18 research outputs found
RELEVANCIA DEL DIAGNÓSTICO DIFERENCIAL ENTRE EL SÍNDROME AÓRTICO AGUDO Y EL SÍNDROME CORONARIO AGUDO EN PACIENTES CON DOLOR TORÁCICO Y CRISIS HIPERTENSIVA: REVISIÓN A PROPÓSITO DE 2 CASOS / Relevance of the differential diagnosis between acute aortic syndrome and acute coronary syndrome in patients with thoracic pain and hypertensive crisis: review on 2 case reports
Acute aortic syndrome is a pathological process with low incidence compared with acute coronary syndrome, although with a worse prognosis in the short term, which is why its early diagnosis and urgent treatment are essential to the favorable evolution of thepatient. Electrocardiographic changes suggestive of myocardial ischemia, with acute evolution, are rare in acute aortic syndrome. Even in the presence of a suggestive thoracic pain and high levels of blood pressure, an adequate differential diagnosis is of utmost importance, since the administration of anticoagulation and antiplatelet therapy in high doses can have a dramatic impact on patient outcome. Two cases are presented in which electrocardiographic changes determined the action to take in patients with acute aortic syndrome
Impact of moderate coronary atherosclerosis on long-term left ventricular remodeling after aortic valve replacement
Background: The role of coronary atherosclerosis (CA+) in ventricular remodeling after
aortic valve replacement (AVR) for isolated aortic stenosis (AS) is not well defined. We sought
to evaluate the impact of not revascularized moderate coronary atherosclerosis in long-term left
ventricular (LV) remodeling after AVR.
Methods: We assessed by coronariography the coronary artery disease in 66 patients referred
for AVR and evaluated morphological and functional LV data by echocardiography both preoperatively
and postoperatively (3 ± 1.2 years).
Results: In patients without coronary atherosclerosis, hypertrophy regression was more intense
and the absolute reverse remodeling was higher in LV mass index (–55.8 ± 36 g/m2 vs
–28.4 ± 34 g/m2, p = 0.004), reduction of LV dimensions (LV end-diastolic diameter
[LVEDD]: –4.1 ± 7.4 mm vs –2.2 ± 8.3 mm, p = 0.04), and regression of wall thickness
(interventricular septum [IVS]: –3.3 ± 2.6 mm vs –1.6 ± 2.2 mm, p = 0.01; and posterior
wall thickness [PWT]: –2.1 ± 2.1 mm vs 0.6 ± 2.1 mm, p = 0.012).
Conclusions: After AVR for AS, not revascularized moderate coronary atherosclerosis determines
a long-term lesser degree of LV hypertrophy regression and a worse absolute reverse
remodeling of LV mass index, LVEDD, IVS and PWT. (Cardiol J 2011; 18, 3: 277–281
Sustained benefit of left ventricular remodelling after valve replacement for aortic stenosis
Background: Valve replacement for aortic stenosis (AS) determines negative ventricular
remodelling. We used cross sectional and Doppler echocardiography to check how rapidly it occurs and to assess if these changes are sustained over time.
Methods: We evaluated in 34 patients subjected to aortic valve replacement for AS morphological
and functional (ejection fraction and E:A ratio) left ventricular data by echocardiography
prior to surgery and 2 postoperative studies: early after surgery (pQ1) and at
mid-term evolution (pQ2).
Results: Left ventricular mass index was reduced at pQ1 (from 152 ± 47 g/m2 to 113 ± 31 g/m2;
p < 0.01) as well as end-diastolic (from 51.3 mm to 48.3 mm; p < 0.03), end-systolic (from
32.2 mm to 29.4 mm; p < 0.02), interventricular septum (from 12.9 mm to 10.3 mm;
p < 0.01), and posterior wall (from 12.5 mm to 11 mm; p < 0.01) dimensions. Left ventricular
ejection fraction (from 61.2% to 65.2%; p < 0.04) and E:A ratio (from 0.94 to 0.98; p < 0.01)
increased significantly at pQ1. There were no significant differences in measurements between
pQ1 and pQ2.
Conclusions: Aortic valve replacement surgery leads to a rapid negative left ventricular
remodelling during the first 7 months, including a decrease in myocardial hypertrophy and an
improvement in systolic and diastolic function. These beneficial hemodynamic changes are
sustained for at least 3 years
Multimerization of Zika Virus-NS5 Causes Ciliopathy and Forces Premature Neurogenesis
Zika virus (ZikV) is a flavivirus that infects neural tissues, causing congenital microcephaly. ZikV has evolved multiple mechanisms to restrict proliferation and enhance cell death, although the underlying cellular events involved remain unclear. Here we show that the ZikV-NS5 protein interacts with host proteins at the base of the primary cilia in neural progenitor cells, causing an atypical non-genetic ciliopathy and premature neuron delamination. Furthermore, in human microcephalic fetal brain tissue, ZikV-NS5 persists at the base of the motile cilia in ependymal cells, which also exhibit a severe ciliopathy. Although the enzymatic activity of ZikV-NS5 appears to be dispensable, the amino acids Y25, K28, and K29 that are involved in NS5 oligomerization are essential for localization and interaction with components of the cilium base, promoting ciliopathy and premature neurogenesis. These findings lay the foundation for therapies that target ZikV-NS5 multimerization and prevent the developmental malformations associated with congenital Zika syndrome.The work in E.M.’s laboratory was supported by grants BFU2016-77498-P, BFU2016-77498-P, and La Maratò de TV3 foundation 201833-10. M.S. holds a Ramón Y Cajal fellowship (RYC2018-025379-I). J.B.-A is a recipient of a BES-2017-080050 PhD scholarship. The work in N.V.’s laboratory was supported by grants BIO2017-83906-P, Maria de Maeztu Unit of Excellence MDM-2014-0435 (MCIU), and La Maratò de TV3 foundation 201833-10. The work in N.A.’s laboratory was supported by NIH/NINDS R00NS089859 and IDDRC-NPDA (CHOP/Penn)
Wpływ umiarkowanej miażdżycy tętnic wieńcowych na przebudowę lewej komory serca u chorych po wymianie zastawki aortalnej
Wstęp: Znaczenie miażdżycy tętnic wieńcowych (CA+) w procesie przebudowy lewej komory
po wymianie zastawki aortalnej (AVR) z powodu izolowanej stenozy aortalnej (AS) jest wciąż
przedmiotem badań. Celem pracy była ocena wpływu niepoddanych rewaskularyzacji umiarkowanych
zmian miażdżycowych tętnic wieńcowych na odległy proces remodelingu lewej komory
serca (LV) po AVR.
Metody: Za pomocą koronarografii oceniono stopień nasilenia choroby wieńcowej u 66 pacjentów
zakwalifikowanych do AVR i pozyskano dane echokardiograficzne dotyczące budowy
i funkcji LV zarówno przed-, jak i pooperacyjnie (3 ± 1,2 roku).
Wyniki: U pacjentów bez miażdżycy tętnic wieńcowych ustąpienie przerostu i całkowite odwrócenie
remodelingu były większe niż w grupie chorych z miażdżycą, gdy porównano indeks
masy LV (–55,8 ± 36 g/m2 v. –28,4 ± 34 g/m2; p = 0,004). Ponadto w grupie osób bez choroby
wieńcowej obserwowano istotne zmniejszenie wymiarów LV [wymiar końcoworozkurczowy
LV (LVEDD): –4,1 ± 7,4 mm v. –2,2 ± 8,3 mm; p = 0,04] oraz grubości ścian [przegrody
międzykomorowej (IVS): –3,3 ± 2,6 mm v. –1,6 ± 2,2 mm; p = 0,01; i ściany tylnej (PWT):
–2,1 ± 2,1 mm v. 0,6 ± 2,1 mm; p = 0,012].
Wnioski: Brak rewaskularyzacji umiarkowanych zmian miażdżycowych w nasierdziowych
tętnicach wieńcowych u pacjentów poddanych AVR z powodu AS prowadzi w odległej obserwacji
do zwolnienia procesu regresji przerostu lewej komory i zaburzenia odwrócenia remodelingu
w analizie następujących parametrów: indeksu masy LV, LVEDD, IVS i PTW. (Folia
Cardiologica Excerpta 2011; 6, 3: 162–167
Universidad, género, docencia e igualdad
La Red de investigación en docencia universitaria “Universidad, docencia, genero e igualdad” persigue avanzar en la calidad e innovación de las enseñanzas universitarias a partir de la inclusión de la perspectiva de género. Se busca dar cumplimiento a las directrices generales de los nuevos planes de estudio respecto del principio de igualdad de oportunidades entre hombres y mujeres en la formación universitaria (Real Decreto 1393/2007. BOE nº 260, 30 de octubre de 2007). En la cuarta edición de la Red, y dada su composición multidisciplinar, se desarrollaron tres líneas de investigación: 1) mantenimiento del “Portal web con recursos docentes con perspectiva de género”, proyecto financiado por el Instituto de la Mujer (PACUI, 2012) e iniciado en el curso 2012-2013; 2) desarrollo (primera versión) de “iLengUA”, una herramienta informática para un discurso inclusivo e igualitario; y 3) diseño de la Guía para una orientación universitaria inclusiva
Recommended from our members
Dietary α‐Linolenic Acid, Marine ω‐3 Fatty Acids, and Mortality in a Population With High Fish Consumption: Findings From the PREvención con DIeta MEDiterránea (PREDIMED) Study
Background: Epidemiological evidence suggests a cardioprotective role of α‐linolenic acid (ALA), a plant‐derived ω‐3 fatty acid. It is unclear whether ALA is beneficial in a background of high marine ω‐3 fatty acids (long‐chain n‐3 polyunsaturated fatty acids) intake. In persons at high cardiovascular risk from Spain, a country in which fish consumption is customarily high, we investigated whether meeting the International Society for the Study of Fatty Acids and Lipids recommendation for dietary ALA (0.7% of total energy) at baseline was related to all‐cause and cardiovascular disease mortality. We also examined the effect of meeting the society's recommendation for long‐chain n‐3 polyunsaturated fatty acids (≥500 mg/day). Methods and Results: We longitudinally evaluated 7202 participants in the PREvención con DIeta MEDiterránea (PREDIMED) trial. Multivariable‐adjusted Cox regression models were fitted to estimate hazard ratios. ALA intake correlated to walnut consumption (r=0.94). During a 5.9‐y follow‐up, 431 deaths occurred (104 cardiovascular disease, 55 coronary heart disease, 32 sudden cardiac death, 25 stroke). The hazard ratios for meeting ALA recommendation (n=1615, 22.4%) were 0.72 (95% CI 0.56–0.92) for all‐cause mortality and 0.95 (95% CI 0.58–1.57) for fatal cardiovascular disease. The hazard ratios for meeting the recommendation for long‐chain n‐3 polyunsaturated fatty acids (n=5452, 75.7%) were 0.84 (95% CI 0.67–1.05) for all‐cause mortality, 0.61 (95% CI 0.39–0.96) for fatal cardiovascular disease, 0.54 (95% CI 0.29–0.99) for fatal coronary heart disease, and 0.49 (95% CI 0.22–1.01) for sudden cardiac death. The highest reduction in all‐cause mortality occurred in participants meeting both recommendations (hazard ratio 0.63 [95% CI 0.45–0.87]). Conclusions: In participants without prior cardiovascular disease and high fish consumption, dietary ALA, supplied mainly by walnuts and olive oil, relates inversely to all‐cause mortality, whereas protection from cardiac mortality is limited to fish‐derived long‐chain n‐3 polyunsaturated fatty acids. Clinical Trial Registration URL: http://www.Controlled-trials.com/. Unique identifier: ISRCTN35739639
Angina and origin of three major coronary arteries from independent ostia in right coronary sinus.
Journal Articleinfo:eu-repo/semantics/publishe
PROFILAXIS DE LA NEFROPATÍA INDUCIDA POR CONTRASTE EN PACIENTES DE ALTO RIESGO CON SÍNDROME CORONARIO AGUDO SIN ELEVACIÓN DEL SEGMENTO ST / Prophylaxis of contrast-induced nephropathy in high risk patients with non-ST-segment elevation acute coronary syndrome
ResumenIntroducción y objetivos: La eficacia de la administración conjunta de suero salino isotónico y N-acetilcisteína presenta resultados dispares en la prevención de la nefropatía por contraste yodado. Nuestro objetivo fue valorar la posible eficacia de esta estrategia combinada en pacientes con alto riesgo de desarrollar nefropatía inducida por contraste, ingresados y sometidos a intervencionismo coronario percutáneo por síndrome coronario agudo sin elevación del segmento ST en nuestro centro. Método: Se aplicó esta estrategia en los pacientes referidos, con al menos un factor de alto riesgo para desarrollar la nefropatía inducida por contraste: mayores de 80 años, diabetes mellitus, creatinina basal mayor de 1,5 mg/dl o alto volumen de contraste (mayor de 400 ml). El protocolo se aplicó durante 12 meses (pacientes que recibieron el protocolo de prevención) y se comparó con similares pacientes en los 12 meses previos que no recibieron profilaxis. Resultados: Un total de 30 pacientes (24 %) desarrollaron nefropatía inducida por contraste. El porcentaje fue significativamente mayor en el grupo que no recibió profilaxis: 35,9 % vs. 11,5 % (p = 0.003). Conclusiones: La combinación de N-acetilcisteína por vía oral e hidratación parenteral en pacientes de alto riesgo, con síndrome coronario agudo sin elevación de ST, podría ser beneficiosa para evitar la aparición de la nefropatía inducida por contraste. /Abstract Introduction and Objectives: The effectiveness of the administration of isotonic saline solution and N-acetylcysteine shows different results in the prevention of iodine contrast nephropathy. Our objective was to assess the potential effectiveness of this combined strategy in patients at high risk for contrast-induced nephropathy, who were admitted in our center for percutaneous coronary intervention due to non-ST-segment elevation acute coronary syndrome. Method: This strategy was applied in the patients mentioned, with at least one risk factor for developing contrast-induced nephropathy: over 80 years, diabetes mellitus, baseline creatinine greater than 1.5 mg / dl or high volume of contrast (greater than 400 ml). The protocol was applied for 12 months (patients that received the prevention protocol) and compared with similar patients in the previous 12 months who received no prophylaxis. Results: A total of 30 patients (24 %) developed contrast-induced nephropathy. The percentage was significantly higher in the group that did not receive prophylaxis: 35.9 % vs. 11.5 % (p = 0.003). Conclusions: The combination of N-acetylcysteine orally and parenteral hydration in high-risk patients with acute coronary syndrome without ST elevation could be beneficial to avoid the appearance of contrast-induced nephropathy
Profilaxis de la nefropatía inducida por contraste en pacientes de alto riesgo con síndrome coronario agudo sin elevación del segmento ST
Introduction and objectives: The effectiveness of the administration of isotonic saline solution and N-acetyl-cysteine shows different results in the prevention of iodine contrast nephropathy. Our objective was to assess the potential effectiveness of this combined strategy in patients at high risk for contrast-induced nephropathy, who were admitted in our center for percutaneous coronary intervention due to non-ST-segment elevation acute coronary syndrome. Method: This strategy was applied in the patients mentioned, with at least one risk factor for developing contrast-induced nephropathy: over 80 years, diabetes mellitus, baseline creatinine greater than 1.5 mg/dl or high volume of contrast (greater than 400 ml). The protocol was applied for 12 months (patients that received the prevention protocol) and compared with similar patients in the previous 12 months who received no prophy-laxis. Results: A total of 30 patients (24%) developed contrast-induced nephropathy. The percentage was significantly higher in the group that did not receive pro-phylaxis: 35.9% vs. 11.5% (p=0.003). Conclusions: The combination of N-acetylcysteine orally and parenteral hydration in high-risk patients with acute coronary syndrome without ST elevation could be beneficial to avoid the appearance of contrast-induced nephropathy.Introducción y objetivos: La eficacia de la administración conjunta de suero salino isotónico y N-acetilcis-teína presenta resultados dispares en la prevención de la nefropatía por contraste yodado. Nuestro objetivo fue valorar la posible eficacia de esta estrategia combinada en pacientes con alto riesgo de desarrollar nefropatía inducida por contraste, ingresados y sometidos a intervencionismo coronario percutáneo por síndrome coronario agudo sin elevación del segmento ST en nuestro centro. Método: Se aplicó esta estrategia en los pacientes referidos, con al menos un factor de alto riesgo para desarrollar la nefropatía inducida por contraste: mayores de 80 años, diabetes mellitus, creatinina basal mayor de 1,5 mg/dl o alto volumen de contraste (mayor de 400 ml). El protocolo se aplicó durante 12 meses (pacientes que recibieron el protocolo de prevención) y se comparó con similares pacientes en los 12 meses previos que no recibieron profilaxis. Re-sultados: Un total de 30 pacientes (24 %) desarrollaron nefropatía inducida por contraste. El porcentaje fue significativamente mayor en el grupo que no recibió profilaxis: 35,9 % vs. 11,5 % (p=0.003). Conclusio-nes: La combinación de N-acetilcisteína por vía oral e hidratación parenteral en pacientes de alto riesgo, con síndrome coronario agudo sin elevación de ST, podría ser beneficiosa para evitar la aparición de la nefropatía inducida por contraste