Atypical lipomatous tumor of the oropharynx: A case report.

Atypical lipomatous tumor or well-differentiated liposarcoma is a rare condition in the laryngopharynx. We present a case of a 63 year-old male with progressive dysphagia who later manifested with a mass that regurgitates outside the oral cavity. Surgical removal was done via a transoral approach, followed by adjuvant radiotherapy.

Lessons from the Implementation of Pilot Practices to Tackle the Burden of Noncommunicable Diseases in Europe.

(1) Background: The gap between research findings and their application in routine practice implies that patients and populations are not benefiting from the investment in scientific research. The objective of this work is to describe the process and main lessons obtained from the pilot practices and recommendation that have been implemented by CHRODIS-PLUS partner organizations; (2) Methods: CHRODIS-PLUS is a Joint Action funded by the European Union Health Programme that continues the work of Joint Action CHRODIS-JA. CHRODIS-PLUS has developed an Implementation Strategy that is being tested to implement innovative practices and recommendations in four main areas of action: health promotion and disease prevention, multimorbidity, fostering quality of care of patients with chronic diseases, and employment and chronic conditions; (3) Results: The Three-Stages CHRODIS-PLUS Implementation Strategy, based on a Local Implementation Working Group, has demonstrated that it can be applied for interventions and in situations and contexts of great diversity, reflecting both its validity and generalizability; (4) Conclusions: Implementation has to recognize the social dynamics associated with implementation, ensuring sympathy toward the culture and values that underpin these processes, which is a key differentiation from more linear improvement approaches.

Excerpts from the documents of Mexican positions and recommendations in cardiovascular diseases and COVID-19.

The recommendations in which the Mexican Society of Cardiology (SMC) in conjunction with the National Association of Cardiologists of Mexico (ANCAM) as well as different Mexican medical associations linked to cardiology are presented, after a comprehensive and consensual review and analysis of the topics related to cardiovascular diseases in the COVID-19 pandemic. Scientific positions are analyzed and responsible recommendations on general measures are given to patients, with personal care, healthy eating, regular physical activity, actions in case of cardio-respiratory arrest, protection of the patient and health personnel as well as precise indications in the use of non-invasive cardiovascular imaging, prescription of medications, care in specific topics such as systemic arterial hypertension, heart failure, arrhythmias and acute coronary syndromes, in addition to emphasizing electrophysiology, interventionism, cardiac surgery and in cardiac rehabilitation. The main interest is to provide the medical community with a general orientation on what to do in daily practice and patients with cardiovascular diseases in the setting of this unprecedented epidemiological crisis of COVID-19.

Se presentan las recomendaciones en las cuales la Sociedad Mexicana de Cardiología (SMC) en conjunto con la Asociación Nacional de Cardiólogos de México (ANCAM), así como diferentes asociaciones médicas mexicanas vinculadas con la cardiología, después de una revisión y análisis exhaustivo y consensuado sobre los tópicos relacionados con las enfermedades cardiovasculares en la pandemia de COVID-19, se analizan posturas científicas y se dan recomendaciones responsables sobre medidas generales a los pacientes, con cuidados personales, alimentación saludable, actividad física regular, acciones en caso de paro cardiorrespiratorio, la protección del paciente y del personal de salud así como las indicaciones precisas en el uso de la imagen cardiovascular no invasiva, la prescripción de medicamentos, cuidados en tópicos específicos como en la hipertensión arterial sistémica, insuficiencia cardiaca, arritmias y síndromes coronarios agudos, además de hacer énfasis en los procedimientos de electrofisiología, intervencionismo, cirugía cardiaca y en la rehabilitación cardiaca. El interés principal es brindar a la comunidad médica una orientación general sobre el quehacer en la práctica cotidiana y pacientes con enfermedades cardiovasculares en el escenario esta crisis epidemiológica sin precedentes de COVID-19.

Cardiac imaging studies in the COVID-19 pandemic.

COVID-19 is an acute respiratory syndrome caused by coronavirus-2 (SARS COV2). The different cardiac imaging methods have issued specific recommendations for the different imaging methods in this pandemic, so it is essential to emphasize the recommendations for carrying out these studies.

El COVID-19 es un síndrome respiratorio agudo ocasionado por el coronavirus-2 (SARS COV2). Los diferentes métodos de imagen cardiaca han dictado recomendaciones específicas de los diferentes métodos de imagen en esta pandemia, por lo que es indispensable recalcar las recomendaciones para la realización de estos estudios.

Estudios de imagen cardiaca en la pandemia COVID-19 / Cardiac imaging studies in the COVID-19 pandemic

Resumen El COVID-19 es un síndrome respiratorio agudo ocasionado por el coronavirus-2 (SARS COV2). Los diferentes métodos de imagen cardiaca han dictado recomendaciones específicas de los diferentes métodos de imagen en esta pandemia, por lo que es indispensable recalcar las recomendaciones para la realización de estos estudios.

Abstract COVID-19 is an acute respiratory syndrome caused by coronavirus-2 (SARS COV2). The different cardiac imaging methods have issued specific recommendations for the different imaging methods in this pandemic, so it is essential to emphasize the recommendations for carrying out these studies.

Extractos de los documentos de posicionamientos y recomendaciones mexicanas en enfermedades cardiovasculares y COVID-19 / Excerpts from the documents of Mexican positions and recommendations in cardiovascular diseases and COVID-19

Resumen Se presentan las recomendaciones en las cuales la Sociedad Mexicana de Cardiología (SMC) en conjunto con la Asociación Nacional de Cardiólogos de México (ANCAM), así como diferentes asociaciones médicas mexicanas vinculadas con la cardiología, después de una revisión y análisis exhaustivo y consensuado sobre los tópicos relacionados con las enfermedades cardiovasculares en la pandemia de COVID-19, se analizan posturas científicas y se dan recomendaciones responsables sobre medidas generales a los pacientes, con cuidados personales, alimentación saludable, actividad física regular, acciones en caso de paro cardiorrespiratorio, la protección del paciente y del personal de salud así como las indicaciones precisas en el uso de la imagen cardiovascular no invasiva, la prescripción de medicamentos, cuidados en tópicos específicos como en la hipertensión arterial sistémica, insuficiencia cardiaca, arritmias y síndromes coronarios agudos, además de hacer énfasis en los procedimientos de electrofisiología, intervencionismo, cirugía cardiaca y en la rehabilitación cardiaca. El interés principal es brindar a la comunidad médica una orientación general sobre el quehacer en la práctica cotidiana y pacientes con enfermedades cardiovasculares en el escenario esta crisis epidemiológica sin precedentes de COVID-19.

Abstract The recommendations in which the Mexican Society of Cardiology (SMC) in conjunction with the National Association of Cardiologists of Mexico (ANCAM) as well as different Mexican medical associations linked to cardiology are presented, after a comprehensive and consensual review and analysis of the topics related to cardiovascular diseases in the COVID-19 pandemic. Scientific positions are analyzed and responsible recommendations on general measures are given to patients, with personal care, healthy eating, regular physical activity, actions in case of cardio-respiratory arrest, protection of the patient and health personnel as well as precise indications in the use of non-invasive cardiovascular imaging, prescription of medications, care in specific topics such as systemic arterial hypertension, heart failure, arrhythmias and acute coronary syndromes, in addition to emphasizing electrophysiology, interventionism, cardiac surgery and in cardiac rehabilitation. The main interest is to provide the medical community with a general orientation on what to do in daily practice and patients with cardiovascular diseases in the setting of this unprecedented epidemiological crisis of COVID-19.

Neurogranin Expression Is Regulated by Synaptic Activity and Promotes Synaptogenesis in Cultured Hippocampal Neurons.

Neurogranin (Ng) is a calmodulin (CaM)-binding protein that is phosphorylated by protein kinase C (PKC) and is highly enriched in the dendrites and spines of telencephalic neurons. It is proposed to be involved in regulating CaM availability in the post-synaptic environment to modulate the efficiency of excitatory synaptic transmission. There is a close relationship between Ng and cognitive performance; its expression peaks in the forebrain coinciding with maximum synaptogenic activity, and it is reduced in several conditions of impaired cognition. We studied the expression of Ng in cultured hippocampal neurons and found that both protein and mRNA levels were about 10% of that found in the adult hippocampus. Long-term blockade of NMDA receptors substantially decreased Ng expression. On the other hand, treatments that enhanced synaptic activity such as long-term bicuculline treatment or co-culture with glial cells or cholesterol increased Ng expression. Chemical long-term potentiation (cLTP) induced an initial drop of Ng, with a minimum after 15 min followed by a slow recovery during the next 2-4 h. This effect was most evident in the synaptosome-enriched fraction, thus suggesting local synthesis in dendrites. Lentiviral expression of Ng led to increased density of both excitatory and inhibitory synapses in the second and third weeks of culture. These results indicate that Ng expression is regulated by synaptic activity and that Ng promotes the synaptogenesis process. Given its relationship with cognitive function, we propose targeting of Ng expression as a promising strategy to prevent or alleviate the cognitive deficits associated with aging and neuropathological conditions.

Determinantes de la vacunación de la gripe en personas de más de 65 años: 20 años no es nada / Determinants of influenza vaccination in people over 65 years: 20 years is nothing

Fundamentos: La efectividad de la vacuna de la gripe ha hecho que sea una medida recomendada para personas de alto riesgo, entre ellos los adultos de 65 y más años. En este trabajo se planteó analizar la evolución de las tasas anuales de vacunación, e identificar subgrupos en la población que tuviese un riesgo significativo de no vacunarse. Métodos: Para el primer objetivo, la fuente de información fueron los datos que informa el Ministerio de Sanidad, Consumo y Bienestar Social. Para analizar las tendencias se llevó a cabo un análisis de series temporales interrumpidas. La fuentede información para el segundo objetivo fue la Encuesta Nacional de Salud de España de 2017. Se llevó a cabo un análisis de regresión logística multivariable. Resultados: La tasa de vacunación de la gripe mostró desde latemporada 2006-07 una disminución absoluta anual de 1,2 puntos (95% IC: 0,8%, 1,6%). La prevalencia de vacunación en 2017 era de 54,9%. Las variables independientemente asociadas con la mayor vacunación de la gripe eran ser hombre, la mayor edad, haber nacido en España, tener más visitas al médico, tener una prescripción de medicamentos, tener una enfermedad crónica, no ser fumador, y el menor consumo de frutas. Conclusiones: La cobertura de la vacuna de la gripe en población de 65 y más años no solo está por debajo de lo recomendado por la Organización Mundial de la Salud e indicado por el Consejo Interterritorial del Sistema Nacional de Salud sino que está disminuyendo significativamente cada año. Los subgrupos con menores tasas de vacunación (mujeres, menores de 75 años, no nacidos en España, con menos visitas al médico,sin prescripción de medicamentos, sin enfermedades crónicas, fumadores y con más consumo de frutas) deben ser identificados para desarrollar campañas y programas destinados a incrementar su vacunación de la gripe de forma que pueda aportar todo su beneficio potencial a la población específica

Background: The effectiveness of the influenza vaccine has made it a recommended intervention for people at high risk, including adults over 65. This work aimed to analyse the trends of annual vaccination rates, and identify subgroups in the population that have a significant risk of not receiving the vaccine. Methods: For the first objective, the source of information was the data reported by the Ministry of Health. To determine the trends in vaccination an analysis of interrupted time series was conducted. A multivariable logistic regression analysis was carried out with the National Health Survey (ENSE) of 2017 for the second objective. Results: The rate of influenza vaccination showed an absolute annual decrease of 1,2 points since the 2006-07 season (95% CI: 0,8%, 1,6%). The prevalence of vaccination in 2017 was 54,9%. The variables independently associated with a higher probability of the influenza vaccine were males, older age, born in Spain, having more visits to the doctor, with prescription of medications, having a chronic illness, being non-smoker, and the lower consumption of fruits. Conclusions: The coverage of the flu vaccine in the population aged 65 and over is not only below the recommendation of the World Health Organization and indicated by the Interterritorial Council of the National Health System, but is significantly decreasing every year. Sub-groups with lover vaccination rates (women, younger than 75 years , foreign born, with less visits to primary care, no prescription of medicines, no chronic diseases, smokers and with higher intake of fruit) should be targets to develop campaigns and programs to increase their uptake of influenza vaccination so it could provide its potential population benefit

[Obstruction of the right ventricular outflow tract on the obstructive hypertrophic cardiomyopathy. Case report and literature review]. / Obstrucción en la vía de salida del ventrículo derecho en la miocardiopatía hipertrófica obstructiva. Informe de un caso y revisión de la literatura.

OHC is a disorder with a broad spectrum of morphological, functional and genetics abnormalities. The Obstruction on the Right Ventricular Outflow (OHCRV) is not expected most of the time, that's way it is not usually detected and rarely mentioned in the cardiological literature. Its clinical presentation may include basically systemic venous hypertension symptoms that come with the hypertrophic cardyomiopathy manifestations. The manifestations of an apparent Right Ventricular Hypertrophic (RVH) in the ECG are probably due to the huge septal vector that activates the septum with a major thickness. The clinical confirmation of the obstruction on the OHCRV produced by a considerable asymmetric septal hypertrophic is easily shown with bidimensional an Doppler echocardiography.

Obstrucción en la vía de salida del ventrículo derecho en la miocardiopatía hipertrófica obstructiva. Informe de un caso y revisión de la literatura / Obstruction of the right ventricular outflow tract on the obstructive hypertrophic cardiomyopathy. Case report and literature review

OHC is a disorder with a broad spectrum of morphological, functional and genetics abnormalities. The Obstruction on the Right Ventricular Outflow (OHCRV) is not expected most of the time, that's way it is not usually detected and rarely mentioned in the cardiological literature. Its clinical presentation may include basically systemic venous hypertension symptoms that come with the hypertrophic cardyomiopathy manifestations. The manifestations of an apparent Right Ventricular Hypertrophic (RVH) in the ECG are probably due to the huge septal vector that activates the septum with a major thickness. The clinical confirmation of the obstruction on the OHCRV produced by a considerable asymmetric septal hypertrophic is easily shown with bidimensional an Doppler echocardiography.

Utilidad de los eco realzadores en el estudio del tiempo de circulación pulmonar / Echo constrast enhancers in the study of pulmonary circulation time

El tiempo de circulación pulmonar (TCP) varía en diversas condiciones clínicas. Para evaluar el TCP, la persistencia del contraste en los ventrículos y la saturación arterial digital de oxígeno estudiamos 14 pacientes con microburbujas inyectadas en vena peroférica. Grupos I. normales, II. con hipertrofia ventricular izquierda y fracción de expulsión (FE) > 50 por ciento, III. con estenosis mitral y IV. en insuficiencia cardiaca y FE < 50 por ciento. En siete pacientes, se administraron 2.5 mg S/L de isosorbide después de la primera inyección. El TCP en latidos fue 7.3 y mayor en cada uno de los grupos. La persistencia del contraste en las cavidades derechas (PCCD) fue 31 latidos en el grupo 1, y mayor en los otros. En cavidades izquierdas fue de 20.6 latidos en el grupo I, y mayor en el resto. La saturación arterial de oxigeno no tuvo cambios. Los pacientes con isosorbide tuvieron menores TCP y de PCCD.Conclusiones: hay diferencias en el TCP entre normales, con estenosis mitral y en insuficiencia cardiaca. La persistencia prolongada del contraste en las cavidades derechas indica tránsito pulmonar anormal. En pacientes con insuficiencia cardiaca, hay mayor persistencia del contraste. El TCP facilita evaluar algunos aspectos de la circulación pulmonar.

Utilidad de la ecocardiografía transesofágica en el diagnóstico de hematoma intramural aórtico / Transesophageal echocardiography in the diagnosis of intramural hematoma of the aorta

El hematoma intramural aórtico, o disección aórtica atípica, es una variedad de disección aórtica que se presenta sin ruptura de la íntima o como estado previo de una disección típica. En este artículo se presentan cinco casos de hematoma intramural aórtico diagnosticado mediante ecocardiografía transesofágica. Éste es un método seguro, sensible, específico, accesible en momentos de urgencia, que permite el diagnóstico sin necesidad de trasladar al paciente y que facilita su seguimiento.