Advancing common bean (Phaseolus vulgaris L.) disease detection with YOLO driven deep learning to enhance agricultural AI.

Common beans (CB), a vital source for high protein content, plays a crucial role in ensuring both nutrition and economic stability in diverse communities, particularly in Africa and Latin America. However, CB cultivation poses a significant threat to diseases that can drastically reduce yield and quality. Detecting these diseases solely based on visual symptoms is challenging, due to the variability across different pathogens and similar symptoms caused by distinct pathogens, further complicating the detection process. Traditional methods relying solely on farmers' ability to detect diseases is inadequate, and while engaging expert pathologists and advanced laboratories is necessary, it can also be resource intensive. To address this challenge, we present a AI-driven system for rapid and cost-effective CB disease detection, leveraging state-of-the-art deep learning and object detection technologies. We utilized an extensive image dataset collected from disease hotspots in Africa and Colombia, focusing on five major diseases: Angular Leaf Spot (ALS), Common Bacterial Blight (CBB), Common Bean Mosaic Virus (CBMV), Bean Rust, and Anthracnose, covering both leaf and pod samples in real-field settings. However, pod images are only available for Angular Leaf Spot disease. The study employed data augmentation techniques and annotation at both whole and micro levels for comprehensive analysis. To train the model, we utilized three advanced YOLO architectures: YOLOv7, YOLOv8, and YOLO-NAS. Particularly for whole leaf annotations, the YOLO-NAS model achieves the highest mAP value of up to 97.9% and a recall of 98.8%, indicating superior detection accuracy. In contrast, for whole pod disease detection, YOLOv7 and YOLOv8 outperformed YOLO-NAS, with mAP values exceeding 95% and 93% recall. However, micro annotation consistently yields lower performance than whole annotation across all disease classes and plant parts, as examined by all YOLO models, highlighting an unexpected discrepancy in detection accuracy. Furthermore, we successfully deployed YOLO-NAS annotation models into an Android app, validating their effectiveness on unseen data from disease hotspots with high classification accuracy (90%). This accomplishment showcases the integration of deep learning into our production pipeline, a process known as DLOps. This innovative approach significantly reduces diagnosis time, enabling farmers to take prompt management interventions. The potential benefits extend beyond rapid diagnosis serving as an early warning system to enhance common bean productivity and quality.

Aortic Regurgitation: From Valvular to Myocardial Dysfunction.

Chronic aortic regurgitation (AR) leads to volume overload in the left ventricle (LV), which is well tolerated for years. In this condition, the LV usually dilates with minimal reduction in the ejection fraction (EF), even in the absence of symptoms. Echocardiography is the primary imaging test used to quantify AR. However, no single assessment of Doppler measures is accurate and precise in individual patients; therefore, the integration of multiple parameters is necessary. Recent guidelines recommend surgical treatment for severe AR in patients who are symptomatic or have an LVEF < 55% and an end-systolic diameter > 50 mm. Nevertheless, advances in imaging technology have improved the quantification of AR and the assessment of LV subclinical dysfunction. It is widely recognized that patients who undergo aortic valve replacement/repair (AVR) due to symptoms or a low LVEF experience worse outcomes than those undergoing AVR for non-Class I indications. In fact, subclinical irreversible myocardial damage may occur in clinically well-compensated and closely monitored patients while awaiting formal surgical indications. This condition could be prevented by the use of multimodal imaging parameters, in particular longitudinal LV strain and magnetic resonance imaging. In addition, better cut-off values for mortality predictors should be established. This review aims to identify simple models that integrate several echocardiographic and cardiac magnetic resonance-derived parameters to predict the optimal timing of surgical treatment in asymptomatic patients with chronic severe AR.

Registro Nacional Argentino de Resonancia Cardíaca (RENAREC) / Argentine National Cardiac Magnetic Resonance Imaging Registry (RENAREC)

RESUMEN Introducción: La utilidad de la resonancia magnética cardíaca (RMC) ha crecido ampliamente en los últimos años, en los cuales se han publicado distintos registros internacionales sobre su uso e impacto clínico. Sin embargo, no contamos con este tipo de información en Argentina. Objetivo: Evaluar indicaciones, protocolos utilizados, seguridad y consecuencias terapéuticas de la RMC en la República Argentina. Material y métodos: Se diseñó un registro prospectivo a nivel nacional con recolección de datos demográficos, indicaciones de RMC, complicaciones asociadas, diagnósticos y consecuencias terapéuticas. Resultados: Participaron 34 centros de 10 provincias de Argentina (85% centros privados, 59% centros con internación). Se incluyeron 1131 pacientes (edad 54 ± 18 años, 61% varones). Las principales indicaciones para el estudio de RMC fueron la miocardiopatía hipertrófica (13,9%) y la arritmia ventricular (12,3%). El 99,7% de los estudios fueron reportados sin complicaciones. Los resultados más frecuentes de la RMC fueron: normal (31,2%), miocardiopatía no isquémica (14,7%), miocardiopatía isquémico-necrótica (11,6%) y miocardiopatía hipertrófica (8,9%). La sospecha clínica fue confirmada en el 23,6% de los casos y la RMC generó un diagnóstico nuevo no sospechado en el 48,7% de los casos. Las consecuencias terapéuticas más frecuentes fueron el alta hospitalaria (31,6%) seguida por el cambio en la medicación (28,1%). Conclusiones: La RMC es un estudio ampliamente utilizado en Argentina, principalmente en centros privados, con un número muy bajo de complicaciones. Las principales indicaciones son las miocardiopatías (hipertrófica y dilatada) y la arritmia ventricular, y provee un diagnóstico nuevo no sospechado en casi la mitad de los casos. Se requieren de otros estudios en el futuro para evaluar las implicancias clínicas y terapéuticas.

ABSTRACT Background: The usefulness of cardiac magnetic resonance imaging (MRI) has greatly increased in the last years. Different international registries have been published on its use; however, there is no data available from Argentina. Objective: The aim of this study was to evaluate different indications, protocols, safety and therapeutic consequences of cardiac MRI in Argentina. Methods: A prospective national registry was designed with collection of demographic data, indications for cardiac MRI, associated complications, diagnoses and therapeutic consequences. Results: A total of 34 centers from 10 provinces of Argentina (85% private and 59% with inpatient capacity) participated in the study, including 1131 patients (mean age 54±18 years and 61% males). The main indications for cardiac MRI were hypertrophic cardiomyopathy (13.9%), and ventricular arrhythmia (12.3%). In 99.7% of cases, no study complications were reported. The most frequent results of cardiac MRI were: normal (31.2%), non-ischemic cardiomyopathy (14.7%), ischemic-necrotic cardiomyopathy (11.6%) and hypertrophic cardiomyopathy (8.9%). Clinical suspicion was confirmed in 23.6% of cases and cardiac MRI generated an unsuspected new diagnosis in 48.7% of cases. The main therapeutic consequences were hospital discharge (31.6%) followed by change in medication (28.1%). Conclusions: Cardiac MRI is widely used in Argentina, mainly in private centers with a very low incidence of complications. Cardiomyopathies (hypertrophic and dilated) and ventricular arrhythmia are its main indication, and it provides a new unsuspected diagnosis in almost half of the cases. Further studies are required to assess its clinical and therapeutic impact.

Algunos factores epidemiológicos de la tuberculosis en el municipio de Morón / Some epidemiological factors of Tuberculosis in Moron

Se realizó un estudio observacional descriptivo de series cronológicas para caracterizar a los 63 pacientes con tuberculosis en el municipio de Morón, durante los años 2007-2011, con una tasa de incidencia acumulada de 99,7. El grupo de edad más afectado es el de 36-40 años, con la tasa específica por grupos de edad de 19. El 65,1 por ciento de los casos fue baciloscopía positiva; el 39,7 por ciento fue diagnosticado en la atención primaria de salud, el 25,4 por ciento en la atención secundaria de salud, sólo un caso fue diagnosticado a nivel terciario; el 15,9 por ciento resultó baciloscopía negativa y 19 por ciento tuberculosis extrapulmonar. Se reflejaron problemas en la atención primaria de salud pues un porciento importante de casos continúa diagnosticándose en la atención secundaria. Se reportó el mayor número de casos en el área de salud Norte y el consejo popular Este, por la presencia de una prisión allí. Los factores de riesgo que más incidieron fueron los alcohólicos (22,2 por ciento), reclusos (17,5 por ciento), trabajadores de salud (14,3 por ciento), contacto de tuberculosis y malas condiciones socioeconómicas (12,7 por ciento). Los afectados tenían entre 2 y 3 factores de riesgo. Los principales síntomas referidos por los pacientes fueron: fiebre (50,8 por ciento), tos (44,4 por ciento), así como astenia y pérdida de peso. El 4,8 por ciento, falleció por esta entidad (AU)

A descriptive and cross-sectional study of chronological series was carried out to characterize the 63 patients with Tuberculosis in Moron municipality, between 2007 and 2011, that represent a rate of accumulated incidence of 99,7. The more affected group is 36-40 years old; with specific group of age of 19 years old. 65, 1 percent of the cases was positive sputum smear for acid-fast bacilli, 39, 7 percent, was diagnosed in the Primary Health Assistance, 25, 4 percent in the Second Health Assistance, and only one case was diagnosed in the Third Health Assistance. 15, 9 percent were negative sputum smear for acid-fast bacilli and 19 percent of extrapulmonary tuberculosis. Problems in the Primary Health Assistance were detected when an important percent of cases was diagnosed in the Second Health Assistance. The most number of cases was reported in the North Health Area and the East popular council, for the presence of a Prison there. The more risk factors were the alcoholics (22.2 percent), prisoners (17.5 percent), health workers (14.3 percent), Tuberculosis contact and bad socioeconomic conditions (12.7 percent). In general way was more than one risk factor per patients. The most important symptoms were: fever (50.8 percent), cough (44.4 percent), asthenia, and lost of appetite. The 4, 8 percent died for this pathology (AU)

VIH/SIDA: prevención y diagnóstico tardío. Morón 1986-2011 / HIV/AIDS: prevention and late diagnoses. Morón 1986-2011

Objetivo: Caracterizar la ocurrencia de los diagnósticos tardíos en personas con VIH/SIDA, y posibles fallas de la prevención en la atención primaria en Morón, en el período comprendido entre 1986-2011. Método: Se realizó un estudio descriptivo de corte transversal; la información se obtuvo de la base de datos nacional de casos VIH/SIDA del Ministerio de Salud Pública. Resultados y Discusión: De los 54 casos de incidencia en el municipio, 10 constituyeron debut clínico (18,5 por ciento); se incrementan los casos a partir del año 2000, con picos en el 2004, 2008 y 2011, lo que afecta más a los grupos etarios de 26-30 años (5,8 por ciento) y el de más de 60 (3,7 por ciento). El área de salud con mayor número de caso fue la Sur (60 por ciento) y el consejo popular Sur (40 por ciento). El sexo masculino es el más afectado (80 por ciento), y entre ellos los hombres que tienen sexo con hombres (70 por ciento). Los principales síntomas fueron la pérdida de peso y la fiebre (90 por ciento). Entre las entidades de presentación, los linfomas constituyen el 40 por ciento, seguido de la criptococosis con el 30 por ciento. El 30 por ciento falleció, de ellos el 20 por ciento en el 2005 y el 10 por ciento en el 2003. Hay un 70 por ciento de supervivencia, el 60 por ciento menos de 1 año (diagnósticos del último año), y un 10 por ciento, entre 11 y 15 años. Conclusiones: Se detectaron problemas en el trabajo de atención primaria de salud en cuanto al funcionamiento del Programa Nacional de Prevención de las ITS-VIH/SIDA (AU)

Objective: Characterize the new cases of late diagnoses in people with HIV/AIDS, and possible failure of prevention in the Health Primary Assistance, in Moron, from 1986 to 2011. Method: A descriptive cross sectional study was carried out, the information was obtained from the national data base of VIH/AIDS cases in the Ministry of Public Health. Results and Discussion: Between 54 of the new cases, 10 were late diagnoses, it represent the 18,5 percent, increasing the cases from the year 2000, with small amount in 2004, 2008 and 2011, affecting more the 26-30 age group (5,8 percent) and more than 60 years old (3,7 percent). The south health area was the one with more number of cases (60 percent), and the South Popular council (40 percent); the masculine sex was the most affected (80 percent) and within them, men who have sex with men 70 percent. The most important symptoms were loss of appetite and fever (90 percent). As main entities, lymphoma represent the 40 percent, following by the Cryptococcosis with 30 percent. 30 percent died, 20 percent of them in the year 2005, and 10 percent in the year 2003. There is a 70 percent of survival, the 60 percent less than 1 year (diagnosis of the last year), and 10 percent, between 11 and 15 years. Conclusions: Problems with the work of Health Primary Assistance were detected with regard to the functioning of the National Program of Prevention the Sexually Transmitted Infections-HIV/AIDS (AU)

Reacciones adversas del tratamiento antirretroviral / Adverse reactions of antiretroviral treatment

Se realizó un estudio descriptivo y transversal para analizar el comportamiento de las reacciones adversas al tratamiento antirretroviral en personas con VIH/SIDA, en la consulta municipal de Morón, entre el año 2000 y 2011; de un universo de 57 casos atendidos en la consulta hasta la fecha, se toma como muestra las 20 personas que asisten a la misma y se encuentran con tratamiento antirretroviral, donde el grupo de edad más afectado es el de 41-45 años, que representa el 30 por ciento. Además, predominaron los que llevan menos de 1 año con tratamiento (45 por ciento), y los que evolucionaron en menos de 1 año del diagnóstico de VIH, a SIDA. El 70 por ciento de los esquemas del tratamiento es a base de 3TC, AZT, NVP. El alcohol y el tabaco se encuentran entre los factores que están presentes en las personas con tratamiento antirretroviral con reacciones adversas. La criptosporidiasis, candidiasis orofaríngea y el herpes zoster, son las infecciones oportunistas que más aparecieron en pacientes con este tratamiento. La polifarmacia está presente en un 60 por ciento de las personas con tratamiento y de ellos el 100 por ciento tuvo reacción adversa a un medicamento; sin embargo, las reacciones adversas y el tratamiento antirretroviral se comportó al 60 por ciento (AU)

Reacciones adversas del tratamiento antirretroviral / Adverse reactions of antiretroviral treatment

Se realizó un estudio descriptivo y transversal para analizar el comportamiento de las reacciones adversas al tratamiento antirretroviral en personas con VIH/SIDA, en la consulta municipal de Morón, entre el año 2000 y 2011; de un universo de 57 casos atendidos en la consulta hasta la fecha, se toma como muestra las 20 personas que asisten a la misma y se encuentran con tratamiento antirretroviral, donde el grupo de edad más afectado es el de 41-45 años, que representa el 30 por ciento. Además, predominaron los que llevan menos de 1 año con tratamiento (45 por ciento), y los que evolucionaron en menos de 1 año del diagnóstico de VIH, a SIDA. El 70 por ciento de los esquemas del tratamiento es a base de 3TC, AZT, NVP. El alcohol y el tabaco se encuentran entre los factores que están presentes en las personas con tratamiento antirretroviral con reacciones adversas. La criptosporidiasis, candidiasis orofaríngea y el herpes zoster, son las infecciones oportunistas que más aparecieron en pacientes con este tratamiento. La polifarmacia está presente en un 60 por ciento de las personas con tratamiento y de ellos el 100 por ciento tuvo reacción adversa a un medicamento; sin embargo, las reacciones adversas y el tratamiento antirretroviral se comportó al 60 por ciento.

[Acute necrotizing pancreatitis by a foreign body. First worldwide report secondary to a match impactation]. / Pancreatitis Aguda Necrotizante por Cuerpo Extraño. Primer caso Reportado SecundariO a un Palillo de Fósforos.

Pancreatitis caused by foreign bodies is exceptionally rare. It has been described: needles, surgical clips, sutures, belt buckles, toothpicks, spines of fish, chicken feathers and bezoars. This is the first case reported in world literature caused by a match ("cerillo"). A 73-year-old women, admitted with the diagnostic of severe necrotizing pancreatitis, APACHE score 12, during 36 hours following the admission she developed refractory hypotension, acute renal failure and finally died. The necropsy showed: extensive necrosis that compromise the whole pancreas and a match impacted in the duct of Wirsung. Microscopic evaluation revealed coagulative parenchymal necrosis, micro abscesses and a dense accumulation of acute inflammatory cells surrounding the match.

Pancreatitis aguda necrotizante por cuerpo extraño. Primer caso reportado secundario a un palillo de fósforos / Acute necrotizing pancreatitis by a foreign body. First reported case secondary to a match stick

Cuadros de pancreatitis causada por cuerpo extraño son excepcionalmente raros. Se han descrito: agujas, clips quirúrgicos, suturas, hebillas de cinturón, mondadientes, espinas de pescado, plumas de pollo y bezoares. Este es el primer caso reportado en la literatura mundial causado de un palito de fósforo (cerillo). Se trata de una mujer de 73 años con diagnóstico de pancreatitis aguda necrotizante, puntaje Apache en 12, que desarrollo en las siguientes 36 horas de la admisión, hipotensión refractaria, falla renal aguda y muerte. La autopsia mostró necrosis extensa que comprometía todo el páncreas y un cerillo impactado en el conducto de Wirsung. Microscópicamente se evidenció necrosis coagulativa parenquimal, micro_abscesos y un denso infiltrado inflamatorio agudo rodeando al cerillo.

Pancreatitis caused by foreign bodies is exceptionally rare. It has been described: needles, surgical clips, sutures, belt buckles, toothpicks, spines of fish, chicken feathers and bezoars. This is the first case reported in world literature caused by a match ("cerillo"). A 73-year-old women, admitted with the diagnostic of severe necrotizing pancreatitis, APACHE score 12, during 36 hours following the admission she developed refractory hypotension, acute renal failure and finally died. The necropsy showed: extensive necrosis that compromise the whole pancreas and a match impacted in the duct of Wirsung. Microscopic evaluation revealed coagulative parenchymal necrosis, micro abscesses and a dense accumulation of acute inflammatory cells surrounding the match.

Enfoque interdisciplinario en el tratamiento del Síndrome de Marfan: resultados a 17 años / Interdisciplinary approach of Marfan Syndrome: a 17-year experience

Introducción: el Síndrome de Marfan (SM) es una enfermedad genética de baja prevalencia (1/5.000) individuos). Esta entidad posee características cardiovasculares, esqueléticas y oculares bien definidas. El pronóstico depende fundamentalmente de la dilatación de la raíz aórtica que provoca disección y/o ruptura de la misma. Hay gran desconocimiento sobre este síndrome por parte de los médicos de todas las especialidades. Con la formación de un equipo interdisciplinario diseñamos un registro sobre esta patología, relevando el comportamiento clínico y quirúrgico. Objetivo: registrar la información clínica y evolutiva de los pacientes con SM derivados de diversos lugares de nuestro país a nuestro centro con el fin de lograr una mejor atención de esta patología y detectar la presencia de dilatación de la raíz aórtica. Material y métodos: entre 1992 y 2009 se incluyeron pacientes con diagnóstico de SM de acuerdo a los criterios internacionales establecidos en Ghent. Fueron evaluados por traumatólogos, cardiólogos, cirujanos cardiovasculares, oftalmólogos, nutricionistas, neumonólogos y psicólogos y controlados periódicamente con un programa preestablecido recibiendo tratamiento preventivo médico y/o quirúrgico. Resultados: se evaluaron 273 pacientes, 145 de sexo masculino (53,5%). La edad promedio fue de 25,7 años (2 a 70 años). Las manifestaciones diagnósticas cardiovasculares correspondieron en orden decreciente a: aneurisma de aorta torácica 84 p (30,7%), insuficiencia valvular aórtica 47 p (17,2%), prolapso de válvula mitral 30 sujetos (10,9%) e insuficiencia mitral en 28 (10,2%). 63 % (90 pacientes) requirió cirugía de reemplazo de aorta ascendente. 76 pacientes en nuestro Hospital, el 84 % de las cirugías fueron programadas. Conclusión: la constitución de un equipo interdisciplinario permitió controlar un importante número de pacientes con SM con la detección de un número significativo de casos pasibles de tratamiento preventivo del aneurisma de aorta torácica.

Introduction: Marfan syndrome is a genetic disorder of low prevalence (1/5,000 subjects). This disorder has well defined cardiovascular, skeletal and ocular features. Its prognosis depends mainly on the aortic root dilation leading to its disection and/or rupture. This Syndrome is not well known among physicians of all specialties. In order to study the clinical and surgical characteristics of this disorder, we form an interdisciplinary team and design a registry. Objective: To register the clinical information and evolution of patients with Marfan Syndrome referred from different areas of our country to our Hospital in order to get a better attention of this disorder and to detect the presence of thoracic aorta dilation. Methods: Between 1992 and 2009, patients with Marfan Syndrome were included according to the international criteria established in Ghent. An interdisciplinary team formed by: traumatologists, cardiologists, cardiovascular surgeons, oftalmologists, specialists in nutrition, neumonologists and psychologists, evaluated and controlled the patients periodically with a pre set program receiving medical and/or surgical treatment. Results: it were evaluated 273 patients, 146 male (53,5%). Average age was 25.7 years (2-70 years old). Cardiovascular manifestations were in decreasing order: thoracic aorta aneurysms 84 p (30.7%), aortic valve regurgitation 47p (17.2%), mitral valve prolapse 30p (10.9%) and mitral regurgitation 28 p (10.2%), 90 patients (63%) required replacement of the ascending aorta, 76 were performed in our Hospital, and 84% of the procedures were scheduled. Conclusions: the formation of an interdisciplinary team allowed to control an important number of patients with Marfan Syndrome detecting a significant amount of cases which could be treated with preventive surgery of the thoracic aorta aneurysms, main cause of early mortality.

[An unusual presentation of liver involvement in hereditary hemorrhagic telangiectasia biliary disease]. / Una presentacion inusual de compromiso hepatico en telangiectasia hemorragica hereditaria: enfermedad biliar.

Hereditary Hemorrhagic Telangiectasia is a relatively common, under-recognized autosomal dominant disorder characterized by angiodysplastic lesions that affect multiple organs, like liver. This is a case of a 76 years old woman with history of pain in the lower third of right hemithorax, presence of tiny telangiectases in fingers, lips and tongue, in addition to pain on palpation of right hypochondrium; the initial abdominal ultrasound assessment showed biliary intrahepatic dilation. Patient meets The Diagnostic Criteria of Curacao for Hereditary Hemorrhagic Telangiectasia. The presence of liver arteriovenous malformations was confirmed by DOPPLER-ECHO and CT scan.

Una presentación inusual de compromiso hepático en telangiectasia hemorrágica hereditaria: enfermedad biliar / An unusual presentation of liver involvement in hereditary hemorrhagic telangiectasia biliary disease

Telangiectasia Hemorrágica Hereditaria es un desorden autosómico dominante sub reconocido y relativamente común caracterizado por lesiones angiodisplásicas que afectan múltiples órganos, entre ellos el hígado. Reportamos el caso de una mujer de 76 años de edad con historia de dolor en el tercio inferior del hemitórax derecho, presencia de tenues telangiectasias en pulpejos de dedos de manos, labios y lengua además de dolor a la palpación del hipocondrio derecho; la ecografía abdominal inicial de esta paciente fue compatible con dilatación de la vía biliar intrahepática. La paciente cumple el criterio diagnóstico de Curacao para Telangiectasia Hemorrágica Hereditaria. La presencia de malformaciones arteriovenosas en hígado fue confirmada por ECO-DOPPLER y Tomografía Espiral Multicorte.

Hereditary Hemorrhagic Telangiectasia is a relatively common, under-recognized autosomal dominant disorder characterized by angiodysplastic lesions that affect multiple organs, like liver. This is a case of a 76 years old woman with history of pain in the lower third of right hemithorax, presence of tiny telangiectases in fingers, lips and tongue, in additionto pain on palpation of right hypochondrium; the initial abdominal ultrasound assessment showed biliary intrahepatic dilation. Patient meets The Diagnostic Criteria of Curacao for Hereditary Hemorrhagic Telangiectasia. The presence of liver arteriovenous malformations was confirmed by DOPPLER-ECHO and CT scan.

Surgical treatment of ascending aortic complications in Marfan syndrome: early and long-term outcomes.

Findings in 54 patients (mean age 39 years, range 18-66 years, 25% female) were analyzed. Of these patients, 21 had dissection of the ascending aorta (15 acute and six chronic) and 33 had aneurysm of the ascending aorta. Surgery was classified as emergency surgery in three cases, as urgent in 15, and as scheduled surgery in 36. The Bentall-De Bono procedure was performed in 39 patients, aortic valve reimplantation was carried out in nine, Cabrol's operation was performed in three, and a homograft was used in three. The mean diameter of the ascending aorta was 66.6 mm. Overall, in-hospital mortality was 3.7% (33.3% for emergency surgery vs. 2.8% for scheduled surgery; P< .001). During the mean follow-up period of 4 years (range, 2 months-14 years), seven patients died, including four who died due to type-B aortic dissection. The actuarial survival rate at 2, 5 and 10 years was 94%, 83% and 75%, respectively, with 88%, 67% and 43% of patients, respectively, not requiring reoperation. Elective aortic root replacement was associated with a low risk and a good survival rate.

Tratamiento quirúrgico de las complicaciones de la aorta ascendente en el síndrome de Marfan. Resultados inmediatos y a largo plazo / Surgical Treatment of Ascending Aortic Complications in Marfan Syndrome: Early and Long-Term Outcomes

Se analizaron los resultados en 54 pacientes con unamedia de edad de 39 (18-66) años; el 25% eran mujeres;21 pacientes presentaban disección (aguda en 15 y crónicaen 6 pacientes) y 33, aneurisma. La operación fuede máxima urgencia en 3 pacientes, urgente en 15 y programada en 36. Utilizamos tubo valvulado en 39 pacientes, reimplante valvular en 9, técnica de Cabrol en 3 y homoinjerto en 3. El diámetro promedio aórtico fue de 66,6 mm. La mortalidad hospitalaria total fue del 3,7% (máxima urgencia, 33,3%; programada, 2,8%; p < 0,001). Durante el seguimiento (media, 4 años [2 meses-14 años]) fallecieron 7 pacientes, 4 por disección aórtica tipo B. A los 2, a los 5 y a los 10 años, la supervivencia actuarial fue del 94, el 83 y el 75% y la libertad de reoperación, del 88, el 67 y el 43%, respectivamente. El reemplazo electivode la aorta ascendente tiene bajo riesgo y buena supervivencia

Findings in 54 patients (mean age 39 years, range 18-66 years, 25% female) were analyzed. Of these patients,21 had dissection of the ascending aorta (15 acute andsix chronic) and 33 had aneurysm of the ascending aorta.Surgery was classified as emergency surgery in threecases, as urgent in 15, and as scheduled surgery in 36.The Bentall-De Bono procedure was performed in 39patients, aortic valve reimplantation was carried out innine, Cabrol’s operation was performed in three, and ahomograft was used in three. The mean diameter of theascending aorta was 66.6 mm. Overall, in-hospitalmortality was 3.7% (33.3% for emergency surgery vs.2.8% for scheduled surgery; P<.001). During the meanfollow-up period of 4 years (range, 2 months-14 years),seven patients died, including four who died due to type-B aortic dissection. The actuarial survival rate at 2, 5 and 10 years was 94%, 83% and 75%, respectively, with 88%, 67% and 43% of patients, respectively, not requiringreoperation. Elective aortic root replacement wasassociated with a low risk and a good survival rate

Immunotherapy for patients with persistent allergic rhinitis unsatisfied with free chronic pharmacotherapy.

BACKGROUND: Chronic pharmacotherapy is recommended to patients with persistent moderate-severe (PM-S) allergic rhinitis (AR). The cost of pharmacotherapy is the main barrier to achieve symptoms control. AIMS OF THE STUDY: To determine the benefits of mite subcutaneous immunotherapy (SIT) in patients with PM-S AR not satisfied with chronic pharmacotherapy received free of charge. METHODS: Open study with seven (7) patients with PM-S AR not satisfied with chronic pharmacotherapy. Prior to enrollment patients had received monthly for more than five months and free of charge, optimal pharmacotherapy. We compared, off pharmacotherapy, symptoms and quality of life (QOL) before and during SIT. RESULTS: Mite SIT improved nasal symptoms, non nasal symptoms and QOL. Off pharmacotherapy patients reported adequate control of symptoms and were satisfied. CONCLUSIONS: Not all patients with PM-S AR are satisfied with chronic pharmacotherapy, even if medication is received free of charge. SIT control symptoms and satisfies patients with PM-S AR unsatisfied with free chronic pharmacotherapy.

Immunotherapy for patients with persistent allergic rhinitis unsatisfied with free chronic pharmacotherapy

Background: Chronic pharmacotherapy is recommended to patients with persistent moderate-severe (PM-S) allergic rhinitis (AR). The cost of pharmacotherapy is the main barrier to achieve symptoms control. Aims of the study: To determine the benefits of mite subcutaneous immunotherapy (SIT) in patients with PM-S AR not satisfied with chronic pharmacotherapy received free of charge. Methods: Open study with seven (7) patients with PM-S AR not satisfied with chronic pharmacotherapy. Prior to enrollment patients had received monthly for more than five months and free of charge, optimal pharmacotherapy. We compared, off pharmacotherapy, symptoms and quality of life (QOL) before and during SIT. Results: Mite SIT improved nasal symptoms, non nasal symptoms and QOL. Off pharmacotherapy patients reported adequate control of symptoms and were satisfied. Conclusions: Not all patients with PM-S AR are satisfied with chronic pharmacotherapy, even if medication is received free of charge. SIT control symptoms and satisfies patients with PM-S AR unsatisfied with free chronic pharmacotherapy

Antecedentes. La farmacoterapia se recomienda a pacientes con rinitis alérgica moderada-grave, persistente. El coste de esta medicación es el principal inconveniente para conseguir el control de los síntomas Objetivo: valorar los beneficios de la inmunoterapia subcutánea (ISC) en pacientes con rhinitis alérgica de esas características, que no están satisfechos con los fármacos recibidos gratuitamente Métodos: estudio de 7 pacientes con rinitis alérgica persistente, moderada o grave, que no están satisfecho con el tratamiento farmacológico que reciben. Antes de la inclusión en el estudio, los pacientes han recibido mensualmente, durante más de 5 meses gratuitamente, la mediación apropiada. Eliminada la farmacoterapia, comparamos los síntomas y la calidad de vida (QOL) antes y durante la inmunoterapia subcutánea. Resultados. La ISC con extracto de ácaros mejoró los síntomas nasales, los síntomas no nasales y la QOL. Sin farmacoterapia, los pacientes tuvieron un control adecuado de los síntomas y estaban satisfechos. Conclusiones: No todos los pacientes con rinitis persistente moderada/grave están satisfechos con la farmacoterapia permanente, incluso si la reciben gratuitamente. La ISC controla los síntomas y satisface a los pacientes que padecen rhinitis con estas características

Interfacial properties of a synthetic peptide derived from hepatitis G virus E2 protein: interaction with lipid monolayers.

A useful approach to get information about the potential fusogenic ability of virus synthetic peptides is the study of its interfacial properties and subsequent study in mono- and bilayers. In this work, we have characterized by means of physicochemical tools (i.e. compression isotherms and surface activity) the sequence 267-284, LLGTEVSEVLGGAGLTGG, derived from the E2 structural protein of HGV/GBV-C. The adsorption of the peptide at the air/water interface was monitored by following the increase in surface pressure as a function of time at two different pH values: 5 and 7. Parameters such as surface excess or molecular area were calculated from the equation of Gibbs. The peptide showed a tendency to migrate to the surface of a saline-buffered solution. It formed stable monolayers at the air/water interface giving a compression isotherm with a shape consistent with that of some alpha-helical peptide conformations. Brewster angle microscopy (BAM) showed that through compression the peptide formed multilayers. The studies with lipid monolayers (DPMC, DMPC/DMPG, and DMPC/DMTAP) showed that the peptide interacts with all the lipids assayed producing a marked disrupting effect upon them. In these effects electrostatic interactions seem to have some participation.

Perturbations induced by synthetic peptides from hepatitis G virus structural proteins in lipid model membranes: a fluorescent approach.

The name HGV/GBV-C remains as an acronym for hepatitis G virus (HGV) and GB virus-C (GBV-C), strain variants of this enveloped RNA virus independently but simultaneously discovered in 1995. Nowadays there is no evidence that it causes hepatitis in humans either during initial infection or after long-term carriage, but it has been recently related with HIV regarding the inhibition of progression to AIDS. The overall genomic organization of HGV/GBV-C is similar to that of hepatitis C virus (HCV) and other members of the Flavivirus family in Hepacivirus genus. Although a stretch of conserved, hydrophobic amino acids within the envelop glycoprotein of HCV has been proposed as the virus fusion peptide, the mode of entry of GBV-C/HGV into target cells is at present unknown. In the present work, sequences derived from the structural E2-protein of HGV/GBV-C have been selected by means of semiempirical methods and then synthesized manually following solid-phase methodologies. Their ability to induce perturbations in model membranes has been analysed by measuring the penetration of such peptides in lipid monolayers and by a series of experiments based on tryptophan peptide fluorescence emission spectra. Besides, release of vesicular contents to the medium was monitored by the ANTS/DPX assay. The membrane destabilization properties of these peptides was found very related with the length of the sequence.