Atrial Fibrillation in the Setting of Acute Pneumonia: Not a Secondary Arrhythmia

Atrial fibrillation (AF) is the most common arrhythmia in the setting of critically ill patients. Pneumonia, and in particular communityacquired pneumonia, is one of the most common causes of illness and hospital admission worldwide. This article aims to review the association between AF and acute diseases, with specific attention to pneumonia, from the pathophysiology to its clinical significance. Even though the relationship between pneumonia and AF has been known for years, it was once considered a transient bystander. In recent years there has been growing knowledge on the clinical significance of this arrhythmia in acute clinical settings, in which it holds a prognostic role which is not so different as compared to that of the so-called "primary"AF. AF is a distinct entity even in the setting of pneumonia, and acute critical illnesses in general, and it should therefore be managed with a guidelines-oriented approach, including prescription of anticoagulants in patients at thromboembolic risk, always considering patients' individuality. More data on the significance of the arrhythmia in this setting will help clinicians to give patients the best possible care

Impact of Glycemic and Blood Pressure Variability on Surrogate Measures of Cardiovascular Outcomes in Type 2 Diabetic Patients

OBJECTIVE—The effect of glycemic variability (GV) on cardiovascular risk has not been fully clarified in type 2 diabetes. We evaluated the effect of GV, blood pressure (BP), and oxidative stress on intima-media thickness (IMT), left ventricular mass index (LVMI), flow-mediated dilation (FMD), and sympathovagal balance (low frequency [LF]/high frequency [HF] ratio) in 26 type 2 diabetic patients (diabetes duration 4.41 6 4.81 years; HbA1c 6.70 6 1.25%) receiving diet and/or metformin treatment, with no hypotensive treatment or complications. RESEARCH DESIGN AND METHODS—Continuous glucose monitoring (CGM) data were used to calculate mean amplitude of glycemic excursion (MAGE), continuous overall net glycemic action (CONGA)-2, mean blood glucose (MBG), mean postprandial glucose excursion (MPPGE), and incremental area under the curve (IAUC). Blood pressure (BP), circadian rhythm, and urinary 15-F2t-isoprostane (8-iso-prostaglandin F2a [PGF2a]) were also evaluated. Subjects were divided into dipper (D) and nondipper (ND) groups according to DBP. RESULTS—IMT and LVMIwere increased inNDversusD(0.7760.08 vs. 0.6860.13 [P=0.04] and 67 6 14 vs. 55 6 11 [P = 0.03], respectively). MBG, MAGE, and IAUC were significantly associated with LF/HF ratio at night (r = 0.50, P = 0.01; r = 0.40, P = 0.04; r = 0.41, P = 0.04, respectively), MPPGE was negatively associated with FMD (r =20.45, P = 0.02), andCONGA-2was positively associatedwith LVMI (r=0.55, P=0.006).TheDsystolic BP was negatively associated with IMT (r =20.43, P = 0.03) andwith LVMI (r =20.52, P = 0.01). Urinary 8-iso-PGF2a was positively associated with LVMI (r = 0.68 P , 0.001). CONCLUSIONS—An impaired GV and BP variability is associated with endothelial and cardiovascular damage in short-term diabetic patients with optimal metabolic control. Oxidative stress is the only independent predictor of increased LV mass and correlates with glucose and BP variability

QT dispersion in patients with systemic lupus erythematosus: the impact of disease activity

<p>Abstract</p> <p>Background</p> <p>Patients with systemic lupus erythematosus (SLE) have increased cardiovascular morbidity and mortality. Although autopsy studies have documented that the heart is affected in most SLE patients, clinical manifestations occur in less than 10%. QT dispersion is a new parameter that can be used to assess homogeneity of cardiac repolarization and autonomic function. We compared the increase in QT dispersion in SLE patients with high disease activity and mild or moderate disease activity.</p> <p>Methods and Results</p> <p>One hundred twenty-four patients with SLE were enrolled in the study. Complete history and physical exam, ECG, echocardiography, exercise test and SLE disease activity index (SLEDAI) were recorded. Twenty patients were excluded on the basis of our exclusion criteria. The patients were divided to two groups based on SLEDAI: 54 in the high-score group (SLEDAI > 10) and 50 in the low-score group (SLEDAI < 10).</p> <p>QT dispersion was significantly higher in high-score group (58.31 ± 18.66 vs. 47.90 ± 17.41 respectively; <it>P </it>< 0.004). QT dispersion was not significantly higher in patients who had received hydroxychloroquine (54.17 ± 19.36 vs. 50.82 ± 15.96, <it>P </it>= 0.45) or corticosteroids (53.58 ± 19.16 vs. 50.40 + 11.59, <it>P </it>= 0.47). There was a statistically significant correlation between abnormal echocardiographic findings (abnormalities of pericardial effusion, pericarditis, pulmonary hypertension and Libman-Sacks endocarditis) and SLEADI (<it>P </it>< 0.004).</p> <p>Conclusions</p> <p>QT dispersion can be a useful, simple noninvasive method for the early detection of cardiac involvement in SLE patients with active disease. Concerning high chance of cardiac involvement, cardiovascular evaluation for every SLE patient with a SLEDAI higher than 10 may be recommended.</p> <p>Trial registration</p> <p>Clinicaltrial.gov registration <a href="http://www.clinicaltrials.gov/ct2/show/NCT01031797">NCT01031797</a></p

Desarrollo de un componente de analítica para la clasificación de textos cortos dirigido a un proyecto institucional e integrable en una plataforma Web

Auxiliar de InvestigaciónLa clasificación de texto es una de las áreas de estudio de la disciplina del aprendizaje de máquina (en inglés Machine Learning) en donde se busca, posterior a una etapa de entrenamiento, predecir una categoría para datos de entrada que no hayan sido clasificados previamente. La longitud de los textos cortos, puede conllevar a una pérdida en la precisión de los resultados entregados por el proceso de clasificación de texto, ya que la cantidad de características aprovechables disminuye. Por lo tanto, se busca explorar una solución que permita realizar tareas de clasificación de textos cortos, con un nivel de precisión cercano al 80 %. Se desarrolló un componente de clasificación de textos cortos en el lenguaje de programación Python, haciendo uso del framework Flask el cual permite peticiones a través de un API y realiza la clasificación datasets que cumplan con el formato de entrada. Se probaron los resultados de este trabajo mediante el uso de publicaciones extraídas desde cuentas de Twitter, debido a la restricción sobre la longitud de sus publicaciones. La clasificación se realizó mediante el uso de algoritmos de aprendizaje supervisado, y en el mejor de los casos, la precisión obtenida fue cercana al 85 %.1. INTRODUCCIÓN 2. MARCO DE REFERENCIA 3. METODOLOGÍA 4. ESTADO DEL ARTE 5. DESARROLLO 6. RESULTADOS 7. CONCLUSIONES 8. TRABAJO FUTURO BIBLIOGRAFÍA ANEXOSPregradoIngeniero de Sistema

Aprendizajes y prácticas educativas en las actuales condiciones de época: COVID-19

“Esta obra colectiva es el resultado de una convocatoria a docentes, investigadores y profesionales del campo pedagógico a visibilizar procesos investigativos y prácticas educativas situadas en el marco de COVI-19. La misma se inscribe en el trabajo llevado a cabo por el equipo de Investigación responsable del Proyecto “Sentidos y significados acerca de aprender en las actuales condiciones de época: un estudio con docentes y estudiantes de la educación secundarias en la ciudad de Córdoba” de la Facultad de Filosofía y Humanidades. Universidad Nacional de Córdoba. El momento excepcional que estamos atravesando, pero que también nos atraviesa, ha modificado la percepción temporal a punto tal que habitamos un tiempo acelerado y angustiante que nos exige la producción de conocimiento provisorio. La presente publicación surge como un espacio para detenernos a documentar lo que nos acontece y, a su vez, como oportunidad para atesorar y resguardar las experiencias educativas que hemos construido, inventado y reinventando en este contexto. En ella encontrarán pluralidad de voces acerca de enseñar y aprender durante la pandemia. Este texto es una pausa para reflexionar sobre el hacer y las prácticas educativas por venir”.Fil: Beltramino, Lucia (comp.). Universidad Nacional de Córdoba. Facultad de Filosofía y Humanidades. Escuela de Archivología; Argentina

Infective endocarditis from Enterococcus faecalis complicating colonoscopy in Heyde's syndrome

A case of infective endocarditis from Enterococcus faecalis after colonoscopy in a patient with aortic stenoinsufficiency and bleeding intestinal angiodysplasia (Heyde's syndrome) is reported. A 77 year old man with aortic stenoinsufficiency presented with enterorrhagia and underwent a colonoscopy, which showed normal findings. Fifteen days later he developed a moderate degree of fever. Blood cultures were positive for E faecalis. An echocardiogram showed aortic valve vegetations, and infective endocarditis was diagnosed and successfully treated by antibiotics. Some months later, intestinal bleeding recurred and intestinal resection was performed. Histopathology showed angiodysplasia. In patients with Heyde's syndrome antibiotic prophylaxis should be considered before colonoscopy

ECG of the Month.

A 10-year-old 17-kg (37-lb) spayed female Italian Spitz was referred to the Veterinary Teaching Hospital of the University of Bologna because of sudden onset of dyspnea (which occurred 24 hours before the referral examination). The referring veterinarian administered prednisone SC without amelioration of the respiratory problem. A diagnosis of chronic mitral valve disease had been made a few months before, and the dog was currently being treated with furosemidea (1 mg/kg [0.45 mg/lb], PO, q 12 h) and benazepril hydrochlorideb (0.25 mg/kg [0.11 mg/lb], PO, q 24 h). No episodes of acute pulmonary edema were previously observed. On physical examination, the dog was obese (body condition score, 8/9). Mild tachypnea was evident (80 breaths/min), but the dog was extremely anxious. The femoral pulse was rhythmic and strong, and heart rate was considered normal (100 beats/min); an olosystolic left-sided heart murmur (grade 3/6) with maximal intensity over the left cardiac apex was ausculted. Auscultation of the lungs revealed no detectable abnormalities. Survey thoracic radiographic views were obtained, and moderate cardiac enlargement was detected (vertebral heart score, 11.3; vertebral heart score for a clinically normal dog, < 10.21). Pulmonary vessels had a normal appearance, and a mildly diffuse interstitial opacity was attributable to fatty infiltration in an obese dog. Transthoracic echocardiography was performed with an ultrasound unitc equipped with a 1- to 5-MHz phased-array transducer and continuous ECG monitoring. Two-dimensional and Doppler echocardiographic findings included mild mitral valve regurgitation due to chronic valve disease, with mild left ventricular and atrial dilation. Results of a CBC, serum biochemical analysis, and urinalysis were unremarkable. Electrocardiography was performed