Left Bundle Branch Pacing vs Left Ventricular Septal Pacing vs Biventricular Pacing for Cardiac Resynchronization Therapy.

BACKGROUND: Left bundle branch pacing (LBBP) and left ventricular septal pacing (LVSP) are considered to be acceptable as LBBAP strategies. Differences in clinical outcomes between LBBP and LVSP are yet to be determined. OBJECTIVES: The purpose of this study was to compare the outcomes of LBBP vs LVSP vs BIVP for CRT. METHODS: In this prospective multicenter observational study, LBBP was compared with LVSP and BIVP in patients undergoing CRT. The primary composite outcome was freedom from heart failure (HF)-related hospitalization and all-cause mortality. Secondary outcomes included individual components of the primary outcome, postprocedural NYHA functional class, and electrocardiographic and echocardiographic parameters. RESULTS: A total of 415 patients were included (LBBP: n = 141; LVSP: n = 31; BIVP: n = 243), with a median follow-up of 399 days (Q1-Q3: 249.5-554.8 days). Freedom from the primary composite outcomes was 76.6% in the LBBP group and 48.4% in the LVSP group (HR: 1.37; 95% CI: 1.143-1.649; P = 0.001), driven by a 31.4% absolute increase in freedom from HF-related hospitalizations (83% vs 51.6%; HR: 3.55; 95% CI: 1.856-6.791; P < 0.001) without differences in all-cause mortality. LBBP was also associated with a higher freedom from the primary composite outcome compared with BIVP (HR: 1.43; 95% CI: 1.175-1.730; P < 0.001), with no difference between LVSP and BIVP. CONCLUSIONS: In patients undergoing CRT, LBBP was associated with improved outcomes compared with LVSP and BIVP, while outcomes between BIVP and LVSP are similar.

Ten years of pediatric surgery in a secondary level perinatal hospital in Mexico.

BACKGROUND: Neonatal surgery is one of the most specialized and demanding areas of pediatric surgery due to the specific anatomical and physiological characteristics of this vulnerable group of patients. This study aimed to present the experience of 10 years of neonatal surgical management in a secondary care perinatal hospital in Mexico. METHODS: We conducted a descriptive, observational, cross-sectional, and retrospective study in a perinatal hospital in Toluca, Mexico, from August 01, 2012, to July 31, 2022. We included patients who underwent surgery within the hospital facilities by the Service of Pediatric Surgery. We studied demographic, clinical, and surgical variables and performed descriptive and inferential statistics. RESULTS: A total of 551 patients underwent surgery during this period with a prevalence of 0.5%. The number of patients operated in the neonatal period was 497 (90.1%). Forty-eight pathologies were recorded, with a predominance of congenital malformations in 64.6% and prenatal diagnosis in 40.5% of cases. The survival rate was 89.7%. In the bivariate analysis of mortality, we found an inverse relationship between weight and gestational age (p < 0.05). CONCLUSION: Although not a local or national reference center, the hospital where the study was conducted treats various congenital and acquired diseases, with a mortality rate that tends to decrease, close to the international average, and lower than national reports.

INTRODUCCIÓN: La cirugía pediátrica en la atención del recién nacido es una de las ramas más especializadas y demandantes debido a las particulares características anatómicas y fisiológicas de este vulnerable grupo de pacientes. El objetivo de este estudio fue presentar la experiencia de diez años de manejo quirúrgico neonatal en un hospital perinatal de segundo nivel de atención en México. MÉTODOS: Se llevó a cabo un estudio descriptivo, observacional, transversal y retrospectivo, en un hospital perinatal de Toluca, México, del 01 de agosto de 2012 al 31 de julio de 2022. Se incluyeron los pacientes sometidos a cirugía dentro de las instalaciones del hospital por parte del servicio de Cirugía Pediátrica. Se estudiaron variables demográficas, clínicas y quirúrgicas, realizando estadística descriptiva e inferencial. RESULTADOS: Un total de 551 pacientes fueron intervenidos quirúrgicamente en este periodo, con una prevalencia de 0.5%. La cantidad de pacientes operados en el periodo neonatal fue de 497 (90.1%). Se presentaron 48 patologías con predominio de las congénitas en el 64.6% y diagnóstico prenatal en el 40.5% de los casos. La supervivencia de los pacientes fue del 89.7%. En el análisis bivariado de mortalidad se encontró una relación inversa con el peso y edad gestacional (p < 0.05). CONCLUSIONES: En el hospital donde se realizó el estudio, a pesar de no ser un centro de referencia local o nacional, se atiende una amplia diversidad de padecimientos congénitos y adquiridos, con una mortalidad con tendencia a disminuir cercana a la media internacional y menor que los reportes nacionales.

Ten years of pediatric surgery in a secondary level perinatal hospital in Mexico / Diez años de cirugía pediátrica en un hospital perinatal de segundo nivel en México

Abstract Background: Neonatal surgery is one of the most specialized and demanding areas of pediatric surgery due to the specific anatomical and physiological characteristics of this vulnerable group of patients. This study aimed to present the experience of 10 years of neonatal surgical management in a secondary care perinatal hospital in Mexico. Methods: We conducted a descriptive, observational, cross-sectional, and retrospective study in a perinatal hospital in Toluca, Mexico, from August 01, 2012, to July 31, 2022. We included patients who underwent surgery within the hospital facilities by the Service of Pediatric Surgery. We studied demographic, clinical, and surgical variables and performed descriptive and inferential statistics. Results: A total of 551 patients underwent surgery during this period with a prevalence of 0.5%. The number of patients operated in the neonatal period was 497 (90.1%). Forty-eight pathologies were recorded, with a predominance of congenital malformations in 64.6% and prenatal diagnosis in 40.5% of cases. The survival rate was 89.7%. In the bivariate analysis of mortality, we found an inverse relationship between weight and gestational age (p < 0.05). Conclusion: Although not a local or national reference center, the hospital where the study was conducted treats various congenital and acquired diseases, with a mortality rate that tends to decrease, close to the international average, and lower than national reports.

Resumen Introducción: La cirugía pediátrica en la atención del recién nacido es una de las ramas más especializadas y demandantes debido a las particulares características anatómicas y fisiológicas de este vulnerable grupo de pacientes. El objetivo de este estudio fue presentar la experiencia de diez años de manejo quirúrgico neonatal en un hospital perinatal de segundo nivel de atención en México. Métodos: Se llevó a cabo un estudio descriptivo, observacional, transversal y retrospectivo, en un hospital perinatal de Toluca, México, del 01 de agosto de 2012 al 31 de julio de 2022. Se incluyeron los pacientes sometidos a cirugía dentro de las instalaciones del hospital por parte del servicio de Cirugía Pediátrica. Se estudiaron variables demográficas, clínicas y quirúrgicas, realizando estadística descriptiva e inferencial. Resultados: Un total de 551 pacientes fueron intervenidos quirúrgicamente en este periodo, con una prevalencia de 0.5%. La cantidad de pacientes operados en el periodo neonatal fue de 497 (90.1%). Se presentaron 48 patologías con predominio de las congénitas en el 64.6% y diagnóstico prenatal en el 40.5% de los casos. La supervivencia de los pacientes fue del 89.7%. En el análisis bivariado de mortalidad se encontró una relación inversa con el peso y edad gestacional (p < 0.05). Conclusiones: En el hospital donde se realizó el estudio, a pesar de no ser un centro de referencia local o nacional, se atiende una amplia diversidad de padecimientos congénitos y adquiridos, con una mortalidad con tendencia a disminuir cercana a la media internacional y menor que los reportes nacionales.

The Emerging Role of Left Bundle Branch Area Pacing for Cardiac Resynchronisation Therapy.

Cardiac resynchronisation therapy (CRT) reduces the risk of heart failure-related hospitalisations and all-cause mortality, as well as improving quality of life and functional status in patients with persistent heart failure symptoms despite optimal medical treatment and left bundle branch block. CRT has traditionally been delivered by implanting a lead through the coronary sinus to capture the left ventricular epicardium; however, this approach is associated with significant drawbacks, including a high rate of procedural failure, phrenic nerve stimulation, high pacing thresholds and lead dislodgement. Moreover, a significant proportion of patients fail to derive any significant benefit. Left bundle branch area pacing (LBBAP) has recently emerged as a suitable alternative to traditional CRT. By stimulating the cardiac conduction system physiologically, LBBAP can result in a more homogeneous left ventricular contraction and relaxation, thus having the potential to improve outcomes compared with conventional CRT strategies. In this article, the evidence supporting the use of LBBAP in patients with heart failure is reviewed.

The Entero-Mammary Pathway and Perinatal Transmission of Gut Microbiota and SARS-CoV-2.

COVID-19 is a severe respiratory disease threatening pregnant women, which increases the possibility of adverse pregnancy outcomes. Several recent studies have demonstrated the ability of SARS-CoV-2 to infect the mother enterocytes, disturbing the gut microbiota diversity. The aim of this study was to characterize the entero-mammary microbiota of women in the presence of the virus during delivery. Fifty mother−neonate pairs were included in a transversal descriptive work. The presence of SARS-CoV-2 RNA was detected in nasopharyngeal, mother rectal swabs (MRS) and neonate rectal swabs (NRS) collected from the pairs, and human colostrum (HC) samples collected from mothers. The microbiota diversity was characterized by high-throughput DNA sequencing of V3-16S rRNA gene libraries prepared from HC, MRS, and NRS. Data were analyzed with QIIME2 and R. Our results indicate that several bacterial taxa are highly abundant in MRS positive for SARS-CoV-2 RNA. These bacteria mostly belong to the Firmicutes phylum; for instance, the families Bifidobacteriaceae, Oscillospiraceae, and Microbacteriaceae have been previously associated with anti-inflammatory effects, which could explain the capability of women to overcome the infection. All samples, both positive and negative for SARS-CoV-2, featured a high abundance of the Firmicutes phylum. Further data analysis showed that nearly 20% of the bacterial diversity found in HC was also identified in MRS. Spearman correlation analysis highlighted that some genera of the Proteobacteria and Actinobacteria phyla were negatively correlated with MRS and NRS (p < 0.005). This study provides new insights into the gut microbiota of pregnant women and their potential association with a better outcome during SARS-CoV-2 infection.

Current practice in transvenous lead extraction in Latin America: Latin American Heart Rhythm Association survey.

BACKGROUND: Transvenous lead extraction (TLE) is standard of care for the management of patients with cardiac implantable electronic device infection or lead-related complications. Currently, objective data on TLE in Latin America is lacking. OBJECTIVE: To describe the current practice standards in Latin American centers performing TLE. METHODS: An online survey was sent through the mailing list of the Latin American Heart Rhythm Society. Online reminders were sent through the mailing list; duplicate answers were discarded. The survey was available for 1 month, after which no more answers were accepted. RESULTS: A total of 48 answers were received, from 44 different institutions (39.6% from Colombia, 27.1% from Brazil), with most respondents (82%) being electrophysiologists. Twenty-nine institutions (66%) performed <10 lead extractions/year, with 7 (16%) institutions not performing lead extraction. Although most institutions in which lead extraction is performed reported using several tools, mechanical rotating sheaths were cited as the main tool (66%) and only 13% reported the use of laser sheaths. Management of infected leads was performed according to current guidelines. CONCLUSION: This survey is the first attempt to provide information on TLE procedures in Latin America and could provide useful information for future prospective registries. According to our results, the number of centers performing high volume lead extraction in Latin America is smaller than that reported in other continents, with most interventions performed using mechanical tools. Future prospective registries assessing acute and long-term success are needed.

A case report of newborn infant with severe COVID-19 in Mexico: Detection of SARS-CoV-2 in human breast milk and stool.

Although COVID-19 in pregnant women and their neonates has been demonstrated, there is not enough evidence about how this vertical transmission occurs. This report describes a SARS-CoV-2 infection in a 21-year-old mother-daughter duo at the time of birth, focusing on the viral RNA detection in the stool of both and the human breast milk.

High intensity ultrasound treatment of faba bean (Vicia faba L.) protein: Effect on surface properties, foaming ability and structural changes.

Response surface methodology was used for establishing the amplitude (72.67%) and time (17.29 min) high-intensity ultrasound (HIUS) conditions leading to an optimized faba bean protein isolate (OFPI) with lower interfacial tension, zeta potential and viscosity, and higher solubility than native faba bean protein isolate (NFPI). OFPI showed significantly higher adsorption dynamics at the air-water interface, and produced foam with significant smaller bubble diameter, higher overrun, stability and yield stress, and lower liquid drainage than NFPI. Fourier Transform Spectroscopy (FT-IR) revealed that the secondary structure of OFPI deferred from NFPI in terms of increases in ß conformations (6.61% ß-sheet, 19.6% ß-turn, 0.8% anti-parallel ß-sheet) and decreases in inter-molecular aggregates (43.54%). Multienzyme study pinpointed that the structural changes could have induced a decrease on the relative protein digestibility of OFPI respect that of NFPI. The results of this work demonstrate that HIUS technology improves the surface and foaming properties of faba bean protein isolate, which may favour the revalorisation of this crop.

Comportamiento fractal estadístico en la dinámica de epidemia de dengue en Palmira, Valle del Cauca, Colombia. 2001-2004 / Statistical fractal behavior of the dengue epidemic dynamics in Palmira, Valle del Cauca, Colombia between 2001-2004

Resumen Introducción. Fenómenos como la monitoria fetal y el repertorio T específico contra el alérgeno Poa p9 han sido evaluados con la ley de Zipf/Mandelbrot. Objetivo. Establecer una metodología de caracterización de la dinámica del dengue en Palmira, Valle del Cauca, Colombia, fundamentada en la ley de Zipf/Mandelbrot y aplicada al periodo 2001-2004. Materiales y métodos. Mediante la ley de Zipf-Mandelbrot se evaluaron las variaciones por grupos de edad (<1 año, 1-4, 5-14, 15-44, 45-59 y >60) y la complejidad del sistema frente al número de infectados de dengue en Palmira para cada año entre 2001 y 2004, se compararon los resultados para establecer variaciones en la complejidad y se realizaron simulaciones de posibles comportamientos que se puedan presentar. Resultados. Las dimensiones fractales para cada año se encontraron entre 0.5329 y 0.8703 y para grupos de edad entre 0.4694 y 0.6689. Las simulaciones de las dinámicas de años presentaron dimensiones fractales entre 0.4512 y 0.6316 y las de rangos de edad entre 0.455 y 0.6095. Conclusión. La dinámica de aparición de infectados de dengue en Palmira obedece a un comportamiento fractal estadístico con grados de complejidad finitos y acotados, útiles en la toma de decisiones en salud pública.

Abstract Introduction: Phenomena such as fetal monitoring and specific T cell repertoire against the allergen Poa p9 have been evaluated through the Zipf/Mandelbrot law. Objective: To establish a methodology for the characterization of the dynamics of dengue in Palmira, Valle del Cauca, Colombia, based on the Zipf/Mandelbrot law during the period 2001-2004. Materials and methods: Using the Zipf-Mandelbrot law, changes by age groups (<1 year, 1-4, 5-14, 15-44, 45-59 and> 60) were evaluated, as well as the complexity of the system versus the number of patients infected with dengue in Palmira, each year between 2001 and 2004. Results were compared to establish variations in the complexity, and simulations of possible behaviors that might arise were performed. Results: Fractal dimensions for each year were among 0.5329 and 0.8703, and for age groups between 0.4694 and 0.6689.The simulations of the dynamics per year presented fractal dimensions between 0.4512 and 0.6316, and age ranges between 0.455 and 0.6095. Conclusion: The dynamic of dengue onset in Palmira is caused by a statistical fractal behavior with finite and limited degrees of complexity, useful in decision-making in public health.

Metodología diagnóstica de la dinámicacardíaca neonatal mediante la ocupaciónespacial del atractor caótico / Diagnostic methodology of neonatal cardiac dynamics by spatial occupation of the chaotic attractor

Desarrollar una metodología diagnóstica de la dinámica cardíaca neonatalfundamentada en la geometría fractal, la teoría de los sistemas dinámicos yla ocupación espacial del atractor cardíaco en el espacio fractal de Box-Counting.Materiales y métodos: inicialmente se realizó una inducción matemática condos registros Holter evaluados clínicamente como normales y tres con patologíaaguda provenientes de la Unidad de Cuidados Intensivos (UCI). Se generó la secuencia de valores de la frecuencia cardíaca (FC) tomando para ello los valoresmáximos y mínimos de la FC/hora y total de latidos/hora durante 21 horas. Seconstruyeron atractores cardíacos, para calcular la dimensión fractal y los espaciosde ocupación en el espacio fractal de Box-Counting, estableciendo diferenciasentre normalidad y enfermedad. Los resultados de la inducción fueron aplicadosa 5 dinámicas normales y 25 patológicas, para confirmar los resultados obtenidosmediante un estudio ciego. Resultados: la ocupación espacial de los atractorescaóticos evaluados en la inducción matemática, evidenció que valores iguales osuperiores a 98 en la rejilla Kg son característicos de normalidad, y los menoresa 98 corresponden a enfermedad aguda; valores que fueron confirmados con loscasos restantes, logrando valores de sensibilidad y especificidad de 100%, y uncoeficiente kappa de 1. Conclusiones: se desarrolló un nuevo diagnóstico físicoy matemático de aplicación clínica para evaluar la dinámica cardíaca neonatal,que permite detectar tempranamente alteraciones de potencial gravedad y señalarcuantitativamente el nivel de agudización de alteraciones específicas, de utilidadpara la toma de decisiones clínicas en la UCI...

Ley matemática para evaluación de la dinámica cardiaca: aplicación en el diagnóstico de arritmias / Mathematical Law for Evaluating Arrhythmic Cardiac Dynamics: Application for the Arrhythmia Diagnosis / Lei matemática para avaliação da dinâmica cardíaca: aplicação no diagnóstico de arritmias

La formulación de una ley matemática para los sistemas dinámicos caóticos ha permitido desarrollar una metodología para la evaluación matemática de la dinámica cardiaca que cuantifica las diferencias entre normalidad y enfermedad, así como su evolución. Materiales y métodos: Se tomaron 70 registros Holter, 60 con presencia de arritmias y 10 normales. Para cada Holter se construyó un atractor a partir de la simulación de los valores de frecuencias cardiacas consecutivas, se midió el espacio de ocupación de cada atractor y su dimensión fractal. Se le aplicó la evaluación matemática a cada Holter y luego se calculó la sensibilidad, especificidad y coeficiente Kappa y se comparó respecto del Gold Standard. Resultados: Los casos diagnosticados convencionalmente como arritmias presentaron espacios de ocupación entre 29 y 198 para la rejilla Kp, y los casos normales presentaron valores mayores a 200. Los valores de sensibilidad y especificidad fueron de 100% y el coeficiente Kappa fue de 1. Conclusión: La ley exponencial permite cuantificar diferencias entre dinámicas con arritmias y normales, así como su evolución, lo que se evidencia en un aumento o disminución de los espacios de ocupación del atractor.

The development of a mathematical law for chaotic dynamical systems has allowed to develop a methodology for the mathematical evaluation of cardiac dynamics which quantifies the differences between normality and disease, as well as their evolution. Material and methods: 70 Holter records, 60 with cardiac arrhythmias and 10 normal were taken. From the simulation values of consecutive heart rates, an attractor was built for each Holter. The space occupancy of each attractor and its fractal dimension were measured. Mathematical evaluation was applied to each Holter and then the sensitivity, specificity and Kappa coefficient of this evaluation with respect to the Gold Standard was calculated. Results: The cases conventionally diagnosed as arrhythmias presented space occupancy between 29 and 198 for Kp grid, and normal cases had higher values at 200. The sensitivity and specificity were 100% and Kappa coefficient was 1. Conclusion: The power law quantifies differences between arrhythmias and normal dynamics, assessing the evolution dynamics towards normality or to disease, this was evidenced by an increase or decrease of the space occupied by the attractor.

Introdução: A formulação de uma lei matemática para os sistemas dinâmicos caóticos tem permitido desenvolver uma metodologia para a avaliação matemática da dinâmica cardíaca que quantifica as diferenças entre normalidade e doença, assim como sua evolução. Materiais e métodos: Se tomaram 70 registros Hotler, 60 com presença de arritmias e 10 normais. Para cada Hotler construiu-se um atractor e sua dimensão fractal. Aplicou-se a avaliação matemática a cada Hotler e depois se calculou a sensibilidade, especificidade e coeficiente Kappa e comparou-se respeito do Gold Standard. Resultados: Os casos diagnosticados convencionalmente como arritmias apresentaram espaços de ocupação entre 29 e 198 para a grade KP, e os casos normais apresentaram valores maiores a 200. Os valores de sensibilidade e especificidade foram de 100% e o coeficiente Kappa foi de 1. Conclusão: A lei exponencial permite quantificar diferenças entre dinâmicas com arritmias e normais, assim como sua evolução, o que se evidencia em um aumento ou diminuição dos espaços de ocupação do atractor.

Evaluación de arritmias con base en el método de ayuda diagnóstica de la dinámica cardiaca basado en la teoría de la probabilidad / Arrhythmias assessment based on a support diagnostic method of cardiac dynamics based on the theory of probability

Objetivo: confirmar la capacidad diagnóstica de una metodología basada en la teoría de probabilidad en casos de arritmia. Materiales y métodos: se realiza un estudio ciego, en el que se analizaron 10 Holter normales y 90 con diferentes tipos de arritmia, de pacientes mayores de 21 años. Se enmascara el diagnóstico convencional y se calcula la probabilidad de rangos de frecuencias cardiacas máximas, mínimas e intermedias cada hora, y de número de latidos por hora, para determinar el diagnóstico matemático de acuerdo con los tres parámetros establecidos previamente. Finalmente, se desenmascara el diagnóstico convencional, que fue tomado como Estándar de Oro, y se realiza un análisis de la concordancia diagnóstica para diferenciar normalidad y arritmia aguda. Resultados: los Holternormales, presentan valores matemáticos característicos de normalidad o en evolucióna enfermedad, mientras que todos los casos patológicos son diagnosticados por la metodología como en evolución a enfermedad o enfermos. Se obtiene una sensibilidad del 100%, una especificidad del 70%, un VPP de 93,33% y un VPNde 100%, y el coeficiente Kappa presenta un valor de 0,82. Conclusiones: la aplicación de la metodología en el estudio de alteraciones arrítmicas, evidencia un orden matemático mediante el cual se logra diferenciar normalidad de enfermedad y detectar estados de evolución a la enfermedad aun en estados clínicos con diagnóstico normal, de posible utilidad preventiva a nivel clínico.

Taquicardia ventricular polimórfica catecolaminérgica / Catecholaminergic polymorphic ventricular tachycardia

La taquicardia ventricular polimórfica catecolaminérgica es una entidad de reciente descripción gracias a los avances diagnósticos en genética y electrofisiología. Consiste en una patología hereditaria que se caracteriza por la inducción de taquicardia ventricular bidireccional en la presencia de catecolaminas sin una anormalidad estructural cardiaca de base. Mutaciones en el gen RyR2 del receptor de rianodina se han identificado como responsables por la forma hereditaria autosómica dominante, mientras que mutaciones en el gen de la calsecuestrina CASQ2 se relacionan con formas autosómicas recesivas. La edad media de inicio es entre los siete y los nueve años de edad, y sus implicaciones clínicas van desde síncope hasta muerte súbita. Su diagnóstico se confirma documentando la inducción de taquicardias ventriculares con una prueba de esfuerzo o durante una infusión de agentes simpaticomiméticos como isoproterenol, apoyado con la codificación de los genes RyR2 o CASQ2. El manejo farmacológico con anti-arrítmicos aun no ha demostrado eficacia por lo que la implantación de cardiodesfibriladores se mantiene como una opción válida. Para casos especiales una alternativa es la denervación simpática cardiaca. Esta entidad abre un campo en la investigación de nuevos medicamentos antiarrítmicos y de la posible utilización de la terapia génica en electrofisiología.

Catecholaminergic Polymorphic Ventricular Tachycardia is an inherited heart rhythm disorder recently discovered by genetic and electrophysiological diagnostic advancements. It consists of an inherited disorder characterized by the induction of bi-directional ventricular tachycardia in the presence of catecholamines, without a structural cardiac abnormality. Mutations in the Ryanodine receptor gene RyR2, have been linked with an autosomic dominant form, while mutations in the Calsequestrin gene CASQ 2 have showed correlation with an autosomic recessive form. The average age of onset is between 7 and 9 years of age, and clinical symptoms vary from syncope to sudden cardiac death. The diagnosis is confirmed by inducting ventricular tachycardia through a stress test or during an infusion of sympathicomimetic drugs like Isoproterenol, aided by the identification of mutations in the RyR2 and CASQ2 genes through gene analysis. Implantable cardiodefibrillator devices remain a valid therapeutic option in many cases due to the fact that antiarrhythmic drugs have not shown efficacy. Sympathetic cardiac denervation can be useful in some special cases. Catecholaminergic Polymorphic Ventricular Tachycardia opens a wide field for the development of new antiarrhythmic drugs and the use of gene therapy for cardiac rhythm disorders.

Methodological considerations in implementing the WHO Global Survey for Monitoring Maternal and Perinatal Health.

OBJECTIVE: To set up a global system for monitoring maternal and perinatal health in 54 countries worldwide. METHODS: The WHO Global Survey for Monitoring Maternal and Perinatal Health was implemented through a network of health institutions, selected using a stratified multistage cluster sampling design. Focused information on maternal and perinatal health was abstracted from hospital records and entered in a specially developed online data management system. Data were collected over a two- to three-month period in each institution. The project was coordinated by WHO and supported by WHO regional offices and country coordinators in Africa and the Americas. FINDINGS: The initial survey was implemented between September 2004 and March 2005 in the African and American regions. A total of 125 institutions in seven African countries and 119 institutions in eight Latin American countries participated. CONCLUSION: This project has created a technologically simple and scientifically sound system for large-scale data management, which can facilitate programme monitoring in countries.

El manejo integrado de roedores plaga Rattus norvegicus en granjas de aves de postura / Integrated pest management of the rat Rattus norvegicus in poultry farms

En este trabajo se describen las prácticas adecuadas en el Manejo Integrado de Plagas (MIP) en granjas de aves de postura. Se determina cuáles fueron las áreas más afectadas, y cuáles los factores que favorecen la invasión de roedores plaga como R. norvegicus. Se recomiendan modificaciones a las condiciones de la granja señalando un manejo eficiente del alimento, así como un buen programa de manejo de la basura, eliminación de malezas y pastos alrededor de la granja, y una aplicación selectiva del rodenticidad en áreas específicas de la granja. Para combatir a los roedores se utilizó un rodenticida derivaso de las piridonas, la difacinona, que ofrece seguridad y eficiencias en su manejo. Una de las metas del proyecto general del laboratorio de Mastozoología, Del Instituto de Biología de la Universidad Nacional Autónoma de México, es generar información práctica y aplicable que responda a las necesidades sobre el MIP en la industria avícola