Miocardiopatía por estrés: takotsubo

Clinic. A 83-year-old woman who presented with acute chest pain after an intense emotional stimulus. Diagnostic tests. EKG showed negative T waves in anterior and ultrasensitive troponins were raised. The echocardiogram showed an intensely depressed with akinesia media and distal segments of all sides and apex, with conventional coronary angiography systolic function without significant lesions. The MRI was consistent with stress cardiomyopathy (ECM) takotsubo. Discussion. of uncertain origin, the ECM can mimic myocardial infarction with normal coronary arteries and good prognosis.Clínica. Mujer de 83 años que consultó por dolor torácico agudo tras un estímulo emocional intenso. Pruebas diagnósticas. El electrocardiograma mostró ondas T negativas en cara anterior y las troponinas ultrasensibles estaban elevadas. El ecocardiograma mostró una función sistólica global intensamente deprimida con acinesia de los segmentos medios y distales de todas las caras y el ápex, con coronariografía convencional sin lesiones significativas. La imagen por RM era compatible con miocardiopatía de estrés (MCE-takotsubo). Discusión. De origen incierto, la MCE puede remedar un infarto de miocardio con coronarias normales y buen pronóstico

Bacteriemia por Actinomyces odontolyticus

History. A 47-year-old male, HIV negative. He reported fever and an injury on his right groin with signs of infection. He had injected himself cocaine on that area. Tests. Blood cultures: A. odontolyticus. Computerized tomography: septic venous thrombosis with endoluminal gas in the common femoral vein, right iliac external and common femoral vein. Evolution. The patient admitted on licking the needle prior to drug injection. Enoxaparin and amoxicilin-clavulanate were initiated. Diagnosis. Bacteriemia and septic thrombophlebitis by A. odontolyticus. Discussion. A. odontolyticus is a common pathogen in the oral cavity and systemic infections in immunocompetent patients are rare.Clínica. Varón de 47 años, VIH negativo, con fiebre y herida infectada en ingle derecha de 11 días de evolución. Se había inyectado cocaína en la zona. Pruebas. Hemocultivos: se aisló A. odontolyticus. Tomografía computarizada: trombosis venosa séptica con gas endoluminal en la vena femoral común, ilíaca externa y común derecha. Evolución. El paciente admitió lamer la aguja antes de inyectarse. Se inició enoxaparina y amoxicilina-ácido clavulánico. Diagnóstico. Bacteriemia y tromboflebitis séptica por A. odontolyticus. Discusión. A. odontolyticus es un patógeno propio de la cavidad oral; las infecciones sistémicas en pacientes inmunocompetentes son muy poco frecuentes

Study of the near-barrier scattering of 8He on 208Pb

The structure and dynamics of 8He have been studied through the collision process with a 208Pb target at energies of 22 and 16 MeV, above and below the Coulomb barrier, respectively. The energy and angular distributions of the elastically scattered 8He and the 6,4He fragments were measured. In this paper, we discuss the method used to determine the effective position of the beam spot on the reaction target and the scattering and solid angles of each pixel of the detector array.Ministerio de Economía y Competitividad FPA2010-22131-C021-01, FPA2014-59954-C3-1-PMinistry of Science and Higher Education of Poland N202 033637European Science Foundation EUI2009-0416

Retinal Thickness Changes Over Time in a Murine AD Model APP NL-F/NL-F.

Background: Alzheimer's disease (AD) may present retinal changes before brain pathology, suggesting the retina as an accessible biomarker of AD. The present work is a diachronic study using spectral domain optical coherence tomography (SD-OCT) to determine the total retinal thickness and retinal nerve fiber layer (RNFL) thickness in an APPNL-F/NL-F mouse model of AD at 6, 9, 12, 15, 17, and 20 months old compared to wild type (WT) animals. Methods: Total retinal thickness and RNFL thickness were determined. The mean total retinal thickness was analyzed following the Early Treatment Diabetic Retinopathy Study sectors. RNFL was measured in six sectors of axonal ring scans around the optic nerve. Results: In the APPNL-F/NL-F group compared to WT animals, the total retinal thickness changes observed were the following: (i) At 6-months-old, a significant thinning in the outer temporal sector was observed; (ii) at 15-months-old a significant thinning in the inner temporal and in the inner and outer inferior retinal sectors was noticed; (iii) at 17-months-old, a significant thickening in the inferior and nasal sectors was found in both inner and outer rings; and (iv) at 20-months-old, a significant thinning in the inner ring of nasal, temporal, and inferior retina and in the outer ring of superior and temporal retina was seen. In RNFL thickness, there was significant thinning in the global analysis and in nasal and inner-temporal sectors at 6 months old. Thinning was also found in the supero-temporal and nasal sectors and global value at 20 months old. Conclusions: In the APPNL-F/NL-F AD model, the retinal thickness showed thinning, possibly produced by neurodegeneration alternating with thickening caused by deposits and neuroinflammation in some areas of the retina. These changes over time are similar to those observed in the human retina and could be a biomarker for AD. The APPNL-F/NL-F AD model may help us better understand the different retinal changes during the progression of AD.This research was funded by the Ophthalmological Network OFTARED (RD16/0008/0005) of the Institute of Health of Carlos III of the Spanish Ministry of Science and Innovation; and the Research Network RETIBRAIN (RED2018-102499-T) and Grant PID2019-106581RB-I00 of the Spanish Ministry of Science and Innovation; and Leducq Foundation for Cardiovascular Research TNE-19CVD01. IL-C was currently supported by a Pre-doctoral Fellowship (CT42/18-CT43/18) from the Complutense University of Madrid. JF-A was currently supported by a Pre-doctoral Fellowship (FPU17/01023) from the Spanish Ministry of Science, Innovation, and Universities.S

A contribution to the historic framework of pressure ulcers

A través de una revisión narrativa, los autores revisan elementos clave relacionados con la historia de las úlceras por presión y su contexto, desde la Edad Antigua, el Renacimiento, el siglo XIX hasta la edad moderna.Through a narrative review, the authors review key facts related with the history of pressure ulcers and their framework, from ancient age, Renaissance, XIX’s century up to the modern age

Economic impact of pressure ulcers. An integrative review

Las lesiones por presión son un importante problema de salud con una gran repercusión epidemiológica y un gran impacto a nivel de salud y calidad de vida que genera importantes costes para las personas, instituciones y sistemas de salud. A pesar de la importancia económica del problema de las lesiones por presión, prácticamente no existe información sistematizada acerca de las diferentes dimensiones de su coste. Para cubrir esta falta de información se planteó la realización de una revisión integrativa acerca de la dimensión económica del problema de las lesiones por presión. Se han identificado y analizado 89 documentos con información económica acerca del problema de las lesiones por presión. La información se ha sistematizado basándose en los siguientes apartados: tiempo necesario para la cicatrización, impacto en las estancias hospitalarias, costes relacionados con la seguridad de los pacientes, impacto en los grupos relacionados de diagnóstico, coste total, coste por episodio, por tipo de tratamiento, de las complicaciones, de las demandas legales, de los años de vida ganados ajustados a calidad de vida, en pacientes lesionados medulares y con otras condiciones, y los costes de medidas preventivas.Pressure Lesions are an important health problem with a great epidemiological impact that affects the health status and quality of life producing important expenses for persons, healthcare institutions and health systems. There is not available systematized information about the different cost components of pressure lesions although the important economic dimension of such problem. In order to cover this lack of systematized information we performed an integrative review about the economic dimension of pressure lesions. We have identified and analyzed 89 documents with economic information about pressure lesions problem. Information has been systematized according with the next categories: time for healing, cost of additional hospital stays, costs related with safety of patients, DRG costs, total cost of treatment, episode’s cost, by type of treatment, related with complications, QALYs, costs in spinal cord patients and in patients with other conditions and global prevention costs

Oral Anticoagulation and Risk of Symptomatic Hemorrhagic Transformation in Stroke Patients Treated With Mechanical Thrombectomy: Data From the Nordictus Registry

Introduction: We aimed to evaluate if prior oral anticoagulation (OAC) and its type determines a greater risk of symptomatic hemorrhagic transformation in patients with acute ischemic stroke (AIS) subjected to mechanical thrombectomy. Materials and Methods: Consecutive patients with AIS included in the prospective reperfusion registry NORDICTUS, a network of tertiary stroke centers in Northern Spain, from January 2017 to December 2019 were included. Prior use of oral anticoagulants, baseline variables, and international normalized ratio (INR) on admission were recorded. Symptomatic intracranial hemorrhage (sICH) was the primary outcome measure. Secondary outcome was the relation between INR and sICH, and we evaluated mortality and functional outcome at 3 months by modified Rankin scale. We compared patients with and without previous OAC and also considered the type of oral anticoagulants. Results: About 1.455 AIS patients were included, of whom 274 (19%) were on OAC, 193 (70%) on vitamin K antagonists (VKA), and 81 (30%) on direct oral anticoagulants (DOACs). Anticoagulated patients were older and had more comorbidities. Eighty-one (5.6%) developed sICH, which was more frequent in the VKA group, but not in DOAC group. OAC with VKA emerged as a predictor of sICH in a multivariate regression model (OR, 1.89 [95% CI, 1.01–3.51], p = 0.04) and was not related to INR level on admission. Prior VKA use was not associated with worse outcome in the multivariate regression model nor with mortality at 3 months. Conclusions: OAC with VKA, but not with DOACs, was an independent predictor of sICH after mechanical thrombectomy. This excess risk was associated neither with INR value by the time thrombectomy was performed, nor with a worse functional outcome or mortality at 3 months

Near barrier scattering of 8He on 208Pb

The exotic nucleus 8He is investigated by means of the measurement of the angular distributions of the elastic channel and the 6He and 4He fragment yields produced in the collision with a 208Pb target at two energies around the Coulomb barrier, 16 and 22 MeV. The experiment was performed at the GANIL-SPIRAL facility, with the aim of extracting information about the structure of 8He and the relevant reaction mechanisms. In this contribution, details of the experimental setup and preliminary data on elastic cross sections are reported

MVA-CoV2-S vaccine candidate confers full protection from SARS-CoV-2 brain infection and damage in susceptible transgenic mice

The protective efficacy of vaccines against SARS-CoV-2 infection in the brain is yet unclear. Here, in the susceptible transgenic K18-hACE2 mouse model of severe COVID-19 disease, we report a detailed spatiotemporal description of the SARS-CoV-2 infection and replication in different areas of the brain. Remarkably, SARS-CoV-2 brain replication occurs primarily in neurons, producing important neuropathological alterations such as neuronal loss, incipient signs of neuroinflammation, and vascular damage in SARS-CoV-2 infected mice. Notably, one or two doses of a modified vaccinia virus Ankara (MVA) vector expressing the SARS-CoV-2 spike (S) protein (MVA-CoV2-S) conferred full protection against SARS-CoV-2 cerebral infection, preventing virus replication in all areas of the brain and its associated damage. This protection was maintained even after SARS-CoV-2 reinfection. To our knowledge, this is the first study of a COVID-19 vaccine candidate showing 100% efficacy against SARS-CoV-2 brain infection and damage, reinforcing the use of MVA-CoV2-S as a promising vaccine candidate against SARS-CoV-2/COVID-19, worth to move forward into clinical trials.The authors thank the Centro de Investigación en Sanidad Animal (CISA)-Instituto Nacional de Investigaciones Agrarias (INIA-CSIC) (Valdeolmos, Madrid, Spain) for the BSL-3 facilities. SARS-CoV-2 MAD6 virus isolate was kindly provided by José M. Honrubia and Dr. Luis Enjuanes (CNB-CSIC, Madrid, Spain). We also thank to Dr. Konstantin L. Levitsky for excellent technical assistance with the confocal acquisition. We thank the Spanish Research Council (CSIC) and the Spanish Ministry of Science and Innovation (MICINN) for continuous support. This research was supported by MCIN/Spanish Research Agency (AEI)/ 10.13039/501100011033 grants: PID2019-105995RB-I00 (J.T.-A. and J.V.), PID2020- 114481RB-I00 (J.G.-A. and M.E.), and PID2019-106410RB-I00 (J.L.-B.). Moreover, this research work was also funded by Red TerCel ISCIII, RD16/0011/0025 (J.T.-A.); Consejería de Salud y Familias, Junta de Andalucía Grant, PECOVID-0078-2020 (R.R.-L. and J.V.); Fondo COVID-19 grant COV20/00151 [Spanish Health Ministry, Instituto de Salud Carlos III (ISCIII)], Fondo Supera COVID-19 (Crue Universidades-Banco Santander) grant and CSIC grant 202120E079 (J.G.-A.); and CSIC grant 2020E84, La CaixaImpulse grant CF01-00008, Ferrovial and MAPFRE donations (M.E.). Additionally, we have also funding from the European Commission-NextGenerationEU, through CSIC's Global Health Platform (PTI Salud Global) (J.G.-A. and M.E.) and the European Research Council (ERC Advanced Grant PRJ201502629) (J.L.-B.).N

Full protection from SARS-CoV-2 brain infection and damage in susceptible transgenic mice conferred by MVA-CoV2-S vaccine candidate

Vaccines against SARS-CoV-2 have been shown to be safe and effective but their protective efficacy against infection in the brain is yet unclear. Here, in the susceptible transgenic K18-hACE2 mouse model of severe coronavirus disease 2019 (COVID-19), we report a spatiotemporal description of SARS-CoV-2 infection and replication through the brain. SARS-CoV-2 brain replication occurs primarily in neurons, leading to neuronal loss, signs of glial activation and vascular damage in mice infected with SARS-CoV-2. One or two doses of a modified vaccinia virus Ankara (MVA) vector expressing the SARS-CoV-2 spike (S) protein (MVA-CoV2-S) conferred full protection against SARS-CoV-2 cerebral infection, preventing virus replication in all areas of the brain and its associated damage. This protection was maintained even after SARS-CoV-2 reinfection. These findings further support the use of MVA-CoV2-S as a promising vaccine candidate against SARS-CoV-2/COVID-19.We thank the CSIC and the Spanish Ministry of Science and Innovation for continuous support. This research was supported by the Spanish Ministry of Science and Innovation/Spanish Research Agency/10.13039/501100011033 grant nos. PID2019-105995RB-I00 (J.J.T.-A. and J.V.), PID2020-114481RB-I00 (J.G.-A. and M.E.), RTI2018-096629-B-I00 (A.P.) and PID2019-106410RB-I00 (J.L.-B.). Moreover, this research was also funded by Red TerCel ISCIII (no. RD16/0011/0025 to J.J.T.-A.), Consejería de Economía, Conocimiento, Empresas y Universidad US-1380891 (to J.J.T.-A. and J.V.), Consejería de Salud y Familias, Junta de Andalucía grant no. PECOVID-0078-2020 (to R.R.-L. and J.V.), Consejería de Educación y Deporte, Junta de Andalucía grant no. PY20_01312 (to A.P.), Fondo COVID-19 grant no. COV20/00151 (Spanish Health Ministry, Instituto de Salud Carlos III), Fondo Supera COVID-19 (Crue Universidades-Banco Santander) grant and CSIC grant no. 202120E079 (J.G.-A.), CSIC grant no. 2020E84, La CaixaImpulse grant no. CF01-00008 and Ferrovial and MAPFRE donations (to M.E.). Additionally, we received funding from the European Commission-NextGenerationEU, through the CSIC’s Global Health Platform (PTI Salud Global) (to J.G.-A. and M.E.) and the European Research Council (ERC Advanced grant no. PRJ201502629) (to J.L.-B.). J.G.-A. and M.E. also acknowledge financial support from the Spanish State Research Agency (no. AEI/10.13039/501100011033) through the ‘Severo Ochoa’ Programme for Centres of Excellence in R&D (nos. SEV-2013-0347 and SEV-2017-0712). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.Peer reviewe