Cumplimiento de las recomendaciones de prevención secundaria de enfermedad coronaria en pacientes sometidos a revascularización coronaria percutánea en el Hospital Universitario Fundación Santa Fe de Bogotá

Marco de referenciadiferentes ensayos clínicos han mostrado que el efecto de las revascularizaciones y los procedimientos de angioplastia en el pronóstico del paciente, tiene sólo un efecto a corto plazo, mientras que la prevención secundaria (cambio de estilo de vida y tratamiento intensivo) mejora el pronóstico a largo plazo.Objetivoevaluar el cumplimiento de las recomendaciones para prevención cardiovascular secundaria, de los pacientes sometidos a revascularización coronaria percutánea en el hospital universitario Fundación Santa Fe de Bogotá, entre los años 2008 y 2010.Materiales y métodosestudio descriptivo, ambispectivo, cuya población estuvo conformada por 332 pacientes sometidos a intervención coronaria percutánea atendidos entre enero de 2008 a diciembre de 2010 en el servicio de hemodinamia del Hospital Universitario Fundación Santa Fe de Bogotá. La recolección de la información se realizó mediante revisión de las historias clínicas de los pacientes y vía telefónica. Las metas de control se basaron en las recomendaciones de la Asociación Americana del Corazón y el Colegio Americano de Cardiología.Resultados332 pacientes fueron sometidos a revascularización coronaria percutánea y 4 fueron excluidos del estudio por falta de datos. La presentación clínica más frecuente fue la angina inestable (32,93%). Sólo se contactaron 172 (52,43%) pacientes, de los cuales 77,4% eran hombres y 22,6% mujeres. Únicamente 6 (3,5%) cumplían con el 100% de las recomendaciones para la prevención secundaria de enfermedad coronaria y 17% cumplía menos del 50% de éstas.Conclusionesla experiencia en la Fundación Santa Fe de Bogotá muestra un pobre cumplimiento de las metas de prevención secundaria de enfermedad coronaria.Contextdifferent clinical trials have shown that the effect of revascularization and angioplasty procedures in the prognosis of the patient has only a short-term effect, while secondary prevention (lifestyle change and intensive treatment) improves long-term prognosis.Objectiveto assess compliance with the recommendations for secondary prevention of cardiovascular disease in patients undergoing percutaneous coronary revascularization at the University Hospital Fundación Santa Fe de Bogotá, between 2008 and 2010.Materials and methodsa descriptive ambispective study, whose population was conformed by 332 patients undergoing percutaneous coronary intervention seen between January 2008 and December 2010 in the service of hemodynamics of the University Hospital Fundación Santa Fe de Bogotá. The data collection was conducted by reviewing the medical records of the patients and by telephone. Control targets were based on the recommendations of the American Heart Association and the American College of Cardiology.Results332 patients underwent percutaneous coronary revascularization. 4 were excluded from the study due to lack of data. The most common clinical presentation was unstable angina (32.93%). Only 172 patients (52.43%) were contacted. From these, 77.4% were male and 22.6% female. Only 6 (3.5%) met 100% of the recommendations for secondary prevention of coronary heart disease and 17% met less than 50% of these recommendations.Conclusionsthe experience in the Fundación Santa Fe de Bogotá shows a poor compliance with the goals of secondary prevention of coronary disease

Dynamics of the MRSA Population in a Chilean Hospital: a Phylogenomic Analysis (2000-2016)

La diseminación mundial de Staphylococcus aureus resistente a meticilina (SARM) está asociada a la aparición y el establecimiento de clones en zonas geográficas específicas. El clon chileno-cordobés (ChC) (ST5-SCCmecI) ha sido el clon de SARM predominante en Chile desde su primera descripción en 1998, a pesar del informe de otros clones de SARM emergentes en los últimos años. Aquí, caracterizamos la historia evolutiva de MRSA desde 2000 hasta 2016 en un centro de salud terciario chileno utilizando análisis filogenómicos. Secuenciamos 469 aislamientos de SARM recogidos entre 2000 y 2016. Evaluamos las tendencias temporales de los clones circulantes y realizamos una reconstrucción filogenómica para caracterizar la dinámica clonal. Encontramos un aumento significativo en la diversidad y riqueza de tipos de secuencia (STs; Spearman r = 0,8748, P , 0,0001) con un índice de diversidad de Shannon que aumentó de 0,221 en el año 2000 a 1,33 en 2016, y una diversidad efectiva (número de Hill; q = 2) que aumentó de 1,12 a 2,71. El análisis de la tendencia temporal reveló que en el periodo de 2000 a 2003 la mayoría de los aislados (94,2%; n = 98) pertenecían al clon ChC. Sin embargo, desde entonces, la frecuencia del clon ChC ha disminuido con el tiempo, representando el 52% de la colección en el período de 2013 a 2016. Este descenso estuvo acompañado por el aumento de dos linajes emergentes de SARM, ST105-SCCmecII y ST72-SCCmecVI. En conclusión, el clon ChC sigue siendo el linaje MRSA más frecuente, pero este linaje está siendo reemplazado gradualmente por varios clones emergentes, el más importante de los cuales es el clon ST105-SCCmecII. Hasta donde sabemos, éste es el mayor estudio de la dinámica clonal del SARM realizado en Sudamérica. © 2023 Martínez et al.The global dissemination of methicillin-resistant Staphylococcus aureus (MRSA) is associated with the emergence and establishment of clones in specific geographic areas. The Chilean-Cordobes clone (ChC) (ST5-SCCmecI) has been the predominant MRSA clone in Chile since its first description in 1998, despite the report of other emerging MRSA clones in recent years. Here, we characterize the evolutionary history of MRSA from 2000 to 2016 in a Chilean tertiary health care center using phylogenomic analyses. We sequenced 469 MRSA isolates collected between 2000 and 2016. We evaluated the temporal trends of the circulating clones and performed a phylogenomic reconstruction to characterize the clonal dynamics. We found a significant increase in the diversity and richness of sequence types (STs; Spearman r = 0.8748, P , 0.0001) with a Shannon diversity index increasing from 0.221 in the year 2000 to 1.33 in 2016, and an effective diversity (Hill number; q = 2) increasing from 1.12 to 2.71. The temporal trend analysis revealed that in the period 2000 to 2003 most of the isolates (94.2%; n = 98) belonged to the ChC clone. However, since then, the frequency of the ChC clone has decreased over time, accounting for 52% of the collection in the 2013 to 2016 period. This decline was accompanied by the rise of two emerging MRSA lineages, ST105-SCCmecII and ST72-SCCmecVI. In conclusion, the ChC clone remains the most frequent MRSA lineage, but this lineage is gradually being replaced by several emerging clones, the most important of which is clone ST105-SCCmecII. To the best of our knowledge, this is the largest study of MRSA clonal dynamics performed in South America. © 2023 Martínez et al

Dynamics of the Mrsa Population in a Chilean Hospital: a Phylogenomic analysis (2000-2016)

The global dissemination of methicillin-resistant Staphylococcus aureus (MRSA) is associated with the emergence and establishment of clones in specific geographic areas. The Chilean-Cordobes clone (ChC) (ST5-SCCmecI) has been the predominant MRSA clone in Chile since its first description in 1998, despite the report of other emerging MRSA clones in recent years. Here, we characterize the evolutionary history of MRSA from 2000 to 2016 in a Chilean tertiary health care center using phylogenomic analyses. We sequenced 469 MRSA isolates collected between 2000 and 2016. We evaluated the temporal trends of the circulating clones and performed a phylogenomic reconstruction to characterize the clonal dynamics. We found a significant increase in the diversity and richness of sequence types (STs; Spearman r = 0.8748, P \u3c 0.0001) with a Shannon diversity index increasing from 0.221 in the year 2000 to 1.33 in 2016, and an effective diversity (Hill number; q = 2) increasing from 1.12 to 2.71. The temporal trend analysis revealed that in the period 2000 to 2003 most of the isolates (94.2%; n = 98) belonged to the ChC clone. However, since then, the frequency of the ChC clone has decreased over time, accounting for 52% of the collection in the 2013 to 2016 period. This decline was accompanied by the rise of two emerging MRSA lineages, ST105-SCCmecII and ST72-SCCmecVI. In conclusion, the ChC clone remains the most frequent MRSA lineage, but this lineage is gradually being replaced by several emerging clones, the most important of which is clone ST105-SCCmecII. to the best of our knowledge, this is the largest study of MRSA clonal dynamics performed in South America. IMPORTANCE Methicillin-resistant Staphylococcus aureus (MRSA) is a major public health pathogen that disseminates through the emergence of successful dominant clones in specific geographic regions. Knowledge of the dissemination and molecular epidemiology of MRSA in Latin America is scarce and is largely based on small studies or more limited typing techniques that lack the resolution to represent an accurate description of the genomic landscape. We used whole-genome sequencing to study 469 MRSA isolates collected between 2000 and 2016 in Chile providing the largest and most detailed study of clonal dynamics of MRSA in South America to date. We found a significant increase in the diversity of MRSA clones circulating over the 17-year study period. Additionally, we describe the emergence of two novel clones (ST105-SCCmecII and ST72-SCCmecVI), which have been gradually increasing in frequency over time. Our results drastically improve our understanding of the dissemination and update our knowledge about MRSA in Latin America

The genetic ancestry of American Creole cattle inferred from uniparental and autosomal genetic markers

Cattle imported from the Iberian Peninsula spread throughout America in the early years of discovery and colonization to originate Creole breeds, which adapted to a wide diversity of environments and later received influences from other origins, including zebu cattle in more recent years. We analyzed uniparental genetic markers and autosomal microsatellites in DNA samples from 114 cattle breeds distributed worldwide, including 40 Creole breeds representing the whole American continent, and samples from the Iberian Peninsula, British islands, Continental Europe, Africa and American zebu. We show that Creole breeds differ considerably from each other, and most have their own identity or group with others from neighboring regions. Results with mtDNA indicate that T1c-lineages are rare in Iberia but common in Africa and are well represented in Creoles from Brazil and Colombia, lending support to a direct African influence on Creoles. This is reinforced by the sharing of a unique Y-haplotype between cattle from Mozambique and Creoles from Argentina. Autosomal microsatellites indicate that Creoles occupy an intermediate position between African and European breeds, and some Creoles show a clear Iberian signature. Our results confirm the mixed ancestry of American Creole cattle and the role that African cattle have played in their development

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

The genetic ancestry of american creole cattle inferred from uniparental and autosomal genetic markers.

Cattle imported from the Iberian Peninsula spread throughout America in the early years of discovery and colonization to originate Creole breeds, which adapted to a wide diversity of environments and later received influences from other origins, including zebu cattle in more recent years. We analyzed uniparental genetic markers and autosomal microsatellites in DNA samples from 114 cattle breeds distributed worldwide, including 40 Creole breeds representing the whole American continent, and samples from the Iberian Peninsula, British islands, Continental Europe, Africa and American zebu. We show that Creole breeds differ considerably from each other, and most have their own identity or group with others from neighboring regions. Results with mtDNA indicate that T1c-lineages are rare in Iberia but common in Africa and are well represented in Creoles from Brazil and Colombia, lending support to a direct African influence on Creoles. This is reinforced by the sharing of a unique Y-haplotype between cattle from Mozambique and Creoles from Argentina. Autosomal microsatellites indicate that Creoles occupy an intermediate position between African and European breeds, and some Creoles show a clear Iberian signature. Our results confirm the mixed ancestry of American Creole cattle and the role that African cattle have played in their development

Six years of experience in percutaneous closure of interatrial septal defects

MARCO DE REFERENCIA: los defectos del tabique interauricular son anormalidades congénitas del tabique interauricular que comprenden la comunicación interauricular y el foramen oval permeable. OBJETIVO: analizar y evaluar los resultados del cierre percutáneo con dispositivo percutáneo de pacientes con defectos del tabique interauricular en el Hospital Universitario Santa Fe de Bogotá desde la introducción de esta técnica en 2005 hasta 2011. MATERIALES Y MÉTODOS: se realizó un estudio descriptivo ambispectivo. La población estuvo conformada por pacientes adultos, independiente de edad y género, a quienes se les realizó cierre percutáneo de cualquier defecto del septo interauricular desde la introducción de esta técnica en enero 1º. de 2005 hasta junio de 2011 en el servicio de hemodinamia del Hospital Universitario Fundación Santa Fe de Bogotá. RESULTADOS: durante el periodo se hicieron 53 procedimientos de corrección de defecto del tabique interauricular por vía percutánea, en los que se usó dispositivo Amplatzer en 94,3% de los casos. El 75% (27 pacientes) se trataron de manera ambulatoria, dándose de alta luego de cuatro horas de efectuado el procedimiento. El 29,8% fueron hombres y 70,2% mujeres, con edad promedio de 52,2 ± 15,1 años. 57,8% de los pacientes tuvo foramen oval permeable y de éstos 54,5% tenía aneurisma asociado; el porcentaje restante, 42%, fue intervenido por comunicación interauricular. CONCLUSIONES: la experiencia en la Fundación Santa Fe de Bogotá muestra un excelente resultado con muy baja tasa de complicaciones, mejorías clínicas en el seguimiento a largo plazo y gran seguridad, factores que permiten que este procedimiento se lleve a cabo de manera ambulatoria.CONTEXT: atrial septal defects are congenital atrial septal abnormalities that comprise the interatrial communication (IAC) and the patent foramen ovale (PFO). OBJECTIVE: to analyze and evaluate the results of percutaneous closure with device in patients with interatrial septal defects in the University Hospital Santa Fe de Bogotá since the introduction of this technique in 2005 to 2011. MATERIALS AND METHODS: descriptive ambispective study. The population consisted of adult patients, regardless of age and gender, who underwent percutaneous closure of any atrial septal defect since the introduction of this technique in January 1st. 2005 to June 2011 in the service of hemodynamics of the University Hospital Fundación Santa Fe de Bogotá. RESULTS: during this period, 53 procedures of percutaneous correction of the atrial septal defect were performed, using the Amplatzer device in 94.3% cases. 75% (27 patients) were treated on an outpatient basis, being discharged four hours after the performance of the procedure. 29.8% were men and 70.2% women with mean age 52.2 ± 15.1 years. 57.8% of patients had patent foramen ovale and of these, 54.5% had associated aneurysm. The remainder 42%, was operated for interatrial communication. CONCLUSIONS: the experience in the Fundación Santa Fe de Bogota shows excellent results with a very low complication rate and clinical improvements in the long-term follow-up, factors that allow that this procedure can be performed on an outpatient basis

Cumplimiento de las recomendaciones de prevención secundaria de enfermedad coronaria en pacientes sometidos a revascularización coronaria percutánea en el Hospital Universitario Fundación Santa Fe de Bogotá

diferentes ensayos clínicos han mostrado que el efecto de las revascularizaciones y los procedimientos de angioplastia en el pronóstico del paciente, tiene sólo un efecto a corto plazo, mientras que la prevención secundaria (cambio de estilo de vida y tratamiento intensivo) mejora el pronóstico a largo plazo. Objetivo: evaluar el cumplimiento de las recomendaciones para prevención cardiovascular secundaria, de los pacientes sometidos a revascularización coronaria percutánea en el hospital universitario Fundación Santa Fe de Bogotá, entre los años 2008 y 2010. Materiales y métodos: estudio descriptivo, ambispectivo, cuya población estuvo conformada por 332 pacientes sometidos a intervención coronaria percutánea atendidos entre enero de 2008 a diciembre de 2010 en el servicio de hemodinamia del Hospital Universitario Fundación Santa Fe de Bogotá. La recolección de la información se realizó mediante revisión de las historias clínicas de los pacientes y vía telefónica. Las metas de control se basaron en las recomendaciones de la Asociación Americana del Corazón y el Colegio Americano de Cardiología. Resultados: 332 pacientes fueron sometidos a revascularización coronaria percutánea y 4 fueron excluidos del estudio por falta de datos. La presentación clínica más frecuente fue la angina inestable (32,93%). Sólo se contactaron 172 (52,43%) pacientes, de los cuales 77,4% eran hombres y 22,6% mujeres. Únicamente 6 (3,5%) cumplían con el 100% de las recomendaciones para la prevención secundaria de enfermedad coronaria y 17% cumplía menos del 50% de éstas. Conclusiones: la experiencia en la Fundación Santa Fe de Bogotá muestra un pobre cumplimiento de las metas de prevención secundaria de enfermedad coronaria