Untargeted metabolomic and lipidomic analyses reveal lipid dysregulation in the plasma of acute leukemia patients.

Acute leukemias (AL) are aggressive neoplasms with high mortality rates. Metabolomics and oxidative status have emerged as important tools to identify new biomarkers with clinical utility. To identify the metabolic differences between healthy individuals (HI) and patients with AL, a multiplatform untargeted metabolomic and lipidomic approach was conducted using liquid and gas chromatography coupled with quadrupole-time-of-flight mass spectrometry (LC-QTOF-MS or GC-QTOF-MS). Additionally, the total antioxidant capacity (TAC) was measured. A total of 20 peripheral blood plasma samples were obtained from patients with AL and 18 samples from HI. Our analysis revealed 135 differentially altered metabolites in the patients belonging to 12 chemical classes; likewise, the metabolic pathways of glycerolipids and sphingolipids were the most affected in the patients. A decrease in the TAC of the patients with respect to the HI was evident. This study conducted with a cohort of Colombian patients is consistent with observations from other research studies that suggest dysregulation of lipid compounds. Furthermore, metabolic differences between patients and HI appear to be independent of lifestyle, race, or geographic location, providing valuable information for future advancements in understanding the disease and developing more global therapies.

Evaluación y comparación del desempeño de cinco modelos de predicción de mortalidad intrahospitalaria en pacientes con falla cardiaca aguda / Evaluation and comparison of the performance of five prediction models of in-hospital mortality in patients with acute heart failure

Resumen Objetivo: Los modelos de predicción de mortalidad intrahospitalaria en pacientes con falla cardiaca aguda pueden ser útiles para la toma de decisiones, situación que hace necesario evaluar la capacidad predictiva y de discriminación en la población colombiana. Método: Estudio de cohorte retrospectiva de pacientes con falla cardiaca aguda. Se evaluó el desempeño de los modelos de predicción de mortalidad intrahospitalaria ADHERE, OPTIMIZE-HF, GWTG-HF y PROTECT, durante los años 2013 a 2015. Se realizó el cálculo de la puntuación para cada uno de los modelos y se determinó la capacidad de predicción y discriminación. Resultados: Se incluyeron 776 pacientes con una edad promedio de 71.5 años (desviación estándar: 14.3), el 56% hombres, con fracción de eyección del ventrículo izquierdo del 39%. La mortalidad global fue del 6.1%. El área bajo la curva para ADHERE fue de 0.56 (intervalo de confianza del 95% [IC95%]: 0.49-0.64), para EHMRG de 0.63 (IC95%: 0.55-0.71], para GWTG-HF de 0.63 (IC95%: 0.55-0.70), para OPTIMIZE de 0.65 (IC95%: 0.56-0.74) y para PROTECT de 0.69 (IC95%: 0.60-0.77). Conclusiones: Los modelos de predicción de muerte intrahospitalaria en pacientes con falla cardiaca aguda muestran pobre desempeño y baja capacidad de predicción y discriminación en población colombiana, lo cual sugiere el desarrollo de escalas de predicción de mortalidad en pacientes con falla cardiaca aguda específicas para dicha población.

Abstract Objective: In-hospital mortality prediction models on acute heart failure can be beneficial for decision-making, a situation necessary to evaluate, our goal was to compare predictive and discriminatory capacity of Colombian population. Method: A retrospective cohort study in patients with acute heart failure was conducted. The following performance evaluation of in-hospital mortality prediction models were conducted from 2013 to 2015: ADHERE, EHMRG, OPTIMIZE-HF, GWTG-HF and PROTECT. Data was calculated for each model, prediction and discriminatory capacity was evaluated. Results: A sample of 776 patients, 56% male, with an average age of 71.5 (standard deviation: 14.3) and with left ventricle ejection fraction rate of 39% was studied. Global mortality was of 6.1%. The area under curve for ADHERE was of 0.56 (95% confidence interval [95% CI]: 0.49-0.64), for EHMRG 0.63 (95% CI: 0.55-0.71), for GWTG-HF 0.63 (95% CI: 0.55-0.70), for OPTIMIZE 0.65 (95% CI: 0.56-0.74) and for PROTECT 0.69 (95% CI: 0.60-0.77). Conclusions: The models for predicting in-hospital death in patients with acute heart failure show poor performance, predictability and discrimination in the Colombian population, suggesting the development of mortality prediction scales in patients with acute heart failure specific to our population.

Micropropagacion in vitro de Rosa rosa sp. a partir de yemas axilares y respuesta callogénica / Rose rosa sp. in vitro micropropagation from axillary buds and callogenic response

El objetivo de este trabajo fue obtener plántulas de Rosa sp y respuesta callogénica a partir de yemas axilares y hojas. Se utilizó Murashige y Skoog (MS) al 100%, como medio de cultivo para la fase de establecimiento, adicionado con myo-inositol 0,1 mg/L, ácido ascórbico 0,1 mg/L, tiamina 0,2 mg/L, sacarosa 30 g, benzylaminopurina (BAP) 0,4 mg/L, kinetina 0,3 mg/L, ácido naftaleno-acético (ANA) 0,3 mg/L, y Agar sigma 6 g; ajustando el pH a 5,8; esterilizados en autoclave a 120°C bajo 15 lb de presión. El análisis de varianza para la fase de multiplicación y enraizamiento determinó que existen diferencias altamente significativas para la variable altura ( p=0,000), para determinar en cuáles medias son significativamente diferentes se realizó la prueba de Kruskal ­ Wallis. Para las variables presencia de raíz (p = 0,3398), número de hojas (p = 0,4775) y formación de callos (p = 0,1964), sin diferencias estadísticamente significativas.

The objective of this work was to obtain Rosa sp seedlings and callogenic response from axillary buds and leaves. Murashige and Skoog (MS) 100%, was used as culture medium for the establishment phase, added with myo-inositol 0.1 mg / L, ascorbic acid 0.1 mg / L, thiamin 0.2 mg / L, sucrose 30 g, benzylaminopurine (BAP) 0.4 mg / L, kinetin 0.3 mg / L, indole-acetic acid (IAA) 0.3 mg / L, and Sigma agar 6 g; adjusting the pH to 5.8; sterilized in an autoclave at 120 °C under 15 lb of pressure. The analysis of variance for the phase of multiplication and rooting determined that there are highly significant differences for the variable height (p = 0.000), in order to determine which means are significantly different, the Kruskal - Wallis test was performed. For the variables presence of root (p = 0. 3398), number of leaves (p = 0.4775) and callus formation (p = 0.1964), without statistically significant differences.

Improving surface EMG burst detection in infrahyoid muscles during swallowing using digital filters and discrete wavelet analysis.

The visual inspection is a widely used method for evaluating the surface electromyographic signal (sEMG) during deglutition, a process highly dependent of the examiners expertise. It is desirable to have a less subjective and automated technique to improve the onset detection in swallowing related muscles, which have a low signal-to-noise ratio. In this work, we acquired sEMG measured in infrahyoid muscles with high baseline noise of ten healthy adults during water swallowing tasks. Two methods were applied to find the combination of cutoff frequencies that achieve the most accurate onset detection: discrete wavelet decomposition based method and fixed steps variations of low and high cutoff frequencies of a digital bandpass filter. Teager-Kaiser Energy operator, root mean square and simple threshold method were applied for both techniques. Results show a narrowing of the effective bandwidth vs. the literature recommended parameters for sEMG acquisition. Both level 3 decomposition with mother wavelet db4 and bandpass filter with cutoff frequencies between 130 and 180Hz were optimal for onset detection in infrahyoid muscles. The proposed methodologies recognized the onset time with predictive power above 0.95, that is similar to previous findings but in larger and more superficial muscles in limbs.

Effectiveness of radiotherapy for metastatic spinal cord compression in patients with short life expectancy.

AIM: To analyze the effect of radiotherapy (RT) in patients with metastatic spinal cord compression (MSCC) and poor prognosis in our center. BACKGROUND: RT is an effective treatment for MSCC. MATERIALS AND METHODS: Prospective evaluation on patients with MSCC and limited survival (according to Rades' scale), and treated with single-dose 8 Gy RT (February 2013-August 2014). Pain, ambulatory status and sphincter control were recorded. Pain relief was evaluated following the International Bone Metastases Consensus Working Party Guidelines. Ambulatory status was evaluated with Frankel's scale. Spinal fracture and instability were recorded. Health aspects were evaluated via a short survey and measuring the time spent on RT. RESULTS: 35 patients were included. 51% had unfavorable histologies; 60% bone fracture and 17% spinal instability. Median Karnofsky score was 60; 100% were on high doses of opioids. Median survival was 1.5 months. 49% had a partial pain response at 2 weeks post-radiation, and 47% at one month. Significant reductions in pain intensity were present at 2 weeks (Visual analog scale, VAS score, from 8 ± 1.5 to 5 ± 1.9). Negligible effects were observed on motor and bladder function, along with side effects. KPS score was maintained during follow-up. 80% of patients spent ≤5% of their remaining lifetime on RT. A survey comparison between clinical judgment and the results according to treatment decision consider that these patients merit treatment evaluation. CONCLUSIONS: A moderate pain response tailored to life expectancy can be obtained in patients treated with radiation. 8-Gy single-dose is an option for patients with limited survival.

Protocolo de adquisición de imágenes diagnósticas por termografía infrarroja / Acquisition protocol of diagnostic imaging by infrared thermography

Introducción: en aplicaciones biomédicas, la termografía infrarroja ha permitido visualizar el patrón de distribución de temperatura de la piel y el tejido subyacente, permitiendo diagnosticar problemas vasculares o nerviosos y, particularmente, trastornos en la termorregulación como el fenómeno de Raynaud y la intolerancia al frío. Sin embargo, las publicaciones no detallan el protocolo de adquisiciónde imágenes ni validan el mismo; factores determinantes para la calidad y relevancia de la informacióndiagnóstica obtenida. Objetivo: diseñar y validar un protocolo de adquisición de imágenes por termografía infrarroja para analizar la termorregulación en la mano. Materiales y métodos: Se diseñó un nuevo protocolo de adquisición de imágenes por termografía infrarroja utilizando un estímulofrío en la mano. Se analizaron estadísticamente regiones de interés de imágenes termográficas de 18 mediciones intrasujeto en un único sujeto y mediciones intersujeto en 17 individuos sanos. Resultados: En las mediciones intrasujeto e intersujeto se encontró que 10 minutos después del estímulo frío el porcentaje de recuperación de la temperatura fue cercano al 100%, excepto en un individuo en el cual, a pesar de no reportar enfermedades o lesiones previas, la punta de los dedos después del estímulo alcanzó apenas los 28 ºC. La prueba de fatiga en uno de los sujetos sanos mostró alteraciones en el proceso de termorregulación de la mano cuando el protocolo se repite en corto tiempo.

Introduction: in biomedical applications, infrared thermography has allowed to visualize the temperaturedistribution patterns of skin and underlying tissue, allowing the diagnosis of vascular or nervous disorders, particularly disturbances in the thermoregulation process as Raynaud’s phenomenon and cold intolerance. However, most papers not detailed the images acquisition protocol or its validation, being these two determining factors to the quality and relevance of the obtained diagnostic information.Objective: To design and validate an acquisition protocol of diagnostic imaging by infrared thermographyto analyze the thermoregulation process in hand. Material and methods: It was designed a new acquisition protocol of diagnostic imaging by infrared thermography using a cold stimulus in hand. It was statistically analyzed the regions of interest of thermographic images of 18 intrasubject measurements (in one individual) and intersubject measurements in 17 healthy individuals. Results: In the intrasubject and intersubject measurements, it found that 10 minutes after the cold stimulus the temperature measured was close to 100% of initial temperature, except for one of healthy subjects who, despite not report diseases or previous injuries, the temperature of the fingertips after stimulus barely reached 28 °C. The fatigue test in one healthy subject presents alterations in the thermoregulation process in hand when the protocol was repeated in a short time.