Metotrexato en la artritis crónica por chikungunya

Chikungunya disease is characterized as a zoonotic pathology that generates considerable disability in humans, weakening their health and physical condition. Chikungunya arthropathy has been shown to cause functional, emotional and quality of life compromise in the different affected populations. To date, there is no unified consensus for the successful treatment of chronic chikungunya arthritis. Various treatment regimens have been used, but still without comprehensive clinical research support. There are reports of the use of methotrexate in the treatment of chronic chikungunya arthritis, which rapidly reduced pain and clinical signs of disease; however, there are no clinical studies demonstrating the effectiveness of this drug in the treatment of this disease.La enfermedad por chikungunya se caracteriza por ser una patología zoonótica que genera una incapacidad considerable en los seres humanos, debilitando su salud y estado físico. La artropatía por chikungunya ha demostrado que genera un compromiso funcional, emocional y de calidad de vida en las distintas poblaciones afectadas. A la fecha no existe consenso unificado para el tratamiento exitoso de la artritis crónica por chikungunya. Se han utilizado diversos esquemas de tratamiento, pero aún sin un respaldo de investigaciones clínicas integrales. Existen estudios clínicos en los cuales sugieren la eficacia del metrotexate en la artritis crónica por chikungunya, sin embargo, a la fecha aún no se han realizado ensayos clínicos aleatorizados con placebo en donde además de comprobar su eficacia, se evalúe su seguridad

COVID-19 Transmission in Children: Implications for Schools

The COVID-19 pandemic poses multiple issues of importance to child health including threats to physical health and disruption of in-school learning. This chapter reviews what is currently known about COVID-19 epidemiology, presentation, pathophysiology, case definitions, therapies, and in-school transmission in children. COVID-19 has some unique characteristics in children including the rare yet severe Multisystem Inflammatory Syndrome in Children (MIS-C) that may be related to acquired immune responses. There are limited studies to date to define therapeutic guidelines in children, however consensus recommendations from multiple organizations are summarized including the use of immunomodulatory therapies (intravenous immunoglobulin, steroids, anakinra and tocilizumab), antiplatelet (aspirin) and anti-coagulant (low molecular weight heparin) therapies. Finally, considerations for safe return to the classroom are discussed including strategies for optimized student to teacher ratios, hand washing, social distancing, sibling pairing and staged re-opening strategies

Factores de riesgo cardiovascular: desde los clásicos hasta los emergentes a la luz de las nuevas evidencias

Cardiovascular diseases (CVD) are the main cause of morbidity and mortality worldwide, especially affecting the population over 60 years of age, they can manifest depending on their origin in coronary disease (acute myocardial infarction, angina pectoris, sudden cardiac arrest, heart failure and sudden death) and cerebrovascular disease (strokes and transient ischemic events). Several risk factors associated with the development of CVD have been described, the classic factors (modifiable and non-modifiable), and others that have been added to the list as a result of new evidence, such as inflammation, thrombosis, stress, alterations in the levels of natriuretic peptides, heavy metals/environmental pollutants, renal insufficiency, and some infectious agents. The objective of this article is to present the state of the art associated with classic cardiovascular risk factors (CRFs) and the evidence that supports emerging CRFs.  Las enfermedades cardiovasculares (ECV) son la causa principal de morbimortalidad a nivel mundial, afectando especialmente a la población mayor de 60 años, pueden manifestarse según su origen en enfermedad coronaria (infarto agudo de miocardio, angina pectoris, insuficiencia cardiaca, y muerte súbita) y enfermedad cerebrovascular (accidentes cerebrovasculares y eventos isquémicos transitorios). Varios factores de riesgo asociados al desarrollo de las ECV han sido descritos; los factores clásicos (modificables y no modificables), y otros que se han añadido a la lista como producto de las nuevas evidencias como es el caso de la inflamación, trombosis, estrés, alteraciones en los niveles de péptidos natriuréticos, metales pesados/contaminantes ambientales, insuficiencia renal y algunos agentes infecciosos. El objetivo de este artículo es presentar el estado del arte asociado con los factores de riesgo cardiovasculares (FRC) clásicos y las evidencias que soportan los FRC emergentes. &nbsp

Comportamiento de la histona demetilasa JMJD2a en la regulación génica durante la hipertrofia y diferenciación cardiaca

136 páginasPara conocer el comportamiento molecular de la demetilasa de histonas JMJD2a tanto en los procesos de diferenciación celular como en el desarrollo de hipertrofia cardiaca, se empleó la línea celular H9C2(2-1) como modelo de estandarización utilizando varios inductores en diferentes concentraciones, sobreexpresando JMJD2a y silenciando con el uso de ARNsi. Para aproximarnos a un modelo humano y una vez estandarizado el proceso, se utilizaron los cardiomiocitos iCell™ y se observó que al inducir hipertrofia empleando neurohormonas, especialmente Ang II y ET-1, el comportamiento de JMJD2a tiende al aumento, al igual que BNP. Al sobreexpresar JMJD2a, los niveles de expresión de BNP se incrementaban, mientras al silenciar, este marcador disminuía su expresión. Además se quiso conocer el comportamiento de JMJD2a en un modelo en el cual se reprogramaron células hiPSCs, se diferenciaron a células cardiacas y se obtuvo clones KO-JMJD2a usando la tecnología CRISPR/Cas9

Potential Of Angiotensin-(1-7) In Covid-19 Treatment

The new coronavirus currently named SARS-CoV-2 was announced by the World Health Organization as the virus causing the COVID-19 pandemic. The pathogenesis of SARS-CoV-2 initiates upon contact of a structural spike protein with the angiotensin II-converting enzyme receptor, leading to the induction of inflammatory mechanisms and progression to severe disease in some cases. Currently, studies have emerged linking COVID-19 with angiotensin-(1-7), demonstrating the potential of angiotensin-(1-7)/Mas Receptor axis induction to control disease severity due to its anti-inflammatory, vasodilator, antioxidant, antiproliferative, anticoagulant, antiangiogenic and fibrosis inhibitory effects. The renin angiotensin-system peptide Angiotensin-(1-7) shows a high therapeutic potential for COVID-19 mainly because of its ability to counteract the adverse effects caused in various organs due to angiotensin II-converting enzyme blockade. In light of these factors, the use of convalescent plasma conjugated therapy and Ang (1-7) agonists for the treatment of COVID-19 patients could be recommended. The differential expression of ACE2 and the varied response to SARS-CoV-2 are thought to be connected. According to several investigations, ACE2 antibodies and pharmacological inhibitors might be used to prevent viral entry. Given its capacity to eliminate the virus while ensuring lung and cardiovascular protection by regulating the inflammatory response, angiotensin-(1-7) is expected to be a safe choice. However, more clinical evidence is required to clarify the therapeutic usage of this peptide. The aim of this review article is to present an update of scientific data and clinical trials on the therapeutic potential of angiotensin-(1-7) in patients with COVID-19