Study of the

The ^{22}Mg(α,p)^{25}Al reaction rate has been identified as a major source of uncertainty for understanding the nucleosynthesis flow in Type-I x-ray bursts. We report a direct measurement of the energy- and angle-integrated cross sections of this reaction in a 3.3-6.9 MeV center-of-mass energy range using the MUlti-Sampling Ionization Chamber (MUSIC). The new ^{22}Mg(α,p)^{25}Al reaction rate is a factor of ∼4 higher than the previous direct measurement of this reaction within temperatures relevant for x-ray bursts, resulting in the ^{22}Mg waiting point of x-ray burst nucleosynthesis flow to be significantly bypassed via the (α,p) reaction.

Mamografía con Inyección de Contraste: Experiencia inicial y revisión de la literatura / Contrast Enhanced Mammography: Initial experience and review of the literature

Objetivo: El objetivo de la presente investigación es evaluar nuestra experiencia inicial en la implementación de la mamografía con inyección de contraste (MCIC) y realizar una revisión de la literatura actual respecto de sus indicaciones. Los estudios se realizaron utilizando mamógrafo con capacidad de realizar MCIC, inyección de contraste iodado endovenoso y posterior toma de las imágenes mamográficas habituales (baja y alta energía). Se incluyeron 20 pacientes, invitadas a participar entre quienes concurrieron a realizar biopsias por punción histológicas. Una paciente realizó un segundo estudio al finalizar la terapia neoadyuvante. Dos de 20 (10%) pacientes tuvieron solo lesiones benignas que no realzaron y 18/20 (90%) lesiones malignas que realzaron. Se biopsiaron 27 lesiones, 4 (15%) fueron benignas y 23 (85%) malignas. La extensión del realce coincidió con la lesión visible en imágenes de baja energía en 9/18 (50%) pacientes, en 1/18 (5%) parte del realce mayor a la imagen de baja energía correspondió a una lesión benigna (falso positivo) y en 8/18 (45%) el realce mayor a la imagen de baja energía se corroboró histológicamente. En 4 (22%) pacientes se modificó la estrategia quirúrgica. En el examen post neoadyuvancia se observó respuesta imagenológica completa, reportándose en la cirugía, lesión residual invasora de 2mm. No se presentaron reacciones alérgicas ni otras complicaciones. Se realizó revisión de indicaciones en la literatura. Conclusiones: Nuestra experiencia inicial y curva de aprendizaje muestran que la MCIC es segura y con buenos resultados(AU)

Objetive The purpose of the investigation is to evaluate our initial experience with the implementation of contrast enhanced mammography (CEM) and a review of the current publications regarding its indications. The study was performed with a mammographic unit with CEM capability and iodine-based contrast medium injection. Low and high energy images (recombined image) were obtained in standard incidences. Twenty patients were invited to participate among those that came to undergo breast core biopsies. One patient had two studies, the second after neoadjuvant therapy. Two of 20 (10%) patients had only benign lesions that did not enhanced and 18/20 (90%) had malignant lesions that enhanced. Twenty-seven lesions were biopsied, 4 (15%) were benign and 23 (85%) were malignant. Enhancement was coincident with low energy images size in 9/18 (50%) patients, in 1/8 (5%) part of the enhancement, larger than the lesion in low energy images was due to a benign lesion (false positive) and 8/18 (45%) the size of the lesion that enhanced was truly larger than low energy images (histology proved). Because of this, surgery strategy was modified in 4 (22%) patients. There was radiologic complete response after neoadjuvant therapy and the surgical path report described a 2mm residual invasive carcinoma. There were no allergic reactions or other complications. A review of the published indications of the method was performed. Conclusions: Our initial experience and learning curve shows that CEM is safe with good clinical outcome (AU)

Evaluación de gravedad en pacientes agudos / Evaluation of severity in acute patients

Severity meaning the risk of adverse outcomes, death or disability, varies along disease's characteristics and patient related factors. Its evaluation is complex and besides subjective perception several, more objective, clinical tools exist along with laboratory data that independently or used in combination, allows the clinician to approach severity of a given patient's condition or a particular disease. We will review several aspects of the evaluation of severity, clinical and laboratory based in addition of some scoring systems, emphasizing perfusion and organ dysfunction evaluation as key elements to assess severity particularly in critical situations. (AU)

Pérdidas hemáticas en UCI: Breve estudio descriptivo / Blood loss in ICU: Brief descriptive study

Background: Anaemia and transfusions are frequent in critically ill patients and there are avoidable causes such as routine laboratory tests. Patients and methods: Descriptive study during one continuous week including patients over 18-years old in a medical-surgical ICU. Results: 18 patients were included during a week in 12 beds in our unit, median age 62,5 years, 50% male. Median daily blood loss was 35ml, 45% in laboratory samples and 27% related to renal replacement therapy. 3 patients required 1 transfusion of red blood cells. Conclusions: There is a pattern of continuous blood loss in critically ill patients, primarily in routine laboratory tests. (AU)

Evaluación de la corrección angular de la integral velocidad tiempo en ecocardiografía. Estudio piloto / Evaluation of the angular correction of the integral velocity time in echocardiography. Pilot study

Background: Echocardiography has now a pivotal role as a tool for hemodynamic monitoring, particularly in the critically ill. However, the ideal acoustic window for relevant measurements such as the velocity time integral are not always available. We propose to evaluate if angular correction of this variable is accurate in comparison with standard technique. Patients and methods: Adult patients were evaluated in the echocardiography unit during Juny 2017, having velocity time integral measured with angulation and standard technique, with convenience sampling. Analysis included difference, means and correlation between basal results and maximal angulation, in Stata 12. Results: 25 patients were included, mean velocity time integral was 23,01cm and with a mean angulation of 32,56º the integral was 24,27cm, with 5,5% difference, statistically significant, linear correlation had a 0,932 coefficient with R-square of 0,7897. Bland-Altman analysis revealed mean difference -1,256cm and agreement limits of -5,219 to 2,707. Discussion: In this study the result of the velocity time integral with angular correction had a good correlation and acceptable precision compared with non-angled measurements, which could allow its use when the acoustic window is sub-optimal, however, these findings should be replicated in critically ill patients. (AU)

Study of the

The existence of ^{26}Al (t_{1/2}=7.17×10^{5} yr) in the interstellar medium provides a direct confirmation of ongoing nucleosynthesis in the Galaxy. The presence of a low-lying 0^{+} isomer (^{26}Al^{m}), however, severely complicates the astrophysical calculations. We present for the first time a study of the ^{26}Al^{m}(d,p)^{27}Al reaction using an isomeric ^{26}Al beam. The selectivity of this reaction allowed the study of ℓ=0 transfers to T=1/2, and T=3/2 states in ^{27}Al. Mirror symmetry arguments were then used to constrain the ^{26}Al^{m}(p,γ)^{27}Si reaction rate and provide an experimentally determined upper limit of the rate for the destruction of isomeric ^{26}Al via radiative proton capture reactions, which is expected to dominate the destruction path of ^{26}Al^{m} in asymptotic giant branch stars, classical novae, and core collapse supernovae.

Salivary Urease and ADS Enzymatic Activity as Endogenous Protection against Dental Caries in Children.

UNLABELLED: The aim of this cross sectional study was to evaluate the ureolytic and arginolytic activities of saliva in children and associate them with their caries status. STUDY DESIGN: 65, 8 year old children, were randomly selected. The ureolytic and arginolytic activity of non stimulated saliva was studied and associated with DMFT and dmft index. Saliva of children were sampled under fasting conditions; Children refrained from any oral hygiene procedures during the 12 hours that preceded the sample collection. Caries activity was scored and divided in 3 groups: Group A: Index zero: without lesions; Group B: Moderate Index: 1 to 3 enamel caries lesions; and Group C: High Index: more than 4 dentin caries lesions. RESULTS: DMFT scores were moderate: 0.4(±0.79) and dmft: 2.78(±2.45). Results expressed in µmol/min/mg/protein, for urease activity were statistically significant (p=0.048): Group A= 0.69 (±0.7); Group B= 0.45 (±0.43); and Group C= 0.39 (±0.55). The arginine deiminase activity was not statistically significant (p=0.16): Group A= 2.53 (±1.42), Group B= 2.31 (±1.57) and Group C= 1.97 (±2.0). CONCLUSION: Higher levels of ureolytic (statistically significant) and arginolytic activity (trend) in saliva were associated with lower DMFT/dmft scores in 8 year old children. There was a higher production of ammonia from the arginine deiminase system than the urease enzyme in saliva (p>0.05).

Measurements of fusion reactions of low-intensity radioactive carbon beams on 12C and their implications for the understanding of X-ray bursts.

The interaction between neutron-rich nuclei plays an important role for understanding the reaction mechanism of the fusion process as well as for the energy production through pycnonuclear reactions in the crust of neutron stars. We have performed the first measurements of the total fusion cross sections in the systems (10,14,15)C+(12)C using a new active target-detector system. In the energy region accessible with existing radioactive beams, a good agreement between the experimental and theoretical cross sections is observed. This gives confidence in our ability to calculate fusion cross sections for systems which are outside the range of today's radioactive beam facilities.

Direct measurement of the (23)Na(α,p)(26)Mg reaction cross section at energies relevant for the production of galactic (26)Al.

The 1809-keV γ ray from the decay of (26)Al(g) is an important target for γ-ray astronomy. In the convective C/Ne burning shell of massive presupernova stars, the (23)Na(α,p)(26)Mg reaction directly influences the production of (26)Al. We have performed a direct measurement of the (23)Na(α,p)(26)Mg reaction cross section at the appropriate astrophysically important energies. The stellar rate calculated in the present work is larger than the recommended rate by nearly a factor of 40 and could strongly affect the production of (26)Al in massive stars.

Fusion reactions with the one-neutron halo nucleus (15)C.

The structure of (15)C, with an s(1/2) neutron weakly bound to a closed-neutron shell nucleus (14)C, makes it a prime candidate for a one-neutron halo nucleus. We have for the first time studied the cross section for the fusion-fission reaction (15)C+(232)Th at energies in the vicinity of the Coulomb barrier and compared it to the yield of the neighboring (14)C+(232)Th system measured in the same experiment. At sub-barrier energies, an enhancement of the fusion yield by factors of 2-5 was observed for (15)C, while the cross sections for (14)C match the trends measured for (12,13)C.

Infarto agudo al miocardio: cómo diagnosticarlo en forma precoz / Acute myocardial infarction: how to diagnose at an early stage

Acute Myocardial infarction is the first cause of death in our country, to reduce its mortality early hospitalization is critical, so adequate treatments that have demonstrated to improve survival can be applied, particularly reperfusion therapy, that requires a diagnosis before 12 hours of evolution of symptoms to be effectively used, to do this early diagnosis two key elements are basic: clinical history and electrocardiography. This two elements are reviewed as their correct application and possible related mistake.

Mitochondrial bioenergetics and dynamics interplay in complex I-deficient fibroblasts.

BACKGROUND: Complex I (CI) deficiency is the most frequent cause of OXPHOS disorders. Recent studies have shown increases in reactive oxygen species (ROS) production and mitochondrial network disturbances in patients' fibroblasts harbouring mutations in CI subunits. OBJECTIVES: The present work evaluates the impact of mutations in the NDUFA1 and NDUFV1 genes of CI on mitochondrial bioenergetics and dynamics, in fibroblasts from patients suffering isolated CI deficiency. RESULTS: Decreased oxygen consumption rate and slow growth rate were found in patients with severe CI deficiency. Mitochondrial diameter was slightly increased in patients' cells cultured in galactose or treated with 2'-deoxyglucose without evidence of mitochondrial fragmentation. Expression levels of the main proteins involved in mitochondrial dynamics, OPA1, MFN2, and DRP1, were slightly augmented in all patients' cells lines. The study of mitochondrial dynamics showed delayed recovery of the mitochondrial network after treatment with the uncoupler carbonyl cyanide m-chlorophenyl hydrazone (cccp) in patients with severe CI deficiency. Intracellular ROS levels were not increased neither in glucose nor galactose medium in patients' fibroblasts. CONCLUSION: Our main finding was that severe CI deficiency in patients harbouring mutations in the NDUFA1 and NDUFV1 genes is linked to a delayed mitochondrial network recovery after cccp treatment. However, the CI deficiency is neither associated with massive mitochondrial fragmentation nor with increased ROS levels. The different genetic backgrounds of patients with OXPHOS disorders would explain, at least partially, differences in the pathophysiological manifestations of CI deficiency.

Síndrome de Tako-tsubo: presentación y revisión actualizada del tema / Tako-Tsubo syndrome: typical clinical case and review

An acute left ventricular disfunction, induced by physical or emotional stress, has been described, known as Tako-tsubo syndrome. Acute coronary disease has shown to be its most important differential diagnosis, based on the similar clinical findings described in this group of patients. It usually presents with chest pain, reversible ST segment elevation in the electrocardiogram, discrete myocardial enzyme elevation and transient left ventricular wall motion abnormality, with no significant coronary arteries disease demonstrated. In this article we present the case of a46 year old woman with a typical Tako-tsubo’s syndrome medical profile who was hospitalized in our Hospital, with an initial diagnosis of an acute ST elevation myocardial infarction. We describe the general study and management of this syndrome and make a discussion about the subject.

Nueva estrategia para preacondicionamiento miocárdico en pacientes sometidos a cirugía cardíaca con circulación extracorpórea / Reduction of postoperative atrial fibrillation through antioxidant supplementation

INTRODUCCION: El estrés oxidativo (EO) es importante en la génesis de diversas patologías. Su rol en patología cardiovascular es reconocido, particularmente en isquemia-reperfusión, fenómeno asociado al uso de circulación extracorpórea (CEC) en cardiocirugía. Complicación frecuente es la fibrilación auricular post-operatoria(FAPO), que ha demostrado participación del EO. Estrategias que lo atenúen podrían reducir incidencia de FAPO. Este trabajo busca determinar efectos de un esquema de suplementación para prevenir el EO y FAPO. METODOLOGIA: Ensayo clínico, doble ciego, aleatorizado. A 80 pacientes programados para cardiocirugía con CEC se administró placebo (n=40) o suplementación(n=40), consistiendo desde 7 días antes de la cirugía ácidos grasos poli-insaturados omega-3 (n-3) (2 g/día), y 2 días pre-cirugía se agrega vitamina C (1 g/día) y E (400 UI/día), todo hasta el alta. Se obtuvieron muestras sanguíneas (al ingreso, en suplementación, en cirugía, en postoperatorio y al alta) y auriculares durante cirugía. El estado antioxidante fue medido por la habilidad plasmática para reducir hierro férrico (FRAP) y el índice GSH/GSSG. Se midió actividad de enzimas catalasa, superóxido-dismutasa y glutatión-peroxidasa. Lipoperoxidación fue medida por niveles de malondialdehído. Para variables paramétricas se usó t de student, entre grupos se usó ANOVA-Bonferroni. Significancia fue p<0.05. RESULTADOS: Suplementación con n-3 disminuyó índice GSH/GSSG en 25 por ciento. En postoperatorio hubo 21 por ciento menos de lipoperoxidación y niveles de FRAP 30 por ciento mayores. Actividad de enzimas mostró incremento significativo. Además disminuyó FAPO desde 25 por ciento a 7,5 por ciento. CONCLUSION: Suplementar con n-3 y vitaminas antioxidantes disminuye ocurrencia de FAPO evitando daño miocárdico bioquímico y funcional por EO.

INTRODUCTION: Oxidative stress is important in the genesis of several diseases. Their role in cardiovascular disease is recognized, particularly in ischemia-reperfusion, a phenomenon associated with the use of cardiopulmonary bypass (CPB) in cardiac surgery. Common complication is postoperative atrial fibrillation (FOAP), which has demonstrated participation of oxidative stress, strategies to mitigate what could reduce the occurrence of FOAP. This paper tries to determine the effect of a supplementation scheme to prevent oxidative stress and its consequences. MATERIALS AND METHODS: Randomized, double-blind, controlled trial. Eighty patients scheduled for CCEC received placebo (n = 40) or supplementation (n = 40). Inclusion criteria: Age 30-80 years, sinus rhythm. Exclusion criteria: previous cardiosurgery, paroxysmal atrial fibrillation, congenital heart disease, chronic diseases. The supplementation consisting of n-3 (2 g / day), vitamins C (1 g /day) and E (400 IU / day) from 7, 2 and 2 days before surgery, respectively, until discharge. In atrial tissue and blood samples the plasma ferric reducing ability (FRAP), index GSH/GSSG, activity of catalase, superoxide dismutase and glutathione-peroxidase, and malondialdehyde levels were measured. Protein carbonylationwas measured in atrial tissue. Parametric variables expressed as mean and standard error were analyzed with student’s t-test, groups were compared using ANOVA-Bonferroni. Significance was p <0.05. RESULTS: The supplementation reduced the incidence of FOAP, lipid peroxidation and protein carbonylation in 73, 21 and 19 percent (p <0.05), respectively, and increased the FRAP (30 percent) and activity of antioxidant enzymes (p <0.05). CONCLUSIONS: Antioxidant supplementation decreases FOAP probably avoiding damage by oxidative stress.

Prevalencia de control insuficiente de factores de riesgo en prevención primaria de patología coronaria / Prevalence of insufficient control of factors of risk in primary prevention of coronary pathology

Background: Coronary artery disease is an important cause of mortality and morbidity in Chile, there are known risk factors for its beginning and progress, controling them could improve prognosis. There is insufficient information on risk factor control in primary prevention, and a descriptive study was designed. Objectives: Describe the extent of use of primary prevention measures on risk factors of coronary artery disease on Chilean patients hospitalized at the Clinical Hospital of the University of Chile on prior outpatient period. Patients and methods: A survey was applied to 63 patients on their hospitalizations rooms. Blood pressure and Low Density Lipoprotein data were obtained from their charts. A database was created and risk factors were analyzed independently. Results: 100 percent of uncontrolled hypertensive patients wereundertreated. 31.25 percent smokers had not received advise on cessation. 48 percent of overweight and 37.5 percent of obese patients were under no management. 34 percent of sedentary patients reported no advise on physical exercise from their regular physicians. Conclusions: The current study reveals several risk factors being undertreated, however it presents important limitations, studies with more patients may be required to confirm these findings. Physicians should be aware of under treatment.

Analysis of mitochondrial DNA sequences in patients with isolated or combined oxidative phosphorylation system deficiency.

BACKGROUND: Enzyme deficiencies of the oxidative phosphorylation (OXPHOS) system may be caused by mutations in the mitochondrial DNA (mtDNA) or in the nuclear DNA. OBJECTIVE: To analyse the sequences of the mtDNA coding region in 25 patients with OXPHOS system deficiency to identify the underlying genetic defect. RESULTS: Three novel non-synonymous substitutions in protein-coding genes, 4681T-->C in MT-ND2, 9891T-->C in MT-CO3 and 14122A-->G in MT-ND5, and one novel substitution in the 12S rRNA gene, 686A-->G, were found. The definitely pathogenic mutation 3460G-->A was identified in an 18-year-old woman who had severe isolated complex I deficiency and progressive myopathy. CONCLUSIONS: Bioinformatic analyses suggest a pathogenic role for the novel 4681T-->C substitution found in a boy with Leigh's disease. These results show that the clinical phenotype caused by the primary Leber's hereditary optic neuropathy mutation 3460G-->A is more variable than has been thought. In the remaining 23 patients, the role of mtDNA mutations as a cause of the OXPHOS system deficiency could be excluded. The deficiency in these children probably originates from mutations in the nuclear genes coding for respiratory enzyme subunits or assembly factors.

Identification of a proximal promoter region critical for the expression of the beta-F1-ATPase gene during Drosophila melanogaster development.

We have studied the spatio-temporal pattern of expression of the gene encoding the H(+) adenosine triphosphate (ATP) synthase beta subunit (beta-F1-ATPase) during Drosophila melanogaster development. The beta-F1-ATPase mRNA is stored in the egg; as development proceeds it is distributed in most embryonic cellular territories, including the mesoderm, and in late embryos it is highly abundant in the ventral cord and midgut. Using a combination of transfection assays in Schneider cells and P-element transformation in flies, we have identified a proximal 5' upstream region of 258 bp essential for the transcriptional activity of the gene during D. melanogaster embryogenesis that is virtually inactive in adult tissues. Electrophoretic mobility shift assays using specific DNA fragments from the 258-bp region detect in embryonic nuclear extracts a complex set of DNA binding proteins that are largely absent in adults. The transcription factor CF2-II has been identified as a potential candidate in the regulation of the beta-F1-ATPase gene.

Microgravity effects on Drosophila melanogaster behavior and aging. Implications of the IML-2 experiment.

Earlier Space experiments had indicated that young male Drosophila flies exposed to microgravity showed an acceleration in aging. In a 14.5-day Space Shuttle Flight we sent 300 young male flies with the purpose of confirming these findings and to establish whether changes in the behavior of the flies were responsible for the effect in accordance with the proposal that alterations in mitochondrial metabolism may be involved in the aging response. By repeatedly video-recording, we have found a very marked increase in the locomotor activity of the fruitflies in Space. The males showed an accelerated aging response upon recovery, both in terms of physiological vitality assays (mating and negative geotaxis) and of life-span curves. The involvement of mitochondrial metabolism is also suggested by the finding of a greater decrease in mitochondrial 16S ribosomal RNA in the microgravity exposed flies than in ground controls. On the other hand, a parallel 1 x g centrifuge control did not show such differences in the life-span curves when compared to flies exposed to a similar centrifugation on the ground. Drosophila females also increased their locomotor activity but did not show differential changes in the life-span curves. These results are discussed in terms of the current mechanisms of aging in multicellular eukaryotic organisms.

Preservation of viable biological samples for experiments in space laboratories.

Standard viable preservation methods for biological samples using low temperatures have been investigated concerning their storage capabilities under higher temperature levels than usual. For a representative set of organism classes (plants, mammalian cells, arthropods and aquatic invertebrates), the minimum appropriate storage conditions have been identified by screening storage temperatures at -196 degrees, -80 degrees, -20 degrees, +4 degrees, +20 degrees/25 degrees C for periods from 2 days to 4 weeks. For storage below 0 degree C, as a typical cryopreservative, dimethylsulfoxide (DMSO) was used. For some samples, the addition of trehalose (as cryopreservative) and the use of a nitrogen atmosphere were investigated. After storage, the material was tested for vitality. The findings demonstrated that acceptable preservation can be achieved under higher storage temperatures than are typically applied. Small, dense cultured plant cells survive for 21 d when moderately cooled (+4 degrees to -20 degrees C); addition of trehalose enhances viability at -20 degrees C. For mammalian cells, the results show that human lymphocytes can be preserved for 3 d at 25 degrees C, 7 d at 4 degrees C and 28 d at -80 degrees C. Friend leukaemia virus transformed cells can be stored for 3 d at 25 degrees C, 14 d at 4 degrees C and 28 d at -80 degrees C. Hybridoma cells can be kept 7 d at 4 degrees C and 28 d at -20 degrees C or -80 degrees C. Model arthropod systems are well preserved for 2 weeks if maintained at lower temperatures that vary depending on the species and/or stage of development; e.g., 12 degrees C for Drosophila imagoes and 4-6 degrees C for Artemia nauplii. For aquatic invertebrates such as sea urchins, embryonic and larval stages can be preserved for several weeks at +6 degrees C, whereas sperm and eggs can best be stored at + 4 degrees C for up to 5 d at maximum. These results enhance the range of feasible space experiments with biological systems. Moreover, for typical terrestrial preservation methods, considerable modification potential is identified.