Baseline ECG and prognosis after transcatheter aortic valve implantation: the role of interatrial block

Background: The clinical significance of conduction disturbances after transcatheter aortic valve implantation has been described; however, little is known about the influence of baseline ECGs in the prognosis of these patients. Our aim was to study the influence of baseline ECG parameters, including interatrial block (IAB), in the prognosis of patients treated with transcatheter aortic valve implantation. Methods and Results: The BIT (Baseline Interatrial Block and Transcatheter Aortic Valve Implantation) registry included 2527 patients with aortic stenosis treated with transcatheter aortic valve implantation. A centralized analysis of baseline ECGs was performed. Patients were divided into 4 groups: normal P wave duration (<120 ms); partial IAB (P wave duration ≥120 ms, positive in the inferior leads); advanced IAB (P wave duration ≥120 ms, biphasic [+/-] morphology in the inferior leads); and nonsinus rhythm (atrial fibrillation/flutter and paced rhythm). The mean age of patients was 82.6±9.8 years and 1397 (55.3%) were women. A total of 960 patients (38.0%) had a normal P wave, 582 (23.0%) had partial IAB, 300 (11.9%) had advanced IAB, and 685 (27.1%) presented with nonsinus rhythm. Mean follow‐up duration was 465±171 days. Advanced IAB was the only independent predictor of all‐cause mortality (hazard ratio [HR], 1.48; 95% CI, 1.10-1.98 [P=0.010]) and of the composite end point (death/stroke/new atrial fibrillation) (HR, 1.51; 95% CI, 1.17-1.94 [P=0.001]). Conclusions: Baseline ECG characteristics influence the prognosis of patients with aortic stenosis treated with transcatheter aortic valve implantation. Advanced IAB is present in about an eighth of patients and is associated with all‐cause death and the composite end point of death, stroke, and new atrial fibrillation during follow‐up

Advantages of adipose tissue stem cells over CD34+ mobilization to decrease hepatic fibrosis in Wistar rats

Introduction and Objectives: Chronic liver inflammation may lead to hepatic cirrhosis, limiting its regenerative capacity. The clinical standard of care is transplantation, although stem cell therapy may be an alternative option. The study aim was to induce endogenous hematopoietic stem cells (HSCs) with granulocyte colony stimulating factor (G-CSF) and/or intravenous administration of adipose tissue-derived mesenchymal stem cells (MSCs) to decrease hepatic fibrosis in an experimental model. Material and methods: A liver fibrosis model was developed with femaleWistar rats via multiple intraperitoneal doses of carbon tetrachloride. Three rats were selected to confirm cirrhosis, and the rest were set into experimental groups to evaluate single and combined therapies of G-CSF-stimulated HSC mobilization and intravenous MSC administration. Results: Treatment with MSCs and G-CSF significantly improved alanine amino transferase levels, while treatment with G-CSF, MSCs, and G-CSF + MSCs decreased aspartate amino transferase levels. Hepatocyte growth factor (HGF) and interleukin 10 levels increased with MSC treatment. Transforming growth factor levels were lower with MSC treatment. Interleukin 1 and tumor necrosis factor alpha levels decreased in all treated groups. Histopathology showed that MSCs and G-CSF reduced liver fibrosis from F4 to F2. Conclusions: MSC treatment improves liver function, decreases hepatic fibrosis, and plays an antiinflammatory role;it promotes HGF levels and increased proliferating cell nuclear antigen when followed by MSC treatment mobilization using G-CSF. When these therapies were combined, however, fibrosis improvement was less evident

Childhood acute leukemias are frequent in Mexico City: descriptive epidemiology

<p>Abstract</p> <p>Background</p> <p>Worldwide, acute leukemia is the most common type of childhood cancer. It is particularly common in the Hispanic populations residing in the United States, Costa Rica, and Mexico City. The objective of this study was to determine the incidence of acute leukemia in children who were diagnosed and treated in public hospitals in Mexico City.</p> <p>Methods</p> <p>Included in this study were those children, under 15 years of age and residents of Mexico City, who were diagnosed in 2006 and 2007 with leukemia, as determined by using the International Classification of Childhood Cancer. The average annual incidence rates (AAIR), and the standardized average annual incidence rates (SAAIR) per million children were calculated. We calculated crude, age- and sex-specific incidence rates and adjusted for age by the direct method with the world population as standard. We determined if there were a correlation between the incidence of acute leukemias in the various boroughs of Mexico City and either the number of agricultural hectares, the average number of persons per household, or the municipal human development index for Mexico (used as a reference of socio-economic level).</p> <p>Results</p> <p>Although a total of 610 new cases of leukemia were registered during 2006-2007, only 228 fit the criteria for inclusion in this study. The overall SAAIR was 57.6 per million children (95% CI, 46.9-68.3); acute lymphoblastic leukemia (ALL) was the most frequent type of leukemia, constituting 85.1% of the cases (SAAIR: 49.5 per million), followed by acute myeloblastic leukemia at 12.3% (SAAIR: 6.9 per million), and chronic myeloid leukemia at 1.7% (SAAIR: 0.9 per million). The 1-4 years age group had the highest SAAIR for ALL (77.7 per million). For cases of ALL, 73.2% had precursor B-cell immunophenotype (SAAIR: 35.8 per million) and 12.4% had T-cell immunophenotype (SAAIR 6.3 per million). The peak ages for ALL were 2-6 years and 8-10 years. More than half the children (58.8%) were classified as high risk. There was a positive correlation between the average number of persons per household and the incidence of the pre-B immunophenotype (Pearson's r, 0.789; P = 0.02).</p> <p>Conclusions</p> <p>The frequency of ALL in Mexico City is among the highest in the world, similar to those found for Hispanics in the United States and in Costa Rica.</p

ICAM-1, P-Selectin, Leucotriene B4, and Myeloperoxidase levels in patients with Liver Transplantation

Niveles de ICAM-1, P-Selectina, Leucotrieno B4 y Mieloperoxidasa en pacientes con trasplante hepático. ICAM-1, P-Selectin, Leucotriene B4, and Myeloperoxidase levels in patients with Liver Transplantation. Cordero-Pérez, P.a, Torres-González, L.a, Camara-Lemarroy, C.a, Cepeda-de la Garza, M. Resumen Objetivo: Determinar las concentraciones séricas de las moléculas de adhesión intracelular 1 (ICAM-1), Pselectina, leucotrieno B4 (LTB 4), y mieloperoxidasa (MPO) en pacientes con trasplante hepático ortotópico (THO). Materiales y métodos: ICAM-1, P-selectina, LTB 4, y los niveles de MPO se determinaron en suero de pacientes con THO por ensayo inmunoenzimático. Resultados: ICAM-1, Pselectina y LTB 4 estuvieron mas elevados en el suero de los receptores con THO en comparación con los controles sanos. Además, ICAM-1 y los niveles de LTB 4 fueron significativamente mayores en los receptores con alteración de los niveles de transaminasas, en comparación con aquellos con valores normales de transaminasas. Conclusiones: Algunos marcadores inflamatorios parecen estar asociados con la función del injerto en los receptores de THO. La vigilancia inmunológica con marcadores inflamatorios en suero puede ser útil para la clínica. Palabras clave: inflamación, moléculas de adhesión, trasplante de hígado. Abstract Aim: To determine the serum concentrations of inter-cellular adhesion molecule 1 (ICAM-1), P-selectin, leukotriene B4 (LTB4), and myeloperoxidase (MPO) in patients with orthotopic liver transplantation (OLT). Materials and methods: ICAM-1, P-selectin, LTB4, and MPO levels were determined in serum from patients with OLT by enzyme-linked immunosorbent assay. Results: ICAM-1, P-selectin and LTB4 were elevated in the serum of OLT recipients compared with normal controls. Additionally, ICAM-1an

Baseline ECG and Prognosis After Transcatheter Aortic Valve Implantation: The Role of Interatrial Block.

Background The clinical significance of conduction disturbances after transcatheter aortic valve implantation has been described; however, little is known about the influence of baseline ECGs in the prognosis of these patients. Our aim was to study the influence of baseline ECG parameters, including interatrial block (IAB), in the prognosis of patients treated with transcatheter aortic valve implantation. Methods and Results The BIT (Baseline Interatrial Block and Transcatheter Aortic Valve Implantation) registry included 2527 patients with aortic stenosis treated with transcatheter aortic valve implantation. A centralized analysis of baseline ECGs was performed. Patients were divided into 4 groups: normal P wave duration

Diseño, contingencia y riesgos del espacio urbano y arquitectónico

La obra tiene como objetivo difundir el conocimiento generado mediante la investigación acerca de la habitabilidad del espacio urbano y arquitectónico, y la percepción urbana y arquitectónica desde las diversas disciplinas del diseño: arquitectónico, urbanístico, industrial y gráfico. Asimismo, da pauta a la reflexión y a la discusión de una serie de condiciones que actualmente están afectando a las ciudades debido a la alta urbanización y a la falta de atención integral para resolver problemas particulares que pueden ser atendidos desde este campo disciplinario