Exceptional Presentation of Heart Thrombi Secondary to Myocardial Infarction Due to COVID-19 Pandemic.

Left ventricular thrombi (LVT) is an uncommon complication that can occur after a myocardial infarction thanks to the discovery of revascularization therapies. Before it, an LVT was described in up to 60% of patients with myocardial infarction. The authors present a case of a 46-year-old female who presented to the emergency department with one week of dyspnea, who had symptoms of chest pain for a week, however, did not show up in the hospital due to the ongoing COVID-19 pandemic. In-patient new-onset heart failure workup during that time was minimized due to the state of emergency COVID-19 pandemic. The patient lost to follow up appointment and then presented again to the hospital with Echocardiogram at that time showing mid to distal septal and apical hypokinesis, EF 30%-35% and a highly mobile circumferential echogenic mass of 2.4x2.4 cm noted in the left ventricle (LV) with differentials of LV thrombus vs cardiac tumor. Hospital complicated by LV thrombus embolization with bilateral lower extremities (LEs) arterial thrombi and limb ischemia. Left cardiac cath with a result of severe triple vessel disease requires either coronary artery bypass grafting (CABG) or complex percutaneous coronary intervention (PCI). A tentative plan was to pursue CABG, however, lower extremities must be healed prior to cardiothoracic surgery.

Correction to: Alterations in bacterial communities, SCFA and biomarkers in an elderly HIV-positive and HIV-negative population in western Mexico.

An amendment to this paper has been published and can be accessed via the original article.

Alterations in bacterial communities, SCFA and biomarkers in an elderly HIV-positive and HIV-negative population in western Mexico.

BACKGROUND: The study of stool microbiota has taken great relevance in the last years, given its role in the maintenance of the intestinal metabolic, physiological, and immunological homeostasis, as well as, its effect over HIV biomarkers levels such as CD4/CD8 ratio, high sensitivity C-Reactive Protein (hs-CRP), related to poor outcomes (rapid progression to AIDS). Several efforts have been made to characterize the gut microbiome. In HIV infection, most of the studies report the presence of a dysbiotic pattern; however, few of them have made an approach in elderly HIV-positive subjects despite the fact that nowadays this subgroup is rising. In this study, we compared the composition of faecal microbiota, Short Chain Fatty Acids (SCFAs), and systemic biomarkers between elderly HIV-positive and HIV-negative subjects. METHODS: A cross-sectional study with 18 HIV-negative controls and 20 HIV-positive patients. The quantification of Bacteroidetes, Firmicutes, Proteobacteria, Actinobacteria, Lactobacillus, Enterobacteriaceae, Bifidobacterium, Escherichia coli, Clostridium leptum, Clostridium coccoides was performed in faecal samples by qPCR. The analysis was performed by calculating the ΔCq of each microorganism using 16S rDNA as a reference gene. Faecal SCFAs were measured by HPLC. The hs-CRP and sCD14 were performed by ELISA. RESULTS: An increase in the Firmicutes/Bacteroidetes ratio, coupled with a significant increase in the proteobacteria phylum was detected in HIV-positive subjects. In contrast, a decrease in the Clostridium leptum group was observed. Nevertheless, these elderly HIV-positive patients showed higher levels of total SCFAs mainly by an augmented propionic acid values, compared to HIV-negative subjects. Whereas high levels of hs-CRP were positively correlated with sCD14 in the HIV-positive group. CONCLUSIONS: Alterations in bacterial communities reveals a dysbiotic state related to an unbalance of faecal SCFAs. Therefore, these intestinal conditions might drive an increase of poor prognostic biomarkers in elderly HIV-positive subjects.

Optimization of radiation doses received by personnel in PET uptake rooms.

Reduction of dose to exposed personnel during positron emission tomography (PET) installation usually relies on physical shielding. While the major contribution of shielding is unquestioned, it is usually the only method applied. Other methods of reduction, such as working procedure optimization, the position of the furniture, and rooms are usually disregarded in these installations. This paper presents a design and work optimization procedure used in a particular institution. The influence on the dose received by personnel due to the positioning of injection chairs, injection room configuration, and working procedures is studied. Using this optimization strategy, it is possible to reduce the technician dose due to patients by a factor of 0.59. Injection room design is much more important for optimizing the received dose than is work-flow management. The influence of the order of patient entrance on received dose was the aspect that produced the smallest variation in received doses. It is recommended that the optimization be carried out for the installation proposed in the design phase, when no additional cost is required, because the position of the doors of the injection rooms depends on the where the injection chairs are situated.

Oftalmologia y metodo científico; bases para su integracion / Opthalmology and scientific method; basis for integration

Este escrito ofrece elementos probatorios de la modificación en el coocimiento médico de las últimas décadas. Fundamenta la necessidad de modificar programas de entrenamiento de pre y post grado para profesionales en ciencias de la salud (PCS) que aún no los contemplan y ofrece una propuesta de solución. A través de una revisión de la literatura médica en general y oftalmológica prueba el cambio del paradigma de conocimiento médico producido por la incorporación de Estadística, Metodología, Epistemología, Lógica y Epidemiologia

Consultas en base de datos a través de microcomputadora / Searches in data bases with the use of micromputer

Ha resultado factible y altamente gratificante la conexión a diversas bases de datos con información médica y oftamlógica utilizando una computadora personal. La obtención de bibliografía en nuestro país resulta así posible, desde el consultorio y en el momento que el oftamólogo encuentre más conveniente

Consultas en base de datos a través de microcomputadora / Searches in data bases with the use of micromputer

Ha resultado factible y altamente gratificante la conexión a diversas bases de datos con información médica y oftamlógica utilizando una computadora personal. La obtención de bibliografía en nuestro país resulta así posible, desde el consultorio y en el momento que el oftamólogo encuentre más conveniente (AU)