Association between R2CHA2DS2-VASc score and three-vessel coronary artery disease in a large population at high cardiovascular risk.

Coronary artery disease (CAD), particularly three-vessel coronary disease (3VD), is the main cause of death in industrialized countries. Chronic kidney disease is an independent risk factor for CAD. The CHA2DS2-VASc score shows a good ability to predict CV events in high-risk population independently from atrial fibrillation. The aim of the present study was to evaluate the association between the R2CHA2DS2-VASc score and 3VD in a population of patients at high cardiovascular risk. Monocentric prospective study evaluated 1017 patients undergoing coronary angiography. The R2CHA2DS2-VASc score was obtained by adding 2 points to the CHA2DS2-VASc score in case of eGFR < 60 ml/min/1.73m2. Coronary lesions causing ≥ 50% reduction of a major epicardial vessel diameter were considered significant. Patients were grouped based on R2CHA2DS2-VASc tertiles and according to the severity of CAD: 3VD vs No-3VD. The 3VD group showed significantly higher R2CHA2DS2-VASc score than the No-3VD group (4.20 ± 2.18 vs 3.36 ± 2.06, p < 0.001). The risk of 3VD increased by 21% for every 1-point increase in the score (OR 1.21; 95% CI 1.13-1.28, p < 0.001). The prevalence of 3VD was higher among patients belonging to higher tertiles of R2CHA2DS2-VASc (17.2% vs 26.7% vs 33.6% for first, second, and third tertile respectively, p < 0.001) with a risk more than doubled for the third tertile compared to the first one (OR 2.45; 95% CI 1.71-3.49, p < 0.001). The R2CHA2DS2-VASc score is independently associated with 3VD in patients at high cardiovascular risk. The score could be considered a useful tool for clinicians to identify patients who are at high risk of 3VD.

Oropouche fever cases diagnosed in Italy in two epidemiologically non-related travellers from Cuba, late May to early June 2024.

Oropouche fever is caused by Oropouche virus (OROV), transmitted primarily through the bite of infected midges, particularly of the genus Culicoides. The virus is mainly circulating in Central and South America where several countries reported an ongoing outbreak. We report here two imported cases of OROV infection identified in Italy, late May-early June 2024. These cases indicate that in the shadow of a massive dengue outbreak in the Americas, the Oropouche outbreak might be more widespread than previously estimated.

Efectos tóxicos en rheina y naftazarina en neutrofilos humanos in vitro / Toxic effects of rhein and naphthazarin in human neutrophilus in vitro

Recientemente se demostró en el BIOMED que la fracción de bajo peso molecular de Aloe barbadensis, rica en antraquinonas, es citotóxica en neutrófilos humanos (PMNs). Sin embargo, algunas antraquinonas como rheína (RH) han mostrado propiedades antiinflamatorias. Debido a que los PMNs son células proinflamatorias cuando se activan, se estudiaron los efectos relacionados con la activación de su NADPH-oxidasa en presencia de rheína. Paralelamente, se estudiaron afectos similares de la naftoquinona naftazarina (NZ), ya que ésta ha mostrado ser una de las quinonas de mayor toxicidad, a través de mecanismos relacionados con estrés oxidativo y adición nucleofílica de compuestos sulfhidrílicos. Así, la incubación de los PMNs con las quinonas a altas concentraciones no produjo pérdidas de viabilidad importantes; NZ ocasionó una pérdida cercana al 40 por ciento y RH mostró poca toxicidad con respecto al control. Además, no se observaron indicios de peroxidación lipídica en los PMNs incubados con ambas drogas. La exposición de las células con NZ ocasionó disminución del glutatión intracelular. Sin embargo, RH no mostró efecto alguno sobre el mismo. Cuando los PMNs se incubaron con las quinonas a bajas concentraciones y se realizaron ensayos sobre la NADPH oxidasa, se mostró que NZ es un potente inhibidor del estallido respiratorio en presencia de los activadores fMLP y PMA. La antraquinona RH mostró un comportamiento diferente ya que se produjo inhibición del estallido respiratorio sólo en presencia de fMLP. Esta conducta se asemeja a conocidos inhibidores de tirosina quinasas y puede estar relacionada con sus efectos antiflamatorios