Latin-American guidelines of recommendations at discharge from an acute coronary syndrome.

The diagnostic criteria, treatments at the time of admission, and drugs used in patients with acute coronary syndrome are well defined in countless guidelines. However, there is uncertainty about the measures to recommend during patient discharge planning. This document brings together the most recent evidence and the standardized and optimal treatment for patients at the time of discharge from hospitalization for an acute coronary syndrome, for comprehensive and safe care in the patient's transition between care from the acute event to the outpatient care, with the aim of optimizing the recovery of viable myocardium, guaranteeing the most appropriate secondary prevention, reducing the risk of a new coronary event and mortality, as well as the adequate reintegration of patients into daily life.

Los criterios diagnósticos, los tratamientos en el momento de la admisión y los fármacos utilizados en pacientes con síndrome coronario agudo están bien definidos en innumerables guías. Sin embargo, existe incertidumbre acerca de las medidas para recomendar durante la planificación del egreso de los pacientes. Este documento reúne las evidencias más recientes y el tratamiento estandarizado y óptimo para los pacientes al momento del egreso de una hospitalización por un síndrome coronario agudo, para un cuidado integral y seguro en la transición del paciente entre la atención del evento agudo y el cuidado ambulatorio, con el objetivo de optimizar la recuperación de miocardio viable, garantizar la prevención secundaria más adecuada, reducir el riesgo de un nuevo evento coronario y la mortalidad, así como la adecuada reinserción de los pacientes en la vida cotidiana.

Central American and Caribbean Consensus Document for the Optimal Management of Oral Anticoagulation in Patients with Non-Valvular Atrial Fibrillation Endorsed by the Central American and Caribbean Society of Arterial Hypertension and Cardiovascular Prevention.

Atrial fibrillation (AF) is the most common arrhythmia in adults. Prevention of the ischaemic risk with oral anticoagulants (OACs) is widely recommended, and current clinical guidelines recommend direct oral anticoagulants (DOACs) as preference therapy for stroke prevention. However, there are currently no clinical practice guidelines or recommendation documents on the optimal management of OACs in patients with AF that specifically address and adapt to the Central American and Caribbean context. The aim of this Delphi-like study is to respond to doubts that may arise in the management of OACs in patients with non-valvular AF in this geographical area. A consensus project was performed on the basis of a systematic review of the literature, a recommended ADOLOPMENT-like approach, and the application of a two-round Delphi survey. In the first round, 31 recommendations were evaluated and 30 reached consensus, of which, 10 unanimously agreed. The study assessed expert opinions in a wide variety of contextualized recommendations for the optimal management of DOACs in patients with non-valvular atrial fibrillation (NVAF). There is a broad consensus on the clinical practice guideline (CPG) statements used related to anticoagulation indication, patient follow-up, anticoagulation therapy complications, COVID-19 management and prevention, and cardiac interventions.

Semiochemicals Associated with the Western Flower Thrips Attraction: A Systematic Literature Review and Meta-Analysis.

The study of the semiochemicals of the western flower thrips (WFT), Frankliniella occidentalis, Pergande (Thysanoptera: Thripidae), is a relevant topic that spans the last two decades. Approximately a hundred articles published on this subject from 2000 to 2022 can be found in academic databases, representing approximately 5% of the research on this important pest. These topics have generated a platform for novel research with a high potential for development. However, to move on to a new research step, an effectiveness evaluation of the compounds discovered so far is necessary. This review conducted a systematic analysis of the research focused on the semiochemicals (kairomones, pheromones, and attractants) for this pest. Papers from the past three decades on WFT attraction to semiochemicals were collected from databases using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The number of individuals attracted to compounds was extracted from the papers and compiled for analysis. With this information, an attraction ratio was calculated. Forty-one possible attractants were found in the literature, with methyl isonicotinate being the most-studied compound so far, with the third-highest attraction ratio. δ-Decalactone was the compound with the highest attraction ratio, but it was one of the least studied. A meta-analysis of the WFT choosing proportion was performed for the compounds with more trials found in the literature. The predicted mean choice percentages for methyl isonicotinate (MIN) and Lurem-TR, the MIN's commercial product, were 76.6% and 66.6%, respectively. There was a convergence among the analyzed studies showing a high degree of research focus on the same group of nitrogen-containing compounds (mainly the pyridine structure). These findings call for future research to diversify the discovery and evaluation of attractive compounds in this relevant study area.

Plastic Surgery Diversity, Equity, and Inclusion Mentorship Program and Workshop: A Single Institution's Experience.

SUMMARY: Several minority groups and students without home plastic surgery programs remain underrepresented in plastic surgery. To address these barriers, our division created the Plastic Surgery Diversity, Equity, and Inclusion Mentorship Program and Workshop. Students meeting at least one of the following eligibility criteria were invited in fall of 2020: medical student in years 1 though 3 or a research year who is (1) underrepresented in medicine, including African American, Hispanic/Latinx, Native American, Pacific Islander; (2) lesbian, gay, bisexual, transgender, or queer (LGBTQ); (3) first-generation low-income; or (4) does not have a plastic surgery residency program associated with their medical school. Students participated in quarterly meetings with their resident mentor and the annual hands-on workshop. The workshop was held on March 20, 2020, with both virtual and in-person participants. It included various didactic lectures, a suture laboratory, a resident panel, a social lunch hour, and extremity and head cadaver dissections with fracture plating. Twenty-four students attended the workshop. The course was rated 9.4 of 10 by students. The top met goals were gaining didactic plastic surgery knowledge (100%), exposure to a plastic surgery residency program (100%), resources to help overcome minority-specific barriers (96%), and technical skills such as suturing (96%). At the conclusion of the workshop, students had a significant increase in confidence in various aspects of plastic surgery knowledge and technical skills. The Plastic Surgery Diversity, Equity, and Inclusion Mentorship Program and Workshop demonstrated preliminary success in providing support for students underrepresented in medicine and students without home programs.

Seguridad y satisfacción de fumigadores para el control de enfermedades transmitidas por vectores en Arequipa / Safety and satisfaction of fumigators for the control of vector-borne diseases in Arequipa

Las enfermedades transmitidas por vectores (ETV) van en repunte, la seguridad y satisfacción del equipo que trabaja en el área de fumigación son prioridad, ya que son el personal clave y estratégico para hacer frente a estas enfermedades que son un gran problema de la salud pública a nivel mundial. Como objetivo se propuso deteminar el nivel de seguridad y satisfacción de fumigadores para el control de enfermedades transmitidas por vectores en Arequipa durante el primer semestre del año 2022. La investigación fue descriptiva, experimental de corte transversal con una muestra de 58 fumigadores. Como instrumento de recolección de datos se aplicó una encuesta validada por expertos que consta de tres secciones con diversos ítems para describir la muestra, perfil sociodemográfico, actividad ocupacional, uso de equipos de protección personal, condiciones de salud y satisfacción de empleo. Se utilizó el programa Excel para elaborar la base de datos y el programa EPIDAT 3.0 para frecuencias, porcentajes e IC 95%. Como resultado, 74,14% eran del sexo masculino y 25,86% femenino, 70,69% tenían 41 años o más, 70,69% tenían más de 10 años de ambigüedad, 32,76% tenían unión de hecho, 48,28% tenían estudios secundarios, por otra parte, 94,83% de colaboradores expuestos a Deltametrina <1 hora en dilución y carga, usan mascarillas y filtros, 86,21% usan guantes, bragas y delantales y 84,48% usa gafas, 53,45% sentían sensación de naúseas o mareos, 93,10% estaban satisfechos con el ambiente laboral. Como conclusión, se hace necesario continuar con investigaciones semejantes en diferentes zonas de Perú(AU)

Vector-borne diseases (VTE) are on the rise, the safety and satisfaction of the team that works in the fumigation area are a priority, since they are the key and strategic personnel to deal with these diseases, which are a major health problem public worldwide. The objective was to determine the level of safety and satisfaction of fumigators for the control of vector-borne diseases in Arequipa during the first semester of 2022. The research was descriptive, experimental, cross-sectional with a sample of 58 fumigators. As a data collection instrument, a survey validated by experts was applied, consisting of three sections with various items to describe the sample, sociodemographic profile, occupational activity, use of personal protective equipment, health conditions, and job satisfaction. The Excel program was used to prepare the database and the EPIDAT 3.0 program for frequencies, percentages and 95% CI. As a result, 74.14% were male and 25.86% female, 70.69% were 41 years of age or older, 70.69% had more than 10 years of ambiguity, 32.76% had a common-law union, 48 28% had secondary education, on the other hand, 94.83% of employees exposed to Deltamethrin <1 hour in dilution and load wear masks and filters, 86.21% wear gloves, panties and aprons and 84.48% wear glasses, 53.45% felt nauseated or dizzy, 93.10% were satisfied with the work environment. In conclusion, it is necessary to continue with similar investigations in different areas of Peru(AU)

Clinical practice patterns in multiple sclerosis management: Mexican consensus recommendations.

BACKGROUND: Multiple sclerosis affects more than 2 million people. Clinical decisions are performed under evidence-based medicine. The appearance of new disease-modifying therapies and changes in diagnostic criteria complicates the decision-making process in clinical practice. OBJECTIVES: To characterize the criteria for radiologically isolated syndrome (RIS), clinically isolated syndrome (CIS), and relapsing-remitting multiple sclerosis (RRMS) by Mexican neurologists in a real-world setting. METHODS: A two-round modified Delphi method (RAND/UCLA) was applied. RESULTS: In RIS, LP, spinal cord MRI and VEP should be included in diagnostic testing; DMT initiation is not necessary. A follow-up MRI within 3 months are recommended. In CIS, corticosteroid therapy should be initiated at first relapse; both simple and Gd-enhanced MRI is mandatory. LP, selective blood tests, and NMO-IgG/AQP4 antibodies should be performed as complementary. IFN beta or GA were the most suitable DMTs for treating high-risk CIS. Patients with RRMS should begin with DMT at diagnosis, include a follow-up MRI if a patient had 2 relapses within 6 months. GA and oral DMTs are the most eligible DMTs for mild RRMS. Monoclonal antibodies-based therapy is chosen when disability is present. Radiological criteria for switching DMT included >1 Gd+ lesion and >2 new T2 lesions. CONCLUSIONS: Although many coincidences, there are still many hollows in the medical attention of MS in Mexico. This consensus recommendation could be helpful to implement better evidence-based recommendations and guidelines in a real-world setting.

Proteomic analysis of Rickettsia akari proposes a 44 kDa-OMP as a potential biomarker for Rickettsialpox diagnosis.

BACKGROUND: Rickettsialpox is a febrile illness caused by the mite-borne pathogen Rickettsia akari. Several cases of this disease are reported worldwide annually. Nevertheless, the relationship between the immunogenicity of R. akari and disease development is still poorly understood. Thus, misdiagnosis is frequent. Our study is aiming to identify immunogenic proteins that may improve disease recognition and enhance subsequent treatment. To achieve this goal, two proteomics methodologies were applied, followed by immunoblot confirmation. RESULTS: Three hundred and sixteen unique proteins were identified in the whole-cell extract of R. akari. The most represented protein groups were found to be those involved in translation, post-translational modifications, energy production, and cell wall development. A significant number of proteins belonged to amino acid transport and intracellular trafficking. Also, some proteins affecting the virulence were detected. In silico analysis of membrane enriched proteins revealed 25 putative outer membrane proteins containing beta-barrel structure and 11 proteins having a secretion signal peptide sequence. Using rabbit and human sera, various immunoreactive proteins were identified from which the 44 kDa uncharacterized protein (A8GP63) has demonstrated a unique detection capability. It positively distinguished the sera of patients with Rickettsialpox from other rickettsiae positive human sera. CONCLUSION: Our proteomic analysis certainly contributed to the lack of knowledge of R. akari pathogenesis. The result obtained may also serve as a guideline for a more accurate diagnosis of rickettsial diseases. The identified 44 kDa uncharacterized protein can be certainly used as a unique marker of rickettsialpox or as a target molecule for the development of more effective treatment.

Repair of Spontaneous Left Atrial Dissection Resulting in Severe Paravalvular Native Mitral Valve Regurgitation.

A 54-year-old male with history of end-stage renal disease secondary to hypertension on hemodialysis with moderate aortic valve insufficiency presented with progressive exertional dyspnea and lower extremity edema over several weeks. Relevant history included hospitalization for Staphylococcus epidermidis bacteremia secondary to dialysis catheter line infection 6 months prior. (Level of Difficulty: Advanced.).

Evaluating polymicrobial immune responses in patients suffering from tick-borne diseases.

There is insufficient evidence to support screening of various tick-borne diseases (TBD) related microbes alongside Borrelia in patients suffering from TBD. To evaluate the involvement of multiple microbial immune responses in patients experiencing TBD we utilized enzyme-linked immunosorbent assay. Four hundred and thirty-two human serum samples organized into seven categories followed Centers for Disease Control and Prevention two-tier Lyme disease (LD) diagnosis guidelines and Infectious Disease Society of America guidelines for post-treatment Lyme disease syndrome. All patient categories were tested for their immunoglobulin M (IgM) and G (IgG) responses against 20 microbes associated with TBD. Our findings recognize that microbial infections in patients suffering from TBDs do not follow the one microbe, one disease Germ Theory as 65% of the TBD patients produce immune responses to various microbes. We have established a causal association between TBD patients and TBD associated co-infections and essential opportunistic microbes following Bradford Hill's criteria. This study indicated an 85% probability that a randomly selected TBD patient will respond to Borrelia and other related TBD microbes rather than to Borrelia alone. A paradigm shift is required in current healthcare policies to diagnose TBD so that patients can get tested and treated even for opportunistic infections.

Prevalencia y extensión de la calcificación arterial coronaria en población mexicana asintomática cardiovascular: estudio Genética de la Enfermedad Aterosclerosa / Prevalence and extent of coronary artery calcification in an asymptomatic cardiovascular Mexican population: Genetics of Atherosclerotic Disease study

Resumen: Objetivo: La prevalencia de calcificación arterial coronaria (CAC), marcador específico de aterosclerosis, no es conocida en México. Nuestro objetivo fue investigar la prevalencia y extensión de CAC y su asociación con factores de riesgo cardiovascular en población mexicana. Métodos: La CAC fue medida por tomografía computarizada multidetector en individuos asintomáticos que participaron en el estudio Genética de la Enfermedad Aterosclerosa. Los factores de riesgo cardiovascular y los medicamentos fueron registrados. Resultados: La muestra incluyó 1,423 individuos (49.5% hombres), con una edad de 53.7 ± 8.4 años. Los portadores de CAC mostraron prevalencias más altas de dislipidemia, diabetes, hipertensión y otros factores de riesgo. La prevalencia de CAC > 0 unidades Agatston fue de 27%, significativamente más alta en hombres (40%) que en mujeres (13%). Los valores medios del puntaje de CAC aumentaron consistentemente con la edad y fueron más altos en hombres que en mujeres en todos los grupos etarios. La edad y el c-LDL elevado se asociaron de manera independiente con la prevalencia de CAC > 0 en hombres y mujeres, mientras que la presión arterial sistólica en las mujeres, y el incremento de la edad en ambos géneros mostró una asociación independiente con la severidad de CAC. Conclusiones: En población mexicana la prevalencia y la extensión de CAC fueron mucho más altas en hombres que en mujeres y aumentaron consistentemente con la edad. Los predictores independientes de la prevalencia de CAC fueron la edad y el c-LDL.

Abstract: Objective: The prevalence of coronary artery calcification (CAC), a specific marker of atherosclerosis, is unknown in Mexico. Our aim was to investigate the prevalence and quantity of CAC and their association with cardiovascular risk factors in a Mexican population. Methods: CAC was measured by multidetector computed tomography in asymptomatic subjects who participated in the Genetics of Atherosclerotic Disease study. Cardiovascular risk factors and medication were recorded. Results: The sample included 1,423 individuals (49.5% men), aged 53.7 ± 8.4 years. Those with CAC showed a higher prevalence of dyslipidaemia, diabetes, hypertension, and other risk factors. The prevalence of CAC > 0 Agatston units was significantly higher among men (40%) than among women (13%). Mean values of CAC score increased consistently with increasing age and were higher in men than women in each age group. Age and high low density lipoprotein cholesterol were independently associated with prevalence of CAC > 0 in men and women, while increasing systolic blood pressure in women and age in both genders showed an independent association with CAC extension. Conclusions: In the Mexican population the prevalence and extent of CAC were much higher in men than in women, and strongly increased with age. Independent predictors of CAC prevalence were age and low density lipoprotein cholesterol (LDL-C).

Organoid cystogenesis reveals a critical role of microenvironment in human polycystic kidney disease.

Polycystic kidney disease (PKD) is a life-threatening disorder, commonly caused by defects in polycystin-1 (PC1) or polycystin-2 (PC2), in which tubular epithelia form fluid-filled cysts. A major barrier to understanding PKD is the absence of human cellular models that accurately and efficiently recapitulate cystogenesis. Previously, we have generated a genetic model of PKD using human pluripotent stem cells and derived kidney organoids. Here we show that systematic substitution of physical components can dramatically increase or decrease cyst formation, unveiling a critical role for microenvironment in PKD. Removal of adherent cues increases cystogenesis 10-fold, producing cysts phenotypically resembling PKD that expand massively to 1-centimetre diameters. Removal of stroma enables outgrowth of PKD cell lines, which exhibit defects in PC1 expression and collagen compaction. Cyclic adenosine monophosphate (cAMP), when added, induces cysts in both PKD organoids and controls. These biomaterials establish a highly efficient model of PKD cystogenesis that directly implicates the microenvironment at the earliest stages of the disease.

Prevalencia y asociación de la calcificación valvular aórtica con factores de riesgo y aterosclerosis coronaria en población mexicana / Aortic valve calcification prevalence and association with coronary risk factors and atherosclerosis in Mexican population

Resumen: Objetivo: La prevalencia de calcificación valvular aórtica (CVA) tiene influencia importante de la etnia y se desconoce en población mexicana. Nuestro objetivo fue investigar la prevalencia de CVA y sus asociaciones con factores de riesgo cardiovascular y calcificación arterial coronaria (CAC). Método: En 1,267 sujetos (53% mujeres) sin enfermedad coronaria conocida y con edad de 35 a 75 años, la CVA y la CAC se evaluaron mediante tomografía computada multidetector, utilizando el método de Agatston. Los factores de riesgo cardiovascular se documentaron en todos los participantes. Las asociaciones de CVA con CAC y factores de riesgo se estimaron usando el análisis de regresión logística múltiple. Resultados: La prevalencia global de CVA y CAC fue del 19.89% y del 26.5%, respectivamente. Ambas condiciones aumentaron con la edad y se encontraron con mayor frecuencia en hombres (25.5 y 37.1%, respectivamente) que en mujeres (14.9 y 13%, respectivamente). La CVA se observó en únicamente el 8.5% de los sujetos sin CAC, mientras que en aquellos con CAC 1-99, 100-399 y > 400 unidades Agatston, las prevalencias fueron del 36.8, 56.8 y 84%, respectivamente. El análisis de regresión logística múltiple ajustado por edad, género, obesidad, inactividad física, hipertensión, dislipidemia y valores altos de insulina, mostró que la presencia de CAC (RM [IC95%]: 3.23 [2.26-4.60]), obesidad (1.94 [1.35-2.79]), género masculino (1.44 [1.01-2.05]) y edad (1.08 [1.03-1.10]), fueron predictores independientes y significativos de la CVA. Conclusiones: La prevalencia de CVA es alta y se asocia significativamente con factores de riesgo aterosclerótico y CAC en población mexicana.

Abstract: Objetive: The prevalence of aortic valve calcification (AVC), strongly influenced by ethnicity, is unknown in Mexican population. The aim of this study was to investigate the prevalence of AVC and its associations with cardiovascular risk factors and coronary artery calcification (CAC), in Mexican subjects. Methods: In 1,267 subjects (53% women) without known coronary heart disease, aged 35 to 75 years, AVC and CAC were assessed by multidetector-computed tomography using the Agatston score. Cardiovascular risk factors were documented in all participants. The associations of AVC with CAC and risk factors were assessed by multivariable logistic regression analyses. Results: The overall prevalence of AVC and CAC was 19.89% and 26.5%, respectively. AVC and CAC increased with age and were found more frequently in men (25.5% and 37.1%, respectively) than in women (14.9% and 13.0%, respectively). AVC was observed in only 8.5% of subjects wit-hout CAC, while those with CAC 1-99, 100-399, and > 400 Agatston units had AVC prevalences of 36.8%, 56.8%, and 84.0%, respectively. The multivariable logistic regression analyses, adjusted for age, gender, obesity, physical inactivity, hypertension, dyslipidemia and high insulin levels, showed that the presence of CAC (OR [CI95%]: 3.23 [2.26-4.60]), obesity (1.94 [1.35-2.79]), male gender (1.44 [1.01-2.05]) and age (1.08 [1.03-1.10]), were significant independent predictors of AVC. Conclusion: Prevalence of AVC is high and significantly associated with atherosclerotic risk factors and CAC in this Mexican population.

[Prevalence and extent of coronary artery calcification in an asymptomatic cardiovascular Mexican population: Genetics of Atherosclerotic Disease study]. / Prevalencia y extensión de la calcificación arterial coronaria en población mexicana asintomática cardiovascular: estudio Genética de la Enfermedad Aterosclerosa.

OBJECTIVE: The prevalence of coronary artery calcification (CAC), a specific marker of atherosclerosis, is unknown in Mexico. Our aim was to investigate the prevalence and quantity of CAC and their association with cardiovascular risk factors in a Mexican population. METHODS: CAC was measured by multidetector computed tomography in asymptomatic subjects who participated in the Genetics of Atherosclerotic Disease study. Cardiovascular risk factors and medication were recorded. RESULTS: The sample included 1,423 individuals (49.5% men), aged 53.7±8.4 years. Those with CAC showed a higher prevalence of dyslipidaemia, diabetes, hypertension, and other risk factors. The prevalence of CAC>0 Agatston units was significantly higher among men (40%) than among women (13%). Mean values of CAC score increased consistently with increasing age and were higher in men than women in each age group. Age and high low density lipoprotein cholesterol were independently associated with prevalence of CAC>0 in men and women, while increasing systolic blood pressure in women and age in both genders showed an independent association with CAC extension. CONCLUSIONS: In the Mexican population the prevalence and extent of CAC were much higher in men than in women, and strongly increased with age. Independent predictors of CAC prevalence were age and low density lipoprotein cholesterol (LDL-C).

[Aortic valve calcification prevalence and association with coronary risk factors and atherosclerosis in Mexican population]. / Prevalencia y asociación de la calcificación valvular aórtica con factores de riesgo y aterosclerosis coronaria en población mexicana.

OBJETIVE: The prevalence of aortic valve calcification (AVC), strongly influenced by ethnicity, is unknown in Mexican population. The aim of this study was to investigate the prevalence of AVC and its associations with cardiovascular risk factors and coronary artery calcification (CAC), in Mexican subjects. METHODS: In 1,267 subjects (53% women) without known coronary heart disease, aged 35 to 75 years, AVC and CAC were assessed by multidetector-computed tomography using the Agatston score. Cardiovascular risk factors were documented in all participants. The associations of AVC with CAC and risk factors were assessed by multivariable logistic regression analyses. RESULTS: The overall prevalence of AVC and CAC was 19.89% and 26.5%, respectively. AVC and CAC increased with age and were found more frequently in men (25.5% and 37.1%, respectively) than in women (14.9% and 13.0%, respectively). AVC was observed in only 8.5% of subjects without CAC, while those with CAC 1-99, 100-399, and >400 Agatston units had AVC prevalences of 36.8%, 56.8%, and 84.0%, respectively. The multivariable logistic regression analyses, adjusted for age, gender, obesity, physical inactivity, hypertension, dyslipidemia and high insulin levels, showed that the presence of CAC (OR [CI95%]: 3.23 [2.26-4.60]), obesity (1.94 [1.35-2.79]), male gender (1.44 [1.01-2.05]) and age (1.08 [1.03-1.10]), were significant independent predictors of AVC. CONCLUSION: Prevalence of AVC is high and significantly associated with atherosclerotic risk factors and CAC in this Mexican population.

Reliable tool for detection of novel Coxiella burnetii antigens, using immobilized human polyclonal antibodies.

Coxiella burnetii (C. burnetii) is the etiological agent of a Q fever-the re-emerging disease with considerable economic impact. Due to many similar symptoms with commonly occurring infections, its clinical diagnosis is very difficult. Thus, a strong effort should be taken to raise the awareness and develop a robust strategy for an accurate diagnosis. The identification of specific C. burnetii biomarkers could be valuable for a sensitive and selective diagnosis of the disease. Herein, we described a workflow to identify immunoreactive proteins of C. burnetii with a high confidence. It is based on immunocapturing of bacterial antigens by biofunctionalized magnetic microspheres, followed by tandem mass spectrometry (MS/MS) identification. We detected dozens of previously reported antigens and proposed 15 novel biomarkers, which specificity was confirmed by in silico epitope analysis. Among them, the cardiolipin synthetase participating in the synthesis of cardiolipin was recognized. This biomarker could play a critical role in the early management of acute Q fever and prevention of Q fever endocarditis.

Estudio comparativo de las curaciones tradicionales y las curaciones avanzadas con apósito hidrocoloide en el tratamiento de heridas superficiales / Comparative study of traditional healing and advanced healing with hydrocolloid dressing in the treatment of superficial wounds

Introducción: Existen diversos métodos de tratamiento para la curación de las heridas como los tradicionales realizados con apósitos secos y los avanzados donde se aplican apósitos oclusivos como los hidrocoloides. Objetivo: Comparar los resultados clínicos del tratamiento con curaciones tradicionales y curaciones avanzadas con apósito hidrocoloide en heridas superficiales. Material y Métodos: Ensayo clínico cuasi experimental. Se trabajó con 47 pacientes atendidos por el Servicio de Cirugía Plástica del Hospital Nacional Almanzor Aguinaga Asenjo de julio a diciembre del 2013 quienes presentaron heridas superficiales; en la mitad de su área se procedió a la curación tradicional y en la otra se realizó curación avanzada con apósito hidrocoloide. Resultados: El tiempo de reepitelización completa en la herida superficial manejada con curación tradicional fue de 14,62 ± 1,98 días y en las curaciones avanzadas de 12,66 ± 1,90 días. Se encontró una frecuencia de infección del 17,02% en pacientes con heridas superficiales manejados con curaciones tradicionales y de 4,26% en las curaciones avanzadas. Conclusiones: Existe diferencia significativa entre el tiempo de reepitelización de heridas superficiales a favor del método de curación avanzada. Asimismo, en las curaciones tradicionales se presentaron mayor frecuencia de complicaciones.

Introduction: There are various methods of treatment for wound healing such a traditional methods made with dry dressing and advanced methods which apply occlusive dressings with hydrocolloids. Objective: To compare the clinical results of treatment with traditional cures and advanced treatments with hydrocolloid dressing in superficial wounds. Material and Methods:Aquasi-experimental. We worked with 47 patients who had superficial wounds in the Service of Plastic Surgery of Almanzor Aguinaga Asenjo National Hospital from july to december 2013. At half the area of the superficial wound proceeded to traditional healing and the other half, advanced healing was performed with hydrocolloid dressing. Results: The time to completere-epithelialization in superficial wound managed with traditional healing was 14.62 ± 1.98 days and 12.66 ± 1.90 days in advanced treatments. In this study was found a frequency of infection of 17.1% in patients with superficial wounds managed with traditional cures and 4.26%in advanced healing. Conclusions: There is significant difference between the time of re-epithelialization of superficial wounds in favor of advanced method. Also, in the present study traditional cures showed greater frequency of complications.

Insulin Resistance in Adipose Tissue but Not in Liver Is Associated with Aortic Valve Calcification.

Background. Insulin resistance is involved in the pathogenesis of cardiovascular disease, but its relationship with cardiovascular calcification has yielded conflicting results. The purpose of the present study was to investigate the role of hepatic and adipose tissue insulin resistance on the presence of coronary artery (CAC > 0) and aortic valve calcification (AVC > 0). Methods. In 1201 subjects (52% women, 53.6 ± 9.3 years old) without familiar and personal history of coronary heart disease, CAC and AVC were assessed by multidetector-computed tomography. Cardiovascular risk factors were documented and lipid profile, inflammation markers, glucose, insulin, and free fatty acids were measured. Hepatic insulin resistance (HOMA-IR) and adipose tissue insulin resistance (Adipo-IR) indices were calculated. Results. There was a significant relationship between HOMA-IR and Adipo-IR indices (r = 0.758, p < 0.001). Participants in the highest quartiles of HOMA-IR and Adipo-IR indices had a more adverse cardiovascular profile and higher prevalence of CAC > 0 and AVC > 0. After full adjustment, subjects in the highest quartile of Adipo-IR index had higher odds of AVC > 0 (OR: 2.40; 95% CI: 1.30-4.43), as compared to those in the lowest quartile. Conclusions. Adipo-IR was independently associated with AVC > 0. This suggests that abnormal adipose tissue function favors insulin resistance that may promote the development and progression of AVC.

Assessment of arterial stiffness from pedal artery Korotkoff sound recordings: feasibility and potential utility.

Brachial artery (BA) Korotkoff sound (KS) timing reflects arterial stiffness. We recorded pedal artery (PA) KS in 68 healthy subjects using an electronic stethoscope and electrocardiography. Intervals between QRS complex of the electrocardiogram and KS waveform peaks (termed the QKD interval) were measured for 60 seconds, averaged, and QKD velocity (v) calculated. Carotid-BA and carotid-PA pulse wave velocities (PWVs) were measured by applanation tonometry. Analyzable KS recordings were obtained from BA and PA in 100% and 92% subjects. PA QKDv decreased less than BA QKDv with progressive cuff inflation. At diastolic blood pressure + 20 mm Hg (maximal yield), BA QKDv was independently associated with weight and pulse pressure, whereas PA QKDv was related to weight and age. PA QKDv correlated with its corresponding PWV stronger than BA QKDv. In conclusion, PA KS is optimally recorded at diastolic blood pressure + 20 mm Hg; PA QKDv is correlated with age and better correlates with PWV than does BA QKDv. This technique may provide a simple arterial stiffness measure.