Surface-enhanced Raman sensor with molecularly imprinted nanoparticles as highly sensitive recognition material for cancer marker amino acids.

Surface-enhanced Raman scattering (SERS) is a powerful technique primarily due to its high sensitivity and signal-enhancing properties, which enable the identification of unique vibrational fingerprints. These fingerprints can be used for the diagnosis and monitoring of diseases such as cancer. It is crucial to selectively identify cancer biomarkers for early diagnosis. A correlation has been established between the reduction in the concentration of specific amino acids and the stage of the disease, particularly tryptophan (TPP) and tyrosine (TRS) in individuals diagnosed with prostate cancer. In this work, we present a strategy to analyze TPP and TRS amino acids using molecularly imprinted polymer nanoparticles (nanoMIPs), which selectively detect target molecules in a SERS sensor. NanoMIPs are synthesized using the solid-phase molecular imprinting method with TPP and TRS as templates. These are then immobilized on a SERS substrate with gold nanoparticles to measure samples prepared from tryptophan and tyrosine in phosphate-buffered saline. The detection and quantification limits of the designed sensor are 7.13 µM and 23.75 µM for TPP, and 22.11 µM and 73.72 µM for TRS, respectively. Our study lays the groundwork for future investigations utilizing nanoMIPs in SERS assessments of TPP and TRS as potential biomarkers for prostate cancer detection.

Assessing Feed-Forward Backpropagation Artificial Neural Networks for Strain-Rate-Sensitive Mechanical Modeling.

The manufacturing processes and design of metal and alloy products can be performed over a wide range of strain rates and temperatures. To design and optimize these processes using computational mechanics tools, the selection and calibration of the constitutive models is critical. In the case of hazardous and explosive impact loads, it is not always possible to test material properties. For this purpose, this paper assesses the efficiency and the accuracy of different architectures of ANNs for the identification of the Johnson-Cook material model parameters. The implemented computational tool of an ANN-based parameter identification strategy provides adequate results in a range of strain rates required for general manufacturing and product design applications. Four ANN architectures are studied to find the most suitable configuration for a reduced amount of experimental data, particularly for cases where high-impact testing is constrained. The different ANN structures are evaluated based on the model's predictive capability, revealing that the perceptron-based network of 66 inputs and one hidden layer of 30 neurons provides the highest prediction accuracy of the effective flow stress-strain behavior of Ti64 alloy and three virtual materials.

Targeted Mass Spectrometry-Based Proteomics Method to Quantify Placental Extracellular Vesicles.

Extracellular vesicles (EVs) carry a wide range of molecules, such as proteins, RNAs, and DNA. EVs are secreted from a wide range of cells, including placental cells. Interestingly, EVs secreted from placental cells have been identified in maternal circulation as early as 6 weeks of gestation, and their concentration increases with the gestational age. While there is growing interest in elucidating the role of exosomes during normal and complicated pregnancies, progress in the field has been delayed because of the inability to quantify placental EVs from the maternal circulation. Recent reports have demonstrated the presence of placental-type alkaline phosphatase (PLAP) EVs only in the blood of pregnant women, indicating that PLAP is a marker to identify EVs secreted from the placenta. Therefore, here we describe a workflow to quantify placental EVs from maternal circulation using a targeted proteomics approach based on selecting specific peptides identified in the PLAP protein.

Hybrid Materials Based on Nanoparticles Functionalized with Alkylsilanes Covalently Anchored to Epoxy Matrices.

In this work, the surface modification of zinc oxide nanoparticles (ZnO-NPs) with 3-glycidyloxy-propyl-trimethoxysilane (GPTMS) was investigated. The ZnO-NPs were synthesized using the physical method of continuous arc discharge in controlled atmosphere (DARC-AC). The surface modification was carried out using a chemical method with constant agitation for 24 h at room temperature. This surface functionalization of zinc oxide nanoparticles (ZnO-NPs-GPTMS) was experimentally confirmed by infrared spectroscopy (FT-IR), TGA, and XRD, and its morphological characterization was performed with SEM. The increase in mechanical bending properties in the two final hybrid materials compared to the base polymers was verified. An average increase of 67% was achieved with a moderate decrease in ductility. In the case of compressive strength, they showed mixed results, maintaining the properties. With respect to thermal properties, it was observed that inorganic reinforcement conferred resistance to degradation on the base material, giving a greater resistance to high temperatures.

Extracellular Vesicles and Preeclampsia: Current Knowledge and Future Research Directions.

Preeclampsia (PE) is associated with long-term morbidity in mothers and lifelong morbidities for their children, ranging from cerebral palsy and cognitive delay in preterm infants, to hypertension, diabetes and obesity in adolescents and young adults. There are several processes that are critical for development of materno-fetal exchange, including establishing adequate perfusion of the placenta by maternal blood, and the formation of the placental villous vascular tree. Recent studies provide persuasive evidence that placenta-derived extracellular vesicles (EVs) represent a significant intercellular communication pathway, and that they may play an important role in placental and endothelial cell (both fetal and maternal) function. These functions are known to be altered in PE. EVs can carry and transport a wide range of bioactive molescules that have potential to be used as biomarkers and therapeutic delivery tools for PE. EV content is often parent cell specific, thus providing an insight or "thumbprint" of the intracellular environment of the originating cell (e.g., human placenta). EV have been identified in plasma under both normal and pathological conditions, including PE. The concentration of EVs and their content in plasma has been reported to increase in association with disease severity and/or progression. Placenta-derived EVs have been identified in maternal plasma during normal pregnancy and PE pregnancies. They contain placenta-specific proteins and miRNAs and, as such, may be differentiated from maternally-derived EVs. The aim of this review, thus, is to describe the potential roles of EVs in preecmpatic pregnancies, focussing on EVs secreted from placental cells. The biogenesis, specificity of placental EVs, and methods used to characterise EVs in the context of PE pregnancies will be also discussed.

Two recombinant human monoclonal antibodies that protect against lethal Andes hantavirus infection in vivo.

Andes hantavirus (ANDV) is an etiologic agent of hantavirus cardiopulmonary syndrome (HCPS), a severe disease characterized by fever, headache, and gastrointestinal symptoms that may progress to hypotension, pulmonary failure, and cardiac shock that results in a 25 to 40% case-fatality rate. Currently, there is no specific treatment or vaccine; however, several studies have shown that the generation of neutralizing antibody (Ab) responses strongly correlates with survival from HCPS in humans. In this study, we screened 27 ANDV convalescent HCPS patient sera for their capacity to bind and neutralize ANDV in vitro. One patient who showed high neutralizing titer was selected to isolate ANDV-glycoprotein (GP) Abs. ANDV-GP-specific memory B cells were single cell sorted, and recombinant immunoglobulin G antibodies were cloned and produced. Two monoclonal Abs (mAbs), JL16 and MIB22, potently recognized ANDV-GPs and neutralized ANDV. We examined the post-exposure efficacy of these two mAbs as a monotherapy or in combination therapy in a Syrian hamster model of ANDV-induced HCPS, and both mAbs protected 100% of animals from a lethal challenge dose. These data suggest that monotherapy with mAb JL16 or MIB22, or a cocktail of both, could be an effective post-exposure treatment for patients infected with ANDV-induced HCPS.

Distribución espacial de las especies de mangle y su asociación con los tipos de sedimentos del sustrato, en el sector estuarino del Humedal Nacional Térraba-Sierpe, Costa Rica / Spatial distribution of mangrove species and their association with the substrate sediment types, estuarine sector Térraba-Sierpe National Wetlands, Costa Rica

Resumen Se describe la composición florística del manglar y la distribución espacial de las principales especies de mangle y otras especies vegetales asociadas, presentes en el sector estuarino del Humedal Nacional Térraba-Sierpe, mediante el levantamiento de campo de 1 127 puntos y 77 parcelas de muestreo de 60x10m. Por otra parte, se explora la relación entre el tipo de sedimento subyacente y las especies de mangle establecidas sobre éste. Los resultados de composición, estructura y distribución de la vegetación del HNTS, muestran que el manglar exhibe un modelo o zonación, consistente en la variación desde la costa al continente y de las márgenes de los canales o esteros al interior de las llanuras de marea, de las distintas especies. Rhizophora racemosa y Pelliciera rhizophorae son las especies que muestran una mayor distribución espacial o distribución continua, con los mayores valores de abundancia (45.44% y el 39.92%, respectivamente), frecuencia (88.31% y 74.03%) y área de manglar (7 670.73ha y 5 824.94ha). Se confirmó la dependencia entre la presencia de especies de mangle y el tipo de sedimento del sustrato, de modo que las especies Avicennia spp. y L. racemosa tienden a distribuirse en los sustratos arenosos con mayor facilidad que las otras especies cuya distribución es más homogénea sobre los sustratos lodosos.

Abstract This research describes the floristic composition and spatial distribution of the main mangroves species and other associated flora present in the estuarine sector of Térraba-Sierpe National Wetland, Costa Rican Pacific. Field survey consists of 1 127 points and 77 sampling points of 60x10m. Results of composition, structure and distribution of mangrove in HNTS exhibits a pattern or species zonation. We found variation from the coast to mainland and from the fringe or estuaries to the interior tidal flats. The species Rhizophora racemosa and Pelliciera rhizophorae showed greater spatial and continuous distribution, with the highest values of abundance (45.44% and 39.92% respectively), frequency (88.31% and 74.03%) and mangrove area (7 670.73ha and 5 824.94ha). The mangrove fern, Acrostichum aureum, was the third most important species, meanwhile, Avicennia spp., Rhizophora mangle y Laguncularia racemosa showed a segregated distribution or a tendency to local conglomeration, Talipariti tiliaceum var. pernambucense, Mora oleifera y Conocarpus erectus were found in very localized areas and other species were considered companions with low contribution to the total coverage. The dependence was confirmed between the presence of mangrove species and sediment type substrate. The species Avicennia spp. and L. racemosa tend to be distributed in sandy substrates more easily than the other species whose distribution is more homogeneous on muddy substrates. Rev. Biol. Trop. 63 (Suppl. 1): 47-60. Epub 2015 April 01.

The juvenile alopecia mutation (jal) maps to mouse Chromosome 2, and is an allele of GATA binding protein 3 (Gata3).

BACKGROUND: Mice homozygous for the juvenile alopecia mutation (jal) display patches of hair loss that appear as soon as hair develops in the neonatal period and persist throughout life. Although a report initially describing this mouse variant suggested that jal maps to mouse Chromosome 13, our preliminary mapping analysis did not support that claim. RESULTS: To map jal to a particular mouse chromosome, we produced a 103-member intraspecific backcross panel that segregated for jal, and typed it for 93 PCR-scorable, microsatellite markers that are located throughout the mouse genome. Only markers from the centromeric tip of Chromosome 2 failed to segregate independently from jal, suggesting that jal resides in that region. To more precisely define jal's location, we characterized a second, 374-member backcross panel for the inheritance of five microsatellite markers from proximal Chromosome 2. This analysis restricted jal's position between D2Mit359 and D2Mit80, an interval that includes Il2ra (for interleukin 2 receptor, alpha chain), a gene that is known to be associated with alopecia areata in humans. Complementation testing with an engineered null allele of Il2ra, however, showed that jal is a mutation in a distinct gene. To further refine the location of jal, the 374-member panel was typed for a set of four single-nucleotide markers located between D2Mit359 and D2Mit80, identifying a 0.55 Mb interval where jal must lie. This span includes ten genes-only one of which, Gata3 (for GATA binding protein 3)-is known to be expressed in skin. Complementation testing between jal and a Gata3 null allele produced doubly heterozygous, phenotypically mutant offspring. CONCLUSIONS: The results presented indicate that the jal mutation is a mutant allele of the Gata3 gene on mouse Chromosome 2. We therefore recommend that the jal designation be changed to Gata3jal, and suggest that this mouse variant may provide an animal model for at least some forms of focal alopecia that have their primary defect in the hair follicle and lack an inflammatory component.

[Left ventricular function in children after successful repair of aortic coarctation]. / Función ventricular izquierda en niños después de la reparación exitosa de la coartación aórtica.

INTRODUCTION AND OBJECTIVES: Lifetime prognosis following successful repair of aortic coarctation can be affected by a number of late complications. The objective of this study was to assess left ventricular function in these patients and to identify factors that predispose to functional abnormalities. METHODS: The study involved patients who had undergone repair of aortic coarctation and who had a pressure gradient pound 15 mmHg after repair and normal systemic blood pressure. Echocardiographic data collected before repair and the results of the most recent postoperative left ventricular function studies were analyzed. RESULTS: The study involved 40 patients and 31 controls. Their mean age at repair was 6.9 years and the mean follow-up period was 4.25 years. During follow-up, the ejection fraction and the shortening fraction were observed to increase in 82.5% and 67.5% of patients, respectively. The myocardial performance index was abnormal in 47.5% of patients. The highest myocardial performance indices were observed in patients with arterial hypertension at diagnosis, in those who were aged over 4 years when they underwent repair, and in those with the most abnormal left ventricles before repair. CONCLUSIONS: Measurement of the myocardial performance index showed that global left ventricular function was abnormal in 47.5% of patients after successful repair of aortic coarctation despite functional parameters being normal or elevated.

Función ventricular izquierda en niños después de la reparación exitosa de la coartación aórtica / Left ventricular function in children after successful repair of aortic coarctation

Introducción y objetivos. El pronóstico para la vida después de una corrección exitosa de coartación aórtica puede verse afectado por varias complicaciones tardías. Nuestro objetivo fue evaluar la función del ventrículo izquierdo en este grupo de pacientes y tratar de identificar factores que predisponen a anomalías circulatorias. Métodos. Se incluyó a pacientes con reparación de coartación aórtica que tuvieron un gradiente en la zona de reparación £ 15 mmHg y presión arterial normal. Se analizaron sus ecocardiogramas antes de la corrección y se estudió la función ventricular izquierda al postoperatorio actual. Resultados. Se estudió a 40 pacientes y 31 controles. La edad de la reparación fue 6,9 años, con 4,25 años de seguimiento. La fracción de eyección y la fracción de acortamiento se encontraron aumentadas en el 82,5 y el 67,5% de los casos, respectivamente, durante el seguimiento. El índice de rendimiento miocárdico fue anormal en el 47,5% de los pacientes. Los pacientes que tenían hipertensión arterial al momento del diagnóstico, los que se corrigieron después de los 4 años y los que tenían un ventrículo izquierdo más anormal antes de la corrección tuvieron índices de rendimiento miocárdico más elevados. Conclusiones. La función ventricular izquierda general evaluada con el índice de rendimiento miocárdico fue anormal en el 47,5% de los casos después de una corrección de coartación aórtica exitosa, pese a tener índices endocárdicos normales o aumentados (AU)

Introduction and objectives. Lifetime prognosis following successful repair of aortic coarctation can be affected by a number of late complications. The objective of this study was to assess left ventricular function in these patients and to identify factors that predispose to functional abnormalities. Methods. The study involved patients who had undergone repair of aortic coarctation and who had a pressure gradient £15 mm Hg after repair and normal systemic blood pressure. Echocardiographic data collected before repair and the results of the most recent postoperative left ventricular function studies were analyzed. Results. The study involved 40 patients and 31 controls. Their mean age at repair was 6.9 years and the mean follow-up period was 4.25 years. During follow-up, the ejection fraction and the shortening fraction were observed to increase in 82.5% and 67.5% of patients, respectively. The myocardial performance index was abnormal in 47.5% of patients. The highest myocardial performance indices were observed in patients with arterial hypertension at diagnosis, in those who were aged over 4 years when they underwent repair, and in those with the most abnormal left ventricles before repair. Conclusions. Measurement of the myocardial performance index showed that global left ventricular function was abnormal in 47.5% of patients after successful repair of aortic coarctation despite functional parameters being normal or elevated (AU)

Comparación de las medidas obtenidas por resonancia magnética con reconstrucción tridimensional y las obtenidas por angiografía digital para el diagnóstico de coartación de aorta / Comparison between the measurements obtained by magnetic resonance and digital angiography in patients with aortic coarctation

Introducción. La angiografía digital (AD) transcateterismo es el estándar de oro en el diagnóstico de la coartación de aorta (CoAo) aunque la resonancia magnética (RM) ha mostrado utilidad en la evaluación del sistema cardiovascular. La medición de los segmentos del arco aórtico facilita la selección de los candidatos para angioplastia transcateterismo evitando una cirugía torácica. No hay reportes de estudios comparativos de las medidas de los diferentes segmentos aórticos, obtenidas por RM y AD. Material y métodos. Se estudiaron 49 pacientes con RM y AD que ingresaron con CoAo entre enero de 2002 y diciembre de 2003. Se determinó el tipo de CoAo. Se midieron los segmentos aórticos por RM y AD y se compararon por medio de correlación lineal (Pearson). En 43 pacientes se realizó angioplastia con globo. Resultados. La variabilidad en la medición de los diferentes segmentos entre ambos métodos fueron: aorta ascendente 1.99-2.10 mm (desviación estándar (DE) 2.7-2.8), arco aórtico 1.79-2 mm (DE 2.55-2.99), istmo 1.53-1.56 mm (DE 2-2.17), aorta descendente 1.75-1.78 mm (DE 2.54-2.55). Las medidas comparadas por correlación lineal muestran r entre 0.80 y 0.999, excepto en arco aórtico por RM que obtuvo r de 0.57. Conclusión. La evaluación con RM de niños con CoAo puede sustituir a la realizada mediante AD ya que una variación de 1.5 a 2.1 mm en las medidas obtenidas por ambos métodos no interfiere con la decisión terapéutica. Sólo debe realizarse la medición del arco aórtico en 2 proyecciones.

Introduction. Quantitative aortic arch analysis may improve the selection of candidates for angioplasty who are most likely to benefit from the procedure. Digital angiography (DA) has traditionally been the definitive preoperative diagnostic procedure for aortic coarctation (AoCo), but magnetic resonance (MR) imaging affords good spatial resolution and excellent contrast between blood vessels and soft tissues and offers great potential for delineating thoracic cardiovascular structures. Material and methods. Forty nine patients with AoCo were examined with MR and DA between June 2002 and December 2003. The site and type of AoCo were determined and the measurements of aortic arch segments were obtained. We realized balloon angioplasty in 43 patients. Results. We compared the measurements using Pearson's linear correlation. The variability of the measurements was: ascending aorta 1.99-2.1 mm (standard deviation [SD] 2.7-2.8), aortic arch 1.79-2 mm (SD 2.55-2.99), aortic isthmus 1.53-1.56 mm (SD 2-2.17), and descending aorta 1.75-1.78 mm (SD 2.54-2.55). The lineal correlation of Pearson for measurements were; r =0.80-0.999 but the aortic arch was r =0.57 by MR. Conclusion. We conclude that quantitative MR measurements of aorta may be used to diagnose of AoCo and avoid using DA. To obtain precise measurements of aortic arch in patients with AoCo, MR should include 2 projections.

[Echocardiographic diagnosis of anomalous origin of one pulmonary artery from the ascending aorta]. / Diagnóstico ecocardiográfico del origen anómalo de una rama de la arteria pulmonar de la aorta ascendente.

OBJECTIVE: To present our experience in the echocardiographic diagnosis of anomalous origin of one pulmonary artery from the ascending aorta (AOPA). To analyze its clinical presentation, treatment and outcomes with special emphasis in the echocardiographic data. METHOD: We reviewed restrospectively the clinical, hemodynamic data, and surgical findings of patients with an echocardiographic diagnosis of AOPA studied in the Hospital Infantil of Mexico "Federico Gomez" from 1991 to 2002. RESULTS: The study includes 12 children with AOPA; Seven were males. The average age at diagnosis was two months; 4 in neonatal period, 3 under 1 year and 5 older than 1 year. The diagnosis was established prospectively by echocardiography in all patients and it was confirmed by angiography in 8 and at surgery in 9. Ten had anomalous origin of right pulmonary artery. The associated anomalies were patent ductus arteriosus in 6, ventricular septal defect in 2 and aortopulmonary window, atrioventricular discordance, double outlet right ventricle and tetralogy of Fallot in one case each. Nine underwent corrective surgery of all the anomalies. One patient died on the sixth postoperative day; the remaining are in good condition without stenosis at the site of the anastomosis. Surgery was refused in one. One patient was not candidate to surgery due to advanced obstructive pulmonary vascular disease (OPVD) and one case is awaiting surgery. CONCLUSION: The diagnosis of AOPA may be established with precision through echocardiography. Cardiac catheterization is seldom needed to confirm morphology but is mandatory in older children with suspected of OPVD.

Diagnóstico ecocardiográfico del origen anómalo de una rama de la arteria pulmonar de la aorta ascendente / Echocardiographic diagnosis of anomalous origin of one pulmonary artery from the ascending aorta

Objetivo: Presentar nuestra experiencia en el diagnóstico ecocardiográfico del origen anómalo de una rama de la arteria pulmonar naciendo de la aorta ascendente (OAAP) y analizar su presentación clínica, tratamiento y evolución con especial énfasis en los aspectos ecocardiográficos. Método: Revisamos retrospectivamente los expedientes clínicos, estudios de gabinete y hallazgos transoperatorios de los pacientes con diagnóstico ecocardiográfico de OAAP estudiados en el Hospital Infantil de México "Federico Gómez" de 1991 al 2002. Resultados: El estudio incluye 12 niños con OAAP. Siete fueron hombres. La edad media de presentación fue de 2 meses. Cuatro pacientes se diagnosticaron en la etapa neonatal, 3 en el primer año y 5 después del año. El diagnóstico se estableció prospectivamente por ecocardiografía en todos y se confirmó al cateterismo en 8 y a la cirugía en 9. El origen aórtico de la rama derecha se encontró en 10 casos y de la izquierda en 2. Las anomalías asociadas fueron PCA en 6, CIV en 2 y ventana aortopulmonar, discordancia atrioventricular, doble vía de salida ventricular derecha y tetralogía de Fallot en 1 caso respectivamente. Se operaron 9 casos. Un paciente falleció en el 6o día postoperatorio. Los restantes se encuentran en buenas condiciones sin estenosis en el sitio de la anastomosis. La cirugía no fue aceptada en un caso. Un paciente no fue candidato a cirugía por enfermedad vascular pulmonar (EVP) avanzada y otro está en espera de cirugía. Conclusiones: El diagnóstico del OAAP puede establecerse con exactitud mediante ecocardiografía. El cateterismo cardiaco rara vez es necesario para confirmar la morfología, pero es obligado en niños mayores con sospecha de EVP.

Objective: To present our experience in the echocardiographic diagnosis of anomalous origin of one pulmonary artery from the ascending aorta (AOPA). To analyze its clinical presentation, treatment and outcomes with special emphasis in the echocardiographic data. Method: We reviewed restrospectively the clinical, hemodynamic data, and surgical findings of patients with an echocardiographic diagnosis of AOPA studied in the Hospital Infantil of Mexico "Federico Gomez" from 1991 to 2002. Results: The study includes 12 children with AOPA; Seven were males. The average age at diagnosis was two months; 4 in neonatal period, 3 under 1 year and 5 older than 1 year. The diagnosis was established prospectively by echocardiography in all patients and it was confirmed by angiography in 8 and at surgery in 9. Ten had anomalous origin of rigth pulmonary artery. The associated anomalies were patent ductus arteriosus in 6, ventricular septal defect in 2 and aortopulmonary window, atrioventricular discordance, double outlet right ventricle and tetralogy of Fallot in one case each. Nine underwent corrective surgery of all the anomalies. One patient died on the sixth postoperative day; the remaining are in good condition without stenosis at the site of the anastomosis. Surgery was refused in one. One patient was not candidate to surgery due to advanced obstructive pulmonary vascular disease (OPVD) and one case is awaiting surgery. Conclusion: The diagnosis of AOPA may be established with precision through echocardiography. Cardiac catheterization is seldom needed to confirm morphology but is mandatory in older children with suspected of OPVD. (Arch Cardiol Mex 2003; 73:115-123).

Síndrome hipereosinofílico: una causa rara de insuficiencia mitral grave en pediatría / Idiopathic hypereosinophilic syndrome: a rare cause of mitral valve failure in children

Introducción. El síndrome hipereosinofílico (SHE) es un desorden leucoproliferativo caracterizado por sobreproducción sostenida de eosinófilos sin causa definida. Es característico de la enfermedad la afección de diferentes órganos incluyendo el corazón. Es una entidad rara en adultos y aún más en edad pediátrica.Caso clínico. Masculino de 6 años de edad con SHE y cardiopatía adquirida caracterizada por insuficiencia mitral grave secundaria a fibrosis de la valva posterior. El diagnóstico se realizó por ecocardiografía y se corroboró por biopsia miocárdica. En espera de recambio de válvula mitral el paciente falleció secundario a insuficiencia cardiaca grave. Conclusión. En este paciente el ecocardiograma permitió el adecuado diagnóstico de la lesión cardiaca, siendo la imagen muy característica, que por experiencia no se ha visto en otros tipos de miocardiopatías. Dada la poca frecuencia de esta entidad la biopsia miocárdica sigue estando indicada para confirmar y estadificar la lesión.

Estenosis pulmonar valvular crítica del recién nacido; valvuloplastía con globo efectuada usando un asa arterio-venosa y dilataciones secuenciales / Critical pulmonary valve stenosis in neonates; its treatment with ballon valvuloplasty using and arteriovenous loop and gradational dilatations

La estenosis pulmonar valvular crítica del recién nacido es una urgencia donde la valvuloplastía puede representar su corrección definitiva. Este recurso tiene particularidades técnicas importantes, relacionadas a la edad y peso del paciente, y a factores anatómicos que contribuyen a la obstrucción. Se presenta el caso de un neonato de 20 días con este problema, en el que el empleo de una asa arterio-venosa a través del conducto arterioso permitió el paso de globos con diámetro progresivamente mayor hasta llegar a la relación globo/anillo de 1.4. Este abordaje puede emplearse con seguridad en casos donde existan dificultades para aplicar la técnica habitual y permite lograr la dilatación valvular adecuada

Enfermedad de Kawasaki en niños mexicanos / Kawasaki disease (KD) in mexican children

Se revisaron 16 casos de enfermedad de Kawasaki (EK) diagnosticados en el Hospital Infantil de México Federico Gómez; su edad promedio fue de tres años; ocho fueron lactantes y predominó el sexo masculino en proporción de 4.3:1; dos pacientes eran hermanos. Doce desarrollaron anomalías coronarias: cinco aneurisma, seis ectasia y uno estenosis difusa. Dos casos con daño coronario grave fallecieron: uno súbitamente por isquemia miocárdica y otro por ruptura de un aneurisma aórtico; de los restantes, en tres persisten las anomalías coronarias pero solo uno con aneurisma gigante desarrolló secuelas graves; los siete restantes se encuentran asintomáticos y su ecocardiograma es normal. Se correlacionó la puntuación igual o superior a 6, todos tuvieron lesión coronaria; dos cursaron con aneurismas gigantes, uno con estenosis coronaria grave, y dos fallecieron. En 10 con puntuación inferior a 6, cuatro tuvieron coronarias normales, no se observaron aneurismas gigantes y ninguno falleció. Aunque se han reportado esporádicamente algunos casos de EK en el país, la presente casuística, proveniente de una sola institución, establece firmemente la presencia de EK en México