RESUMEN
BACKGROUND: The COVID-19 pandemic has highlighted a correlation between cardiac complications and elevated cardiac biomarkers, which are linked to poorer clinical outcomes. OBJECTIVE: This study aims to determine the clinical impact of cardiac biomarkers in COVID-19 patients in Latin America. SUBJECTS AND METHODS: The CARDIO COVID 19-20 Registry is a multicenter observational study across 44 hospitals in Latin America and the Caribbean. It included hospitalized COVID-19 patients (n = 476) who underwent troponin, natriuretic peptide, and D-dimer tests. Patients were grouped based on the number of positive biomarkers. RESULTS: Among the 476 patients tested, 139 had one positive biomarker (Group C), 190 had two (Group B), 118 had three (Group A), and 29 had none (Group D). A directly proportional relationship was observed between the number of positive biomarkers and the incidence of decompensated heart failure. Similarly, there was a proportional relationship between the number of positive biomarkers and increased mortality. In Group B, patients with elevated troponin and natriuretic peptide and those with elevated troponin and D-dimer had 1.4 and 1.5 times higher mortality, respectively, than those with elevated natriuretic peptide and D-dimer. CONCLUSIONS: In Latin American COVID-19 patients, a higher number of positive cardiac biomarkers is associated with increased cardiovascular complications and mortality. These findings suggest that cardiac biomarkers should be utilized to guide acute-phase treatment strategies.
RESUMEN
Cardiac rhabdomyoma (CRHM) is the principal cardiac tumor in children and is most often associated with tuberous sclerosis complex (TSC). Mutations in the TSC1 and TSC2 genes cause the overactivation of the mammalian Target of Rapamycin (mTOR). This protein family is responsible for abnormal cell proliferation leading to the formation of CRHMs and hamartomas in other organs. Despite the tendency for spontaneous regression, some CRHMs can cause heart failure and intractable arrhythmias, requiring surgical resection. In recent years, the use of everolimus and sirolimus (mTOR inhibitors) in the treatment of CRHMs has been reported. We report two cases of neonates with giant rhabdomyomas, with hemodynamic repercussions treated with low-dose everolimus (4.5â mg/m2/week). In both cases, we obtained an approximate decrease of 50% in the total area of the mass after three weeks of treatment. Despite rebound growth after stopping the drug, we were able to evidence that the use of low doses of everolimus immediately after birth is effective and safe in the treatment of giant CRHMs, avoiding surgical resection of the tumor and associated morbidity and mortality.
RESUMEN
In 1967, the founding of the Comisión Nacional de Investigación Científica y Tecnológica (Conicyt) constituted a milestone by creating a national and public body, different from the university, which coordinated and financed scientific-technological activity, linked to the productive development in Chile, and the history of Latin American research councils. Conicyt led a demanding process by debating the contents of a scientific policy in a period in which Chile experienced opposing political-economic development models that conditioned its formulation and objectives. This article characterizes the origins and development of this commission from 1967 to 1981 when the Fondo Nacional de Ciencia y Tecnología was created and a new institutional stage began.
En 1967, la fundación de la Comisión Nacional de Investigación Científica y Tecnológica constituyó un hito al crearse un organismo nacional y público, distinto al universitario, que coordinó y financió la actividad científica-tecnológica, vinculándola al desarrollo productivo en Chile, y a la historia de los consejos de investigación latinoamericanos. La Comisión lideró un exigente proceso al debatir los contenidos de una política científica en un periodo en que Chile experimentó modelos de desarrollo político-económico opuestos que condicionaron su formulación y objetivos. Este artículo caracteriza los orígenes y desarrollo de esta comisión desde 1967 hasta 1981, cuando al crearse el Fondo Nacional de Ciencia y Tecnología se inicia una nueva etapa institucional.
Asunto(s)
Políticas , Tecnología , Humanos , Chile , Instituciones de SaludRESUMEN
Resumen En 1967, la fundación de la Comisión Nacional de Investigación Científica y Tecnológica constituyó un hito al crearse un organismo nacional y público, distinto al universitario, que coordinó y financió la actividad científica-tecnológica, vinculándola al desarrollo productivo en Chile, y a la historia de los consejos de investigación latinoamericanos. La Comisión lideró un exigente proceso al debatir los contenidos de una política científica en un periodo en que Chile experimentó modelos de desarrollo político-económico opuestos que condicionaron su formulación y objetivos. Este artículo caracteriza los orígenes y desarrollo de esta comisión desde 1967 hasta 1981, cuando al crearse el Fondo Nacional de Ciencia y Tecnología se inicia una nueva etapa institucional.
Abstract In 1967, the founding of the Comisión Nacional de Investigación Científica y Tecnológica (Conicyt) constituted a milestone by creating a national and public body, different from the university, which coordinated and financed scientific-technological activity, linked to the productive development in Chile, and the history of Latin American research councils. Conicyt led a demanding process by debating the contents of a scientific policy in a period in which Chile experienced opposing political-economic development models that conditioned its formulation and objectives. This article characterizes the origins and development of this commission from 1967 to 1981 when the Fondo Nacional de Ciencia y Tecnología was created and a new institutional stage began.
Asunto(s)
Ciencia , Administración Pública , Formulación de Proyectos , Política Nacional de Ciencia, Tecnología e Innovación , Chile , Historia del Siglo XXRESUMEN
This study aimed to determine the effects of in-feed inclusion of humic substances (HS) and/or calcium carbonate (CaCO3) on the performance and welfare of laying hens. A total number of 144 Hy-Line Brown laying hens (55 weeks old) were randomly assigned to four treatments, T1-T4 (36 birds per treatment). T1 hens were fed on a control diet without HS or CaCO3, T2 hens were fed on the control diet + 2.00 g per bird per day CaCO3, T3 hens were fed on the control diet + 0.20% HS and T4 hens were fed on the control diet + 0.20% HS + 2.00 g/bird/day CaCO3. The experiment started after 15 days of adaptation and lasted 8 weeks. The parameters evaluated were percentage of hen-day egg production, food consumption, mortality, egg quality parameters and heart rate variability (welfare indicator). Hens in the T3 group showed a significantly lower feed intake than those in the other three groups, however, significantly higher daily egg production was recorded in groups T3 and T4 compared to T1 and T2. Eggshell quality characteristics were significantly improved by HS supplementation and eggs laid by hens in groups T1, and T4 presented paler yolk and shell color than those in the other groups. In conclusion, these results indicated that in-feed inclusion of HS had a beneficial effect on laying hens' productive performance including egg production and eggshells quality.
RESUMEN
We present the case of a term newborn, with no significant perinatal history, who was taken to the emergency room at 18 days old for intermittent episodes of cyanosis, with no signs of respiratory distress, oxygensaturation of 85%, arterial gases with moderate hypoxemia, and chest X-ray.
RESUMEN
Objective: The purpose of this study was to evaluate early changes in myocardial function in overweight and obese children without hypertension. Methods: Cross-sectional study involving 150 participants of both sexes between 6 and 15 years old. Anthropometric and biochemical evaluations were performed. Ventricular function was assessed by conventional echocardiographic methods and myocardial deformation analysis by two-dimensional speckle tracking echocardiography. One-way analysis of variance was employed for the global comparison of study variables between groups (children with normal weight, overweight and obesity), and post hoc analysis with Bonferroni correction was used for multiple comparison, considering normal-weight children as the reference category. Results: Overall, 142 participants were included, 50 (35%) with normal weight, 39 (28%) overweight and 53 (37%) obesity. Diastolic diameter of the left ventricular (LV) and interventricular septum, diameter of the left atrium and LV mass were significantly higher in children with obesity compared to those with normal weight. No significant differences in the conventional indicators of LV systolic and diastolic function were found between groups. Significant differences in the regional myocardial deformation between the three groups were observed. Mean global longitudinal myocardial deformation was smaller in patients with obesity (-20.9% vs. -23.5%, p < 0.05) compared to children with normal weight. Conclusions: The childhood obesity was associated with altered myocardial deformation, even in the presence of normal ejection fraction. Myocardial deformation evaluation is relevant in the assessment of pediatric patients with obesity.
Objetivo: El propósito de este estudio fue evaluar los cambios tempranos en la función miocárdica en niños con sobrepeso y obesidad, sin hipertensión arterial. Métodos: Estudio transversal en el que se incluyeron 150 participantes de ambos sexos entre 6 y 15 años. Se realizaron evaluaciones antropométricas, bioquímicas y de función ventricular mediante métodos ecocardiográficos convencionales y análisis de deformación miocárdica con ecocardiografía bidimensional speckle tracking. La comparación global entre los grupos de estudio (niños con peso normal, sobrepeso y obesidad) se llevó a cabo con la prueba de análisis de varianza (ANOVA) de una vía y análisis post hoc con corrección de Bonferroni para las comparaciones múltiples, y se consideró a los niños con peso normal como grupo de referencia. Resultados: La muestra final fue de 142 participantes, 50 (35%) con peso normal, 39 (28%) con sobrepeso y 53 (37%) con obesidad. El diámetro diastólico del ventrículo izquierdo (VI) y el septum interventricular, y el diámetro de la aurícula izquierda (AI) y la masa del VI fueron significativamente más altos en el grupo con obesidad en comparación con el grupo con peso normal. No se observaron diferencias significativas en los indicadores convencionales de la función sistólica y diastólica ventricular izquierda. Se observaron diferencias significativas en la deformación miocárdica regional entre los tres grupos. La media de deformación miocárdica longitudinal global fue más baja en los pacientes con obesidad (−20.9% vs. −23.5%; p < 0.05) en comparación con los niños con peso normal. Conclusiones: La obesidad infantil se asoció a alteraciones en la deformación miocárdica, incluso en presencia de fracción de expulsión normal. La evaluación de la deformación miocárdica es relevante en los pacientes pediátricos con obesidad.
RESUMEN
Resumen Objetivo: El propósito de este estudio fue evaluar los cambios tempranos en la función miocárdica en niños con sobrepeso y obesidad, sin hipertensión arterial. Métodos: Estudio transversal en el que se incluyeron 150 participantes de ambos sexos entre 6 y 15 años. Se realizaron evaluaciones antropométricas, bioquímicas y de función ventricular mediante métodos ecocardiográficos convencionales y análisis de deformación miocárdica con ecocardiografía bidimensional speckle tracking. La comparación global entre los grupos de estudio (niños con peso normal, sobrepeso y obesidad) se llevó a cabo con la prueba de análisis de varianza (ANOVA) de una vía y análisis post hoc con corrección de Bonferroni para las comparaciones múltiples, y se consideró a los niños con peso normal como grupo de referencia. Resultados: La muestra final fue de 142 participantes, 50 (35%) con peso normal, 39 (28%) con sobrepeso y 53 (37%) con obesidad. El diámetro diastólico del ventrículo izquierdo (VI) y el septum interventricular, y el diámetro de la aurícula izquierda (AI) y la masa del VI fueron significativamente más altos en el grupo con obesidad en comparación con el grupo con peso normal. No se observaron diferencias significativas en los indicadores convencionales de la función sistólica y diastólica ventricular izquierda. Se observaron diferencias significativas en la deformación miocárdica regional entre los tres grupos. La media de deformación miocárdica longitudinal global fue más baja en los pacientes con obesidad (−20.9% vs. −23.5%; p menor 0.05) en comparación con los niños con peso normal. Conclusiones: La obesidad infantil se asoció a alteraciones en la deformación miocárdica, incluso en presencia de fracción de expulsión normal. La evaluación de la deformación miocárdica es relevante en los pacientes pediátricos con obesidad.
Abstract Objective: The purpose of this study was to evaluate early changes in myocardial function in overweight and obese children without hypertension. Methods: Cross-sectional study involving 150 participants of both sexes between 6 and 15 years old. Anthropometric and biochemical evaluations were performed. Ventricular function was assessed by conventional echocardiographic methods and myocardial deformation analysis by two-dimensional speckle tracking echocardiography. One-way analysis of variance was employed for the global comparison of study variables between groups (children with normal weight, overweight and obesity), and post hoc analysis with Bonferroni correction was used for multiple comparison, considering normal-weight children as the reference category. Results: Overall, 142 participants were included, 50 (35%) with normal weight, 39 (28%) overweight and 53 (37%) obesity. Diastolic diameter of the left ventricular (LV) and interventricular septum, diameter of the left atrium and LV mass were significantly higher in children with obesity compared to those with normal weight. No significant differences in the conventional indicators of LV systolic and diastolic function were found between groups. Significant differences in the regional myocardial deformation between the three groups were observed. Mean global longitudinal myocardial deformation was smaller in patients with obesity (−20.9% vs. −23.5%, p less 0.05) compared to children with normal weight. Conclusions: The childhood obesity was associated with altered myocardial deformation, even in the presence of normal ejection fraction. Myocardial deformation evaluation is relevant in the assessment of pediatric patients with obesity.
Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Ecocardiografía , Obesidad Infantil/complicaciones , Corazón/diagnóstico por imagen , Miocardio/patología , Estudios Transversales , Obesidad Infantil/epidemiología , Ventrículos Cardíacos/diagnóstico por imagenRESUMEN
Objective: The purpose of this study was to evaluate early changes in myocardial function in overweight and obese children without hypertension. Methods: This was a cross-sectional study involving 150 participants of both sexes between 6 and 15 years old. Anthropometric and biochemical evaluations were performed. Ventricular function was assessed by conventional echocardiographic methods and myocardial deformation analysis by two-dimensional speckle tracking echocardiography. One-way analysis of variance was employed for the global comparison of study variables between groups (children with normal weight, overweight, and obesity), and post hoc analysis with Bonferroni correction was used for multiple comparisons, considering normal weight children as the reference category. Results: Overall, 142 participants were included, 50 (35%) with normal weight, 39 (28%) overweight, and 53 (37%) obesity. The diastolic diameter of the left ventricular and interventricular septum, and diameter of the left atrium and LV mass were significantly higher in children with obesity compared to those with normal weight. No significant differences in the conventional indicators of LV systolic and diastolic function were found between groups. Significant differences in the regional myocardial deformation between the three groups were observed. Mean global longitudinal myocardial deformation was smaller in patients with obesity (-20.9% vs. -23.5%, p < 0.05) compared to children with normal weight. Conclusions: The childhood obesity was associated with altered myocardial deformation, even in the presence of normal ejection fraction. Myocardial deformation evaluation is relevant in the assessment of pediatric patients with obesity.
Objetivo: El propósito de este estudio fue evaluar los cambios tempranos en la función miocárdica en niños con sobrepeso y obesidad, sin hipertensión arterial. Métodos: Estudio transversal en el que se incluyeron 150 participantes de ambos sexos entre 6 y 15 años. Se realizaron evaluaciones antropométricas, bioquímicas y de función ventricular mediante métodos ecocardiográficos convencionales y análisis de deformación miocárdica con ecocardiografía bidimensional speckle tracking. La comparación global entre los grupos de estudio (niños con peso normal, sobrepeso y obesidad) se llevó a cabo con la prueba de análisis de varianza (ANOVA) de una vía y análisis post hoc con corrección de Bonferroni para las comparaciones múltiples, y se consideró a los niños con peso normal como grupo de referencia. Resultados: La muestra final fue de 142 participantes, 50 (35%) con peso normal, 39 (28%) con sobrepeso y 53 (37%) con obesidad. El diámetro diastólico del ventrículo izquierdo (VI) y el septum interventricular, y el diámetro de la aurícula izquierda (AI) y la masa del VI fueron significativamente más altos en el grupo con obesidad en comparación con el grupo con peso normal. No se observaron diferencias significativas en los indicadores convencionales de la función sistólica y diastólica ventricular izquierda. Se observaron diferencias significativas en la deformación miocárdica regional entre los tres grupos. La media de deformación miocárdica longitudinal global fue más baja en los pacientes con obesidad (−20.9% vs. −23.5%; p < 0.05) en comparación con los niños con peso normal. Conclusiones: La obesidad infantil se asoció a alteraciones en la deformación miocárdica, incluso en presencia de fracción de expulsión normal. La evaluación de la deformación miocárdica es relevante en los pacientes pediátricos con obesidad.
Asunto(s)
Ecocardiografía , Corazón/diagnóstico por imagen , Miocardio/patología , Obesidad Infantil/complicaciones , Adolescente , Niño , Estudios Transversales , Femenino , Ventrículos Cardíacos/diagnóstico por imagen , Humanos , Masculino , Obesidad Infantil/epidemiologíaRESUMEN
BACKGROUND: Delayed sternal closure (DSC) after cardiac surgery is a therapeutic option in the treatment of the severely impaired heart in pediatric cardiac surgery. METHODS: A single-center retrospective review of all bypass surgeries performed over a 10-year period (2003-2012). RESULTS: Of a total of 2325 patients registered in our database, the DSC group included 259 cases (11%), and the remaining 2066 cases (89%) constituted the control group (PSC). RACHS-1 risk was higher for the DSC group (74% had a score of 3 or 4) than for the PSC group (82% had a score of 2 or 3). The most frequent diagnosis for the DSC group was transposition of the great arteries (28%). We found out that hemodynamic instability was the main indication observed in patients aged ≤ 8 years (63%), while bleeding was the principal indication for patients aged ≥ 8 years (94%) (p ≤ 0.001). The average time between surgery and sternal closure was 2.3 ± 1.4 days. Overall mortality rates were higher for patients of the DSC group (22%) than for the PSC group (8.7%) (OR: 0.4 (95% CI: 0.4 to 0.5), p < 0.05). There were six patients with DSC who developed mediastinitis (2.3%). The risk of mediastinitis was significantly higher when DSC was performed 4 days after the primary surgery. CONCLUSIONS: DSC is an important management strategy for congenital cardiac surgery in infants and children. The prolonged sternal closure time is associated with an increased rate of postoperative mediastinitis.
Asunto(s)
Procedimientos Quirúrgicos Cardíacos/métodos , Esternón/cirugía , Procedimientos Quirúrgicos Cardíacos/mortalidad , Niño , Preescolar , Demografía , Femenino , Cardiopatías/congénito , Cardiopatías/diagnóstico , Cardiopatías/mortalidad , Cardiopatías/cirugía , Humanos , Masculino , Periodo Posoperatorio , Factores de Riesgo , Resultado del TratamientoRESUMEN
BACKGROUND: Antimicrobial peptides are on the first line of defense against pathogenic microorganisms of many living beings. These compounds are considered natural antibiotics that can overcome bacterial resistance to conventional antibiotics. Due to this characteristic, new peptides with improved properties are quite appealing for designing new strategies for fighting pathogenic bacteria. METHODS: Sixteen designed peptides were synthesized using Fmoc chemistry; five of them are new cationic antimicrobial peptides (CAMPs) designed using a genetic algorithm that optimizes the antibacterial activity based on selected physicochemical descriptors and 11 analog peptides derived from these five peptides were designed and constructed by single amino acid substitutions. These 16 peptides were structurally characterized and their biological activity was determined against Escherichia coli O157:H7 (E. coli O157:H7), and methicillin-resistant strains of Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (P. aeruginosa) were determined. RESULTS: These 16 peptides were folded into an α-helix structure in membrane-mimicking environment. Among these 16 peptides, GIBIM-P5S9K (ATKKCGLFKILKGVGKI) showed the highest antimicrobial activity against E. coli O157:H7 (MIC=10µM), methicillin-resistant Staphylococcus aureus (MRSA) (MIC=25µM) and Pseudomonas aeruginosa (MIC=10 µM). Peptide GIBIM-P5S9K caused permeabilization of the bacterial membrane at 25 µM as determined by the Sytox Green uptake assay and the labelling of these bacteria by using the fluoresceinated peptide. GIBIM-P5S9K seems to be specific for these bacteria because at 50 µM, it provoked lower than 40% of erythrocyte hemolysis. CONCLUSION: New CAMPs have been designed using a genetic algorithm based on selected physicochemical descriptors and single amino acid substitution. These CAMPs interacted quite specifically with the bacterial cell membrane, GIBIM-P5S9K exhibiting high antibacterial activity on Escherichia coli O157:H7, methicillin-resistant strains of Staphylococcus aureus and P. aeruginosa.
Asunto(s)
Péptidos Catiónicos Antimicrobianos/farmacología , Escherichia coli O157/efectos de los fármacos , Staphylococcus aureus Resistente a Meticilina/efectos de los fármacos , Péptidos/síntesis química , Péptidos/farmacología , Pseudomonas aeruginosa/efectos de los fármacos , Péptidos Catiónicos Antimicrobianos/química , Diseño de FármacosRESUMEN
BACKGROUND: The Cry toxins, or δ-endotoxins, are a diverse group of proteins produced by Bacillus thuringiensis. While DNA secondary structures are biologically relevant, it is unknown if such structures are formed in regions encoding conserved domains of Cry toxins under shuffling conditions. We analyzed 5 holotypes that encode Cry toxins and that grouped into 4 clusters according to their phylogenetic closeness. The mean number of DNA secondary structures that formed and the mean Gibbs free energy [Formula: see text] were determined by an in silico analysis using different experimental DNA shuffling scenarios. In terms of spontaneity, shuffling efficiency was directly proportional to the formation of secondary structures but inversely proportional to ∆G. RESULTS: The results showed a shared thermodynamic pattern for each cluster and relationships among sequences that are phylogenetically close at the protein level. The regions of the cry11Aa, Ba and Bb genes that encode domain I showed more spontaneity and thus a greater tendency to form secondary structures (<∆G). In the region of domain III; this tendency was lower (>∆G) in the cry11Ba and Bb genes. Proteins that are phylogenetically closer to Cry11Ba and Cry11Bb, such as Cry2Aa and Cry18Aa, maintained the same thermodynamic pattern. More distant proteins, such as Cry1Aa, Cry1Ab, Cry30Aa and Cry30Ca, featured different thermodynamic patterns in their DNA. CONCLUSION: These results suggest the presence of thermodynamic variations associated to the formation of secondary structures and an evolutionary relationship with regions that encode highly conserved domains in Cry proteins. The findings of this study may have a role in the in silico design of cry gene assembly by DNA shuffling techniques.