses to European and American countries. IBER-XYFAS is an international network of research groups, agrofood companies and regional governments, financed by CYTED that aims gather all available data on the bacterium, on its vectors, on the crops affected in Ibero-American countries and on the prevention and control activities that are being carried out. The specific objectives of the network will focus on the following work packages: P1) Information on the bacterium; P2) Information on transmission vectors; P3) Information on the interaction of the bacteria with the plant; P4) Information on therapies; P5) Information on remote sensing methodologies; P6) Information on the environmental, social and economic impact of diseases and control measures. The purpose of the information exchange is to generate knowledge that will contribute to the development of a technological alert and surveillance system that will enable local or national governments to take the necessary measures to continue, contain and ultimately eradicate the disease. The main outputs of IBER-XYFAS are: to promote the scientific and technological integration of the Ibero-American region and the effective transfer of knowledge and technologies; to encourage the participation of researchers from the Ibero-American region in other programs and the active participation of different actors in the control of the disease; to promote the development of effective transfer activities to small producers and vulnerable sectors; to contribute to the improvement of the social perception of R+D+I and its results; to promote the improvement of production through the integration of technological and economic aspects; to design technological protocols for the control of the disease