Post-myocardial infarction left ventricular pseudoaneurysm diagnosed incidentally by echocardiography

A 54-year-old male developed a left ventricular pseudoaneurysm (Ps) along the lateral wall of the left ventricle (LV), which was diagnosed incidentally by two-dimensional transthoracic echocardiography (2DTTE) 6 months after an acute myocardial infarction. Color flow imaging (CFI) showed blood flow from the LV into the aneurysmal cavity and invasive coronary angiography revealed sub-occlusion of the circumflex artery. A complementary study using cardiovascular magnetic resonance (CMR) confirmed a dilated left ventricle with depressed ejection fraction, thin dyskinetic anterolateral and inferolateral walls, a Ps adjacent to the lateral wall of the LV contained by the pericardium and blood passing in and out through a small defect in the LV mid-anterolateral wall. Late gadolinium-enhanced imaging demonstrated transmural myocardial infarction in the lateral wall and delayed enhancement of the pericardium, which formed the walls of the Ps. A conservative approach was adopted in this case, optimizing the patient’s heart failure medications, including cardioselective beta-blocker agents, angiotensin-converting enzyme inhibitors, spironolactone and chronic anticoagulation therapy because of a high risk of ischemic stroke in these patients. At the 13-month follow-up, the patient remained stable with New York Heart Association class II heart failure. In conclusion, 2DTTE and CFI seem to be suitable initial methods for diagnosing Ps of the LV, but CMR is an excellent complementary method for characterizing further this cardiac entity. Furthermore, the long-term outcome of patients with Ps of the LV who are treated medically appears to be relatively benign

Los desafíos en la continuidad de atención de personas viviendo con VIH en el Perú durante la pandemia de la COVID-19 [Challenges to the continuity of care of people living with HIV throughout the COVID-19 crisis in Peru]

The COVID-19 pandemic and societal response implemented may interact with the ongoing HIV epidemic in multiple ways. There are approximately 87000 people living with HIV (PLWH) who are at risk of developing COVID-19 in Peru and 67,000 of them are on antiretroviral therapy (ART) and at risk of limitations in their access to ART, compromising their adherence and their health during the pandemic. Finally, the potential effect of the pandemic on the mental health of PLWH is not documented. This opinion aims to: describe the clinical implications of the HIV/SARS-CoV-2 coinfection; discuss the challenges to the continuity of care of PLWH in Peru during the COVID-19 crisis; and comment possible implications that the COVID-19 crisis may pose on the mental health of PLWH

¿Es adecuada la utilización del servicio de urgencias en el periodo neonatal?

Introducción: los servicios de urgencias son frecuentados, con un elevado índice, por neonatos con patología banal y dudas de puericultura. Nuestro objetivo es analizar, en neonatos, la adecuación del uso de urgencias. Material y métodos: análisis de los informes de los neonatos que acudieron al Servicio de Urgencias del Hospital Marina Salud de Denia (Alicante, España) durante el año 2014 y de la adecuación del uso de urgencias según los nuevos criterios establecidos: ingreso hospitalario, derivación, clasificación y exploraciones complementarias. Resultados: los servicios de urgencias son utilizados por neonatos con patología considerada no urgente, llanto, irritabilidad o malestar (32,08%), y vómitos o regurgitaciones del recién nacido (13,21%), siendo el diagnóstico de alta más frecuente el de normalidad (20%). Según los criterios de adecuación establecidos para el uso del servicio de urgencias neonatales, el 63,50% de los motivos de consulta neonatal no fueron adecuados. Conclusiones: la mayoría de las consultas de neonatos son catalogadas como uso no adecuado de los servicios de urgencias y deberían por tanto manejarse en Atención Primaria

Broken R-parity, stop decays, and neutrino physics

We discuss the phenomenology of the lightest stop in models where R-parity is broken by bilinear superpotential terms. In this class of models we consider scenarios where the R-parity breaking two-body decay ~t_1->\tau^+b competes with the leading three-body decays such as ~t_1->W^+b~\chi^0_1. We demonstrate that the R-parity violating decay can be sizable and in some parts of the parameter space even the dominant one. Moreover we discuss the expectations for \~t_1->\mu^+b and ~t_1->e^+b. The recent results from solar and atmospheric neutrinos suggest that these are as important as the tau bottom mode. The \~t_1->l^+b decays are of particular interest for hadron colliders, as they may allow a full mass reconstruction of the lighter stop. Moreover these decay modes allow cross checks on the neutrino mixing angle involved in the solar neutrino puzzle complementary to those possible using neutralino decays. For the so--called small mixing angle or SMA solution ~t_1->e^+b should be negligible, while for the large mixing angle type solutions all ~t_1->l^+b decays should have comparable magnitude.Comment: 51 pages, 6 figures, LaTeX2e and RevTeX4, published versio

Charged lepton Flavor Violation in Supersymmetry with Bilinear R-Parity Violation

The simplest unified extension of the Minimal Supersymmetric Standard Model with bi-linear R-parity violation naturally predicts a hierarchical neutrino mass spectrum, suitable to explain atmospheric and solar neutrino fluxes. We study whether the individual violation of the lepton numbers L_{e,mu,tau} in the charged sector can lead to measurable rates for BR(mu->e gamma)and $BR(tau-> mu gamma). We find that some of the R-parity violating terms that are compatible with the observed atmospheric neutrino oscillations could lead to rates for mu->e gamma measurable in projected experiments. However, the Delta m^2_{12} obtained for those parameters is too high to be compatible with the solar neutrino data, excluding therefore the possibility of having measurable rates for mu->e gamma in the model.Comment: 29 pages, 8 figures. Constraint from solar neutrino data included, conclusions changed respect v

Stau LSP and comparison with H^+(-) phenomenology

In supersymmetric models with explicit breaking of R-parity the lightest supersymmetric particle (LSP) may be the lightest stau, \stau_1. Such a scenario would provide a clear sign of R-parity violating SUSY, although its phenomenology may resemble that of a charged Higgs boson, $H^\pm$. We discuss various ways of distinguishing a LSP \stau_1 from $H^\pm$ at future colliders, and address the case of \stau_1 mimicking the signal for $H^\pm$. As an example we suggest that the recent L3 signal for $H^+H^-\to qq'qq'$ and $H^+H^-\to qq'\tau\nu_{\tau}$ could be more easily explained by a LSP \stau_1.Comment: 22 pages, 2 figures, Revtex, short discussion and references adde

Plasma MicroRNA Signature Validation for Early Detection of Colorectal Cancer

OBJECTIVES: Specific microRNA (miRNA) signatures in biological fluids can facilitate earlier detection of the tumors being then minimally invasive diagnostic biomarkers. Circulating miRNAs have also emerged as promising diagnostic biomarkers for colorectal cancer (CRC) screening. In this study, we investigated the performance of a specific signature of miRNA in plasma samples to design a robust predictive model that can distinguish healthy individuals from those with CRC or advanced adenomas (AA) diseases. METHODS: Case control study of 297 patients from 8 Spanish centers including 100 healthy individuals, 101 diagnosed with AA, and 96 CRC cases. Quantitative real-time reverse transcription was used to quantify a signature of miRNA (miRNA19a, miRNA19b, miRNA15b, miRNA29a, miRNA335, and miRNA18a) in plasma samples. Binary classifiers (Support Vector Machine [SVM] linear, SVM radial, and SVM polynomial) were built for the best predictive model. RESULTS: Area under receiving operating characteristic curve of 0.92 (95% confidence interval 0.871-0.962) was obtained retrieving a model with a sensitivity of 0.85 and specificity of 0.90, positive predictive value of 0.94, and negative predictive value of 0.76 when advanced neoplasms (CRC and AA) were compared with healthy individuals. CONCLUSIONS: We identified and validated a signature of 6 miRNAs (miRNA19a, miRNA19b, miRNA15b, miRNA29a, miRNA335, and miRNA18a) as predictors that can differentiate significantly patients with CRC and AA from those who are healthy. However, large-scale validation studies in asymptomatic screening participants should be conducted

Testing neutrino mixing at future collider experiments

Low energy supersymmetry with bilinear breaking of R-parity leads to a weak-scale seesaw mechanism for the atmospheric neutrino scale and a radiative mechanism for the solar neutrino scale. The model has striking implications for collider searches of supersymmetric particles. Assuming that the lightest SUSY particle is the lightest neutralino we demonstrate that (i) The neutralino decays inside the detector even for tiny neutrino masses. (ii) Measurements of the neutrino mixing angles lead to predictions for the ratios of various neutralino branching ratios implying an independent test of neutrino physics at future colliders, such as the Large Hadron Collider or a Linear Collider.Comment: LaTex, 35 pages, 20 figures included, version 2, section on model shortened, Fig. 13 replaced, typos corrected, version to appear in Phys.Rev.

Bridging the gap between low and high mass dwarf galaxies

While the dark matter content within the most massive giant and smallest dwarf galaxies has been probed -- spanning a range of over one million in mass -- an important observational gap remains for galaxies of intermediate mass. This gap covers K band magnitudes of approximately -16 > M_K > -18 (for which dwarf galaxies have B--K ~ 2). On the high mass side of the gap are dwarf elliptical (dE) galaxies, that are dominated by stars in their inner regions. While the low mass side includes dwarf spheroidal (dSph) galaxies that are dark matter-dominated and ultra compact dwarf (UCD) objects that are star-dominated. Evolutionary pathways across the gap have been suggested but remain largely untested because the `gap' galaxies are faint, making dynamical measurements very challenging. With long exposures on the Keck telescope using the ESI instrument we have succeeded in bridging this gap by measuring the dynamical mass for five dwarf galaxies with M_K ~ -17.5 (M_B ~ --15.5). With the exception of our brightest dwarf galaxy, they possess relatively flat velocity dispersion profiles of around 20 km/s. By examining their 2D scaling relations and 3D fundamental manifold, we found that the sizes and velocity dispersions of these gap galaxies reveal continuous trends from dE to dSph galaxies. We conclude that low-luminosity dwarf elliptical galaxies are dominated by stars, not by dark matter, within their half light radii. This finding can be understood if internal feedback processes are operating most efficiently in gap galaxies, gravitationally heating the centrally-located dark matter to larger radii. Whereas external environmental processes, which can strip away stars, have a greater influence on dSph galaxies resulting in their higher dark matter fractions. Abridged.Comment: 20 pages, includes 12 figures, accepted for publication in MNRA