Endocarditis Infecciosa Mural Apical del Ventrículo Izquierdo: Presentación de caso clínico y revisión bibliográfica / Infectious Apical Mural Endocarditis of the Left Ventricle: Clinical case presentation and bibliographic review

RESUMEN La endocarditis mural es una forma infrecuente de infección intracardiaca que afecta al endocardio no valvular que pue- de presentarse con complicaciones similares a la endocarditis infecciosa valvular. Se recomienda la ecocardiografía para confirmar el diagnóstico cuando exista un alto índice de sospecha. Con respecto al tratamiento, existe evidencia limitada acerca de las estrategias terapéuticas en la endocarditis mural, sin embargo en la mayoría de casos reportados se recomienda iniciar antibioticoterapia dirigida asociado a una intervención quirúrgica precoz. A continuación, se presenta un caso clínico de un paciente masculino de 74 años con fenómenos embólicos sistémicos, en quien se documenta por ecocardiograma transesofágico una endocarditis mural en ápex del ventrículo izquierdo asociado a una bacteriemia por Staphylococcus aureus. Este caso pone de manifiesto la importancia de una valoración ecocardiográfica detallada de las válvulas y cámaras cardíacas ante la sospecha de una endocarditis infecciosa.

ABSTRACT Mural endocarditis is an uncommon form of intracardiac infection affecting the non valvular endocardium that can present with complications similar to valvular infective endocarditis. Echocardiography is recommended to confirm the diagnosis when there is a high index of suspicion. Regarding treatment, there is limited evidence about therapeutic strategies in mural endocarditis, however in most reported cases it is recommended to initiate targeted antibiotic therapy associated with early surgical intervention. The following is a clinical case of a 74-year-old male patient with systemic embolic phenomena, in whom a transesophageal echocardiogram documented mural endocarditis in the apex of the left ventricle associated with Staphylococcus aureus bacteremia. This case highlights the importance of a detailed echocardiographic assessment of the cardiac valves and chambers when infective endocarditis is suspected.

Synthesis of Novel Heterocyclic Ferrocenyl Chalcones and Their Biological Evaluation.

Breast cancer is currently the most commonly diagnosed cancer, with 287,850 new cases estimated for 2022 as reported by the American Cancer Society. Therefore, finding an effective treatment for this disease is imperative. Chalcones are α,ß-unsaturated systems found in nature. These compounds have shown a wide array of biological activities, making them popular synthetic targets. Chalcones consist of two aromatic substituents connected by an enone bridge; this arrangement allows for a large number of derivatives. Given the biological relevance of these compounds, novel ferrocene-heterocycle-containing chalcones were synthesized and characterized based on a hybrid drug design approach. These heterocycles included thiophene, pyrimidine, thiazolyl, and indole groups. Fourteen novel heterocyclic ferrocenyl chalcones were synthesized and characterized. Herein, we also report their cytotoxicity against triple-negative breast cancer cell lines MDA-MB-231 and 4T1 and the noncancer lung cell line MRC-5. System 3 ferrocenyl chalcones displayed superior anticancer properties compared to their system 1 analogues. System 3 chalcones bearing five-membered heterocyclic substituents (thiophene, pyrazole, pyrrole, and pyrimidine) were the most active toward the MDA-MB-231 cancer cell line with IC50 values from 6.59 to 12.51 µM. Cytotoxicity of the evaluated compounds in the 4T1 cell line exhibited IC50 values from 13.23 to 213.7 µM. System 3 pyrazole chalcone had consistent toxicity toward both cell lines (IC50 ∼ 13 µM) as well as promising selectivity relative to the noncancer MRC-5 control. Antioxidant activity was also evaluated, where, contrary to anticancer capabilities, system 1 ferrocenyl chalcones were superior to their system 3 analogues. Antioxidant activity comparable to that of ascorbic acid was observed for thiophene-bearing ferrocenyl chalcone with EC50 = 31 µM.

Exploring Titanium(IV) Complexes as Potential Antimicrobial Compounds.

Due to the rapid mutation of pathogenic microorganisms, drug-resistant superbugs have evolved. Antimicrobial-resistant germs may share their resistance genes with other germs, making them untreatable. The search for more combative antibiotic compounds has led researchers to explore metal-based strategies centered on perturbing the bioavailability of essential metals in microbes and examining the therapeutic potential of metal complexes. Given the limited knowledge on the application of titanium(IV), in this work, eight Ti(IV) complexes and some of their corresponding ligands were screened by the Community for Open Antimicrobial Drug Discovery for antimicrobial activity. The compounds were selected for evaluation because of their low cytotoxic/antiproliferative behavior against a human non-cancer cell line. At pH 7.4, these compounds vary in terms of their solution stability and ligand exchange lability; therefore, an assessment of their solution behavior provides some insight regarding the importance of the identity of the metal compound to the antimicrobial therapeutic potential. Only one compound, Ti(deferasirox)2, exhibited promising inhibitory activity against the Gram-positive bacteria methicillin-resistant Staphylococcus aureus and minimal toxicity against human cells. The ability of this compound to undergo transmetalation with labile Fe(III) sources and, as a consequence, inhibit Fe bioavailability and ribonucleotide reductase is evaluated as a possible mechanism for its antibiotic effect.

Efecto del Programa de Rehabilitación Cardiaca del Hospital San Vicente Paúl sobre parámetros bioquímicos, antropométricos y funcionales en pacientes con cardiopatía isquémica del 1º de enero del 2014 al 31 de diciembre del 2015 / Effect of the Cardiac Rehabilitation Program of the Hospital San Vicente Paúl on biochemical, anthropometric and functional parameters in patients with ischemic heart disease from January 1, 2014 to December 31, 2015

Resumen Introducción y objetivos: Los programas de rehabilitación cardiaca (RHC) son considerados como los más eficaces entre las intervenciones de prevención secundaria. El cual su función es mejorar la sobrevida como así también, la calidad de vida de estos enfermos. El objetivo fundamental de este trabajo es analizar el impacto de un Programa de Rehabilitación Cardiaca en pacientes portadores de cardiopatía isquémica con respecto a parámetros bioquímicos, antropométricos y funcionales. Pacientes y métodos: Fue un estudio observacional retrospectivo, unicéntrico, con seguimiento de 3 años. Se incluyo un total de 228 pacientes. Con criterios de inclusión: >18 años, con EAC y al menos una comorbilidad de riesgo cardiovascular que completaran el PRC. Se excluyó enfermedad valvular sin cardiopatía isquémica preexistente, infarto agudo al miocardio reciente, ángor inestable, obstrucción del tracto de salida del ventrículo izquierdo, y los que no cumplieron el PRC. Resultados: De los 228 pacientes que se incluyeron el PRC del HSVP el 70,7% eran hombres y el 29,3% eran mujeres con diagnóstico de cardiopatía isquémica. El promedio de edad era de 60.2 +- 11.4 años en total entre hombres y mujeres. El peso de los pacientes masculinos previo al ingreso del PRC fue de 77,7 kg +-13,2 kg, y las mujeres 69,7 kg +- 13,1 kg. Al final del fue de 75,5 kg +-13,1 kg y el de las mujeres era de 68,3 +- 13,1 kg. En la caminata de 6 minutos el promedio de mujeres al inicio fue de 390,0 mts y el de los hombres de 386,6, y la segunda vez posterior a la rehabilitación en hombres fue de 595,8 +- 107,2 y el de las mujeres fue de 549+-102,4. Los niveles de PCR de los hombres al inicio del programa fue de 1,2 +-2,4 mg/dL y el de las mujeres fue de 1,5 +- 1,9 mg/dL al finalizar los hombres tuvieron un promedio de 1,8+-3,0 Conclusiones: Los PRC dependen de la participación de profesionales de la salud que trabajen en equipo para alcanzar resultados finales, los cuales están basados no solo en el ejercicio sino también en el cambio de estilo de vida del paciente, por lo tanto, necesita de servicios asociados como fisioterapia, nutrición, psicología.

Abstract Effect of the Cardiac Rehabilitation Program of the Hospital San Vicente Paúl on biochemical, anthropometric and functional parameters in patients with ischemic heart disease from January 1, 2014 to December 31, 2015 Introduction and objectives: Cardiac Rehabilitation Programs, are considered the most effective programs among secondary prevention interventions. The function is to improve survival as well as the quality of life of these patients. The main objective of this work is to analyze the impact of Cardiac Rehabilitation Program in patients with ischemic heart disease with the respect biochemical, anthropometric and functional parameters. Patients and method: A observational, retrospective single-center, study with a 3-year-follow up. A total of 228 patients were included, witch 70.7% were men with an average of 60.2+-11.4 years. The inclusion criteria were: > 18 years with CAD and at least one cardiovascular risk comorbidity and completed the Cardiac Rehabilitation Program. Valvular disease without pre-existing ischemic heart disease, recent acute myocardial infarction, unstable angina, left ventricular outflow tract obstruction, and those who did not went to the Program. Results: The 228 patients who were included in the HSVP CRP, 70.7% were men and 29.3% were women with a diagnosis of ischemic heart disease. The average age was 60.2 + - 11.4 years in total between men and women. The weight of male patients prior to admission to the CRP was 77.7 kg + -13.2 kg, and women 69.7 kg + -13.1 kg. At the end of the program, the weight of the men was 75.5 kg + -13.1 kg and that of the women was 68.3 + - 13.1 kg. The total waist circumference at the start of the program was 100.1 ± 11.4 cm. In women the average was 98.4 + - 12.7cm, that of men was 101.1 + - 10.8 cm. At the end of the program, the total average of men and women was 96.7 + - 11.0, the average of women at the end of the program was 96.2 + - 12.6 cm and of men was 96. 9 + - 10. In the 6-minute walk, the average of women at the beginning was 390.0 meters and that of men was 386.6, and the second time after rehabilitation in men was 595.8 + - 107.2 and the of women it was 549 + -102.4. In men, the previous total cholesterol was 154.8 + -39.7 mg / dL and that of women was 162.0 + -40.2 mg / dL and at the end of the program the value of men was 161 .6 + -46.0 mg / dL and 170.8 + -41.8 mg / dL for women. The CRP levels of the men at the beginning of the program was 1.2 + -2.4 mg / dL and that of the women was 1.5 + - 1.9 mg / dL at the end of the program, the men had an average of 1.8 + -3.0. Conclusion: The Cardiac Rehabilitation Program depends on the partipation of health professionals care who work as a team to achieve final results, witch are based not only on exercise but also on the change in the patient's lifestyle, therefore, they need associated services such as physiotherapy, nutrition, psychology.

Arsenic and fluoride removal from groundwater by electrocoagulation using a continuous filter-press reactor.

We investigated simultaneous arsenic and fluoride removal from ground water by electrocoagulation (EC) using aluminum as the sacrificial anode in a continuous filter-press reactor. The groundwater was collected at a depth of 320 m in the Bajío region in Guanajuato Mexico (arsenic 43 µg L(-1), fluoride 2.5 mg L(-1), sulfate 89.6 mg L(-1), phosphate 1.8 mg L(-1), hydrated silica 112.4 mg L(-1), hardness 9.8 mg L(-1), alkalinity 31.3 mg L(-1), pH 7.6 and conductivity 993 µS cm(-1)). EC was performed after arsenite was oxidized to arsenate by addition of 1 mg L(-1) hypochlorite. The EC tests revealed that at current densities of 4, 5 and 6 mA cm(-2) and flow velocities of 0.91 and 1.82 cm s(-1), arsenate was abated and residual fluoride concentration satisfies the WHO standard (CF < 1.5 mg L(-1)). Spectrometric analyses performed on aluminum flocs indicated that these are mainly composed of aluminum-silicates of calcium and magnesium. Arsenate removal by EC involves adsorption on aluminum flocs, while fluoride replaces a hydroxyl group from aluminum aggregates. The best EC was obtained at 4 mA cm(-2) and 1.82 cm s(-1) with electrolytic energy consumption of 0.34 KWh m(-3).