RESUMO

Guava (Psidium guajava L.) is a semi-domesticated fruit tree of moderate importance in the Neotropics, utilized for millennia due to its nutritional and medicinal benefits, but its origin of domestication remains unknown. In this study, we examine genetic diversity and population structure in 215 plants from 11 countries in Mesoamerica, the Andes, and Amazonia using 25 nuclear microsatellite loci to propose an origin of domestication. Genetic analyses reveal one gene pool in Mesoamerica (Mexico) and four in South America (Brazilian Amazonia, Peruvian Amazonia and Andes, and Colombia), indicating greater differentiation among localities, possibly due to isolation between guava populations, particularly in the Amazonian and Andean regions. Moreover, Mesoamerican populations show high genetic diversity, with moderate genetic structure due to gene flow from northern South American populations. Dispersal scenarios suggest that Brazilian Amazonia is the probable origin of guava domestication, spreading from there to the Peruvian Andes, northern South America, Central America, and Mexico. These findings present the first evidence of guava domestication in the Americas, contributing to a deeper understanding of its evolutionary history.

Assuntos

RESUMO

Resumen: Los productos acuáticos reestructurados se procesan principalmente a partir de especies de pescado infravaloradas, recortes de filetes o subproductos de especies de pescado no comerciales. Una de las pesquerías subvaloradas en el sur de México, es la del macabil (Albula vulpes). El objetivo de este estudio fue evaluar el efecto de la adición de harinas no convencionales y la reducción del nivel de cloruro de sodio en las propiedades mecánicas y funcionales de productos reestructurados de macabil. Se elaboraron reestructurados de macabil para analizar las muestras con harina de amaranto (HA) o harina de grillo (HG) doméstico (0 %, 5 % y 10 %) y tres niveles de sal (0 %, 1 % y 2 %). Se evaluó la pérdida de agua por cocción, la cantidad de agua extraíble y la textura de los geles. El uso de ambas harinas no convencionales disminuyó la pérdida de agua por cocción entre un 49.09 % y 61.97 %, con 1 % de sal. La adición de sal redujo el agua extraíble del reestructurado. Los valores de dureza variaron (P < 0.05) entre tratamientos. La mayor dureza se obtuvo en los tratamientos con HA al 10 % y sal al 1 % (64.55 N) y con HG al 10 % y sal al 2 % (63.50 N). La cohesividad varió de 0.53 a 0.71 (adimensional) en los tratamientos con 1 % y 2 % de sal, indicando pocos cambios en la estructura interna por efecto de los aditivos. Las harinas no convencionales permitieron la gelificación proteica, formando reestructurados con propiedades texturales adecuadas para un producto cárnico. La adición del 10 % de HG común o de HA y 1 % de uso de sal, en la formulación de reestructurados de pescado, ofrece una alternativa saludable en el desarrollo de alimentos de pescado.

Abstract: Restructured seafood products are primarily processed from undervalued fish species, fillet trimmings, or byproducts of non-commercial fish species. One of the underrated fisheries in southern Mexico is that of the bonefish (Albula vulpes). The objective of this study was to evaluate the effect of adding non-conventional flours and reducing the sodium chloride level on the mechanical and functional properties of restructured bonefish products. Bonefish restructured products were prepared to analyze samples with (0 %, 5 %, and 10 %) amaranth flour (AF) or cricket flour (CF) and three levels of salt (0 %, 1 % and 2 %). The cooking water loss, the amount of extractable water and the texture from gels were evaluated. The use of both non-conventional flours reduced cooking water loss by 49.09 % to 61.97 % with 1 % salt. The addition of salt reduced the extractable water in the restructured product. Hardness values varied (P < 0.05) among treatments. The highest hardness was obtained in treatments with 10 % AF and 1 % salt (64.55 N) and with 10 % CF and 2 % salt (63.50 N). Cohesiveness ranged from 0.53 to 0.71 (dimensionless) in treatments with 1 % and 2 % salt, indicating minimal changes in internal structure due to additives. Non-conventional flours allowed for protein gelation, forming restructured products with suitable textural properties for a meat product. The addition of 10 % CF or AF and 1 % salt in fish restructured product formulation offers a healthy alternative in the development of fish-based foods.

RESUMO

Resumen Después de varias décadas, el Programa de Ciencias Médicas, Odontológicas y de la Salud sigue formando investigadores que integran las diversas instituciones en donde labora personal de salud. Es notable cómo algunos campos han crecido y cómo se ha incrementado la participación de las mujeres, tanto en maestría como en doctorado. Se presenta un panorama general de ingreso y graduación de acuerdo con los campos de conocimiento y por el sexo de las personas. Se hace un comentario sobre los cambios en las personas que dirigen instituciones que, en algunos casos, por más de 100 años eran dirigidas por personas del sexo masculino.

Abstract By reviewing the scientific literature specialized in sleep disorders (TS) carried out in Mexico, especially at the TS Clinic (Faculty of Medicine-UNAM) at the General Hospital of Mexico (CTS-HGM) from 1948 to 2020, it was possible to document the history of ST research in Mexico and the role played by the CTS-HGM. Sleep Medicine (MS) is one of the newest specialties in Mexico and case research in this field began around 1948, while formal research in 1974. The founding of CTS-HGM in 1997 led to significant development in TS research in Mexico. In addition, the CTS-HGM became a center of care for patients with these problems, as well as important research center since its publications cover all the diagnostic categories of the CITS.

RESUMO

This research investigated the impact of ohmic heating (OH) on the physicochemical properties and resistant starch formation in native corn starch. Electric field strengths (EFS) of 50, 75, and 100 V/cm were applied to native starch, at a starch-water ratio of 1:1 w/v. The conductivity of the medium is a crucial factor in ohmic heating. In this study, the conductivity values at 120 °C were measured at 1.5 mS/m. The study revealed two distinct outcomes resulting from the application of different EFS. Firstly, a thermal effect induced gelatinization, resulting in a reduction in the enthalpy of corn starch, an increase in the water absorption index (WAI) and the water solubility index (WSI), and a decrease in peak viscosity. Secondly, a non-thermal effect of OH was observed, leading to the electrolysis of certain starch compounds and water. This electrolysis process generated radicals (-OH) that interacted with starch components, augmenting the percentage of resistant starch. This increase was associated with elevated levels of carbonyl and carboxyl groups at 75 and 100 V/cm.

Assuntos

RESUMO

BACKGROUND: The periparturient period in dairy cows is marked by immunosuppression which increases the likelihood of infectious disorders, particularly also mastitis. An in-depth understanding of peripartum leukocyte biology is vital for the implementation of highly successful post-partum disease prevention measures. Immune checkpoint molecules, such as programmed death 1 (PD-1) and cytotoxic T-lymphocyte antigen 4 (CTLA-4), are critical inhibitory receptors expressed on immune cells, particularly T cells, that drive immunosuppressive signaling pathways. However, the potential role of immune checkpoint molecules expression in T-cells on udder health has never been explored. Thus, the association between the occurrence of new postpartum intramammary infections (IMIs) and the expression of programmed cell death protein 1 (PD-1) and cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) on blood T-cells during the peripartum period was investigated. RESULTS: In this study, the incidence of IMIs by any pathogen in early lactation was not associated with a higher expression of PD-1 and CTLA-4 in the periparturient period. However, the incidence of IMIs by major pathogens throughout the first month of lactation was significantly associated with higher expression of PD-1 at 14 days before calving (P = 0.03) and CTLA-4 at parturition (P = 0.03) by blood T-cells. Also, the expression of CTLA-4 at D0 (P = 0.012) by T-cells was associated with the occurrence of persistent IMIs during the first month of lactation. CONCLUSIONS: To our knowledge, this is the first report to investigate the expression of PD-1 and CTLA-4 by blood T-lymphocytes during the periparturient period in dairy cows and to explore their relationship with the incidence of new IMIs in the postpartum period. Thus, a comprehensive understanding of leukocyte biology during peripartum would appear to be a prerequisite for the identification of resilient dairy cows or targets innovative (immunological) non-antibiotic approaches in the transition period.

Assuntos

RESUMO

BACKGROUND: Prolonged fetal exposure to hyperglycemia may increase the risk of developing abnormal glucose metabolism and type-2 diabetes during childhood, adolescence, and adulthood; however, the mechanisms by which gestational diabetes mellitus (GDM) predisposes offspring to metabolic disorders remain unknown. AIM: To quantify the nerve axons, macrophages, and vasculature in the pancreas from adult offspring born from mouse dams with GDM. METHODS: GDM was induced by i.p. administration of streptozotocin (STZ) in ICR mouse dams. At 12 wk old, fasting blood glucose levels were determined in offspring. At 15 wk old, female offspring born from dams with and without GDM were sacrificed and pancreata were processed for immunohistochemistry. We quantified the density of sensory [calcitonin gene-related peptide (CGRP)] and tyrosine hydroxylase (TH) axons, blood vessels (endomucin), and macro-phages (CD68) in the splenic pancreas using confocal microscopy. RESULTS: Offspring mice born from STZ-treated dams had similar body weight and blood glucose values compared to offspring born from vehicle-treated dams. However, the density of CGRP+ and TH+ axons, endomucin+ blood vessels, and CD68+ macrophages in the exocrine pancreas was significantly greater in offspring from mothers with GDM vs control offspring. Likewise, the microvasculature in the islets was significantly greater, but not the number of macrophages within the islets of offspring born from dams with GDM compared to control mice. CONCLUSION: GDM induces neuronal, vascular, and inflammatory changes in the pancreas of adult progeny, which may partially explain the higher propensity for offspring of mothers with GDM to develop metabolic diseases.

Assuntos

RESUMO

This systematic review and meta-analysis aimed to evaluate the analgesic efficacy and adverse effects of celecoxib after total knee arthroplasty. Keywords in the PubMed and Scopus databases were used to find article abstracts. Each included clinical trial was assessed using the Cochrane Collaboration risk of bias tool, and we extracted data on postoperative pain assessment using the Visual Analogue Scale (VAS) at rest, ambulation, and active range of motion, rescue analgesic intake, and adverse effects. Inverse variance tests with mean differences were used to analyze the numerical variables. The Mantel-Haenszel statistical method and the odds ratio were used to evaluate the dichotomous data. According to this qualitative assessment (n = 482), two studies presented conclusions in favor of celecoxib (n = 187), one showed similar results between celecoxib and the placebo (n = 44), and three clinical trials did not draw conclusions as to the effectiveness of celecoxib versus the placebo (n = 251). Moreover, the evaluation of the rescue analgesic intake showed that the patients receiving celecoxib had a lower intake compared to patients receiving a placebo (n = 278, I2 = 82%, p = 0.006, mean difference = -6.89, 95% IC = -11.76 to -2.02). In conclusion, the pooled analysis shows that administration of celecoxib alone results in a decrease in rescue analgesic consumption compared to a placebo after total knee surgery.

RESUMO

A poorly studied issue in women with breast cancer is the role of incretins (GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1)) in the quantity and quality of muscle mass in lean and obese individuals. The current report aims to analyze the patterns of association and the role of incretin in muscle functionality and body composition in women with cancer compared with healthy women (mammography BI-RADS I or II) to elucidate whether GIP and GLP-1 can be used to estimate the risk, in conjunction with overweight or obesity, for breast cancer. We designed a case-control study in women with a breast cancer diagnosis confirmed by biopsy in different clinical stages (CS; n = 87) and healthy women with a mastography BI-RADS I or II within the last year (n = 69). The women were grouped according to body mass index (BMI): lean (<25 kg/m2BS), overweight (≥25-<30 kg/m2BS), and obese (≥30 kg/m2BS). We found that GLP-1 and GIP levels over 18 pg/mL were associated with a risk of breast cancer (GIP OR = 36.5 and GLP-1 OR = 4.16, for the entire sample), particularly in obese women (GIP OR = 8.8 and GLP-1 OR = 6.5), and coincidentally with low muscle quality indexes, showed an association between obesity, cancer, incretin defects, and loss of muscle functionality.

RESUMO

This study evaluated the ultrasound-assisted extraction of phenolic compounds from Guadua angustifolia leaves, along with their optimization using response surface methodology. The effects of two sonication process conditions were determined using a central composite experimental design, with three levels (low, medium, and high) evaluated for time (10, 20, and 30 min) and temperature (20 °C, 35 °C, and 50 °C). A total of 12 experiments with four replicates were conducted at the central point, with the total phenol and flavonoid contents determined using the Folin-Ciocalteu colorimetric method and complexation with AlCl3, respectively. The optimized extract was analyzed using ultra-performance liquid chromatography (UPLC), and the antioxidant capacity of the optimized extract was determined by DPPH• (2,2-Diphenyl-1-Picrylhydrazyl) and ABTS•+ (2,2'-Azino-bis (3-ethylbenzthiazoline-6-sulfonic acid) assays. Extraction at 50 °C for 20 min was found to favor the extraction of phenol and total flavonoids. The experimental validation of the total phenol and flavonoid content produced values of 7.39 mg gallic acid equivalents per gram of dry matter and 1.55 mg quercetin equivalents per gram of dry matter, respectively. These values suggest that the extraction process is reproducible, with a relative standard deviation of 22.9 % and 14.1 %, respectively. The chromatographic profile showed that optimization favored the visualization of phenolic compounds compared to the non-optimized extract. The optimized extract had higher antioxidant capacity than the non-optimized extract, with values of 209.23 and 144.76 µmol Trolox per gram extract for the DPPH• and ABTS•+ techniques, respectively. Thus, the conditions evaluated in the ultrasound-assisted extraction were an efficient technique capable of extracting the maximum amount of phenolic compounds with antioxidant activity from the leaves of G. angustifolia, showing its potential application in various industries.

RESUMO

OBJECTIVE: To assess SARS-CoV-2 antibody prevalence and titers in people living with HIV (PLWHIV) on antiretroviral treatment (ART) enrolled at a tertiary reference hospital in Mexico. METHODS: Two plasma aliquots per person, used for HIV viral load follow-up between 01/2020 and 09/2021, were used to assess total anti-N and neutralizing SARS-CoV-2 antibodies. Sociodemographic, clinical, and SARS-CoV-2 exposure risk information were collected. The risk associated with SARS-CoV-2 exposure and associations with antibody titers were analyzed with logistic, Cox, and linear multivariable models. RESULTS: 803 PLWHIV participated; 233 had detectable SARS-CoV-2 antibodies (prevalent cases), and 132 seroconverted (incident cases). Overall, the adjusted prevalence was 46.45%, with an incidence rate of 3.78 cases/100 person-months. Factors associated with prevalent cases included lower age, location (western zone of Mexico City and the neighboring Mexico State), use of public transport, attendance at meetings without social distancing, and higher CD4 + T cell counts (p < 0.05; multivariable logistic model). BNT162b2 vaccination reduced incident cases (Cox adjusted HR = 0.4; p = 0.013). Notably, previously infected and vaccinated individuals showed maximization of neutralizing activity (p < 0.001). No associations between SARS-CoV-2 neutralization and HIV-related variables (CD4 + T cell counts, viral load, number of years in viral suppression, ART regimen) were found in multivariable analysis. CONCLUSIONS: SARS-CoV-2 infection was associated with community risk rather than HIV-associated variables in PLWH on ART and clinical follow-up. Antibody neutralization activity in vaccinated participants was maximized with previous SARS-CoV-2 infection.

Assuntos

RESUMO

RESUMEN La endocarditis mural es una forma infrecuente de infección intracardiaca que afecta al endocardio no valvular que pue- de presentarse con complicaciones similares a la endocarditis infecciosa valvular. Se recomienda la ecocardiografía para confirmar el diagnóstico cuando exista un alto índice de sospecha. Con respecto al tratamiento, existe evidencia limitada acerca de las estrategias terapéuticas en la endocarditis mural, sin embargo en la mayoría de casos reportados se recomienda iniciar antibioticoterapia dirigida asociado a una intervención quirúrgica precoz. A continuación, se presenta un caso clínico de un paciente masculino de 74 años con fenómenos embólicos sistémicos, en quien se documenta por ecocardiograma transesofágico una endocarditis mural en ápex del ventrículo izquierdo asociado a una bacteriemia por Staphylococcus aureus. Este caso pone de manifiesto la importancia de una valoración ecocardiográfica detallada de las válvulas y cámaras cardíacas ante la sospecha de una endocarditis infecciosa.

ABSTRACT Mural endocarditis is an uncommon form of intracardiac infection affecting the non valvular endocardium that can present with complications similar to valvular infective endocarditis. Echocardiography is recommended to confirm the diagnosis when there is a high index of suspicion. Regarding treatment, there is limited evidence about therapeutic strategies in mural endocarditis, however in most reported cases it is recommended to initiate targeted antibiotic therapy associated with early surgical intervention. The following is a clinical case of a 74-year-old male patient with systemic embolic phenomena, in whom a transesophageal echocardiogram documented mural endocarditis in the apex of the left ventricle associated with Staphylococcus aureus bacteremia. This case highlights the importance of a detailed echocardiographic assessment of the cardiac valves and chambers when infective endocarditis is suspected.

Assuntos

RESUMO

Introduction: Time-fixed analyses have traditionally been utilized to examine outcomes in post-infarction ventricular septal defect (VSD). The aims of this study were to: (1) analyze the relationship between VSD closure/non-closure and mortality; (2) assess the presence of immortal-time bias. Material and methods: In this retrospective cohort study, patients with ST-elevation myocardial infarction (STEMI) complicated by VSD. Time-fixed and time-dependent Cox regression methodologies were employed. Results: The study included 80 patients: surgical closure (n = 26), transcatheter closure (n = 20), or conservative management alone (n = 34). At presentation, patients without VSD closure exhibited high-risk clinical characteristics, had the shortest median time intervals from STEMI onset to VSD development (4.0, 4.0, and 2.0 days, respectively; P = 0.03) and from STEMI symptom onset to hospital arrival (6.0, 5.0, and 0.8 days, respectively; P < 0.0001). The median time from STEMI onset to closure was 22.0 days (P = 0.14). In-hospital mortality rate was higher among patients who did not undergo defect closure (50%, 35%, and 88.2%, respectively; P < 0.0001). Closure of the defect using a fixed-time method was associated with lower in-hospital mortality (HR = 0.13, 95% CI 0.05-0.31, P < 0.0001, and HR 0.13, 95% CI 0.04-0.36, P < 0.0001, for surgery and transcatheter closure, respectively). However, when employing a time-varying method, this association was not observed (HR = 0.95, 95% CI 0.45-1.98, P = 0.90, and HR 0.88, 95% CI 0.41-1.87, P = 0.74, for surgery and transcatheter closure, respectively). These findings suggest the presence of an immortal-time bias. Conclusions: This study highlights that using a fixed-time analytic approach in post-infarction VSD can result in immortal-time bias. Researchers should consider employing time-dependent methodologies.

Assuntos

RESUMO

The development of bio-based materials remains one of the most important alternatives to plastic materials. Although research in this field is growing, reporting various materials and methodologies, it is still necessary to increase exploration. The aim of this work was to expand and complement previous research on the preparation and characterization of high- and low-methoxyl pectin films obtained by casting, with the addition of commercial and recovered sunflower waxes. The results showed that the addition of sunflower waxes to the pectin matrix generated some discontinuity in the aggregate, increasing the thickness and roughness of the film. However, due to their hydrophobic nature, the waxes contributed to lower vapor transmission rate values of the films. On the other hand, the low-methoxyl pectin films had a more crystalline structure, which could help to diminish water vapor permeability values, mechanical resistance and rigidity, and improve their elongation. Regarding chemical characteristics, most of the raw materials' chemical groups were found in the resulting films, and the presence of C-H bending due to pectin gelation was observed. Finally, the compatibility and contribution of pectin and sunflower waxes to the production of the films were demonstrated, as well as the possibility of using materials from industrial waste in food packaging applications.

RESUMO

The nixtamalization process used for tortilla production entails extended processing time and generates pollutant effluents. Ohmic heating (OH) is an emerging technology that uses an alternating electric current for rapid and uniform food heating and mitigates effluent concerns. However, gaps exist in nutrient bioavailability studies. In this work, we assessed OH's impact on tortilla nutritional value, protein, and calcium using a rat model. Twenty-five male Wistar rats were fed one of four diets for 21 days: raw corn (RC) as an experimental control, OH-processed tortillas (OHTs), traditionally processed tortillas (TPTs), commercial tortillas (CTs), and a casein diet (CD) as a growth control. Despite similar protein and macronutrient profiles, OH significantly enhanced insoluble fiber content. The weight gain sequence was OHTs > TPTs > CTs > RC. OHTs exhibited superior protein digestibility (88.52%), which was 3% higher than other diets. The serum albumin (2.63-2.73 g/dL) indicated moderate malnutrition due to the tortilla's lower protein content. Nonetheless, the protein efficiency ratio (1.2-1.74) showed no significant difference from TPTs. Bone characteristics and fracture strength resembled the tortilla-fed groups, surpassing RC. X-ray diffraction and scanning electron microscopy confirmed that the OHT and TPT diets improved male rat bone thickness and crystallinity. The findings suggest the potential for OH as an eco-friendly tortilla production method, maintaining nutritional value comparable to traditional methods.

RESUMO

The aim of this systematic review and meta-analysis was to evaluate the analgesic effect of different doses of tapentadol immediate release (IR) and its adverse effects after a bunionectomy. Pubmed, Cochrane, Lilacs, Medline, and Imbiomed were used to identify abstracts of scientific publications related to the keywords of this systematic review (PROSPERO ID CRD42023437295). Moreover, the risk of bias in all included articles was assessed using the Cochrane Collaboration risk of bias tool. Data on the sum of pain intensity, total pain relief, global assessment, and adverse effects were extracted. The statistical method of inverse variance with means difference was used to evaluate the numerical data and the Mantel-Haenszel and Odd Ratio test to analyze the dichotomous data. In addition, the number needed to treat, the number needed to harm, and the 95% confidence intervals were calculated. A qualitative evaluation (n = 2381) was carried out according to the conclusions of the authors. Tapentadol (n = 1772) was more effective in relieving postoperative pain than the placebo (n = 609) after a bunionectomy. In addition, the analgesic efficacy of IR tapentadol (n = 1323) versus the placebo (n = 390) was evaluated in a total of 1713 patients using a global evaluation of the treatments. All three doses of IR tapentadol showed better results compared to the placebo after a bunionectomy. Finally, the adverse effects have a direct relationship with the dose, and the greatest number of adverse effects are most observed with tapentadol IR 100 mg (n = 2381). It is concluded that tapentadol IR (100 mg) leads to the best satisfaction score in this meta-analysis.

RESUMO

Soil salinity is a limiting factor in crop productivity. Inoculating crops with microorganisms adapted to salt stress is an alternative to increasing plant salinity tolerance. Few studies have simultaneously propagated arbuscular mycorrhizal fungi (AMF) and dark septate fungi (DSF) using different sources of native inoculum from halophyte plants and evaluated their effectiveness. In alfalfa plants as trap culture, this study assessed the infectivity of 38 microbial consortia native from rhizosphere soil (19) or roots (19) from six halophyte plants, as well as their effectiveness in mitigating salinity stress. Inoculation with soil resulted in 26-56% colonization by AMF and 12-32% by DSF. Root inoculation produced 10-56% and 8-24% colonization by AMF and DSF, respectively. There was no difference in the number of spores of AMF produced with both inoculum types. The effective consortia were selected based on low Na but high P and K shoot concentrations that are variable and are relevant for plant nutrition and salt stress mitigation. This microbial consortia selection may be a novel and applicable model, which would allow the production of native microbial inoculants adapted to salinity to diminish the harmful effects of salinity stress in glycophyte plants in the context of sustainable agriculture.

RESUMO

Mycena section Calodontes is macromorphologically distinguished by the collybioid or mycenoid basidiome, which is pink, purple, or violet, and, rarely, reddish-brown or yellowish. It is further characterized by the presence of oxalate crystals in the basal mycelium. The section comprises approximately 40 taxa, of which only five species and one variety exhibit bioluminescence. As part of an extensive study on Mycena sect. Calodontes in Mexico, specimens belonging to this section were collected and subjected to morphological analysis. Sequences from the nuclear internal transcribed spacer (ITS) of nuclear ribosomal DNA, RNA polymerase II large subunit Rpb1 (rpb1), and translation elongation factor-1α (Tef-1α) were generated to infer the relationships within Mycena sect. Calodontes using maximum likelihood and Bayesian inference. The phylogenetic evidence, along with the macro- and micromorphological features, supported the recognition of five new bioluminescent species within Mycena sect. Calodontes. Detailed macro- and micromorphological descriptions, line-drawing illustrations, and light and dark photographs of the new species are provided.

RESUMO

Background: Ventricular septal defect (VSD) complicating acute myocardial infarction (MI) represents a life-threatening condition and has a mortality of >90% if left untreated. Case summary: A 53-year-old man with a prior medical history of diabetes and hypertension presented with cardiogenic shock secondary to VSD as a mechanical complication of non-reperfused inferior MI. Discussion: The choice of mechanical support can be difficult in this type of patient. Given the risk of an increased shunt because of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and the increase in left ventricle (LV) afterload, several measures were taken to plan the best ECMO configuration. Given the absence of any real improvement in the LV and an elevated residual ratio between pulmonary and systemic flow (Qp/Qs), the final decision was to switch to left atrial VA-ECMO (LAVA-ECMO). The use of LAVA-ECMO improved the patient's haemodynamics and allowed his condition to stabilize; LAVA-ECMO is feasible and may be effective as a mechanical circulatory support (MCS) strategy for patients in cardiogenic shock due to VSD as a mechanical complication of acute MI.