Influence of Gender in Advanced Heart Failure Therapies and Outcome Following Transplantation

Biological differences between males and females change the course of different diseases and affect therapeutic measures' responses. Heart failure is not an exception to these differences. Women account for a minority of patients on the waiting list for heart transplantation or other advanced heart failure therapies. The reason for this under-representation is unknown. Men have a worse cardiovascular risk profile and suffer more often from ischemic heart disease. Conversely, transplanted women are younger and more frequently have non-ischemic cardiac disorders. Women's poorer survival on the waiting list for heart transplantation has been previously described, but this trend has been corrected in recent years. The use of ventricular assist devices in women is progressively increasing, with comparable results than in men. The indication rate for a heart transplant in women (number of women on the waiting list for millions of habitants) has remained unchanged over the past 25 years. Long-term results of heart transplants are equal for both men and women. We have analyzed the data of a national registry of heart transplant patients to look for possible future directions for a more in-depth study of sex differences in this area. We have analyzed 1-year outcomes of heart transplant recipients. We found similar results in men and women and no sex-related interactions with any of the factors related to survival or differences in death causes between men and women. We should keep trying to approach sex differences in prospective studies to confirm if they deserve a different approach, which is not supported by current evidence

Resultados del retrasplante cardiaco: subanálisis del Registro Español de Trasplante Cardiaco

[Abstract] Introduction and objectives: Heart retransplantation (ReHT) is controversial in the current era. The aim of this study was to describe and analyze the results of ReHT in Spain. Methods: We performed a retrospective cohort analysis from the Spanish Heart Transplant Registry from 1984 to 2018. Data were collected on donors, recipients, surgical procedure characteristics, immunosuppression, and survival. The main outcome was posttransplant all-cause mortality or need for ReHT. We studied differences in survival according to indication for ReHT, the time interval between transplants and era of ReHT. Results: A total of 7592 heart transplants (HT) and 173 (2.3%) ReHT were studied (median age, 52.0 and 55.0 years, respectively). Cardiac allograft vasculopathy was the most frequent indication for ReHT (42.2%) and 59 patients (80.8%) received ReHT >5 years after the initial transplant. Acute rejection and primary graft failure decreased as indications over the study period. Renal dysfunction, hypertension, need for mechanical ventilation or intra-aortic balloon pump and longer cold ischemia time were more frequent in ReHT. Median follow-up for ReHT was 5.8 years. ReHT had worse survival than HT (weighted HR, 1.43; 95%CI, 1.17-1.44; P<.001). The indication of acute rejection (HR, 2.49; 95%CI, 1.45-4.27; P<.001) was related to the worst outcome. ReHT beyond 5 years after initial HT portended similar results as primary HT (weighted HR, 1.14; 95%CI, 0.86-1.50; P<.001). Conclusions: ReHT was associated with higher mortality than HT, especially when indicated for acute rejection. ReHT beyond 5 years had a similar prognosis to primary HT.[Resumen] Introducción y objetivos. El retrasplante cardiaco (ReTC) representa un tema controvertido actualmente. Nuestro objetivo es describir y analizar los resultados del ReTC en España. Métodos. Análisis retrospectivo del Registro Español de Trasplante Cardiaco de 1984 a 2018. Se recogieron datos sobre donante, receptor, cirugía, inmunosupresión y supervivencia. La mortalidad por todas las causas o la necesidad de ReTC postrasplante fueron el objetivo principal. Se estudiaron diferencias en supervivencia según indicación, tiempo entre trasplantes y época del ReTC. Resultados. Se estudiaron en total 7.592 trasplantes cardiacos (TxC) y 173 (2,3%) ReTC (mediana de edad, 52,0 y 55,0 años respectivamente). La enfermedad vascular del injerto fue la indicación de ReTC más frecuente (42,2%) y 59 pacientes (80,8%) recibieron el ReTC más de 5 años después del trasplante inicial. El rechazo agudo y el fallo primario del injerto disminuyeron como indicaciones durante el periodo estudiado. La insuficiencia renal, la hipertensión, la necesidad de ventilación mecánica o balón intraaórtico y la mayor duración de la isquemia fría fueron más frecuentes en el ReTC. La mediana de seguimiento del ReTC fue 5,8 años. El ReTC tuvo peor supervivencia que el TxC (HR ponderado = 1,43; IC95%, 1,17-1,44; p < 0,001). El rechazo agudo (HR = 2,49; IC95%, 1,45-4,27; p < 0,001) se relacionó con el peor resultado. El ReTC más allá de 5 años del trasplante inicial presagia resultados similares a los del TxC primario (HR ponderado = 1,14; IC95%, 0,86-1,50; p < 0,001). Conclusiones. El ReTC se asoció con mayor mortalidad que el TxC, especialmente por rechazo agudo. El pronóstico del ReTC realizado más de 5 años después es similar al del TxC primario

Preparación y estudio del ácido N,N,N',N'- tetracarboximetiltiourea (ATMT) o ácido tiourea tetraacético

Se prepara un nuevo agente secuestrante o complexona de tipo poliaminopolicarboxílico, al que se ha denominado N,N,N',N'-tetracarboximetil-tiourea (ATMT) o ácido tioureatetraacético, con siete posiciones teóricas de coordinación. Como paso previo se ha sintetizado el éster tetrametílico del ATMT. Los dos compuestos se han preparado por primera vez en la literatura. La complexona aislada se estudia por técnicas analíticas, potenciométricas, de infrarrojo, térmico-diferenciales y por cromatografía de los gases resultantes de su descomposición térmica

Future urban growth scenarios and ecosystem services valuation in the Tepic-Xalisco Metropolitan area, Mexico

Currently, there is a need to establish new territorial planning instruments focused on sustainable development. The simulation of spatial scenarios is an essential tool to evaluate different alternatives for urban planning. The objective of this work was to explore future urban growth through the analysis of landscape patterns and the economic quantification of ecosystem services of three prospective scenarios, simulated towards the horizon year 2045. Each scenario was formulated, based on the application of different socioeconomic, political and environmental development strategies whose actions have a direct impact on land-use changes. The starting point was an urban growth simulation model, based on Cellular Automata with Markov Chains (CA-Markov), developed from previous work for the study area. Three scenarios were constructed with the intention of showing the spatial characteristics of three different alternatives of the evolution of future urban growth and through them, quantify the economic value and the consequences that would occur in the territory due to the effect of the different decisions taken. Landscape metrics were applied to detect the spatial processes and patterns of urban growth for each of the simulated scenarios and, finally, the costs of ecosystem services associated with the loss or gain of territory (that each of the different land covers and land uses would contribute) were quantified. The three simulated scenarios revealed that the Tepic-Xalisco Metropolitan Zone (MZ) will be in a process of urban coalescence in the next 30 years; and that the path designed to move towards an Industrialisation Scenario (ES2-IN) estimates economic losses of more than $31 million dollars per year for the ecosystem services associated particularly with the reduction of forest cover

Insights into the co-assemblies formed by different aromatic short-peptide amphiphiles

This study was supported by project PID2020-118498GB-I00 funded by MCIN/AEI/10.13039/501100011033, Spain and by project CTQ2017-85658-R funded by MCIN/AEI/10.13039/501100011033/FEDER "Una manera de hacer Europa", Spain, and by FEDER/Junta de Andalucia-Consejeria de Transformacion Economica, Industria, Conocimiento y Universidades (Spain) project P18-FR-3533. CGV and MCMT acknowledge respectively grants FPU17/00491 and PRE2018083773 funded by MCIN/AEI/10.13039/501100011033 and FSE "El FSE invierte en tu futuro", Spain. Thanks go to the CIC personnel of the University of Granada for technical assistance. We thank the Centro de Servicios de Informatica y Redes de Comunicaciones (CSIRC), Universidad de Granada, for providing the computing time. The authors acknowledge Dr Rosario Herranz and Dr Francisco Fueyo-Gonzalez for the fluorophore 9-azetidinyl-5-butyl-quinolimide (AQui) used in this study, which was synthesized at Instituto de Quimica Medica-CSIC (IQM-CSIC) with the support of the Ministerio de Ciencia e Innovacion/Agencia Estatal de Investigacion grant FU201567284-R.We have investigated the co-self-assembly, in water and at room temperature, of different aromatic short peptides containing Fmoc- (fluorenylmethyloxycarbonyl-) and Nap- (2-(naphthalen-2-yloxy)acetyl) groups having also different chirality. Using a combination of spectroscopy and microscopy techniques we have shown that mixtures of peptides have a stronger preference to form co-assemblies giving rise to different types of fibrils of well-defined morphology. Kinetic analysis of fluorescence resonance energy transfer (FRET) between Fmoc- and Nap- side groups reported more information about the process of self-assembly between different dipeptides. We have shown that when peptides are mixed in an equimolar ratio, the kinetics of co-aggregation is faster than that occurring when the proportion is unbalanced. Moreover, following the emission band of Nap-excimers we have shown that these peptides form co-assemblies in an alternate fashion at an equimolar ratio. The mechanism of self-assembly has been studied by molecular dynamics and monitored by differential scanning calorimetry. The mechanical properties of the resulting composite hydrogels have been evaluated by rheology. These results show that the formation of co-assemblies is promoted by π–π interactions between the different aromatic groups resulting in accelerating polymerization due to destabilization of the intermediates.MCIN/AEI, Spain PID2020-118498GB-I00 FPU17/00491MCIN/AEI/FEDER "Una manera de hacer Europa", Spain CTQ2017-85658-RFEDER/Junta de Andalucia-Consejeria de Transformacion Economica, Industria, Conocimiento y Universidades (Spain) P18-FR-3533FSE "El FSE invierte en tu futuro", Spain PRE2018083773Ministerio de Ciencia e Innovacion/Agencia Estatal de Investigacion gran

Estabilidad en un sistema dinámico del mercado actual y potencial de las organizaciones

En este trabajo estudiamos la existencia de pun­tos fijos en un modelo dinámico económico, en tiempo discreto, que relaciona el mercado actual y potencial de una colectividad cualquiera. Una vez establecida la existencia y unicidad de un punto fijo. realizamos el estudio de su estabilidad local y encontramos, una región en un plano de vari­abilidad de los parámetros. que se denomina plano paramétrico, donde se verifica una condición nece­saria y suficiente de estabilidad. A continuación, clasificamos el punto fijo según la región del plano paramétrico en la que esté situado.Junta de Andalucía ACC-944-SEJ-2002Junta de Andalucía ACC-944-SEJ-200

Bifurcaciones locales en el mercado actual y potencial: El mercado cervecero español

En este trabajo establecemos las condiciones nece­sarias para la existencia de bifurcaciones de codi­mensión 1 y 2 de un modelo dinámico discreto en el mercado actual y potencial de las organiza­ciones. Tal y como ocurre con el estudio de la esta­bilidad, los resultados están ligado a determinadas regiones del plano paramétrico. Posteriormente, sobre el modelo aplicado al mercado cervecero español, aplicamos los resultados obtenidos para analizar si las cuotas de mercado para los merca­dos potenciales y actuales de un determinado pro­ducto tenderán a estabilizarse, o si por el contrario sufrirán aumentos y/o disminuciones periódicas, es decir, una vez encontrado el punto de equilibrio para el mercado cervecero, estudiamos como cam­bia el comportamiento de los mercados, en un en­torno de dicho equilibrio, al variar los valores de los parámetros de ajuste encontrados.Junta de Andalucía ACC-944-SEJ-2002Junta de Andalucía CC-944-SEJ-200

Results of heart retransplantation: subanalysis of the Spanish Heart Transplant Registry

Sin financiación6.975 JCR (2021) Q1, 33/143 Cardiac & Cardiovascular Systems0.407 SJR (2021) Q3, 205/356 Cardiology and Cardiovascular MedicineNo data IDR 2020UE