Prognostic value of silent myocardial infarction in patients with chronic kidney disease after kidney transplantation.

We have shown that silent myocardial infarction (SMI) on 12-lead ECG is associated with increased cardiovascular disease (CVD) risk in patients awaiting renal transplantation (RT). In this study, we evaluated the prevalence of SMI in patients undergoing RT and their prognostic value after RT. MI was determined by automated analysis of ECG. SMI was defined as ECG evidence of MI without a history of clinical MI (CMI). The primary outcome was a composite of CVD death, non-fatal MI and coronary revascularization after RT. Of the 1189 patients who underwent RT, a 12-lead ECG was available in >99%. Of the entire cohort 6% had a history of CMI while 7% had SMI by ECG. During a median follow-up of 4.6 years, 147 (12%) experienced the primary outcome (8% CVD death, 4% MI, 4% coronary revascularization) and 12% died. Both SMI and CMI were associated with an increased risk of CVD events and all-cause deaths. In a multivariable adjusted Cox-regression model, both SMI (adjusted hazard ratio 2.03 [1.25-3.30], p = .004) and CMI (2.15 [1.24-3.74], p = .007) were independently associated with the primary outcome. SMI detected by ECG prior to RT is associated with increased risk of CVD events after RT.

Castration-induced prostate epithelial cell apoptosis results from targeted oxidative stress attack of M1142 -macrophages.

Prostate development and function are regulated by androgens. Epithelial cell apoptosis in response to androgen deprivation is caspase-9-dependent and peaks at Day 3 after castration. However, isolated epithelial cells survive in the absence of androgens. Znf142 showed an on-off expression pattern in intraepithelial CD68-positive macrophages, with the on-phase at Day 3 after castration. Rats treated with gadolinium chloride to deplete macrophages showed a significant drop in apoptosis, suggesting a causal relationship between macrophages and epithelial cell apoptosis. Intraepithelial M1-polarization was also limited to Day 3, and the inducible nitric oxide synthase (iNOS) knockout mice showed significantly less apoptosis than wild-type controls. The epithelial cells showed focal DNA double-strand breaks (DSB), 8-oxoguanine, and protein tyrosine-nitrosylation, fingerprints of exposure to peroxinitrite. Cultured epithelial cells induced M1-polarization and showed focal DSB and underwent apoptosis. The same phenomena were reproduced in LNCaP cells cocultured with Raw 264.7 macrophages. In conclusion, the M1 142 -macrophage (named after Znf142) attack causes activation of the intrinsic apoptosis pathway in epithelial cells after castration.

Outcomes of Acute Myocardial Infarction in Female Patients With Type 1 Diabetes Mellitus.

There is a paucity of data on acute myocardial infarction (AMI) outcomes for female patients with type 1 diabetes (T1DM) compared with men. The National Inpatient Sample Database was queried from 2011 to 2019 for relevant International Classification of Diseases, Ninth and Tenth Revision procedural and diagnostic codes. Hospitalizations with an admitting diagnosis of non-ST-elevation myocardial infarction or ST-elevation myocardial infarction were compared between male and female patients with T1DM. A multivariate logistic regression adjusting for baseline characteristics and primary diagnosis was performed. A p <0.001 was considered significant. A total of 50,020 hospitalizations for AMI in patients with T1DM were identified, of which 23,980 (47.9%) were women. The baseline characteristics are listed in Table 1. Women experienced similar rates of all-cause and inhospital mortality (5.0% vs 4.7%, p = 0.082). However, after adjusting for baseline characteristics and primary diagnosis, women had higher odds of mortality (adjusted odds ratio [aOR] 1.26, 95% confidence interval [CI] 1.15 to 1.38). Women were less likely to undergo cardiac catheterization (65.7% vs 68.2%; aOR 0.90, 95% CI 0.86 to 0.94) and coronary artery bypass grafting (5.6% vs 6.9%; aOR 0.76, 95% CI 0.70 to 0.82, p <0.001 for both). There was no difference in the use of percutaneous coronary intervention (41.0% vs 41.9%; aOR 1.01, 95% CI 0.97 to 1.05, p = 0.042). The female gender is not protective against AMI in patients with T1DM. Women with T1DM, on average, experience AMI at the same age as men, are less likely to undergo surgical revascularization, and have higher odds of mortality.

Gephyrocharax machadoi, a new species of Stevardiinae (Characiformes: Characidae) from the Rio Paraguai basin, central Brazil.

Gephyrocharax machadoi, new species, is described from tributaries of the rio Sepotuba, upper rio Paraguai basin, Mato Grosso state, Brazil. The new species is distinguished from its congeners, except Gephyrocharax major, by presenting two modified scales on the ventral caudal-fin lobe (pouch scales): a larger, sexually dimorphic scale, slightly superior and anterior in position, followed by a smaller, posterior and ventrally placed accessory scale (vs. a single modified pouch scale without ventrally placed accessory scales). Gephyrocharax machadoi differs from G. major by presenting a gap (more conspicuous in mature males than in mature females) between the second and third ventral procurrent caudal-fin rays (vs. second and third ventral procurrent caudal-fin rays near each other or fused distally); premaxilla with tricuspid teeth (vs. tetra- to pentacuspid teeth); and body depth 21.5-25.4% of SL (vs. 25.9-36.8% in SL). Spermiogenesis and spermatozoa morphology are also described.

Fibrolipoma gigante de la espalda / Fibrolipome géant du dos / Back giant fibrolipoma

Introducción: en el cumplimiento de una misión internacionalista en la Clínica del Colaborador, ubicada en La Paz, Bolivia, se presentó una niña de 12 años de edad, portadora de una gran tumoración en la espalda, acompañada de otras deformidades, que no había sido tratada por carecer de recursos económicos. Los médicos que la habían visto antes habían expresado que al realizar una cirugía, único modo de resolver la situación, no se garantizaba la vida de la menor y también por el hecho de residir en una región intrincada del país. El objetivo de esta comunicación es mostrar un caso poco común en la práctica diaria y el resultado de su tratamiento. Descripción: el tratamiento realizado fue eminentemente quirúrgico, apoyado en un tratamiento higiénico-dietético adecuado y la posterior rehabilitación. Los resultados fueron excelentes; finalmente pudo restituirse a la paciente a su lugar de residencia, su escuela y la sociedad. Conclusiones: la tumoración gigante de la espalda, acompañada de otras deformidades en la paciente, se resolvieron después de un tratamiento adecuado(AU)

Introducción: in the fulfilment of an internationalist mission in the Clinic of Collaboration located in La Paz, Bolivia, the Cuban physicians received the case of a girl aged 12 carrier of a big back tumor, together with other deformities, never before treated due to a lack of economic resources. The previous physicians had expressed that the surgery was the only way to solve the situation but without to guarantee the life of patient and also due to she lives in a dense region of the country. The objective of this communication is to show a uncommon case in the daily practice and the result of its treatment. Description: the treatment applied was totally surgical, supported by a proper hygienic-dietetic treatment and its latter rehabilitation. Results were excellent; finally it was possible to refer patient to her place of residence, its school and the society. Conclusions: the giant back tumor, together with other deformities in the patient, disappeared after an appropriate treatment(AU)

Introduction: pendant une mission de collaboration médicale en Bolivie, on a pu constater le cas d'une fille âgée de 12 ans atteinte d'une tumeur dorsale, accompagnée d'autres difformités, et sans traitement-faute de ressources économiques pour se faire soigner, ayant été assistée à la Clinique du collaborateur, à La Paz. D'autres médecins l'ayant vue auparavant avaient déconseillé le traitement chirurgical, seule solution à son problème, à cause du risque pour sa vie et de l'éloignement de son domicile. Le but de ce travail est de rapporter un cas peu fréquent dans la pratique quotidienne, et le résultat de son traitement. Description: le traitement a été certainement chirurgical, soutenu par une hygiène et une diète de qualité, et une bonne rééducation. Les résultats ont été excellents, la patiente a pu se réincorporer à son milieu familial, à son école et à la société. Conclusions: la tumeur géante du dos, accompagnée d'autres difformités, a disparu après l'application du traitement approprié(AU)