Transfusion related acute lung injury-TRALI: a review

Acute pulmonary damage caused by transfusion is characterized by the sudden onset of respiratory distress in newly transfused patients within 6 hours after the transfusion, bilateral infiltrative changes in chest X-ray, PaO2/FIO2 <300 mmHg, absence of other risk factors for acute lung injury and absence of signs suggesting cardiogenic origin of pulmonary edema. Being one of the most serious complications of blood transfusion, plasma is the most involved factor, although all blood components can cause it, and is caused by antigen reactions/leukocyte antibody and lipid activity with ability to modify the biological response on primitive leukocytes. The diagnosis is based on the integration of clinical, radiological and gasometric elements, ruling out the rest of the possible causes of acute lung injury. Its differential diagnosis should include hemodynamic overload, anaphylactic reaction, bacterial contamination of transfused blood products and transfusion hemolytic reaction. The treatment is supportive measures based on the needs and does not differ from the treatment of acute lung injury secondary to other etiologies, severe cases require endotracheal intubation and mechanical ventilation while the non-severe can be managed with oxygen therapy

The neurobiology of splitbrain crayfish

Background: They crayfish brain is segmented into two symmetrical hemiganglia. Normally both hemiganglia are in direct communication through a series of well-defined neural bridges that cross de midline to form reciprocal cross connections.Methods: An original study was carried out in the Department of Physiology of the Faculty of Medicine, UNAM during the period from August 2019 to August 2020. 13 Crayfish Procambarus clarkii weighing between 1g to 30g were used. Each eyestalk of the animals was tied to a displacement transducer coupled with a polygraph so that optomotor or electrical activity was bilaterally recorded. The separation of the right from the left hemiganglia from the cerebral or supraesophageal ganglion was performed with a sagittal section, splitbrain (SB).Results: The normal photo motor reflex in crayfish eye is measured as a gradual decrease in the ERG amplitude. During tactile stimulation, the visual activation of both eyestalks in normal crayfish leads to a highly regular bilateral activity. The regular activity can only be altered by disturbing the mechanoreceptors located in the shell surrounding the eyestalks.Conclusions: The procedure presented in this article provides unique characteristics for the study of the nervous system such as a detailed response of the bilateral optomotor reflex

Chronic venous insufficiency: a review

Chronic venous insufficiency (CVI) comprises a complete spectrum of morphological and functional abnormalities of the venous system1 including any long-term functional and morphological alteration. CVI accounts for several abnormalities of the venous system. It is a highly prevalent disease that causes serious economic consequences, a decrease in the quality of life and can lead to serious complications. An exhaustive review was performed with the available literature, using the PubMed, ScienceDirect, Scopus and Cochrane databases from 2004 to 2021. The search criteria were formulated to identify reports related to chronic venous insufficiency. The pathophysiology of chronic venous insufficiency begins with chronic venous hypertension and the dilation of the vessel, this leads to a series of pathological changes in the venous wall and surrounding tissues, in advanced stages of CVI, skin lesions are associated with an increased proliferation of skin capillaries and microcirculatory abnormalities that may be the result of an altered level of factors responsible for the angiogenic response, such as vascular endothelial growth factor (VEGF), fibroblast growth factor 2 (FGF2) and angiostatin. In this review, updates on pathophysiology, clinic, diagnosis, classification and treatment of this disease are analyzed, with special emphasis on therapeutic options. Chronic venous insufficiency is a disease that affects the patient at several levels, mainly diminishing his/her quality of life. Currently there are various treatments ranging from habit modifications, pharmacological, to endovenous and surgical treatment.

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

El papel de las mujeres en la política española: el caso del PSOE Women's role in the spanish politics: the PSOE case

En este artículo se analiza la incorporación de las mujeres en los distintos niveles de la vida política, como puede ser, los partidos políticos y las instituciones representativas. Los aspectos sobre los que ha versado el mismo son las medidas o acciones que han desarrollado el Partido Socialista Obrero Español entorno a la democracia paritaria, para así poder evaluar las consecuencias que han producido sobre la propia organización partidista, y sobre aquellos ámbitos institucionales donde han obtenido representación (Cortes Generales, Parlamentos Autonómicos, y Ayuntamientos) para averiguar hasta que punto la integración de las mujeres en la vida política es real, o sólo obedece a intereses partidistas.<br>This article analyzes women incorporation in different levels of political life, namely in the political parties and representative institutions. The aspects it focused on were the actions taken by the PSOE (Spanish Labour Socialist Party) in relation to the paritary democracy, so as to properly evaluate the consequences produced on the organization party itself and on those institutional areas where they have obtained representation (General Spanish Parliament, Autonomous Parliaments, and City Halls), to observe whether women are actually committed to political life or such integration only obeys to political party interests

Risk factors for death, stroke, and bleeding in 28,628 patients from the GARFIELD-AF registry: Rationale for comprehensive management of atrial fibrillation

Backgroun

Risk Profile and 1-Year Outcome of Newly Diagnosed Atrial Fibrillation in Japan - Insights From GARFIELD-AF -

Background: Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective non-interventional study of stroke prevention in patients with newly diagnosed non-valvular AF (NAVF) that is being conducted in 35 countries

International trends in clinical characteristics and oral anticoagulation treatment for patients with atrial fibrillation: Results from the GARFIELD-AF, ORBIT-AF I, and ORBIT-AF II registries

Background Atrial fibrillation (AF) is the most common cardiac arrhythmia in the world. We aimed to provide comprehensive data on international patterns of AF stroke prevention treatment