Evidence of an upper ionospheric electric field perturbation correlated with a gamma ray burst.

Earth's atmosphere, whose ionization stability plays a fundamental role for the evolution and endurance of life, is exposed to the effect of cosmic explosions producing high energy Gamma-ray-bursts. Being able to abruptly increase the atmospheric ionization, they might deplete stratospheric ozone on a global scale. During the last decades, an average of more than one Gamma-ray-burst per day were recorded. Nevertheless, measurable effects on the ionosphere were rarely observed, in any case on its bottom-side (from about 60 km up to about 350 km of altitude). Here, we report evidence of an intense top-side (about 500 km) ionospheric perturbation induced by significant sudden ionospheric disturbance, and a large variation of the ionospheric electric field at 500 km, which are both correlated with the October 9, 2022 Gamma-ray-burst (GRB221009A).

ß-Cyclodextrins as affordable antivirals to treat coronavirus infection.

The SARS-CoV-2 pandemic made evident that there are only a few drugs against coronavirus. Here we aimed to identify a cost-effective antiviral with broad spectrum activity and high safety profile. Starting from a list of 116 drug candidates, we used molecular modelling tools to rank the 44 most promising inhibitors. Next, we tested their efficacy as antivirals against α and ß coronaviruses, such as the HCoV-229E and SARS-CoV-2 variants. Four drugs, OSW-1, U18666A, hydroxypropyl-ß-cyclodextrin (HßCD) and phytol, showed in vitro antiviral activity against HCoV-229E and SARS-CoV-2. The mechanism of action of these compounds was studied by transmission electron microscopy and by fusion assays measuring SARS-CoV-2 pseudoviral entry into target cells. Entry was inhibited by HßCD and U18666A, yet only HßCD inhibited SARS-CoV-2 replication in the pulmonary Calu-3 cells. Compared to the other cyclodextrins, ß-cyclodextrins were the most potent inhibitors, which interfered with viral fusion via cholesterol depletion. ß-cyclodextrins also prevented infection in a human nasal epithelium model ex vivo and had a prophylactic effect in the nasal epithelium of hamsters in vivo. All accumulated data point to ß-cyclodextrins as promising broad-spectrum antivirals against different SARS-CoV-2 variants and distant alphacoronaviruses. Given the wide use of ß-cyclodextrins for drug encapsulation and their high safety profile in humans, our results support their clinical testing as prophylactic antivirals.

Digoxin is a potent inhibitor of Bunyamwera virus infection in cell culture.

Drug repurposing is a valuable source of new antivirals because many compounds used to treat a variety of pathologies can also inhibit viral infections. In this work, we have tested the antiviral capacity of four repurposed drugs to treat Bunyamwera virus (BUNV) infection in cell cultures. BUNV is the prototype of the Bunyavirales order, a large group of RNA viruses that includes important pathogens for humans, animals and plants. Mock- and BUNV-infected Vero and HEK293T cells were treated with non-toxic concentrations of digoxin, cyclosporin A, sunitinib and chloroquine. The four drugs inhibited BUNV infection with varying potency in Vero cells, and all except sunitinib also in HEK293T cells, with digoxin rendering the lowest half maximal inhibitory concentration (IC50). Since digoxin rendered the best results, we selected this drug for a more detailed study. Digoxin is an inhibitor of the Na+/K+ ATPase, a plasma membrane enzyme responsible for the energy-dependent exchange of cytoplasmic Na+ for extracellular K+ in mammalian cells and involved in many signalling pathways. Digoxin was shown to act at an early time point after viral entry reducing the expression of the viral proteins Gc and N. Effects on the cell cycle caused by BUNV and digoxin were also analysed. In Vero cells, digoxin favoured the transition from G1 phase of the cell cycle to S phase, an effect that might contribute to the anti-BUNV effect of digoxin in this cell type. Transmission electron microscopy showed that digoxin impedes the assembly of the characteristic spherules that harbour the BUNV replication complexes and the morphogenesis of new viral particles. Both BUNV and digoxin induce similar changes in the morphology of mitochondria that become more electron-dense and have swollen cristae. The alterations of this essential organelle might be one of the factors responsible for digoxin-induced inhibition of viral infection. Digoxin did not inhibit BUNV infection in BHK-21 cells that have a digoxin-resistant Na+/K+ ATPase, which suggests that the effects of the blockade of this enzyme is a key factor of the antiviral activity of digoxin in BUNV-infected Vero cells.

Factores de riesgo de cardiotoxicidad precoz por quimioterapia en pacientes con cáncer de mama / Risk factors for early cardiotoxicity due to chemotherapy in patients with breast cancer / Fatores de risco para cardiotoxicidade precoce por quimioterapia em pacientes com câncer de mama

RESUMEN Introducción: la quimioterapia triplica el riesgo de toxicidad miocárdica. Junto con las segundas neoplasias, es la causa más frecuente de mortalidad en pacientes con cáncer de mama con larga supervivencia. Objetivo: identificar los factores de riesgo de cardiotoxicidad precoz por quimioterapia en pacientes con cáncer de mama Métodos: se realizó un estudio longitudinal prospectivo de cohorte única, con 224 pacientes portadoras de cáncer de mama en tratamiento con quimioterapia seguidas en consulta de cardio-oncologíade la policlínica de especialidades del Hospital Provincial General "Carlos Manuel de Céspedes", Bayamo, Granma, Cuba, en el periodo comprendido entre 15 de enero de 2019 a 23 marzo de 2021. Los predictores independientes de cardiotoxicidad se obtuvieron usando regresión logística multivariable. Resultados: la prevalencia de cardiotoxicidad fue de 19,2 % con edad media de 60,4 años, desviación estándar 12,7; hipertensión arterial, dislipidemia y otros marcadores de riesgo para enfermedades cardiovasculares como diabetes mellitus (riesgo relativo 2,8), cardiopatía hipertensiva (riesgo relativo 7,8), hipertrofia ventricular izquierda (riesgo relativo 3,3)y grasa epicárdica mayor de 6 mm, fueron variables relacionadas significativamente al riesgo de cardiotoxicidad. Conclusiones: cardiopatía hipertensiva, hipertrofia ventricular izquierda, diabetes mellitus, edad igual o mayor de 65 años y dislipidemia, incrementaron el riesgo de aparición de cardiotoxicidad y se relacionaron significativamente con ella, por tanto, resultaron ser factores de riesgo con influencia independiente sobre la cardiotoxicidad. Los resultados obtenidos nos permiten proyectar estudios de predicción de desarrollo y reversibilidad de cardiotoxicidad en pacientes de alto riesgo que reciban tratamientos cardioprotectores.

ABSTRACT Introduction: chemotherapy triples the risk of myocardial toxicity. Along with second neoplasms, it is the most frequent cause of mortality in long-surviving breast cancer patients. Objective: to identify the risk factors for early cardiotoxicity due to chemotherapy in patients with breast cancer. Methods: a prospective longitudinal study of a single cohort was carried out, with 224 patients with breast cancer undergoing chemotherapy treatment followed up in the cardio-oncology consultation of the specialties polyclinic at the General Provincial Hospital "Carlos Manuel de Céspedes." Bayamo. Granma, Cuba in the period from January 15, 2019 to March 23, 2021. Independent predictors of cardiotoxicity were obtained using multivariate logistic regression. Results: the prevalence of cardiotoxicity was 19.2% with a mean age of 60.4 years, standard deviation 12.7; arterial hypertension, dyslipidemia and other risk markers for cardiovascular diseases such as diabetes mellitus (relative risk 2.8), hypertensive heart disease (relative risk 7.8), left ventricular hypertrophy (relative risk 3.3) and epicardial fat greater than 6 mm, were variables significantly related to the risk of cardiotoxicity. Conclusions: hypertensive heart disease left ventricular hypertrophy, Diabetes Mellitus, age ≥65 years and dyslipidemia increased the risk of cardiotoxicity and were significantly related to it, therefore, they turned out to be risk factors with independent influence on cardiotoxicity. The results obtained allow us to plan studies to predict the development and reversibility of cardiotoxicity in high-risk patients receiving cardioprotective treatments.

RESUMO Introdução: a quimioterapia triplica o risco de toxicidade miocárdica. Juntamente com as segundas neoplasias, é a causa mais frequente de mortalidade em pacientes com câncer de mama de longa sobrevida. Objetivo: identificar os fatores de risco para cardiotoxicidade precoce por quimioterapia em pacientes com câncer de mama. Métodos: foi realizado um estudo longitudinal prospectivo de coorte única, com 224 pacientes com câncer de mama em tratamento com quimioterapia acompanhadas na consulta de cardio-oncologia da policlínica de especialidades do Hospital Geral Provincial "Carlos Manuel de Céspedes", Bayamo, Granma, Cuba, no período de 15 de janeiro de 2019 a 23 de março de 2021. Os preditores independentes de cardiotoxicidade foram obtidos por meio de regressão logística multivariada. Resultados: a prevalência de cardiotoxicidade foi de 19,2% com média de idade de 60,4 anos, desvio padrão de 12,7; hipertensão arterial, dislipidemia e outros marcadores de risco para doenças cardiovasculares como diabetes mellitus (risco relativo 2,8), cardiopatia hipertensiva (risco relativo 7,8), hipertrofia ventricular esquerda (risco relativo 3,3) e gordura epicárdica maior que 6 mm, foram variáveis ​​significativamente relacionadas ao risco de cardiotoxicidade. Conclusões: cardiopatia hipertensiva, hipertrofia ventricular esquerda, diabetes mellitus, idade ≥65 anos e dislipidemia aumentaram o risco de cardiotoxicidade e estiveram significativamente relacionados a ela, portanto, revelaram-se fatores de risco com influencia independente na cardiotoxicidade. Os resultados obtidos permitem planejar estudos para prever o desenvolvimento e a reversibilidade da cardiotoxicidade em pacientes de alto risco recebendo tratamentos cardioprotetores.

Factores de riesgo de cardiotoxicidad precoz por quimioterapia en pacientes con cáncer de mama / Risk factors for early cardiotoxicity due to chemotherapy in patients with breast cancer

Introducción: la quimioterapia triplica el riesgo de toxicidad miocárdica. Junto con las segundas neoplasias, es la causa más frecuente de mortalidad en pacientes con cáncer de mama con larga supervivencia. Objetivo: identificar los factores de riesgo de cardiotoxicidad precoz por quimioterapia en pacientes con cáncer de mama. Métodos: se realizó un estudio longitudinal prospectivo de cohorte única, con 224 pacientes portadoras de cáncer de mama en tratamiento con quimioterapia seguidas en consulta de cardio-oncología de la policlínica de especialidades del Hospital Provincial General Carlos Manuel de Céspedes, Bayamo, Granma, Cuba, en el periodo comprendido entre 15 de enero de 2019 a 23 marzo de 2021. Los predictores independientes de cardiotoxicidad se obtuvieron usando regresión logística multivariable. Resultados: la prevalencia de cardiotoxicidad fue de 19,2 por ciento con edad media de 60,4 años, desviación estándar 12,7; hipertensión arterial, dislipidemia y otros marcadores de riesgo para enfermedades cardiovasculares como diabetes mellitus (riesgo relativo 2,8), cardiopatía hipertensiva (riesgo relativo 7,8), hipertrofia ventricular izquierda (riesgo relativo 3,3) y grasa epicárdica mayor de 6 mm, fueron variables relacionadas significativamente al riesgo de cardiotoxicidad. Conclusiones: cardiopatía hipertensiva, hipertrofia ventricular izquierda, diabetes mellitus, edad igual o mayor de 65 años y dislipidemia, incrementaron el riesgo de aparición de cardiotoxicidad y se relacionaron significativamente con ella, por tanto, resultaron ser factores de riesgo con influencia independiente sobre la cardiotoxicidad. Los resultados obtenidos nos permiten proyectar estudios de predicción de desarrollo y reversibilidad de cardiotoxicidad en pacientes de alto riesgo que reciban tratamientos cardioprotectores(AU)

Introduction: chemotherapy triples the risk of myocardial toxicity. Along with second neoplasms, it is the most frequent cause of mortality in long-surviving breast cancer patients. Objective: to identify the risk factors for early cardiotoxicity due to chemotherapy in patients with breast cancer. Methods: a prospective longitudinal study of a single cohort was carried out, with 224 patients with breast cancer undergoing chemotherapy treatment followed up in the cardio-oncology consultation of the specialties polyclinic at the General Provincial Hospital Carlos Manuel de Céspedes. Bayamo. Granma, Cuba in the period from January 15, 2019 to March 23, 2021. Independent predictors of cardiotoxicity were obtained using multivariate logistic regression. Results: the prevalence of cardiotoxicity was 19.2 percent with a mean age of 60.4 years, standard deviation 12.7; arterial hypertension, dyslipidemia and other risk markers for cardiovascular diseases such as diabetes mellitus (relative risk 2.8), hypertensive heart disease (relative risk 7.8), left ventricular hypertrophy (relative risk 3.3) and epicardial fat greater than 6 mm, were variables significantly related to the risk of cardiotoxicity. Conclusions: hypertensive heart disease left ventricular hypertrophy, Diabetes Mellitus, age ≥65 years and dyslipidemia increased the risk of cardiotoxicity and were significantly related to it, therefore, they turned out to be risk factors with independent influence on cardiotoxicity. The results obtained allow us to plan studies to predict the development and reversibility of cardiotoxicity in high-risk patients receiving cardioprotective treatments(EU)

Tromboembolismo pulmonar como forma de presentación de neurofibrosarcoma cardíaco

RESUMEN Los tumores cardíacos pueden provocar síncope, falla cardíaca, fenómenos embólicos y muerte. Se requiere un elevado índice de sospecha debido a la similitud clínica con otras enfermedades sistémicas. Se describe el caso de una mujer de 26 años que empezó con dificultad respiratoria, tos, expectoración hemoptoica, hipotensión arterial y manifestaciones de insuficiencia cardíaca a predominio derecho. La ecocardiografía mostró una masa tumoral en aurícula derecha y múltiples imágenes de trombos a nivel del tronco de la arteria pulmonar, con signos de disfunción ventricular derecha e hipertensión pulmonar grave. Fue intervenida quirúrgicamente, pero el tumor era irresecable, pues infiltraba el pericardio y la vena cava inferior. La paciente falleció un día después de la operación. El estudio histológico confirmó que el tumor era un neurofibrosarcoma.

ABSTRACT Cardiac tumors can cause syncope, heart failure, embolic events, and death. A high index of suspicion is required due to the clinical similarity with other systemic diseases. Here is described the case of a 26-year-old woman who began with respiratory distress, cough, hemoptoic expectoration, low blood pressure and manifestations of heart failure predominantly on the right. The echocardiography showed a tumor mass in the right atrium and multiple images of thrombi at the level of the pulmonary artery trunk, with signs of right ventricular dysfunction and severe pulmonary hypertension. She underwent surgery, but the tumor was unresectable, as it infiltrated the pericardium and the inferior vena cava. The patient died one day after surgery. The histological study confirmed that the tumor was a neurofibrosarcoma.

A Statistical Analysis of Death Rates in Italy for the Years 2015-2020 and a Comparison with the Casualties Reported from the COVID-19 Pandemic.

We analyze the data about casualties in Italy in the period 1 January 2015 to 30 September 2020 released by the Italian National Institute of Statistics (ISTAT). The aim of this article was the description of a statistically robust methodology to extract quantitative values for the seasonal excesses of deaths featured by the data, accompanying them with correct estimates of the relative uncertainties. We will describe the advantages of the method adopted with respect to others listed in literature. The data exhibit a clear sinusoidal behavior, whose fit allows for a robust subtraction of the baseline trend of casualties in Italy, with a surplus of mortality in correspondence to the flu epidemics in winter and to the hottest periods in summer. The overall quality of the fit to the data turns out to be very good, an indication of the validity of the chosen model. We discuss the trend of casualties in Italy by different classes of ages and for the different genders. We finally compare the data-subtracted casualties, as reported by ISTAT, with those reported by the Italian Department for Civil Protection (DPC) relative to the deaths directly attributed to the Coronavirus Disease 2019 caused by the SARS-CoV-2 virus (COVID-19), and we point out the differences in the two samples, collected under different assumptions.

Míxoma auricular izquierdo: informe de dos casos / Left atrial myxoma. Reporá oftwo cases

Introducción: los mixomas auriculares representan los tumores cardiacos más frecuentes, son infrecuentes pero provocan un alto porcentaje de complicaciones sistémicas y embolicas. La cirugía es la única terapéutica posible y la recidiva ocurre hasta en el 5 por ciento de los pacientes operados. Con el objetivo de ilustrar ecocardiográficamente y explicar las posibles causas de recurrencia, se describe el presente caso clínico. Presentación de caso: mujer de 53 años intervenida quirúrgicamente de un míxoma auricular izquierdo en2008 y se confirmó recurrencia asintomática del tumor 7 años después; también se informa de varón de 48 años que presentó síndrome doloroso precordial diagnosticándose mixoma auricular izquierdo gigante y tras tratamiento quirúrgico su evolución es satisfactoria. Discusión: las formas clínicas de presentación más frecuentes son episodios síncopales de corta duración, arritmias cardíacas, edema pulmonar y síntomas de bajo gasto cardiaco. Conclusiones: la ecocardiografía transtorácica representa una herramienta fundamental para el diagnóstico precoz y las recidivas del tumor(AU)

Introduction: atrial myxomas represent the most frequent cardiac tumors, they are infrequent but cause a high percentage of systemic and embolic complications. Surgery is the only possible therapy and recurrence occurs in up to 5 percent of operated patients. In order to illustrate echocardiographically and explain the possible causes of recurrence, the present clinical case is described. Case presentation: a 53-year-old woman surgically treated for a left atrial myxoma in 2008 and asymptomatic recurrence of the tumor was confirmed 7 years later; we also report a 48-year-old man who presented precordial pain syndrome diagnosed giant left atrial myxoma and after surgical treatment his evolution is satisfactory. Discussion: the most frequent clinical forms of presentation are syncopal episodes of short duration, cardiac arrhythmias, pulmonary edema and symptoms of low cardiac output.Conclusions: Transthoracic echocardiography represents a fundamental tool for early diagnosis and tumor recurrence(EU)

Míxoma auricular izquierdo. Informe de dos casos / Left atrial myxoma. Reporá oftwo cases / Earbud esquerdo. Relato de dois casos

RESUMEN Introducción: los mixomas auriculares representan los tumores cardiacos más frecuentes, son infrecuentes pero provocan un alto porcentaje de complicaciones sistémicas y embolicas. La cirugía es la única terapéutica posible y la recidiva ocurre hasta en el 5 % de los pacientes operados. Con el objetivo de ilustrar ecocardiográficamente y explicar las posibles causas de recurrencia, se describe el presente caso clínico. Presentación de caso: mujer de 53 años intervenida quirúrgicamente de un míxoma auricular izquierdo en 2008 y se confirmó recurrencia asintomática del tumor 7 años después; también se informa de varón de 48 años que presentó síndrome doloroso precordial diagnosticándose mixoma auricular izquierdo gigante y tras tratamiento quirúrgico su evolución es satisfactoria. Discusión: las formas clínicas de presentación más frecuentes son episodios síncopales de corta duración, arritmias cardíacas, edema pulmonar y síntomas de bajo gasto cardiaco. Conclusiones: la ecocardiografía transtorácica representa una herramienta fundamental para el diagnóstico precoz y las recidivas del tumor.

ABSTRAC Introduction: atrial myxomas represent the most frequent cardiac tumors, they are infrequent but cause a high percentage of systemic and embolic complications. Surgery is the only possible therapy and recurrence occurs in up to 5% of operated patients. In order to illustrate echocardiographically and explain the possible causes of recurrence, the present clinical case is described. Case presentation: a 53-year-old woman surgically treated for a left atrial myxoma in 2008 and asymptomatic recurrence of the tumor was confirmed 7 years later; We also report a 48-year-old man who presented precordial pain syndrome diagnosed giant left atrial myxoma and after surgical treatment his evolution is satisfactory. Discussion: the most frequent clinical forms of presentation are syncopal episodes of short duration, cardiac arrhythmias, pulmonary edema and symptoms of low cardiac output. Conclusions: Transthoracic echocardiography represents a fundamental tool for early diagnosis and tumor recurrence.

RESUMO Introdução: os mixomas da orelharepresentam os tumores cardíacos os maiscomuns, são raros mas causamumaporcentagem elevada de complicações sistemáticas e do bottlede. A cirurgia é a única terapêuticapossível e a recidiva ocorreem até 5% dos pacientes operados. A fim ilustrar ecocardiograficamente e explicar as causas possíveis do retorno, o caso clínico atual é descrito. Apresentação do caso: a mulher dos anos de idade 53 interveiocirùrgicacirurgicamente de ummixoma atrial esquerdoem 2008 e o retorno assintomático do tumor foi confirmado 7 anosmais tarde; É relatado também que o macho 48-year-old que teve a síndrome dolorosa precordial que diagnostica-se com o mixoma atrial esquerdo gigante e após o tratamentocirúrgicosuaevolução é satisfatória. Discussão: as formas clínicas maiscomuns de apresentaçãosãoepisódios síncronos de curta duração, arritmias cardíacas, edema pulmonar e sintomas de baixo débito cardíaco. Conclusões: a Ecocardiografiatranstorácica é umaferramenta crítica para o diagnóstico adiantado e relapses do tumor.

Evaluación pronóstica del síndrome coronario agudo en pacientes con síndrome metabólico / Prognostic evaluation of acute coronary syndrome in patients with metabolic syndrome

Introducción: el síndrome metabólico incrementa el riesgo para enfermedad cardiovascular y duplica la mortalidad. Objetivo: identificar los factores pronósticos de muerte por síndrome coronario agudo en pacientes con síndrome metabólico. Método: se realizó estudio observacional analítico de cohorte en 186 pacientes con síndrome coronario agudo admitidos entre 01 febrero de 2015 y 20 de octubre de 2018. Se incluyeron variables clínicas y epidemiológicas; se evaluó la fuerza de asociación entre las variables cualitativas y el riesgo de desarrollar muerte por síndrome coronario agudo en presencia de síndrome metabólico con el Odds Ratio con intervalo de confianza al 95 por ciento. Se realizó análisis multivariado utilizando el modelo de regresión logística de Cox. Resultados: la prevalencia del síndrome metabólico fue 45,7 por ciento, con edad media de 60,6 años; sexo femenino y grupo de edades mayor de 61 años duplicaron el riesgo de forma no significativa. Hipertrofia ventricular izquierda, insuficiencia cardiaca y fibrilación auricular incrementaron el riesgo de aparición de síndrome coronario agudo estadísticamente significativa en presencia del síndrome metabólico, p, 000. Disfunción ventricular izquierda moderada a severa [OR 5.7 IC 95 por ciento (1,115-5,961) p, 000], clase de Killip-Kimball ≥II [OR 7,9 IC 95 por ciento (3,10-20,15) p, 000] e infarto sin elevación del ST [OR 2,970 IC 95 por ciento (1,174-7,518) p, 000], se relacionaron significativamente con la muerte. Conclusiones: el síndrome metabólico incrementa el riesgo de sufrir síndrome coronario agudo y muerte pero no está relacionado significativamente con la supervivencia(AU)

Introduction: metabolic syndrome increases the risk for cardiovascular disease and doubles mortality. Objective: to identify the prognostic factors of death due to acute coronary syndrome in patients with metabolic syndrome. Method: a cohort analytical observational study was conducted in 186 patients with acute coronary syndrome admitted between 01 February 2015 and 20 October 2018. Clinical and epidemiological variables were included; the strength of association between the qualitative variables and the risk of developing death due to acute coronary syndrome in the presence of metabolic syndrome with Odds Ratio with 95 percent confidence interval was evaluated. Multivariate analysis was performed using the Cox logistic regression model. Results: the prevalence of the metabolic syndrome was 45.7 percent, with a mean age of 60.6 years; female sex and age group over 61 years doubled the risk in a non-significant way. Left ventricular hypertrophy, heart failure and atrial fibrillation increased the risk of the appearance of a statistically significant acute coronary syndrome in the presence of the metabolic syndrome, p, 000. Moderate to severe left ventricular dysfunction [OR 5.7 95 percent CI (1,115-5,961) p, 000], Killip-Kimball class ≥II [OR 7.9 IC 95 percent (3, 10-20, 15) p, 000] and infarction without ST elevation [OR 2.970 95 percent CI (1.174-7.518) p, 000], were significantly related to death. Conclusions: metabolic syndrome increases the risk of suffering acute coronary syndrome and death but it is not significantly related to survival(EU)

Evaluación pronóstica del síndrome coronario agudo en pacientes con síndrome metabólico / Prognostic evaluation of acute coronary syndrome in patients with metabolic syndrome / Avaliação prognóstica da síndrome coronariana aguda em pacientes com síndrome metabólica

RESUMEN Introducción: el síndrome metabólico incrementa el riesgo para enfermedad cardiovascular y duplica la mortalidad. Objetivo: identificar los factores pronósticos de muerte por síndrome coronario agudo en pacientes con síndrome metabólico. Método: se realizó estudio observacional analítico de cohorte en 186 pacientes con síndrome coronario agudo admitidos entre 01 febrero de 2015 y 20 de octubre de 2018. Se incluyeron variables clínicas y epidemiológicas; se evaluó la fuerza de asociación entre las variables cualitativas y el riesgo de desarrollar muerte por síndrome coronario agudo en presencia de síndrome metabólico con el Odds Ratio con intervalo de confianza al 95%. Se realizó análisis multivariado utilizando el modelo de regresión logística de Cox. Resultados: la prevalencia del síndrome metabólico fue 45,7 %, con edad media de 60,6 años; sexo femenino y grupo de edades mayor de 61 años duplicaron el riesgo de forma no significativa. Hipertrofia ventricular izquierda, insuficiencia cardiaca y fibrilación auricular incrementaron el riesgo de aparición de síndrome coronario agudo estadísticamente significativa en presencia del síndrome metabólico, p, 000. Disfunción ventricular izquierda moderada a severa [OR 5.7 IC 95 % (1,115-5,961) p, 000], clase de Killip-Kimball ≥II [OR 7,9 IC 95 % (3,10-20,15) p, 000] e infarto sin elevación del ST [OR 2,970 IC 95 % (1,174-7,518) p, 000], se relacionaron significativamente con la muerte. Conclusiones: el síndrome metabólico incrementa el riesgo de sufrir síndrome coronario agudo y muerte pero no está relacionado significativamente con la supervivencia.

ABSTRACT Introduction: metabolic syndrome increases the risk for cardiovascular disease and doubles mortality. Objective: to identify the prognostic factors of death due to acute coronary syndrome in patients with metabolic syndrome. Method: a cohort analytical observational study was conducted in 186 patients with acute coronary syndrome admitted between 01 February 2015 and 20 October 2018. Clinical and epidemiological variables were included; the strength of association between the qualitative variables and the risk of developing death due to acute coronary syndrome in the presence of metabolic syndrome with Odds Ratio with 95% confidence interval was evaluated. Multivariate analysis was performed using the Cox logistic regression model. Results: the prevalence of the metabolic syndrome was 45.7%, with a mean age of 60.6 years; Female sex and age group over 61 years doubled the risk in a non-significant way. Left ventricular hypertrophy, heart failure and atrial fibrillation increased the risk of the appearance of a statistically significant acute coronary syndrome in the presence of the metabolic syndrome, p, 000. Moderate to severe left ventricular dysfunction [OR 5.7 95% CI (1,115-5,961) p, 000], Killip-Kimball class ≥II [OR 7.9 IC 95% (3, 10-20, 15) p, 000] and infarction without ST elevation [OR 2.970 95% CI (1.174-7.518) p, 000], were significantly related to death. Conclusions: metabolic syndrome increases the risk of suffering acute coronary syndrome and death but it is not significantly related to survival.

RESUMO Introdução: a síndrome metabólica aumenta o risco de doença cardiovascular e duplica a mortalidade. Objetivo: identificar os fatores prognósticos do óbito por síndrome coronariana aguda em pacientes com síndrome metabólica. Método: estudo de coorte observacional analítico foi realizado em 186 pacientes com síndrome coronariana aguda admitidos entre 01 de fevereiro de 2015 e 20 de Outubro de 2018. Foram incluídos variáveis ​​clínicas e epidemiológicas; a força de associação entre variáveis ​​qualitativas e o risco de morte por síndrome coronária aguda, na presença de síndrome metabólica com probabilidades confiança Rácio intervalo de 95% foi avaliada. A análise multivariada foi realizada usando o modelo de regressão logística de Cox. Resultados: a prevalência da síndrome metabólica foi de 45,7%, com idade média de 60,6 anos; Sexo feminino e faixa etária acima de 61 anos dobraram o risco de forma não significativa. hipertrofia do ventrículo esquerdo, falha cardíaca e fibrilação atrial aumentou o risco de síndroma coronária aguda estatisticamente significativa na presença de síndroma metabólico, p, 000. Disfunção Ventricular Esquerda moderada a grave [OU 5,7 (IC 95% 1,115-5,961) p.000], Killip-Kimball ≥II [OR 7,9, IC de 95% (3,10-20,15) p.000] e enfarte sem elevação do segmento ST [OR 95% CI 2,970 (1,174-7,518) p.000], estavam significativamente relacionados com a morte. Conclusões: A síndrome metabólica aumenta o risco de síndrome coronariana aguda e morte, mas não significativamente associada com a sobrevivência.

Targeting host lipid flows: Exploring new antiviral and antibiotic strategies.

Bacteria and viruses pose serious challenges for humans because they evolve continuously. Despite ongoing efforts, antiviral drugs to treat many of the most troubling viruses have not been approved yet. The recent launch of new antimicrobials is generating hope as more and more pathogens around the world become resistant to available drugs. But extra effort is still needed. One of the current strategies for antiviral and antibiotic drug development is the search for host cellular pathways used by many different pathogens. For example, many viruses and bacteria alter lipid synthesis and transport to build their own organelles inside infected cells. The characterization of these interactions will be fundamental to identify new targets for antiviral and antibiotic drug development. This review discusses how viruses and bacteria subvert cell machineries for lipid synthesis and transport and summarises the most promising compounds that interfere with these pathways.

HIV-1 Adapts To Replicate in Cells Expressing Common Marmoset APOBEC3G and BST2.

UNLABELLED: Previous studies have shown that a major block to HIV-1 replication in common marmosets operates at the level of viral entry and that this block can be overcome by adaptation of the virus in tissue-cultured cells. However, our current studies indicate that HIV-1 encounters additional postentry blocks in common marmoset peripheral blood mononuclear cells. Here, we show that the common marmoset APOBEC3G (A3G) and BST2 proteins block HIV-1 in cell cultures. Using a directed-evolution method that takes advantage of the natural ability of HIV-1 to mutate during replication, we have been able to overcome these blocks in tissue-cultured cells. In the adapted viruses, specific changes were observed in gag, vif, env, and nef. The contribution of these changes to virus replication in the presence of the A3G and BST2 restriction factors was studied. We found that certain amino acid changes in Vif and Env that arise during adaptation to marmoset A3G and BST2 allow the virus to replicate in the presence of these restriction factors. The changes in Vif reduce expression levels and encapsidation of marmoset APOBEC3G, while the changes in Env increase viral fitness and discretely favor cell-to-cell transmission of the virus, allowing viral escape from these restriction factors. IMPORTANCE: HIV-1 can infect only humans and chimpanzees. The main reason for this narrow tropism is the presence in many species of dominant-acting factors, known as restriction factors, that block viral replication in a species-specific way. We have been exploring the blocks to HIV-1 in common marmosets, with the ultimate goal of developing a new animal model of HIV-1 infection in these monkeys. In this study, we observed that common marmoset APOBEC3G and BST2, two known restriction factors, are able to block HIV-1 in cell cultures. We have adapted HIV-1 to replicate in the presence of these restriction factors and have characterized the mechanisms of escape. These studies can help in the development of a novel animal model for in vivo infection of marmosets with HIV-1-like viruses.

Aspectos clínico-epidemiológicos en pacientes tratadas quirúrgicamente por enfermedad mamaria

Introducción: el cáncer de mama constituye un gran problema de salud, ocupando la tercera causa más frecuente de cáncer en el mundo; mucho se ha investigado y escrito acerca de esa patología, cuyo alcance como problema de salud es muy significativo.Objetivo: describir la frecuencia con que se presentan ciertos aspectos clínicos y epidemiológicos en un grupo de pacientes diagnosticados y tratados quirúrgicamente por enfermedad mamariaMétodo: se realizó un estudio descriptivo, retrospectivo y transversal en pacientes con cáncer de mama, los cuales recibieron tratamiento quirúrgico en el Hospital General Docente Aleida Fernández Chardiet, durante el periodo de enero de 2001 a junio de 2005, en el municipio Güines, provincia Mayabeque. El universo estuvo conformado por todas los pacientes que fueron intervenidas quirúrgicamente, por alguna afección mamaria La muestra la constituyó los pacientes que fueron operados en este periodo, pero que presentaron alguna enfermedad maligna de la mama. Algunas de las variables analizadas fueron: la edad, el color de la piel, el autoexamen de mama.Resultados: el mayor porcentaje de pacientes estuvieron comprendidos entre 46-65 años, predominando el sexo femenino 98,1 por ciento, color blanco de la piel 88,5 por ciento. Elevado porciento de nódulos y dolor mamario como motivo de consulta; el 53,8 por ciento se realizaba autoexamen de mama. El 66,4 por ciento tuvo una sobrevida mayor de 5 años y actualmente más de la mitad 54,8 por ciento se encuentran vivas.Conclusiones: los pacientes diagnosticados con cáncer de mama y tratados quirúrgicamente en el área de salud, se asocian a un tiempo de sobrevida muy favorable, siendo el mayor motivo de consulta la presencia de nódulos y el dolor mamario (AU)

Introduction: breast cancer is a major health problem, ranking the third most common cause of cancer in the world, much has been researched and written about that pathology, of which scope as a health problem is very significant.Objective: To describe the frequency with which certain clinical and epidemiological aspects are presented in a group of patients diagnosed and surgically treated for breast disease.Method: a descriptive, retrospective and cross-sectional study was performed in patients with breast cancer who received surgical treatment at Aleida Fernández Chardiet General Teaching Hospital during the period from January 2001 to June 2005, in Güines municipality, Mayabeque province. The universe consisted of all patients who underwent surgery for some breast condition. The sample was constituted by all the patients who were operated in this period, but showed some malignant breast disease. Some of the variables analyzed were: age, skin color, breast self-examination.Results: the highest percentage of patients were between 46-65 years, predominantly female 98,1 per cent, white skin color 88,5 per cent. High percentage of nodules and breast pain as a reason for consultation, 53,8 per cent performed breast self-examination. 66,4 per cent had a higher survival rate of 5 years and currently more than half 54,8 per cent are alive.Conclusions: patients diagnosed with breast cancer and surgically treated in the health area, are associated with a favorable survival time, being the main reason for consultation the presence of nodules and breast pain (AU)

Aspectos clínico-epidemiológicos en pacientes tratadas quirúrgicamente por enfermedad mamaria / Clinical-epidemiological aspects in patients surgically treatment due to breast disease

Introducción: el cáncer de mama constituye un gran problema de salud, ocupando la tercera causa más frecuente de cáncer en el mundo; mucho se ha investigado y escrito acerca de esa patología, cuyo alcance como problema de salud es muy significativo.Objetivo: describir la frecuencia con que se presentan ciertos aspectos clínicos y epidemiológicos en un grupo de pacientes diagnosticados y tratados quirúrgicamente por enfermedad mamariaMétodo: se realizó un estudio descriptivo, retrospectivo y transversal en pacientes con cáncer de mama, los cuales recibieron tratamiento quirúrgico en el Hospital General Docente Aleida Fernández Chardiet, durante el periodo de enero de 2001 a junio de 2005, en el municipio Güines, provincia Mayabeque. El universo estuvo conformado por todas los pacientes que fueron intervenidas quirúrgicamente, por alguna afección mamaria La muestra la constituyó los pacientes que fueron operados en este periodo, pero que presentaron alguna enfermedad maligna de la mama. Algunas de las variables analizadas fueron: la edad, el color de la piel, el autoexamen de mama.Resultados: el mayor porcentaje de pacientes estuvieron comprendidos entre 46-65 años, predominando el sexo femenino 98,1 por ciento, color blanco de la piel 88,5 por ciento. Elevado porciento de nódulos y dolor mamario como motivo de consulta; el 53,8 por ciento se realizaba autoexamen de mama. El 66,4 por ciento tuvo una sobrevida mayor de 5 años y actualmente más de la mitad 54,8 por ciento se encuentran vivas.Conclusiones: los pacientes diagnosticados con cáncer de mama y tratados quirúrgicamente en el área de salud, se asocian a un tiempo de sobrevida muy favorable, siendo el mayor motivo de consulta la presencia de nódulos y el dolor mamario

Introduction: breast cancer is a major health problem, ranking the third most common cause of cancer in the world, much has been researched and written about that pathology, of which scope as a health problem is very significant.Objective: To describe the frequency with which certain clinical and epidemiological aspects are presented in a group of patients diagnosed and surgically treated for breast disease.Method: a descriptive, retrospective and cross-sectional study was performed in patients with breast cancer who received surgical treatment at Aleida Fernández Chardiet General Teaching Hospital during the period from January 2001 to June 2005, in Güines municipality, Mayabeque province. The universe consisted of all patients who underwent surgery for some breast condition. The sample was constituted by all the patients who were operated in this period, but showed some malignant breast disease. Some of the variables analyzed were: age, skin color, breast self-examination.Results: the highest percentage of patients were between 46-65 years, predominantly female 98,1 per cent, white skin color 88,5 per cent. High percentage of nodules and breast pain as a reason for consultation, 53,8 per cent performed breast self-examination. 66,4 per cent had a higher survival rate of 5 years and currently more than half 54,8 per cent are alive.Conclusions: patients diagnosed with breast cancer and surgically treated in the health area, are associated with a favorable survival time, being the main reason for consultation the presence of nodules and breast pain

Valor del método dermatoscópico ®Lista Recapitulativa de los Tres Puntos de Soyer¼ en el diagnóstico de las lesiones cutáneas pigmentadas en pacientes del Hospital Hermanos Ameijeiras, La Habana-Cuba, 2008 / Value of the Soyer´s Three Point Checklist dermoscopic method in the diagnosis of pigmented skin lesions in patients from ®Hermanos Ameijeiras¼ Hospital, Havana City, Cuba during 2008

OBJETIVO: Determinar el valor diagnóstico del método dermatoscópico ®Lista Recapitulativa de los Tres Puntos de Soyer¼ (LRTPS) en el diagnóstico de las lesiones cutáneas pigmentadas en pacientes del Hospital Hermanos Ameijeiras (La Habana-Cuba) durante el año 2008. MATERIAL Y MÉTODOS: Se realizó un estudio descriptivo transversal con 102 pacientes que asistieron a la Consulta de Dermatoscopía en el Hospital ®Hermanos Ameijeiras¼ de Ciudad de la Habana, Cuba, en el año 2008 para caracterizar la relación de este método de diagnóstico dermatoscópico y el comportamiento biológico de las lesiones cutáneas pigmentadas en el período estudiado. Se calcularon las tasas de sensibilidad y especificidad del método para el puntaje extremo de las lesiones y de las proporciones de malignidad / benignidad para las puntuaciones intermedias. RESULTADOS: La Lista de los Tres Puntos se comportó como un confiable método de alta sensibilidad y especificidad para el diagnóstico de benignidad de las lesiones con puntuación de cero. La sensibilidad para el diagnóstico de malignidad de lesiones con puntuación de tres fue baja, mientras que la especificidad fue alta. Existieron lesiones benignas y malignas con puntuación de 1 y 2, siendo mayor la proporción de lesiones benignas en el primer grupo y de lesiones malignas en el segundo grupo. CONCLUSIÓN: El método demuestra ser una herramienta útil y sencilla para determinar elcomportamiento biológico de las lesiones cutáneas pigmentadas.

OBJECTIVE: To determine the diagnostic value of dermatoscopic method ®Value of the Soyer´s Three Point Checklist¼ in the diagnosis of pigmented skin lesions in patients from ®Hermanos Ameijeiras¼ Hospital (La Habana-Cuba) during 2008. MATERIAL AND METHODS: A descriptive and transversal study was carried out with 102 patients from dermoscopy consultation at ®Hermanos Ameijeiras¼ Hospital, Havana City, Cuba during the year 2008 to characterize the relationship between the diagnostic method and the biological behavior of the pigmented skin lesion in the period studied. The sensibility and specificity rate for the extreme pointed pigmented skin lesions were calculated and also the proportions between malignancy and benignity for the middle pointed lesions. RESULTS: The Three Point Checklist was taken as a reliable method of high sensibility and specificity for the diagnosis of the benignity of the lesion having cero-point. The sensibility to the malignancy diagnosis of three-points lesions was low mean while the specificity was high.There were malignant and benign lesions with one and two points, being higher the proportion of benign lesions in the first group and of malignant lesions in the second one. CONCLUSION: The method shows to be a useful and easy tool to determine the biological behavior of a pigmented skin lesion.

Criocirugía en dermatología. Experiencia en el Hospital Clínico Quirúrgico Universitario Hermanos Armeijeiras / Cryosurgery in dermatology. Experience in the Hospital Clínico Quirúrgico Universitario Hermanos Armeijeiras

Se realizó un estudio abierto, prospectivo en el Policlínico Docente: "Joaquín Albarrán" en el período comprendido entre enero y diciembre del año 2005, con el objetivo de evaluar la efectividad terapéutica de la criocirugía frente a afecciones dermatológicas en las cuales ha sido reportado su uso. Se determinó la respuesta al tratamiento y la aparición de recidivas de las afecciones dermatológicas atendidas durante ese lapso, y se evaluaron las reacciones adversas que se presentaron. La eficacia terapéutica fue evaluada dos semanas después de culminar el tratamiento, comparando el estado inicial y final de las lesiones. A los pacientes con respuesta total a la criocirugía se les realizó seguimiento trimestral durante un año para detectar posibles recidivas. Se demostró que la criocirugía puede ser utilizada en una amplia gama de afecciones dermatológicas, con alta efectividad (99,7 por ciento), pocas recidivas (9,3 por ciento) y reacciones adversas de leve intensidad (100 por ciento).

A prospective study was carried out to know the therapeutical effectiveness of the cryosurgery in the treatment of dermatological diseases in which their use has been reported. It was made in the time period comprised between January and December 2005 in the "Joaquín Albarrán" teaching polyclinic. The therapeutical effectiveness was assessed a couple of weeks after completing the treatment, comparing the initial and final state of lesions. The patients who responded to the cryosurgery were followed up quarterly during a year in order to detect possible relapses. The results demonstrated the high therapeutical effectiveness of the cryosurgery in many dermatological diseases (99,7 per cent), the relapse proportions were few (9,3 per cent), and all adverse events observed were of mild intensity and of spontaneous disappearance.

Queratosis seborreica clonal a propósito de un caso / Clonal seborrheic keratosis. A purpose of a case

La queratosis seborreica clonal es una variante histológica rara de queratosis seborreica. Se informa sobre una paciente de sexo femenino, de 87 años de edad, que acudió a consulta de dermatología por presentar lesión tumoral única, de 10 centímetros de diámetro, localizada en abdomen, de 40 años de evolución y crecimiento lento, asociada a intenso prurito. Se diagnosticó clínicamente queratosis seborreica gigante y, desde el punto de vista histopatológico, una variante clonal. Se realizó extirpación quirúrgica de la lesión, con resultados satisfactorios.

Clonal seborrheic keratosis is a rare histological type of seborrheic keratosis. An 87 year-old female patient is presented that came for dermatology consultation due to a lone tumoral lesion, 10 cm in diameter, located in the abdomen, with 40 years of slow growth, associated to intense pruritus. It was clinically diagnosed as giant seborrheic keratosis, and the biopsy showed clonal variant. She had surgical extirpation of the lesion with satisfactory results.