2D model of groundwater flow and total dissolved HCH transport through the Gállego alluvial aquifer downstream the Sardas landfill (Huesca, Spain).

The organic pollutants disposed at the Sardas landfill in Sabiñánigo (Huesca, northeastern Spain) by the INQUINOSA lindane factory have reached the Gállego alluvial aquifer and could affect the Sabiñánigo reservoir. The daily oscillations of the reservoir water level produce a tidal effect on the piezometric heads of the aquifer. These oscillations are transmitted in a damped way with a time lag, thus attesting that the silting sediments of the reservoir and the natural silts of the Gállego alluvial are interposed between the reservoir water and the layer of sands and gravels. A 2D finite element groundwater flow and total dissolved hexachlorocyclohexane (HCH) transport model through the Gállego alluvial aquifer is presented here. The flow model was constructed to: (1) Quantify the tidal effect, produced by the daily fluctuations of the reservoir water level on the aquifer; (2) Estimate the hydrodynamic parameters of the layer of sands and gravels; and 3) Estimate the vertical hydraulic conductivity of the silting sediments and silts; and (4) Quantify aquifer/reservoir interactions. The flow model reproduces the dynamics of the tidal effect and attests that groundwater velocity and flow direction changes daily in response to the oscillations of the reservoir level. Model results reproduce the measured well hydrographs and the Darcy velocity derived from tracer tests and confirm the validity of the conceptual model. The transport model of total dissolved HCH simulates the time evolution of the contaminant plume. The computed concentrations of total dissolved HCH and the contaminant mass outflux are very sensitive to changes in the source terms and the distribution coefficient, Kd of HCH. The best fit to the measured HCH plumes in September 2010 and December 2020 is obtained with a Kd ranging from 1 to 3 L/kg. The computed flux of dissolved HCH leaving the Sardas site in 2020 towards the Sabiñánigo reservoir ranges from 0.6 kg/year for Kd = 3 L/kg to 3.1 kg/year for Kd = 1 L/kg. The findings of this study will be most useful for planning and designing remedial and containment actions at the Sardas site and other similar lindane-affected sites.

Heart rate variability-based prediction of early cardiotoxicity in breast-cancer patients treated with anthracyclines and trastuzumab.

BACKGROUND: Cardiotoxicity is a recognized complication in breast cancer (BC) patients undergoing chemotherapy with anthracyclines with or without trastuzumab. However, the prognostic value of heart rate variability (HRV) indexes for early cardiotoxicity development remains unknown. METHODS: Fifty BC patients underwent TTE assessment before and three months after chemotherapy. HRV indexes were obtained from continuous electrocardiograms in supine position with spontaneous breathing, active standing, and supine position with controlled breathing. The magnitude of change (Δ) between supine-standing and supine-controlled breathing was calculated. Variables were compared using t-test or ANOVA. Cardiotoxicity predictive value was assessed by ROC curve analysis. A p value of < 0.05 was considered significant. RESULTS: TTE revealed reduced left atrial conduit strain in the cardiotoxicity group. Mean heart rate increased during all maneuvers at follow-up, with no differences in HRV indexes between patients with or without cardiotoxicity. However, a lower Δ in supine-controlled breathing of several HRV indexes predicted early cardiotoxicity identified by echocardiography (e.g. SDNN ≤ -8.44 ms: Sensitivity = 75%, Specificity = 69%). CONCLUSIONS: BC patients treated with chemotherapy maintain cardiac autonomic responses to physiological stimuli after 3 months of chemotherapy. However, a lower Δ during active standing and controlled breathing before chemotherapy may predict early cardiotoxicity.

Functional features of the exopolysaccharide extracts produced by Lactiplantibacillus strains isolated from table olives.

This study evaluates the functional characteristics of the exopolysaccharide (EPS) extracts produced by various strains of Lactiplantibacillus pentosus (LPG1, 119, 13B4, and Lp13) and Lactiplantibacillus plantarum (Lp15) isolated from table olives. None of the EPS crude extracts showed cytotoxicity when administered to THP-1 human macrophage cells at dosages ranging from 6.25 to 50 µg mL-1. Many exhibited anti-inflammatory properties (reduction of pro-inflammatory cytokines TNF-α and IL-6 production) and antioxidant activity (reduction of ROS%) when macrophages were stimulated with Escherichia coli lipopolysaccharide. Notably, the EPS extract produced by the L. pentosus LPG1 strain had the best results corroborated by western blot immune analysis for differential expression of COX-2, Nrf-2, and HO-1 proteins, with the most significant antioxidant and anti-inflammatory response observed at a dosage of 50 µg mL-1. Chemical analysis revealed that the EPS extract produced by this strain contains a heteropolymer composed of mannose (35.45%), glucose (32.99%), arabinose (17.93%), xylose (7.48%), galactose (4.03%), rhamnose (1.34%), and fucose (0.77%). Finally, we conducted response surface methodology to model the EPS extract production by L. pentosus LPG1 considering pH (3.48-8.52), temperature (16.59-33.41 °C) and salt concentration (0.03-8.77% NaCl) as independent variables. The model identified linear effects of salt and pH and quadratic effects of salt as significant terms. The maximum EPS extract production (566 mg L-1) in a synthetic culture medium (MRS) was achieved at pH 7.5, salt 7.0%, and a temperature of 20 °C. These findings suggest the potential for novel applications for the EPS produced by L. pentosus LPG1 as nutraceutical candidates for use in human diets.

Photoprotective Effects of Two New Morin-Schiff Base Derivatives on UVB-Irradiated HaCaT Cells.

Ultraviolet (UV) radiation harms the skin, causing oxidative damage, inflammation, and disruption of the skin's barrier function. There is considerable interest in identifying new natural ingredients with antioxidant and anti-inflammatory properties to serve as adjuvants in sunscreens. The flavonoid morin (1) can undergo structural modifications to enhance its biological properties. The aim of this study was to synthesize two new morin-Schiff base derivatives, morin oxime (2) and morin semicarbazone (3), comparing their photoprotective effects with that of the parent compound on UVB-exposed HaCaT keratinocytes. The chemical structure of the novel compounds was revealed based on spectroscopic data analysis. Our findings demonstrated that derivatives 2 and 3 enhanced the light absorption capability in the UV-visible (vis) range compared to 1. Tested compounds exhibited a higher scavenger capacity than Trolox. Moreover, pre-treatment with all compounds protected HaCaT cells from UVB-induced cell death. Compound 3 demonstrated the strongest antioxidant effect, reducing reactive oxygen species (ROS) generation and, subsequently, malondialdehyde (MDA) levels. Additionally, compounds 2 and 3 exhibited greater anti-inflammatory effects than compound 1, significantly reducing interleukin (IL)-6 production levels at all tested concentrations. These findings have demonstrated, for the first time, a promising photoprotective activity of two new Schiff base derivatives and suggest their use as natural sunscreen ingredients.

Exploring Metabolic and Gut Microbiome Responses to Paraquat Administration in Male Wistar Rats: Implications for Oxidative Stress.

In this study, we examined the metabolic and gut microbiome responses to paraquat (PQ) in male Wistar rats, focusing on oxidative stress effects. Rats received a single intraperitoneal injection of PQ at 15 and 30 mg/kg, and various oxidative stress parameters (i.e., MDA, SOD, ROS, 8-isoprostanes) were assessed after three days. To explore the omic profile, GC-qTOF and UHPLC-qTOF were performed to assess the plasma metabolome; 1H-NMR was used to assess the urine metabolome; and shotgun metagenomics sequencing was performed to study the gut microbiome. Our results revealed reductions in body weight and tissue changes, particularly in the liver, were observed, suggesting a systemic effect of PQ. Elevated lipid peroxidation and reactive oxygen species levels in the liver and plasma indicated the induction of oxidative stress. Metabolic profiling revealed changes in the tricarboxylic acid cycle, accumulation of ketone body, and altered levels of key metabolites, such as 3-hydroxybutyric acid and serine, suggesting intricate links between energy metabolism and redox reactions. Plasma metabolomic analysis revealed alterations in mitochondrial metabolism, nicotinamide metabolism, and tryptophan degradation. The gut microbiome showed shifts, with higher PQ doses influencing microbial populations (e.g., Escherichia coli and Akkermansia muciniphila) and metagenomic functions (pyruvate metabolism, fermentation, nucleotide and amino acid biosynthesis). Overall, this study provides comprehensive insights into the complex interplay between PQ exposure, metabolic responses, and gut microbiome dynamics. These findings enhance our understanding of the mechanisms behind oxidative stress-induced metabolic alterations and underscore the connections between xenobiotic exposure, gut microbiota, and host metabolism.

Abrupt Photoperiod Changes Differentially Modulate Hepatic Antioxidant Response in Healthy and Obese Rats: Effects of Grape Seed Proanthocyanidin Extract (GSPE).

Disruptions of the light/dark cycle and unhealthy diets can promote misalignment of biological rhythms and metabolic alterations, ultimately leading to an oxidative stress condition. Grape seed proanthocyanidin extract (GSPE), which possesses antioxidant properties, has demonstrated its beneficial effects in metabolic-associated diseases and its potential role in modulating circadian disruptions. Therefore, this study aimed to assess the impact of GSPE administration on the liver oxidant system of healthy and diet-induced obese rats undergoing a sudden photoperiod shift. To this end, forty-eight photoperiod-sensitive Fischer 344/IcoCrl rats were fed either a standard (STD) or a cafeteria diet (CAF) for 6 weeks. A week before euthanizing, rats were abruptly transferred from a standard photoperiod of 12 h of light/day (L12) to either a short (6 h light/day, L6) or a long photoperiod (18 h light/day, L18) while receiving a daily oral dose of vehicle (VH) or GSPE (25 mg/kg). Alterations in body weight gain, serum and liver biochemical parameters, antioxidant gene and protein expression, and antioxidant metabolites were observed. Interestingly, GSPE partially ameliorated these effects by reducing the oxidative stress status in L6 through an increase in GPx1 expression and in hepatic antioxidant metabolites and in L18 by increasing the NRF2/KEAP1/ARE pathway, thereby showing potential in the treatment of circadian-related disorders by increasing the hepatic antioxidant response in a photoperiod-dependent manner.

Neopentecostalismo, teología de la prosperidad y neoliberalismo. Hacia una lógica religiosa para el Homo oeconoimicus

El presente escrito tiene por objetivo demostrar que la relación entre la teología de la prosperidad, que se toma aquí específicamente en su expresión neopentecostal, y el neoliberalismo, entendido desde su dimensión de fuerza productora de subjetividad, se ha fortalecido dentro del actual marco de reproducción sistémica del capitalismo. Para esto se divide el escrito en tres partes: la primera, que se encarga de exponer conceptualmente el neopentecostalismo; la segunda, donde se expone la teología de la prosperidad; y, por último, aquella que trabaja la manera en que el fenómeno religioso neopentecostal, como ejemplo de fe de la prosperidad, se vincula con el neoliberalismo. De este modo, y a partir del método documental-bibliográfico, se puede evidenciar cómo es que el actual viraje del capitalismo se dirige hacia ciertas prácticas y discursos religiosos, de modo que pueda capturarlos y volverlos a su favor, ya que dichas prácticas y discursos permiten, entre otras cosas, una alternativa para curar, momentáneamente, el sufrimiento subjetivo que padece el Homo oeconomicus por vivir como manda el sistema.

The purpose of this paper is to demonstrate the relationship theology of prosperity, which is specifically taken in its neo-Pentecostal expression, and neoliberalism as necessary within the current framework of systemic reproduction of capitalism. For this, the writing is divided into three parts: the first, which is responsible for conceptually exposing neo-Pentecostalism; the second, where the theology of prosperity is exposed; and, finally, the one that works on the way in which the neo-Pentecostal religious phenomenon, as an example of faith in prosperity, is linked to neoliberalism. In this way, it can be evidenced how the current turn of capitalism is directed towards religion, so that it can capture it and turn it in its favor, since it allows an alternative to cure, momentarily, the subjective suffering of Homo oeconomicus that inhabits within the system that he himself produced.

O objetivo deste artigo é demonstrar que a relação entre a teologia da prosperidade, específicamente tomada em sua expressão neopentecostal, e o neoliberalismo, entendido a partir de sua dimensão de força produtora de subjetividade, tem se fortalecido no atual quadro de reprodução do capitalismo. Para isso, o escrito está dividido em três partes: a primeira, que se encarrega de expor conceitualmente o neopentecostalismo; a segunda, onde é exposta a teologia da prosperidade; e, por fim, a que trabalha a maneira como o fenômeno religioso neopentecostal, como exemplo de fé na prosperidade, se vincula ao neoliberalismo. Desta forma, e a partir do método bibliográfico-documental, pode-se evidenciar como a atual virada do capitalismo está voltada para a religião, de modo que possa capturá-la e transformá-la a seu favor, pois permite uma alternativa para curar, momentaneamente, o sofrimento subjetivo sofrido pelo homo oeconomicus por viver como manda o sistema.

A Comparative Analysis of Deep Learning Convolutional Neural Network Architectures for Fault Diagnosis of Broken Rotor Bars in Induction Motors.

Induction machines (IMs) play a critical role in various industrial processes but are susceptible to degenerative failures, such as broken rotor bars. Effective diagnostic techniques are essential in addressing these issues. In this study, we propose the utilization of convolutional neural networks (CNNs) for detection of broken rotor bars. To accomplish this, we generated a dataset comprising current samples versus angular position using finite element method magnetics (FEMM) software for a squirrel-cage rotor with 28 bars, including scenarios with 0 to 6 broken bars at every possible relative position. The dataset consists of a total of 16,050 samples per motor. We evaluated the performance of six different CNN architectures, namely Inception V4, NasNETMobile, ResNET152, SeNET154, VGG16, and VGG19. Our automatic classification system demonstrated an impressive 99% accuracy in detecting broken rotor bars, with VGG19 performing exceptionally well. Specifically, VGG19 exhibited high accuracy, precision, recall, and F1-Score, with values approaching 0.994 and 0.998. Notably, VGG19 exhibited crucial activations in its feature maps, particularly after domain-specific training, highlighting its effectiveness in fault detection. Comparing CNN architectures assists in selecting the most suitable one for this application based on processing time, effectiveness, and training losses. This research suggests that deep learning can detect broken bars in induction machines with accuracy comparable to that of traditional methods by analyzing current signals using CNNs.

Usefulness of COL11A1 as a Prognostic Marker of Tumor Infiltration.

BACKGROUND: Determining the infiltration of carcinomas is essential for the proper follow-up and treatment of cancer patients. However, it continues to be a diagnostic challenge for pathologists in multiple types of tumors. In previous studies (carried out in surgical specimens), the protein COL11A1 has been postulated as an infiltration marker mainly expressed in the extracellular matrix (ECM). We hypothesized that a differential expression of COL11A1 may exist in the peritumoral stroma of tumors that have acquired infiltrating properties and that it may be detected in the small biopsies usually available in normal clinical practice. MATERIAL AND METHODS: In our study, we performed immunohistochemical staining in more than 350 invasive and noninvasive small samples obtained via core needle biopsy (CNB), colonoscopy, or transurethral resection of bladder tumor (TURBT) of breast, colorectal, bladder, and ovarian cancer. RESULTS: Our results revealed that COL11A1 immunostaining had a sensitivity to classify the samples into infiltrative vs. noninfiltrative tumors of 94% (breast), 97% (colorectal), >90% (bladder), and 74% (ovarian); and a specificity of 97% (breast), 100% (colorectal), and >90% (bladder). In ovarian cancer, the negative predictive value (0.59) did not present improvement over the usual histopathological markers. In all samples tested, the cumulative sensitivity was 86% and the specificity 96% (p < 0.0001). CONCLUSIONS: COL11A1-positive immunostaining in small biopsies of breast, colon, bladder and ovarian cancer is an accurate predictive marker of tumor infiltration that can be easily implemented in daily clinical practice.

Comorbidities and clinical symptoms can modify myocardial function: a cross-sectional study with PET/CT / Comorbilidades y síntomas clínicos que pueden modificar la función miocárdica: estudio transversal con PET/TC

Abstract Objective: Associating comorbidities and cardiac symptoms that alter myocardial mechanical function could help clinicians to correctly identify at-risk population. Methods: We conducted a functional open population cross-sectional study of patients referred to a positron emission tomography/computed tomography unit in Mexico City for evaluation of myocardial function, perfusion, and coronary circulation. Ischemia was defined as a sum difference score ≥ 2. Association between comorbidities and cardiac symptoms was tested using logistic regression models and trend analysis. We performed an interaction analysis to evaluate the addition of any accompanying symptoms to comorbid conditions on impairment of myocardial function. Results: One thousand two hundred and seventy-three patients were enrolled, 66.1% male, with a mean age of 62.4 (± 12.7) years, 360 (28.7%) with ischemia, 925 (72.7%) with at least one comorbidity, and 676 (53.1%) had at least one associated cardiac symptom. Patients without ischemia, type 2 diabetes, arterial hypertension, and adverse cardiac symptoms were associated with adverse mechanical, perfusion, and coronary flow parameters. We observed a trend of a cumulative number of comorbidities and cardiac symptoms with increased ischemia and decreased coronary flow. Only in decreased left ventricular ejection fraction, we demonstrated an interaction effect between increased comorbidities and adverse symptoms. Conclusion: The high burden of comorbidities and symptoms in our population alters myocardial function regardless of the level of ischemia.

Resumen Objetivo: La asociación de comorbilidades y síntomas cardíacos que alteran la función miocárdica podría ayudar a los médicos a identificar correctamente a poblaciones de riesgo. Métodos: Se realizó un estudio transversal en población abierta de pacientes referidos a una unidad de PET/CT en la Ciudad de México para evaluación de la función miocárdica, perfusión y circulación coronaria. La isquemia se definió como una suma de diferencia de puntuación (SDS) ≥ 2. La asociación entre las comorbilidades y los síntomas cardíacos se fundamentó mediante modelos de regresión logística y análisis de tendencias. Realizamos un análisis de interacción para evaluar la adición de cualquier síntoma acompañante a condiciones comórbidas en el deterioro de la función miocárdica. Resultados: Se incluyeron 1.273 pacientes, 66,1% del sexo masculino, con una edad media de 62,4 (± 12.7) años, 360 (28,7%) con isquemia, 925 (72,7%) con al menos una comorbilidad y 676 (53,1%) con al menos una menos un síntoma cardíaco asociado. En pacientes sin isquemia, la diabetes mellitus tipo 2, la hipertensión arterial y los síntomas cardíacos adversos se asociaron con parámetros mecánicos, de perfusión y de flujo coronario adversos. Se observó una tendencia con el número acumulado de comorbilidades y síntomas cardíacos con aumento de la isquemia y disminución del flujo coronario. Solo en la disminución de la FEVI se demostró un efecto de interacción entre el aumento de las comorbilidades y los síntomas adversos. Conclusión: La alta carga de comorbilidades y síntomas en nuestra población altera la función miocárdica independientemente del nivel de isquemia.

Right Ventricular Apical Hypertrophic Cardiomyopathy in Association With Infundibular, Valvular, and Supravalvular Pulmonary Stenosis.

A 31-year-old man was referred to our hospital because of exertional dyspnea and palpitations. Cardiac examination revealed a systolic murmur in the pulmonic area. Owing to the suspicion of pulmonary stenosis, cardiac magnetic resonance was notable for apical hypertrophy of the right ventricle and mixed pulmonary stenosis. (Level of Difficulty: Intermediate.).

Epidemiology of dog bites to people in Uruguay (2010-2020).

BACKGROUND: Dog bites to people are a serious public health problem. Limited information exists at the country level in Latin America. The COVID-19 pandemic changed people's lifestyles and their relationship with pets, and this could potentially affect the incidence of dog bites injuries. OBJECTIVE: The main objectives of our study were to determine the prevalence of dog-bite injuries in Uruguay from 2010 to 2020 and to compare the prevalence in 2020 to that of pre-pandemic years. METHODS: Cross-sectional study. Dog-bite notifications for the 2010 and 2020 period were analysed using data from the Uruguayan Ministry of Public Health. RESULTS: The annual dog-bite injury rate for the 2010-2020 period was 87.51 per 100,000 people. The frequency of bites varied with the victims' sex, with males accounting for 51.8% of the bites (p < 0.0001), and with age, with a higher frequency of bites in the ≤14 years old age group (p < 0.01). The frequency of dog bites was also higher in spring and summer than in autumn (p < 0.0001). There was no statistical difference in the frequency of dog-bite injuries when comparing 2020 with the pre-COVID-19 pandemic years. CONCLUSIONS: In Uruguay, the frequency of dog-bite injuries varied with season and with the age and sex of the victim. In the first year of the COVID-19 pandemic, the number of people bitten by dogs was no different than that of previous years. This is the first study in Latin America to report national rather than regional data and to include all age groups.

18F-sodium fluoride positron emission tomography provides pertinent additional information to computed tomography for assessment and management of tarsal pain in horses.

OBJECTIVE: To assess the value of 18F-sodium fluoride (18F-NaF) positron emission tomography (PET) for imaging the tarsus and proximal metatarsus and compare it with CT and lameness evaluation. ANIMALS: 25 horses with lameness localized to the tarsal and proximal metatarsal regions that underwent 18F-NaF PET/CT between 2016 and 2021. METHODS: 18F-NaF PET and CT images were retrospectively independently evaluated by 3 observers. Standardized uptake values (SUV) were used to characterize 18F-NaF uptake. Correlation between PET and CT findings with subjective and objective maximum (Max-D) and minimum pelvic height lameness data was estimated. RESULTS: The inter-observer Kappa-weighted value (κ) was higher for PET (κ = 0.66) than CT (κ = 0.6). CT and PET scores were fairly correlated (R = 0.49; P < 0.05). PET SUVratio (SUV of the main lesion/SUV talus) had the highest correlation with Max-D (R = 0.71; P < .05). PET and CT scores for the plantar region were significantly higher in Quarter Horses (P < .05) and showed consistently higher correlation with objective lameness data (CT plantar grade - Max-D [R = 0.6; P < .05], PET plantar grade - Max-D [R = 0.47; P = .04]) than other regions of the distal tarsal joints. Three Warmbloods presented marked uptake at the medial cochlea of the distal tibia. CLINICAL RELEVANCE: PET had a moderate correlation with CT for assessment of tarsal lesions. The degree of PET uptake can help differentiate active versus inactive lesions. Specific location of the uptake is important in determining clinical relevance.

Rhythm and ROS: Hepatic Chronotherapeutic Features of Grape Seed Proanthocyanidin Extract Treatment in Cafeteria Diet-Fed Rats.

Polyphenols play a key role in the modulation of circadian rhythms, while the cafeteria diet (CAF) is able to perturb the hepatic biological rhythm and induce important ROS production. Consequently, we aimed to elucidate whether grape seed proanthocyanidin extract (GSPE) administration recovers the CAF-induced hepatic antioxidant (AOX) misalignment and characterize the chronotherapeutic properties of GSPE. For this purpose, Fischer 344 rats were fed a standard diet (STD) or a CAF and concomitantly treated with GSPE at two time-points (ZT0 vs. ZT12). Animals were euthanized every 6 h and the diurnal rhythms of hepatic ROS-related biomarkers, hepatic metabolites, and AOX gene expression were examined. Interestingly, GSPE treatment was able to recover the diurnal rhythm lost due to the CAF. Moreover, GSPE treatment also increased the acrophase of Sod1, as well as bringing the peak closer to that of the STD group. GSPE also corrected some hepatic metabolites altered by the CAF. Importantly, the differences observed at ZT0 vs. ZT12 due to the time of GSPE administration highlight a chronotherapeutic profile on the proanthocyanin effect. Finally, GSPE could also reduce diet-induced hepatic oxidative stress not only by its ROS-scavenging properties but also by retraining the circadian rhythm of AOX enzymes.

Post-mortem findings in Spanish patients with COVID-19; a special focus on superinfections.

Introduction: Whole-body autopsies may be crucial to understand coronavirus disease 2019 (COVID-19) pathophysiology. We aimed to analyze pathological findings in a large series of full-body autopsies, with a special focus on superinfections. Methods: This was a prospective multicenter study that included 70 COVID-19 autopsies performed between April 2020 and February 2021. Epidemiological, clinical and pathological information was collected using a standardized case report form. Results: Median (IQR) age was 70 (range 63.75-74.25) years and 76% of cases were males. Most patients (90%,) had at least one comorbidity prior to COVID-19 diagnosis, with vascular risk factors being the most frequent. Infectious complications were developed by 65.71% of the patients during their follow-up. Mechanical ventilation was required in most patients (75.71%) and was mainly invasive. In multivariate analyses, length of hospital stay and invasive mechanical ventilation were significantly associated with infections (p = 0.036 and p = 0.013, respectively). Necropsy findings revealed diffuse alveolar damage in the lungs, left ventricular hypertrophy in the heart, liver steatosis and pre-infection arteriosclerosis in the heart and kidneys. Conclusion: Our study confirms the main necropsy histopathological findings attributed to COVID-19 in a large patient series, while underlining the importance of both comorbid conditions and superinfections in the pathology.

Intraoperative immediate strength recovery following lacertus fibrosus release in patients with proximal median nerve compression at the elbow.

PURPOSE: In the literature, we find that patients with lacertus syndrome (LS), proximal median nerve compression at the elbow, present subjective improvement of thumb, and index flexion strength after lacertus fibrosus (LF) release. The aim of this study is to objectively evaluate the immediate change in intraoperative flexion strength after LF release. METHOD: We retrospectively reviewed prospectively collected data of a cohort of 24 patients with a double crush syndrome of the median nerve with no response to conservative treatment. All patients had surgery with LF and carpal tunnel release (CTR) under wide-awake local anaesthesia and no tourniquet (WALANT) and were evaluated intraoperatively with a dynamometer immediately before and after LF release. Flexor digitorum profundus of the second finger (FDP2) and Flexor pollicis longus (FPL) were tested in peak strength to failure. The primary outcome was the percentage of change in strength before and after the release in both assessed muscles. CTR was done after evaluating the change in flexor strength. RESULTS: A percentage of 79.2 women with an average age of 43.3 years. The average strength of FDP2 before LF release was 15.5 pounds (lbs.) (7.0 kg) (SD, 7.2 lbs (3.3 kg)) and 27.1 lbs. (12.2 kg) (SD, 7.1 lbs. (3.2 kg)) after LF release, which corresponds to a 96% (SD, 70%) change in strength (p=0.000). For FPL, the average pre-release strength was 17.7 lbs. (8.0kg) (SD, 4.8 lbs. (2.2 kg)) and 27.4 lbs. (12.4 kg) (SD, 5.2 lbs. (2.4 kg)) post-release, this corresponded to a 65% (SD, 38%) change in strength (p=0.000). CONCLUSIONS: Peak strength to failure in FDP2 and FPL has an immediate significant recovery after LF surgical release in patients with Lacertus syndrome. LEVEL OF EVIDENCE: IV, retrospective study.

Cardiovascular diagnostic methods in patients with diabetes mellitus. A review.

Cardiovascular diseases are the most common cause of mortality in the world. Currently, type 2 diabetes mellitus (T2DM) is one of the main risk factors for major adverse cardiovascular events. T2DM patients have a four-fold higher risk of developing heart failure and 10 to 12 times higher mortality. Echocardiography in all its modalities is the best clinical tool for heart failure diagnosis, since it provides static and dynamic images of the heart that allow to identify structural and functional changes, such as pressure variations, flow changes, left ventricular ejection fraction and myocardial surfaces anatomical remodeling.

Las enfermedades cardiovasculares constituyen la causa más común de mortalidad en el mundo. Actualmente, la diabetes mellitus tipo 2 (DM2) representa uno de los principales factores de riesgo de eventos adversos cardiovasculares mayores. Los pacientes que las padecen tienen un riesgo cuatro veces mayor de desarrollar insuficiencia cardíaca y una mortalidad de 10 a 12 veces mayor. La ecocardiografía en todas sus modalidades es la mejor herramienta clínica para el diagnóstico de la insuficiencia cardíaca, ya que proporciona imágenes estáticas y dinámicas del corazón que permiten identificar cambios estructurales y funcionales, como alteraciones en las presiones, cambios de flujo, fracción de expulsión del ventrículo izquierdo y remodelación anatómica de las superficies miocárdicas.

Spectrum of the anomalous origin of the coronary arteries.

The anomalous origin of the coronary arteries (AOCA) has several patterns. Most are functional and asymptomatic. However, some are associated with persistent chest pain and sudden cardiac death. Multiple imaging techniques are available for the assessment of AOCA. We present a report of 4 cases with AOCA, including the anomalous aortic origin of a coronary artery (AAOCA) of the right coronary artery, AAOCA of the circumflex artery, AAOCA of the left anterior descending artery, and AAOCA of the circumflex artery with retroaortic trajectory, in which the clinical manifestations throughout the cases are discussed, highlighting the similarity among patients despite having different patterns. Multiple imaging techniques are indispensable for assessing AOCA, where transthoracic echocardiogram is the first-line study, and cardiac computed tomography provides detailed cardiac and coronary anatomy.