Endocarditis mitroaórtica complicada con aneurisma y perforación en velo anterior mitral

We present an 81-year-old male admitted for the study of fever associated with weight loss, asthenia, and decrease of appetite. The transoesophageal echocardiogram confirmed the existence of a complicated mitroaortic endocarditis with an aneurysm and perforation of the mitral anterior leaflet.Varón de 81 años que ingresa para estudio de un síndrome general y fiebre. En el ecocardiograma transesofágico se confirma la existencia de una endocarditis mitroaaortica complicada con un aneurisma y perforación del velo anterior mitral

Manejo intervencionista de una insuficiencia mitral por pseudocleft en paciente pluripatológico

We report a case of heart failure with poor response to conventional medical treatment in a multi-pathological patient with severe mitral valve insufficiency secondary to pseudocleft in which an interventional approach was decided with a MitraClip implant. This clinical case describes the importance of a multidisciplinary approach in the treatment of heart failure patients by integrating multiples areas of cardiology such as clinical, advanced imaging and percutaneous interventions.Se presenta un caso de insuficiencia cardíaca refractaria a tratamiento médico en paciente pluripatológico con insuficiencia mitral grave por pseudocleft en el que se decide un manejo intervencionista con implante de MitraClip. Este caso destaca la importancia del manejo multidisciplinar de la insuficiencia cardíaca integrando distintas áreas de la cardiología como la clínica, la imagen avanzada y el intervencionismo percutáneo

Increased expression of fatty-acid and calcium metabolism genes in failing human heart

Background: Heart failure (HF) involves alterations in metabolism, but little is known about cardiomyopathy-(CM)-specific or diabetes-independent alterations in gene expression of proteins involved in fatty-acid (FA) uptake and oxidation or in calcium-(Ca(2+))-handling in the human heart. Methods: RT-qPCR was used to quantify mRNA expression and immunoblotting to confirm protein expression in left-ventricular myocardium from patients with HF (n = 36) without diabetes mellitus of ischaemic (ICM, n = 16) or dilated (DCM, n = 20) cardiomyopathy aetiology, and non-diseased donors (CTL, n = 6). Results: Significant increases in mRNA of genes regulating FA uptake (CD36) and intracellular transport (Heart-FA-Binding Protein (HFABP)) were observed in HF patients vs CTL. Significance was maintained in DCM and confirmed at protein level, but not in ICM. mRNA was higher in DCM than ICM for peroxisome-proliferator-activated-receptor-alpha (PPARA), PPAR-gamma coactivator-1-alpha (PGC1A) and CD36, and confirmed at the protein level for PPARA and CD36. Transcript and protein expression of Ca(2+)-handling genes (Two-Pore-Channel 1 (TPCN1), Two-Pore-Channel 2 (TPCN2), and Inositol 1,4,5-triphosphate Receptor type-1 (IP3R1)) increased in HF patients relative to CTL. Increases remained significant for TPCN2 in all groups but for TPCN1 only in DCM. There were correlations between FA metabolism and Ca(2+)-handling genes expression. In ICM there were six correlations, all distinct from those found in CTL. In DCM there were also six (all also different from those found in CTL): three were common to and three distinct from ICM. Conclusion: DCM-specific increases were found in expression of several genes that regulate FA metabolism, which might help in the design of aetiology-specific metabolic therapies in HF. Ca(2+)-handling genes TPCN1 and TPCN2 also showed increased expression in HF, while HF- and CM-specific positive correlations were found among several FA and Ca(2+)-handling genes

Narrativas audiovisuales emergentes: creaciones didácticas multimedia realizadas por alumnos para enseñanza y aprendizaje en campus virtuales

Diseño, escritura y realización de contenidos videográficos y multimedia para la enseñanza virtual. El alumnado de Ciencias de la Información analiza, crea y difunde materiales narrativos creados para campus virtuales y cursos online innovadores

Vídeo educativo para enseñanza presencial y virtual: narrativas audiovisuales online tras COVID-19

Depto. de Teorías y Análisis de la ComunicaciónFac. de Ciencias de la InformaciónFALSEsubmitte

Profesionales de atención primaria de Madrid y violencia de pareja hacia la mujer en el año 2012

Background: Morbidity associated to partner violence against women (PVAW) justify these patients repeated visits to Heh Services. Primary Care is the ideal place for detectión and first aid, due to its easy accesibility and continuated assistance. Nevertheless, numbers show important difficulties to achieve this goal. Our aim is to find out the level of knowledge, opinions, awareness about organizacional barriers and improvement proposals suggested by the workers of primary care. Method: Cross-sectional descriptive study using an anonymous and voluntary survey during the months of August and September 2010, targeted to all professionals who perform their work in a Primary Care Area of Madrid. We made a descriptive analysis of variables and used chi² to compare the answers. Results: Answer rate is 170 (21.4%). There are stereotypes regarding battered woman and perpetrador. 118 (70.7%) professionals believe that this is a major problem and 154 (91.7%) that usually goes unnoticed. 91 (55.2%) know their legal commitments. 73 (51.8%) think that there are organizational barriers, among them: the burden of care 50(29%), lack of specific training 40(23.5), lack of knowledge about the procedure to be followed 20(11.8%) and about the professional responsabilities 12 (7%). Conclusions: All profesional categoríes showed an average level of knowledge, except for social workers that was high. Primary Care workers think that PVAW is an important issue that usually goes unnoticed. Half of them know the legal commitments o detección. There are organizacional barriers and stereotypes.Fundamentos: La morbilidad asociada a la violencia de pareja hacia la mujer (VPHM) justifica que sus víctimas acudan reiteradamente a los centros de salud. La accesibilidad y continuidad asistencial hacen de la atención primaria (AP) el lugar idóneo para su detección y primer abordaje. Sin embargo, los datos reflejan las dificultades de los/as profesionales para lograr este fin. El objetivo es analizar el nivel de conocimientos, opiniones, barreras organizativas percibidas y propuestas de mejora de los profesionales de AP. Método: Estudio transversal descriptivo realizado mediante una encuesta anónima y autoadministrada durante los meses de agosto y septiembre de 2010, dirigida a todos/as profesionales de AP del área 8 de Madrid. Se realizó un análisis descriptivo de variables y la chi² para comparar las respuestas obtenidas. Resultados: Tasa de respuesta 170 (21,4%). 118 (70,7%) profesionales creen que este es un problema importante y 154 (91,7%) que habitualmente pasa desapercibido. 91 (55,2%) conocen las obligaciones legales que tienen cuando la detectan. 73 (51,8%) piensan que existen barreras organizativas. Entre ellas: presión asistencial 50(29%), fa de formación específica 40(23,5%), desconocimiento del procedimiento a seguir 20(11,8%) y de las competencias de cada profesional 12(7%). Conclusiones: El nivel de conocimientos medio para todas las categorías profesionales estudiadas, excepto para trabajo social que es alto. Los/as profesionales de AP consideran que la VPHM es un problema importante que pasa desapercibido. La mitad de ellos/as conocen las obligaciones legales que conlleva la detección. Existen barreras organizativas y estereotipos

Searching for genetic modulators of the phenotypic heterogeneity in Brugada syndrome.

In Brugada syndrome, even within the same family where all affected individuals share the same mutation, phenotypic variation is prominent, with variable penetrance and expressivity, presenting different degrees of involvement. It is difficult to establish a direct correlation between genotype and phenotype to predict prognosis in complications and risk of sudden death. The factors that modulate this inter- and intra-familial phenotypic variability remain to be determined. With the intention of testing whether other genetic factors, in addition to the causal mutation in SCN5A, may have a modulating effect on the Brugada phenotype and the risk of sudden death, we have studied 8 families with a causal variant in SCN5A with at least two affected individuals, one of whom has suffered cardiac arrest or sudden death. Whole exome sequencing was performed looking for additional variants that modify the phenotype and allow us to predict a better or worse prognosis for the evolution of the disease. The results did not show any clear genetic modifier; nevertheless, highlight the possible implication of the cholesterol and fibrosis pathways, as well as the circadian rhythm, as possible modulators of Brugada syndrome phenotype