La orejuela izquierda como fuente de accidentes cerebrovasculares: cerrar (y cómo), o no cerrar (y por qué)

The left atrial appendage is considered the main source of emboli in strokes in patients with atrial fibrillation. Oral anticoagulant therapy significantly reduces the risk of cerebral embolic events compared to aspirin, but it is associated with bleeding complications, and is not always used. Closure of the left atrial appendage reduces the rate of thromboembolic events, and it is currently recommended in patients with atrial fibrillation submitted to mitral valve surgery. However, the formation of emboli in these patients may be due to other causes, as the role of the atrial appendage could be less important than is assumed. Moreover, not all patients are candidates for oral anticoagulation, and not all are kept in a proper therapeutic range, which could justify the formation of atrial thrombi. There are several methods for performing the closure of the appendage: direct suture in concomitant mitral surgery, epicardial exclusion by stapling or clips, or endovascular occlusion by percutaneous application. However, the results seem inconclusive with regards to their effectiveness for complete occlusion of the appendage, safety, and efficacy in preventing cerebral embolic events. To add to the confusion, some authors reveal no clear benefit in suture closure, and even describe an increased risk of thromboembolism. We present a review of left atrial appendage closure for the prevention of strokes, as well as the different procedures described above

Cirugía de la fibrilación auricular

Atrial fibrillation surgery is based on creating scars in the atrium, in order to avoid re-entry phenomena that may initiate and perpetuate arrhythmia, and driving the normal stimuli from the sinus node to the atrio-ventricular node. The complexity and increased risk of the initial surgical technique, based on a "cut-and-sew" procedure, have enhanced other current procedures, in which different energies are used making it possible to perform scars in a safer and less invasive way. At present, atrial fibrillation surgery is not performed routinely in all cardiothoracic surgical centers, and there is no consensus in which is the best type of technique. Even if the results are good, they depend on multiples factors such as duration of arrhythmia, atrial size and type of technique employed. In addition, there is some variability in the description within the scientific community of the results and procedures used, which makes its analysis confusing. In this paper we review the different techniques described, the results and their application in minimally invasive surgery

Influence of surfactant-humectant adjuvants on physical properties, droplet size, and efficacy of glufosinate formulations

Glufosinate efficacy is inconsistent among weed species and under environmental conditions that favor rapid droplet drying. Surfactant-humectant adjuvants could maximize glufosinate efficacy by increasing wetting and penetration into the leaf surface while decreasing evaporation rate (ER). However, there is a lack of information in the literature about the interaction of surfactant-humectants adjuvants with glufosinate. The objective of this study was to investigate the influence of surfactanthumectant adjuvants on the physical properties, droplet size, and efficacy of two glufosinate formulations. Laboratory, greenhouse, and field studies were conducted at the Pesticide Application Technology Laboratory of the University of Nebraska- Lincoln. Treatment design was a 2 × 5 factorial with two glufosinate formulations combined with five adjuvant treatments plus an untreated control. Density and viscosity of glufosinate solutions mostly increased with the addition of adjuvants. However, the influence of the adjuvants on dynamic surface tension (dST), static contact angle (sCA), and evaporation rate (ER) varied by glufosinate formulation, adjuvant, and relative humidity (RH). Under greenhouse conditions, an improvement in efficacy by adding adjuvants was mainly observed for Interline solutions. The addition of adjuvants to Interline solutions increased biomass reduction up to 19 and 35% for common lambsquarters (Chenopodium album L.) and kochia [Bassia scoparia (L.) A. J. Scott], respectively. Also, some of the adjuvants presented null or antagonistic influence on herbicide efficacy. No increase in control, biomass reduction, and mortality of horseweed (Erigeron canadensis L.) and Palmer amaranth (Amaranthus palmeri S. Watson) was observed with the use of adjuvants under field conditions. Herbicide-adjuvant-plant-environment interaction is complex. Thus, the use of surfactant-humectant adjuvants may not increase herbicide efficacy

Theory of light-matter interaction in nematic liquid crystals and the second Painlevé equation

We study global minimizers of an energy functional arising as a thin sample limit in the theory of light-matter interaction in nematic liquid crystals. We show that depending on the parameters various defects are predicted by the model. In particular we show existence of a new type of topological defect which we call the shadow kink. Its local profile is described by the generalized Hastings and McLeod solutions of the second Painlevé equation (Claeys et al. in Ann Math 168(2):601–641, 2008; Hastings and McLeod in Arch Ration Mech Anal 73(1):31–51, 1980). As part of our analysis we give a new proof of existence of these solutions

A human antibody against Zika virus crosslinks the E protein to prevent infection

The recent Zika virus (ZIKV) epidemic has been linked to unusual and severe clinical manifestations including microcephaly in fetuses of infected pregnant women and Guillian-Barré syndrome in adults. Neutralizing antibodies present a possible therapeutic approach to prevent and control ZIKV infection. Here we present a 6.2 Å resolution three-dimensional cryo-electron microscopy (cryoEM) structure of an infectious ZIKV (strain H/PF/2013, French Polynesia) in complex with the Fab fragment of a highly therapeutic and neutralizing human monoclonal antibody, ZIKV-117. The antibody had been shown to prevent fetal infection and demise in mice. The structure shows that ZIKV-117 Fabs cross-link the monomers within the surface E glycoprotein dimers as well as between neighbouring dimers, thus preventing the reorganization of E protein monomers into fusogenic trimers in the acidic environment of endosomes

Cold atmospheric gas plasma disinfection of chicken meat and chicken skin contaminated with Listeria innocua

Gas plasmas generated at atmospheric pressure and ambient temperatures offer a possible decontamination method for poultry products. The efficacy of cold atmospheric gas plasmas for decontaminating chicken skin and muscle inoculated with Listeria innocua was examined. Optimization of operating conditions for maximal bacterial inactivation was first achieved using membrane filters on which L. innocua had been deposited. Higher values of AC voltage, excitation frequency and the presence of oxygen in the carrier gas resulted in the greatest inactivation efficiency, and this was confirmed with further studies on chicken muscle and skin. Under optimal conditions, a 10 s treatment gave > 3 log reductions of L. innocua on membrane filters, an 8 min treatment gave 1 log reduction on skin, and a 4 min treatment gave > 3 log reductions on muscle. These results show that the efficacy of gas plasma treatment is greatly affected by surface topography. Scanning electron microscopy (SEM) images of chicken muscle and skin revealed surface features wherein bacteria could effectively be protected from the chemical species generated within the gas plasma. The developments in gas plasma technology necessary for its commercial application to foods are discussed

Comparison of Conventional Polyethylene Wear and Signs of Cup Failure in Two Similar Total Hip Designs

Multiple factors have been identified as contributing to polyethylene wear and debris generation of the acetabular lining. Polyethylene wear is the primary limiting factor in the functional behavior and consequent longevity of a total hip arthroplasty (THA). This retrospective study reviewed the clinical and radiographic data of 77 consecutive THAs comparing in vivo polyethylene wear of two similar acetabular cup liners. Minimum follow-up was 7 years (range 7–15). The incidence of measurable wear in a group of machined liners sterilized with ethylene oxide and composed of GUR 1050 stock resin was significantly higher (61%) than the compression-molded, GUR 1020, O(2)-free gamma irradiation sterilized group (24%) (P = 0.0004). Clinically, at a 9-year average followup, both groups had comparable HHS scores and incidence of thigh or groin pain, though the machined group had an increased incidence of osteolysis and annual linear wear rate

Ecosystem-bedrock interaction changes nutrient compartmentalization during early oxidative weathering

Ecosystem-bedrock interactions power the biogeochemical cycles of Earth's shallow crust, supporting life, stimulating substrate transformation, and spurring evolutionary innovation. While oxidative processes have dominated half of terrestrial history, the relative contribution of the biosphere and its chemical fingerprints on Earth's developing regolith are still poorly constrained. Here, we report results from a two-year incipient weathering experiment. We found that the mass release and compartmentalization of major elements during weathering of granite, rhyolite, schist and basalt was rock-specific and regulated by ecosystem components. A tight interplay between physiological needs of different biota, mineral dissolution rates, and substrate nutrient availability resulted in intricate elemental distribution patterns. Biota accelerated CO2 mineralization over abiotic controls as ecosystem complexity increased, and significantly modified stoichiometry of mobilized elements. Microbial and fungal components inhibited element leaching (23.4% and 7%), while plants increased leaching and biomass retention by 63.4%. All biota left comparable biosignatures in the dissolved weathering products. Nevertheless, the magnitude and allocation of weathered fractions under abiotic and biotic treatments provide quantitative evidence for the role of major biosphere components in the evolution of upper continental crust, presenting critical information for large-scale biogeochemical models and for the search for stable in situ biosignatures beyond Earth.Comment: 41 pages (MS, SI and Data), 16 figures (MS and SI), 6 tables (SI and Data). Journal article manuscrip

Seasonal effects on HPLC-DAD-UV and UPLC-ESI-MS fingerprints and analgesic activities of vernonia condensata baker extracts

Vernonia condensata Baker leaves have different uses in Brazilian folk medicine, including as analgesic and anti-inflammatory agents. The purpose of this study was to evaluate the seasonal effects on their high performance liquid chromatography with a diode array detector (HPLC-DAD-UV) and ultra-performance liquid chromatography coupled to a mass spectrometer with an electrospray interface (UPLC-ESI-MS) fingerprints, as well as their analgesic activities in mice. There were significant seasonal effects on the relative abundances of the metabolites of the V. condensate leaves as well as on their activities. Analgesic activities in the writhing test were observed with the polar fraction of the leaf extracts collected in autumn, winter and summer (400 mg kg(-1)); and with the intermediate fraction of leaves collected in autumn (25 and 400 mg kg(-1)) and in the summer (100 mg kg(-1)). In conclusion, the results confirm peripherally-mediated anti-inflammatory and analgesic activities for V. condensata leaves and suggest that these are influenced by the harvesting season. N-oxides alkaloids as well as vernonioside play important roles in determining this activity262350358CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQCOORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESFundacao Araucari