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1.
Research (Wash D C) ; 6: 0254, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38023417

RESUMEN

Connexin 43 (CX43) is one of the major components of gap junctions, the structures responsible for the intercellular communication and transmission of the electrical impulse in the left ventricle. There is limited information on the histological changes of CX43 with age and their effect on electrophysiology, especially in humans. Here, we analyzed left ventricular biopsies from living donors starting at midlife to characterize age-related CX43 remodeling. We assessed its quantity, degree of lateralization, and spatial heterogeneity together with fibrotic deposition. We observed no significant age-related remodeling of CX43. Only spatial heterogeneity increased slightly with age, and this increase was better explained by biological age than by chronological age. Importantly, we found that CX43 features varied considerably among individuals in our population with no relevant relationship to age or fibrosis content, in contrast to animal species. We used our experimental results to feed computational models of human ventricular electrophysiology and to assess the effects of interindividual differences in specific features of CX43 and fibrosis on conduction velocity, action potential duration, and arrhythmogenicity. We found that larger amounts of fibrosis were associated with the highest arrhythmic risk, with this risk being increased when fibrosis deposition was combined with a reduction in CX43 amount and/or with an increase in CX43 spatial heterogeneity. These mechanisms underlying high arrhythmic risk in some individuals were not associated with age in our study population. In conclusion, our data rule out CX43 remodeling as an age-related arrhythmic substrate in the population beyond midlife, but highlight its potential as a proarrhythmic factor at the individual level, especially when combined with increased fibrosis.

2.
Hum Resour Health ; 21(1): 27, 2023 03 31.
Artículo en Inglés | MEDLINE | ID: mdl-37004070

RESUMEN

BACKGROUND: The unavailability of human and material resources can affect access to eye health services, constituting an obstacle in the fight against avoidable visual impairment. This study aimed to assess the availability and distribution of human and material resources for eye health in the public sector in Nampula province. METHODS: A mixed method approach was used, which included document reviews (to extract information regarding the number of professionals and inhabitants in each district) and application of a questionnaire to heads of the ophthalmology department in each health facility (to obtain the list of available equipment). The ratios of eye health professionals per population in Nampula province and each of its districts were calculated and evaluated taking into account the recommendations of the World Health Organization (WHO). Based on the level of care of each health facility, the availability of equipment was evaluated. RESULTS: Nampula Province has not reached the recommended ratio of eye health professionals per population in the different categories (ophthalmic technicians with 0.8 per 100 thousand inhabitants; optometrists and ophthalmologists with 0.4 and 0.2 per 250 thousand inhabitants, respectively). Most districts of Nampula did not reach the recommended ratio in the three categories of professionals, except Nampula City (provincial capital). However, there was a greater concentration of professionals and facilities with eye health services in the provincial capital. Primary and secondary level health facilities lacked some equipment to provide eye health services within their scope. CONCLUSIONS: There is an unequal distribution of the workforce in Nampula and the centralization of surgical services at the Central Hospital of Nampula level. Therefore, there is a need to review resource distribution strategies and decentralization policy of eye health services in Nampula.


Asunto(s)
Servicios de Salud , Sector Público , Humanos , Mozambique , Personal de Salud , Instituciones de Salud
3.
Eur J Pharm Biopharm ; 183: 74-91, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36623752

RESUMEN

The incidence and prevalence of invasive fungal infections have increased significantly over the last few years, leading to a global health problem due to the lack of effective treatments. Amphotericin B (AmB) and itraconazole (ITR) are two antifungal drugs with different mechanisms of action. In this work, AmB and ITR have been formulated within granules to elicit an enhanced pharmacological effect, while enhancing the oral bioavailability of AmB. A Quality by Design (QbD) approach was utilised to prepare fixed-dose combination (FDC) granules consisting of a core containing AmB with functional excipients, such as inulin, microcrystalline cellulose (MCC), chitosan, sodium deoxycholate (NaDC) and Soluplus® and polyvinyl pyrrolidone (PVP), coated with a polymeric layer containing ITR with Soluplus® or a combination of Poloxamer 188 and hydroxypropyl methyl cellulose-acetyl succinate (HPMCAS). A Taguchi design of experiments (DoE) with 7 factors and 2 levels was carried out to understand the key factors impacting on the physicochemical properties of the formulation followed by a Box-Behnken design with 3 factors in 3 levels chosen to optimise the formulation parameters. The core of the FDC granules was obtained by wet granulation and later coated using a fluidized bed. In vitro antifungal efficacy was demonstrated by measuring the inhibition halo against different species of Candida spp., including C. albicans (24.19-30.48 mm), C. parapsilosis (26.38-27.84 mm) and C. krusei (11.48-17.92 mm). AmB release was prolonged from 3 to 24 h when the AmB granules were coated. In vivo in CD-1 male mice studies showed that these granules were more selective towards liver, spleen and lung compared to kidney (up to 5-fold more selective in liver, with an accumulation of 8.07 µg AmB/g liver after twice-daily 5 days administration of granules coated with soluplus-ITR), resulting in an excellent oral administration option in the treatment of invasive mycosis. Nevertheless, some biochemical alterations were found, including a decrease in blood urea nitrogen (∼17 g/dl) and alanine aminotransferase (<30 U/l) and an increase in the levels of bilirubin (∼0.2 mg/dl) and alkaline phosphatase (<80 U/l), which could be indicative of a liver failure. Once-daily regimen for 10 days can be a promising therapy.


Asunto(s)
Anfotericina B , Micosis , Masculino , Ratones , Animales , Anfotericina B/farmacología , Anfotericina B/química , Antifúngicos/química , Itraconazol , Micosis/tratamiento farmacológico , Candida albicans
4.
iScience ; 25(2): 103822, 2022 Feb 18.
Artículo en Inglés | MEDLINE | ID: mdl-35198884

RESUMEN

Age-related fibrosis in the left ventricle (LV) has been mainly studied in animals by assessing collagen content. Using second-harmonic generation microscopy and image processing, we evaluated amount, aggregation and spatial distribution of LV collagen in young to old pigs, and middle-age and elder living donors. All collagen features increased when comparing adult and old pigs with young ones, but not when comparing adult with old pigs or middle-age with elder individuals. Remarkably, all collagen parameters strongly correlated with lipofuscin, a biological age marker, in humans. By building patient-specific models of human ventricular tissue electrophysiology, we confirmed that amount and organization of fibrosis modulated arrhythmia vulnerability, and that distribution should be accounted for arrhythmia risk assessment. In conclusion, we characterize the age-associated changes in LV collagen and its potential implications for ventricular arrhythmia development. Consistency between pig and human results substantiate the pig as a relevant model of age-related LV collagen dynamics.

5.
Aging Cell ; 20(7): e13383, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-34092006

RESUMEN

Aging is the main risk factor for cardiovascular diseases. In humans, cardiac aging remains poorly characterized. Most studies are based on chronological age (CA) and disregard biological age (BA), the actual physiological age (result of the aging rate on the organ structure and function), thus yielding potentially imperfect outcomes. Deciphering the molecular basis of ventricular aging, especially by BA, could lead to major progresses in cardiac research. We aim to describe the transcriptome dynamics of the aging left ventricle (LV) in humans according to both CA and BA and characterize the contribution of microRNAs, key transcriptional regulators. BA is measured using two CA-associated transcriptional markers: CDKN2A expression, a cell senescence marker, and apparent age (AppAge), a highly complex transcriptional index. Bioinformatics analysis of 132 LV samples shows that CDKN2A expression and AppAge represent transcriptomic changes better than CA. Both BA markers are biologically validated in relation to an aging phenotype associated with heart dysfunction, the amount of cardiac fibrosis. BA-based analyses uncover depleted cardiac-specific processes, among other relevant functions, that are undetected by CA. Twenty BA-related microRNAs are identified, and two of them highly heart-enriched that are present in plasma. We describe a microRNA-gene regulatory network related to cardiac processes that are partially validated in vitro and in LV samples from living donors. We prove the higher sensitivity of BA over CA to explain transcriptomic changes in the aging myocardium and report novel molecular insights into human LV biological aging. Our results can find application in future therapeutic and biomarker research.


Asunto(s)
Envejecimiento/genética , Biomarcadores/metabolismo , Ventrículos Cardíacos/metabolismo , MicroARNs/genética , Femenino , Humanos , Masculino
6.
Int J Legal Med ; 135(3): 829-836, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33190163

RESUMEN

Current methods used in terminal ballistics to determine the volume of temporary cavities created by projectiles in soft tissue simulants (such as ballistic soap) usually involve silicone-casting to obtain the cavity moulds. However, these methods have important drawbacks including their little sensitivity and precision, besides the fact that they are destructive. Imaging techniques such as computed tomography (CT) might not only overcome those limitations but also offer useful tools for digitally reporting the scientific results. This work accomplished the 3D digital reconstruction of the cavities created by different projectiles in ballistic soap blocks. This way, the total volume of the cavities, the projectile penetration depths, and other measurements were determined, rendering better capabilities when compared to the current silicone method. All these features were achieved through the CT analysis and 3D Slicer imaging software. In addition, it is worth mentioning that the method can preserve the evidence by digitally obtaining, signing, and storing the infographic videos displaying the 3D-reconstructed cavities. Graphical abstract.


Asunto(s)
Balística Forense/métodos , Heridas por Arma de Fuego/diagnóstico por imagen , Heridas por Arma de Fuego/patología , Humanos , Imagenología Tridimensional , Modelos Biológicos , Siliconas , Jabones , Tomografía Computarizada por Rayos X
7.
Sci Rep ; 10(1): 19941, 2020 11 17.
Artículo en Inglés | MEDLINE | ID: mdl-33203905

RESUMEN

Cardiac tissue slices preserve the heterogeneous structure and multicellularity of the myocardium and allow its functional characterization. However, access to human ventricular samples is scarce. We aim to demonstrate that slices from small transmural core biopsies collected from living donors during routine cardiac surgery preserve structural and functional properties of larger myocardial specimens, allowing accurate electrophysiological characterization. In pigs, we compared left ventricular transmural core biopsies with transmural tissue blocks from the same ventricular region. In humans, we analyzed transmural biopsies and papillary muscles from living donors. All tissues were vibratome-sliced. By histological analysis of the transmural biopsies, we showed that tissue architecture and cellular organization were preserved. Enzymatic and vital staining methods verified viability. Optically mapped transmembrane potentials confirmed that action potential duration and morphology were similar in pig biopsies and tissue blocks. Action potential morphology and duration in human biopsies and papillary muscles agreed with published ranges. In both pigs and humans, responses to increasing pacing frequencies and ß-adrenergic stimulation were similar in transmural biopsies and larger tissues. We show that it is possible to successfully collect and characterize tissue slices from human myocardial biopsies routinely extracted from living donors, whose behavior mimics that of larger myocardial preparations both structurally and electrophysiologically.


Asunto(s)
Potenciales de Acción , Electrofisiología Cardíaca , Fenómenos Electrofisiológicos , Ventrículos Cardíacos/fisiopatología , Donadores Vivos , Potenciales de la Membrana , Animales , Humanos , Porcinos
8.
Biomolecules ; 10(9)2020 09 17.
Artículo en Inglés | MEDLINE | ID: mdl-32957719

RESUMEN

Cardiomyocytes' geometry and connexin 43 (CX43) amount and distribution are structural features that play a pivotal role in electrical conduction. Their quantitative assessment is of high interest in the study of arrhythmias, but it is usually hampered by the lack of automatic tools. In this work, we propose a software algorithm (Myocyte Automatic Retrieval and Tissue Analyzer, MARTA) to automatically detect myocytes from fluorescent microscopy images of cardiac tissue, measure their morphological features and evaluate the expression of CX43 and its degree of lateralization. The proposed software is based on the generation of cell masks, contouring of individual cells, enclosing of cells in minimum area rectangles and splitting of these rectangles into end-to-end and middle compartments to estimate CX43 lateral-to-total ratio. Application to human ventricular tissue images shows that mean differences between automatic and manual methods in terms of cardiomyocyte length and width are below 4 µm. The percentage of lateral CX43 also agrees between automatic and manual evaluation, with the interquartile range approximately covering from 3% to 30% in both cases. MARTA is not limited by fiber orientation and has an optimized speed by using contour filtering, which makes it run hundreds of times faster than a trained expert. Developed for CX43 studies in the left ventricle, MARTA is a flexible tool applicable to morphometric and lateralization studies of other markers in any heart chamber or even skeletal muscle. This open-access software is available online.


Asunto(s)
Conexina 43/metabolismo , Microscopía Fluorescente/métodos , Miocardio/metabolismo , Miocitos Cardíacos/metabolismo , Algoritmos , Animales , Humanos , Masculino , Miocardio/citología , Miocitos Cardíacos/citología , Ratas Wistar , ATPasas Transportadoras de Calcio del Retículo Sarcoplásmico/metabolismo
9.
Sci Rep ; 8(1): 8507, 2018 05 31.
Artículo en Inglés | MEDLINE | ID: mdl-29855587

RESUMEN

The sequence of cheek teeth mineralization, eruption, and replacement of an extinct horse species is here documented with radiological techniques for the first time thanks to the exceptional preservation of Hipparion sp. mandibles from Cerro de los Batallones (Madrid Basin, Spain). The sequence of dental ontogeny in mammals provides valuable insights about life history traits, such as the pace of growth, and about the mode of formation of fossiliferous assemblages. We have determined that the order of permanent cheek teeth mineralization and eruption of hipparionine horses is m1, m2, (p2, p3), p4, m3. Cheek teeth mineralization timing of hipparionine horses coincides with the one observed in modern equids. In turn, there are differences in the eruption timing of the p4 and m3 between horses belonging to the Anchitheriinae and Hipparionini compared to equids of the Equus genus that might be related to the shorter durability of the deciduous tooth dp4 in anchitheriine and hipparionine horses and, more broadly, to an increased durability of equid teeth through their evolutionary history. Based on the dental eruption sequence, hipparionine horses are slow-growing, long-living mammals. The Hipparion sp. assemblage from Batallones-10 conforms to an attritional model, as individuals more vulnerable to natural mortality predominate.


Asunto(s)
Equidae/anatomía & histología , Extinción Biológica , Fósiles/anatomía & histología , Diente/anatomía & histología , Animales , Historia Antigua , Rasgos de la Historia de Vida , Radiografía
10.
EuroIntervention ; 12(16): 1962-1968, 2017 Mar 20.
Artículo en Inglés | MEDLINE | ID: mdl-27973334

RESUMEN

AIMS: The aim of the study was to assess the safety and efficacy of percutaneous closure of paravalvular prosthetic leak (PVL) and to identify the predictors of procedural success and early complications. METHODS AND RESULTS: A total of 514 first-attempt percutaneous PVL closure in 469 patients were included at 19 centres. Technical and procedural success was achieved in 86.6% and 73.2% of the patients, respectively. In multivariate analysis, the independent predictors for procedural success in mitral lesions were the type of device used (AMPLATZER AVP III vs. others, HR 2.68 [1.29-5.54], p=0.008) and the number of procedures performed at the centre (top quartile vs. others, HR 1.93 [1.051-3.53], p=0.03). For aortic leaks the only predictor of procedural success was the leak size (≥10 mm vs. <10 mm, HR 3.077 [1.13-8.33], p=0.027). The overall major adverse events rate (death or emergency surgery or stroke) at 30 days was 5.6%; the only predictor for combined adverse events was New York Heart Association functional Class IV (HR 4.2 [1.42-12.34], p=0.009). CONCLUSIONS: Percutaneous closure of PVL can be performed with a reasonable rate of procedural success and a low rate of major complications. The type of device used, the accumulated experience and the leak size are predictors of procedural success.


Asunto(s)
Cateterismo Cardíaco/instrumentación , Prótesis Valvulares Cardíacas , Insuficiencia de la Válvula Mitral/cirugía , Complicaciones Posoperatorias , Sistema de Registros , Dispositivo Oclusor Septal , Anciano , Anciano de 80 o más Años , Ecocardiografía Tridimensional/métodos , Femenino , Prótesis Valvulares Cardíacas/efectos adversos , Implantación de Prótesis de Válvulas Cardíacas/métodos , Humanos , Masculino , Persona de Mediana Edad , Dispositivo Oclusor Septal/efectos adversos , Resultado del Tratamiento
11.
Am J Cardiol ; 118(4): 578-84, 2016 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-27378142

RESUMEN

Vascular complications in transcatheter aortic valve implantation using transfemoral approach are related to higher mortality. Complete percutaneous approach is currently the preferred technique for vascular access. However, some centers still perform surgical cutdown. Our purpose was to determine complications related to vascular access technique in the population of the Spanish TAVI National Registry. From January 2010 to July 2015, 3,046 patients were included in this Registry. Of them, 2,465 underwent transfemoral approach and were treated with either surgical cutdown and closure (cutdown group, n = 632) or percutaneous approach (puncture group, n = 1,833). Valve Academic Research Consortium-2 definitions were used to assess vascular and bleeding complications. Propensity matching resulted in 615 matched pairs. Overall, 30-day vascular complications were significantly higher in the puncture group (109 [18%] vs 42 [6.9%]; relative risk [RR] 2.60; 95% confidence interval [CI] 1.85 to 3.64, p <0.001) due mostly by minor vascular events (89 [15%] vs 25 [4.1%], RR 3.56, 95% CI 2.32 to 5.47, p <0.001). Bleeding rates were lower in the puncture group (18 [3%] vs 40 [6.6%], RR 0.45, 95% CI 0.26 to 0.78, p = 0.003) mainly driven by major bleeding (9 [1.5%] vs 21 [3.4%], RR 0.43, 95% CI 0.20 to 0.93, p = 0.03). At a mean follow-up of 323 days, complication rates remained significantly different between groups (minor vascular complications 90 [15%] vs 31 [5.1%], hazard ratio 2.99, 95% CI 1.99 to 4.50, p <0.001 and major bleeding 10 [1.6%] vs 21 [3.4%], hazard ratio 0.47, 95% CI 0.22 to 1.0, p = 0.04, puncture versus cutdown group, respectively). In conclusion, percutaneous approach yielded higher rates of minor vascular complications but lower rates of major bleeding compared with the surgical cutdown, both at 30-day and at mid-term follow-up in our population.


Asunto(s)
Estenosis de la Válvula Aórtica/cirugía , Disección/métodos , Arteria Femoral , Infarto del Miocardio/epidemiología , Hemorragia Posoperatoria/epidemiología , Punciones/métodos , Sistema de Registros , Reemplazo de la Válvula Aórtica Transcatéter/métodos , Anciano , Anciano de 80 o más Años , Medios de Contraste , Femenino , Fluoroscopía , Humanos , Estimación de Kaplan-Meier , Tiempo de Internación , Masculino , Tempo Operativo , Complicaciones Posoperatorias/epidemiología , Modelos de Riesgos Proporcionales , España
13.
An. cir. card. cir. vasc ; 12(5): 248-249, nov.-dic. 2006. ilus
Artículo en Es | IBECS | ID: ibc-052791

RESUMEN

Presentamos el caso de una paciente de 49 años que desarrolló varios episodios de embolismos arteriales recurrentes, mostrándose en el estudio efectuado, la presencia de dos trombos móviles en aorta descendente, relacionados a un trastorno genético de la coagulación. Revisamos las distintas etiologías asociadas a esta entidad, así como su diagnóstico y tratamiento


We present a 49-years-old woman who presesented several embolic arterial recurrent episodes associated to floating thrombus in the descending thoracic aorta, secondary to genetic coagulation disorder. We review the different etiologies, diagnosis and treatment


Asunto(s)
Femenino , Adulto , Humanos , Aneurisma de la Aorta/complicaciones , Aneurisma de la Aorta/diagnóstico , Aneurisma de la Aorta/terapia , Síndromes del Arco Aórtico/complicaciones , Ecocardiografía Transesofágica/métodos , Factores de Riesgo , Embolectomía/métodos , Trombosis/fisiopatología , Acenocumarol/uso terapéutico , Endarterectomía/métodos , Ecocardiografía Transesofágica , Embolia/complicaciones , Aorta/patología , Aorta , Enfermedades de la Aorta/complicaciones , Enfermedades de la Aorta/diagnóstico , Trombosis/complicaciones , Trombosis , Endarterectomía/tendencias , Endarterectomía
14.
Electrophoresis ; 27(24): 5101-9, 2006 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-17120261

RESUMEN

We evaluate the usefulness of a commercially available microchip CE (MCE) device in different genetic identification studies performed with mitochondrial DNA (mtDNA) targets, including the haplotype analysis of HVR1 and HVR2 and the study of interspecies diversity of cytochrome b (Cyt b) and 16S ribosomal RNA (16S rRNA) mitochondrial genes in forensic and ancient DNA samples. The MCE commercial system tested in this study proved to be a fast and sensitive detection method of length heteroplasmy in cytosine stretches produced by 16 189T>C transitions in HVR1 and by 309.1 and 309.2 C-insertions in HVR2. Moreover, the quantitative analysis of PCR amplicons performed by LIF allowed normalizing the amplicon input in the sequencing reactions, improving the overall quality of sequence data. These quantitative data in combination with the quantification of genomic mtDNA by real-time PCR has been successfully used to evaluate the PCR efficiency and detection limit of full sequencing methods of different mtDNA targets. The quantification of amplicons also provided a method for the rapid evaluation of PCR efficiency of multiplex-PCR versus singleplex-PCR to amplify short HV1 amplicons (around 100 bp) from severely degraded ancient DNA samples. The combination of human-specific (Cyt b) and universal (16S rRNA) mtDNA primer sets in a single PCR reaction followed by MCE detection offers a very rapid and simple screening test to differentiate between human and nonhuman hair forensic samples. This method was also very efficient with degraded DNA templates from forensic hair and bone samples, because of its applicability to detect small amplicon sizes. Future possibilities of MCE in forensic DNA typing, including nuclear STRs and SNP profiling are suggested.


Asunto(s)
Dermatoglifia del ADN/métodos , ADN Mitocondrial/análisis , Electroforesis por Microchip/métodos , Antropología Forense/métodos , Genética Forense/métodos , Animales , Huesos/química , Bovinos , Citocromos b/genética , ADN Mitocondrial/genética , Perros , Cabello/química , Haplotipos , Humanos , Ratones , ARN Ribosómico 16S/genética , Ratas , Receptores de Tipo II del Péptido Intestinal Vasoactivo/genética , Receptores de Tipo I del Polipéptido Intestinal Vasoactivo/genética , Análisis de Secuencia de ADN
15.
An. cir. card. cir. vasc ; 12(1): 6-10, ene.-feb. 2006. ilus, tab
Artículo en Es | IBECS | ID: ibc-045514

RESUMEN

Objetivos: En el presente estudio se realiza una valoración clínica y ecocardiográfica en pacientes a los que se les implantó una bioprótesis sin soporte de Toronto. Material: Presentamos 84 pacientes a los que se les implantó una bioprótesis de Toronto (80 Toronto SPV y 4 Toronto Root), con una edad media de 67 años, de los cuales el 71% presentaban estenosis aórtica degenerativa. Siete pacientes tenían endocarditis aórtica nativa activa. El 18% requirieron revascularización coronaria. Se les realizó ecocardiografía al alta hospitalaria y al año. Resultados: En el 70% de nuestros pacientes no hubo ninguna complicación postoperatoria. La causa de morbilidad más frecuente fue la fibrilación auricular. El seguimiento ecocardiográfico al año reveló una reducción significativa de los gradientes transvalvulares respecto al alta hospitalaria. La presencia de insuficiencia aórtica se presentó en 6% de nuestros pacientes. Conclusiones: La bioprótesis de Toronto es una alternativa con ventajas hemodinámicas importantes respecto a las bioprótesis con soporte. Sus principales indicaciones son pacientes mayores, con anillos aórticos pequeños y en casos de endocarditis previa


Objective: The present study was undertaken to evaluate mid term clinical and echocardiographic outcome after aortic valve replacement with the Toronto stentless valve bioprosthesis. Methods: Toronto stentless valve was implanted in 84 patients (80 Toronto SPV and 4 Toronto Root), with a mean age of 67 years. Preoperative diagnosis were aortic stenosis (71%).Seven patients presented active native aortic infective endocarditis. 18% required coronary artery by-pass surgery. Echocardiographic evaluation at the discharge and the year was done to them. Results: In 70% of these patients there was no postoperating complication. The main morbidity cause was the auricular fibrillation. The echocardiographic evaluation at year revealed a significant reduction of the mean gradient with respect to the discharge. The presence of regurgitation aortic appeared in 6% of our patients. Conclusions: Stentless bioprosthesis of Toronto is an alternative with important haemodinamic advantages. It main indication is in older patients, small aortic annulus and previous endocarditis


Asunto(s)
Masculino , Femenino , Adulto , Anciano , Persona de Mediana Edad , Anciano de 80 o más Años , Humanos , Insuficiencia de la Válvula Aórtica/cirugía , Estenosis de la Válvula Aórtica/cirugía , Prótesis Valvulares Cardíacas , Endocarditis/cirugía , Bioprótesis , Implantación de Prótesis de Válvulas Cardíacas , Hemodinámica/fisiología , Ecocardiografía Doppler , Resultado del Tratamiento , Estudios Prospectivos
16.
Croat Med J ; 46(4): 540-8, 2005 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-16100756

RESUMEN

In cases of mass disaster, there is often a need for managing, analyzing, and comparing large numbers of biological samples and DNA profiles. This requires the use of laboratory information management systems for large-scale sample logging and tracking, coupled with bioinformatic tools for DNA database searching according to different matching algorithms, and for the evaluation of the significance of each match by likelihood ratio calculations. There are many different interrelated factors and circumstances involved in each specific mass disaster scenario that may challenge the final DNA identification goal, such as: the number of victims, the mechanisms of body destruction, the extent of body fragmentation, the rate of DNA degradation, the body accessibility for sample collection, or the type of DNA reference samples availability. In this paper, we examine the different steps of the DNA identification analysis (DNA sampling, DNA analysis and technology, DNA database searching, and concordance and kinship analysis) reviewing the "lessons learned" and the scientific progress made in some mass disaster cases described in the scientific literature. We will put special emphasis on the valuable scientific feedback that genetic forensic community has received from the collaborative efforts of several public and private USA forensic laboratories in assisting with the more critical areas of the World Trade Center (WTC) mass fatality of September 11, 2001. The main challenges in identifying the victims of the recent South Asian Tsunami disaster, which has produced the steepest death count rise in history, will also be considered. We also present data from two recent mass fatality cases that involved Spanish victims: the Madrid terrorist attack of March 11, 2004, and the Yakolev-42 aircraft accident in Trabzon, Turkey, of May 26, 2003.


Asunto(s)
Dermatoglifia del ADN/métodos , Desastres , Antropología Forense , Antropología Forense/métodos , Humanos , España
17.
An. cir. card. cir. vasc ; 11(1): 51-54, ene.-feb. 2005. ilus
Artículo en Es | IBECS | ID: ibc-037531

RESUMEN

La fibrosis endomiocárdica es una miocardiopatía restrictiva progresiva de origen desconocido más comúnmente frecuente en países tropicales. Está caracterizada por una fibrosis progresiva y un engrosamiento del endocardio ventricular, muchas veces asociada a insuficiencia de las válvulas auriculoventriculares. El tratamiento quirúrgico consiste en la decorticación del endocardio ventricular y recambio o reparación de las válvulas auriculoventriculares. La operación es el tratamiento de elección a causa del severo pronóstico progresivo y de la inefectividad del tratamiento médico. La cirugía pudiera tener un efecto beneficioso en comparación con el tratamiento médico en pacientes en clase funcional III y IV. Presentamos nuestra experiencia con una cirugía correctiva realizada sobre esta lesión llevada a cabo sobre un joven originario de Guinea


Endomyocardial fibrosis is a progressive restrictive endocardial disease of unknown origin more commonly ocurring in tropical countries. This is characterized by progressive fibrosis and thickening of the ventricular endocardium, often associated with atrioventricular valve incompetence. The surgical treatment consists of decortication of the ventricular endocardium and replacement or repair of the atrioventricular valve. Operation seems to be the treatment of choise because endomyocardial fibrosis is characterized by a grave prognosis and medical therapy is ineffective. Surgery could have a beneficial effect over medical treatment in class III and IV patients. We present our experience with a corrective operation of this lesion carried out in a young boy originate from Guinea


Asunto(s)
Masculino , Adolescente , Humanos , Fibrosis Endomiocárdica/diagnóstico , Fibrosis Endomiocárdica/fisiopatología , Fibrosis Endomiocárdica/cirugía , Endocardio/patología , Endocardio/fisiopatología , Endocardio/cirugía , Fibrosis Endomiocárdica/patología , Fibrosis Endomiocárdica , Cardiomiopatía Restrictiva/diagnóstico , Cardiomiopatía Restrictiva/cirugía , Cardiomiopatías/patología , Cardiomiopatías/fisiopatología , Cardiomiopatías/cirugía
18.
Forensic Sci Int ; 139(2-3): 141-9, 2004 Jan 28.
Artículo en Inglés | MEDLINE | ID: mdl-15040907

RESUMEN

We explore different designs to estimate both nuclear and mitochondrial human DNA (mtDNA) content based on the detection of the 5' nuclease activity of the Taq DNA polymerase using fluorogenic probes and a real-time quantitative PCR detection system. Human mtDNA quantification was accomplished by monitoring the real-time progress of the PCR-amplification of two different fragment sizes (113 and 287 bp) within the hypervariable region I (HV1) of the mtDNA control region, using two fluorogenic probes to specifically determine the mtDNA copy of each fragment size category. This mtDNA real-time PCR design has been used to assess the mtDNA preservation (copy number and degradation state) of DNA samples retrieved from 500 to 1500 years old human remains that showed low copy number and highly degraded mtDNA. The quantification of nuclear DNA was achieved by real-time PCR of a segment of the X-Y homologous amelogenin (AMG) gene that allowed the simultaneous estimation of a Y-specific fragment (AMGY: 112 bp) and a X-specific fragment (AMGX: 106 bp) making possible not only haploid or diploid DNA quantitation but also sex determination. The AMG real-time PCR design has been used to quantify a set of 57 DNA samples from 4-5 years old forensic bone remains with improved sensitivity compared with the slot-blot hybridization method. The potential utility of this technology to improve the quality of some PCR-based forensic and ancient DNA studies (microsatellite typing and mtDNA sequencing) is discussed.


Asunto(s)
Dermatoglifia del ADN/métodos , ADN/análisis , Dosificación de Gen , Reacción en Cadena de la Polimerasa/métodos , Amelogenina , Animales , Núcleo Celular/genética , Proteínas del Esmalte Dental/genética , Femenino , Antropología Forense/métodos , Hominidae/genética , Humanos , Masculino , Análisis para Determinación del Sexo , Secuencias Repetidas en Tándem , Germen Dentario
19.
Forensic Sci Int ; 139(2-3): 231-5, 2004 Jan 28.
Artículo en Inglés | MEDLINE | ID: mdl-15040922

RESUMEN

Haplotype, allele frequencies and population data of 17 Y-chromosome STR loci DYS19, DYS385, DYS389I, DYS389II, DYS390, DYS391, DYS392, DYS393, DYS437, DYS438, DYS439, DYS460 (GATA A7.1), DYS461 (GATA A7.2), GATA A10, GATA C4 and GATA H4 were determined from a sample of 148 unrelated male individuals from Spain. A total of 144 haplotypes were identified by the 17 Y-STR markers, of which 141 were unique, two were found in two individuals and one was found in three individuals. The haplotype diversity (99.95%) and discrimination capacity (97.30%) were calculated. Comparisons were made with previously published haplotype data on other Iberian population samples and no significant differences were found.


Asunto(s)
Cromosomas Humanos Y , Frecuencia de los Genes , Genética de Población , Haplotipos , Secuencias Repetidas en Tándem , Dermatoglifia del ADN/métodos , Humanos , Masculino , España
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