Aplicaciones clínicas del strain de la aurícula izquierda

Atrial strain is a novel echocardiographic technique for assessing atrial function, which is composed of 3 phases: reservoir, conduit and pump. Advances in analysis software and the standardisation of its measurement have allowed its use to increase exponentially in recent years. This technique has been evaluated in multiple scenarios, and has been shown to provide diagnostic and prognostic value in various cardiovascular pathologies. In this review we present how atrial strain is obtained, as well as the prognostic role of this technique in different clinical settingsEl strain auricular es una técnica ecocardiográfica novedosa que permite evaluar la función auricular, que se compone de 3 fases: reservorio, conducto y bomba. Los avances en los softwares de análisis y la estandarización de su medición han permitido que su uso haya aumentado de forma exponencial en los últimos años. Esta técnica se ha evaluado en múltiples escenarios, y se ha demostrado que aporta valor diagnóstico y pronóstico en diversas patologías cardiovasculares. En esta revisión presentamos la forma de obtener el strain auricular, así como el papel pronóstico de esta técnica en distintos contextos clínicos

Phenolic composition of artichoke waste and its antioxidant capacity on differentiated Caco-2 cells

Artichoke waste represents a huge amount of discarded material. This study presents the by‐products (bracts, exterior leaves, and stalks) of the 'Blanca de Tudela' artichoke variety as a potential source of phenolic compounds with promising antioxidant properties. Artichoke residues were subjected to different extraction processes, and the antioxidant capacity and phenolic composition of the extracts were analyzed by spectrophotometric methods and high performance liquid chromatography (HPLC) analyses, respectively. The most abundant polyphenols in artichoke waste were chlorogenic acid, luteolin‐7‐O‐rutinoside, and luteolin‐7‐O‐glucoside. Minor quantities of cynarin, luteolin, apigenin‐7‐O‐glucoside, apigenin‐7‐O‐rutinoside, and naringenin‐7‐O-glucoside were also found. The antioxidant activity of the obtained extracts determined by ABTS [2, 2’‐azinobis (3‐ethylbenzothiazoline‐6‐sulphonic acid)], DPPH (2,2‐diphenyl‐1‐pycrilhydracyl), and FRAP (Ferric Ion Reducing Antioxidant Power) was highly correlated with the total concentration of phenolic compounds. Chlorogenic acid, luteolin‐7‐O‐glucoside, and luteolin‐7‐O‐rutinoside, the most abundant compounds in 60% methanol extracts, are the components most responsible for the antioxidant activity of the artichoke waste extracts. The extract with the best antioxidant capacity was selected to assay its antioxidant potential on a model intestinal barrier. This action of the hydroxycinnamic acids on intestinal cells (Caco-2) was confirmed. In summary, artichoke waste may be considered a very interesting ingredient for food functionalization and for therapeutic purposes.This research was funded by the Spanish Ministry of Economy and Innovation under Grant (SAF2016-75441-R), Aragón Regional Government (B16-17R, Fondos FEDER 'otra manera de hacer Europa'.), CIBERobn under Grant (CB06/ 03/1012) of the Instituto de Salud Carlos III, and SUDOE (Redvalue, SOE1/PI/E0123)

Nueva metodología para la documentación tridimensional de estructuras arqueológicas con alta definición, el caso del yacimiento arqueológico de la Plaza Porticada en Santander

El yacimiento arqueológico de la Plaza Velarde de Santander se ubica en la esquina Sudeste de la conocida como plaza porticada y los trabajos arqueológicos desarrollados en él se han prolongado, de manera intermitente, desde 2006 hasta 2013. Las excavaciones arqueológicas realizadas han permitido documentar diversos vestigios de las estructuras que conformaban la Puebla Nueva de la villa medieval de Santander, especialmente el tramo de la cerca medieval de la villa comprendida entre la Puerta del Mar y el Portillo de Don Gutierre además de ambas entradas a la villa. También se ha podido documentar la evolución de los espacios urbanos ubicados en dicha zona desde el siglo XII hasta el XX con la construcción de las primeras estructuras pétreas de la Puebla nueva a finales del siglo XIII, la creación de la Rúa Chiquita, la posterior Plaza del Príncipe y la destrucción provocada por el incendio de 1941. También se han obtenido diversas evidencias de la ocupación del espacio extramuros de la villa colindante al tramo de muralla presente en el yacimiento, así como de proceso de ensanche de la ciudad producido a finales desde mediados del siglo XVIII y consistente en el relleno de zonas marítimas para crear nuevas áreas de población. El trabajo realizado ha permitido documentar con una alta precisión geométrica las distintas estructuras aparecidas en dicho yacimiento, consiguiendo una alta definición y resolución espacial de los distintos objetos y estructuras aparecidos durante la última fase de la excavación

Pluripotency factors regulate the onset of Hox cluster activation in the early embryo

Pluripotent cells are a transient population of the mammalian embryo dependent on transcription factors, such as OCT4 and NANOG, which maintain pluripotency while suppressing lineage specification. However, these factors are also expressed during early phases of differentiation, and their role in the transition from pluripotency to lineage specification is largely unknown. We found that pluripotency factors play a dual role in regulating key lineage specifiers, initially repressing their expression and later being required for their proper activation. We show that Oct4 is necessary for activation of HoxB genes during differentiation of embryonic stem cells and in the embryo. In addition, we show that the HoxB cluster is coordinately regulated by OCT4 binding sites located at the 3′ end of the cluster. Our results show that core pluripotency factors are not limited to maintaining the precommitted epiblast but are also necessary for the proper deployment of subsequent developmental programs.This work was funded by the Spanish government (grants BFU2017-84914-P and PID2020-115755GB-I00 to M.M.; BFU2016-74961-P and BFU2016-81887-REDT to J.L.G.-S.), the Andalusian government (grant BIO-396 to J.L.G.-S.), and the European Research Council (ERC; grant agreement 740041 to J.L.G.-S.). M.T. held Juan de la Cierva fellowships from the Spanish government (FJCI-2017-31791 and IJC2019-038897-I), R.R. and R.D.A. held FPU fellowships from the government, and J.V. was the recipient of a “La Caixa” fellowship. Work in the laboratory of J.L.G.-S. was supported by a María de Maetzu Unit of Excellence Grant (MDM-2016-0687) to the Department of Gene Regulation and Morphogenesis of the CABD. The CBMSO is supported by an institutional grant from the Fundación Ramon Areces, and the CNIC is supported by the Instituto de Salud Carlos III (ISCIII), the Ministerio de Ciencia e Innovación (MCIN), and the Pro CNIC Foundation, and is a Severo Ochoa Center of Excellence (grant CEX2020-001041-S funded by MICIN/AEI/10.13039/501100011033). : With funding from the Spanish government through the ‘Severo Ochoa Centre of Excellence’ accreditation (CEX2020-001041-S)

Excavaciones en la cueva de El Olivo (Pruvia, Llanera): campañas 2013-2016

Depto. de Prehistoria, Historia Antigua y ArqueologíaFac. de Geografía e HistoriaTRUEpu

Impact of COVID-19 pandemic on diagnosis, staging and outcomes of patients with early-onset colorectal cancer

[Background]: Although we seem to be recovering from COVID-19, we are now facing the long-term consequence of the pandemic on vulnerable subgroup of patients such as patients with early-onset colorectal cancer (EOCRC). We aim to study how the COVID-19 pandemic affected the diagnosis and clinic-pathological characteristics, treatment and outcomes of patients with EOCRC.[Methods]: This is an observational retrospective study including patients with EOCRC diagnosed between September 2016 and August 2021 at Hospital Universitario La Paz, Madrid, Spain. Two cohorts were stablished: before and after March 14, 2020, the day of the first lockdown in Spain.[Results]: A total of 1409 patients with CRC were included. Of those, 5,2% were EOCRC (n=75). Fifty-five (73%) and 20 (27%) were diagnosed pre, and post pandemic. The rate of EOCRC diagnosis per month was 1,8 and 1,1 in the pre and postpandemic group, respectively. Fifty percent of patients in the postpandemic group were diagnosed with metastatic disease, while only 29% had stage IV at diagnosis in the prepandemic subgroup (P = 0,09). High tumor budding, surgical margins affected, lymphovascular, and perineural invasion were also pathological features more observed in the postpandemic subgroup, although results are not statistically significant. The differences between both groups are depicted. After a median follow-up of 23 months (33 and 14 months in the pre and postpandemic group, respectively), 11 patients have died (15%). Median overall survival (OS) was not reached in either group. At 12 months, 94% and 89% of patients were alive in the pre and postpandemic group, respectively.[Conclusions]: COVID-19 has influenced the diagnosis and staging of patients with EOCRC. Long-term follow-up is needed to assess the survival in this population. The role of primary care in the diagnosis and early referral of these patients is, more than ever, crucial.Peer reviewe

Immigrant IBD Patients in Spain Are Younger, Have More Extraintestinal Manifestations and Use More Biologics Than Native Patients

BackgroundPrevious studies comparing immigrant ethnic groups and native patients with IBD have yielded clinical and phenotypic differences. To date, no study has focused on the immigrant IBD population in Spain. MethodsProspective, observational, multicenter study comparing cohorts of IBD patients from ENEIDA-registry who were born outside Spain with a cohort of native patients. ResultsWe included 13,524 patients (1,864 immigrant and 11,660 native). The immigrants were younger (45 +/- 12 vs. 54 +/- 16 years, p < 0.001), had been diagnosed younger (31 +/- 12 vs. 36 +/- 15 years, p < 0.001), and had a shorter disease duration (14 +/- 7 vs. 18 +/- 8 years, p < 0.001) than native patients. Family history of IBD (9 vs. 14%, p < 0.001) and smoking (30 vs. 40%, p < 0.001) were more frequent among native patients. The most prevalent ethnic groups among immigrants were Caucasian (41.5%), followed by Latin American (30.8%), Arab (18.3%), and Asian (6.7%). Extraintestinal manifestations, mainly musculoskeletal affections, were more frequent in immigrants (19 vs. 11%, p < 0.001). Use of biologics, mainly anti-TNF, was greater in immigrants (36 vs. 29%, p < 0.001). The risk of having extraintestinal manifestations [OR: 2.23 (1.92-2.58, p < 0.001)] and using biologics [OR: 1.13 (1.0-1.26, p = 0.042)] was independently associated with immigrant status in the multivariate analyses. ConclusionsCompared with native-born patients, first-generation-immigrant IBD patients in Spain were younger at disease onset and showed an increased risk of having extraintestinal manifestations and using biologics. Our study suggests a featured phenotype of immigrant IBD patients in Spain, and constitutes a new landmark in the epidemiological characterization of immigrant IBD populations in Southern Europe

Natural History of MYH7-Related Dilated Cardiomyopathy

BACKGROUND Variants in myosin heavy chain 7 (MYH7) are responsible for disease in 1% to 5% of patients with dilated cardiomyopathy (DCM); however, the clinical characteristics and natural history of MYH7-related DCM are poorly described. OBJECTIVES We sought to determine the phenotype and prognosis of MYH7-related DCM. We also evaluated the influence of variant location on phenotypic expression. METHODS We studied clinical data from 147 individuals with DCM-causing MYH7 variants (47.6% female; 35.6 +/- 19.2 years) recruited from 29 international centers. RESULTS At initial evaluation, 106 (72.1%) patients had DCM (left ventricular ejection fraction: 34.5% +/- 11.7%). Median follow-up was 4.5 years (IQR: 1.7-8.0 years), and 23.7% of carriers who were initially phenotype-negative developed DCM. Phenotypic expression by 40 and 60 years was 46% and 88%, respectively, with 18 patients (16%) first diagnosed at <18 years of age. Thirty-six percent of patients with DCM met imaging criteria for LV noncompaction. During follow-up, 28% showed left ventricular reverse remodeling. Incidence of adverse cardiac events among patients with DCM at 5 years was 11.6%, with 5 (4.6%) deaths caused by end-stage heart failure (ESHF) and 5 patients (4.6%) requiring heart transplantation. The major ventricular arrhythmia rate was low (1.0% and 2.1% at 5 years in patients with DCM and in those with LVEF of <= 35%, respectively). ESHF and major ventricular arrhythmia were significantly lower compared with LMNA-related DCM and similar to DCM caused by TTN truncating variants. CONCLUSIONS MYH7-related DCM is characterized by early age of onset, high phenotypic expression, low left ventricular reverse remodeling, and frequent progression to ESHF. Heart failure complications predominate over ventricular arrhythmias, which are rare. (C) 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation

Sars-Cov-2 Infection in Patients on Long-Term Treatment with Macrolides in Spain: A National Cross-Sectional Study

[eng] The aim of this study was to know the prevalence and severity of COVID-19 in patients treated with long-term macrolides and to describe the factors associated with worse outcomes. A cross-sectional study was conducted in Primary Care setting. Patients with macrolides dispensed continuously from 1 October 2019 to 31 March 2020, were considered. Main outcome: diagnosis of coronavirus disease-19 (COVID-19). Secondary outcomes: symptoms, severity, characteristics of patients, comorbidities, concomitant treatments. A total of 3057 patients met the inclusion criteria. Median age: 73 (64-81) years; 55% were men; 62% smokers/ex-smokers; 56% obese/overweight. Overall, 95% of patients had chronic respiratory diseases and four comorbidities as a median. Prevalence of COVID-19: 4.8%. This was in accordance with official data during the first wave of the pandemic. The most common symptoms were respiratory: shortness of breath, cough, and pneumonia. Additionally, 53% percent of patients had mild/moderate symptoms, 28% required hospital admission, and 19% died with COVID-19. The percentage of patients hospitalized and deaths were 2.6 and 5.8 times higher, respectively, in the COVID-19 group (p < 0.001). There was no evidence of a beneficial effect of long-term courses of macrolides in preventing SARS-CoV-2 infection or the progression to worse outcomes in old patients with underlying chronic respiratory diseases and a high burden of comorbidity