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INTRODUCTION: The number of patients who have a cardiac implantable electronic device (CIEDs) that undergo a course of radiotherapy is increasing due to the ageing population. The majority of clinical studies only evaluate any CIED malfunction at the end of a course of irradiation or in a case of there being symptoms of possible malfunction. As a result, little data has been collected on CIED status acquired during an active course of irradiation. MATERIAL AND METHODS: We aimed to evaluate the correct functioning of a CIED during a course of radiotherapy. So, a retrospective analysis was made of all patients having CIEDS in a single institution during their course of radiotherapy. All CIEDs were systematically checked before and during the course of radiotherapy according to the risk of device failure and patient dependence. RESULTS: Data was analysed from 56 patients (43 men, 13 women) with a mean age of 78.2 years, of whom 87.5% of the patients carried a pacemaker (PM), the 39% of the patients were PM dependent, and the remaining patients carried an implantable cardioverter-defibrillator (ICD). An observable dose of irradiation was evident in only 10 cases. 69.1% of the CIEDs were checked daily and the remainder were checked weekly. During the radiotherapy course, 82% of the patients did not complain of any cardiological event. The CIED of five patients experienced an increase in the threshold and, in another case, a sudden reduction in the duration of the battery was reported. Another patient with a CIED experienced a cardiac insufficiency episode triggered by a ventricular tachycardia. CONCLUSION: In conclusions, although adverse clinical events from exposure of a CIED to irradiation are rare, they can appear in any group of risk. No dose-dependency was observed on the malfunction of the CIED.

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PURPOSE: Autophagy has lately emerged as an important biological process with implications in several hematological pathologies. Recently, a growing body of evidence supports a putative role of autophagy in chronic lymphocytic leukemia; however, no definitive clue has been established so far. To elucidate this issue, we have developed a pilot study to measure autophagic flux in peripheral blood mononuclear cells from chronic lymphocytic leukemia patients, and explored its correlation with classical clinical/analytical parameters. METHODS/PATIENTS: Thirty-three chronic lymphocytic leukemia patients participated in the study. Autophagic flux in peripheral blood mononuclear cells was determined by western blot measuring the levels of the proteins p62 and lipidated LC3. Moreover, p62 mRNA levels were analyzed by RT-qPCR. RESULTS: Lymphocytosis and the percentage of tumoral lymphocytes in chronic lymphocytic leukemia patients statistically correlate with a blocked autophagic flux. CONCLUSION: Alterations in autophagic flux could play an important role in the physiopathology of chronic lymphocytic leukemia.

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Dense grain flows in nature consist of a mixture of solid constituents that are immersed in an ambient fluid. In order to obtain a good representation of these flows, the interaction mechanisms between the different constituents of the mixture should be considered. In this article, we study the dynamics of a dense granular flow composed of a binary mixture of small and large grains immersed in an ambient fluid. In this context, we extend the two-phase approach proposed by Meruane et al. [J. Fluid Mech. 648, 381 (2010)] to the case of flowing dense binary mixtures of solid particles, by including in the momentum equations a constitutive relation that describes the interaction mechanisms between the solid constituents in a dense regime. These coupled equations are solved numerically and validated by comparing the numerical results with experimental measurements of the front speed of gravitational granular flows resulting from the collapse, in ambient air or water, of two-dimensional granular columns that consisted of mixtures of small and large spherical particles of equal mass density. Our results suggest that the model equations include the essential features that describe the dynamics of grains flows of binary mixtures in an ambient fluid. In particular, it is shown that segregation of small and large grains can increase the front speed because of the volumetric expansion of the flow. This increase in flow speed is damped by the interaction forces with the ambient fluid, and this behavior is more pronounced in water than in air.

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Se estudiaron 869 historias clínicas que corresponden a los egresos ocurridos durante el período 1981-1982 en el Servicio A del Hospital Psiquiátrico de Santiago. Se practicó terapia electroconvulsiva al 27,5% de la población en estudio. Destaca el hecho que el promedio de edad de ésta, estaba sobre los 30 años y que más de la mitad tenía antecedentes de hospitalizaciones anteriores así como de terapia electroconvulsiva previa. Lo anterior apunta al grado de cronicidad de los pacientes psiquiátricos hospitalizados en nuestros sectores de agudos. En el 86,8% de los pacientes se realizó una serie de ES; en el 11,7% dos series y en el 1,5% tres series. El número promedio de TE por paciente fue de 12,96%. Las indicaciones más frecuentes fueron la esquizofrenia (82%) y las psicosis reactivas (5%). Destaca la escasa cantidad de psicosis afectivas tratadas con ES (2%). El promedio de TE aplicada en cuadros esquizofrénicos fue de 14%, en las psicosis reactivas 6,7% y en las psicosis afectivas 6,8%. Se realizó examen físico previo en la totalidad de los enfermos. La posición de los electrodos fue bilateral frontotemporal. En general, las aplicaciones de TE se realizaron con una frecuencia de una por día, salvo los fines de semana. En el 97,9% fueron realizadas por la enfermera, con un voltaje promedio de 106.15 voltios y un tiempo promedio de 0.20 segundos. Se premedicó a casi la totalidad de los enfermos con atropina vía IM. En el 23,5% de los casos se utilizó previamente Diazepam por vía EV. Sólo en el 5,2% se utilizó anestesia general (Tiopental y Succinilcolina). Se observaron complicaciones en dos enfermos, las que corresponddieron a distensiones musculares, lo que constituyó 0,8%. La razón entre la descarga eléctrica aplicada y la convulsión generalizada producida fue de 0,7. En el 12,14% a pesar de aplicar repetidas descargas, no se pudo obtener una convulsión generalizada. La desaparición de la productividad psicótica se logró, en sólo el 37,5% de los pacientes esquizofrénicos crónicos, lo que contrasta con el 83,3% logrado en los pacientes portadores de cuadros esquizofrénicos incipientes. Las proyecciones clínicas y terapéuticas de los resultados obtenidos son discutidas

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