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1.
Front Neurosci ; 16: 891523, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35812209

RESUMO

Hippocampal-dependent memories emerge late during postnatal development, aligning with hippocampal maturation. During sleep, the two-stage memory formation model states that through hippocampal-neocortical interactions, cortical slow-oscillations (SO), thalamocortical Spindles, and hippocampal sharp-wave ripples (SWR) are synchronized, allowing for the consolidation of hippocampal-dependent memories. However, evidence supporting this hypothesis during development is still lacking. Therefore, we performed successive object-in-place tests during a window of memory emergence and recorded in vivo the occurrence of SO, Spindles, and SWR during sleep, immediately after the memory encoding stage of the task. We found that hippocampal-dependent memory emerges at the end of the 4th postnatal week independently of task overtraining. Furthermore, we observed that those animals with better performance in the memory task had increased Spindle density and duration and lower density of SWR. Moreover, we observed changes in the SO-Spindle and Spindle-SWR temporal-coupling during this developmental period. Our results provide new evidence for the onset of hippocampal-dependent memory and its relationship to the oscillatory phenomenon occurring during sleep that helps us understand how memory consolidation models fit into the early stages of postnatal development.

2.
Behav Brain Res ; 385: 112555, 2020 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-32109438

RESUMO

During spatial navigation, some typical parameters of learning have been observed, such as latency or path length. However, these parameters are sensitive to patterns of navigation and orientation that are not easily measurable. In the present study, we used a modified version of the Oasis maze and evaluated different parameters of learning, navigation, and orientation in different animal groups. Through a PCA (Principal component analysis) we found different factors such as learning, navigation, speediness, anxiety, orientation, path variability, and turning behavior. Each factor gathers different groups of behavioral variables. ANOVA analysis of those factors demonstrates that some of them are more strongly modulated by trial progression, while others by animal group differences, indicating that each group of variables is better reflecting one of these dimensions. To understand the nature of these navigation differences, we studied orientation strategies between animal conditions and across trials. We found that the main navigational strategy used by the animals consist of locating the target and directing their behaviors towards this area. When testing how this strategy changed after cognitive impairment or enhancement, we found that AßOs treated animals (Amyloid ß Oligomers, Alzheimer animal model) have strong orientation difficulties at locating the target at longer distances. While animals with learning enhancement (exercised rat) do not show changes in orientation behaviors. These analyses highlight that experimental manipulations affect learning, but also induced changes in the navigational strategies. We concluded that both dimensions can explain the differences observed in typical learning variables, such as latency or path length, motivating the development of new tools that asses this two-dimension as a separate but, interacting phenomenon.


Assuntos
Peptídeos beta-Amiloides/farmacologia , Aprendizagem em Labirinto/fisiologia , Orientação Espacial/fisiologia , Fragmentos de Peptídeos/farmacologia , Navegação Espacial/fisiologia , Animais , Comportamento Animal/efeitos dos fármacos , Comportamento Animal/fisiologia , Região CA3 Hipocampal , Modelos Animais de Doenças , Hipocampo , Masculino , Aprendizagem em Labirinto/efeitos dos fármacos , Orientação Espacial/efeitos dos fármacos , Condicionamento Físico Animal , Análise de Componente Principal , Ratos , Aprendizagem Espacial/fisiologia , Navegação Espacial/efeitos dos fármacos
3.
Brain Res ; 1723: 146376, 2019 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-31408622

RESUMO

During exercise, multiple sensory information such as visual outflow, proprioception, and vestibular information promote an increase in arousal state, which may convey positive effects on cognitive abilities such as memory. Nevertheless, which of the components of the ascending arousal system (AAS) are engaged during physical activity and which of them are critical for cognitive enhancement, induced by exercise is still unclear. Two experiments were conducted, to answer these questions: in the first one, the neuronal activity of different components of the AAS was evaluated by c-Fos immunoreactivity (Fos-ir) in running rats exposed to a lock or unlock running wheel. We found a specific Fos-ir increase in the tuberomammillary nucleus (TMN) associated with physical exercise. In the second experiment sedentary and exercised rats were challenged to conduct an object recognition memory task, and the activity of the AAS after learning was evaluated by c-Fos immunoreactivity. The exercised group showed a higher performance in the object recognition memory task which gets correlated with an increase on Fos-ir in the TMN, but not with the other components of the AAS, suggesting that the increase on TMN activity induced by exercise may be the foremost contributor of the AAS to memory enhancement observed in exercised animals.


Assuntos
Memória/fisiologia , Condicionamento Físico Animal/fisiologia , Proteínas Proto-Oncogênicas c-fos/genética , Animais , Nível de Alerta/fisiologia , Encéfalo/fisiologia , Cognição/fisiologia , Regulação da Expressão Gênica/genética , Regulação da Expressão Gênica/fisiologia , Região Hipotalâmica Lateral/fisiologia , Aprendizagem/fisiologia , Masculino , Atividade Motora/fisiologia , Neurônios/metabolismo , Proteínas Proto-Oncogênicas c-fos/metabolismo , Ratos , Ratos Sprague-Dawley
4.
Front Neurosci ; 13: 577, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31316329

RESUMO

The chances to succeed in goal-directed behaviors, such as food or water-seeking, improve when the subject is in an increased arousal state. The appetitive phase of these motivated behaviors is characterized by high levels of behavioral and vegetative excitation. The key decision of engaging in those particular behaviors depends primarily on prefrontal cortical areas, such as the ventromedial prefrontal cortex. We propose that the infralimbic cortex (ILC) located in the medial prefrontal cortex induces an increase in arousal during the appetitive phase of motivated behavior, and that this increase in arousal is, in turn, mediated by the activation of the brain histaminergic system, resulting in higher motivation for getting food rewards. To test this hypothesis, we conduct a progressive ratio operant conditioning to test the degree of motivation for food, while simultaneously manipulating the histaminergic system through pharmacologic interventions. We found that the behavioral responses to obtain food in hungry rats were disrupted when the ILC was inhibited through muscimol infusion, blocking brain H1 histamine receptors by intracerebroventricular infusion of pyrilamine or by satiety. In contrast, the consummatory behavior was not affected by ILC inhibition. The extracellular histamine levels in the ILC were increased in direct correlation with the degree of motivation measured in the progressive ratio test. ILC inhibition also prevented this increase in histamine levels. The rise in extracellular histamine levels during the progressive ratio test was similar (ca. 200%) during the active or the resting period of the day. However, different basal levels are observed for these two periods. Our findings suggest that increased histamine levels during this behavior are not simply explained by the awaked state, but instead, there is a motivation-related release of histamine, suggestive of a specific form of brain activation. Serotonin (another critical component of the ascending arousal system) was also tested. Interestingly, changes in levels of this neuromodulator were not detected during the progressive ratio test. In conclusion, our results suggest that ILC activation and subsequent increase in brain histamine release are both necessary for the normal performance of a motivated behavior such as feeding.

5.
J Gerontol A Biol Sci Med Sci ; 74(7): 1043-1051, 2019 06 18.
Artigo em Inglês | MEDLINE | ID: mdl-29300914

RESUMO

Klotho is an aging-related protein associated with hippocampal cognitive performance in mammals. Klotho regulates progenitor cell proliferation in non-neuronal tissues, but its role in adult hippocampal neurogenesis (AHN) has not been explored. Klotho expression in the adult mouse hippocampus was examined by immunofluorescence and polymerase chain reaction. AHN was evaluated in the hippocampus of klotho knock-out mice (KO), klotho KO/vitamin D-receptor mutant mice, and in a model of local klotho hippocampal knockdown. The recombinant Klotho effect on proliferation was measured in mouse-derived hippocampal neural progenitor cells. Hippocampal-dependent memory was assessed by a dry-land version of the Morris water maze. Klotho was expressed in the granular cell layer of the adult Dentate Gyrus. AHN was increased in klotho KO mice, but not in klotho KO/vitamin D-receptor mutant mice. Inversely, local downregulation of hippocampal Klotho diminished AHN. Recombinant Klotho increased the proliferation rate of neural progenitors. Downregulation of hippocampal Klotho correlated with a decreased performance in hippocampal-dependent memory. These results suggest that Klotho directly participates in regulating AHN. Our observations indicate that Klotho promotes proliferation, AHN and hippocampal-dependent cognition. Increased neurogenesis in klotho KO mice may be secondary to the activation of other pathways altered in the model, such as vitamin D.


Assuntos
Proliferação de Células/fisiologia , Giro Denteado , Glucuronidase/metabolismo , Memória/fisiologia , Neurogênese/fisiologia , Animais , Comportamento Animal/fisiologia , Cognição/fisiologia , Giro Denteado/diagnóstico por imagem , Giro Denteado/metabolismo , Imunofluorescência/métodos , Proteínas Klotho , Aprendizagem em Labirinto , Camundongos , Células-Tronco Neurais/fisiologia
6.
Antioxid Redox Signal ; 29(12): 1125-1146, 2018 10 20.
Artigo em Inglês | MEDLINE | ID: mdl-29357673

RESUMO

AIMS: Previous studies indicate that hippocampal synaptic plasticity and spatial memory processes entail calcium release from intracellular stores mediated by ryanodine receptor (RyR) channels. In particular, RyR-mediated Ca2+ release is central for the dendritic spine remodeling induced by brain-derived neurotrophic factor (BDNF), a neurotrophin that stimulates complex signaling pathways leading to memory-associated protein synthesis and structural plasticity. To examine if upregulation of ryanodine receptor type-2 (RyR2) channels and the spine remodeling induced by BDNF entail reactive oxygen species (ROS) generation, and to test if RyR2 downregulation affects BDNF-induced spine remodeling and spatial memory. RESULTS: Downregulation of RyR2 expression (short hairpin RNA [shRNA]) in primary hippocampal neurons, or inhibition of nitric oxide synthase (NOS) or NADPH oxidase, prevented agonist-mediated RyR-mediated Ca2+ release, whereas BDNF promoted cytoplasmic ROS generation. RyR2 downregulation or inhibitors of N-methyl-d-aspartate (NMDA) receptors, or NOS or of NADPH oxidase type-2 (NOX2) prevented RyR2 upregulation and the spine remodeling induced by BDNF, as did incubation with the antioxidant agent N-acetyl l-cysteine. In addition, intrahippocampal injection of RyR2-directed antisense oligodeoxynucleotides, which caused significant RyR2 downregulation, caused conspicuous defects in a memorized spatial memory task. INNOVATION: The present novel results emphasize the key role of redox-sensitive Ca2+ release mediated by RyR2 channels for hippocampal structural plasticity and spatial memory. CONCLUSION: Based on these combined results, we propose (i) that BDNF-induced RyR2-mediated Ca2+ release and ROS generation via NOS/NOX2 are strictly required for the dendritic spine remodeling and the RyR2 upregulation induced by BDNF, and (ii) that RyR2 channel expression is crucial for spatial memory processes. Antioxid. Redox Signal. 29, 1125-1146.


Assuntos
Cálcio/metabolismo , Hipocampo/metabolismo , Plasticidade Neuronal , Canal de Liberação de Cálcio do Receptor de Rianodina/metabolismo , Memória Espacial , Animais , Células Cultivadas , Hipocampo/citologia , Oxirredução , Ratos , Ratos Sprague-Dawley , Espécies Reativas de Oxigênio/metabolismo
7.
PLoS One ; 12(2): e0171304, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28158285

RESUMO

Spatial memory, among many other brain processes, shows hemispheric lateralization. Most of the published evidence suggests that the right hippocampus plays a leading role in the manipulation of spatial information. Concurrently in the hippocampus, memory consolidation during sleep periods is one of the key steps in the formation of newly acquired spatial memory traces. One of the most characteristic oscillatory patterns in the hippocampus are sharp-wave ripple (SWR) complexes. Within this complex, fast-field oscillations or ripples have been demonstrated to be instrumental in the memory consolidation process. Since these ripples are relevant for the consolidation of memory traces associated with spatial navigation, and this process appears to be lateralized, we hypothesize that ripple events between both hippocampi would exhibit different temporal dynamics. We tested this idea by using a modified "split-hyperdrive" that allows us to record simultaneous LFPs from both right and left hippocampi of Sprague-Dawley rats during sleep. We detected individual events and found that during sleep periods these ripples exhibited a different occurrence patterns between hemispheres. Most ripple events were synchronous between intra- rather than inter-hemispherical recordings, suggesting that ripples in the hippocampus are independently generated and locally propagated within a specific hemisphere. In this study, we propose the ripples' lack of synchrony between left and right hippocampi as the putative physiological mechanism underlying lateralization of spatial memory.


Assuntos
Fenômenos Eletrofisiológicos , Hipocampo/fisiologia , Sono/fisiologia , Análise de Variância , Animais , Eletroencefalografia , Masculino , Memória , Ratos
8.
Behav Brain Res ; 313: 226-232, 2016 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-27444242

RESUMO

Perinatal asphyxia (PA) is associated with long-term neuronal damage and cognitive deficits in adulthood, such as learning and memory disabilities. After PA, specific brain regions are compromised, including neocortex, hippocampus, basal ganglia, and ascending neuromodulatory pathways, such as dopamine system, explaining some of the cognitive disabilities. We hypothesize that other neuromodulatory systems, such as histamine system from the tuberomammillary nucleus (TMN), which widely project to telencephalon, shown to be relevant for learning and memory, may be compromised by PA. We investigated here the effect of PA on (i) Density and neuronal activity of TMN neurons by double immunoreactivity for adenosine deaminase (ADA) and c-Fos, as marker for histaminergic neurons and neuronal activity respectively. (ii) Expression of the histamine-synthesizing enzyme, histidine decarboxylase (HDC) by western blot and (iii) thioperamide an H3 histamine receptor antagonist, on an object recognition memory task. Asphyxia-exposed rats showed a decrease of ADA density and c-Fos activity in TMN, and decrease of HDC expression in hypothalamus. Asphyxia-exposed rats also showed a low performance in object recognition memory compared to caesarean-delivered controls, which was reverted in a dose-dependent manner by the H3 antagonist thioperamide (5-10mg/kg, i.p.). The present results show that the histaminergic neuronal system of the TMN is involved in the long-term effects induced by PA, affecting learning and memory.


Assuntos
Asfixia/tratamento farmacológico , Histamina/metabolismo , Região Hipotalâmica Lateral/metabolismo , Memória , Animais , Asfixia/metabolismo , Asfixia/patologia , Dopamina/metabolismo , Feminino , Antagonistas dos Receptores Histamínicos/farmacologia , Região Hipotalâmica Lateral/efeitos dos fármacos , Região Hipotalâmica Lateral/patologia , Memória/efeitos dos fármacos , Neurônios/efeitos dos fármacos , Neurônios/metabolismo , Neurônios/patologia , Proteínas Proto-Oncogênicas c-fos/metabolismo , Ratos Wistar , Receptores Histamínicos/efeitos dos fármacos
9.
PLoS One ; 11(2): e0148484, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26845170

RESUMO

The histaminergic system is one component of the ascending arousal system which is involved in wakefulness, neuroendocrine control, cognition, psychiatric disorders and motivation. During the appetitive phase of motivated behaviors the arousal state rises to an optimal level, thus giving proper intensity to the behavior. Previous studies have demonstrated that the histaminergic neurons show an earlier activation during the appetitive phase of feeding, compared to other ascending arousal system nuclei, paralleled with a high increase in arousal state. Lesions restricted to the histaminergic neurons in rats reduced their motivation to get food even after 24 h of food deprivation, compared with intact or sham lesioned rats. Taken together, these findings indicate that the histaminergic system is important for appetitive behavior related to feeding. However, its role in other goal-directed behaviors remains unexplored. In the present work, male rats rendered motivated to obtain water, sex, or amphetamine showed an increase in Fos-ir of histaminergic neurons in appetitive behaviors directed to get those reinforcers. However, during appetitive tests to obtain sex, or drug in amphetamine-conditioned rats, Fos expression increased in most other ascending arousal system nuclei, including the orexin neurons in the lateral hypothalamus, dorsal raphe, locus coeruleus and laterodorsal tegmental neurons, but not in the ventral tegmental area, which showed no Fos-ir increase in any of the 3 conditions. Importantly, all these appetitive behaviors were drastically reduced after histaminergic cell-specific lesion, suggesting a critical contribution of histamine on the intensity component of several appetitive behaviors.


Assuntos
Anfetamina , Apetite , Comportamento Apetitivo , Região Hipotalâmica Lateral/fisiologia , Comportamento Sexual Animal , Animais , Feminino , Região Hipotalâmica Lateral/patologia , Masculino , Neurônios/metabolismo , Proteínas Proto-Oncogênicas c-fos/metabolismo , Ratos
10.
Cell Rep ; 14(6): 1382-1394, 2016 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-26854229

RESUMO

Contextual memory formation relies on the induction of new genes in the hippocampus. A polymorphism in the promoter of the transcription factor XBP1 was identified as a risk factor for Alzheimer's disease and bipolar disorders. XBP1 is a major regulator of the unfolded protein response (UPR), mediating adaptation to endoplasmic reticulum (ER) stress. Using a phenotypic screen, we uncovered an unexpected function of XBP1 in cognition and behavior. Mice lacking XBP1 in the nervous system showed specific impairment of contextual memory formation and long-term potentiation (LTP), whereas neuronal XBP1s overexpression improved performance in memory tasks. Gene expression analysis revealed that XBP1 regulates a group of memory-related genes, highlighting brain-derived neurotrophic factor (BDNF), a key component in memory consolidation. Overexpression of BDNF in the hippocampus reversed the XBP1-deficient phenotype. Our study revealed an unanticipated function of XBP1 in cognitive processes that is apparently unrelated to its role in ER stress.


Assuntos
Fator Neurotrófico Derivado do Encéfalo/genética , Hipocampo/metabolismo , Memória/fisiologia , Neurônios/metabolismo , Proteína 1 de Ligação a X-Box/genética , Animais , Fator Neurotrófico Derivado do Encéfalo/metabolismo , Diacilglicerol O-Aciltransferase/genética , Diacilglicerol O-Aciltransferase/metabolismo , Retículo Endoplasmático/genética , Estresse do Retículo Endoplasmático/genética , Potenciais Evocados/fisiologia , Perfilação da Expressão Gênica , Regulação da Expressão Gênica no Desenvolvimento , Hipocampo/citologia , Potenciação de Longa Duração/fisiologia , Masculino , Camundongos , Camundongos Knockout , Anotação de Sequência Molecular , Neurônios/citologia , Regiões Promotoras Genéticas , Transdução de Sinais , Resposta a Proteínas não Dobradas/genética , Proteína 1 de Ligação a X-Box/deficiência
11.
Nanotechnology ; 26(40): 405702, 2015 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-26377736

RESUMO

We present the mapping of the plasmonic properties of gold nanoparticles that are embedded in a TiO2 thin film deposited over two different substrates, glass and silicon. An improved electron energy-loss spectroscopy (EELS) imaging technique was used to extract plasmon maps with nanometre resolution. Several representative cases of randomly dispersed NPs have been examined to carefully evaluate surrounding effects on the optical response of such nanostructured material. Data were compared to analytical calculations and showed good agreement. These results validate previous structural and far-field optical results and provide a clear description of the optical phenomena that take place at a nanometre scale in these materials. They are of primary importance for enlightening the way to the fabrication of thin film materials including metallic nanostructures for photovoltaic applications.

12.
J Neurophysiol ; 114(2): 1183-95, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26108957

RESUMO

In a rest period immediately after a task, neurons in the hippocampus, neocortex, and striatum exhibit spatiotemporal correlation patterns resembling those observed during the task. This reactivation has been proposed as a neurophysiological substrate for memory consolidation. We provide new evidence that rodent ventral tegmental area (VTA) neurons are selective for different types of food stimuli and that stimulus-sensitive neurons strongly reactivate during the rest period following a task that involved those stimuli. Reactivation occurred primarily during slow wave sleep and during quiet awakeness. In these experiments, VTA reactivation patterns were uncompressed and occurred at the firing rate level, rather than on a spike-to-spike basis. Mildly aversive stimuli were reactivated more often than positive ones. The VTA is a pivotal structure involved in the perception and prediction of reward and stimulus salience and is a key neuromodulatory system involved in synaptic plasticity. These results suggest new ways in which dopaminergic signals could contribute to the biophysical mechanisms of selective, system-wide, memory consolidation, and reconsolidation during sleep.


Assuntos
Potenciais de Ação/fisiologia , Neurônios/fisiologia , Sono/fisiologia , Área Tegmentar Ventral/fisiologia , Animais , Dopamina/metabolismo , Masculino , Microeletrodos , Ratos Endogâmicos F344 , Vigília/fisiologia
14.
Front Syst Neurosci ; 6: 51, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22783171

RESUMO

Brain histamine may affect a variety of different behavioral and physiological functions; however, its role in promoting wakefulness has overshadowed its other important functions. Here, we review evidence indicating that brain histamine plays a central role in motivation and emphasize its differential involvement in the appetitive and consummatory phases of motivated behaviors. We discuss the inputs that control histaminergic neurons of the tuberomamillary nucleus (TMN) of the hypothalamus, which determine the distinct role of these neurons in appetitive behavior, sleep/wake cycles, and food anticipatory responses. Moreover, we review evidence supporting the dysfunction of histaminergic neurons and the cortical input of histamine in regulating specific forms of decreased motivation (apathy). In addition, we discuss the relationship between the histamine system and drug addiction in the context of motivation.

15.
Langmuir ; 26(10): 7458-63, 2010 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-20187628

RESUMO

Here we describe a simple, powerful technique based on the laser ablation of a target immersed in a water solution of a metal salt. With this method, nanoparticles of different metals and alloys can be processed very quickly. Both the target and the salt solution can be chosen to produce metal nanoparticles of different sizes, surface-oxidized nanoparticles (silica-silver, for example), or even more complex structures to be defined by the researcher on one or more steps because the technique combines the advantages of both physical and chemical methods. We have applied this technique to the fabrication of inert silica-metal (silver, gold, and silver-gold) nanoparticles with a strong surface plasmon resonance all together in a single step. The advantage of the simultaneous production of silica during laser ablation is the stabilization of the metal nanoparticle colloid but also the possibility to reduce the toxicity of these nanoparticles.


Assuntos
Ouro/química , Lasers , Nanopartículas Metálicas/química , Dióxido de Silício/síntese química , Prata/química , Tamanho da Partícula , Dióxido de Silício/química , Propriedades de Superfície
16.
Rev. cuba. cir ; 29(1): 164-72, ene.-feb. 1990. ilus
Artigo em Espanhol | LILACS | ID: lil-85581

RESUMO

Se presenta un caso de un joven de 18 años de edad, víctima de una herida por arma blanca penetrante en el ventrículo izquierdo, de 2 cm de longitud y con localización próxima a la punta del corazón; que fue tratado con excelentes resultados, a pesar de la gravedad de la lesión y de haberse intervenido prácticamente en estado premortem. Se hace énfasis en la importancia de la toracotomía inmediata cmo proceder de elección, la utilización de algunas medidas terapéuticas en el control de la pericarditis y la arritmia y en el valor de los factores que se deben considerar en el pronóstico de la lesión


Assuntos
Adolescente , Humanos , Masculino , Traumatismos Cardíacos , Ferimentos Penetrantes , Ferimentos Perfurantes , Toracotomia , Ventrículos do Coração/lesões
17.
Rev. cuba. cardiol. cir. cardiovasc ; 1(2): 37-42, jul.-dic. 1987. tab
Artigo em Espanhol | LILACS | ID: lil-53716

RESUMO

Se hace una revisión de las historias clínicas de los pacientes con diagnóstico de endocarditis infecciosa en el año 1985. Se analizan las cardiopatías de base y se obtiene, aproximadamente, la misma frecuencia de endocarditis infecciosa para las cardiopatías congénitas y la valvulopatía reumática crónica. Prevaleció la endocarditis precoz y los síntomas y signos clínicos fueron los mismos que aparecen en la literatura médica al respecto (fiebre, palidez cutaneomucosa, etcétera). El estafilococo coagulasa positivo fue el microorganismo que más frecuentemente se aisló y, en general, predominaron los gérmenes grampositivos. La mortalidad fue elevada, tal y como corresponde a los pacientes cardíacos


Assuntos
Humanos , Endocardite
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