Rehabilitación cardiaca en mujeres y hombres después de un infarto agudo del miocardio

Fundamento: la rehabilitación cardiovascular favorece la recuperación de los pacientes que sufren de infarto del agudo del miocardio. Objetivo caracterizar la rehabilitación cardiovascular en mujeres y hombres con un primer infarto agudo de miocardio no complicado con elevación del segmento ST. Métodos: se realizó un estudio descriptivo y transversal en el Centro de Atención Cardiovascular del Hospital Provincial Docente Clínico Quirúrgico Manuel Ascunce Domenech de Camagüey en el período comprendido entre septiembre de 2015 hasta septiembre del 2016. La muestra estuvo constituida por 65 pacientes a los que se realizó una prueba ergométrica y ecocardiograma pre-alta y 6 semanas después de rehabilitados. A los cinco años se evaluó supervivencia. Se realizó prueba de ergométrica máxima limitada por síntomas para determinar estratificación de riesgo, capacidad funcional, prescripción de la actividad y proporcionar información al paciente. Resultados: hubo mayor incidencia de infarto rehabilitado en el sexo masculino, el grupo de edad más afectado fue el de 50-59 años y la hipertensión arterial fue el factor de riesgo cardiovascular predominante. Hubo notable mejoría en los parámetros ergométricos y hemodinámicos después de las 6 semanas de la rehabilitación. La reacción hipertensiva y la disnea, disminuyeron en la mayoría de los casos al final del estudio. Los pacientes que comenzaron el estudio mejoraron su clase funcional a las 6 semanas de rehabilitados y hubo un incremento de la categoría riesgo bajo a expensas del riesgo moderado. La supervivencia a los cinco años fue del 89,9 %. Conclusiones: se obtuvo una significativa mejoría de parámetros clínicos y ergométricos, así como la reincorporación a las labores cotidianas en los pacientes que participaron en el programa. Las mujeres recibieron menos beneficios de este programa que los hombres.

Background: cardiovascular rehabilitation favors the recovery of patients suffering from acute myocardial infarction. Objective: to characterize cardiovascular rehabilitation in women and men with a first uncomplicated acute myocardial infarction with ST-segment elevation. Methods: a descriptive and cross-sectional study was carried out at the Cardiovascular Care Center of the Manuel Ascunce Domenech Teaching Clinical Surgical Provincial Hospital in Camagüey in the period from September 2015 to September 2016. The sample consisted of 65 patients. who underwent a stress test and echocardiogram before discharge and 6 weeks after rehabilitation. Survival was evaluated at five years. Symptom-limited maximal stress test was performed to determine risk stratification, functional capacity, activity prescription and provide information to the patient. Results: there was a higher incidence of rehabilitated infarction in males, the most affected age group was 50-59 years, and arterial hypertension was the predominant cardiovascular risk factor. There was notable improvement in the ergometric and hemodynamic parameters after 6 weeks of rehabilitation. The hypertensive reaction and dyspnea decreased in most cases at the end of the study. The patients who began the study improved their functional class 6 weeks after rehabilitation and there was an increase in the low risk category at the expense of moderate risk. Five-year survival was 89.9 %. Conclusions: a significant improvement of clinical and ergometric parameters was obtained, as well as the return to daily tasks in the patients who participated in the program. Women received fewer benefits from this program than men.

Expression of pathogenesis-related proteins in transplastomic tobacco plants confers resistance to filamentous pathogens under field trials.

Plants are continuously challenged by pathogens, affecting most staple crops compromising food security. They have evolved different mechanisms to counterattack pathogen infection, including the accumulation of pathogenesis-related (PR) proteins. These proteins have been implicated in active defense, and their overexpression has led to enhanced resistance in nuclear transgenic plants, although in many cases constitutive expression resulted in lesion-mimic phenotypes. We decided to evaluate plastid transformation as an alternative to overcome limitations observed for nuclear transgenic technologies. The advantages include the possibilities to express polycistronic RNAs, to obtain higher protein expression levels, and the impeded gene flow due to the maternal inheritance of the plastome. We transformed Nicotiana tabacum plastids to co-express the tobacco PR proteins AP24 and ß-1,3-glucanase. Transplastomic tobacco lines were characterized and subsequently challenged with Rhizoctonia solani, Peronospora hyoscyami f.sp. tabacina and Phytophthora nicotianae. Results showed that transplastomic plants expressing AP24 and ß-1,3-glucanase are resistant to R. solani in greenhouse conditions and, furthermore, they are protected against P.hyoscyami f.sp. tabacina and P. nicotianae in field conditions under high inoculum pressure. Our results suggest that plastid co- expression of PR proteins AP24 and ß-1,3-glucanase resulted in enhanced resistance against filamentous pathogens.

High-throughput SuperSAGE for gene expression analysis of Nicotiana tabacum-Rhizoctonia solani interaction.

OBJECTIVE: The ubiquitous soil pathogen Rhizoctonia solani causes serious diseases in different plant species. Despite the importance of this disease, little is known regarding the molecular basis of susceptibility. SuperSAGE technology and next-generation sequencing were used to generate transcript libraries during the compatible Nicotiana tabacum-R. solani interaction. Also, we used the post-transcriptional silencing to evaluate the function of a group of important genes. RESULTS: A total of 8960 and 8221 unique Tag sequences identified as differentially up- and down-regulated were obtained. Based on gene ontology classification, several annotated UniTags corresponded to defense response, metabolism and signal transduction. Analysis of the N. tabacum transcriptome during infection identified regulatory genes implicated in a number of hormone pathways. Silencing of an mRNA induced by salicylic acid reduced the susceptibility of N. tabacum to R. solani. We provide evidence that the salicylic acid pathway was involved in disease development. This is important for further development of disease management strategies caused by this pathogen.

'Candidatus Liberibacter asiaticus', Causal Agent of Citrus Huanglongbing, Is Reduced by Treatment with Brassinosteroids.

Huanglongbing (HLB) constitutes the most destructive disease of citrus worldwide, yet no established efficient management measures exist for it. Brassinosteroids, a family of plant steroidal compounds, are essential for plant growth, development and stress tolerance. As a possible control strategy for HLB, epibrassinolide was applied to as a foliar spray to citrus plants infected with the causal agent of HLB, 'Candidatus Liberibacter asiaticus'. The bacterial titers were reduced after treatment with epibrassinolide under both greenhouse and field conditions but were stronger in the greenhouse. Known defense genes were induced in leaves by epibrassinolide. With the SuperSAGE technology combined with next generation sequencing, induction of genes known to be associated with defense response to bacteria and hormone transduction pathways were identified. The results demonstrate that epibrassinolide may provide a useful tool for the management of HLB.

Expression of a Nicotiana tabacum pathogen-induced gene is involved in the susceptibility to black shank.

Many host genes induced during compatible plant-pathogen interactions constitute targets of pathogen virulence factors that act to suppress host defenses. In order to identify Nicotiana tabacum L. genes for pathogen-induced proteins involved in susceptibility to the oomycete Phytophthora parasitica var. nicotianae, we used SuperSAGE technology combined with next-generation sequencing to identify transcripts that were differentially upregulated during a compatible interaction. We identified a pathogen-induced gene (NtPIP) that was rapidly induced only during the compatible interaction. Virus-induced gene silencing of NtPIP reduced the susceptibility of N. tabacum to P. parasitica var. nicotianae. Additionally, transient expression of NtPIP in the resistant species Nicotiana megalosiphon Van Heurck & Mull. Arg. compromised the resistance to P. parasitica var. nicotianae. This pathogen-induced protein is therefore a positive regulator of the susceptibility response against an oomycete pathogen in tobacco.

NmDef02, a novel antimicrobial gene isolated from Nicotiana megalosiphon confers high-level pathogen resistance under greenhouse and field conditions.

Plant defensins are small cysteine-rich peptides that inhibit the growth of a broad range of microbes. In this article, we describe NmDef02, a novel cDNA encoding a putative defensin isolated from Nicotiana megalosiphon upon inoculation with the tobacco blue mould pathogen Peronospora hyoscyami f.sp. tabacina. NmDef02 was heterologously expressed in the yeast Pichia pastoris, and the purified recombinant protein was found to display antimicrobial activity in vitro against important plant pathogens. Constitutive expression of NmDef02 gene in transgenic tobacco and potato plants enhanced resistance against various plant microbial pathogens, including the oomycete Phytophthora infestans, causal agent of the economically important potato late blight disease, under greenhouse and field conditions.

Over-expression of a protein kinase gene enhances the defense of tobacco against Rhizoctonia solani.

To identify Nicotiana tabacum genes involved in resistance and susceptibility to Rhizoctonia solani, suppression subtractive hybridization was used to generate a cDNA library from transcripts that are differentially expressed during a compatible and incompatible interaction. This allowed the isolation of a protein kinase cDNA that was down-regulated during a compatible and up-regulated during an incompatible interaction. Quantitative RT-PCR analysis of this gene confirmed the differential expression patterns between the compatible and incompatible interactions. Over-expression of this gene in tobacco enhanced the resistance to damping-off produced by an aggressive R. solani strain. Furthermore, silencing of this protein kinase gene reduced the resistance to a non-aggressive R. solani strain. A set of reported tobacco-resistant genes were also evaluated in tobacco plants over-expressing and silencing the protein kinase cDNA. Several genes previously associated with resistance in tobacco, like manganese superoxide dismutase, Hsr203J, chitinases and phenylalanine ammonia-lyase, were up-regulated in tobacco plants over-expressing the protein kinase cDNA. Potentially, the protein kinase gene could be used to engineer resistance to R. solani in tobacco cultivars susceptible to this important pathogen.

Black shank resistant tobacco by silencing of glutathione S-transferase.

A glutathione S-transferase gene was amplified from cDNA of Nicotiana tabacum roots infected with Phytophthora parasitica var. nicotianae. The gene was cloned in sense and anti-sense orientation to an RNAi vector for induced gene silencing, and reduced expression of the gene was detected by RT-PCR. A statistically significant increase in resistance of N. tabacum to infection following gene silencing was found for glutathione S-transferase-silenced plants compared with control plants. Some defense genes were up-regulated in glutathione S-transferase-silenced plants during the interaction with the pathogen. This is the first evidence of the role of glutathione S-transferase as negative regulator of defense response.

Hernia diafragmática traumática, la gran imitadora: reporte de un caso / Traumatic diaphragmatic hernia, the great imitator: a case report

Se presentó el caso de una paciente de 64 años de edad, portadora de una hernia diafragmática traumática con antecedentes de un trauma toracoabdominal cerrado, ocurrido en su hogar. Los traumas cerrados son propios de los países desarrollados, mientras que los abiertos son más frecuentes en países en desarrollo. Entre sus clasificaciones se destaca la clínica y los medios diagnósticos convencionales. La laparoscopia, toracoscopia, tomografía computarizada y la resonancia magnética son útiles para el diagnóstico temprano de hernias diafragmáticas ocultas. Debe existir un alto índice de sospecha en traumas toracoabdominales para diagnosticar tempranamente la hernia diafragmática traumática ya que la misma puede imitar enfermedades cardiovasculares, respiratorias y torácicas en un alto por ciento de los casos

Hernia diafragmática traumática, la gran imitadora: reporte de un caso / Traumatic diaphragmatic hernia, the great imitator: a case report

Se presentó el caso de una paciente de 64 años de edad, portadora de una hernia diafragmática traumática con antecedentes de un trauma toracoabdominal cerrado, ocurrido en su hogar. Los traumas cerrados son propios de los países desarrollados, mientras que los abiertos son más frecuentes en países en desarrollo. Entre sus clasificaciones se destaca la clínica y los medios diagnósticos convencionales. La laparoscopia, toracoscopia, tomografía computarizada y la resonancia magnética son útiles para el diagnóstico temprano de hernias diafragmáticas ocultas. Debe existir un alto índice de sospecha en traumas toracoabdominales para diagnosticar tempranamente la hernia diafragmática traumática ya que la misma puede imitar enfermedades cardiovasculares, respiratorias y torácicas en un alto por ciento de los casos(AU)

EIL2 transcription factor and glutathione synthetase are required for defense of tobacco against tobacco blue mold.

In order to identify tobacco (Nicotiana megalosiphon) genes involved in broad-spectrum resistance to tobacco blue mold (Peronospora hyoscyami f. sp. tabacina), suppression subtractive hybridization was used to generate cDNA from transcripts that are differentially expressed during an incompatible interaction. After differential screening by membrane-based hybridization, clones corresponding to 182 differentially expressed genes were selected, sequenced, and analyzed. The cDNA collection comprised a broad repertoire of genes associated with various processes. Northern blot analysis of a subset of these genes confirmed the differential expression patterns between the compatible and incompatible interaction. Subsequent virus-induced gene silencing (VIGS) of four genes that were found to be differentially induced was pursued. While VIGS of a lipid transfer protein gene or a glutamate decarboxylase gene in Nicotiana megalosiphon did not affect blue mold resistance, silencing of an EIL2 transcription factor gene and a glutathione synthetase gene was found to compromise the resistance of Nicotiana megalosiphon to P. hyoscyami f. sp. tabacina. Potentially, these genes can be used to engineer resistance in blue mold-susceptible tobacco cultivars.