Delta of Egypt Atrial Fibrillation Registry Phase Two

Background: Atrial Fibrillation (AF) is the most frequent cardiac arrhythmia found in clinical practice. The assessed frequency of AF in adults is between 2% and 4%, with greater incidence and frequency rates in developed nations [1,2]. AF prevalence increases with advancing age, and with some cardiac and non-cardiac disorders, also it may exist in the absence of any conditions [2]. We aimed to determine case characteristics, practice patterns, management strategies and outcomes of atrial fibrillation in the delta area of Egypt. Methods: This registry-based cross-sectional study included 1000 atrial fibrillation patients (with any AF patterns) who were allowed to enter ER in cardiac centers and hospitals in middle Delta of Egypt from April 2020 to March 2021. Results: 267 patients (26.7%) were unstable. Heart failure, hypertension, and coronary disease were still prevalent comorbidities in our AF dataset, where hypertension accounts for over 50% of all AF cases. Rheumatic valvular heart disorder was a major underlying disease for the development of AF, still about 25.5% by echocardiography. Lone AF still high 20.6%. CHA2DS2VASc score ?2 is 83.5%. A high proportion of cases were treated with pharmaceuticals for rate control nearly 52.7% of the cases and nearly 30.3% of the cases were given pharmacological medications for the cardioversion to the sinus rhythm and a small proportion of the cases were given electrical cardioversion nearly 7%. Conclusions: Coronary disease, hypertension, and heart failure were still usual comorbidities in AF. Rheumatic valvular heart disease is still about 25.5% of the total registry. Amiodarone is the most prevalent antiarrhythmic medications (AAD) used. lone AF still high 20.6%. minimal use of novel oral anticoagulant (OAC).

Role of P Wave Duration and Tissue Doppler Imaging as Predictive Indicators for Paroxysmal Atrial Fibrillation in Hypertensive Patients

Background: Atrial fibrillation (AF) is the most prevalent chronic arrhythmia in the heart. AF accounts for one-third of rhythm disorder hospitalizations. AF increases profoundly the risk of stroke, heart failure, and death. This study used P-wave and transthoracic echocardiography with tissue Doppler imaging (TDI) to determine paroxysmal AF predictors in hypertensive individuals. Methods: This case control study was performed on 100 hypertensive adult patients. They were classified into two equal group: Group I included hypertensive patients diagnosed to have paroxysmal AF. Group II (control group) included hypertensive patients with normal sinus rhythm. All subjects were subjected to electrocardiographic and conventional and tissue Doppler Imaging measurements. Results: Pmax had significantly increased in PAF patients compared to sinus rhythm patients. PAL, PAR, PAI, LR, LI and IR had significantly increased in PAF patients compared to sinus rhythm patients. In Multivariate logistic regression analysis, Pmax, PAL, PAI, PAR, LR, LI and IR were found to be independent predictors for PAF. Therefore, Pmax, PAL PAI, PAR, LR, LI and IR were found to be significant predictors for PAF. Best cut-off values for Pmax, PAL, PAI, PAR, LR, LI and IR were: (118, 81, 61, 49.9, 34, 20 and 16 ms) with sensitivity (76, 96, 96, 88, 82, 86 and 77.5 ), specificity (84, 100, 98, 92, 78, 82 and 76) and the AUC of (0.850, 0.979, 0.987, 0.961, 0.836, 0.891 and 0.798) respectively. Conclusions: Electrocardiographic P-wave analysis and echocardiographic TDI may identify hypertension patients at risk for paroxysmal AF, since the combination of Pmax and TDI may help in predicting the development of AF in hypertensive individuals.

Ligation of intersphincteric fistula tract (LIFT) for the treatment of anal fistula: a prospective observational study

Background: The ligation of intersphincteric fistula fract (LIFT) technique avoids postoperative anal continence disturbances and preserves quality of life. Methods: A total of 70 patients with anal fistula (AF) were treated in the Day Surgery Unit. The LIFT technique was the primary treatment in 63 patients. The other had previously undergone placement of a loose seton (two-step approach). The mean follow-up was 66.8 months. Statistical analysis was performed using contingency tables, the chi-square test, and the Student T-test. Results: The use of LIFT was successful in 40 patients (57.1%). However, 6 patients (8.6%) presented persistence of postoperative intersphincteric fistula, being successfully treated by fistulotomy. There were no differences in this technique's success rate between high and low AF (p = 0.45). The success rate of one-step LIFT, however, was significantly higher (p = 0.03). No disturbances of continence were observed. Conclusions: The LIFT technique has a role in the treatment of AF, is suitable for ambulatory surgery, and has a low complications rate. A two-step approach is not always needed. (AU)

AF4/FMR2 and IL-10 gene single nucleotide polymorphisms are correlated with disease susceptibility and immune infiltration in ankylosing spondylitis / 南方医科大学学报

OBJECTIVE@#To explore the correlation of polymorphisms of AF4/FMR2 family genes and IL-10 gene with genetic susceptibility to ankylosing spondylitis (AS) and identify the high-risk factors of AS.@*METHODS@#This case-control study was conducted among 207 AS patients and 321 healthy individuals. The tag single nucleotide polymorphisms (SNPs) rs340630, rs241084, rs10865035, rs1698105, and rs1800896 of the AF4/FMR2 family gene and IL-10 gene of the AS patients were genotyped, and the distribution frequencies of the genotypes and alleles were analyzed to explore the relationship between different genetic models and AS and the gene-gene and gene-environment interactions.@*RESULTS@#Gender ratio, smoking history, drinking history, hypertension, erythrocyte sedimentation rate and C-reactive protein differed significantly between the case group and the control group (P < 0.05). The dominant model and recessive model of AFF1 rs340630, the recessive model of AFF3 rs10865035, and the recessive model of IL-10 rs1800896 were significantly different between the two groups (P=0.031, 0.010, 0.031, and 0.019, respectively). Gene-environment interaction analysis suggested that the interaction model incorporating AFF1 rs340630, AFF2 rs241084, AFF3 rs10865035, AFF4 rs1698105, IL-10 rs1800896, smoking history and drinking history was the best model. The genes related with AF4/FMR2 and IL-10 were enriched in the biological processes of AF4 super extension complex, interleukin family signal transduction, cytokine stimulation and apoptosis. The expression levels of AF4/FMR2 and IL-10 were positively correlated with immune infiltration (r > 0).@*CONCLUSION@#The SNPs of AF4/FMR2 and IL-10 genes are associated with the susceptibility to AS, and the interactions of AF4/FMR2 and IL-10 genes with the environmental factors contributes causes AS through immune infiltration.

Validation of MyDiagnostick tool to identify atrial fibrillation in a multi-ethnic Asian population

INTRODUCTION@#MyDiagnostick is an atrial fibrillation (AF) screening tool that has been validated in the Caucasian population in the primary care setting.@*METHODS@#In our study, we compared MyDiagnostick with manual pulse check for AF screening in the community setting.@*RESULTS@#In our cohort of 671 candidates from a multi-ethnic Asian population, AF prevalence was found to be 1.78%. Of 12 candidates, 6 (50.0%) had a previous history of AF and another 6 (50.0%) were newly diagnosed with AF. Candidates found to have AF during the screening were older (72.0 ± 11.7 years vs. 56.0 ± 13.0 years, P < 0.0001) and had a higher CHADSVASC risk score (2.9 ± 1.5 vs. 1.5 ± 1.1, P = 0.0001). MyDiagnostick had a sensitivity of 100.0% and a specificity of 96.2%. In comparison, manual pulse check had a sensitivity of 83.3% and a specificity of 98.9%.@*CONCLUSION@#MyDiagnostick is a simple AF screening device that can be reliably used by non-specialist professionals in the community setting. Its sensitivity and specificity are comparable and validated across various studies performed in different population cohorts.

Diacylated anthocyanins from purple sweet potato (Ipomoeabatatas L.) attenuate hyperglycemia and hyperuricemia in mice induced by a high-fructose/high-fat diet / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Studies have shown that targeting xanthine oxidase (XO) can be a feasible treatment for fructose-induced hyperuricemia and hyperglycemia. This study aimed to evaluate the dual regulatory effects and molecular mechanisms of diacylated anthocyanins from purple sweet potato (diacylated AF-PSPs) on hyperglycemia and hyperuricemia induced by a high-fructose/high-fat diet. The body weight, organ index, serum biochemical indexes, and liver antioxidant indexes of mice were measured, and the kidneys were observed in pathological sections. The relative expression levels of messenger RNAs (mRNAs) of fructose metabolism pathway enzymes in kidney were detected by fluorescent real-time quantitative polymerase chain (qPCR) reaction technique, and the expression of renal transporter protein and inflammatory factor pathway protein was determined by immunohistochemistry (IHC) technique. Results showed that diacylated AF-PSPs alleviated hyperuricemia in mice, and that this effect might be related to the regulation of liver XO activity, lipid accumulation, and relevant renal transporters. Diacylated AF-PSPs reduced body weight and relieved lipid metabolism disorder, liver lipid accumulation, and liver oxidative stress, thereby enhancing insulin utilization and sensitivity, lowering blood sugar, and reducing hyperglycemia in mice. Also, diacylated AF-PSPs restored mRNA levels related to renal fructose metabolism, and reduced kidney injury and inflammation. This study provided experimental evidence for the mechanisms of dual regulation of blood glucose and uric acid (UA) by diacylated AF-PSPs and their utilization as functional foods in the management of metabolic syndrome.

A palpable depression

everal studies have shown that patients with depression, anxiety and stress have a higher ratio in developing atrial fibrillation (AF), with higher proportion occurring in patients with recurrent episodes of AF which are related to severity of disease and increased mortality ratio. We aim to discuss the case of AF caused by mental disorder to examine its relationship and impact in patient抯 clinical outcomes.A 70 years-old-man came to clinic with palpitation five days before admission. He often cries and has not been able to sleep since his wife died three months prior. He admits to have neither hope nor desire to do his usual activities or even start new activities. Vital signs show BP 140/90 mmHg, pulse 150x/m, RR 20x/m, SpO298%. Cardiopulmonary examination revealed irregular S1-S2. ECG shows premature atrial contraction which evolved to asinus rhythm with HR 150x/minute, AF and incomplete right bundle branch block a months after the first ECG was examined. Depression-Anxiety-stress scoring-42 (DASS-42) was conducted in this patient. Results shows the patient has very severe depression, intermediate anxiety and severe stress.Mental disorders lead to increased etiology of cardiac remodeling factors due to degeneration and sympathetic stimulation, which then induced the AF. Further research is needed to examine whether psychiatric treatment can prevent AF in improving quality of life, healthy behavior and awareness for managing mental health.

STUDY OF PATIENTS WITH ATRIAL FIBRILLATION IN VIEW OF ETIOLOGICAL EVALUATION AND CLINICAL PROFILE.

Background : Atrial fibrillation(AF) is the most common sustained arrhythmia encountered inclinical practice,accounting 1/3 of hospital-admissions for arrhythmia and rate of admissions for AFhas risen recently.The principle significance of AF both to patient and healthcare system is fivefoldincreased risk of embolic stroke.Methodology: Electrocardiogram confirmed 100 adult(≥18 years) patients of AF were included inthis study and evaluated clinically.Results: Incidence of AF in India is significantly high in younger age group and in Female(58%) ascompared to Western countries,where AF is more common in old age and in Male(42%).Mostcommon cause of AF is Rheumatic heart disease as compared to Western countries,where IHD is thecommonest cause.The average age of patient having RHD developing AF,in India,is 15-20 yearsearlier than patients from Western countries.Most common complication of AF is Congestive cardiacfailure. Most serious complication of AF is Cardio-embolic stroke.Increase in size of Left Atrium inAF is associated with increased risk of Cardio-embolic stroke.Conclusion: Trials have shown reduction in risk,if patients are adequately anticoagulated.so earlyevaluation and prophylactic treatment can reduce mortality and morbidity in patients of AF.

Natural exosome-like nanovesicles from edible tea flowers suppress metastatic breast cancer via ROS generation and microbiota modulation

Although several artificial nanotherapeutics have been approved for practical treatment of metastatic breast cancer, their inefficient therapeutic outcomes, serious adverse effects, and high cost of mass production remain crucial challenges. Herein, we developed an alternative strategy to specifically trigger apoptosis of breast tumors and inhibit their lung metastasis by using natural nanovehicles from tea flowers (TFENs). These nanovehicles had desirable particle sizes (131 nm), exosome-like morphology, and negative zeta potentials. Furthermore, TFENs were found to contain large amounts of polyphenols, flavonoids, functional proteins, and lipids. Cell experiments revealed that TFENs showed strong cytotoxicities against cancer cells due to the stimulation of reactive oxygen species (ROS) amplification. The increased intracellular ROS amounts could not only trigger mitochondrial damage, but also arrest cell cycle, resulting in the in vitro anti-proliferation, anti-migration, and anti-invasion activities against breast cancer cells. Further mice investigations demonstrated that TFENs after intravenous (i.v.) injection or oral administration could accumulate in breast tumors and lung metastatic sites, inhibit the growth and metastasis of breast cancer, and modulate gut microbiota. This study brings new insights to the green production of natural exosome-like nanoplatform for the inhibition of breast cancer and its lung metastasis via i.v. and oral routes.

In Vitro Evaluation of a Recently Developed Rotary File: AF Rotary / Avaliação in vitro de um arquivo rotativo desenvolvido recentemente: AF Rotary

Objective: Aim of the present study is to evaluate mechanical properties of a newly developed rotary file, AF Rotary (Fanta Dental, Shanghai, China), and to compare these features with a worldwide spread rotary file, Protaper Gold F2 (PTG F2; Dentsply Maillefer, Ballaigues, Switzerland). Material and Methods: 60 AF Rotary 25.06 and 60 PTG F2 were divided in three groups of 20 files each. A group underwent to cyclic fatigue resistance tests, second group underwent to torsional resistance tests, third group underwent to bending tests. The statistical analysis was performed using t student test with significance level set at 95% (p < 0.05). Results: AF Rotary showed significantly higher torsional resistance and cyclic fatigue resistance (p < 0.05) when compared to the PTG F2. AF Rotary also showed significantly lower bending resistance (p < 0.05) when compared to the PTG F2. Conclusion: Therefore, within the limitations of this study, the results show better performances for AF Rotary compared to PTG F2 regarding the cyclic fatigue test, the torsional test and the bending test. Since the PTG F2 is a commonly used and widely investigated instrument it could be possible to state that the AF Rotary exhibits remarkable in vitro performances. (AU)

Objetivo: O objetivo do presente estudo é avaliar as propriedades mecânicas de uma lima rotativa recém-desenvolvida, AF Rotary (Fanta Dental, Shanghai, China), e comparar essas características com uma lima rotativa mundialmente difundida, Protaper Gold F2 (PTG F2; Dentsply Maillefer, Ballaigues, Suíça). Material e Métodos: 60 AF Rotary 25.06 e 60 PTG F2 foram divididos em três grupos de 20 arquivos cada. Um grupo foi submetido a testes de resistência à fadiga cíclica, o segundo grupo foi submetido a testes de resistência à torção, o terceiro grupo foi submetido a testes de flexão. A análise estatística foi realizada por meio do teste t student com nível de significância de 95% (p <0,05). Resultados: AF Rotary apresentou resistência torcional e resistência à fadiga cíclica significativamente maiores (p <0,05) quando comparado ao PTG F2. AF Rotary também apresentou resistência à flexão significativamente menor (p <0,05) quando comparado ao PTG F2. Conclusão: Portanto, dentro das limitações deste estudo, os resultados mostram melhores desempenhos do AF Rotary em relação ao PTG F2 no que diz respeito ao teste de fadiga cíclica, ao teste de torção e ao teste de flexão. Uma vez que o PTG F2 é um instrumento comumente usado e amplamente investigado, pode-se afirmar que o AF Rotary exibe desempenhos in vitro notáveis. (AU)

Effects of Ziziphi Spinosae Semen and Albiziae Flos on Behavior and Endoplasmic Reticulum Stress PERK/ATF4/CHOP Pathway in Depression Model Rats / 中国实验方剂学杂志

Objective:To investigate the effect of Ziziphi Spinosae Semen （ZSS） and Albiziae Flos （AF） on behavior and endoplasmic reticulum stress endoplasmic reticulum stress protein kinase R-like endoplasmic reticulum kinase （PERK）/activated transcription factor 4 （ATF4）/CCAAT enhancer binding protein （CHOP） pathway in depression model rats， and to explore its antidepressant mechanism. Method:The male SD rats were divided into normal group， model group， ZSS-AF high dose， middle dose and low dose groups （16， 8， 4 g·kg^-1） and Venlafaxine group （0.008 g·kg^-1）， <italic>n</italic>=15 in each group. Except the normal group， the depression model was established in the rats of other 5 groups by the method of chronic unpredictable mild stress （CUMS） combined with isolated feeding. The normal group and model group were given with distilled water by gavage when modeling， while other groups received corresponding drug by intragastric administration for 21 days. Behavior changes of rats in each group were observed by the open field test and sugar water consumption test on 1^thand 21^thday of the experiment. The protein expressions of PERK， CHOP， B-cell lymphoma-2 associated X protein （Bax） and cysteine-containing aspartate-specific proteases-3（Caspase-3） were detected by Western blot（WB）， the ultrastructural changes of the hippocampus were observed by transmission electron microscope， the apoptosis of hippocampal neurons was observed by terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL） method. Result:Compared with the normal group， the scores of open field test and sugar water consumption rate in model group rats decreased （<italic>P</italic><0.01）. Compared with the model group， the scores of open field test and water consumption rate increased （<italic>P</italic><0.01） in ZSS-AF groups and Venlafaxine group. Transmission electron microscope showed that the changes of neuronal damage in hippocampal were revealed in the model group， whereas those neuronal damages were relieved in ZSS-AF groups and Venlafaxine group. TUNEL method showed that the number of apoptotic neurons in hippocampal increased in the model group （<italic>P</italic><0.01）， but decreased in ZSS-AFgroups and Venlafaxine group （<italic>P</italic><0.01）. WB results showed that as compared with the normal group， protein expressions of PERK， CHOP， Bax and Caspase-3 were up-regulated significantly in the model group （<italic>P</italic><0.01）， whereas those were down-regulated in ZSS-AF groups and Venlafaxine group （<italic>P</italic><0.05， <italic>P</italic><0.01）. Conclusion:The antidepressant effect of ZSS-AF herbal pair may be correlated with the regulation of endoplasmic reticulum stress PERK/ATF4/-CHOP pathway.

Clinical characteristics and prognosis of MLL-AF6 positive patients with acute myeloid leukemia / 北京大学学报(医学版)

OBJECTIVE@#To investigate the clinical features and prognosis of acute myeloid leukemia (AML) patients with the mixed lineage leukemia (MLL) gene rearrangements AF6 (MLL-AF6) positive.@*METHODS@#In the study, 11 patients who were newly diagnosed with MLL-AF6 positive AML were analyzed retrospectively, related literature was reviewed to clarify the clinical features and prognosis of MLL-AF6 positive patients.@*RESULTS@#Among the 11 patients, there were 6 males and 5 females, with a median age of 36 years. Six patients were diagnosed with AML M5 and five with M4 according to FAB classification (French-American-British classification systems). Gingival swelling and pain occurred in 6 cases and fever occurred in 5 cases. At first diagnosis, the median white blood cells were 55.5×109/L. Immunotype showed the expression of myeloid/monocyte and early stem cell series antigens. The expression level of MLL-AF6 fusion gene (real-time quantitative PCR) was 14.2%-214.5%, and 6/11 cases (54.5%) were associated with high EVI1 gene expression. Mutations of KRAS, TET2, ASXL1, TP53, DNMT3A, and FLT3-ITD were detected by next generation sequencing (NGS) in 4 patients. Chromosome G banding examination showed that 2 cases were t(6;11)(q27, q23) with complex karyotype abnormality, 4 cases with +8 abnormality and 2 cases with normal karyotype. Hematological complete remission (CR) was achieved in 8/11 patients (72.7%) after conventional induction chemotherapy, and primary drug resistance was observed in 3 patients. Two of the eight patients with CR were negative for minimal residual disease (MRD), with a median CR duration of 4.5 months. Two patients with positive MRD and three patients with refractory recurrence underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT), but all died due to leukemia progression. At the end of follow-up on December 1, 2019, 2 patients were alive and 9 died, with median survival time of 9 months.@*CONCLUSION@#The AML patients with MLL-AF6 positive were mostly young, the majority of FAB types were M4 and M5, and most of the patients often had fever as the first symptom, with increased white blood cells, accompanied by organ infiltration, and high EVI1 gene expression. The hematological remission rate of routine chemotherapy is not low, but it is difficult to achieve molecular remission, most of which have early recurrence. Early allo-HSCT in a molecular negative state may prolong the CR duration.

Research on Reliability Index and Realization of Magnetic Resonance (MR) Based on Clinical Use Condition / 中国医疗器械杂志

Combined with the clinical use condition of MR in use in Shanghai Sixth People's Hospital, MR components are divided into scanning type I and scanning type II. At the same time, combined with the main loss force of MR components, the research divides MR components into dynamic components and electric thermal components. In this study, a complete set of MR system reliability indexes and implementation methods are given, including system reliability index determination, system reliability allocation, component reliability index realization, system reliability prediction and system reliability verification. At the same time, this study also gives the methods of reliability prediction and reliability verification, and gives the MTBF calculation method of MR system based on clinical use data statistics.

Lo mejor de ACC 2021

Entre el 15 y el 17 del pasado mes de mayo de 2021 se llevó a cabo un nuevo congreso virtual del American College of Cardiology, uno de los eventos científicos más esperados de la cardiología mundial. Se contó con expositores de excelente nivel y la presentación de trabajos destacados que han realizado un aporte significativo a nuestra práctica clínica referidos a un gran abanico de situaciones frecuentes: cirugía cardíaca, cardiología intervencionista, manejo de arritmias. A continuación, seleccionamos y resumimos algunos de los trabajos más significativos: Aspirin versus clopidogrel for chronic maintenance monotherapy after percutaneous coronary intervention (HOST-EXAM). TicAgrelor versus CLOpidogrel in Stabilized Patients with Acute Myocardial Infarction (TALOS-AMI). Left Atrial Appendage Occlusion during Cardiac Surgery to Prevent Stroke III (LAAOS III). Sotagliflozin in Patients with Diabetes and Recent Worsening Heart Failure (SOLOIST-WHF). A Randomized Ablation-based atrial Fibrillation rhythm control versus rate control Trial in patients with heart failure and high burden Atrial Fibrillation (RAFT-AF). Aspirin Dosing: A Patient-Centric Trial Assessing Benefits and Long-Term Effectiveness (ADAPTABLE).

Summary: The Annual meeting of the American Cardiology College Congress was held virtually between 15th and 17th of May in present 2021. This is indeed one of the most expected and relevant scientific events in the world of Cardiology. We had excellent speakers and outstanding presentations updating central themes in our clinical practice referring to a wide range of frequent situations such us: cardiac surgery, interventional cardiology, management of arrhythmias. Bellow, we select and summarize some of the most significant works: Aspirin versus clopidogrel for chronic maintenance monotherapy after percutaneous coronary intervention (HOST-EXAM). TicAgrelor versus CLOpidogrel in Stabilized Patients with Acute Myocardial Infarction (TALOS-AMI). Left Atrial Appendage Occlusion during Cardiac Surgery to Prevent Stroke III (LAAOS III). Sotagliflozin in Patients with Diabetes and Recent Worsening Heart Failure (SOLOIST-WHF). A Randomized Ablation-based atrial Fibrillation rhythm control versus rate control Trial in patients with heart failure and high burden Atrial Fibrillation (RAFT-AF). Aspirin Dosing: A Patient-Centric Trial Assessing Benefits and Long-Term Effectiveness (ADAPTABLE).

De 15 a 17 de maio de 2021, foi realizada uma nova reunião virtual do congresso anual do American College of Cardiology, um dos eventos científicos mais relevantes do mundo da cardiologia. Houve excelentes palestrantes e a apresentação de estudos notáveis ​​que atualizaram temas centrais em nossa prática clínica referentes a uma ampla gama de situações comuns: cirurgia cardíaca, cardiologia intervencionista, manejo de arritmias. A seguir, selecionamos e resumimos algumas das obras mais significativas: Aspirina versus clopidogrel para monoterapia de manutenção crônica após intervenção coronária percutânea (EXAME-HOST). TicAgrelor versus CLOpidogrel em pacientes estabilizados com infarto agudo do miocárdio (TALOS-AMI). Oclusão do apêndice atrial esquerdo durante a cirurgia cardíaca para prevenir acidente vascular cerebral III (LAAOS III). Sotagliflozina em pacientes com diabetes e insuficiência cardíaca recente (SOLOIST-WHF). Um ensaio randomizado de controle de ritmo de fibrilação atrial baseado em ablação versus controle de frequência em pacientes com insuficiência cardíaca e fibrilação atrial de alta carga (RAFT-AF). Dosagem de aspirina: um estudo centrado no paciente que avalia os benefícios e eficácia a longo prazo (ADAPTÁVEL).

Lymphocyte proliferative responses in dairy cows supplemented with an immunomodulatory feed additive and administered polyvalent vaccination / [Proliferação de linfócitos em vacas leiteiras suplementadas com um aditivo alimentar imunomodulador e vacinadas com vacina polivalente]

O presente estudo avaliou o efeito da suplementação com OmniGen-AF® na proliferação de linfócitos e títulos de anticorpos após vacinação em bovinos leiteiros. Amostras de sangue periférico foram coletadas de 32 vacas leiteiras para quantificação dos títulos de anticorpos anti-Leptospira, e amostras de sangue periférico de 16 vacas leiteiras foram também coletadas para avaliação da proliferação de linfócitos. Observou-se que a suplementação com OmniGen-AF® aumentou a proliferação basal de linfócitos (sem estímulos) 21 dias após a vacinação (P=0,03), apesar de reduzir a proliferação de linfócitos B quando estimulada com Leptospira borgpetersenii serovar Hardjo inativada pelo calor (P=0,03). Ademais, nenhum efeito da suplementação sobre a proliferação de linfócitos no momento imediatamente anterior à vacinação e nos títulos de anticorpos anti-Leptospira foi encontrado. Além disso, a proliferação de linfócitos estimulada com lipopolissacarídeos foi maior em vacas multíparas que em primíparas 21 dias após a vacinação (P=0,03). Desse modo, o presente estudo demonstra que a suplementação com OmniGen-AF® não afetou de forma robusta a proliferação de linfócitos e os títulos de anticorpos anti-Leptospira após vacinação em vacas leiteiras sadias.(AU)

Simultaneous thoracoscopic approach in a patient with long-standing persistent atrial fibrillation and primary lung cancer: the first described case

Abstract Cardiac rhythm disorders are common in many patients with cancer. The management of synchronous long-standing persistent atrial fibrillation and pulmonary lesions remains a serious surgical dilemma due to the lack of clinical data and surgical guidelines. To the best of our knowledge, this is the first described case of simultaneous thoracoscopic pulmonary segmentectomy and left atrial posterior wall and pulmonary vein isolation combined with left atrial appendage resection in a patient with early-stage primary lung cancer and long-standing persistent atrial fibrillation.

Identificación de alteraciones moleculares en pacientes Venezolanos con diagnóstico de leucemia linfoblástica aguda / Identification of molecular alterations in Venezuelan patients with acute lymphoblastic leukemia diagnosis

La Leucemia Linfoblástica Aguda (LLA) es la neoplasia más frecuente en edad pediátrica. En los últimos años, entre el 15 y 20% de los pacientes fracasan en el tratamiento. Conocimientos en citogenética y biología molecular repercuten de manera importante en la determinación del pronóstico y del esquema de tratamiento adecuado. En Venezuela existe un conocimiento limitado en cuanto a la genética molecular de esta alteración onco-hematológica. El objetivo del trabajo fue evaluar las alteraciones genéticas más frecuentes en pacientes venezolanos con diagnóstico clínico de leucemia linfoblástica aguda. Se realizó un estudio transversal, descriptivo y prospectivo de 2006 a 2014, en el que se evaluaron las translocaciones ETV6/RUNX1, MLL/AF4, TCF3/PBX1, BCR/ABL1, así como las mutaciones en los genes PAX5 y FLT3 mediante el uso de diferentes tipos de PCR. Ciento treinta pacientes con diagnóstico clínico de leucemia linfocítica aguda fueron incluidos en el estudio. Se identificaron alteraciones moleculares en 56 pacientes (43,1%), en los que observamos la presencia de una o varias alteraciones en conjunción en un mismo paciente. Las alteraciones identificadas fueron t(12;21) (11,5%), t(4;11) (8,5%), t(1;19) (10%), t(9;22) (20,8%), ITD-FLT3 (14,8%), mutación P80S (4,2%) y S77del (4,2%) en el gen PAX5. La prevalencia de BCR/ ABL, es una de las más altas que ha sido descrita hasta ahora en casos de LLA donde la mayor parte de la población está conformada por pacientes pediátricos. Estos resultados representan el primer estudio molecular de la LLA en Venezuela, sentando las bases para el diagnóstico y seguimiento de la enfermedad en su población.

Acute Lymphoblastic Leukemia (ALL) is the most common neoplasm in pediatric age. In recent years, between 15 and 20% of patients failed in their treatments. Knowledge on cytogenetics and molecular biology has an important impact on the determination of the prognosis and the appropriate treatment scheme. In Venezuela there is limited knowledge regarding the molecular genetics of this onco-hematological alteration. The aim of this work was to evaluate the most frequent genetic alterations in Venezuelan patients with a clinical diagnosis of acute lymphoblastic leukemia. A cross-sectional, descriptive and prospective study was carried out from 2006 to 2014, in which the translocations ETV6/RUNX1, MLL/AF4, TCF3/PBX1, BCR/ABL1, as well as mutations in the PAX5 and FLT3 genes were evaluated through the use of different types of PCR. One hundred and thirty patients with a clinical diagnosis of acute lymphocytic leukemia were included in the study. Molecular alterations were identified in 56 patients (43.1%), in which we observed the presence of one or several alterations in conjunction in the same patient. The alterations identified were t(12; 21) (11.5%), t(4; 11) (8.5%), t(1; 19) (10%), t(9; 22) (20.8%), ITD-FLT3 (14.8%), P80S mutation (4.2%) and S77del (4.2%) in the PAX5 gene. The prevalence of BCR/ABL is one of the highest described so far in cases of ALL where most of the population is made up of pediatric patients. These results represent the first molecular study of ALL in Venezuela, laying the foundations for the diagnosis and monitoring of the disease in its population.

Encarceramento feminino: reflexões acerca do abandono afetivo e fatores associados / Female incarceration: reflections of affective and associated factors / Encarcelamiento femenino: reflexiones acerca del abandono afectivo y factores asociados / Incarcération des femmes: réflexions sur les facteurs associés

O presente trabalho aborda histórica e criticamente o encarceramento feminino, bem como o abandono afetivo experienciado pelas mulheres encarceradas. A pesquisa foi realizada com base em revisão de literatura, tendo sido investigado a partir das características da mulher criminosa desenvolvido pela criminologia positivista no final do século XIX, até o acervo literário mais atual sobre essa temática do encarceramento feminino, o rompimento do ideal de mulher estabelecido historicamente despontou como um dos principais fatores, juntamente com as relações de poder de base patriarcal instituídas sobre essas mulheres. Junto a isso, buscou-se apresentar de que maneira as relações de poder atravessam o corpo das mulheres encarceradas por meio de estratégias de dominação, apontar os significados que permeiam a entrada das mulheres na criminalidade, bem como a maneira com as quais elas são punidas. Nesse último quesito, foi apresentada a direta relação que a desigualdade de gênero se aloca nas atuações de quem se relaciona diretamente com a população carcerária feminina.

The present work approaches historically and critically the female incarceration, as well as the affective abandonment experienced by imprisoned women. The research was carried out based on a literature review in which aspects from the characteristics of the criminal women developed by positivist criminology at the end of the 19th century to the most current literary collection on the female incarceration 's subject were delineated. The breaking of the ideal of women established historically along with the patriarchal base power relations instituted upon these women emerged as main factors. Additionally, it was presented how power relations cross the body of imprisoned women through strategies of domination and to point out the meanings that permeate the entry of women into criminality, as well as the manner in which they are punished. Based on this last issue, the direct relationship between gender inequality and the actions of those directly involved with the female incarcerated population was presented.

El presente trabajo aborda histórica y críticamente el encarcelamiento femenino, así como el abandono afectivo experimentado por las mujeres encarceladas. La investigación fue realizada con base en revisión de literatura, siendo investigado a partir de las características de la mujer criminal desarrollada por la criminología positivista, a finales del siglo XIX, hasta el acervo literário más actual acerca de la temática del encarcelamiento femenino, el rompimiento del ideal de mujer establecido históricamente surgió como uno de los principales factores, junto con las relaciones de poder de base patriarcal instituidas sobre estas mujeres. Junto a eso, se buscó presentar de qué manera las relaciones de poder atraviesan el cuerpo de las mujeres encarceladas por medio de estrategias de dominación, apuntar los significados que permean la entrada de las mujeres en la criminalidad, así como la manera con que ellas son castigadas. En este último aspecto, se presentó la directa relación que la desigualdad de género se asigna en las actuaciones de quienes se relacionan directamente con la población carcelaria femenina.

Le présent travail aborde historiquement et de manière critique l'incarcération des femmes, ainsi que l'abandon affectif vécu par les femmes emprisonnées. La recherche a été réalisée sur la base d'une revue de la littérature, après avoir étudié les caractéristiques de la femme criminelle développée par la criminologie positiviste à la fin du XIXe siècle, ainsi que la collection littéraire la plus récente sur l'incarcération des femmes, la rupture de l'idéal de la femme. établi historiquement est apparu comme l'un des principaux facteurs avec les relations de pouvoir patriarcales établies sur ces femmes. En même temps, l'objectif était de montrer comment les relations de pouvoir traversent le corps des femmes emprisonnées par le biais de stratégies de domination, afin de mettre en évidence les significations qui imprègnent l'entrée des femmes dans la criminalité, ainsi que la manière dont elles sont punies. Dans cette dernière question, le lien direct entre l'inégalité entre les sexes et les actions de ceux directement liés à la population carcérale féminine a été présenté.

Prophylactic Use of Magnesium Sulphate to Prevent Arrythmias in Patients with Rheumatic Heart Disease Undergoing Closed Mitral Valvotomy

Maintenance of sinus rhythm is superior to incidence of atrial fibrillation (AF) in patients with rheumatic heartdisease undergoing Closed Mitral Valvotomy (CMV). The present study was done to evaluate the effect ofprophylactic use of Magnesium Sulphate (MgSo4), intravenously (i.v) soon after opening the stenosed MitralValve using Tubbs dilators by Surgeon, in patients undergoing CMV. One hundred and twenty patients withMitral Stenosis (MS) (mitral valve area < 1cm2), normal mitral valvular apparatus, no mitral regurgitation,mitral score not more than 7/16 planned for CMV. These patients were divided in two groups of 60 each.Group (I) (n=60) received. MgSo4, 30 mg/kg diluted to 20 ml with normal saline soon after mitral valvotomyand Group - II (n=60) received 20 ml of normal saline. The standardized protocol for CMV was maintainedfor all the patients. Before surgery AF was observed in 56.67% of patients in group I and 48.33% of patientsin group II (p=0.46). Postoperatively in ICU, 30% of patients in group I and 70% of patients in group II hadAF(p<0.0001). A single prophylactic intra operative dose of i.v MgSO4 decreased post valvotomy arrhythmiain comparision to placebo group . Thus, a single dose of intraoperative MgSO4 can be used to decreasepostoperative arrhythmias in patients of M.S undergoing CMV

A Study Of Etiology, Clinical Profile And Complications Of Patients With Atrial Fibrillation

BACKGROUND: Atrial fiillation (AF) is the most common cardiac arrhythmia, occurring in 1–2% of the general population. AF confers a 5–fold risk of stroke. Much earlier detection of the arrhythmia might allow the timely introduction of therapies to protect the patient, not only from the consequences of the arrhythmia, but also from progression of AF from an easily treated condition to an utterly refractory problem. AIM OF STUDY: Analysis of etiological features, clinical features and Complications of atrial fiillation. METHODOLOGY: 100 cases of atrial fiillation both male and female were included in the study. The diagnosis was made on clinical grounds and then confirmed by ECG and Echo cardiogram. RESULTS: In this study of atrial fiillation, the occurrence of AF is maximum in age group 61 and above. Out of 100 cases 43 cases were male, 57 cases were female, and 60 cases were rheumatic heart disease. CONCLUSION: In this study common aetiology of AF was RHD 60% followed by Hypertensive heart disease and Ischemic heart disease each carries 10%. The most common symptomatic presentations were dyspnea and palpitation followed by chest pain and dizziness. The commonest complication noted was heart failure.