Efecto de la Ablación por Catéter Sobre Ciertas Estructuras Auriculares de Pacientes con Fibrilación Auricular Paroxística: El Caso del Seno Coronario

[ES] Numerosos estudios previos han reportado alteraciones significativas de varias características de la onda P en el electrocardiograma (ECG) de superficie tras un procedimiento de ablacion por cateter (AC) de fibrilación auricular paroxística (FAP). Sin embargo, no se ha reportado resultado alguno sobre una de las estructuras auriculares mas empleada como referencia en el registro de señales invasivas durante procedimientos de AC, como es el seno coronario (SC). Para indagar en este asunto, este estudio utiliza registros bipolares del SC de 26 pacientes sometidos a AC de FAP. Los registros fueron grabados en ritmo sinusal (RS) y duraron 5 minutos. El trabajo incluye la deteccion y el analisis de las siguiente características de ondas de activacion local (OALs): duracion, amplitud, ¿ area positiva y negativa, variabilidad morfologica (VM), dispersión y el número de tramos crecientes y decrecientes (NTCD). Las características mencionadas se compararon antes y despues de la AC usando el test U de Mann-Whitney, calculando tambien sus valores medianos. Duracion, amplitud y áreas positivas y negativas marcaron un moderado decrecimiento (de ¿1,42 % a ¿14,28 %). La VM y la dispersion se incrementaron (de +1,20 % a +64,81 %). No se encontro ninguna alteracion en el NTCD. En consecuencia, los resultados obtenidos coincidieron en su mayor parte con hallazgos similares reportados sobre la onda P del ECG en trabajos previos. No obstante, las características de las OALs en registros bipolares del SC no sufrieron una alteracion significativa por causa de la AC (p > 0,05). En consecuencia, las mayores alteraciones observadas en estudios sobre la onda P del ECG deben provenir, posiblemente, de otras areas auriculares alejadas del SC o son ¿ una superposicion de alteraciones de menor nivel que tienen lugar en multiples zonas auriculares.El presente trabajo ha sido cofinanciado por los proyectos de investigacion competitiva DPI2017-83952-C3 de MINECO-AEI-FEDER-UE, SBPLY/17/180501/000411 de la JCCLM y AICO/2019/036 de la GVA.Vraka, A.; Bertomeu-González, V.; Hornero Sos, F.; Quesada Dorador, A.; Alcaraz Martínez, R.; Rieta, JJ. (2020). Efecto de la Ablación por Catéter Sobre Ciertas Estructuras Auriculares de Pacientes con Fibrilación Auricular Paroxística: El Caso del Seno Coronario. Sociedad Española de Ingeniería Biomédica. 105-108. http://hdl.handle.net/10251/17827310510

Confiabilidad de las Ondas de Activación Local para Evaluar el Sustrato Auricular de Pacientes con Fibrilación Auricular Paroxística

[ES] El análisis de electrogramas (EGMs) del seno coronario (SC) durante la ablación por catérer (AC) de fibrilación auricular (FA) es clave para la evaluación del sustrato auricular. No obstante, los canales del catéter de registro suelen verse afectados por mal contacto y por el movimiento cardíaco. Este trabajo estudia los canales más fiables para preservar las dinámicas de la FA durante el ritmo sinusal (RS). Se han empleado 44 registros bipolares multicanal del SC de 60-300 segundos de 28 pacientes con FA paroxística sometidos a AC. Cada registro contenía cinco canales: distal, medio-distal, medio, medio-proximal, proximal. En cada canal se calcularon características de las ondas de activación local (OALs): duración, área y correlación entre morfologías dominantes. Se han utilizado los tests de KruskalWallis, Mann-Whitney y Mann-Whitney con corrección de Bonferroni para la comparación multicanal, por pares y uno frente a los demás, respectivamente. El canal distal presentó resultados menos fiables, con OALs de duración larga (p = 0,047), amplitud baja (pmax < 0,003) y menos área (pmax < 0,020) y con correlación entre sus OALs y las OALs del canal proximal relativamente baja (85,57 %). Las OALs entre los canales medio y medio-próximal fueron más consistentes, con correlación entre sus OALs muy altas (95,02 %), presentando además duración más corta (p = 0,084) y amplitud (pmax < 0,050) y áreas mayores (pmax < 0,070). En consecuencia, los canales medios y medio-proximales son más robustos, preservando al máximo las dinámicas de la FA, por ello se aconseja su empleo para evaluar el sustrato auricular de pacientes con FA durante el RS.Trabajo cofinanciado por los proyectos de investigación competitiva DPI2017-83952-C3 de MINECO-AEIFEDER-UE, SBPLY/17/180501/000411 de la JCCLM y AICO/2019/036 de la GVA.Vraka, A.; Hornero Sos, F.; Bertomeu-González, V.; Osca Asensi, J.; Alcaraz Martínez, R.; Rieta, JJ. (2020). Confiabilidad de las Ondas de Activación Local para Evaluar el Sustrato Auricular de Pacientes con Fibrilación Auricular Paroxística. Sociedad Española de Ingeniería Biomédica. 430-433. http://hdl.handle.net/10251/178274S43043

γ-Tocotrienol suppresses prostate cancer cell proliferation and invasion through multiple-signalling pathways

Tocotrienol-rich fraction (TRF) has demonstrated antiproliferative effect on prostate cancer (PCa) cells. To elucidate this anticancer property in PCa cells, this study aimed, first, to identify the most potent isomer for eliminating PCa cells; and second, to decipher the molecular pathway responsible for its activity. Results showed that the inhibitory effect of γ-tocotrienol was most potent, which resulted in induction of apoptosis as evidenced by activation of pro-caspases and the presence of sub-G1 cell population. Examination of the pro-survival genes revealed that the γ-tocotrienol-induced cell death was associated with suppression of NF-κB, EGF-R and Id family proteins (Id1 and Id3). Meanwhile, γ-tocotrienol treatment also resulted in the induction of JNK-signalling pathway and inhibition of JNK activity by a specific inhibitor (SP600125) was able to partially block the effect of γ-tocotrienol. Interestingly, γ-tocotrienol treatment led to suppression of mesenchymal markers and the restoration of E-cadherin and γ-catenin expression, which was associated with suppression of cell invasion capability. Furthermore, a synergistic effect was observed when cells were co-treated with γ-tocotrienol and Docetaxel. Our results suggested that the antiproliferative effect of γ-tocotrienol act through multiple-signalling pathways, and demonstrated for the first time the anti-invasion and chemosensitisation effect of γ-tocotrienol against PCa cells

Comparison of Risk Stratification Scores in Pulmonary Arterial Hypertension: A Monocentric Retrospective Study at Lausanne University Hospital.

Risk assessment is the cornerstone of pulmonary arterial hypertension (PAH) management. Risk stratification scores predict prognosis and help individualize treatment. The aims of the study include the following: (1) to compare the prediction for transplant-free survival (TFs) of 3 risk assessment tools at 3 and 5 years after diagnosis and (2) to analyze whether the initial risk stratification was altered after 1 year of treatment. We collected retrospectively data of 50 patients diagnosed with PAH Group 1. We categorized them as low, intermediate, and high mortality risk at baseline and at 1 year with the (1) Registry to Evaluate Early and Long-Term PAH Disease Management (REVEAL) risk score version 2.0, (2) Swedish/Comparative Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension (PH) (COMPERA) score, and (3) French PH Network Registry (FPHR) score. TFs at 3 years is predicted by the 3 scores computed at baseline with an area under the curve (AUC) of 0.73, 0.73, and 0.77, respectively. The predictive value increased when the scores were calculated after 1 year of treatment (AUC = 0.91, 0.89, and 0.78). The prediction of TFs at 5 years was better evaluated by the COMPERA and FPHR (AUC = 0.85) than by REVEAL 2.0 (AUC = 0.69) computed at baseline. A low risk status was associated with excellent TFs whatever the scoring used. In accordance with the original publications, the 3 scores are able to predict survival up to 5 years after diagnosis. The better performance of the scores after 1 year is a further evidence for their clinical use and an indirect proof for treatment efficacy

Synergistic induction of prostate cancer cell death by g-tocotrienol and lovastatin is mediated by direct geranylgeranyl pyrophosphate inhibition through a caspase-independent pathway

The definitive version is available at www.blackwell-synergy.com © Federation of European Biochemical SocietiesOdysseos A. D., Vraka P. S., Liapis V., Hay, S. and Evdokiou A

Biologic Treatments in Interstitial Lung Diseases

Interstitial lung diseases (ILD) represent a group of heterogeneous parenchymal lung disorders with complex pathophysiology, characterized by different clinical and radiological patterns, ultimately leading to pulmonary fibrosis. A considerable proportion of these disease entities present with no effective treatment, as current therapeutic regimens only slow down disease progression, thus leaving patients, at best case, with considerable functional disability. Biologic therapies have emerged and are being investigated in patients with different forms of ILD. Unfortunately, their safety profile has raised many concerns, as evidence shows that they might cause or exacerbate ILD status in a subgroup of patients. This review article aims to summarize the current state of knowledge on their role in patients with ILD and highlight future perspectives. © Copyright © 2019 Karampitsakos, Vraka, Bouros, Liossis and Tzouvelekis

Nurses&apos; burnout and associated risk factors during the COVID-19 pandemic: A systematic review and meta-analysis

Aims: To examine the nurses&apos; burnout and associated risk factors during the COVID-19 pandemic. Design: We followed the Cochrane criteria and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines for this systematic review and meta-analysis. Data Sources: PubMed, Scopus, ProQuest, Cochrane COVID-19 registry, CINAHL and pre-print services (medRχiv and PsyArXiv) were searched from January 1 to November 15, 2020 and we removed duplicates. Review Methods: We applied a random effect model to estimate pooled effects since the heterogeneity between results was very high. Results: Sixteen studies, including 18,935 nurses met the inclusion criteria. The overall prevalence of emotional exhaustion was 34.1%, of depersonalization was 12.6% and of lack of personal accomplishment was 15.2%. The main risk factors that increased nurses&apos; burnout were the following: younger age, decreased social support, low family and colleagues readiness to cope with COVID-19 outbreak, increased perceived threat of Covid-19, longer working time in quarantine areas, working in a high-risk environment, working in hospitals with inadequate and insufficient material and human resources, increased workload and lower level of specialized training regarding COVID-19. Conclusion: Nurses experience high levels of burnout during the COVID-19 pandemic, while several sociodemographic, social and occupational factors affect this burnout. Impact: We found that burnout among nurses is a crucial issue during the COVID-19 pandemic. There is an urgent need to prepare nurses to cope better with COVID-19 pandemic. Identification of risk factors for burnout could be a significant weapon giving nurses and health care systems the ability to response in a better way against the following COVID-19 waves in the near future. © 2021 John Wiley &amp; Sons Lt

Seroprevalence of SARS-CoV-2 antibodies and associated factors in healthcare workers: a systematic review and meta-analysis

Background: Healthcare workers (HCWs) represent a high-risk population for infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Aim: To determine the seroprevalence of SARS-CoV-2 antibodies among HCWs, and identify the factors associated with this seroprevalence. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were applied for this systematic review and meta-analysis. Databases including PubMed/MEDLINE and preprint services (medRχiv and bioRχiv) were searched from inception to 24th August 2020. Findings: Forty-nine studies including 127,480 HCWs met the inclusion criteria. The estimated overall seroprevalence of SARS-CoV-2 antibodies among HCWs was 8.7% (95% confidence interval 6.7–10.9%). Seroprevalence was higher in studies conducted in North America (12.7%) compared with those conducted in Europe (8.5%), Africa (8.2) and Asia (4%). Meta-regression showed that increased sensitivity of antibody tests was associated with increased seroprevalence. The following factors were associated with seropositivity: male gender; Black, Asian and Hispanic HCWs; work in a coronavirus disease 2019 (COVID-19) unit; patient-related work; front-line HCWs; healthcare assistants; shortage of personal protective equipment; self-reported belief of previous SARS-CoV-2 infection; previous positive polymerase chain reaction test; and household contact with suspected or confirmed cases of COVID-19. Conclusion: The seroprevalence of SARS-CoV-2 antibodies among HCWs is high. Excellent adherence to infection prevention and control measures; sufficient and adequate personal protective equipment; and early recognition, identification and isolation of HCWs infected with SARS-CoV-2 are imperative to decrease the risk of SARS-CoV-2 infection. © 2020 The Healthcare Infection Societ