¿Es posible reducir la mortalidad de la endocarditis infecciosa?: cambios a lo largo de un período de 15 años

La endocarditis infecciosa (EI) es una enfermedad con tasas de mortalidad elevadas, a pesar de los avances recientes en los métodos de diagnóstico y tratamiento de la misma. OBJETIVOS 1,- Evaluar si se han producido cambios en la mortalidad de la EI en pacientes no adictos a drogas intravenosas en los últimos años. 2,- Estudiar los posibles factores relacionados con dichos cambios. 3,- Estudiar los cambios en mortalidad en los subgrupos definidos por edad, germen causal, tipo de EI y existencia o no de lesión cardiaca previa. MATERIAL Y MÉTODOS Estudiamos un total de 236 casos de EI desde Enero/87 a Diciembre/03 (tº medio de seguimiento: 73 meses). Se subdividió a los pacientes (pts) en 2 periodos de estudio: 1987-1995 (115 casos) y 1996-2003 (121 casos). RESULTADOS La edad media fue de 48 años, 64% varones, predominaron las EI sobre válvula nativa (68%) frente a las protésicas (32%). En un 13% no se identificó el germen causal. Los gérmenes más frecuentes fueron los estafilococos. En un 30% no existía cardiopatía previa. Destaca una alta tasa de complicaciones severas (75%). La mitadd de los casos precisaron cirugía en la fase activa de la enfermedad. Se observa una mayor edad de los pts en los últimos años, mayor nº de casos de EI sin cardiopatía, un aumento de los casos provocados por estafilococos y enterococos y una mayor detección de verrugas por ecocardiografía. También en los últimos años se reduce la tasa de complicaciones severas y la mortalidad en la fase activa de la enfermedad (22% vs 13%). Se reduce la mortalidad en los últimos años en los pts mayores de 65 años (53% vs 20%) y en los pts con cardiopatía (24% vs 13%). CONCLUSIONES 1,- Se han modificado la epidemiología de la EI; pts de mayor edad, con más frecuencia sin cardiopatía y diferente espectro de microorganismos causales. 2,- Se ha conseguido una reducción de las complicaciones severas. 3,- Se ha reducido la mortalidad durante la fase precoz de la enfermedad. 4,- En dos subgrupos de pacientes considerados de mal pronóstico (mayores de 65 años y pts con cardiopatía) se consigue una reducción significativa de las tasas de mortalida

Work engagement and sense of coherence as predictors of psychological distress during the first phase of the COVID-19 pandemic in Chile

Objectives: The aim of this study was to analyse the relationship between sense of coherence, work engagement, and work environment variables as predictors of the level of psychological distress during the first phase of the COVID-19 pandemic in Chile. Methods: Cross-sectional descriptive study collected between April 22 and December 16, 2020, using non-probabilistic snowball sampling. The study variables and instruments were sociodemographic variables, work engagement (UWES-9 scale), sense of coherence (Antonovsky SOC-13 scale), and psychological distress (GHQ-12 scale). Multivariate analysis and binary logistic regression were performed including the scores of the three questionnaires and other variables such as effectiveness, safety, stress, health perception, and sex. Finally, the CHAID technique was applied to create a segmentation tree. Results: 72.7 % of participants had high levels of psychological distress, more predominantly among women, with work stress and low sense of coherence acting as the most influential mediators in generating psychological distress, and even more so when both were combined. Low work engagement and the availability of safe and effective means to prevent infection were predictors of psychological distress among workers. Conclusion: During the first phase of the COVID-19 pandemic, factors that contributed to psychological distress in the Chilean population were identified. These included a fair or poor perception of health, being a woman, work-related stress, availability of safety measures, low level of work engagement, and low level of sense of coherence. Identifying these factors may help prevent similar effects in future phases of the current pandemic or in future pandemics.Departamento de Biología Ambiental y Salud PúblicaDepartamento de Economía General y Estadístic

Mixoma de características atípicas: un simulador en tiempos de COVID-19

We present a case of a 55-year-old woman with an atypical myxoma in the left atrium. She was admitted for one month history of fever, cough and dyspnea associated with radiological alveolar infiltrates in the chest X-ray. Echocardiography revealed the existence of a heterogeneous mass in the left atrium dependent on the interatrial septum with a large cystic content prolapsing through mitral valve and causing significant obstruction. Its echocardiographic morphological characteristics suggested myxoma or sarcoma as two possible etiological diagnoses. Urgently surgical intervention was practiced and the intraoperative biopsy confirmed the existence of atrial myxoma.Se presenta el caso de una mujer de 55 años con un mixoma en aurícula izquierda de morfología atípica. Fue ingresada por un cuadro de fiebre, tos y disnea de 1 mes de evolución asociado con la aparición de infiltrados alveolares en la radiografía de tórax. La ecocardiografía reveló la existencia de una masa en aurícula izquierda dependiente del septo interauricular, heterogénea y con un gran componente quístico, que prolapsaba a través de la válvula mitral causando obstrucción significativa. Sus características morfológicas ecocardiográficas hicieron pensar en un mixoma o un sarcoma como dos posibles diagnósticos etiológicos. Fue intervenida de forma urgente y la biopsia intraoperatoria confirmó la existencia de un mixoma auricular

Percepción del mensaje educativo emitido por el Instituto Municipal de Salud en el plegable sobre cáncer de mama y cérvix : Pereira 2005

CD-T 613.042 44 G586;73 p.Este trabajo de investigación pretende identificar la percepción que tiene la población del barrio Cuba de Pereira, del mensaje educativo sobre cáncer de mama y cervix, trasmitido a través de un plegable distribuido por el Instituto Municipal de Salud de Pereira, durante el año 2005, para el logro y fortalecimiento de una comunicación efectiva en los procesos educativos con la comunidad.Universidad Libre de Pereir

The Assessment of Myocardial Longitudinal Strain in a Paediatric Spanish Population Using a New Software Analysis

Two-dimensional speckle-tracking echocardiography (2DSTE) has been present for years. However, it is underutilized due to the expertise and time requirements for its analysis. Our aims were to provide strain values in a paediatric Spanish population and to assess the feasibility and reproducibility of a new strain software analysis in our environment. Methods: A cross-sectional study of 156 healthy children aged 6 to 17 years. Longitudinal strain (LS) analysis of the left ventricle, right ventricle, and left atrium was performed. Feasibility and reproducibility were assessed. The associations of clinical and echocardiographic variables with strain values were investigated by multivariate analysis. Results: Mean age was 11 ± 3 years (50% female). Feasibility of LS measurement ranged from 94.2% for left ventricle global LS (LVGLS) to 98.1% for other chamber strain parameters. Strain values were 26.7 ± 2.3% for LVGLS; 30.5 ± 4.4% and 26.9 ± 4% for right ventricle free wall LS (RVFWLS) and four chambers view LS (RV4CLS) respectively; and 57.8 ± 10.5%, 44.9 ± 9.5%, and 12.9 ± 5.5% for left atrium LS reservoir phase (LALSr), conduct phase (LALScd) and contraction phase (LALSct), also respectively. Body surface area (BSA) and age presented a negative correlation with strain values. Higher values were found in females than in males, except for LALScd. Excellent intra- and inter-observer reproducibility were found for right and left ventricular strain measurement, with intraclass correlation coefficients (ICC) ranging from 0.88 to 0.98, respectively. In conclusion, we described strain values in a healthy Spanish paediatric population. LS assessment by this new strain analysis software by semi-automatic manner was highly feasible and reproducible

Erratum to: Targeting the association of calgranulin B (S100A9) with insulin resistance and type 2 diabetes

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Mitochondrial bioenergetics boost macrophage activation, promoting liver regeneration in metabolically compromised animals

Background and aims: Hepatic ischemia-reperfusion injury (IRI) is the leading cause of early posttransplantation organ failure as mitochondrial respiration and ATP production are affected. A shortage of donors has extended liver donor criteria, including aged or steatotic livers, which are more susceptible to IRI. Given the lack of an effective treatment and the extensive transplantation waitlist, we aimed at characterizing the effects of an accelerated mitochondrial activity by silencing methylation-controlled J protein (MCJ) in three preclinical models of IRI and liver regeneration, focusing on metabolically compromised animal models. Approach and results: Wild-type (WT), MCJ knockout (KO), and Mcj silenced WT mice were subjected to 70% partial hepatectomy (Phx), prolonged IRI, and 70% Phx with IRI. Old and young mice with metabolic syndrome were also subjected to these procedures. Expression of MCJ, an endogenous negative regulator of mitochondrial respiration, increases in preclinical models of Phx with or without vascular occlusion and in donor livers. Mice lacking MCJ initiate liver regeneration 12 h faster than WT and show reduced ischemic injury and increased survival. MCJ knockdown enables a mitochondrial adaptation that restores the bioenergetic supply for enhanced regeneration and prevents cell death after IRI. Mechanistically, increased ATP secretion facilitates the early activation of Kupffer cells and production of TNF, IL-6, and heparin-binding EGF, accelerating the priming phase and the progression through G1 /S transition during liver regeneration. Therapeutic silencing of MCJ in 15-month-old mice and in mice fed a high-fat/high-fructose diet for 12 weeks improves mitochondrial respiration, reduces steatosis, and overcomes regenerative limitations. Conclusions: Boosting mitochondrial activity by silencing MCJ could pave the way for a protective approach after major liver resection or IRI, especially in metabolically compromised, IRI-susceptible organs.Funding information: Supported by grants from Ministerio de Ciencia, Innovación y Universidades MICINN (PID2020-117116RB-100, RTI2018-096759-A-100, RTI2018-095114-B-I00, PID2019-108977RB-100 and RTI2018-095700-B100, integrado en el Plan Estatal de Investigación Científica y Técnica y Innovación, cofinanciado con Fondos FEDER, to M.L.M.-C., T.C.D., C.P., P.M.-S., and N.G.A.A., respectively), Subprograma Retos Colaboración RTC2019-007125-1; Fundación Científica de la Asociación Española Contra el Cáncer (AECC Scientific Foundation) Rare Tumor Calls 2017 (to M.L.M.-C.); Asociación Española contra el Cáncer (to T.C.D. and M.S.-M); La Caixa Foundation Program (HR17-00601, to M.L.M.-C.), Proyectos Investigación en Salud DTS20/00138 (to M.L.M.-C.); Departamento de Industria del Gobierno Vasco (to M.L.M.-C.); Departamento de Educación del Gobierno Vasco (to N.G.-U. and J.S.); Acción Estratégica Ciber Emergentes 2018 (Ciberehd-ISCIII) and Gilead Sciences International Research Scholars Program in Liver Disease (to M.V.-R.); Ciberehd_ISCIII_MINECO is funded by the Instituto de Salud Carlos IIIAcknowledgments: We thank MINECO for the Severo Ochoa Excellence Accreditation to CIC bioGUNE (SEV-2016-0644). We acknowledge Begoña Rodríguez Iruretagoyena for the technical support provided

Liver fibrosis secondary to bile duct injury: correlation of Smad7 with TGF-β and extracellular matrix proteins

<p>Abstract</p> <p>Background</p> <p>Liver fibrosis is the result of continuous liver injury stemming from different etiological factors. Bile duct injury induces an altered expression of TGF-β, which has an important role in liver fibrosis because this cytokine induces the expression of target genes such as collagens, PAI-1, TIMPs, and others that lead to extracellular matrix deposition. Smad7 is the principal inhibitor that regulates the target gene transcription of the TGF-β signaling. The aim of the study was to determine whether Smad7 mRNA expression correlates with the gene expression of <it>TGF-β, Col I</it>, <it>Col III</it>, <it>Col IV</it>, or <it>PAI-1 </it>in liver fibrosis secondary to bile duct injury (BDI).</p> <p>Results</p> <p>Serum TGF-β concentration was higher in BDI patients (39 296 pg/ml) than in liver donors (9008 pg/ml). Morphometric analysis of liver sections showed 41.85% of tissue contained fibrotic deposits in BDI patients. mRNA expression of Smad7, Col I, and PAI-1 was also significantly higher (<it>P </it>< 0.05) in patients with BDI than in controls. Smad7 mRNA expression correlated significantly with TGF-β concentration, Col I and Col III expression, and the amount of fibrosis.</p> <p>Conclusion</p> <p>We found augmented serum concentration of TGF-β and an increase in the percentage of fibrotic tissue in the liver of BDI patients. Contrary to expected results, the 6-fold increase in <it>Smad7 </it>expression did not inhibit the expression of <it>TGF-β, collagens</it>, and <it>PAI-1</it>. We also observed greater expression of Col I and Col III mRNA in BDI patients and significant correlations between their expression and TGF-β concentration and Smad7 mRNA expression.</p

Abundance determination of multiple star-forming regions in the HII galaxy SDSS J165712.75+321141.4

We analyze high signal-to-noise spectrophotometric observations acquired simultaneously with TWIN, a double-arm spectrograph, from 3400 to 10400 \AA of three star-forming regions in the HII galaxy SDSS J165712.75+321141.4. We have measured four line temperatures: Te([OIII]), Te([SIII]), Te([OII]), and Te([SII]), with high precision, rms errors of order 2%, 5%, 6% and 6%, respectively, for the brightest region, and slightly worse for the other two. The temperature measurements allowed the direct derivation of ionic abundances of oxygen, sulphur, nitrogen, neon and argon. We have computed CLOUDY tailor-made models which reproduce the O2+ measured thermal and ionic structures within the errors in the three knots, with deviations of only 0.1 dex in the case of O+ and S2+ ionic abundances. In the case of the electron temperature and the ionic abundances of S+/H+, we find major discrepancies which could be consequence of the presence of colder diffuse gas. The star formation history derived using STARLIGHT shows a similar age distribution of the ionizing population among the three star-forming regions. This fact suggests a similar evolutionary history which is probably related to a process of interaction with a companion galaxy that triggered the star formation in the different regions almost at the same time. The hardness of the radiation field mapped through the use of the softness parameter $\eta$ is the same within the observational errors for all three regions, implying that the equivalent effective temperature of the radiation fields are very similar for all the studied regions of the galaxy, in spite of some small differences in the ionization state of different elements.Comment: 18 pages, 10 figures, accepted by MNRA