Single-cell atlas of the small intestine throughout the human lifespan demonstrates unique features of fetal immune cells.

Proper development of mucosal immunity is critical for human health. Over the past decade, it has become evident that in humans, this process begins in utero. However, there are limited data on the unique features and functions of fetal mucosal immune cells. To address this gap, we integrated several single-cell ribonucleic acid sequencing datasets of the human small intestine (SI) to create an SI transcriptional atlas throughout the human life span, ranging from the first trimester to adulthood, with a focus on immune cells. Fetal SI displayed a complex immune landscape comprising innate and adaptive immune cells that exhibited distinct transcriptional programs from postnatal samples, especially compared with pediatric and adult samples. We identified shifts in myeloid populations across gestation and progression of memory T-cell states throughout the human lifespan. In particular, there was a marked shift of memory T cells from those with stem-like properties in the fetal samples to fully differentiated cells with a high expression of activation and effector function genes in adult samples, with neonatal samples containing both features. Finally, we demonstrate that the SI developmental atlas can be used to elucidate improper trajectories linked to mucosal diseases by implicating developmental abnormalities underlying necrotizing enterocolitis, a severe intestinal complication of prematurity. Collectively, our data provide valuable resources and important insights into intestinal immunity that will facilitate regenerative medicine and disease understanding.

Subjective well-being, happiness, and environmental health factors related to women planning a pregnancy or pregnant, using mobile health intervention.

Objectives: To compare the environmental health results in women trying to get pregnant or pregnant using a mobile health application (Green Page) through healthcare professionals or self-completed by women, and to explore the relationship between the subjective well-being of these women with their lifestyles and environmental factors. Methods: A descriptive study with mixed methods was conducted in 2018. A mobile health survey was used in two phases. Phase 1 was a cross-sectional study through professionals (n = 1100) followed by phase 2, a convenience sampling through women's self-reporting (n = 3425). A personalized report was downloadable with health recommendations for the well-being of the mother and child. Results: Of the 3205 participants (mean age = 33 years, SD = 0.2 years), 1840 were planning a pregnancy and 1365 were pregnant. One in five pregnant women had a low level of happiness. Globally, subjective well-being and happiness were found to be negatively associated with lack of contact with nature, sedentary lifestyle, excess weight, environmental exposure, and older age in pregnancy. Precisely 45%, 60%, and 14% of women were exposed to tobacco, alcohol, and illegal drugs, respectively. The women self-reported levels of risk factors higher than when the tool was used by or through professionals. Conclusions: The use of mobile health interventions focused on environmental health during planning or pregnancy periods could help improve the quality of healthcare and foster greater involvement of women in their self-care process, thus promoting empowerment, healthier environments, and lifestyles. Ensuring equity of access and data protection are global challenges to be addressed.

Immune dysregulation in Glycogen Storage Disease 1b - a CyTOF approach.

Glycogen Storage Disease type 1b (GSD1b) is a rare disease manifesting as hypoglycemia, recurrent infections and neutropenia, resulting from deleterious mutations in the SLC37A4 gene encoding the glucose-6-phosphate transporter. The susceptibility to infections is thought to be attributed not only to the neutrophil defect, though extensive immunophenotyping characterization is currently missing. Here we apply a systems immunology approach utilizing Cytometry by Time Of Flight (CyTOF) to map the peripheral immune landscape of 6 GSD1b patients. When compared to control subjects, those with GSD1b had a significant reduction in anti-inflammatory macrophages, CD16+ macrophages, and Natural Killer cells. Additionally, there was a preference towards a central versus an effector memory phenotype in multiple T cell populations, which may suggest that these changes stem from an inability of activated immune cell populations to undergo the appropriate switch to glycolytic metabolism in the hypoglycemic conditions associated with GSD1b. Furthermore, we identified a global reduction of CD123, CD14, CCR4, CD24 and CD11b across several populations and a multi-cluster upregulation of CXCR3, hinting at a potential role of impaired immune cell trafficking in the context of GSD1b. Taken together, our data indicates that that the immune impairment observed in GSD1b patients extends far beyond neutropenia and encompasses innate and adaptive compartments, which may provide novel insights into the pathogenesis of this disorder.

Leucoencefalopatía multifocal progresiva: enfermedad grave en el paciente inmunosuprimido. Reporte de caso / Progressive multifocal leukoencephalopathy: severe disease in the immunosuppressed patient. Case report

RESUMEN INTRODUCCIÓN: Los pacientes con compromiso del sistema inmune pueden desarrollar una enfermedad neurológica incapacitante e incluso mortal, como lo es la leucoencefalopatía multifocal progresiva (LMP) producida por el virus de John Cunningham (JC). PRESENTACIÓN DEL CASO: Se presenta el caso de un hombre de 26 años con diagnóstico reciente de infección por virus de la inmunodeficiencia humana (VIH) que presentó síntomas constitucionales, déficit neurológico progresivo por hemiparesia espástica izquierda, disminución de la agudeza visual y cambios comportamentales. En las imágenes de resonancia magnética (IRM) cerebral contrastada se encontró afectación subcortical difusa de la sustancia blanca con compromiso de las fibras en U que, correlacionado con una prueba de reacción en cadena de la polimerasa (PCR) para virus JC en LCR, confirmó el diagnóstico de LMP. DISCUSIÓN: La LMP puede manifestarse por medio de síntomas cognitivos usualmente imperceptibles para el clínico, pero también como déficit sensorio-motor y visual que se puede corroborar en las IRM al identificar las lesiones típicas en la sustancia blanca, o bien por medio de detección del virus por PCR en líquido cefalorraquídeo. El manejo específico de la causa que desencadenó la inmunosupresión sigue siendo el pilar de tratamiento. CONCLUSIÓN: La mínima sospecha diagnóstica en aquellos pacientes con factores de riesgo y manifestaciones clínicas concordantes con la enfermedad debe llevar a que se confirme el diagnóstico y que se inicie prontamente el manejo terapéutico en búsqueda de restablecer la respuesta inmune.

ABSTRACT INTRODUCTION: Patients with immunocompromised or weakened immune system can develop a disabling and even life-threatening neurological disorder such as progressive multifocal leukoencephalopathy (PML) caused by John Cunningham (JC) virus. CASE PRESENTATION: We present the case of a 26-year-old man with a recent diagnosis of human immunodeficiency virus (HIV) infection who presented constitutional symptoms, progressive neurological deficit due to left spastic hemiparesis with decreased visual acuity and behavioral changes. The brain Magnetic Resonance Imaging (MRI) showed diffuse subcortical involvement of the white matter including the U-fibers, which, correlated with a detection of JC virus DNA by polymerase chain reaction (PCR) cerebrospinal fluid, confirmed the diagnosis of PML. DISCUSSION: PML can range from subtle cognitive impairment imperceptible to the clinician to sensory-motor deficits and visual disturbances that can be corroborated in MRI by identifying the typical lesions in the white matter or by detecting the virus by PCR in cerebrospinal fluid. The specific management of the cause that triggered the immunosuppression continues to be the mainstay of treatment. CONCLUSION: At the minimum diagnostic suspicion in patients with risk factors and clinical manifestations consistent with the disease should proceed to confirm the diagnosis and promptly immune reconstitution.

Hydrothermal Synthesis of Fluorapatite Coatings over Titanium Implants for Enhanced Osseointegration-An In Vivo Study in the Rabbit.

This work aims at the development and characterization of fluorapatite coatings, innovatively prepared by the hydrothermal method, aiming for enhanced osseointegration of titanium implants. Fluoride-containing coatings were prepared and characterized by scanning and transmission electron microscopy, Fourier-transform infrared spectroscopy-attenuated total reflectance, and X-ray photoelectron spectroscopy. The biological response was characterized by microtomographic evaluation and histomorphometric analysis upon orthotopic implantation in a translational rabbit experimental model. Physic-chemical analysis revealed the inclusion of fluoride in the apatite lattice with fluorapatite formation, associated with the presence of citrate species. The in vivo biological assessment of coated implants revealed an enhanced bone formation process-with increased bone-to-implant contact and bone volume. The attained enhancement of the osteogenic process may be attributable to the conjoined modulatory activity of selected fluoride and citrate levels within the produced coatings. In this regard, the production of fluorapatite coatings with citrate, through the hydrothermal method, entails a promising approach for enhanced osseointegration in implant dentistry and orthopedic applications.

Mercury (II) removal from aqueous solutions by iron nanoparticles synthesized from extract of Eucalyptus grandis.

Artisanal mining is the main source of mercury emissions in South America, which generates a serious environmental impact due to this toxic metal, recent research is directed to minimize the impact, therefore this study focuses on the green synthesis of nanoparticles for the absorption of mercury in water. For the synthesis of iron nanoparticles, an extract of Eucalyptus grandis was used with iron chloride salts using water as solvent. The synthesized nanoparticles showed a specific surface area of 131.90 m2/g, determined by Brunauer-Emmett-Teller isotherm (BET). Nanoparticles were characterized by Fourier transformed infrared spectroscopy (FTIR) and transmission electron microscopy (MET). The behavior of nanoparticles synthesized during Hg (II) retention was evaluated measuring pH, temperature, nanoparticle dosing, presence of other ions and comparing with other adsorbents. All analyses measured by atomic absorption spectroscopy by the cold vapor technique (CVAAS), presenting a retention percentage for Hg (II) between 75.05 and 79.59% with pH between 4 and 7. The adsorption isothermal was adjusted to the Freundlich model and the percentage of retention of Hg by the synthesized nanoparticle was 79.26%. This work shows a method for obtaining an environmentally friendly mercury adsorbent from iron and E. grandis with a mercury retention capacity comparable to commercial adsorbents.

Factores de riesgo neuropsicológico y de personalidad asociados en la poliaccidentalidad laboral / Associated neuropsychological and personality risk factors in occupational polyaccidentality

Introducción: El bienestar y la salud de cada uno de los trabajadores son primordiales en el Departamento de Salud Ocupacional de la Fundación Hospital Universitario Metropolitano. Es importante que el personal goce de un nivel de vida saludable para cumplir satisfactoriamente con todas sus obligaciones y las metas planeadas de la organización. Objetivo: Analizar los factores neuropsicológicos y de personalidad asociados en un grupo de personas que se han accidentado dos o más veces (poliaccidentados). Métodos: Se desarrolló un diseño metodológico de casos y controles. Se tomó como población las bases de datos del departamento de seguridad y salud en el trabajo, con 50 trabajadores accidentados en dos o más ocasiones (poliaccidentados). Se aplicaron como técnicas de recolección de datos la escala abreviada de inteligencia Reynolds (Rist) para apreciar el coeficiente de inteligencia de los sujetos y el cuestionario de personalidad de Cattell (16 Pf), que midió 16 factores primarios y cuatro secundarios. Se utilizó la Batería Neuropsicológica de Funciones Ejecutivas y Lóbulos Frontales (BANFE) para evaluar los factores neuropsicológicos. Resultados: fue procesados mediante el paquete estadístico Statistical package Social Science (Spss) versión 21.0 que permitió realizar la prueba de hipótesis para las variables estudiadas, se utilizó la prueba U de Mann Whitney, con un criterio alfa de 0,05 y un nivel de confianza del 95 por ciento. Conclusiones: El grupo de poliaccidentados presentó alteraciones en las áreas orbito-medial, ventromedial y dorso-laterales lo que los predispone a una mayor posibilidad de realizar actividades riesgosas y presentar menor consciencia del riesgo(AU)

Introduction: The well-being and health of each of the workers are paramount in the Department of Occupational Health at Fundación Hospital Universitario Metropolitano. It is important that the staff enjoy a healthy standard of living in order to satisfactorily fulfil all their obligations and the planned goals of the organization. Objective: To look at the neuropsychological and personality factors associated in a group of individuals who have been injured two or more times (poly-accidented). Methods: A case-control methodological design was developed. The databases of the Department of Labor Safety and Health were taken as the population, with 50 workers injured on two or more occasions (poly-accidents). The abbreviated Reynolds Intelligence Scale (Rist) was applied as data collection techniques to assess the intelligence coefficient of the subjects and Cattell personality questionnaire (16 Pf), to measured 16 primary factors and four secondary factors. The Neuropsychological Battery of Executive Functions and Frontal Lobes (BANFE) was used to evaluate neuropsychological factors. Results: They were processed using the Statistical Package Social Science (Spss) version 21.0 that allowed the hypothesis test to be carried out for the variables studied, Mann Whitney U test was used, with 0.05 alpha criterion and 95 percent level of confidence. Conclusions: The group of poly-accidented patients showed alterations in the orbito-medial, ventromedial and dorso-lateral areas, which predisposes them to greater possibility of carrying out risky activities and presenting less risk awareness(AU)

Effect of endovenous lidocaine on analgesia and serum cytokines: double-blinded and randomized trial.

STUDY OBJECTIVE: This trial aimed to compare postoperative analgesia, opioid consumption, duration of ileus and hospital stay, and cytokine levels in patients undergoing laparoscopic cholecystectomies who received intravenous lidocaine in comparison with a control group. DESIGN: Prospective, longitudinal, double-blind, and randomized study. SETTING: Operating room and postoperative recovery area. PATIENTS: Forty-four American Society of Anesthesiologists I and II patients older than 17 years, undergoing laparoscopic cholecystectomy, under general anesthesia. INTERVENTIONS: The first group received intravenous lidocaine during the procedure until 1 hour postoperatively, whereas the second group received saline. Both groups received dipyrone and morphine patient-controlled analgesia. MEASUREMENTS: Pain was assessed by Visual Numeric Scale at rest and when coughing at different times after the end of the surgery. Blood samples were taken at the end of procedure and 24 hours later. The total morphine patient-controlled analgesia demand, the time for the first flatus, and the length of hospital stay were also recorded. MAIN RESULTS: Groups were similar in relation to sex (P= .2), age (P= .5), weight (P= .08), and length of surgery (P= .6). No differences were observed regarding the intensity of postoperative pain between the groups, either at rest (P= .76) or when coughing (P= .31), in morphine consumption (P= .9), and in the duration of ileus (P= .5) or length of hospital stay (P= .9). The inflammatory markers interleukin (IL)-1 (P= .02), IL-6 (P< .01), interferon-γ (P< .01), and tumor necrosis factor α (P< .01) showed significant reduction in the lidocaine group against the placebo group, except IL-10 (P= .01), that, because of its anti-inflammatory effects, increased its concentration. CONCLUSIONS: Intravenous lidocaine was not able to reduce postoperative pain, opioid consumption, and duration of ileus or length of hospital stay. However, its anti-inflammatory effect was noticeable.

Statistical analysis of teeth autotransplantation in Portugal's region of Chaves.

AIM: The aim of this study was to evaluate the success rate of 33 transplanted teeth in a northern population of Portugal. METHODS: The mean follow-up period was 7 years, ranging from 6 months to 20 years. RESULTS: Six teeth (18%) were rated as unsuccessful, 52% of the donor teeth were transplanted to receptor alveolus after immediate exodontia and 24% were transplanted to receptor alveolus surgically prepared. From the total number of cases, 64% had open root apex at the time of the transplantation and, in the latest control, of all teeth root development was over in 55%. Teeth ankylosis was present in 38% of all cases and 58% of all 33 transplants presented pulpar vitality. Data shows that, in males, teeth transplanted into natural alveolus were non-ankylosed, with normal color and vital teeth with incomplete root development at the time of the surgery. All cumulative curves obtained showed no statistical significance, mainly due to the low number of unsuccessful teeth autotransplantations. Orthodontic treatment performed after tooth autotransplantation showed success in 15% of all cases. CONCLUSION: Data reconfirms that autotransplantation of teeth is, in selected patients, the best option to replace a missing tooth in young patients.

[Bullying and its association with psychiatric disorders in a Mexican students sample]. / El acoso escolar (bullying) y su asociación con trastornos psiquiátricos en una muestra de escolares en México.

OBJECTIVE: To study the relationship between bullying behavior and psychopathology. MATERIALS AND METHODS: A total of 1 092 students identified their peers' bullying status based on the Bull-S questionnaire. Parents completed the Child Behavior Checklist (CBCL) to determine psychopathology levels. RESULTS: The bullying group had associations with anxiety, somatic symptoms, oppositionalism and behavior problems; the bully-victims group had associations with attention, oppositionalism and behavior problems; victims had higher anxiety scores.These differences were significant compared with the control group. CONCLUSIONS: Bullying is associated with psychopathology, which requires timely psychiatric attention.

El acoso escolar (bullying) y su asociación con trastornos psiquiátricos en una muestra de escolares en México / Bullying and its association with psychiatric disorders in a Mexican students sample

OBJETIVO: Estudiar la relación entre el tipo de psicopatología y el acoso escolar en una muestra de niños de las escuelas públicas de la Ciudad de México. MATERIAL Y MÉTODOS: Un total de 1 092 escolares identificó por medio del Test Bull-S a un grupo de agresores,víctimas,víctima-agresores y neutros. Los padres contestaron la Lista de Síntomas del Niño (Child Behavior Checklist, CBCL) para determinar el rango clínico de psicopatología. RESULTADOS: El grupo de agresores tuvo asociación con las escalas de ansiedad, síntomas somáticos, oposicionismo y de conducta. El grupo de víctima-agresores presentó asociación con los problemas de atención,oposicionismo y de conducta.En el grupo de víctimas las asociaciones encontradas fueron con los problemas de ansiedad.Estas diferencias fueron significativas frente al grupo control (neutros). CONCLUSIÓN: El acoso escolar se asocia con psicopatología que requiere de atención psiquiátrica oportuna.

OBJECTIVE: To study the relationship between bullying behavior and psychopathology. MATERIALS AND METHODS: A total of 1 092 students identified their peers' bullying status based on the Bull-S questionnaire. Parents completed the Child Behavior Checklist (CBCL) to determine psychopathology levels. RESULTS: The bullying group had associations with anxiety, somatic symptoms, oppositionalism and behavior problems; the bully-victims group had associations with attention, oppositionalism and behavior problems; victims had higher anxiety scores.These differences were significant compared with the control group. CONCLUSIONS: Bullying is associated with psychopathology, which requires timely psychiatric attention.

Effect of cyclic loading and environmental aging on the fracture toughness of dental resin composite.

OBJECTIVE: The main purpose of this study was (1) to investigate the effects of cyclic loading and environmental aging on three dental resin composites with different filler compositions: a fiber filler, a hybrid filler, and a microfill; and (2) to predict fracture in dental resin composite under mixed-mode loading conditions. METHODS: Diametral disk specimens 25 mm in diameter and 2 mm in thickness were used in this study. Two methods were used for generating initial cracks in the specimen. The first method involved machining a 3-mm notch in the center of the disk specimens, and then the notch tips were sharpened with a 0.2-mm-diameter jeweler's saw blade. In the second method for obtaining sharper crack tips, a three-way wedge was forced into a 3.175-mm hole drilled in the center of the specimen, resulting in sharp cracks emanating from the notch tips. CYCLIC TESTS: The specimens were aged for 4 months in air, water, artificial saliva, and a 50/50 (by volume) mixture of ethanol and water at room temperature in sealed polyethylene containers. Both unaged and aged specimens (5 specimens for each variable) were subjected to cyclic loading at a frequency of 5 Hz with sinusoidal loads cycling for 1, 1000, and 100,000 cycles at a load level approximately 60% of the fracture load for noncycled specimens. Following load cycling, the specimens were tested in compression in a displacement-controlled loading mode at a loading rate of 1.27 mm/min. RESULTS: Test results show that aging in a 50/50 alcohol-water mixture lowered the fracture toughness of dental resin composite, which was further reduced by cyclic loading. MIXED-MODE TESTS: The maximum tensile stress (MTS) criterion was used to predict fracture in dental resin composite under mixed-mode loading conditions. The loads at failure were used as input into a finite element model. After obtaining the stress field in the specimens by the finite element method, the mixed-mode stress intensity factors were calculated using an interaction energy integral method. RESULTS: Good agreement was obtained between the fracture envelope predicted by the MTS criterion and the experimental fracture toughness data. Hence, it can be concluded that it is only necessary to characterize the mode I fracture toughness to fully characterize the mixed-mode behavior of the dental resin composites that were considered in the present study.

Reproducción, distribución y abundancia del pez Pseudupeneus grandisquamis (Perciformes: Mullidae), en el Golfo de Tehuantepec, México / Reproduction, distribution and abundance of the fish Pseudupeneus grandisquamis (Perciformes: Mullidae), in the Gulf of Tehuantepec, Mexico

As result of its biological and ecological strategies, Pseudupeneus grandisquamis is a dominant species in the demersal community of the Gulf of Tehuantepec, Mexico. Our main objective was to understand these strategies with respect to distribution, abundance and reproduction. We analyzed 5,175 individuals representing partial collections from five oceanographic expeditions between 1989 and 1990. It is a typical demersal marine species, with a wide distribution on the continental shelf. The highest abundance of P. grandisquamis occurs in March and November, around the 40 m isobath, facing the Superior-Inferior lake systems and Mar Muerto Lagoon. Reproduction occurred during all of the months studied, particularly from August to October, corresponding to the rainy season, when the salinity and temperature is lower. The presence of juveniles, principally in November and March, suggests a long period of recruitment; they are distributed mainly in the Superior-Inferior Lagoons, which serves as a nursery area where they remain until they are adults. The total female to male sex ratio was nearly 1:1 throughout the year. The maximum total length was 213 mm and the size at first maturity was 138 mm TL. The high abundance and reproduction occur when the gulf has a high level of ecological production, in accordance with the dynamics of the system, where the influence of coastal lagoons is important. Protection strategies for the area above the continental shelf of the Gulf of Tehuantepec are recommended for the estuary processes and for the reproduction and rearing of a large number of species, including P. grandisquamis.

Como resultado de sus estrategias biológicas y ecológicas, el pez Pseudupeneus grandisquamis es una especie dominante en la comunidad demersal del Golfo de Tehuantepec. Nuestro principal objetivo fue conocer estas estrategias con base en su distribución, abundancia y reproducción. Se analizaron un total de 5 175 individuos que forman parte de las recolectas de peces obtenidas en cinco cruceros oceanográficos realizados en el Golfo de Tehuantepec, México, entre 1989-1990. Es una especie demersal típicamente marina, con amplia distribución en la plataforma continental. La mayor abundancia de P. grandisquamis se presenta en marzo y noviembre, alrededor de la isobata de los 40 m y frente a los sistemas lagunares Superior-Inferior y Laguna del Mar Muerto. La reproducción de la especie se presenta durante todos los meses analizados, principalmente durante los meses de agosto a octubre, correspondiente a la época de lluvias. La presencia de jóvenes, principalmente en noviembre y marzo, sugiere un amplio periodo de reclutamiento durante estos meses cuya distribución se refleja principalmente en el área influenciada por las lagunas Superior-Inferior, que representa un área de crianza. La proporción sexual total hembras:machos fue prácticamente 1:1. La talla máxima en la región es de 213 mm y la talla de primera madurez es de 138 mm LT. La alta abundancia y reproducción se presentan cuando el golfo tiene alta producción, acorde con la dinámica del sistema, donde tiene gran relevancia la influencia de las lagunas costeras. Se sugiere aplicar estrategias de protección a las zonas sobre la plataforma continental del Golfo de Tehuantepec influenciadas por procesos estuarinos y que representan áreas de reproducción y crianza para un gran número de especies, entre las que se encuentra P. grandisquamis.

[Reproduction, distribution and abundance of the fish Pseudupeneus grandisquamis (Perciformes: Mullidae), in the Gulf of Tehuantepec, Mexico]. / Reproducción, distribución y abundancia del pez Pseudupeneus grandisquamis (Perciformes: Mullidae), en el Golfo de Tehuantepec, México.

As result of its biological and ecological strategies, Pseudupeneus grandisquamis is a dominant species in the demersal community of the Gulf of Tehuantepec, Mexico. Our main objective was to understand these strategies with respect to distribution, abundance and reproduction. We analyzed 5,175 individuals representing partial collections from five oceanographic expeditions between 1989 and 1990. It is a typical demersal marine species, with a wide distribution on the continental shelf. The highest abundance of P. grandisquamis occurs in March and November, around the 40 m isobath, facing the Superior-Inferior lake systems and Mar Muerto Lagoon. Reproduction occurred during all of the months studied, particularly from August to October, corresponding to the rainy season, when the salinity and temperature is lower. The presence of juveniles, principally in November and March, suggests a long period of recruitment; they are distributed mainly in the Superior-Inferior Lagoons, which serves as a nursery area where they remain until they are adults. The total female to male sex ratio was nearly 1:1 throughout the year. The maximum total length was 213 mm and the size at first maturity was 138 mm TL. The high abundance and reproduction occur when the gulf has a high level of ecological production, in accordance with the dynamics of the system, where the influence of coastal lagoons is important. Protection strategies for the area above the continental shelf of the Gulf of Tehuantepec are recommended for the estuary processes and for the reproduction and rearing of a large number of species, including P. grandisquamis.

Cardiomiopatia dilatada familiar / Dilated familiar cardiomyopathy

Se presenta un estudio de 12 pacientes con cardiomiopatía dilatada (CMD), correspondientes a 3 generaciones de un segmento familiar, señalándose principalmente sus características clínicas y electrocardiográficas. Una etapa pre-clínica de larga duración, cursa con compromiso auricular izquierdo y prolongación de la conducción aurículo-ventricular (AV). Posteriormente se incrementa el bloqueo AV y se instala bloqueo intraventricular izquierdo; esta etapa, de corta evolución (1-4 años), estuvo asociada a insuficiencia cardíaca congestiva y/o embolismo sistémico. En 3 casos autopsiados se encontró extensa cardiomiocitolisis, escasa o nula fibrosis, y evidencia de inflamación en uno de ellos. Se comentan algunos aspectos de la génesis, diagnóstico y tratamiento de la CMD familiar

Miocardiopatia hipertrófica apical / Apical hypertrophic cardiomyopathy

Os autores fizeram a revisäo de 4591 pacientes submetidos ao cateterismo cardíaco com cineangiocoronariografia e encontraram 246 (5,3%) portadores de miocardiopatias em geral. Destes, 45 (0,98% do geral e 18,3% do grupo) apresentavam Cardiomiopatia Hipertrófica (CH), sendo que os últimos 34 pacientes foram estudados por apresentarem a cineventriculografia simultânea no VD-VE em OAE a 60 graus (CS VD-VE). Os autores encontraram 3 grupos de CH: 1 - CH clássica: 19 pacientes (55,9%). 2 - CH apical )MHA): 9 pacientes (26,5%) 3 - CH mista (grupo 1 + grupo 2): 6 pacientes (17,6%). Os autores estudaram particularmente a Miocardiopatia Hipertrófica Apical (grupo 2), que apresentou aspectos clínicos, radiológicos, eletrocardiográficos, ecocardiográficos, hemodinâmicos e cineangiocardiográficos especiais. Os autores concluíram que: 1 - A MHA é um tipo de CH näo obstrutiva que necessita ser devidamente procurada para se fazer o diagnóstico. 2 - O diagnóstico pode ser feito através do ecocardiograma e da CS VD-VE. 3 - Os nossos dados do E.C.G. na MHA näo apresentaram aspectos que pudessem ser imputados como características da doença

Desempenho da funçäo ventricular na pericardite crónica constritiva / Performance of ventricular function in chronic constrictive pericarditis

Os autores avaliaram a funçäo ventricular em 13 pacientes com PCC através dos registros pressóricos intracardíacos e da cineangiocardiografia dos ventrículos direito e esquerdo, e fizeram comparaçäo com umgrupo considerado normal. O estudo do ventrículo direito mostrou: 1 - Diminuiçäo do VDF, VSE, FE e CpE; 2 - Aumento da Pd2. No estudo do ventrículo esquerdo, encontraram: 1 - Diminuiçäo do VSE, FE e CpE; 2 - Aumento da Pd2 e do VDF. Todos os parâmetros acima apresentaram significaçäo estatistica (P < 0,001): näo foi observada variaçäo do VSF do ventrículo direito e do VDF do ventrículo esquerdo (P >0,05). Os autores concluem que, além das alteraçöes referentes à restriçäo diastólica ventricular, foram encontrados achados compatíveis com disfunçäo sistólica biventricular na maioria dos pacientes estudados