[Digital artery pseudoaneurysm. Case report and systematic review of the literature]. / Pseudoaneurisma de arteria digital. Reporte de un caso y revisión sistemática de la bibliografía.

INTRODUCTION: aneurysms are focal and permanent dilations of an artery; in pseudoaneurysms, the normal layers of the blood vessel are replaced by fibrous tissue. Due to their low incidence, as well as the diagnostic and therapeutic challenge they represent; our objective is to present the clinical case of a pseudoaneurysm of a digital artery of the hand and to carry out a systematic review of this pathology. MATERIAL AND METHODS: literature search in Medline, using the terms "digital artery" and "aneurysm." Studies of vascular dilation pathology affecting the hand and fingers were incorporated. Studies with pathology of proximal involvement of the hand were excluded. CASE PRESENTATION: a 79-year-old female patient who, after a sharp force trauma to the fifth finger of the left hand, develops a rapidly growing necrotic tumor. She had ultrasound and angiography that suggested hematoma. Surgical management was decided, during which it was observed that the tumor involved ulnar collateral digital artery of the fifth finger. The lesion and the arterial segment involved were resected. Post-surgical course without complications. The histopathological diagnosis of pseudoaneurysm of the lesion was confirmed. DISCUSSION: traumatic etiology is the most frequent cause of digital aneurysms. Risk factors for pseudoaneurysms include sharp force trauma and alterations of the coagulation pathways, as in the case presented. CONCLUSION: the pseudoaneurysm of a digital artery is a rare pathology with great variability of therapeutic management. Surgical resection of the lesion with vascular flow reconstruction is the recommended treatment.

INTRODUCCIÓN: los aneurismas son dilataciones vasculares localizadas y permanentes de una arteria; en los pseudoaneurismas, las capas normales del vaso sanguíneo son reemplazadas por tejido fibroso. Debido a su baja incidencia, así como el desafío diagnóstico y terapéutico que representan; nuestro objetivo es presentar el caso clínico de un pseudoaneurisma de una arteria digital de la mano y realizar una revisión sistemática sobre dicha patología. MATERIAL Y MÉTODOS: búsqueda bibliográfica en Medline, utilizando los términos "arteria digital" y "aneurisma". Se incorporaron estudios de patología de dilatación vascular que afecte la mano y los dedos. Se excluyeron trabajos con patología de afección proximal de la mano. PRESENTACIÓN DE CASO: paciente femenino de 79 años de edad, que posterior a herida cortante de quinto dedo de mano izquierda, desarrolla tumoración necrótica de rápido crecimiento. Contaba con ecografía y angiografía que sugerían hematoma. Se decidió manejo quirúrgico, durante el cual se observó que la tumoración involucraba arteria digital colateral cubital del quinto dedo. Se resecó lesión y segmento arterial involucrado. Cursó postquirúrgico sin complicaciones. Se confirmó el diagnóstico histopatológico de pseudoaneurisma de la lesión. DISCUSIÓN: la etiología traumática es la causa más frecuente de los aneurismas digitales. Los factores de riesgo para los pseudoaneurismas incluyen lesiones penetrantes y alteraciones de la cascada de coagulación, como en el caso presentado. CONCLUSIÓN: el pseudoaneurisma de una arteria digital es una patología rara y con gran variabilidad de manejo terapéutico. La resección quirúrgica de la lesión con la reconstrucción del flujo vascular, es el tratamiento recomendado.

Late consolidation of the scaphoid. Case report and literature review.

Scaphoid fractures are a common wrist injury accounting for 2-7% of all adult fractures. Nonunion is described in 5-12% of cases leading to osteoarthritis. Several classifications have been developed focused on this pathology and its complication. We present a case of a 28 years old male patient with a scaphoid fracture and nonunion who spontaneously consolidates without treatment. We performed a literature review to recognize this pathology, its common evolution and possible treatment options.

Las fracturas de escafoides son una lesión frecuente de la muñeca y representan de 2-7% de todas las fracturas en adultos. La no unión se describe en 5-12% de los casos y conduce a la osteoartritis. Se han desarrollado varias clasificaciones centradas en esta patología y su complicación. Presentamos el caso de un paciente varón de 28 años con fractura y no unión de escafoides que consolida espontáneamente sin tratamiento. Realizamos una revisión bibliográfica para reconocer esta patología, su evolución habitual y las posibles opciones de tratamiento.

Perceived Impact of COVID-19 Among Callers to the National Suicide Prevention Lifeline.

Background: Research indicates that the COVID-19 pandemic caused increases in psychological distress and suicidal ideation. Aims: To describe the ways suicidal callers to the National Suicide Prevention Lifeline (Lifeline) perceived COVID-19 to have impacted them and assess whether these callers perceived COVID-19-related stress as contributing to their suicidal thoughts. Method: Telephone interviews were conducted with 412 suicidal callers to 12 Lifeline centers. Logistic regression analyses were used to examine the associations between demographic factors and individual COVID-19 stressors and to determine whether callers who endorsed COVID-19-related stress as contributing to their suicidal thoughts differed from those who did not regarding demographics, current suicide risk, history of suicidality, Lifeline use, or individual COVID-19 stressors. Results: Over half of callers reported that COVID-19-related stress contributed to their suicidal ideation (CRSSI). Callers who endorsed CRSSI had higher odds than those who did not of mentioning financial difficulties when asked how COVID-19 impacted them. The two groups of callers did not differ on the other factors examined. Limitations: Interviewed callers may not be representative of all Lifeline callers. Conclusion: Despite the subjective burden of COVID-19-related stress on suicidal Lifeline callers, this was not associated with new suicidality or heightened suicide risk.

Prediction of the Nitrogen Content of Rice Leaf Using Multi-Spectral Images Based on Hybrid Radial Basis Function Neural Network and Partial Least-Squares Regression.

This paper's novel focus is predicting the leaf nitrogen content of rice during growing and maturing. A multispectral image processing-based prediction model of the Radial Basis Function Neural Network (RBFNN) model was proposed. Moreover, this paper depicted three primary points as the following: First, collect images of rice leaves (RL) from a controlled condition experimental laboratory and new shoot leaves in different stages in the visible light spectrum, and apply digital image processing technology to extract the color characteristics of RL and the morphological characteristics of the new shoot leaves. Secondly, the RBFNN model, the General Regression Model (GRL), and the General Regression Method (GRM) model were constructed based on the extracted image feature parameters and the nitrogen content of rice leaves. Third, the RBFNN is optimized by and Partial Least-Squares Regression (RBFNN-PLSR) model. Finally, the validation results show that the nitrogen content prediction models at growing and mature stages that the mean absolute error (MAE), the Mean Absolute Percentage Error (MAPE), and the Root Mean Square Error (RMSE) of the RFBNN model during the rice-growing stage and the mature stage are 0.6418 (%), 0.5399 (%), 0.0652 (%), and 0.3540 (%), 0.1566 (%), 0.0214 (%) respectively, the predicted value of the model fits well with the actual value. Finally, the model may be used to give the best foundation for achieving exact fertilization control by continuously monitoring the nitrogen nutrition status of rice. In addition, at the growing stage, the RBFNN model shows better results compared to both GRL and GRM, in which MAE is reduced by 0.2233% and 0.2785%, respectively.

ICESat-2/ATLAS Onboard Flight Science Receiver Algorithms: Purpose, Process, and Performance.

The Advanced Topographic Laser Altimetry System (ATLAS) is the sole instrument on the Ice, Cloud, and land Elevation Satellite 2 (ICESat-2). Without some method of reducing the transmitted data, the volume of ATLAS telemetry would far exceed the normal X-band downlink capability or require many more ground station contacts. The ATLAS Onboard Flight Science Receiver Algorithms (hereinafter Receiver Algorithms or Algorithms) control the amount of science data that is telemetered from the instrument, limiting the data volume by distinguishing surface echoes from background noise, and allowing the instrument to telemeter data from only a small vertical region about the signal. This is accomplished through the transfer of the spacecraft's location and attitude to the instrument every second, use of an onboard Digital Elevation Model, implementation of signal processing techniques, and use of onboard relief and surface type reference maps. Extensive ground testing verified the performance of the Algorithms. On-orbit analysis shows that the Algorithms are working as expected from the ground testing; they are performing well and meeting the mission requirements.

[Intra-articular fracture of the calcaneus associated with injury to lateral collateral ligaments of the ankle]. / Fractura intraarticular de calcáneo asociada a lesión de ligamentos colaterales laterales del tobillo.

Calcaneal fractures are the most frequent of the tarsus (3.5% of all fractures). Young adults are mainly affected, being more frequent in men (5.9:1). On the other hand, ligament injuries associated with fracture of the calcaneus are very infrequent. We describe a case of a 39 year old patient who suffered ankle trauma. He presented instability in plantar flexion and inversion. A fracture of the calcaneus was diagnosed. During surgery, a complete lesion of the lateral ligament complex was found. The reduction and osteosynthesis associated with ligament reconstruction was performed. We consider important to confirm the stability of the ankle after a calcaneus fracture. Lack of diagnosis in this type of injuries can evolve into chronic instability.

Las fracturas de calcáneo son las más frecuentes del tarso (3.5% de todas las fracturas). Afectan a adultos jóvenes, siendo más frecuentes en hombres (5.9:1). Por otro lado, las lesiones ligamentarias asociadas a fractura de calcáneo no son muy frecuentes. Presentamos un caso de un paciente de 39 años que sufrió entorsis de tobillo. Mostraba inestabilidad en flexión plantar e inversión. Radiografías mostraron una fractura de calcáneo. Durante la cirugía se evidenció una lesión completa del complejo ligamentario lateral. Se realizó la reducción y osteosíntesis asociada a la reconstrucción ligamentaria. Ante fracturas de calcáneo es importante corroborar la estabilidad del tobillo. La falta de diagnóstico en este tipo de lesiones puede generar inestabilidades crónicas.

[Association of hypertension and antihypertensive agents and the severity of COVID-19 pneumonia. A monocentric French prospective study]. / Association entre l'hypertension artérielle, les traitements inhibiteurs du système rénine angiotensine et les formes graves de COVID-19. Étude prospective monocentrique française.

BACKGROUND AND AIM: Angiotensin converting enzyme (ACE) type 2 is the receptor of SARSCoV-2 for cell entry into lung cells. Because ACE-2 may be modulated by ACE inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs), there are concern that patients treated with ACEIs and ARBs are at higher risk for COVID-19 infection or severity. This study sought to analyse the association of severe forms of COVID-19 and mortality with hypertension and a previous treatment with ACEI and ARB. METHODS: Prospective follow-up of 433 consecutive patients hospitalised for COVID-19 pneumonia confirmed by PCR or highly probable on clinical, biological, and radiological findings, and included in the COVHYP study. Mortality and severe COVID-19 (criteria: death, intensive care unit, or hospitalisation >30 days) were compared in patients receiving or not ACEIs and ARBs. Follow-up was 100% at hospital discharge, and 96.5% at >1month. RESULTS: Age was 63.6±18.7 years, and 40%) were female. At follow-up (mean 78±50 days), 136 (31%) patients had severity criteria (death, 64 ; intensive care unit, 73; hospital stay >30 days, 49). Hypertension (55.1% vs 36.7%, P<0.001) and antihypertensive treatment were associated with severe COVID-19 and mortality. The association between ACEI/ARB treatment and COVID-19 severity criteria found in univariate analysis (Odds Ratio 1.74, 95%CI [1.14-2.64], P=0.01) was not confirmed when adjusted on age, gender, and hypertension (adjusted OR1.13 [0.59-2.15], P=0.72). Diabetes and hypothyroidism were associated with severe COVID-19, whereas history of asthma was not. CONCLUSION: This study suggests that previous treatment with ACEI and ARB is not associated with hospital mortality, 1- and 2-month mortality, and severity criteria in patients hospitalised for COVID-19. No protective effect of ACEIs and ARBs on severe pneumonia related to COVID-19 was demonstrated.

MRI Spectrum of Brain Involvement in Sphingosine-1-Phosphate Lyase Insufficiency Syndrome.

SGPL1 encodes sphingosine-1-phosphate lyase, the final enzyme of sphingolipid metabolism. In 2017, a condition featuring steroid-resistant nephrotic syndrome and/or adrenal insufficiency associated with pathogenic SGPL1 variants was reported. In addition to the main features of the disease, patients often exhibit a range of neurologic deficits. In a handful of cases, brain imaging results were described. However, high-quality imaging results and a systematic analysis of brain MR imaging findings associated with the condition are lacking. In this study, MR images from 4 new patients and additional published case reports were reviewed by a pediatric neuroradiologist. Analysis reveals recurring patterns of features in affected patients, including isolated callosal dysgenesis and prominent involvement of the globus pallidus, thalamus, and dentate nucleus, with progressive atrophy and worsening of brain lesions. MR imaging findings of abnormal deep gray nuclei, microcephaly, or callosal dysgenesis in an infant or young child exhibiting other typical clinical features of sphingosine-1-phosphate lyase insufficiency syndrome should trigger prompt genetic testing for SGPL1 mutations.

An LC/MS/MS method for quantitation of chemopreventive sphingadienes in food products and biological samples.

Colorectal cancer (CRC) is a leading cause of cancer mortality. Diet has a significant influence on colon cancer risk. Identifying chemopreventive agents, dietary constituents, practices and/or diet supplements that promote gut health and reduce the incidence of intestinal neoplasias and CRC could significantly impact public health. Sphingadienes (SDs) are dietary sphingolipids found in plant-based food products. SDs are cytotoxic to colon cancer cells and exhibit chemopreventive properties. The aim of the present study was to develop a sensitive and robust ultra-high performance liquid chromatography tandem mass spectrometry (UHPLC-MS/MS) method for quantifying SDs in food products and biological samples. The assay was linear over a concentration range of 80nM to 50µM and was sensitive to a detection limit of 3.3nM. Post-extraction stability was 100% at 24h. SD content in soy oils was approximately 10nM. SDs were detected transiently in the plasma of adult mice 10min after gavage delivery of a 25mg/kg bolus and declined to baseline by 1h. SD uptake in the gut was maximal in the duodenum and peaked 1h after gavage delivery. Disappearance of SDs in the lower gastrointestinal tract suggests either rapid metabolism to yet unidentified products or potentially luminal export.

Melanocortin 4 receptor activates ERK-cFos pathway to increase brain-derived neurotrophic factor expression in rat astrocytes and hypothalamus.

Melanocortins are neuropeptides with well recognized anti-inflammatory and anti-apoptotic effects in the brain. Of the five melanocortin receptors (MCR), MC4R is abundantly expressed in the brain and is the only MCR present in astrocytes. We have previously shown that MC4R activation by the α-melanocyte stimulating hormone (α-MSH) analog, NDP-MSH, increased brain-derived neurotrophic factor (BDNF) expression through the classic cAMP-Protein kinase A-cAMP responsive element binding protein pathway in rat astrocytes. Now, we examined the participation of the mitogen activated protein kinases pathway in MC4R signaling. Rat cultured astrocytes treated with NDP-MSH 1 µM for 1 h showed increased BDNF expression. Inhibition of extracellular signal-regulated kinase (ERK) and ribosomal p90 S6 kinase (RSK), an ERK substrate, but not of p38 or JNK, prevented the increase in BDNF expression induced by NDP-MSH. Activation of MC4R increased cFos expression, a target of both ERK and RSK. ERK activation by MC4R involves cAMP, phosphoinositide-3 kinase (PI3K) and the non receptor tyrosine kinase, Src. Both PI3K and Src inhibition abolished NDP-MSH-induced BDNF expression. Moreover, we found that intraperitoneal injection of α-MSH induces BDNF and MC4R expression and activates ERK and cFos in male rat hypothalamus. Our results show for the first time that MC4R-induced BDNF expression in astrocytes involves ERK-RSK-cFos pathway which is dependent on PI3K and Src, and that melanocortins induce BDNF expression and ERK-cFos activation in rat hypothalamus.

Regulation of Immune Cell Migration by Sphingosine-1-Phosphate.

Sphingosine-1-phosphate [S1P] is a potent bioactive sphingolipid molecule. In response to a stimulus, S1P is produced intracellularly by the action of two sphingosine kinases, and then it is exported to the extracellular environment or acts as an intracellular second messenger. S1P binds to its cognate G-protein coupled receptors, which are known as S1P receptors. There are five S1P receptors that have been identified in vertebrates. By activating S1P receptors, S1P controls a variety of physiological and pathological processes including cell migration, angiogenesis, vascular maturation, inflammation, and invasion, metastasis, and chemoresistance in cancer. S1P has emerged as a critical regulator of leukocyte migration and plays a central role in lymphocyte egress from the thymus and secondary lymphoid organs. In the current review article, we summarize the current understanding of the emigration of lymphocytes and other leukocytes from bone marrow, thymus and secondary lymphoid organs to the circulation, as well as the clinical implications of modulating the activity of the major S1P receptor, S1PR1.

Predictors of protective behaviors among American travelers to the 2009 Hajj.

BACKGROUND: Respiratory-borne infectious diseases can spread rapidly at mass gatherings. The 2009 Hajj took place during the influenza A (H1N1) pandemic. This study investigates factors associated with compliance with recommended influenza A (H1N1)-related health practices and behaviors among American pilgrims to the 2009 Hajj: receiving seasonal influenza vaccinations, receiving influenza A (H1N1) vaccinations, and behaviors intended to mitigate respiratory illness. METHODS: American residents from Minnesota and Michigan completed anonymous surveys prior to and following travel to the 2009 Hajj. Surveys assessed demographics; knowledge, attitudes and practices (KAP) related to influenza A (H1N1); seasonal and H1N1 vaccinations; health-seeking behaviors; sources of health information; and protective behaviors during the Hajj. RESULTS: Pre- and post-travel surveys were completed by 186 participants. Receiving seasonal influenza vaccination was reported by 138 (63%) respondents, and 80 (36%) reported receiving an influenza A (H1N1) vaccine. One hundred forty-four (79%) respondents reported engaging in protective behaviors during the Hajj to prevent illness. In multivariable models, greater perceived severity of influenza A (H1N1) before traveling was associated with: seasonal influenza vaccination (OR=1.74, 95% CI=1.14-2.62, p=.01), influenza A (H1N1) vaccination (OR=2.02, 95% CI=1.35-3.02, p=.001), and engaging in protective behaviors during the Hajj (OR=1.62, 95% CI=1.00-2.63, p=.003). CONCLUSIONS: This study found that accurate knowledge of influenza A (H1N1) symptoms, transmission, and prevention was associated with greater perceived severity of influenza A (H1N1); and perceived influenza A (H1N1) severity was associated with engaging in recommended protective health practices. Understanding the barriers to and facilitators of compliance with recommended behaviors can help guide the development of tailored outreach strategies to mitigate the impact and spread of respiratory disease.

Recent progress on the superconducting ion source VENUS.

The 28 GHz Ion Source VENUS (versatile ECR for nuclear science) is back in operation after the superconducting sextupole leads were repaired and a fourth cryocooler was added. VENUS serves as an R&D device to explore the limits of electron cyclotron resonance source performance at 28 GHz with its 10 kW gryotron and optimum magnetic fields and as an ion source to increase the capabilities of the 88-Inch Cyclotron both for nuclear physics research and applications. The development and testing of ovens and sputtering techniques cover a wide range of applications. Recent experiments on bismuth demonstrated stable operation at 300 eµA of Bi(31+), which is in the intensity range of interest for high performance heavy-ion drivers such as FRIB (Facility for Rare Isotope Beams). In addition, the space radiation effects testing program at the cyclotron relies on the production of a cocktail beam with many species produced simultaneously in the ion source and this can be done with a combination of gases, sputter probes, and an oven. These capabilities are being developed with VENUS by adding a low temperature oven, sputter probes, as well as studying the RF coupling into the source.

Short-term electrical stimulation of the lower esophageal sphincter increases sphincter pressure in patients with gastroesophageal reflux disease.

BACKGROUND: Electrical stimulation (ES) of the lower esophageal sphincter (LES) increases resting LES pressure (LESP) in animal models. Our aims were to evaluate the safety of such stimulation in humans, and test the hypothesis that ES increases resting LESP in patients with gastroesophageal reflux disease (GERD). METHODS: A total of 10 subjects (nine female patients, mean age 52.6 years), with symptoms of GERD responsive to PPIs, low resting LES pressure, and abnormal 24-h intraesophageal pH test were enrolled. Those with hiatal hernia >2 cm and/or esophagitis >Los Angeles Grade B were excluded. Bipolar stitch electrodes were placed longitudinally in the LES during an elective laparoscopic cholecystectomy, secured by a clip and exteriorized through the abdominal wall. Following recovery, an external pulse generator delivered two types of stimulation for periods of 30 min: (i) low energy stimulation; pulse width of 200 µs, frequency of 20 Hz and current of 5-15 mA (current was increased up to 15 mA if LESP was less than 15 mmHg), and (ii) high energy stimulation; pulse width of 375 ms, frequency of 6 cpm, and current 5 mA. Resting LESP, amplitude of esophageal contractions and residual LESP in response to swallows were assessed before and after stimulation. Symptoms of chest pain, abdominal pain, and dysphagia were recorded before, during, and after stimulation and 7-days after stimulation. Continuous cardiac monitoring was performed during and after stimulation. KEY RESULTS: All patients were successfully implanted nine subjects received high frequency, low energy, and four subjects received low frequency, high energy stimulation. Both types of stimulation significantly increased resting LESP: from 8.6 mmHg (95% CI 4.1-13.1) to 16.6 mmHg (95% CI 10.8-19.2), P < 0.001 with low energy stimulation and from 9.2 mmHg (95% CI 2.0-16.3) to 16.5 mmHg (95% CI 2.7-30.1), P = 0.03 with high energy stimulation. Neither type of stimulation affected the amplitude of esophageal peristalsis or residual LESP. No subject complained of dysphagia. One subject had retrosternal discomfort with stimulation at 15 mA that was not experienced with stimulation at 13 mA. There were no adverse events or any cardiac rhythm abnormalities with either type of stimulation. CONCLUSIONS & INFERENCES: Short-term stimulation of the LES in patients with GERD significantly increases resting LESP without affecting esophageal peristalsis or LES relaxation. Electrical stimulation of the LES may offer a novel therapy for patients with GERD.

S1P lyase regulates DNA damage responses through a novel sphingolipid feedback mechanism.

The injurious consequences of ionizing radiation (IR) to normal human cells and the acquired radioresistance of cancer cells represent limitations to cancer radiotherapy. IR induces DNA damage response pathways that orchestrate cell cycle arrest, DNA repair or apoptosis such that irradiated cells are either repaired or eliminated. Concomitantly and independent of DNA damage, IR activates acid sphingomyelinase (ASMase), which generates ceramide, thereby promoting radiation-induced apoptosis. However, ceramide can also be metabolized to sphingosine-1-phosphate (S1P), which acts paradoxically as a radioprotectant. Thus, sphingolipid metabolism represents a radiosensitivity pivot point, a notion supported by genetic evidence in IR-resistant cancer cells. S1P lyase (SPL) catalyzes the irreversible degradation of S1P in the final step of sphingolipid metabolism. We show that SPL modulates the kinetics of DNA repair, speed of recovery from G2 cell cycle arrest and the extent of apoptosis after IR. SPL acts through a novel feedback mechanism that amplifies stress-induced ceramide accumulation, and downregulation/inhibition of either SPL or ASMase prevents premature cell cycle progression and mitotic death. Further, oral administration of an SPL inhibitor to mice prolonged their survival after exposure to a lethal dose of total body IR. Our findings reveal SPL to be a regulator of ASMase, the G2 checkpoint and DNA repair and a novel target for radioprotection.

Successful treatment of recurrent epithelial ingrowth associated with interface fluid syndrome, flap necrosis, and epithelial defects following LASIK.

PURPOSE: to report the successful treatment of two patients who developed flap necrosis preceded by recurrent epithelial ingrowth and interface fluid syndrome after LASIK. METHODS: patient 1 was treated with epithelial debridement and flap suturing. Patient 2 was initially treated with epithelial debridement and flap suturing, but developed recurrent epithelial ingrowth in the right eye and 2 weeks later in the left eye. RESULTS: patient 1 developed diffuse interface fluid accumulation in the left eye after epithelial debridement and flap suturing and was treated with timolol meleate 0.5% solution and methazolamide. The interface fluid resolved and the cornea and flap became clear. Slit-lamp examination identified a small area of epithelial ingrowth recurrence, which has remained stable for 3 years. Patient 2 was successfully retreated with epithelial debridement followed by fibrin tissue adhesive application. Five months after debridement and fibrin tissue adhesive, no recurrence of epithelial ingrowth or interface fluid accumulation was noted. CONCLUSIONS: epithelial ingrowth and interface fluid syndrome may be associated with secondary flap necrosis following LASIK, which can be effectively treated with debridement and flap suturing or fibrin tissue adhesive application.

Coronary artery connection: cone trunk sharks varieties anatomy study (Selachians) / Conexión de la arteria coronaria: estudio de las variedades anatómicas del cono tronco en tiburones (Selachians)

Due to our interest in clarifying the congenic problems at the origin of the coronary arteries, we have published in the early 70´s a theory (Borges et al., 1974) in which the coronary arteries would be the last pair of aortic arches that, at the beginning of the embryogenesis, would be connected with the previous arch, trunk of the lung's artery through a duct which we named "ductus coronarius".

Debido a nuestro interés en aclarar los problemas congénicos en el origen de las arterias coronarias, hemos publicado a principios de los años 70 una teoría (Borges et al., 1974) en que las arterias coronarias serían el último par de arcos aórticos que, en el comienzo de la embriogénesis, estarían conectadas con el arco anterior, tronco de la arteria pulmonar a través de un conducto que hemos llamado "conducto coronario".

Is there a difference in the efficacy of peripartum antiretroviral regimens in reducing mother-to-child transmission of HIV in Africa?

BACKGROUND: Peripartum antiretroviral regimens have been shown to prevent mother-to-child transmission of HIV (MTCT) in randomized clinical trials; however, direct comparison of published results is impossible given methodological and population differences. OBJECTIVE: To directly compare the efficacy of different antiretroviral regimens in reducing the risk of 6-week MTCT rate in African breastfeeding populations. METHODS: Pooled analysis including all mother-infant pairs from any relevant trial: West African ZDV-placebo trials, Petra ZDV+3TC [two regimens A (pre/intra/post-partum) and B (intra/post-partum), placebo from Uganda and Tanzania], SAINT (NVP and Petra arm B), HIVNET012 (NVP, ultra short ZDV pp) and the Vitamin A trial (as placebo arm in South Africa). Peripartum HIV infection was any positive RNA or DNA polymerase chain reaction test < day 60. The MTCT risk was estimated at 6 weeks for each treatment arm and compared with placebo or single-dose NVP using logistic regression adjusting for maternal CD4 cell count, breastfeeding and birthweight. RESULTS: Overall, 4125 singleton live-births were included; 3629 (88%) were assessed for HIV status at 6 weeks of age. In comparison with placebo, zidovudine + lamivudine (ZDV+3TC) arm A [adjusted odds ratio (AOR), 0.23; P < 0.0001], ZDV+3TC arm B (AOR, 0.49; P < 0.001), antenatal ZDV short (AOR, 0.55; P = 0.006) and nevirapine (NVP) (AOR, 0.60; P = 0.0007) significantly reduced MTCT. In comparison with NVP, only the longest regimen of ZDV+3TC (AOR, 0.39, P < 0.0005) was significantly more effective. CONCLUSION: These results are in line with current World Health Organisation guidelines suggesting equivalence of choice between single-dose NVP and short-course ZDV, and confirm the greater efficacy of ZDV+3TC than with any single antiretroviral drug.