Adenovirus 36 seropositivity is related to the expression of anti-adipogenic lncRNAs GAS5 and MEG3 in adipose tissue obtained from subjects with obesity.

BACKGROUND: Human Adenovirus D-36 (HAdV-D36) promotes adipogenesis in cellular and animal models and may contribute to the development of human obesity. Induction of PPARγ by HAdV-D36 seems to have a central role in the maintenance of adipogenic status. There is limited information about epigenetic mechanisms contributing to this process in human adipose tissue. This study evaluated the expression of lncRNAs (ADINR, GAS5 and MEG3) and miRNAs (miR-18a and miR-140) involved in the adipogenic process in visceral adipose tissue (VAT) of subjects with obesity with previous HAdV-D36 infection (seropositive) and unexposed (seronegative) subjects with obesity. METHODS: Individuals with obesity were grouped according to the presence of antibodies against HAdV-D36 (Seropositive: HAdV-D36[+], n = 29; and Seronegative: HAdV-D36[-], n = 28). Additionally, a group of individuals without obesity (n = 17) was selected as a control group. The HAdV-D36 serology was carried out by ELISA. Biopsies of VAT were obtained during an elective and clinically indicated surgery (bariatric or cholecystectomy). RNA extraction from VAT was performed and the expression of PPARG and non-coding RNAs was evaluated by qPCR. RESULTS: HAdV-D36[+] individuals had lower expression of anti-adipogenic lncRNAs GAS5 (p = 0.016) and MEG3 (p = 0.035) compared with HAdV-D36[-] subjects with obesity. HAdV-D36[+] subjects also presented increased expression of the adipogenic miRNA miR-18a (p = 0.042), which has been reported to be modulated by GAS5 through a RNA sponging mechanism during adipogenic differentiation. Additionally, an inverse correlation of GAS5 with PPARG expression was observed (r = -0.917, p = 0.01). CONCLUSION: Our results suggest that HAdV-D36 is related to non-coding RNAs implicated in adipogenesis, representing a potential mechanism by which previous HAdV-D36 infection could be associated with the long-term maintenance of adipogenic status, probably through the GAS5/miR-18a axis.

Factores relacionados con complicaciones cardiovasculares intrahospitalarias en el género femenino / Factors related to in-hospital cardiovascular complications in the female gender

Resumen Introducción: las enfermedades del corazón son la primera causa de muerte en el mundo tanto en el hombre como en la mujer. La presentación de la cardiopatía isquémica varía dependiendo de múltiples factores, entre ellos el género. Materiales y método: estudio observacional, transversal con componente analítico de todos los pacientes ingresados con síndrome coronario agudo en el Hospital Docente Clínico-Quirúrgico Comandante Manuel Fajardo, entre enero del 2016 y diciembre del 2020. Resultados: el género femenino presentó una mediana de edad de 73 (RIC: 62-80), significativamente superior a la del género masculino, con mayor prevalencia de hipertensión arterial y diabetes mellitus (n = 353 y n = 143, respectivamente; p < 0.01). Se identificaron la edad, el valor de la creatinina y el síndrome coronario agudo con elevación del ST como factores desencadenantes de complicaciones cardíacas (RR: 1.01; IC 95%: 1.00-1.07; p = 0.03; RR: 1.01; IC 95%: 1.00-1.02; p = 0.01; y RR: 2.77; IC 95%: 1.31-5.87; p = 0.02, respectivamente). Conclusiones: las mujeres con síndrome coronario agudo presentaron una edad superior a la de los hombres, con mayor prevalencia de hipertensión arterial y diabetes mellitus, mientras las variables predictoras de complicaciones cardiovasculares intrahospitalarias identificadas fueron la edad, el valor de creatinina sérica y el síndrome coronario agudo con elevación del ST.

Abstract Introduction: heart disease is the leading cause of death in the world for both men and women. The presentation of ischemic heart disease varies depending on multiple factors, including gender. Materials and method: observational, cross-sectional study with an analytical component of all patients admitted with ACS at the Comandante Manuel Fajardo Clinical-Surgical Teaching Hospital, between January 2016 and December 2020. Results: female patients had a median age of 73 (IQR: 62-80) significantly higher than the male gender; with a higher prevalence of arterial hypertension and diabetes mellitus (n = 353 and n = 143 respectively and p < 0.01). Age, creatinine value, and STEACS were identified as triggering factors for cardiac complications (RR: 1.01; 95% CI: 1.00-1.07; p = 0.03; RR: 1.01; 95% CI: 1.00-1.02; p = 0.01; and RR: 2.77; 95% CI: 1.31-5.87; p = 0.02 respectively). Conclusions: women with ACS were older than men, with a higher prevalence of arterial hypertension and diabetes mellitus, while the predictive variables of intrahospital cardiovascular complications identified were age, serum creatinine value, and ACS with ST elevation.

Palladium Phthalocyanine Nanowire-Based Highly Sensitive Sensors for NO2(g) Detection.

Palladium phthalocyanine (PdPc) nanowires (NWs) were developed to achieve the gas sensing of NO2 in the sub-parts-per-million (ppm) range. Non-substituted metal phthalocyanine are well known for their p-type semiconducting behavior, which is responsible for its gas-sensing capabilities. Nanofabrication of the PdPc NWs was performed by physical vapor deposition (PVD) on an interdigitated gold electrode (IDE). The coordination of palladium in the structure was confirmed with UV-Vis spectroscopy. Gas-sensing experiments for NO2 detection were undertaken at different sensed gas concentrations from 4 ppm to 0.5 ppm at room temperature. In this work, the responses at different gas concentrations are reported. In addition, structural studies of the PdPc NWs with scanning electron microscopy (SEM) and electron-dispersive X-ray diffraction (EDS) are shown.

Effects of Preoperative Sarcopenia-Related Parameters on Cardiac Autonomic Function in Women with Obesity Following Bariatric Surgery: A One-Year Prospective Study.

OBJECTIVES: Investigate changes in blood pressure (BP) and heart rate variability (HRV) in women with and without sarcopenia-related parameters who underwent bariatric surgery (BS) during a one-year follow-up. SUBJECTS AND METHODS: Women were separated into obesity (OB, n = 20) and women with obesity displaying sarcopenia-related parameters (SOP, n = 14) and evaluated before BS and 3, 6, and 12 months after BS. SOP was defined as low handgrip strength (HS) and/or low appendicular skeletal mass adjusted for weight (ASM/wt × 100, %) in the lowest quartile of the sample. ASM/wt × 100, % and HS were significantly lower in SOP than OB over a one-year follow-up of BS (p < 0.05). RESULTS: There was a reduction in diastolic BP, heart rate (HR), SDHR, LF, and the LF/HF ratio (p < 0.05) and an increase in the HF band in both groups during the follow-up period (p < 0.05). SOP women had reduced root mean square differences of successive RR intervals (RMSSD) and HF band and an increased LF band and SD2/SD1 ratio compared to the OB group during the one-year follow-up (p < 0.05). ASM/wt × 100, % was negatively associated with the LF band (r = -0.24, p = 0.00) and positively associated with the HF band (r = 0.22, p = 0.01). Conversely, HS had no association with LF (r = -0.14, p = 0.09) and HF (r = 0.11, p = 0.19). ASM/wt × 100, % and HS were negatively associated with the LF/HF ratio (p < 0.05). CONCLUSIONS: Women who underwent BS had an improved HRV over a one-year follow-up. However, the improvement in HRV variables was less pronounced in women with low muscle mass and/or HS during the follow-up period.

Clozapine-Induced Eosinophilia: a Case Report

Introduction: Clozapine is an atypical antipsychotic drug eligible for treatment-resistant schizophrenia. It frequently represents the best and the only choice in resistant schizophrenia. However, its use is feared by many professionals due to its possible adverse effects, such as eosinophilia. Case report: We report a case of a young white male suffering from treatment-resistant schizophrenia who rapidly developed eosinophilia after starting clozapine. Discussion: We present a case of a 26-year-old white man diagnosed with schizophrenia with poor clinical response to several antipsychotics owing to which clozapine was started. Psychotic symptoms improved dramatically but a progressively ascendant eosinophilia was reported during serial haematological analyses. The patient remained physically asymptomatic. An exhaustive assessment with ancillary diagnostic tests revealed no cause for eosinophilia. Thus, a diagnosis of clozapine-induced eosinophilia was made. The drug was discontinued and eosinophil count progressively returned to normal but psychotic symptoms worsened. Conclusions: Clozapine treatment is frequently feared due to its possible side effects and complications, delaying its use in refractory schizophrenia. Also, to our knowledge, there are no specific guidelines on how to manage haematological side effects such as eosinophilia. This is problematic as, in some cases, it may lead to an unnecessary withdrawal of clozapine with a worsening of psychotic symptoms. We present a brief discussion of the recent literature on the subject.

Introducción: La clozapina es un fármaco antipsicótico atípico eligible para la esquizofrenia resistente al tratamiento. Con frecuencia representa la mejor y la única opción para la esquizofrenia resistente. Sin embargo, muchos profesionales temen utilizarla por sus posibles efectos adversos, como la eosinofilia. Reporte de caso: Se expone el caso de un joven blanco que sufre esquizofrenia resistente al tratamiento y desarrolló eosinofilia rápidamente tras comenzar el tratamiento con clozapina. Discusión: Varón de 26 años con diagnóstico de esquizofrenia y mala respuesta clínica a varios antipsicóticos, por lo que se inició clozapina. Los síntomas psicóticos mejoraron drásticamente, pero los análisis hematológicos seriados informaron una eosinofilia en ascenso progresivo. El paciente permaneció físicamente asintomático. Una evaluación exhaustiva con pruebas de diagnóstico complementarias no reveló ninguna causa de eosinofilia. Por lo tanto, se diagnosticó eosinofilia inducida por clozapina. Se suspendió el fármaco, el recuento de eosinófilos volvió progresivamente a la normalidad, pero los síntomas psicóticos empeoraron. Conclusiones: A menudo se teme tratar con clozapina por sus posibles efectos secundarios y sus complicaciones, lo cual retrasa su uso en la esquizofrenia refractaria. Además, hasta donde sabemos, no existen pautas específicas sobre cómo tratar los efectos secundarios hematológicos como la eosinofilia. Esto es problemático porque, en algunos casos, puede conducir a suspender innecesariamente la clozapina y que empeoren los síntomas psicóticos. Se presenta una breve discusión de la literatura reciente sobre el tema.

Caracterización del síndrome coronario agudo en pacientes octogenarios / Characterization of the acute coronary syndrome in octogenarian patients

Introducción: La edad representa uno de los mayores predictores de riesgo de complicaciones cardiovasculares en pacientes con síndrome coronario agudo. La prevalencia de este síndrome en el grupo de los pacientes octogenarios es elevada. Métodos: Estudio prospectivo de cohortes analítico de todos los pacientes ingresados en la unidad de cuidados coronarios intensivos del Hospital Universitario Comandante Manuel Fajardo de la Habana, entre el año 2016 y el 2020. Objetivo: Caracterizar la población de pacientes octogenarios con síndrome coronario agudo y las posibles asociaciones entre la ocurrencia de complicaciones intrahospitalarias no letales y los factores de riesgo cardiovasculares. Resultados: Prevaleció el sexo femenino (64,2 por ciento), los antecedentes de hipertensión arterial (89,7 por ciento), cardiopatía isquémica (66,7 por ciento), y el tabaquismo (32 por ciento). Se encontraron asociaciones estadísticas significativas entre el tipo de síndrome coronario agudo y la presencia de complicaciones cardiovasculares de cualquier tipo (p=0,006); el aumento de la creatinina se asoció con la presencia de complicaciones hemodinámicas (Mdn=97; Rango=97,52; p=0,012), así como también la fracción de eyección del ventrículo izquierdo mostró una asociación muy significativa con la presencia de complicaciones cardiovasculares de cualquier tipo (Mdn=59; Rango=63,3; p<0,001) y hemodinámicas (Rango=55,2; p<0,001). Conclusiones: Se caracterizó la población de pacientes octogenarios con síndrome coronario agudo con elevación del segmento ST se asoció con un aumento de las complicaciones cardiovasculares intrahospitalarias, de la misma manera que sucedió con el valor de la fracción de eyección del ventrículo izquierdo(AU)

Introduction: Age represents one of the greatest predictors of risk of cardiovascular complications in patients with acute coronary syndrome. The prevalence of this syndrome in the group of octogenarian patients is high. Objective: To characterize the population of octogenarian patients with acute coronary syndrome and the possible associations between the occurrence of non-lethal intrahospital complications and cardiovascular risk factors. Methods: This is a prospective analytical cohort study of all patients admitted to the intensive coronary care unit of Manuel Fajardo University Hospital in Havana, from 2016 to 2020. Results: The female sex (64.2percent), a history of arterial hypertension (89.7percent), ischemic heart disease (66.7percent), and smoking habits (32percent) outweighed. Significant statistical associations were found between the type of acute coronary syndrome and the presence of cardiovascular complications of any type (p=0.006); the increase in creatinine was associated with the presence of hemodynamic complications (Mdn=97; Range=97.52; p=0.012), as well as the left ventricular ejection fraction showed a highly significant association with the presence of cardiovascular complications of any type (Mdn=59; Range=63.3; p<0.001) and hemodynamic (Range=55.2; p<0.001). Conclusions: The octogenarian population of patients with ST-segment elevation acute coronary syndrome was characterized and was associated with an increase in in-hospital cardiovascular complications, in the same way that it happened with the value of the left ventricular ejection fraction(AU)

Cardiovascular Complications in Patients Hospitalized for COVID-19: A Cohort Study in Havana, Cuba.

INTRODUCTION AND OBJECTIVE: At least one in ten patients infected with COVID develop cardiovascular complications during hospitalization, increasing the number of deaths from this cause. However, the determinants of risk are not clearly elucidated. This study aims to determine whether there is a relationship between in-hospital cardiac complications and cardiovascular history and hospital evolution. METHODS: Prospective cohort study of 373 patients with a positive diagnosis of SARS-CoV-2 admitted to an Intensive Care Unit between March and October 2021. RESULTS: Median age was 69 (IQR: 57-77), 29.2 % of patients presented cardiovascular complications: 21.2 % electrical, 5.9 % acute coronary syndrome and 1.9 % pulmonary thromboembolism. Age RR: 1.02 (95 % CI: 1.00-1.04; p = 0.020) and history of ischemic heart disease RR: 2.23 (95 % CI: 1.27-3.92; p = 0.005) were identified as independent predictors of in-hospital cardiac complications. CONCLUSIONS: Age and history of ischemic heart disease were identified as independent predictor variables of cardiovascular complications in patients admitted with severe COVID-19 involvement; being significantly associated with lower survival.

Wellens syndrome as an independent predictor of in-hospital cardiovascular complications.

INTRODUCTION: Wellens Syndrome was described for the first time in the eighties, as an equivalent pattern of a critical lesion of the anterior descending artery. Different risk factors have been associated with a worse prognosis during hospitalisation in patients with non-ST segment elevation acute coronary syndrome. However, it is unknown whether the presence of Wellens Syndrome alone contributes to an increase in in-hospital cardiovascular complications. MATERIAL AND METHOD: Analytical prospective cohort study in 141 patients with the diagnosis of acute coronary syndrome without ST segment elevation who underwent coronary angiography between 2016 and 2020. RESULTS: Wellens syndrome was diagnosed in 64 patients with a mean age of 66.31 ± 12.54, of which 21 patients had a cardiac event during hospitalisation: hemodynamic complication 14 (21.9%), refractory or recurrent angina 4 (6.3%) and Acute myocardial infarction 3 (4.7%) confirming a relative risk (RR): 4.88 (95% confidence interval (CI) 1.92-12.45) p = 0.001. CONCLUSIONS: The presence of Wellens Syndrome is independently associated with the appearance of cardiac complications during hospitalisation.Key pointsSW is now known to be a relatively frequent presentation of ACS, not addressed in depth in clinical practice guidelines for NSTEACS. This syndrome is generally caused by a severe ADA occlusion that, if not adequately treated, could evolve into a large infarction. According to the results of the different series published, the incidence of cardiovascular risk factors in SW is similar to other forms of presentation of ischaemic heart disease.At present, the exact relationship between the main cardiovascular risk factors and SW is unknown; in addition to the possible associations of this syndrome with in-hospital cardiovascular complications and its value as a predictor of the occurrence of cardiac complications, elements that are included in the results of the present study.

Relación del supradesnivel del segmento ST en aVR con las complicaciones cardiovasculares / Relationship of ST-segment elevation in AVR to cardiovascular complications

Introducción: El patrón de supradesnivel del segmento ST en aVR en el síndrome coronario agudo se asocia con un aumento de la mortalidad. Objetivo: Evaluar la relación entre el patrón de supradesnivel del segmento ST en aVR y las complicaciones cardiovasculares no letales. Método: Estudio observacional de corte transversal, con componente analítico de todos los pacientes ingresados con síndrome coronario agudo sin elevación del segmento ST, en el Hospital Universitario Manuel Fajardo de la Habana entre los años 2016 y 2020. Resultados: Predominó el sexo femenino en el primer grupo, con una mediana de 78 años. Hubo incidencia de cardiopatía isquémica (75 por ciento y 56,4 por ciento) e hipertensión arterial (78,8 por ciento y 85,8 por ciento ). Se determinó una relación estadística significativa entre el patrón con elevación del segmento ST en aVR y las complicaciones cardiovasculares con un riesgo relativo de 5,769 veces. Conclusiones: El patrón de supradesnivel del segmento ST en un síndrome coronario agudo sin elevación del segmento ST predice complicaciones intrahospitalarias cardiovasculares no letales(AU)

Introduction: The pattern of ST-segment elevation in aVR in acute coronary syndrome is associated with increased mortality. Objective: To evaluate the relationship between the pattern of ST-segment elevation in aVR and nonlethal cardiovascular complications. Methods: Observational cross-sectional study, with analytical component of all patients admitted with non-ST-segment elevation acute coronary syndrome at the Manuel Fajardo University Hospital of Havana between 2016 and 2020. Results: Female gender predominated in the first group, with an average age of 78 years. There was incidence of ischemic heart disease (75 percent and 56.4 percent) and arterial hypertension (78.8 percent and 85.8 percent). A significant statistical relationship was determined between the pattern with ST-segment elevation in aVR and cardiovascular complications with a relative risk of 5.769 times. Conclusions: ST-segment suprathreshold pattern in non-ST-segment elevation acute coronary syndrome predicts non-lethal in-hospital cardiovascular complications(AU)

Desenlaces clínicos y radiológicos del tratamiento quirúrgico de la cadera paralítica en pacientes con parálisis cerebral en Bogotá, Colombia / Clinical and radiological outcomes of surgical treatment for paralytic hip in cerebral palsy patients in Bogotá, Colombia

Introducción. La parálisis cerebral (PC) produce una alteración del tono y del balance muscular que puede generar luxación paralítica de cadera (LPC), especialmente en los pacientes más comprometidos Objetivo. Describir los desenlaces clínicos y radiológicos de los pacientes con PC que recibieron tratamiento quirúrgico de la LPC en el Instituto Roosevelt. Materiales y métodos. Estudio observacional retrospectivo realizado en 92 pacientes entre 4 y 18 años con PC y LPC operados entre 2010 y 2014. Se realizaron análisis bivariados para realizar comparaciones entre los hallazgos clínicos y radiológicos antes de la operación de corrección de la LPC y al finalizar el periodo posoperatorio mediante las pruebas de McNemar, T de student y U de- Mann-Whitney. Resultados. La media de edad fue 7,45 años, el 84,8% de los pacientes tenía PC espástica y el 59,8% fue clasificado en el nivel V del Gross motor function classification system. Se realizaron 155 cirugías en los 92 pacientes, los procedimientos más frecuentes fueron reducción cerrada y osteotomías pélvica, femoral varizante y femoral desrotadora. En el posoperatorio el dolor y la dificultad para realizar el aseo, sedestación y abducción de caderas disminuyeron significativamente (p<0,001). Además, hubo diferencias estadísticas en los índices y ángulos radiológicos pre y posoperatorios. Conclusión: Si bien se encontró una mejoría significativa en los desenlaces clínicos y radiológicos evaluados, los procedimientos reconstructivos y de salvamento predominaron, en detrimento de los preventivos, por lo que es necesario fortalecer los programas de seguimiento y prevención de la LPC y sus complicaciones en la institución para disminuir morbilidad en los pacientes con PC

Introduction: Cerebral palsy (CP) causes an alteration of muscle tone and balance that may lead to paralytic hip dislocation (PHD), especially in the most severely affected patients. Objective: To describe the clinical and radiological outcomes of patients with CP who underwent surgical treatment of PHD at the Instituto Roosevelt. Methodology: Retrospective observational study performed on 92 patients aged 4 to 18 years with CP and PHD operated on between 2010 and 2014. Bivariate analyses were performed to compare clinical and radiological findings before and after the surgery to correct PHD using McNemar's test, Student's t-test, and Mann-Whitney U-test. Results: The mean age was 7.45 years, 84.8% of the patients had spastic CP, and 59.8% were classified at level V of the Gross Motor Function Classification System. A total of 155 surgeries were performed in the 92 patients, the most frequent procedures being closed reduction and pelvic, femoral varus, and femoral derotation osteotomies. After surgery, pain, and difficulty in personal care, sitting and hip abduction decreased significantly (p<0.001). In addition, statistical differences were found between preoperative and postoperative radiological indices and angles. Conclusion: Although a significant improvement was found in the clinical and radiological outcomes evaluated, reconstructive and salvage procedures predominated over preventive ones, thus making it necessary to strengthen follow-up and prevention programs for PHD and its complications in the institution in order to reduce morbidity in patients with CP

Calidad de vida en pacientes mayores de 75 años con síndrome coronario agudo / Quality of life in patients older than 75 years with acute coronary syndrome

Introducción: La oclusión parcial o total de una arteria coronaria epicárdica es la génesis más frecuente de los síndromes coronarios agudos. Con la intención de medir el impacto de las enfermedades y el tratamiento en el funcionamiento diario, bienestar físico, emocional y social de cada persona se introduce el término calidad de vida relacionada con la salud. Objetivo: Evaluar la calidad de vida en pacientes mayores de 75 años con síndrome coronario agudo. Métodos: Se realizó un estudio observacional de corte prospectivo con componente analítico en 82 pacientes con diagnóstico de síndrome coronario agudo que recibieron el intervencionismo coronario percutáneo, mayores de 75 años, ingresados en la unidad de cuidados intensivos coronarios del Hospital Clínico-Quirúrgico Comandante Manuel Fajardo en el período comprendido entre enero de 2015 y diciembre de 2019. Resultados: La mediana para la edad fue de 80 años con rango intercuartílico de (77-82), no existió diferencias significativas en cuento al sexo, prevaleció la hipertensión arterial (80,5 por ciento) y los antecedentes de infarto agudo de miocardio (41,5 por ciento). En sentido general las medianas y los rangos en los pacientes con síndrome coronario agudo sin elevación del segmento ST fueron superiores a los que presentaron síndrome coronario agudo con elevación del segmento ST. Las mujeres presentaron una peor función social que los hombres. Conclusiones: Se evaluó la calidad de vida en pacientes mayores de 75 años con síndrome coronario agudo con elevación del segmento ST, tuvieron peores puntuaciones en las diferentes dimensiones de la calidad de vida relacionada con la salud, las mujeres presentaron una peor función social en comparación con los hombres(AU)

Introduction: Partial or total occlusion of an epicardial coronary artery is the most frequent genesis of acute coronary syndromes. With the intention of measuring the impact of disease and treatment on the daily functioning, physical, emotional and social well-being of each person, the term health-related quality of life is introduced. Objective: To evaluate the quality of life in patients over 75 years of age with acute coronary syndrome. Methods: A prospective observational study with an analytical component was conducted in 82 patients with a diagnosis of acute coronary syndrome who received percutaneous coronary interventionism, over 75 years of age, admitted to the coronary intensive care unit of the Clinical-Surgical Hospital Comandante Manuel Fajardo from January 2015 to December 2019. Results: The average age was 80 years with an interquartile range of (77-82), there were no significant differences in terms of gender, hypertension (80.5percent) and a history of acute myocardial infarction (41.5percent) prevailed. In general, the averages and ranges in patients with non-ST-segment elevation acute coronary syndrome were higher than those with ST-segment elevation acute coronary syndrome. Women had worse social function than men. Conclusions: Quality of life was assessed in patients older than 75 years with ST-segment elevation acute coronary syndrome. They had worse scores in the different dimensions of health-related quality of life, women presented worse social function compared to men(AU)

Alteraciones electrocardiográficas en pacientes hospitalizados con COVID-19 / Electrocardiographic alterations in hospitalized patients with COVID-19

Resumen: Introducción: Como consecuencia del daño directo provocado por el virus SARS-CoV-2 sobre el corazón se producen alteraciones electrocardiográficas. Objetivo: Determinar si existe relación entre las alteraciones electrocardiográficas intrahospitalarias, con los antecedentes cardiovasculares y su evolución hospitalaria. Materiales y método: Estudio de cohortes, prospectivo, analítico, en 373 pacientes con el diagnóstico positivo de enfermedad por el nuevo coronavirus 2019 que ingresaron en la Unidad de Cuidados Intensivos del Hospital Docente "Comandante Manuel Fajardo" (La Habana, Cuba) entre marzo del 2020 y octubre del mismo año. Resultados: La mediana de edad fue de 69 (RIC 57-77); el 14.2% de los pacientes presentó fibrilación auricular, el 8,3% bloqueo de rama derecha y el 4.8% alteraciones del segmento ST. La edad, los antecedentes de cardiopatía isquémica y la diabetes mellitus se identificaron como variables predictoras independientes de alteraciones electrocardiográficas (RR 1.02; IC 95%: 1.01-1.04; p = 0.007; 2.21; IC 95%: 1.19-4.10, p = 0.012 y RR 1.71; IC 95%: 1.04-2.85, p = 0.036, respectivamente). Conclusiones: La prevalencia de alteraciones electrocardiográficas en pacientes hospitalizados con el nuevo coronavirus fue mayor comparada con otras series. Los antecedentes de cardiopatía isquémica y diabetes mellitus, además de la edad, se identificaron como variables predictoras independientes de alteraciones electrocardiográficas en pacientes con afección grave por la enfermedad del nuevo coronavirus 2019.

Abstract: Introduction: As a consequence of the direct damage caused by the virus on the heart, electrocardiographic alterations occur. Objective: To determine if there is a relationship between in-hospital electrocardiographic alterations with cardiovascular history and hospital evolution. Materials and method: Analytical prospective cohort study in 373 patients with a positive diagnosis of disease due to the new coronavirus 2019 who were admitted to the Intensive Care Unit of the "Comandante Manuel Fajardo" Universitary Hospital (Havana, Cuba) between March 2020 and October of the same year. Results: The median age was 69 (IQR; 57-77), 14.2% of patients had atrial fibrillation, 8.3% right bundle branch block, and 4.8% ST-segment abnormalities. Age, history of ischemic heart disease, and diabetes mellitus were identified as independent predictor variables of electrocardiographic abnormalities (RR 1.02; 95% CI: 1.01-1.04, p = 0.007; RR 2.21; 95% CI: 1.19-4.10, p = 0.012 and RR 1.71 95% CI: 1.04-2.85, p = 0.036, respectively). Conclusions: The prevalence of electrocardiographic abnormalities in hospitalized patients with the new coronavirus was higher compared to other series. History of ischemic heart disease and diabetes mellitus, in addition to age, were identified as independent predictors of electrocardiographic abnormalities in patients severely affected by the new coronavirus disease 2019.

JM-20, a Benzodiazepine-Dihydropyridine Hybrid Molecule, Inhibits the Formation of Alpha-Synuclein-Aggregated Species.

Studies showed that JM-20, a benzodiazepine-dihydropyridine hybrid molecule, protects against rotenone and 6-hydroxydopamine neurotoxicity. However, its protective effects against cytotoxicity induced by endogenous neurotoxins involved in Parkinson's disease (PD) pathogenesis have never been investigated. In this study, we evaluated the ability of JM-20 to inhibit alpha-synuclein (aSyn) aggregation. We also evaluated the interactions of JM-20 with aSyn by molecular docking and molecular dynamics and assessed the protective effect of JM-20 against aminochrome cytotoxicity. We demonstrated that JM-20 induced the formation of heterogeneous amyloid fibrils, which were innocuous to primary cultures of mesencephalic cells. Moreover, JM-20 reduced the average size of aSyn positive inclusions in H4 cells transfected with SynT wild-type and synphilin-1-V5, but not in HEK cells transfected with synphilin-1-GFP. In silico studies showed the interaction between JM-20 and the aSyn-binding site. Additionally, we showed that JM-20 protects SH-SY5Y cells against aminochrome cytotoxicity. These results reinforce the potential of JM-20 as a neuroprotective compound for PD and suggest aSyn as a molecular target for JM-20.

Green Extraction of Annatto Seed Oily Extract and Its Use as a Pharmaceutical Material for the Production of Lipid Nanoparticles.

This work developd nanomaterials formulated from annatto seed oily extract (ASE), myristic acid (tetradecanoic acid), and their fatty acid esters. The annatto seed oily extract was obtained using only soybean oil (ASE + SO) and Brazil nut oil (ASE + BNO). The UV/VIS analysis of the oily extracts showed three characteristic peaks of the bixin molecule at 430, 456 and 486 nm. The lipid nanoparticles obtained using myristic acid and ASE + BNO or only BNO showed better results than the oil soybean extract, i.e., the particle size was <200 nm, PDI value was in the range of 0.2−0.3, and had no visual physical instability as they kept stable for 28 days at 4 °C. Lipid nanoemulsions were also produced with esters of myristic acid and ASE + BNO. These fatty acid esters significantly influenced the particle size of nanoemulsions. For instance, methyl tetradecanoate led to the smallest particle size nanoemulsions (124 nm), homogeneous size distribution, and high physical stability under 4 and 32 °C for 28 days. This work demonstrates that the chemical composition of vegetable oils and myristic acid esters, the storage temperature, the chain length of fatty acid esters (FAE), and their use as co-lipids improve the physical stability of lipid nanoemulsions and nanoparticles from annatto seed oily extract.

Factores asociados al síndrome de Wellens en pacientes con síndrome coronario agudo sin elevación del segmento ST / Factors associated to Wellens' syndrome in patients with acute coronary syndrome without ST-segment elevation

Introducción: El síndrome de Wellens constituye un equivalente del síndrome coronario agudo con elevación del segmento ST. Este incluye dos patrones electrocardiográficos que sugieren lesión crítica de la arteria descendente anterior. Objetivo: Evaluar probables factores asociados al síndrome de Wellens en pacientes con síndrome coronario agudo sin elevación del segmento ST y lesiones coronarias significativas en la arteria descendente anterior. Material y métodos: Se realizó un estudio observacional, analítico, transversal en pacientes con diagnóstico de síndrome coronario agudo sin elevación del ST y lesión significativa en la arteria descendente anterior, comprobada mediante coronariografía, ingresados en la unidad de cuidados coronarios intensivos del Hospital Clínico-Quirúrgico Manuel Fajardo entre el 2016 y 2019. Resultados: La edad media fue de 66 años, predominó el sexo masculino (53,9 por ciento) y el antecedente de hipertensión arterial (89,5 por ciento). Los pacientes con síndrome de Wellens tuvieron un significativo menor porcentaje de antecedente de cardiopatía isquémica (58,1 por ciento vs. 84,8 por ciento; p = 0,012). Además, el síndrome arrojó asociación estadísticamente muy significativa con la condición de fumador activo (51,2 por ciento vs. 15,2 por ciento; p < 0,01). No se encontró relación estadística significativa entre el síndrome de Wellens y el resultado angiográfico. Conclusiones: La presencia de los patrones electrocardiográficos del síndrome de Wellens se asocia con el hábito tabáquico en pacientes con síndrome coronario agudo sin elevación del segmento ST y lesiones coronarias en la arteria descendente anterior, y su ausencia se asocia con el antecedente de cardiopatía isquémica en el mismo subgrupo de individuos(AU)

Introduction: Wellens' syndrome is equivalent to acute coronary syndrome with ST-segment elevation. It includes two electrocardiographic patterns suggesting a critical lesion in the anterior descending artery. Objective: Evaluate probable factors associated to Wellens' syndrome in patients with acute coronary syndrome without ST-segment elevation and significant coronary lesions in the anterior descending artery. Methods: A cross-sectional observational analytical study was conducted of patients diagnosed with acute coronary syndrome without ST-segment elevation and significant lesion in the anterior descending artery verified by coronary arteriography, admitted to the intensive coronary care unit at Manuel Fajardo Clinical Surgical Hospital in the period 2016-2019. Results: Mean age was 66 years, with a predominance of the male sex (53.9 percent) and a history of hypertension (89.5 percent). Patients with Wellens' syndrome had a significantly lower percentage of ischemic heart disease antecedents (58.1 percent vs. 84.8 percent; p = 0.012). A very significant statistical association was observed between the syndrome and active smoking (51.2 percent vs. 15.2 percent; p < 0.01). A significant statistical relationship was not found between Wellens' syndrome and angiographic results. Conclusions: The presence of electrocardiographic patterns of Wellens' syndrome is associated to smoking in patients with acute coronary syndrome without ST-segment elevation and coronary lesions in the anterior descending artery, whereas their absence is associated to a history of ischemic heart disease in the same subgroup of individuals(AU)

JM-20 treatment prevents neuronal damage and memory impairment induced by aluminum chloride in rats.

The number of people with dementia worldwide is estimated at 50 million by 2018 and continues to rise mainly due to increasing aging and population growth. Clinical impact of current interventions remains modest and all efforts aimed at the identification of new therapeutic approaches are therefore critical. Previously, we showed that JM-20, a dihydropyridine-benzodiazepine hybrid molecule, protected memory processes against scopolamine-induced cholinergic dysfunction. In order to gain further insight into the therapeutic potential of JM-20 on cognitive decline and Alzheimer's disease (AD) pathology, here we evaluated its neuroprotective effects after chronic aluminum chloride (AlCl3) administration to rats and assessed possible alterations in several types of episodic memory and associated pathological mechanisms. Oral administration of aluminum to rodents recapitulates several neuropathological alterations and cognitive impairment, being considered a convenient tool for testing the efficacy of new therapies for dementia. We used behavioral tasks to test spatial, emotional- associative and novel object recognition memory, as well as molecular, enzymatic and histological assays to evaluate selected biochemical parameters. Our study revealed that JM-20 prevented memory decline alongside the inhibition of AlCl3 -induced oxidative stress, increased AChE activity, TNF-α and pro-apoptotic proteins (like Bax, caspase-3, and 8) levels. JM-20 also protected against neuronal damage in the hippocampus and prefrontal cortex. Our findings expanded our understanding of the ability of JM-20 to preserve memory in rats under neurotoxic conditions and confirm its potential capacity to counteract cognitive impairment and etiological factors of AD by breaking the progression of key steps associated with neurodegeneration.

Factores de riesgo asociados a las variantes clínicas del síndrome coronario agudo / Risk factors associated with clinical variants of acute coronary syndrome

Introducción: En la actualidad, carecen los estudios que relacionan los factores de riesgo cardiovascular con las formas clínicas del síndrome coronario agudo. En caso de existir estos estudios, sería posible desarrollar estrategias de prevención más focalizadas e individualizadas. Objetivo: Identificar si existe asociación entre las formas clínicas del síndrome coronario agudo y algunos factores de riesgo vascular clásicos. Métodos: Se realizó un estudio observacional analítico transversal en pacientes ingresados en el servicio de cuidados coronarios del Hospital Clínico Quirúrgico Comandante Manuel Fajardo entre los años 2013 y 2018. Fueron incluidos los pacientes con diagnóstico de síndrome coronario agudo. Los datos se extrajeron de las historias clínicas. Para comprobar la hipótesis se utilizaron modelos univariantes y multivariantes. Un valor de p˂ 0,05 fue considerado significativo. Resultados: Se estudiaron 393 pacientes, de los cuales el 25,7 por ciento fueron diagnosticados con síndrome coronario agudo con elevación del segmento ST y el 74,3 por ciento con síndrome coronario agudo sin elevación del segmento ST. En el primer grupo, la mediana de edad de los pacientes fue significativamente mayor (p < 0,001). El tabaquismo constituyó una variable predictora de la elevación del segmento ST (OR: 3,89; IC 95 por ciento: 2,24-6,73, p < 0,001). Se relacionaron de manera inversa el antecedente de cardiopatía isquémica (OR: 0,13; IC 95 por ciento: 0,07-0,25; p < 0,001) y la hipertensión arterial (OR: 0,38; IC 95 por ciento: 0,20-0,72; p= 0,003). Conclusiones: Se concluye que el tabaquismo constituye un predictor de síndrome coronario agudo con elevación del segmento ST, mientras que el antecedente de cardiopatía isquémica y la hipertensión arterial se relacionaron con la no elevación del segmento ST(AU)

Introduction: Currently, there is a lack of studies that relate cardiovascular risk factors with clinical forms of acute coronary syndrome. If these studies happen, it would be possible to develop more targeted and individualized prevention strategies. Objective: To identify if there is an association between the clinical forms of acute coronary syndrome and some classic vascular risk factors. Methods: A cross-sectional analytical observational study was carried out in patients admitted to the coronary care service at Commandant Manuel Fajardo Clinical Surgical Hospital from 2013 to 2018. Patients with diagnosis of acute coronary syndrome were included. Data were pulled out from medical records. To test the hypothesis, univariate and multivariate models were used. A value of p ˂ 0.05 was considered significant. Results: Three hundred ninety three (393) patients were studied, of which 25.7 percent were diagnosed with acute coronary syndrome with ST segment elevation and 74.3 percent with acute coronary syndrome without ST segment elevation. In the first group, the median age of the patients was significantly higher (p < 0.001). Smoking was a predictor variable for ST segment elevation (OR: 3.89; 95 percent CI: 2.24-6.73, p < 0.001). A history of ischemic heart disease (OR: 0.13; 95 percent CI: 0.07-0.25; p < 0.001) and arterial hypertension (OR: 0.38; 95 percent CI: 0, were inversely related). 20-0.72; p = 0.003). Conclusions: It is concluded that smoking is a predictor of acute coronary syndrome with ST segment elevation, while history of ischemic heart disease and arterial hypertension were related to non-ST segment elevation(AU)

Signo de «spiked helmet» (casco prusiano) en electrocardiograma de una paciente con cirugía abdominal

RESUMEN En la evaluación de pacientes con eventos abdominales o torácicos agudos se ha encontrado una elevación del segmento ST similar a la que se presenta en el infarto agudo de miocardio. Este nuevo patrón se caracteriza por presentar elevación de la línea isoeléctrica precedente a los QRS, seguido de una onda R picuda y supradesnivel convexo del segmento ST que se denomina, debido a su semejanza gráfica, signo de «spiked helmet» (casco prusiano), lo cual -traducido al español- significa casco con púas. Se presenta el caso de una paciente de 56 años de edad, con antecedentes de hipertensión arterial, a quien se le realizó una cirugía abdominal urgente y presentó, en el electrocardiograma, un supradesnivel del segmento ST > 1 mm en DII, DIII y aVF, con ondas R picudas, que desaparecieron a las 6 horas, sin que se demostrara enfermedad cardíaca asociada.

ABSTRACT An ST-segment elevation similar to that in acute myocardial infarction has been found during the assessment of patients with acute abdominal or thoracic events. In this relatively new electrocardiographic pattern, the elevation of the isoelectric line precedes the QRS, followed by a sharp R wave and convex ST-segment elevation known as the "spiked helmet" sign because of its resemblance to the Prussian military helmet, the Pickelhaube. We present the case of a 56-year-old female patient with a history of high blood pressure who underwent emergency abdominal surgery. The electrocardiogram showed ST-segment elevation > 1 mm in DII, DIII and aVF, with sharp R waves that disappeared at 6 hours. No associated cardiac disease was identified.