Bovine rabies cases in Ecuador: a retrospective cross-sectional observational study (2007 to 2020).

The hematophagous bats are usually the main reservoir of sylvatic rabies, being one of the most important viral zoonoses affecting humans and livestock in Latin America. Despite the most countries have already studied spatio-temporal distribution of bovine rabies, however, in Ecuador, little has been reported about the state of rabies in the country. Aiming to this objective, a descriptive observational study was realized from 2007 to 2020 based on the formal reports by WAHI-OIE and surveillance of bovine rabies retrieved from its official website. During the study period in Ecuador, some 895 cases of rabies were confirmed in cattle. In addition, in the total of bovine rabies cases seen in Andean and Coast regions (185 effected bovines), Loja and Esmeraldas had 95 (6.16% cases per 10,000 animals) and 51 (1.7% cases per 10,000 animals), respectively. Furthermore, the Amazon region indicated higher rabies cases in cattle than to the observed in other regions (710 rabies cases) while it was highly fluctuating with respect to the years (9.74 to 42.82% cases per 10,000 animals). However, Zamora (292 rabies cases), Orellana (115 rabies cases) and Sucumbíos (113 rabies cases) yielded the highest incidence rates than other provinces (9 to 42% cases per 10,000 animals). Based on this evidence, it has been fundamental to assess the current national program for preventing and control of the sylvatic rabies, being also necessary to include concept of the ecology of the vampire bat. Regardless of these results, vaccination is vital for control programs to prevent rabies in livestock and need to be widely increased for limiting their geographic and temporal spread.

Hip arthroscopy for femoroacetabular impingement with 10-year minimum follow-up. / Artroscopia de cadera como tratamiento del choque femoroacetabular con seguimiento mínimo de 10 años.

PURPOSE: To determine outcomes after hip arthroscopy (HA) for femoroacetabular impingement (FAI) at a minimun 10-year follow up and identified risk factors for revision surgery. METHODS: Retrospective study of a prospective database of patients undergoing HA between January 2010 and December 2011. Rim chondral injuries were evaluated using the acetabular labral articular disruptions system (ALAD). Clinical and radiological data was obtained. Cumulative survival was estimated by Kaplan-Meier and a multivariate Cox proportional hazards model. RESULTS: Seventy-four patients were included in the study. Mean follow-up was 132 months. There was statistically significant improvement from preoperative PROs at latest follow-up. Seventeen patients (23.9%) underwent revision surgery. Odds ratio for revision surgery was 8.08 in a patient above 40 years old, 7.57 in a patient Tönnis greater than 1, and 4.25 in a patient ALAD 2-3. Cumulative survivorship rate at 10 years was 77.8%, with a 45.4% for patients with Tönnis grade greater than 1 in front of 85.2% for patients with Tönnis grade of 1 or less (P<.001). Risk factor for revision surgery was preoperative degree of osteoarthrosis (P=.02). CONCLUSION: Cumulative survivorship rate at 10 years was 45.4% for patients with Tönnis grade greater than 1 in front of 85.2% for patients with Tönnis grade of 1 or less (P<.001). Age, chondral injuries, and degree of osteoarthrosis would increase the risk for revision surgery.

[Translated article] Hip arthroscopy for femoroacetabular impingement with 10-year minimum follow-up.

PURPOSE: To determine outcomes after hip arthroscopy (HA) for femoroacetabular impingement (FAI) at a minimun 10-year follow up and identified risk factors for revision surgery. METHODS: Retrospective study of a prospective database of patients undergoing HA between January 2010 and December 2011. Rim chondral injuries were evaluated using the acetabular labral articular disruptions system (ALAD). Clinical and radiological data was obtained. Cumulative survival was estimated by Kaplan-Meier and a multivariate Cox proportional hazards model. RESULTS: Seventy-four patients were included in the study. Mean follow-up was 132 months. There was statistically significant improvement from preoperative PROs at latest follow-up. Seventeen patients (23.9%) underwent revision surgery. Odds ratio for revision surgery was 8.08 in a patient above 40 years old, 7.57 in a patient Tönnis greater than 1, and 4.25 in a patient ALAD 2-3. Cumulative survivorship rate at 10 years was 77.8%, with a 45.4% for patients with Tönnis grade greater than 1 in front of 85.2% for patients with Tönnis grade of 1 or less (p<.001). Risk factor for revision surgery was preoperative degree of osteoarthrosis (p=.02). CONCLUSION: Cumulative survivorship rate at 10 years was 45.4% for patients with Tönnis grade greater than 1 in front of 85.2% for patients with Tönnis grade of 1 or less (p<.001). Age, chondral injuries, and degree of osteoarthrosis would increase the risk for revision surgery.

Impact of three co-occurring physical ecosystem engineers on soil Collembola communities.

The interplay between organisms with their abiotic environment may have profound effects within ecological networks, but are still poorly understood. Soil physical ecosystem engineers (EEs) modify the abiotic environment, thereby potentially affecting the distribution of other species, such as microarthropods. We focus on three co-occurring physical EEs (i.e. cattle, vegetation, macrodetritivore) known for their profound effect on soil properties (e.g. pore volume, microclimate, litter thickness). We determined their effects on Collembola community composition and life-form strategy (a proxy for vertical distribution in soil) in a European salt marsh. Soil cores were collected in grazed (compacted soil, under short and tall vegetation) and non-grazed areas (decompacted soil, under short and tall vegetation), their pore structure analysed using X-ray computed tomography, after which Collembola were extracted. Collembola species richness was lower in grazed sites, but abundances were not affected by soil compaction or vegetation height. Community composition differed between ungrazed sites with short vegetation and the other treatments, due to a greater dominance of epigeic Collembola and lower abundance of euedaphic species in this treatment. We found that the three co-occurring EEs and their interactions modify the physical environment of soil fauna, particularly through changes in soil porosity and availability of litter. This alters the relative abundance of Collembola life-forms, and thus the community composition within the soil. As Collembola are known to play a crucial role in decomposition processes, these compositional changes in litter and soil layers are expected to affect ecosystem processes and functioning.

Evaluating the added value of multi-input atmospheric transport ensemble modeling for applications of the Comprehensive Nuclear Test-Ban Treaty organization (CTBTO).

The Comprehensive Nuclear Test-Ban Treaty Organization (CTBTO) runs to date operationally an atmospheric transport modeling chain in backward mode based on operational deterministic European Centre for Medium-Range Weather Forecasts-Integrated Forecasting System (ECMWF-IFS) and on National Centers for Environmental Prediction-Global Forecast System (NCEP-GFS) input data. Meanwhile, ensemble dispersion modeling is becoming more and more widespread due to the ever increasing computational power and storage capacities. The potential benefit of this approach for current and possible future CTBTO applications was investigated using data from the ECMWF-Ensemble Prediction System (EPS). Five different test cases - among which are the ETEX-I experiment and the Fukushima accident - were run in backward or forward mode and - in the light of a future operational application - special emphasis was put on the performance of an arbitrarily selected 10- versus the full 51-member ensemble. For those test cases run in backward mode and based on a puff release it became evident that Possible Source Regions (PSRs) can be meaningfully reduced in size compared to results based solely on the deterministic run by applying minimum and probability of exceedance ensemble metrics. It was further demonstrated that a given puff release of 4E10 Bq of Se-75 can be reproduced within the meteorological uncertainty range [1.9E9 Bq,1.7E13 Bq] including a probability for not exceeding an assumed upper limit source term using simple scaling of a measurement with the corresponding ensemble metrics of backward fields. For the test cases run in forward mode it was found that the control run as well as 10- and 51-member medians all exhibit similar performance in time series evaluation. Maximum rank difference adds up to less than 10% with reference to possible rank values [0,4]. The maximum difference in the Brier score for both ensembles is less than 3%. The main added value of the ensemble lies in producing meteorologically induced concentration uncertainties and thus explaining observed measurements at specific sites. Depending on the specific test case and on the ensemble size between 27 and 74% of samples all lie within concentration ranges derived from the different meteorological fields used. In the future uncertainty information per sample could be used in a full source term inversion to account for the meteorological uncertainty in a proper way. It can be concluded that a 10-member meteorological ensemble is good enough to already benefit from useful ensemble properties. Meteorological uncertainty to a large degree is covered by the 10-member subset because forecast uncertainty is largely suppressed due to concatenating analyses and short term forecasts, as required in the operational CTBTO procedure, on which this study focuses. Besides, members from different analyses times are on average unrelated. It was recommended to Working Group B of CTBTO to implement the ensemble system software in the near future.

Point-of-care ultrasound after attempted suicidal hanging.

Focused cardiac ultrasound (FoCUS) can provide critical information quickly to determine the etiology after cardiac arrest and may expedite a diagnosis in order to identify underlying treatable causes. We present a case of reversible acute left ventricular dysfunction after cardiopulmonary resuscitation following attempted suicide by hanging presenting with severe hypoxemia. FoCUS revealed findings consistent with severe left ventricular dysfunction, and point-of-care ultrasound (PoCUS) ruled out pneumothorax. These findings, in conjunction with the clinical presentation, facilitated an early identification and rapid evaluation of cardiogenic shock; furthermore, they led to the use of FoCUS, which can provide critical information quickly on site for a patient who is suddenly symptomatic after severe mechanical asphyxia in the pediatric emergency department, pediatric intensive care unit, or the prehospital setting.

Non-invasive cardiovascular assessment of pregnancy in healthy female cats.

INTRODUCTION: The aim of this study was to evaluate cardiac morphology, indices of systolic and diastolic function, systolic blood pressure (SBP), and uterine artery resistance index (RI) during normal feline pregnancy. ANIMALS; MATERIALS AND METHODS: Twenty domestic short-hair pregnant queens, weighing 2.4-3.9 kg. Animals were assessed by two-dimensional, M-mode, and Doppler echocardiography, non-invasive SBP measurement, and uterine Doppler ultrasound every 10 days from mating to parturition. RESULTS: Interventricular septal thickness at end-diastole and end-systole, left ventricular internal dimension at end-diastole, left ventricular free wall thickness at end-diastole and end-systole, fractional shortening, stroke volume, cardiac output (CO), heart rate, and peak velocities of early and late diastolic transmitral flow increased during the second half of gestation, while SBP and RI decreased during the same period (p < 0.01). DISCUSSION AND CONCLUSIONS: Cardiac structure and function varied during normal pregnancy in these queens. Eccentric hypertrophy, increased indices of systolic function, and increased measurements of CO seem to be the consequences of the hemodynamic modifications occurring during pregnancy. The assessment of maternal cardiovascular function may prove a useful screening tool to detect pregnancy complications in feline species.

Emerging applications at the interface of DNA nanotechnology and cellular membranes: Perspectives from biology, engineering, and physics.

DNA nanotechnology has proven exceptionally apt at probing and manipulating biological environments as it can create nanostructures of almost arbitrary shape that permit countless types of modifications, all while being inherently biocompatible. Emergent areas of particular interest are applications involving cellular membranes, but to fully explore the range of possibilities requires interdisciplinary knowledge of DNA nanotechnology, cell and membrane biology, and biophysics. In this review, we aim for a concise introduction to the intersection of these three fields. After briefly revisiting DNA nanotechnology, as well as the biological and mechanical properties of lipid bilayers and cellular membranes, we summarize strategies to mediate interactions between membranes and DNA nanostructures, with a focus on programmed delivery onto, into, and through lipid membranes. We also highlight emerging applications, including membrane sculpting, multicell self-assembly, spatial arrangement and organization of ligands and proteins, biomechanical sensing, synthetic DNA nanopores, biological imaging, and biomelecular sensing. Many critical but exciting challenges lie ahead, and we outline what strikes us as promising directions when translating DNA nanostructures for future in vitro and in vivo membrane applications.

Characterization of black spot resistance in diploid roses with QTL detection, meta-analysis and candidate-gene identification.

KEY MESSAGE: Two environmentally stable QTLs linked to black spot disease resistance in the Rosa wichurana genetic background were detected, in different connected populations, on linkage groups 3 and 5. Co-localization between R-genes and defense response genes was revealed via meta-analysis. The widespread rose black spot disease (BSD) caused by the hemibiotrophic fungus Diplocarpon rosae Wolf. is efficiently controlled with fungicides. However, in the actual context of reducing agrochemical use, the demand for rose bushes with higher levels of resistance has increased. Qualitative resistance conferred by major genes (Rdr genes) has been widely studied but quantitative resistance to BSD requires further investigation. In this study, segregating populations connected through the BSD resistant Rosa wichurana male parent were phenotyped for disease resistance over several years and locations. A pseudo-testcross approach was used, resulting in six parental maps across three populations. A total of 45 individual QTLs with significant effect on BSD resistance were mapped on the male maps (on linkage groups (LG) B3, B4, B5 and B6), and 12 on the female maps (on LG A1, A2, A3, A4 and A5). Two major regions linked to BSD resistance were identified on LG B3 and B5 of the male maps and were integrated into a consensus map built from all three of the male maps. A meta-analysis was used to narrow down the confidence intervals of individual QTLs from three populations by generating meta-QTLs. Two 'hot spots' or meta-QTLs were found per LG, enabling reduction of the confidence interval to 10.42 cM for B3 and 11.47 cM for B5. An expert annotation of NBS-LRR encoding genes of the genome assembly of Hibrand et al. was performed and used to explore potential co-localization with R-genes. Co-localization with defense response genes was also investigated.

Genetic determinism of prickles in rose.

KEY MESSAGE: The genetic determinism of prickle in rose is complex, with a major locus on LG3 that controls the absence/presence of prickles on the rose stem. Rose is one of the major ornamental plants. The selection of glabrous cultivars is an important breeding target but remains a difficult task due to our limited genetic knowledge. Our objective was to understand the genetic and molecular determinism of prickles. Using a segregating diploid rose F1 population, we detected two types of prickles (glandular and non-glandular) in the progeny. We scored the number of non-glandular prickles on the floral and main stems for three years. We performed QTL analysis and detected four prickle loci on LG1, 3, 4 and 6. We determined the credible interval on the reference genome. The QTL on LG3 is a major locus that controls the presence of prickles, and three QTLs (LG3, 4 and 1) may be responsible for prickle density. We further revealed that glabrous hybrids are caused by the combination of the two recessive alleles from both parents. In order to test whether rose prickles could originate from a 'trichome-like structure,' we used a candidate approach to characterize rose gene homologues known in Arabidopsis, involved in trichome initiation. Four of these homologues were located within the overlapping credible interval of the detected QTLs. Transcript accumulation analysis weakly supports the involvement of trichome homologous genes, in the molecular control of prickle initiation. Our studies provide strong evidence for a complex genetic determinism of stem prickle and could help to establish guidelines for glabrous rose breeding. New insights into the relationship between prickles and trichomes constitute valuable information for reverse genetic research on prickles.

Controlled Sign Reversal of Electroresistance in Oxide Tunnel Junctions by Electrochemical-Ferroelectric Coupling.

The persistence of ferroelectricity in ultrathin layers relies critically on screening or compensation of polarization charges which otherwise destabilize the ferroelectric state. At surfaces, charged defects play a crucial role in the screening mechanism triggering novel mixed electrochemical-ferroelectric states. At interfaces, however, the coupling between ferroelectric and electrochemical states has remained unexplored. Here, we make use of the dynamic formation of the oxygen vacancy profile in the nanometer-thick barrier of a ferroelectric tunnel junction to demonstrate the interplay between electrochemical and ferroelectric degrees of freedom at an oxide interface. We fabricate ferroelectric tunnel junctions with a La_{0.7}Sr_{0.3}MnO_{3} bottom electrode and BaTiO_{3} ferroelectric barrier. We use poling strategies to promote the generation and transport of oxygen vacancies at the metallic top electrode. Generated oxygen vacancies control the stability of the ferroelectric polarization and modify its coercive fields. The ferroelectric polarization, in turn, controls the ionization of oxygen vacancies well above the limits of thermodynamic equilibrium, triggering the build up of a Schottky barrier at the interface which can be turned on and off with ferroelectric switching. This interplay between electronic and electrochemical degrees of freedom yields very large values of the electroresistance (more than 10^{6}% at low temperatures) and enables a controlled switching between clockwise and counterclockwise switching modes in the same junction (and consequently, a change of the sign of the electroresistance). The strong coupling found between electrochemical and electronic degrees of freedom sheds light on the growing debate between resistive and ferroelectric switching in ferroelectric tunnel junctions, and moreover, can be the source of novel concepts in memory devices and neuromorphic computing.

DNA Nunchucks: Nanoinstrumentation for Single-Molecule Measurement of Stiffness and Bending.

Bending of double-stranded DNA (dsDNA) has important applications in biology and engineering, but measurement of DNA bend angles is notoriously difficult and rarely dynamic. Here we introduce a nanoscale instrument that makes dynamic measurement of the bend in short dsDNAs easy enough to be routine. The instrument works by embedding the ends of a dsDNA in stiff, fluorescently labeled DNA nanotubes, thereby mechanically magnifying their orientations. The DNA nanotubes are readily confined to a plane and imaged while freely diffusing. Single-molecule bend angles are rapidly and reliably extracted from the images by a neural network. We find that angular variance across a population increases with dsDNA length, as predicted by the worm-like chain model, although individual distributions can differ significantly from one another. For dsDNAs with phased A6-tracts, we measure an intrinsic bend of 17 ± 1° per A6-tract, consistent with other methods, and a length-dependent angular variance that indicates A6-tracts are (80 ± 30)% stiffer than generic dsDNA.

Kinetic Transition in Amyloid Assembly as a Screening Assay for Oligomer-Selective Dyes.

Assembly of amyloid fibrils and small globular oligomers is associated with a significant number of human disorders that include Alzheimer's disease, senile systemic amyloidosis, and type II diabetes. Recent findings implicate small amyloid oligomers as the dominant aggregate species mediating the toxic effects in these disorders. However, validation of this hypothesis has been hampered by the dearth of experimental techniques to detect, quantify, and discriminate oligomeric intermediates from late-stage fibrils, in vitro and in vivo. We have shown that the onset of significant oligomer formation is associated with a transition in thioflavin T kinetics from sigmoidal to biphasic kinetics. Here we showed that this transition can be exploited for screening fluorophores for preferential responses to oligomer over fibril formation. This assay identified crystal violet as a strongly selective oligomer-indicator dye for lysozyme. Simultaneous recordings of amyloid kinetics with thioflavin T and crystal violet enabled us to separate the combined signals into their underlying oligomeric and fibrillar components. We provided further evidence that this screening assay could be extended to amyloid-ß peptides under physiological conditions. Identification of oligomer-selective dyes not only holds the promise of biomedical applications but provides new approaches for unraveling the mechanisms underlying oligomer versus fibril formation in amyloid assembly.

Candidiasis mucocutanea generalizada en una paciente con sindrome poliglandular tipo 1. a proposito de un caso / Generalized mucocutaneous candidiasis in a child with type 1 polygenellular syndrome: a case proposed

Resumen La candidiasis mucocutánea crónica (CMC) es una enfermedad persistente no invasiva que tiene como característica afecciones que incluyen infección por Candida en piel, uñas y membranas mucosas, asociadas a manifestaciones autoinmunes secundarias a alteraciones genéticas en el sistema inmune. La mutación del gen regulador autoinmune AIRE es la principal causa de candidiasis mucocutánea crónica aunque otros genes han estado implicados total o parcialmente con fenotipos clínicos relacionados. Se presenta el caso de una niña de 15 años de edad, que ingresa en nuestra consulta con clínica de inmunosupresión, alteraciones endocrinológicas e infección por Candida Albicans, y que representó un reto diagnóstico.

Abstract Chronic Mucocutaneous Candidiasis is a non invasive persistent disease that has characteristics that include infection by Candida in skin, nails and mucous membranes, associated with several autoimmune diseases to genetic alterations in the immune system. The mutation of the AIRE autoimmune regulatory gene is the main cause of chronic mucocutaneous candidiasis, although other genes have been totally or partially implicated with related clinical phenotypes. We have the case of a 15-year-old girl who entered to our clinic with immunosuppression, endocrinological alterations and Candida Albicans infection, which represented a diagnostic challenge.

Ferroelectric Control of Interface Spin Filtering in Multiferroic Tunnel Junctions.

The electronic reconstruction occurring at oxide interfaces may be the source of interesting device concepts for future oxide electronics. Among oxide devices, multiferroic tunnel junctions are being actively investigated as they offer the possibility to modulate the junction current by independently controlling the switching of the magnetization of the electrodes and of the ferroelectric polarization of the barrier. In this Letter, we show that the spin reconstruction at the interfaces of a La_{0.7}Sr_{0.3}MnO_{3}/BaTiO_{3}/La_{0.7}Sr_{0.3}MnO_{3} multiferroic tunnel junction is the origin of a spin filtering functionality that can be turned on and off by reversing the ferroelectric polarization. The ferroelectrically controlled interface spin filter enables a giant electrical modulation of the tunneling magnetoresistance between values of 10% and 1000%, which could inspire device concepts in oxides-based low dissipation spintronics.

Molecular characterization of Trypanosoma cruzi and Leishmania spp. coinfection in mammals of Venezuelan coendemic areas.

BACKGROUND & OBJECTIVES: Trypanosoma cruzi and Leishmania spp. are protozoans that cause American trypanosomiasis and leishmaniasis, respectively. In endemic foci where both diseases coincide, coinfection can occur. The objective of this work was the characterization of the parasites involved in coinfection in several endemic areas of Venezuela. METHODS: Molecular characterization was done in 30 samples of several species of mammals (Didelphis marsupialis, Equus mulus, Rattus rattus, Canis familiaris, Felis catus, and Sciurus granatensis) from the states of Anzoategui, Cojedes and Capital District diagnosed with T. cruzi and Leishmania spp. coinfections. For the typing of T. cruzi DTUs, the markers of miniexon, 24Sa rDNA, 18Sa rDNA, and hsp60-PCR-RFLP (EcoRV) were used. Infection by Leishmania spp. was characterized by miniexon multiplex PCR for complexes of Leishmania and ITS1-PCR-RFLP (HaeIII, HhaI, and RsaI) for the identification of the species. RESULTS: The T. cruzi TcI was present in 100% of the coinfected mammals, which included 76.7% of triple infection by T. cruzi TcI-complex-L. (L) mexicana-L. infantum/chagasi, 13.3% of double infection by T. cruzi TcI-L. mexicana and 10% of double infection by T. cruzi Tcl-L. infantum/chagasi. INTERPRETATION & CONCLUSION: These results suggest that the double or triple infection is a phenomenon existing in almost all the coendemics areas and mammals studied, which might influence the mechanisms of adaptation and pathogenicity of these parasites.

Predictors of Mortality in Nondemented Patients With Parkinson Disease: Motor Symptoms Versus Nonmotor Symptoms.

BACKGROUND AND OBJECTIVE: The aim of this study is to identify risk factors for mortality in a community-based cohort of nondemented patients with Parkinson disease (PD) during prospective long-term follow-up, while also comparing the effect of motor complications to nonmotor symptoms (NMS) on risk of mortality. METHODS: One hundred forty seven nondemented patients with PD (57.1% males; 70.9 ± 8.6 years old) were included in this 48 month follow-up, longitudinal, single, evaluation study. Motor and therapy-related complications were assessed using the Unified Parkinson's Disease Rating Scale/part-IV (UPDRS-IV). Non-Motor Symptoms Scale (NMSS) total score was used to assess NMS burden. Cox proportional hazard models were applied to identify independent predictors of mortality during follow-up. RESULTS: Twenty-two patients of 146 (15.1%) died (1 case without information). Both UPDRS-IV and NMSS total scores were higher at baseline in patients with PD who died (3.5 ± 3.1 vs 2.4 ± 2.4, P = .049 and 96.9 ± 58.6 vs 61.9 ± 51.0, P = .004, respectively). Unadjusted hazard ratios (HRs) associated with UPDRS-IV and NMSS total scores among those who died during follow-up were 1.171 (95% confidence interval [CI]: 1.012-1.357; P = .035) and 1.008 (95% CI: 1.002-1.013; P = .006), respectively. Independent predictors of mortality during follow-up after adjusting for other covariates were UPDRS-IV (HR: 1.224; 95% CI: 1.002-1.494; P = .047), age (HR: 1.231; 95% CI: 1104-1.374; P < .0001), and comorbidity (Charlson Index; HR: 1.429; 95% CI: 1.023-1.994; P = .036), but not NMSS total score (HR: 1.005; 95% CI: 0.996-1.014; P = .263). CONCLUSIONS: Both motor complications (UPDRS-IV) and NMS (NMSS) were associated with mortality at 4 years, being motor complications an independent predictor of it.

Anthracycline-based triplets do not improve the efficacy of platinum-fluoropyrimidine doublets in first-line treatment of advanced gastric cancer: real-world data from the AGAMEMON National Cancer Registry.

BACKGROUND: Although anthracycline-based triplets are one of the most widely used schedules to treat advanced gastric cancer (AGC), the benefit of including epirubicin in these therapeutic combinations remains unknown. This study aims to evaluate both the efficacy and tolerance of triplets with epirubicin vs. doublets with platinum-fluoropyrimidine in a national AGC registry. METHODS: Patients with AGC treated with polychemotherapy without trastuzumab at 28 hospitals in Spain between 2008 and 2016 were included. The effect of anthracycline-based triplets against doublets was evaluated by propensity score matching (PSM) and Cox proportional hazards (PH) regression. RESULT: A total of 1002 patients were included (doublets, n = 653; anthracycline-based triplets, n = 349). The multivariable Cox PH regression failed to detect significantly increased OS in favor of triplets with anthracyclines: HR 0.90 (95% CI, 0.78-1.05), p = 0.20035. After PSM, the sample contained 325 pairs with similar baseline characteristics. This method was also unable to reveal an increase in OS: 10.5 (95% CI, 9.7-12.3) vs. 9.9 (95% CI, 9.2-11.4) months, HR 0.91 (CI 95%, 0.76-1.083), and (log-rank test, p = 0.226). Response rates (42.1 vs. 33.1%, p = 0.12) and PFS (HR 0.95, CI 95%, 0.80-1.13, log-rank test, p = 0.873) were not significantly higher with epirubicin-based regimens. The triplets were associated with greater grade 3-4 hematological toxicity, and increased hospitalization due to toxicity by 68%. The addition of epirubicin is viable, but 23.7% discontinued treatment because of adverse effects or patient decision. CONCLUSION: Anthracyclines added to platinum-fluoropyrimidine doublets did not improve the response rate or survival outcomes in patients with AGC but entailed greater toxicity.

Echocardiographic and electrocardiographic parameters during the normal postpartum period in toy breeds of dogs.

The aim of this study was to evaluate echocardiographic and electrocardiographic parameters during the normal canine postpartum period. Twenty clinically healthy pregnant bitches of toy breeds (11 Miniature poodles, five Yorkshire terriers, two Maltese terriers and two Bichons Frises) were evaluated on days -3, 3, 10, 17, 24, 38, 52 and 80 relative to parturition (day 0). During the first postpartum week, the width of the interventricular septum in systole, the shortening fraction and the left atrium size decreased, while the left ventricle internal diameter in systole and end systolic stress increased. There were progressive decreases in the velocity of circumferential fibre shortening, stroke volume, cardiac output, and mitral E and A wave values. Systolic blood pressure increased markedly during the first postpartum week to gradually increase thereafter. Heart rate and corrected QT interval progressively decreased, while P wave amplitude increased. QRS complex amplitude decreased in the second week after parturition and then increased during the following weeks. In conclusion, there were changes in systolic function and some structural adaptive changes in the bitch during the first 80days postpartum. In addition, maternal heart rate and corrected QT interval decreased, while P wave and QRS amplitudes increased.