Should Physicians Be Aware of Rhythm Disturbances in Adults with Systemic Autoimmune Diseases and Anti-Ro52 Antibodies? A Cross-Sectional Study.

Objectives: The association between anti-Ro/SSA antibodies and the appearance of cardiac rhythm disorders in adults is discussed. We aim to study this relationship, together with active treatments and comorbidities, and its impact on daily clinical practice in adults with systemic autoimmune diseases (SADs). Methods: This cross-sectional single-center study was conducted in a tertiary hospital between January 2021 and March 2022. A sample of adult patients followed up in the SAD Unit with a diagnosis of a SAD and previously tested for anti-Ro/SSA and anti-La/SSB were recruited. All of them underwent a 12-lead electrocardiogram. Results: 167 patients were included. 90 (53.9%) were positive for anti-Ro60, 101 (60.5%) for anti-Ro52, and 45 (26.9%) for anti-La/SSB; 52 (31.3%) were triple-negative. 84% were women, and the mean age was 59 years (standard deviation 12.8). The most common SAD was primary Sjögren's syndrome (34.8%), followed by systemic lupus erythematosus (24.6%) and rheumatoid arthritis (22.8%). A statistically significant relationship was found between anti-Ro52 positivity and cardiac rhythm disorders (relative risk = 2.007 [1.197-3.366]), specifically QTc prolongation (relative risk = 4.248 [1.553-11.615]). Multivariate regressions showed a significant association, with diabetes mellitus being the most related comorbidity. The association between anti-Ro52 antibodies and atrioventricular conduction disorders was not significant. Conclusions: The presence of anti-Ro52 antibodies in adult patients with SADs is associated with an increased risk of QTc prolongation. Electrocardiographic screening of patients with SAD, anti-Ro52 antibodies, and other risk factors, like diabetes mellitus or QT-prolonging drugs, seems advisable. Those with baseline electrocardiogram abnormalities or additional risk factors should undergo electrocardiographic monitoring.

Putative Secondary Structure at 5’UTR as a Potential Antiviral Target against SARS-CoV-2 / Estructura secundaria en 5’UTR como diana antiviral contra el SARS-CoV-2

SARS-CoV-2 is an enveloped positive-sense single-stranded RNA coronavirus that causes COVID-19, ofwhich the current outbreak has resulted in a high number ofcases and fatalities throughout the world, even vaccine dosesare being administered. The aim of this work was to scan theSARS-CoV-2 genome in search for therapeutic targets. Wefound a sequence in the 5’UTR (NC\_045512:74-130), consisting of a typical heptamer next to a structured region thatmay cause ribosomal frameshifting. The potential biologicalvalue of this region is relevant through its low similarity withother viruses, including coronaviruses related to SARS-CoV,and its high sequence conservation within multiple SARSCoV-2 isolates. We have predicted the secondary structure ofthe region by means of different bioinformatic tools. We havesuggested a most probable secondary structure to proceedwith a 3D reconstruction of the structured segment. Finally,we carried out virtual docking on the 3D structure to look fora binding site and then for drug ligands from a database oflead compounds. Several molecules that could be probablyadministered as oral drugs show promising binding affinitywithin the structured region, and so it could be possible interfere its potential regulatory role (AU)

El SARS-CoV-2 es un coronavirus de ARN monocatenariode sentido positivo envuelto que causa COVID-19, del cual elbrote actual ha provocado una gran cantidad de casos y muertes en todo el mundo, incluso cuando se están administrandodosis de vacunas. En este trabajo hemos escaneado el genomadel SARS-CoV-2 en busca de dianas terapéuticas. Encontramosuna secuencia en el 5’UTR (NC \ _045512: 74-130), que consiste en un heptámero típico junto a una región estructurada quepuede causar cambios en la pauta de lectura. El valor biológicopotencial de esta región es relevante debido a su baja similitud con otros virus, incluidos los coronavirus relacionados conel SARS-CoV, y su alta conservación de secuencia dentro demúltiples aislados de SARS-CoV-2. Hemos predicho la estructura secundaria de la región mediante diferentes herramientasbioinformáticas. Hemos sugerido una estructura secundariamás probable para así proceder al acoplamiento virtual en laestructura 3D para buscar un sitio de unión y luego ligandosde fármacos. Hemos encontrado varias moléculas que probablemente podrían administrarse como fármacos orales muestran una afinidad de unión prometedora dentro de la regiónestructurada, por lo que es posible que interfieran en su posiblefunción reguladora de la replicación viral. (AU)

Genetic Susceptibility to Acute Kidney Injury.

Acute kidney injury (AKI) is a widely held concern related to a substantial burden of morbidity, mortality and expenditure in the healthcare system. AKI is not a simple illness but a complex conglomeration of syndromes that often occurs as part of other syndromes in its wide clinical spectrum of the disease. Genetic factors have been suggested as potentially responsible for its susceptibility and severity. As there is no current cure nor an effective treatment other than generally accepted supportive measures and renal replacement therapy, updated knowledge of the genetic implications may serve as a strategic tactic to counteract its dire consequences. Further understanding of the genetics that predispose AKI may shed light on novel approaches for the prevention and treatment of this condition. This review attempts to address the role of key genes in the appearance and development of AKI, providing not only a comprehensive update of the intertwined process involved but also identifying specific markers that could serve as precise targets for further AKI therapies.

Distinguishing septic shock from non-septic shock in postsurgical patients using gene expression.

OBJECTIVES: To obtain a gene expression signature to distinguish between septic shock and non-septic shock in postoperative patients, since patients with both conditions show similar signs and symptoms. METHODS: Differentially expressed genes were selected by microarray analysis in the discovery cohort. These genes were evaluated by quantitative real time polymerase chain reactions in the validation cohort to determine their reliability and predictive capacity by receiver operating characteristic curve analysis. RESULTS: Differentially expressed genes selected were IGHG1, IL1R2, LCN2, LTF, MMP8, and OLFM4. The multivariate regression model for gene expression presented an area under the curve value of 0.922. These genes were able to discern between both shock conditions better than other biomarkers used for diagnosis of these conditions, such as procalcitonin (0.589), C-reactive protein (0.705), or neutrophils (0.605). CONCLUSIONS: Gene expression patterns provided a robust tool to distinguish septic shock from non-septic shock postsurgical patients and shows the potential to provide an immediate and specific treatment, avoiding the unnecessary use of broad-spectrum antibiotics and the development of antimicrobial resistance, secondary infections and increase health care costs.

Gene Expression Patterns Distinguish Mortality Risk in Patients with Postsurgical Shock.

Nowadays, mortality rates in intensive care units are the highest of all hospital units. However, there is not a reliable prognostic system to predict the likelihood of death in patients with postsurgical shock. Thus, the aim of the present work is to obtain a gene expression signature to distinguish the low and high risk of death in postsurgical shock patients. In this sense, mRNA levels were evaluated by microarray on a discovery cohort to select the most differentially expressed genes between surviving and non-surviving groups 30 days after the operation. Selected genes were evaluated by quantitative real-time polymerase chain reaction (qPCR) in a validation cohort to validate the reliability of data. A receiver-operating characteristic analysis with the area under the curve was performed to quantify the sensitivity and specificity for gene expression levels, which were compared with predictions by established risk scales, such as acute physiology and chronic health evaluation (APACHE) and sequential organ failure assessment (SOFA). IL1R2, CD177, RETN, and OLFM4 genes were upregulated in the non-surviving group of the discovery cohort, and their predictive power was confirmed in the validation cohort. This work offers new biomarkers based on transcriptional patterns to classify the postsurgical shock patients according to low and high risk of death. The results present more accuracy than other mortality risk scores.

Respuesta al ECG de febrero de 2018 / Response to ECG, February 2018

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ECG de febrero de 2018 / ECG, February 2018

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Respuesta al ECG de julio de 2016 / Response to ECG, July 2016

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ECG de julio de 2016 / ECG, July 2016

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Tormenta arrítmica refractaria: papel del bloqueo simpático transitorio / Refractory electrical storm: a role for transient sympathetic blockade

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Tormenta arrítmica secundaria a infarto agudo de miocardio e insuficiencia cardiaca tratada mediante bloqueo de ganglio estrellado izquierdo / Electrical storm secondary to acute myocardial infarction and heart failure treated with left stellate ganglion block

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