Registro español de trasplante cardiaco. XXXIII informe oficial de la Asociación de Insuficiencia Cardiaca de la Sociedad Española de Cardiología / Spanish Heart Transplant Registry. 33rd official report of the Heart Failure Association of the Spanish Society of Cardiology

Introducción y objetivos Se actualizan los datos anuales de Registro español de trasplante cardiaco con los hallazgos de los procedimientos realizados en 2021. Métodos Se describen las principales características clínicas, del tratamiento recibido y de los resultados en términos de supervivencia del año 2021 y las tendencias en el periodo 2012-2020. Resultados En 2021 se han realizado 302 trasplantes cardiacos (un 8,6% más que el año anterior). En 2021 se ha confirmado la tendencia observada en años anteriores a una disminución de los trasplantes urgentes y a la realización de estos mayoritamente con dispositivos de asistencia ventricular. Las demás características y los resultados en términos de supervivencia muestran una clara tendencia a la estabilización en la última década. Respecto a 2019, en los años de la pandemia por SARS-CoV-2 (2020 y 2021) no se detecta un impacto relevante en los resultados en la fase aguda tras el trasplante y en la serie histórica. Conclusiones En 2021 se ha recuperado la actividad de trasplante hasta cifras previas a la pandemia por SARS-CoV-2, que no ha tenido un impacto global significativo en los resultados. Las características del procedimiento y los resultados muestran una clara tendencia a la estabilización en la última década (AU)

Introduction and objectives This report updates the annual data of the Spanish heart transplant registry with the procedures performed in 2021. Methods We describe the clinical profile, therapeutic characteristics and outcomes in terms of survival of the procedures performed in 2021. Their temporal trends are updated for the 2012 to 2020 period. Results In 2021, 302 heart transplants were performed (8.6% increase versus 2020). The tendency in 2021 confirmed that of prior years, with fewer urgent transplants and a preference for the use of ventricular assist devices. The remaining characteristics and survival showed a clear trend toward stability in the last decade. Compared with 2019, the SARS-CoV-2 pandemic (2020 and 2021) did not affect short- or long-term survival. Conclusions In 2021, transplant activity returned to prepandemic levels. The SARS-CoV-2 pandemic did not significantly affect transplant outcomes. The main transplant features and outcomes have clearly stabilized in the last decade (AU)

Neurohormonal activation induces intracellular iron deficiency and mitochondrial dysfunction in cardiac cells.

BACKGROUND: Iron deficiency (ID) is common in patients with heart failure (HF) and is associated with poor outcomes, yet its role in the pathophysiology of HF is not well-defined. We sought to determine the consequences of HF neurohormonal activation in iron homeostasis and mitochondrial function in cardiac cells. METHODS: HF was induced in C57BL/6 mice by using isoproterenol osmotic pumps and embryonic rat heart-derived H9c2 cells were subsequently challenged with Angiotensin II and/or Norepinephrine. The expression of several genes and proteins related to intracellular iron metabolism were assessed by Real time-PCR and immunoblotting, respectively. The intracellular iron levels were also determined. Mitochondrial function was analyzed by studying the mitochondrial membrane potential, the accumulation of radical oxygen species (ROS) and the adenosine triphosphate (ATP) production. RESULTS: Hearts from isoproterenol-stimulated mice showed a decreased in both mRNA and protein levels of iron regulatory proteins, transferrin receptor 1, ferroportin 1 and hepcidin compared to control mice. Furthermore, mitoferrin 2 and mitochondrial ferritin were also downregulated in the hearts from HF mice. Similar data regarding these key iron regulatory molecules were found in the H9c2 cells challenged with neurohormonal stimuli. Accordingly, a depletion of intracellular iron levels was found in the stimulated cells compared to non-stimulated cells, as well as in the hearts from the isoproterenol-induced HF mice. Finally, neurohormonal activation impaired mitochondrial function as indicated by the accumulation of ROS, the impaired mitochondrial membrane potential and the decrease in the ATP levels in the cardiac cells. CONCLUSIONS: HF characteristic neurohormonal activation induced changes in the regulation of key molecules involved in iron homeostasis, reduced intracellular iron levels and impaired mitochondrial function. The current results suggest that iron could be involved in the pathophysiology of HF.

Rifabutin for treating tuberculosis in solid organ transplant recipients: A retrospective observational study and literature review.

BACKGROUND: The treatment of tuberculosis (TB) in solid organ transplant (SOT) recipients is challenging owing to interactions between rifampin and immunosuppressive drugs. Rifabutin, a rifamycin with excellent activity against Mycobacterium tuberculosis and that induces cytochrome p450 less, may facilitate treatment. We report our experience with rifabutin for treating TB in SOT recipients and review the available literature. METHODS: A retrospective observational study of all SOT recipients with TB between January 2000 and December 2019. The clinical characteristics and outcomes of patients treated with and without rifabutin-containing regimens were compared and a literature review was conducted. RESULTS: We included 31 SOT recipients with TB, among whom 22 (71%) were men and the median age was 62 years (interquartile range 50-20). There were no significant differences between patients treated with rifabutin (n = 12), rifampin (n = 14), and non-rifamycins (n = 5) in clinical cure rates (83.3%, 64.3%, and 100%, respectively; P = .21), side effects (25%, 37.5%, and 20%, respectively; P = .74), or mortality (16.7%, 35.7%, and 0%, respectively; P = .21). Only one patient, treated with rifampin, suffered graft rejection. The literature review identified 59 SOT recipients with TB treated with rifabutin-containing regimens from 8 publications. Overall, the clinical cure, graft rejection, and mortality rates were 93.2%, 5.1%, and 6.8%, respectively. CONCLUSIONS: Rifabutin-containing regimens offer a reliable alternative to rifampin when treating TB in SOT recipients.

Dogs as a source of Salmonella spp. in apparently healthy dogs in the Valencia Region. Could it be related with intestinal lactic acid bacteria?

BACKGROUND: Although salmonellosis is considered one of the most important food-borne zoonotic diseases in Europe, close contact between dogs and their owners can also be a potential source of Salmonella spp. for humans. This study assessed the prevalence and antimicrobial resistance of Salmonella spp. in apparently healthy dogs in the Valencian Region, eastern Spain. Moreover, a macroscopic comparison of lactic acid bacteria in both Salmonella-positive and Salmonella-negative dogs was carried out. RESULTS: Of a total of 325 dogs sampled, 6 (1.85%) were positive for Salmonella spp. with 3 different serotypes, Havana (3), Mikawasima (2) and monophasic Typhimurium (1). All isolates were susceptible to all antimicrobials tested except monophasic S. Typhimurium, which was resistant to ampicillin. Finally, macroscopic results revealed that lactic acid bacteria had higher heterogeneity in the Salmonella-negative dogs than in the Salmonella-positive dogs. Although the results in our study showed a low prevalence of Salmonella spp., raw food has been suggested as a risk factor for bacteria in dog faeces. CONCLUSIONS: Public awareness campaigns on good hygiene practices, especially after handling canine faeces or raw food, are necessary. Furthermore, to reduce the potential transmission of bacteria, dogs should be fed food that has been properly cooked, as raw or undercooked food can be a source of zoonotic pathogens. Moreover, further studies must be performed to determine the relationship between lactic acid bacteria and Salmonella spp. in dog faeces.

Measurement of the interaction between mucin and oenological tannins by Surface Plasmon Resonance (SPR); relationship with astringency.

The interaction between stomach porcine mucin and 3 oenological tannins (extract of ellagitannins from oak, extract of gallotannins from gall nuts and extract of proanthocyanidins from grape seeds) was measured by Surface Plasmon Resonance (SPR). These tannins were analysed and their astringency was determined using the Astringency Index method and by tasting. The interaction constants were determined using a Biacore SPR device (1:1 Langmuir binding model). The results indicate that the ellagitannins are more astringent than gallotannins and those, in turn, are more astringent than seed proanthocyanidins if the richness of the commercial extracts is considered. The astringency index of these tannins had high correlation and regression coefficients with their kinetic and thermodynamic dissociation constants. This data support a hypothesis that astringency depends not only on the thermodynamic tendency to form the complex between tannins and salivary proteins but also probably on the time required to dissociate the complex.

Effect of kaolin silver complex on the control of populations of Brettanomyces and acetic acid bacteria in wine.

In this work, the effects of kaolin silver complex (KAgC) have been evaluated to replace the use of SO2 for the control of spoilage microorganisms in the winemaking process. The results showed that KAgC at a dose of 1 g/L provided effective control against the development of B. bruxellensis and acetic acid bacteria. In wines artificially contaminated with an initial population of B. bruxellensis at 104 CFU/mL, a concentration proven to produce off flavors in wine, only residual populations of the contaminating yeast remained after 24 days of contact with the additive. Populations of acetic bacteria inoculated into wine at concentrations of 102 and 104 CFU/mL were reduced to negligible levels after 72 h of treatment with KAgC. The antimicrobial effect of KAgC against B. bruxellensis and acetic bacteria was also demonstrated in a wine naturally contaminated by these microorganisms, decreasing their population in a similar way to a chitosan treatment. Related to this effect, wines with KAgC showed lower concentrations of acetic acid and 4-ethyl phenol than wines without KAgC. The silver concentration from KAgC that remained in the finished wines was below the legal limits. These results demonstrated the effectiveness of KAgC to reduce spoilage microorganisms in winemaking.

Recycling of residual IGCC slags and their benefits as degreasers in ceramics.

This work studies the evolution of IGCC slag grains within a ceramic matrix fired at different temperatures to investigate the effect of using IGCC slag as a degreaser. Pressed ceramic specimens from two clay mixtures are used in this study. The M1 mixture is composed of standard clays, whereas the M2 mixture is composed of the same clay mixture as M1 mixture but contains 15% by weight IGCC slag. The amount of IGCC slag added coincides with the amount of slag typically used as a degreaser in the ceramic industry. Specimens are fired at 950 °C, 1000 °C, 1050 °C, 1100 °C and 1150 °C. The mineralogical composition and the IGCC slag grain shape within the ceramic matrix are determined by X-ray diffraction, polarized light microscopy and scanning electron microscopy. The results reveal that the surface of the slag grains is welded to the ceramic matrix while the quartz grains are separated, which causes increased water absorption and reduces the mechanical strength. IGCC slag, however, reduces water absorption. This behaviour is due to the softening temperature of the slag. This property is quite important from an industrial viewpoint because IGCC slag can serve as an alternative to traditional degreasing agents in the ceramic building industry. Additionally, using IGCC slag allows for the transformation of waste into a secondary raw material, thereby avoiding disposal at landfills; moreover, these industrial wastes are made inert and improve the properties of ceramics.

Biogenic amine production by Oenococcus oeni isolates from malolactic fermentation of Tempranillo wine.

In this article, we examine the production of biogenic amines, histamine, putrescine, tyramine, and cadaverine by 90 strains of Oenococcus oeni isolated from different cellars of Castilla-La Mancha (Spain) during wine malolactic fermentation. Amino biogenic capacity of strains was qualitatively analyzed on agar. After that, production of amines on a synthetic medium and on wine, and presence in strains of histidine, ornithine, and tyrosine decarboxylase genes were determined. Only two strains were able to produce histamine or putrescine, both on synthetic medium and wine. The presence of the corresponding genes in these strains was also confirmed. These results suggest that O. oeni does not significantly contribute to the overall biogenic amine content of wines. The main contribution of this work is the isolation of a putrescine-producing O. oeni strain that harbors the ornithine gene, since this gene appears to be rarely present in the genome of O. oeni.

Carcinoma suprarrenal virilizante prepuberal / Prepuberal virilizing adrenocortical carcinoma

El carcinoma suprarrenal es una entidad poco frecuente y excepcional como productor de síndrome adrenogenital prepuberal. Sus criterios de malignidad, al igual que la eficacia de tratamiento adyuvante, son tema de discusión, lo que unido a su pronóstico sombrío mueve a la publicación de casos aislados de distintos grupos quirúrgicos en un intento de conocer esta patología. Presentamos un caso de carcinoma suprarrenal virilizante en paciente prepuberal tratado mediante suprarrenalectomía; la paciente se encuentra asintomática tras 5 años de la intervención (AU)

Colectomía subtotal por estreñimiento crónico idiopático / Subtotal colectomy to treat chronic idiopathic constipation

El estreñimiento crónico idiopático rara vez necesita tratamiento quirúrgico, pero puede estar indicado ante el grado avanzado del cuadro, la mala calidad de vida o la existencia de complicaciones. Están indicadas diversas técnicas, según el segmento de colon y/o recto afectado y las alteraciones funcionales responsables del estreñimiento. Presentamos el caso de una mujer adulta que precisó de una colectomía subtotal con anastomosis cecorrectal ante la existencia de un gran megacolon, la realización de deposiciones cada 20-25 días y la existencia de dolores abdominales secundarios a crisis de volvulaciones transitorias (AU)

[Tuberculosis in health personnel: importance of surveillance and control programs]. / Tuberculosis en trabajadores de la salud: importancia de los programas de vigilancia y control.

OBJECTIVE: To describe tuberculosis surveillance results among healthcare workers of a tertiary care center. MATERIAL AND METHODS: All medical records of workers from 1992-1998 were reviewed. Demographics, labor, medical history, previous testing, PPD, booster shots and follow-up were analyzed. Statistical analysis was performed with odds ratios, p-values, and 95% confidence intervals. Subgroup analysis were done with chi 2. Kaplan-Meier estimates were used to analyze times to conversion. RESULTS: Surveillance was done in 1617 workers (68% female and 32% male). Mean age was 26.9 +/- 7.6 (15-68) years. Job positions were 30.5% nurses, 14.6% residents and 14.1% interns. Place of origin was Mexico City in 65.8%. BCG vaccination was present in 71.6% and 15.1% had previous PPD. Admission PPD was positive in 39.6%, negative in 48.3% and 12.1% were lost to follow-up. On negatives, 483 booster shots were applied, and 49 additional positives were found. Follow-up was done in 231 workers, of which 100 (43.3%) converted. The mean time for conversion was 22.8 +/- 12.4 months. The conversion rate at twelve months was 20%. Fifty workers received/accepted isoniazid prophylaxis. CONCLUSIONS: A high percentage of workers were PPD-positive; booster shots allowed the detection of an additional 10%. A high conversion rate underscores the need to organize tuberculosis control programs in Mexico.

[Treatment with omeprazole, clarithromycin and amoxicillin over 6 days in patients with Helicobacter pylori-infected duodenal ulcer]. / Tratamiento con omeprazol, claritromicina y amoxicilina durante 6 días en pacientes con úlcera duodenal infectados por Helicobacter pylori.

OBJECTIVE: To investigate the eradication rate of Helicobacter pylori with omeprazole, amoxicillin and clarithromycin during 6 days in patients with duodenal ulcer. To compare the reliability of the analysis of the eradication with urea-13C breath test performed one month and 3 months after therapy. To evaluate the one-year reinfection rate. PATIENTS AND METHODS: Prospective study including 99 patients with duodenal ulcer (65 with acute disease and 34 in maintenance treatment) infected by Helicobacter pylori (urease rapid test and urea-13C breath test positive). Patients were treated with omeprazole 20 mg, clarithromycin 500 mg and amoxicillin 1 g, b.i.d., during 6 days. The infection status was investigated 1 and 3 months after treatment by urea-13C breath test. The one-year reinfection rate was investigated using the same test. RESULTS: Per protocol eradication rates were 76% (95%-CI: 66-84) one month and 73% (95%-CI: 63-81) 3 months after treatment. In the intention to treat analysis, eradication rates were 74% (95%-CI: 64-82) and 70% (95%-CI: 60-79), respectively. Side effects were mild and uncommon. The rate of false negative urea-13C breath test results one month after therapy with respect to 3 months was 4.2% (95%-CI: 0.8-11.7). One-year reinfection rate determined in 56 patient was absent. CONCLUSIONS: The eradication of Helicobacter pylori with triple therapy for 6 days in patients with duodenal ulcer is not satisfactory. To investigate Helicobacter pylori infection with urea-13C breath test one month after treatment overestimates the results of the eradication. One-year reinfection rate is clinically irrelevant.

[Intraperitoneal hemorrhage after labor as manifestation of renal angiomyolipoma]. / Hemorragia intraperitoneal tras parto como manifestación de un angiomiolipoma renal.

We report a case of renal angiomyolipoma in a patient who, following normal delivery, presented with abdominal pain and acute abdomen with severe hemodynamic compromise that led to hypovolemic shock. Following diagnosis by emergency exploratory laparotomy, a left nephrectomy was performed. We underscore the difficulty involved in the diagnosis of acute abdomen from hemoperitoneum resulting from a ruptured angiomyolipoma, and highlight the rarity of this condition. Our patient was submitted to radical surgery because of vessel (hilum) invasion. The tumor was benign and no complications were observed. Patient work up eight years postoperatively revealed no local or systemic evidence of disease.