Prevalencia, características y pronóstico de las anomalías congénitas de las arterias coronarias con origen en el seno de Valsalva contralateral, en una población adulta de pacientes referidos para la realización de un TAC coronario en un hospital terciario

Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Medicina, Departamento de Medicina. Fecha de lectura: 28-06-2017Esta tesis tiene embargado el acceso al texto completo hasta el 28-12-201

Candida albicans: genetics, dimorphism and pathogenicity

Candida albicans is a dimorphic fungus that causes severe opportunistic infections in humans. Recent advances in molecular biology techniques applied to this organism (transformation systems, gene disruption strategies, new reporter systems, regulatable promoters) allow a better knowledge of both the molecular basis of dimorphism and the role of specific genes in Candida morphogenesis. These same molecular approaches together with the development of appropriate experimental animal models to analyze the virulence of particular mutants, may help to understand the molecular basis of Candida virulence

Plan estratégico Johnson & Johnson 2011-2013

Johnson & Johnson (J&J), empresa con una larga trayectoria y sólida posición en el mercado a nivel global en el cuidado de la salud, a pesar de su liderazgo en la venta de productos farmacéuticos sin receta OTC en USA, estaba siendo cuestionada por la calidad de algunos de sus medicamentos emblemáticos en el periodo 2009-2010. Dada esta situación, se ha elaborado el presente plan estratégico para la categoría de medicamentos OTC, división consumo mercado USA, que le permita a J&J poder corregir los problemas que le ocasionaron una pérdida en sus ventas y participación de mercado

Partial duplication of the internal yugular vein and its relation with the espinal nerve. Description of two cases.

Introduction and objective: Duplication of internal jugular vein is a rare finding and, in most cases, it is diagnosed incidentally in the neck dissection. Description: We present two cases of unilateral partial duplication of the internal jugular vein after neck dissection in two patients with laryngeal carcinomas. Discussion: The internal jugular vein drains the blood of cranial cavity. Duplication can be unilateral, bilateral, partial or total. In some cases it is due to the passage of nerve structures causing a duplicate vein with an anterior and posterior branch. Conclusions: Duplication of internal jugular vein is a rare entity, but it is necessary to remember its existence in neck surgery, when reading angiograms and when placing central catheters.Introducción y objetivo: La duplicación de la vena yugular interna es un hallazgo raro y es diagnosticada en la mayoría de los casos de forma incidental durante la disección cervical. Descripción: Presentamos dos casos de duplicidad parcial unilateral de la vena yugular interna identificadas durante la disección cervical en dos pacientes con carcinomas laríngeos. Discusión: La vena yugular interna drena la sangre de la cavidad craneal. La duplicación puede ser unilateral, bilateral, parcial o total. En algunos casos es debido al paso de estructuras nerviosas originando una vena duplicada con una rama anterior y otra posterior. Conclusiones: La duplicidad de la vena yugular interna es una entidad muy rara pero hay que tenerla presente en la cirugía cervical, la interpretación de las angiografías y la colocación de las vías centrales

Deep-sea habitat characterization using acoustic data and underwater imagery in Gazul mud volcano (Gulf of Cádiz, NE Atlantic)

Gazul is the shallowest mud volcano (MV) within the Shallow Field of Fluid Expulsion (SFFE) of the northeastern Gulf of Cádiz (NE Atlantic; 300–1200 m depth). The SFFE represents an important geo- and biodiversity area that was designated as a Site of Community Importance under the European Habitats Directive in 2014. In this study, geological features, habitats and associated biodiversity, as well as anthropogenic impacts, were characterized at Gazul MV from underwater imagery and multibeam bathymetry. Multivariate methods using the Bray-Curtis similarity index identified six main habitats, each of which harbored a characteristic faunal assemblage that included: (1) sandy ripple bottoms typified by the actiniarian Actinauge richardi; (2) sandy, muddy, coarse sand and bioclastic bottoms dominated by the solitary coral Flabellum chunii; (3) coarse sand and bioclastic bottoms, together with soft sediments covered by scattered methane-derived authigenic carbonates (MDACs) (mixed bottoms), characterized by the echinoid Cidaris cidaris; (4) hard bottoms comprising MDACs dominated by a wide variety of sponges and gorgonians; (5) coral-rubble bottoms typified by the presence of colonial scleractinian communities dominated by Madrepora oculata; and (6) mixed bottoms characterized by the presence of a styelid ascidian. Slope and water depth were the main factors explaining assemblages’ distribution, which was also supported by the presence of MDACs such as slabs, crusts and chimneys on the seafloor, as well as by the geomorphologic diversity of Gazul MV. The results highlight Gazul MV as an eco-biologically important area harboring different vulnerable marine ecosystem (VME) elements with indicator taxa such as scleractinians, sponges, gorgonians and black corals. ROV images revealed abandoned or lost fishing gears and marine debris on the seafloor, indicating anthropogenic impacts in Gazul MV and adjacent areas. Indeed trawling fisheries activities have also been detected in Vessel Monitoring System datasets. A fishery restricted area is recommended in Gazul MV due to the occurrence of diverse VMEs and species included in different conservation directives and conventions.Postprin

Clinical Validation of a 3-Dimensional Ultrafast Cardiac Magnetic Resonance Protocol Including Single Breath-Hold 3-Dimensional Sequences

Objectives: This study sought to clinically validate a novel 3-dimensional (3D) ultrafast cardiac magnetic resonance (CMR) protocol including cine (anatomy and function) and late gadolinium enhancement (LGE), each in a single breath-hold. Background: CMR is the reference tool for cardiac imaging but is time-consuming. Methods: A protocol comprising isotropic 3D cine (Enhanced sensitivity encoding [SENSE] by Static Outer volume Subtraction [ESSOS]) and isotropic 3D LGE sequences was compared with a standard cine+LGE protocol in a prospective study of 107 patients (age 58 ± 11 years; 24% female). Left ventricular (LV) mass, volumes, and LV and right ventricular (RV) ejection fraction (LVEF, RVEF) were assessed by 3D ESSOS and 2D cine CMR. LGE (% LV) was assessed using 3D and 2D sequences. Results: Three-dimensional and LGE acquisitions lasted 24 and 22 s, respectively. Three-dimensional and LGE images were of good quality and allowed quantification in all cases. Mean LVEF by 3D and 2D CMR were 51 ± 12% and 52 ± 12%, respectively, with excellent intermethod agreement (intraclass correlation coefficient [ICC]: 0.96; 95% confidence interval [CI]: 0.94 to 0.97) and insignificant bias. Mean RVEF 3D and 2D CMR were 60.4 ± 5.4% and 59.7 ± 5.2%, respectively, with acceptable intermethod agreement (ICC: 0.73; 95% CI: 0.63 to 0.81) and insignificant bias. Both 2D and 3D LGE showed excellent agreement, and intraobserver and interobserver agreement were excellent for 3D LGE. Conclusions: ESSOS single breath-hold 3D CMR allows accurate assessment of heart anatomy and function. Combining ESSOS with 3D LGE allows complete cardiac examination in less than 1 min of acquisition time. This protocol expands the indication for CMR, reduces costs, and increases patient comfort. (J Am Coll Cardiol Img 2021;14:1742–1754)Funding included Instituto de Salud Carlos III (ISCIII) and the European Regional Development Fund (ERDF) Grants DTS17/00136 to Dr. Ibáñez and PI19/01704 to Dr. Fernandez-Jimenez; Spanish Society of Cardiology Translational Research Grant 2016 to Dr. Ibáñez; European Research Council ERC-CoG 819775-MATRIX to Dr. Ibáñez; Comunidad de Madrid S2017/BMD-3867-RENIM-CM to Drs. Desco and Ibáñez; and Ministerio de Ciencia e Innovación (MICINN) RETOS2019-107332RB-I00 to Dr. Ibáñez. Dr. Fernandez-Jimenez received funding from the European Union Horizon 2020 research and innovation programme under Marie Sklodowska-Curie Hrant Agreement No. 707642. The CNIC is supported by the ISCIII, the MICINN, and the Pro CNIC Foundation. Drs. Fernandez-Jimenez, Nothnagel, Fuster, Ibáñez, and Javier Sánchez-González are inventors of a joint patent (Philips/CNIC) for the new cine imaging method here described and validated/protected under the IP #2014P00960EP. Drs. Nothnagel, Kouwenhoven, Clemence, and Javier Sánchez-González are Philips employees. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose

Design and rationale of a multicentre, randomised, double-blind, placebo-controlled clinical trial to evaluate the effect of vitamin D on ventricular remodelling in patients with anterior myocardial infarction: the VITamin D in Acute Myocardial Infarction (VITDAMI) trial

Introduction:Decreased plasma vitamin D (VD) levels are linked to cardiovascular damage. However, clinical trials have not demonstrated a benefit of VD supplements on left ventricular (LV) remodelling. Anterior ST-elevation acute myocardial infarction (STEMI) is the best human model to study the effect of treatments on LV remodelling. We present a proof-of-concept study that aims to investigate whether VD improves LV remodelling in patients with anterior STEMI. Methods and analysis:The VITamin D in Acute Myocardial Infarction (VITDAMI) trial is a multicentre, randomised, double-blind, placebo-controlled trial. 144 patients with anterior STEMI will be assigned to receive calcifediol 0.266 mg capsules (Hidroferol SGC)/15 days or placebo on a 2:1 basis during 12 months. Primary objective:to evaluate the effect of calcifediol on LV remodelling defined as an increase in LV end-diastolic volume >= 10\% (MRI). Secondary objectives:change in LV end-diastolic and end-systolic volumes, ejection fraction, LV mass, diastolic function, sphericity index and size of fibrotic area; endothelial function; plasma levels of aminoterminal fragment of B-type natriuretic peptide, galectin-3 and monocyte chemoattractant protein-1; levels of calcidiol (VD metabolite) and other components of mineral metabolism (fibroblast growth factor-23 (FGF-23), the soluble form of its receptor klotho, parathormone and phosphate). Differences in the effect of VD will be investigated according to the plasma levels of FGF-23 and klotho. Treatment safety and tolerability will be assessed. This is the first study to evaluate the effect of VD on cardiac remodelling in patients with STEMI. Ethics and dissemination: This trial has been approved by the corresponding Institutional Review Board (IRB) and National Competent Authority (Agencia Espanola de Medicamentos y Productos Sanitarios (AEMPS)). It will be conducted in accordance with good clinical practice (International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use-Good Clinical Practice (ICH-GCP)) requirements, ethical principles of the Declaration of Helsinki and national laws. The results will be submitted to indexed medical journals and national and international meetings.The VITDAMI trial is an investigator initiated study, sponsored by the Instituto de Investigacion Sanitaria Fundacion Jimenez Diaz (IIS-FJD). Funding has been obtained from Fondo de Investigaciones Sanitarias (PI14/01567; http://www.isciii.es/) and Spanish Society of Cardiology (http://secardiologia.es/). In addition, the study medication has been provided freely by the pharmaceutical Company FAES FARMA S.A. (Leioa, Vizcaya, Spain; http://faesfarma.com/). This company was the only funder who collaborated in study design (IG-H).S

Vulnerable marine ecosystems and biological features of Gazul mud volcano (Gulf of Cádiz): A contribution towards a potential "Gulf of Cádiz" EBSA

The Gulf of Cádiz (GoC) represents an area of socioeconomic and scientific importance for oceanographic, geological and biological processes. An interesting feature of the GoC is the presence of a large amount of mud volcanoes (MVs) and diapirs that display different seepage, seabed types, oceanographic settings and biological communities. Detailed exploration of some MVs is still needed for detecting Vulnerable Marine ecosystems (VMEs) that seem to be rare in other areas of the GoC, improving the current knowledge on its biodiversity and ecological attributes. During different expeditions (MEDWAVES-ATLAS, INDEMARES-CHICA 0610 & 0412 and ISUNEPCA 0616) carried out in different years, biological samples and videos were obtained in Gazul MV (Spanish Margin of the GoC). The study of those samples and videos has revealed the presence of several ecologically important VMEs (e.g. 3 species of reef framework-forming corals, coral gardens including solitary scleractinians, gorgonians and antipatharians, as well as deep-sea sponge aggregations and chemosynthesis-related structures) and a large number of species occurring in this MV, including new records for the European margin, threatened species and non-previously described species. The combination of different environmental and anthropogenic factors allowed the present-day persistence of these VMEs in the GoC. Some of Gazul MV biological and ecological attributes fit several criteria of the Convention on Biological Diversity for EBSA description (e.g. 1,3,4,6) that, together with those of other areas of the GoC, may contribute to the future potential nomination of an EBSA in this area of the NE Atlantic