Prophylactic use of standardized extract of propolis of Apis mellifera (EPP-AF®) reduces lung inflammation and improves survival in experimental lethal sepsis.

ETHNOPHARMACOLOGICAL RELEVANCE: Sepsis poses one of the biggest public health problems, necessitating the search for new therapeutic alternatives. For centuries, propolis has been widely used in folk medicine to treat various inflammatory and infectious diseases. Given its extensive use, it has excellent potential as an adjuvant treatment for patients with sepsis. OBJECTIVE: This study evaluated prophylactic treatment with standardized propolis extract (EPP-AF®) and followed the prognosis of sepsis induced by ligation and cecal ligation and puncture (CLP). METHODS: Initially, for survival assessment, Swiss mice were separated into five groups: Sham (false operated), control (PBS), ATB (received antibiotic, 8 mg/kg), P10 (received EPP-AF®, 10 mg/kg), and P100 (received EPP-AF®, 100 mg/kg). The animals received PBS, antibiotic, or EPP-AF® by the subcutaneous route 6 h before the CLP procedure. Animal survival was assessed every 12 h for five days when all of them were euthanized. RESULTS: We show that the treatment with EPP-AF® significantly increased the life expectancy of animals with sepsis compared to the control group. Interestingly, prophylactic treatment with EPP-AF® showed no effect on the number of colony-forming units in the peritoneum, blood, or lung. However, there was a decrease in cellular influx in the peritoneum. This alteration was unrelated to the number of bone marrow cells or the differential counting of peripheral blood cells. The coagulogram remained unchanged, including the number of platelets and prothrombin time-activated partial thromboplastin time. However, the inflammatory infiltrate and bleeding in the lung tissue were lower in the animals that received EPP-AF®. CONCLUSION: Thus, it was possible to conclude that prophylactic treatment with EPP-AF® preserved the lung parenchyma, resulting in an increased lifespan of mice with sepsis. It can be a helpful adjuvant in prophylactic treatment with antibiotics in presurgical conditions.

Antiviral action of aqueous extracts of propolis from Scaptotrigona aff. postica (Hymenoptera; Apidae) against Zica, Chikungunya, and Mayaro virus

The limited availability of antivirals for new highly pathogenic strains of virus has become a serious public health. Therefore, news products against these pathogens has become an urgent necessity. Among the multiple sources for news antibiotics and antivirals, insect exudates or their products has become an increasingly frequent option. Insects emerged 350 million years ago and have showed a high adaptability and resistance to the most varied biomes. Their survival for so long, in such diferent environments, is an indication that they have a very efcient protection against environmental infections, despite not having a developed immune system like mammals. Since the ancient civilizations, the products obtained from the bee have been of great pharmacological importance, being used as antimicrobial, anti-infammatory, antitumor and several other functions. Investigations of biological activity of propolis have been carried out, mainly in the species Apis mellifera, and its product have showed activity against some important viruses. However, for the Meliponini species, known as stingless bees, there are few studies, either on their chemical composition or on their biological activities. The importance of studying these bees is because they come from regions with native forests, and therefore with many species of plants not yet studied, in addition to which they are regions still free of pesticides, which guarantees a greater fdelity of the obtained data. Previous studies by our group with crude hydroalcoholic extract of propolis demonstrated an intense antiviral activity against Herpes, infuenza, and rubella viruses. In this work, we chose to use aqueous extracts, which eliminates the presence of other compounds besides those originally present in propolis, in addition to extracting substances diferent from those obtained in alcoholic extracts. Therefore, this study aimed to identify, isolate and characterize compounds with antiviral efects from aqueous propolis extracts from Scaptotrigona af postica, in emerging viruses such as zicavirus, chikungunya, and mayaro virus. The evaluation of the antiviral activity of the crude and purifed material was performed by reducing infectious foci in VERO cell cultures. The results obtained with crude propolis, indicate a high reduction of zica virus (64×) and mayaro (128×) when was used 10% v/v of propolis. The reduction of chikungunya virus was of 256 fold, even when was used 5% v/v of propolis. The chemical characterization of the compounds present in the extracts was performed by high-pressure liquid chromatography. Through the purifcation of propolis by HPLC and mass spectrometry, it was possible to identify and isolate a peak with antiviral activity. This substance showed activity against all viruses tested. When purifed fraction was used, the reduction observed was of 16 fold for zicavirus, 32 fold for mayaro virus and 512 fold for chikungunya virus. Likewise, it was observed that the antiviral response was concentration dependent, being more intense when propolis was added 2 h after the viral infection. Now we are carrying out the chemical characterization of the purifed compounds that showed antiviral action.

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)

Treatment of Symptomatic Functional Atrioventricular Block by Cardioneuroablation as an Alternative to Pacemaker Implantation.

A woman with recurrent presyncope caused by a functional atrioventricular (AV) block after meals, with limiting symptoms, underwent cardioneuroablation and AV node vagal denervation without pacemaker implantation. Normal AV conduction was recovered with complete abolishment of symptoms. (Level of Difficulty: Advanced.).

Area Deprivation Index and Oral Anticoagulation in New Onset Atrial Fibrillation.

Objective: Oral anticoagulation is a standard of care for thromboembolic stroke prevention in individuals with atrial fibrillation (AF). Social determinants of health have had limited investigation in AF and particularly in access to anticoagulation. We examined the relation between area deprivation index (ADI) and anticoagulation in individuals at risk of stroke due to AF. Methods: We conducted a retrospective analysis of patients with incident, non-valvular AF from 2015-2020 receiving care at a large, regional health center. We extracted demographics, medications, and problem lists and used administrative coding to identify comorbid conditions and relevant covariates, and individual-level residential address to ascertain ADI. We examined the relation between ADI and receipt of prescribed oral anticoagulation (warfarin or direct-acting oral anticoagulant, or DOAC) at 90 days following AF diagnosis in multivariable-adjusted models. Results: Following exclusions, the dataset included 20,210 individuals (age 74.5±10.9 years; 51% women; 94% white race). In multivariable-adjusted analyses, individuals in the highest quartile of ADI had a 16% lower likelihood of receiving anticoagulation prescription than those in the lowest ADI quartile (Odds Ratio [OR] 0.84; 95% Confidence Interval [CI], 0.75-0.95) at 90 days following AF diagnosis. In those receiving anticoagulation, individuals in the highest ADI quartile had a 24% lower likelihood of receiving a DOAC prescription as opposed to warfarin prescription than those in the lowest quartile (OR 0.76; 95% CI, 0.60-0.96) at 90 days following AF diagnosis. Conclusions: We demonstrate the association of higher neighborhood deprivation as determined by ADI with decreased likelihood of (1) anticoagulation prescribing for stroke prevention in AF and (2) prescription of a DOAC when any oral anticoagulation is prescribed. Our results suggest neighborhood-based health inequities in the receipt of anticoagulation prescription for stroke prevention in AF in a large, regional health care system.

Effect of Occurrence of Lamin A/C (LMNA) Genetic Variants in a Cohort of 101 Consecutive Apparent "Lone AF" Patients: Results and Insights.

Objective: Mutations in the Lamin A/C (LMNA) gene are commonly associated with cardiac manifestations, such as dilated cardiomyopathy (DCM) and conduction system disease. However, the overall spectrum and penetrance of rare LMNA variants are unknown. The present study described the presence of LMNA variants in patients with "lone atrial fibrillation (AF)" as their sole clinical presentation. Methods: One-hundred and one consecutive patients with "lone AF" criteria were initially screened by genetic testing. Genetic variants were classified according to the American College of Genetic and Genomic criteria. All subjects were evaluated through clinical and familial history, ECG, 24-h Holter monitoring, echocardiogram, cardiac magnetic resonance, treatment response, and the present relatives of LMNA carriers. In addition, whole-exome data from 49,960 UK Biobank (UKB) participants were analyzed to describe the overall penetrance of rare LMNA missense and loss of function (LOF) variants. Results: Three missense variants in LMNA were identified in probands with AF as their first and unique clinical manifestation. Other five first-degree relatives, after the screening, also presented LMNA gene variants. Among 49,960 analyzed UKB participants, 331 carried rare LMNA missense or LOF variant. Participants who carried a rare LMNA variant were significantly associated with higher odds of arrhythmic events and of an abnormal ECG in the per-protocol ECG exam (p = 0.03 and p = 0.05, respectively). Conclusion: Although a rare occurrence, our findings emphasize the possibility of an initial presentation of apparently "lone AF" in LMNA gene variant carriers.

Modulation of the Host Nuclear Compartment by Trypanosoma cruzi Uncovers Effects on Host Transcription and Splicing Machinery.

Host manipulation is a common strategy for invading pathogens. Trypanosoma cruzi, the causative agent of Chagas Disease, lives intracellularly within host cells. During infection, parasite-associated modifications occur to the host cell metabolism and morphology. However, little is known about the effect of T. cruzi infection on the host cell nucleus and nuclear functionality. Here, we show that T. cruzi can modulate host transcription and splicing machinery in non-professional phagocytic cells during infection. We found that T. cruzi regulates host RNA polymerase II (RNAPII) in a time-dependent manner, resulting in a drastic decrease in RNAPII activity. Furthermore, host cell ribonucleoproteins associated with mRNA transcription (hnRNPA1 and AB2) are downregulated concurrently. We reasoned that T. cruzi may hijack the host U2AF35 auxiliary factor, a key regulator for RNA processing, as a strategy to affect the splicing machinery activities directly. In support of our hypothesis, we carried out in vivo splicing assays using an adenovirus E1A pre-mRNA splicing reporter, showing that intracellular T. cruzi directly modulates the host cells by appropriating U2AF35. For the first time, our results provide evidence of a complex and intimate molecular relationship between T. cruzi and the host cell nucleus during infection.

Electrocardiographic Imaging for Atrial Fibrillation: A Perspective From Computer Models and Animal Experiments to Clinical Value.

Electrocardiographic imaging (ECGI) is a technique to reconstruct non-invasively the electrical activity on the heart surface from body-surface potential recordings and geometric information of the torso and the heart. ECGI has shown scientific and clinical value when used to characterize and treat both atrial and ventricular arrhythmias. Regarding atrial fibrillation (AF), the characterization of the electrical propagation and the underlying substrate favoring AF is inherently more challenging than for ventricular arrhythmias, due to the progressive and heterogeneous nature of the disease and its manifestation, the small volume and wall thickness of the atria, and the relatively large role of microstructural abnormalities in AF. At the same time, ECGI has the advantage over other mapping technologies of allowing a global characterization of atrial electrical activity at every atrial beat and non-invasively. However, since ECGI is time-consuming and costly and the use of electrical mapping to guide AF ablation is still not fully established, the clinical value of ECGI for AF is still under assessment. Nonetheless, AF is known to be the manifestation of a complex interaction between electrical and structural abnormalities and therefore, true electro-anatomical-structural imaging may elucidate important key factors of AF development, progression, and treatment. Therefore, it is paramount to identify which clinical questions could be successfully addressed by ECGI when it comes to AF characterization and treatment, and which questions may be beyond its technical limitations. In this manuscript we review the questions that researchers have tried to address on the use of ECGI for AF characterization and treatment guidance (for example, localization of AF triggers and sustaining mechanisms), and we discuss the technological requirements and validation. We address experimental and clinical results, limitations, and future challenges for fruitful application of ECGI for AF understanding and management. We pay attention to existing techniques and clinical application, to computer models and (animal or human) experiments, to challenges of methodological and clinical validation. The overall objective of the study is to provide a consensus on valuable directions that ECGI research may take to provide future improvements in AF characterization and treatment guidance.

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).

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)

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.

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.

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.

Fetal deaths in pregnancies with SARS-CoV-2 infection in Brazil: A case series.

BACKGROUND: There are few reports of miscarriages or stillbirths in women infected with SARS-CoV-2. We present five consecutive cases of fetal death (≥12 weeks) without other putative causes in women with laboratory-confirmed (RT-PCR) COVID-19 managed in a single Brazilian institution. CASE SERIES: All five women were outpatients with mild or moderate forms of COVID-19 and were not taking any medication. Four were nulliparous, all were overweight or obese, and none had any comorbidities or pregnancy complications that could contribute to fetal demise. Fetal death occurred at 21-38 weeks of gestation, on COVID-days 1-22. SARS-Cov-2 was detected by RT-PCR in amniotic fluid in one case and in placental specimens in two cases. All five women had acute chorioamnionitis on placental histology, massive deposition of fibrin, mixed intervillitis/villitis, and intense neutrophil and lymphocyte infiltration. One fetus had neutrophils inside alveolar spaces, suggestive of fetal infection. CONCLUSIONS: These five cases of fetal demise in women with confirmed COVID-19 without any other significant clinical or obstetric disorders suggest that fetal death can be an outcome of SARS-CoV-2 infection in pregnancy. The intense placental inflammatory reaction in all five cases raises the possibility of a direct effect of SARS-CoV-2 on the placenta.

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.

Influence of an immune-modulatory feed supplement on performance and immune function of beef cows and calves preweaning.

The ability to positively alter immune and stress response with nutritional compounds is of great interest and importance to the beef industry. There is a proprietary product (OmniGen-AF [OG]; Phibro Animal Health, Quincy, IL) reported to have performance-enhancing benefits by altering animal response to stress and immune challenges. The objective of this 2-yr research project was to study the effect of supplementing OG to beef cows and their calves on breeding and growth performance. One hundred and twelve multiparous beef cows and 48 primiparous cows were randomly assigned to treatment in year 1; control (CON, no OG; n = 56 multiparous and 24 primiparous) or treatment (OG fed at 8.8 g/100 kg body weight [BW]; n = 56 multiparous and 24 primiparous). Multiparous cows (mean ± SD = 6.4 ± 0.4 yr; BW = 589 ± 9.2 kg; body condition score [BCS] 6.2 ± 0.07) were used in both years of the experiment and primiparous cows (mean ± SD = 2.1 ± 0.04 yr of age, weighed 400 ± 7.5 kg, and BSC of 5.6 ± 0.06) were only used in the first year of the experiment. CON and OG supplements were offered over two production cycles beginning in December approximately 60 d prior to projected calving through pre-breeding in May of each year. Calves from treatment cows were offered treatments in a creep supplement limited to a daily rate of 1% as-fed of BW prorated for 3-d/wk feeding from mid-July through weaning with OG offered at 8.8 g/100 kg BW. Primiparous cow's BW, BCS, and calf performance were not affected by treatment (P ≥ 0.15) in year 1. BW of multiparous OG cows tended (P = 0.10) to be heavier at weaning in year 1 and was greater (P = 0.05) at the onset of the experiment in year 2. Body condition of OG cows was greater (P ≤ 0.02) at weaning in both years 1 and 2, as well as at the onset of the experiment in year 2. Calves fed OG from the mature cows gained more (P = 0.05) BW during the creep feeding period than CON. Core body temperatures of OG heifers measured during the late summer with intravaginal temperature data loggers tended (P ≤ 0.10) to be less at 1400 and 1700 hours and were less (P = 0.05) at 1800 hours than CON heifers. Feeding OG did not result in changes (P = 0.25) in serum titer response to the BVD virus of calves during year 2. The results of the current experiment indicate feeding OG to beef cows and calves can result in improvement in BCS of cows, enhance weight gain of calves preweaning, and reduce heat loads in heifer calves during the late summer.

Analysis of Relevant Features from Photoplethysmographic Signals for Atrial Fibrillation Classification.

Atrial Fibrillation (AF) is the most common cardiac arrhythmia found in clinical practice. It affects an estimated 33.5 million people, representing approximately 0.5% of the world's population. Electrocardiogram (ECG) is the main diagnostic criterion for AF. Recently, photoplethysmography (PPG) has emerged as a simple and portable alternative for AF detection. However, it is not completely clear which are the most important features of the PPG signal to perform this process. The objective of this paper is to determine which are the most relevant features for PPG signal analysis in the detection of AF. This study is divided into two stages: (a) a systematic review carried out following the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) statement in six databases, in order to identify the features of the PPG signal reported in the literature for the detection of AF, and (b) an experimental evaluation of them, using machine learning, in order to determine which have the greatest influence on the process of detecting AF. Forty-four features were found when analyzing the signal in the time, frequency, or time-frequency domains. From those 44 features, 27 were implemented, and through machine learning, it was found that only 11 are relevant in the detection process. An algorithm was developed for the detection of AF based on these 11 features, which obtained an optimal performance in terms of sensitivity (98.43%), specificity (99.52%), and accuracy (98.97%).

Electrocardiographic "Northwest QRS Axis" in the Brugada Syndrome: A Potential Marker to Predict Poor Outcome.

Conduction delay in the right ventricular outflow tract as manifested in the electrocardiogram constitutes a high-risk predictor of ventricular arrhythmias in patients with Brugada syndrome. We present a case with a right QRS axis between -90° and ±180°. This feature has never been reported in the context of Brugada syndrome. (Level of Difficulty: Advanced.).

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.