Adherencia al tratamiento farmacológico y no farmacológico en pacientes con falla cardiaca

Consequences of non-adherence to treatment are expressed in various spheres of the individual's life, in various components of the health system and in the population's morbidity and mortality, which generates repercussions in the medical and economical aspects and in the individual’s life quality. Objective: To determine the prevalence of adherence to pharmacological and non-pharmacological treatment in patients with heart failure. Methods: A cross sectional study was conducted in patients with heart failure during 2012 in the Heart Failure and Heart Transplant Clinic of the Fundación Cardiovascular de Colombia. 161 adult patients were included with the diagnosis of heart failure. Adherence to pharmacological and non-pharmacological treatment was evaluated as well as compliance of the patients with heart failure. Results: 80.12% (n=129; 95% CI 73.11 – 85.98%) of the patients are often adhered to pharmacological and non-pharmacological treatment, compliance to pharmacological treatment with the Morisky-Green test was of 53.42% (n=86; 95% CI 45.39 - 61.3%). Conclusions: The results of this study are an approach to the problem of adherence to pharmacological and non-pharmacological treatment of patients with heart failure. It is recommended for future researches, the realization of multicenter studies with probabilistic samplings.Las consecuencias de la no adherencia al tratamiento se expresan en diversas esferas de la vida de la persona, en diversos componentes del sistema de salud y en el cuadro de morbilidad y mortalidad de la población, lo cual genera grandes repercusiones desde el punto de vista médico, económico y en la calidad de vida de la persona. Objetivo: Determinar la prevalencia de adherencia al tratamiento farmacológico y no farmacológico en pacientes con falla cardiaca. Métodos: Se realizó un estudio de corte transversal en pacientes con falla cardiaca en el 2012 en la Clínica de Falla Cardiaca y Trasplante Cardiaco de la Fundación Cardiovascular de Colombia. Se incluyeron 161 pacientes adultos con diagnóstico médico de falla cardiaca. Se evaluó la adherencia al tratamiento farmacológico y no farmacológico y el cumplimiento en los pacientes con falla cardiaca. Resultados: El 80.12% (n=129; IC 95% 73.11 - 85.98%) de los pacientes se encuentra frecuentemente adheridos al tratamiento farmacológico y no farmacológico, el cumplimiento al tratamiento farmacológico con el test de Morisky-Green fue de 53.42% (n=86; IC 95% 45.39 - 61.3%). Conclusiones: Los resultados del presente estudio son un acercamiento a la problemática de la adherencia al tratamiento farmacológico y no farmacológico de los pacientes con falla cardiaca. Se recomienda para futuras investigaciones, la realización de estudios multicéntricos con muestreos probabilísticos

IL18 Gene Variants Influence the Susceptibility to Chagas Disease

Chagas disease is a parasitic disorder caused by the infection with the flagellated protozoan Trypanosoma cruzi. According to the World Health Organization, more than six million people are currently infected in endemic regions. Genetic factors have been proposed to influence predisposition to infection and development of severe clinical phenotypes like chronic Chagas cardiomyopathy (CCC). Interleukin 18 (IL18) encodes a proinflammatory cytokine that has been proposed to be involved in controlling T. cruzi infection. In this study, we analyzed the possible role of six IL18 gene variants (rs5744258, rs360722, rs2043055, rs187238, rs1946518 and rs360719), which cover most of the variation within the locus, in the susceptibility to infection by T. cruzi and/or CCC. In total, 1,171 individuals from a Colombian region endemic for Chagas disease, classified as seronegative (n = 595), seropositive asymptomatic (n = 175) and CCC (n = 401), were genotyped using TaqMan probes. Significant associations with T. cruzi infection were observed when comparing seronegative and seropositive individuals for rs187238 (P = 2.18E-03, OR = 0.77), rs360719 (P = 1.49E-03, OR = 0.76), rs2043055 (P = 2.52E-03, OR = 1.29), and rs1946518 (P = 0.0162, OR = 1.22). However, dependence analyses suggested that the association was mainly driven by the polymorphism rs360719. This variant is located within the promoter region of the IL18 gene, and it has been described that it creates a binding site for the transcription factor OCT-1 affecting IL-18 expression levels. In addition, no evidence of association was observed between any of the analyzed IL18 gene polymorphisms and the development of CCC. In summary, our data suggest that genetic variation within the promoter region of IL18 is directly involved in the susceptibility to infection by T. cruzi, which provides novel insight into disease pathophysiology and adds new perspectives to achieve a more effective disease control.This work is part of the doctoral thesis “Estudio de las bases genéticas de la enfermedad de Chagas” from the Biomedicine PhD program at the Universidad de Granada (Spain).Peer reviewe

Análisis de tecnologías para la transformación de material aglomerado de madera con fines de reciclaje

Los Tableros de Partículas y Tableros de Fibra de madera están compuestos de agua y aglomerantes como la urea-formaldehido que hacen su proceso de degradación más lento. En la transformación de tablero se generan residuos que son utilizados como combustible o depositados en vertederos municipales, lo cual es perjudicial para el medio ambiente debido a las sustancias químicas nocivas utilizadas en el proceso de adhesión y conformación del tablero. El objetivo de este trabajo es realizar una búsqueda de tecnologías para la transformación de los residuos de material aglomerado de madera, con fines de reúso o reciclaje. Se realizó una identificación de palabras clave, se elaboró una ecuación de búsqueda, se ejecutó en dos bases de datos científicas y en  webgrafía. Los resultados fueron analizados para orientar la aplicación de los procesos de transformación. Como resultados se  analizaron 31 artículos de investigación, 6 casos de uso, se concluyen 7 procesos químicos y 5 procesos físicos

Within-individual phenotypic plasticity in flowers fosters pollination niche shift

Phenotypic plasticity, the ability of a genotype of producing different phenotypes when exposed to different environments, may impact ecological interactions. We study here how within-individual plasticity in Moricandia arvensis flowers modifies its pollination niche. During spring, this plant produces large, cross-shaped, UV-reflecting lilac flowers attracting mostly long-tongued large bees. However, unlike most co-occurring species, M. arvensis keeps flowering during the hot, dry summer due to its plasticity in key vegetative traits. Changes in temperature and photoperiod in summer trigger changes in gene expression and the production of small, rounded, UV-absorbing white flowers that attract a different assemblage of generalist pollinators. This shift in pollination niche potentially allows successful reproduction in harsh conditions, facilitating M. arvensis to face anthropogenic perturbations and climate change.Ministerio de Economía y Competitividad | Ref. CGL2015-71634-PMinisterio de Economía y Competitividad | Ref. CGL2015-63827-PAgencia Estatal de Investigación | Ref. CGL2017-86626-C2-1-PAgencia Estatal de Investigación | Ref. CGL2017-86626-C2-2-PMinisterio de Economía y Competitividadd | Ref. UNGR15-CE-3315Ministerio de Economía y Competitividad | Ref. RYC-2012-12277Ministerio de Economía y Competitividad | Ref. UNGR15-CE-3315Junta de Andalucía | Ref. P18-FR-3641Fundación BBVA | Ref. PR17_ECO_0021Xunta de Galici

Synthesis, Structure, and Biological Assays of Novel Trifluoromethyldiazepine–Metal Complexes

A new series of CuII, NiII, CoII, and MnIII complexes have been synthesised from the (6Z)-6-(7-trifluoromethyl-1,2,3,4-tetrahydro-5H-1,4-diazepin-5-ylidene)cyclohexa-2,4-dien-1-one (HDZP) ligand. These complexes were characterised by elemental, spectroscopic (IR and UV-vis), and thermal analysis. The crystal structure of Cu-DZP was solved by X-ray diffraction methods. The complex crystallises in the monoclinic P21/c space group, with two molecules per unit cell. The crystal lattice is stabilised by different intra and intermolecular interactions. Hirshfeld surface analysis was employed to obtain additional information about interactions that are responsible for the crystal packing. Quantitative examination of the fingerprint plots indicated the dominant contribution of H⋯H and H⋯X (X = O, F) interactions in the crystal packing. In addition, C-H⋯chelate ring (CR) and C-H⋯π interactions are described in detail and evaluated using DFT calculations. The antibacterial properties and the mechanism of inhibition of the main bacterial resistant mechanism, the biofilm, of the metal complexes and free ligand were investigated. [Mn(DZP)3]·2H2O was the most active complex against the Pseudomonas aeruginosa biofilm formation with an inhibition of 40 %. However, none of the complexes inhibit more than 25 % of the Gram negative bacteria microbial development. The most meaningful result was the bactericidal effect of [Co(DZP)2(H2O)2]·2H2O against the Gram positive bacteria, Staphylococcus aureus, which inhibits the bacterial development and significantly reduces the biofilm formation at low concentration.Fil: Rocha, Mariana. Universidad Nacional de Tucumán; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Instituto de Química del Noroeste. Universidad Nacional de Tucumán. Facultad de Bioquímica, Química y Farmacia. Instituto de Química del Noroeste; ArgentinaFil: Echeverría, Gustavo Alberto. Facultad de Ciencias Exactas, Universidad Nacional de la Plata; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Física La Plata. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Instituto de Física La Plata; ArgentinaFil: Piro, Oscar Enrique. Facultad de Ciencias Exactas, Universidad Nacional de la Plata; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Física La Plata. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Instituto de Física La Plata; ArgentinaFil: Jios, Jorge Luis. Facultad de Ciencias Exactas, Universidad Nacional de la Plata; ArgentinaFil: Molina, Rocío Daniela Inés. Universidad Nacional de Tucumán; Argentina. Universidad Nacional de Tucumán. Instituto de Biotecnología Farmacéutica y Alimentaria. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Instituto de Biotecnología Farmacéutica y Alimentaria; ArgentinaFil: Arena, Mario Eduardo. Universidad Nacional de Tucumán; Argentina. Universidad Nacional de Tucumán. Instituto de Biotecnología Farmacéutica y Alimentaria. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Instituto de Biotecnología Farmacéutica y Alimentaria; ArgentinaFil: Ulic, Sonia Elizabeth. Facultad de Ciencias Exactas, Universidad Nacional de la Plata; Argentina. Universidad Nacional de Luján; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Química Inorgánica "Dr. Pedro J. Aymonino". Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Centro de Química Inorgánica "Dr. Pedro J. Aymonino"; ArgentinaFil: Gil, Diego Mauricio. Universidad Nacional de Tucumán; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Instituto de Química del Noroeste. Universidad Nacional de Tucumán. Facultad de Bioquímica, Química y Farmacia. Instituto de Química del Noroeste; Argentin

Contemporary characteristics and outcomes in chagasic heart failure compared with other nonischemic and ischemic cardiomyopathy

Background: Chagas’ disease is an important cause of cardiomyopathy in Latin America. We aimed to compare clinical characteristics and outcomes in patients with heart failure (HF) with reduced ejection fraction caused by Chagas’ disease, with other etiologies, in the era of modern HF therapies. Methods and Results: This study included 2552 Latin American patients randomized in the PARADIGM-HF (Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure) and ATMOSPHERE (Aliskiren Trial to Minimize Outcomes in Patients With Heart Failure) trials. The investigator-reported etiology was categorized as Chagasic, other nonischemic, or ischemic cardiomyopathy. The outcomes of interest included the composite of cardiovascular death or HF hospitalization and its components and death from any cause. Unadjusted and adjusted Cox proportional hazards models were performed to compare outcomes by pathogenesis. There were 195 patients with Chagasic HF with reduced ejection fraction, 1300 with other nonischemic cardiomyopathy, and 1057 with ischemic cardiomyopathy. Compared with other etiologies, Chagasic patients were more often female, younger, and had lower prevalence of hypertension, diabetes mellitus, and renal impairment (but had higher prevalence of stroke and pacemaker implantation) and had worse health-related quality of life. The rates of the composite outcome were 17.2, 12.5, and 11.4 per 100 person-years for Chagasic, other nonischemic, and ischemic patients, respectively—adjusted hazard ratio for Chagasic versus other nonischemic: 1.49 (95% confidence interval, 1.15–1.94; P=0.003) and Chagasic versus ischemic: 1.55 (1.18–2.04; P=0.002). The rates of all-cause mortality were also higher. Conclusions: Despite younger age, less comorbidity, and comprehensive use of conventional HF therapies, patients with Chagasic HF with reduced ejection fraction continue to have worse quality of life and higher hospitalization and mortality rates compared with other etiologies. Clinical Trial Registration: PARADIGM-HF: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01035255; ATMOSPHERE: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00853658

La Informática Industrial en las Ingenierías Industriales

El término Informática Industrial se utiliza para dar cabida a un conjunto muy diverso de disciplinas y tecnologías. El encontrar un criterio unificador que articule los diversos enfoques posibles y que, ayude tanto al docente como al alumno, en el proceso de enseñanza/aprendizaje de manera que se brinde conocimiento perdurable y al mismo tiempo actualizado, es una tarea clave. En esta contribución se discuten estas ideas relativas a la docencia de esta disciplina en las diferentes titulaciones de la Escuela de Ingenierías Industriales de la UVA, manifestando ideas de cómo ese marco conceptual puede adaptarse al contexto de las diferentes especialidades.Departamento de Ingeniería de Sistemas y Automática2018-01-0

Metabolomic profiling of end-stage heart failure secondary to chronic Chagas cardiomyopathy

Chronic Chagas cardiomyopathy (CCC) is the most frequent and severe clinical form of chronic Chagas disease, representing one of the leading causes of morbidity and mortality in Latin America, and a growing global public health problem. There is currently no approved treatment for CCC; however, omics technologies have enabled significant progress to be made in the search for new therapeutic targets. The metabolic alterations associated with pathogenic mechanisms of CCC and their relationship to cellular and immunopathogenic processes in cardiac tissue remain largely unknown. This exploratory study aimed to evaluate the potential underlying pathogenic mechanisms in the failing myocardium of patients with end-stage heart failure (ESHF) secondary to CCC by applying an untargeted metabolomic profiling approach. Cardiac tissue samples from the left ventricle of patients with ESHF of CCC etiology (n = 7) and healthy donors (n = 7) were analyzed using liquid chromatography-mass spectrometry. Metabolite profiles showed altered branched-chain amino acid and acylcarnitine levels, decreased fatty acid uptake and oxidation, increased activity of the pentose phosphate pathway, dysregulation of the TCA cycle, and alterations in critical cellular antioxidant systems. These findings suggest processes of energy deficit, alterations in substrate availability, and enhanced production of reactive oxygen species in the affected myocardium. This profile potentially contributes to the development and maintenance of a chronic inflammatory state that leads to progression and severity of CCC. Further studies involving larger sample sizes and comparisons with heart failure patients without CCC are needed to validate these results, opening an avenue to investigate new therapeutic approaches for the treatment and prevention of progression of this unique and severe cardiomyopathy

Synthesis, structure, and biological assays of novel trifluoromethyldiazepine–metal complexes

A new series of CuII, NiII, CoII, and MnIII complexes have been synthesised from the (6Z)-6-(7-trifluoromethyl-1,2,3,4-tetrahydro-5H-1,4-diazepin-5-ylidene)cyclohexa-2,4-dien-1-one (HDZP) ligand. These complexes were characterised by elemental, spectroscopic (IR and UV-vis), and thermal analysis. The crystal structure of Cu-DZP was solved by X-ray diffraction methods. The complex crystallises in the monoclinic P21/c space group, with two molecules per unit cell. The crystal lattice is stabilised by different intra and intermolecular interactions. Hirshfeld surface analysis was employed to obtain additional information about interactions that are responsible for the crystal packing. Quantitative examination of the fingerprint plots indicated the dominant contribution of H⋯H and H⋯X (X = O, F) interactions in the crystal packing. In addition, C–H⋯chelate ring (CR) and C–H⋯π interactions are described in detail and evaluated using DFT calculations. The antibacterial properties and the mechanism of inhibition of the main bacterial resistant mechanism, the biofilm, of the metal complexes and free ligand were investigated. [Mn(DZP)₃]·2H₂O was the most active complex against the Pseudomonas aeruginosa biofilm formation with an inhibition of 40 %. However, none of the complexes inhibit more than 25 % of the Gram negative bacteria microbial development. The most meaningful result was the bactericidal effect of [Co(DZP)₂(H₂O)₂]·2H₂O against the Gram positive bacteria, Staphylococcus aureus, which inhibits the bacterial development and significantly reduces the biofilm formation at low concentration.Instituto de Física La PlataPlanta Piloto Multipropósito - Laboratorio de Servicios a la Industria y al Sistema CientíficoCentro de Química Inorgánic

Psychometric properties of the Minnesota Living with Chronic Heart Failure Questionnaire in a Colombian population

Introduction: Although the Minnesota Living with Heart Failure Questionnaire (MLHF-Q) is one of the most widely used tools to assess Health-Related Quality of Life (HRQoL) in patients with chronic heart failure (CHF), it has not been validated in Latin American Spanish-speaking populations. Objective: We evaluated internal consistency and construct validity of the MLHF-Q in patients with CHF from Colombia. Methods: The Spanish version of the MLHF-Q was given to 200 patients. Cronbach’s alpha was used to evaluate internal consistency. Confirmatory factorial Principal Component Analysis (PCA) and Rasch analysis were used to evaluate construct validity. The discriminative capacity was measured using the Mann-Whitney U test. Results: Median age was 64 years, 63% of the patients included in the study were men, and 79.5% had a left ventricular ejection fraction (LVEF) ≤ 45%. The median of the total score of HRQoL was 40 points (Q1=20; Q3=55), physical dimension 11 points (Q1=4; Q3=23) and emotional dimension 7 points (Q1=3; Q3=13). Global internal consistency of MLHF-Q was 0.91 (95% CI 0.89 - 0.93). In the PCA, the three dimensions explained 47.7% and 54.0% in Rasch analysis, in which five items presented misfit. Worse HRQoL was observed among women than men in the emotional dimension (p=0.047). Discriminative capacity for the overall score of the MLHF-Q and their subscales was observed in age and New York Heart Association (NYHA) functional class (p<0.05). Conclusions: Our findings confirmed the three-factor structure of the MLHF-Q, and satisfactory level for internal consistency. Additionally, these results suggest that the questionnaire adequately reflects the severity of the disease. However, further studies are required to validate these findings in Colombian population and to evaluate the sensitivity to change of the MLHF-Q in longitudinal designs. Introducción: El Minnesota Living with Heart Failure Questionnaire (MLHF-Q) es uno de los instrumentos más utilizados para medir la Calidad de Vida Relacionada con la Salud (CVRS) en pacientes con Falla cardíaca Crónica (FCC); sin embargo, éste no ha sido validado en poblaciones latinoamericanas hispanohablantes. Objetivo: Evaluar la consistencia interna y validez de constructo del MLHF-Q en pacientes con FCC de Colombia. Métodos: La versión en español del MLHF-Q fue diligenciada por 200 pacientes. La consistencia interna se evaluó con el Alpha de Cronbach. La validez de constructo fue examinada por dos métodos: Análisis de Componentes Principales (ACP) confirmatorio y análisis Rasch. Se evaluó la capacidad discriminativa del instrumento con la prueba U-Mann-Whitney. Resultados: Mediana de edad de 64 años, 63% hombres y el 79.5% de los participantes tenían fracción de eyección del ventrículo izquierdo (FEVI) ≤ 45%. La mediana del puntaje total de CVRS fue 40 puntos (Q1=20; Q3=55), dimensión física 11 puntos (Q1=4; Q3=23) y dimensión emocional 7 puntos (Q1=3; Q3=13). La consistencia interna fue 0.91 (IC 95% 0.89 - 0.93). En el ACP, las tres dimensiones explicaron el 54.0% y 47.7% en el análisis Rasch, en éste último cinco ítems presentaron desajuste. Se observó peor CVRS en mujeres que en hombres en la dimensión emocional (p=0.047) y se evidenció capacidad discriminativa de las subescalas y el puntaje total del MLHF-Q en la edad y la clase funcional New York Heart Association (NYHA) (p<0.05). Conclusión: Nuestros hallazgos confirmaron la estructura de tres factores del MLHF-Q y un nivel satisfactorio para la consistencia interna. Adicionalmente, estos resultados sugieren que el cuestionario refleja adecuadamente la gravedad de la enfermedad. Sin embargo, se requieren estudios adicionales en población colombiana para validar estos hallazgos y evaluar la sensibilidad al cambio del MLHF-Q en diseños longitudinales.&nbsp