HyperMRI: hyperspectral and magnetic resonance fusion methodology for neurosurgery applications.

PURPOSE: Magnetic resonance imaging (MRI) is a common technique in image-guided neurosurgery (IGN). Recent research explores the integration of methods like ultrasound and tomography, among others, with hyperspectral (HS) imaging gaining attention due to its non-invasive real-time tissue classification capabilities. The main challenge is the registration process, often requiring manual intervention. This work introduces an automatic, markerless method for aligning HS images with MRI. METHODS: This work presents a multimodal system that combines RGB-Depth (RGBD) and HS cameras. The RGBD camera captures the patient's facial geometry, which is used for registration with the preoperative MR through ICP. Once MR-depth registration is complete, the integration of HS data is achieved using a calibrated homography transformation. The incorporation of external tracking with a novel calibration method allows camera mobility from the registration position to the craniotomy area. This methodology streamlines the fusion of RGBD, HS and MR images within the craniotomy area. RESULTS: Using the described system and an anthropomorphic phantom head, the system has been characterised by registering the patient's face in 25 positions and 5 positions resulted in a fiducial registration error of 1.88 ± 0.19 mm and a target registration error of 4.07 ± 1.28 mm, respectively. CONCLUSIONS: This work proposes a new methodology to automatically register MR and HS information with a sufficient accuracy. It can support the neurosurgeons to guide the diagnosis using multimodal data over an augmented reality representation. However, in its preliminary prototype stage, this system exhibits significant promise, driven by its cost-effectiveness and user-friendly design.

Uses, Botanical Characteristics, and Phenological Development of Slender Nightshade (Solanum nigrescens Mart. and Gal.).

Slender nightshade (Solanum nigrescens Mart. and Gal.) is a perennial, herbaceous plant from the Solanaceae family, which is distributed in various environments. The aim of this study was to review the scientific literature and to establish slender nightshade plants under greenhouse conditions in order to record their phenological development. The specialized literature regarding the distribution, botanical characteristics, and uses of such species was analyzed. The phenological development was recorded based on the BBCH (Biologische Bundesanstalt, Bundessortenamt, Chemische Industrie) guide. Slender nightshade seeds were germinated under greenhouse conditions, then transferred to red porous volcano gravel locally known as tezontle in black polyethylene bags and watered with a Steiner nutrient solution. Changes in phenology were monitored and recorded from germination to the ripening of fruit and seeds. Slender nightshade has a wide distribution in Mexico and is used for medicinal and gastronomical purposes, as well as to control pathogens. The phenological development of slender nightshade has seven stages from germination to the ripening of fruit and seeds. Slender nightshade is a poorly studied plant with potential for human consumption. The phenological recording provides a tool for its management and further research as a crop.

Orthorexia nervosa risk and associated factors among Chilean nutrition students: a pilot study.

BACKGROUND: Orthorexia nervosa (ON) is characterized by an excessive, obsessive concern with healthy eating generating psychological complications and even malnutrition at a caloric and protein level. Current evidence suggests that people with greater food knowledge are the most likely to be affected, placing nutrition students as a populational risk group. Since there are no nationwide studies dealing with orthorexia nervosa in this risk group, the present pilot study intends to identify risk factors for orthorexia nervosa in a sample of Nutrition and Dietetics students in Chile. METHOD: A descriptive cross-sectional pilot study was done on 90 Nutrition and Dietetics students from a Chilean university, representing 70% of its population. The ORTHO-11-ES instrument was applied to determine ON risk, along with consulting about attitudinal, physical-clinical and social variables. Statistical tests were performed in GraphPad PRISM 8.0®, applying probability ratios and personal correlation, between the sociodemographic variables and the risk of orthorexia nervosa. This study was approved by the university Ethics Committee based on the Helsinki Declaration. RESULTS: 23.3% of the studied population was at risk of suffering ON. Associated variables were being in the second year of their major (OR 2.22), coming from a charter school (OR 3.00) and cohabitation being limited to ≤ 1 person (OR 2.47). Particularly, declared physical activity limits are associated to the risk of suffering ON (Sedentary OR 2.42, Heavy OR 3.53), as well as time spent on the social network Instagram (< 1 h OR 2.77, > 3 h OR 1.80). CONCLUSIONS: There is an ON risk prevalence of 23.3% in the present pilot sample under study, indicating that years of study, cohabitation, secondary educational establishment, physical activity and Instagram use constitute associated factors for the studied condition. Some results vary from international evidence, describing a dual nature in the variables for Instagram time and declared physical activity for ON risk. This study needs replication in more representative samples and longitudinal character with control groups which can confirm the studied elements as ON risk factors. Orthorexia nervosa (ON) is an expression created to indicate a possible new eating disorder characterized by excessive and obsessive preoccupation with healthy eating. Some of its most distinctive traits include marked anxiety over food, exaggerated fear over the appearance of some diseases and shame about physical appearance. This ultimately impacts food choice, planning, acquisition, preparation and consumption, creating psychological complications along with some associated with malnutrition. Considering that Nutrition students are an at-risk group, the present pilot study evaluated its prevalence and associated factors in a specific sample in Chile. Conditions associated with the risk of orthorexia nervosa identified in the present study include: number of hours spent using Instagram, limited cohabitation, extreme physical activity, and number of years in the major. These results should be taken cautiously, with their association confirmed in follow-up studies.

Early clinical outcomes after transaxillary versus transfemoral TAVI. Data from the Spanish TAVI registry.

INTRODUCTION AND OBJECTIVES: Transaxillary access (TXA) has become the most widely used alternative to transfemoral access (TFA) in patients undergoing transcatheter aortic valve implantation (TAVI). The aim of this study was to compare total in-hospital and 30-day mortality in patients included in the Spanish TAVI registry who were treated by TXA or TFA access. METHODS: We analyzed data from patients treated with TXA or TFA and who were included in the TAVI Spanish registry. In-hospital and 30-day events were defined according to the recommendations of the Valve Academic Research Consortium. The impact of the access route was evaluated by propensity score matching according to clinical and echocardiogram characteristics. RESULTS: A total of 6603 patients were included; 191 (2.9%) were treated via TXA and 6412 via TFA access. After adjustment (n=113 TXA group and n=3035 TFA group) device success was similar between the 2 groups (94%, TXA vs 95%, TFA; P=.95). However, compared with the TFA group, the TXA group showed a higher rate of acute myocardial infarction (OR, 5.3; 95%CI, 2.0-13.8); P=.001), renal complications (OR, 2.3; 95%CI, 1.3-4.1; P=.003), and pacemaker implantation (OR, 1.6; 95%CI, 1.01-2.6; P=.03). The TXA group also had higher in-hospital and 30-day mortality rates (OR, 2.2; 95%CI, 1.04-4.6; P=.039 and OR, 2.3; 95%CI, 1.2-4.5; P=.01, respectively). CONCLUSIONS: Compared with ATF, TXA is associated with higher total mortality, both in-hospital and at 30 days. Given these results, we believe that TXA should be considered only in those patients who are not suitable candidates for TFA.

Supervised Machine Learning Methods and Hyperspectral Imaging Techniques Jointly Applied for Brain Cancer Classification.

Hyperspectral imaging techniques (HSI) do not require contact with patients and are non-ionizing as well as non-invasive. As a consequence, they have been extensively applied in the medical field. HSI is being combined with machine learning (ML) processes to obtain models to assist in diagnosis. In particular, the combination of these techniques has proven to be a reliable aid in the differentiation of healthy and tumor tissue during brain tumor surgery. ML algorithms such as support vector machine (SVM), random forest (RF) and convolutional neural networks (CNN) are used to make predictions and provide in-vivo visualizations that may assist neurosurgeons in being more precise, hence reducing damages to healthy tissue. In this work, thirteen in-vivo hyperspectral images from twelve different patients with high-grade gliomas (grade III and IV) have been selected to train SVM, RF and CNN classifiers. Five different classes have been defined during the experiments: healthy tissue, tumor, venous blood vessel, arterial blood vessel and dura mater. Overall accuracy (OACC) results vary from 60% to 95% depending on the training conditions. Finally, as far as the contribution of each band to the OACC is concerned, the results obtained in this work are 3.81 times greater than those reported in the literature.

Surface Chemistry of Gold Nanoparticles Produced by Laser Ablation in Pure and Saline Water.

Pulsed laser ablation in liquid (PLAL) is a powerful method for producing nanoparticle colloids with a long-term stability despite the absence of stabilizing organic agents. The colloid stability involves different reactivities and chemical equilibria with complex ionic-specific effects at the nanoparticle/solvent interface which must be strongly influenced by their chemical composition. In this work, the surface composition of PLAL-produced gold nanoparticles in alkaline and saline (NaBr) water is investigated by X-ray photoelectron spectroscopy on free-flying nanoparticles, exempt from any substrate or radiation damage artifact. The Au 4f photoelectron spectra with a depth profiling investigation are used to evaluate the degree of nanoparticle surface oxidation. In alkaline water, the results preclude any surface oxidation contrary to the case of nanoparticles produced in NaBr solution. In addition, the analysis of Br 3d core-level photoelectron spectra agrees with a clear signature of Br on the nanoparticle surface, which is confirmed by a specific valence band feature. This experimental study is supported by DFT calculations, evaluating the energy balance of halide adsorption on different configurations of gold surfaces including oxidation or adsorbed salts.

Impact of diabetes in patients waiting for invasive cardiac procedures during COVID-19 pandemic.

BACKGROUND: During COVID-19 pandemic, elective invasive cardiac procedures (ICP) have been frequently cancelled or postponed. Consequences may be more evident in patients with diabetes. OBJECTIVES: The objective was to identify the peculiarities of patients with DM among those in whom ICP were cancelled or postponed due to the COVID-19 pandemic, as well as to identify subgroups in which the influence of DM has higher impact on the clinical outcome. METHODS: We included 2,158 patients in whom an elective ICP was cancelled or postponed during COVID-19 pandemic in 37 hospitals in Spain. Among them, 700 (32.4%) were diabetics. Patients with and without diabetes were compared. RESULTS: Patients with diabetes were older and had a higher prevalence of other cardiovascular risk factors, previous cardiovascular history and co-morbidities. Diabetics had a higher mortality (3.0% vs. 1.0%; p = 0.001) and cardiovascular mortality (1.9% vs. 0.4%; p = 0.001). Differences were especially important in patients with valvular heart disease (mortality 6.9% vs 1.7% [p < 0.001] and cardiovascular mortality 4.9% vs 0.9% [p = 0.002] in patients with and without diabetes, respectively). In the multivariable analysis, diabetes remained as an independent risk factor both for overall and cardiovascular mortality. No significant interaction was found with other clinical variables. CONCLUSION: Among patients in whom an elective invasive cardiac procedure is cancelled or postponed during COVID-19 pandemic, mortality and cardiovascular mortality is higher in patients with diabetes, irrespectively on other clinical conditions. These procedures should not be cancelled in patients with diabetes.

Consequences of canceling elective invasive cardiac procedures during Covid-19 outbreak.

BACKGROUND: During COVID-19 pandemic in Spain, elective procedures were canceled or postponed, mainly due to health care systems overwhelming. OBJECTIVE: The objective of this study was to evaluate the consequences of interrupting invasive procedures in patients with chronic cardiac diseases due to the COVID-19 outbreak in Spain. METHODS: The study population is comprised of 2,158 patients that were pending on elective cardiac invasive procedures in 37 hospitals in Spain on the 14th of March 2020, when a state of alarm and subsequent lockdown was declared in Spain due to the COVID-19 pandemic. These patients were followed-up until April 31th. RESULTS: Out of the 2,158 patients, 36 (1.7%) died. Mortality was significantly higher in patients pending on structural procedures (4.5% vs. 0.8%, respectively; p < .001), in those >80 year-old (5.1% vs. 0.7%, p < .001), and in presence of diabetes (2.7% vs. 0.9%, p = .001), hypertension (2.0% vs. 0.6%, p = .014), hypercholesterolemia (2.0% vs. 0.9%, p = .026) [Correction added on December 23, 2020, after first online publication: as per Dr. Moreno's request changes in p-values were made after original publication in Abstract.], chronic renal failure (6.0% vs. 1.2%, p < .001), NYHA > II (3.8% vs. 1.2%, p = .001), and CCS > II (4.2% vs. 1.4%, p = .013), whereas was it was significantly lower in smokers (0.5% vs. 1.9%, p = .013). Multivariable analysis identified age > 80, diabetes, renal failure and CCS > II as independent predictors for mortality. CONCLUSION: Mortality at 45 days during COVID-19 outbreak in patients with chronic cardiovascular diseases included in a waiting list due to cancellation of invasive elective procedures was 1.7%. Some clinical characteristics may be of help in patient selection for being promptly treated when similar situations happen in the future.

[Impact of COVID-19 on ST-segment elevation myocardial infarction care. The Spanish experience]. / Impacto de la COVID-19 en el tratamiento del infarto agudo de miocardio con elevación del segmento ST. La experiencia española.

INTRODUCTION AND OBJECTIVES: The COVID-19 outbreak has had an unclear impact on the treatment and outcomes of patients with ST-segment elevation myocardial infarction (STEMI). The aim of this study was to assess changes in STEMI management during the COVID-19 outbreak. METHODS: Using a multicenter, nationwide, retrospective, observational registry of consecutive patients who were managed in 75 specific STEMI care centers in Spain, we compared patient and procedural characteristics and in-hospital outcomes in 2 different cohorts with 30-day follow-up according to whether the patients had been treated before or after COVID-19. RESULTS: Suspected STEMI patients treated in STEMI networks decreased by 27.6% and patients with confirmed STEMI fell from 1305 to 1009 (22.7%). There were no differences in reperfusion strategy (> 94% treated with primary percutaneous coronary intervention in both cohorts). Patients treated with primary percutaneous coronary intervention during the COVID-19 outbreak had a longer ischemic time (233 [150-375] vs 200 [140-332] minutes, P < .001) but showed no differences in the time from first medical contact to reperfusion. In-hospital mortality was higher during COVID-19 (7.5% vs 5.1%; unadjusted OR, 1.50; 95%CI, 1.07-2.11; P < .001); this association remained after adjustment for confounders (risk-adjusted OR, 1.88; 95%CI, 1.12-3.14; P = .017). In the 2020 cohort, there was a 6.3% incidence of confirmed SARS-CoV-2 infection during hospitalization. CONCLUSIONS: The number of STEMI patients treated during the current COVID-19 outbreak fell vs the previous year and there was an increase in the median time from symptom onset to reperfusion and a significant 2-fold increase in the rate of in-hospital mortality. No changes in reperfusion strategy were detected, with primary percutaneous coronary intervention performed for the vast majority of patients. The co-existence of STEMI and SARS-CoV-2 infection was relatively infrequent.

Impact of COVID-19 on ST-segment elevation myocardial infarction care. The Spanish experience.

INTRODUCTION AND OBJECTIVES: The COVID-19 outbreak has had an unclear impact on the treatment and outcomes of patients with ST-segment elevation myocardial infarction (STEMI). The aim of this study was to assess changes in STEMI management during the COVID-19 outbreak. METHODS: Using a multicenter, nationwide, retrospective, observational registry of consecutive patients who were managed in 75 specific STEMI care centers in Spain, we compared patient and procedural characteristics and in-hospital outcomes in 2 different cohorts with 30-day follow-up according to whether the patients had been treated before or after COVID-19. RESULTS: Suspected STEMI patients treated in STEMI networks decreased by 27.6% and patients with confirmed STEMI fell from 1305 to 1009 (22.7%). There were no differences in reperfusion strategy (> 94% treated with primary percutaneous coronary intervention in both cohorts). Patients treated with primary percutaneous coronary intervention during the COVID-19 outbreak had a longer ischemic time (233 [150-375] vs 200 [140-332] minutes, P<.001) but showed no differences in the time from first medical contact to reperfusion. In-hospital mortality was higher during COVID-19 (7.5% vs 5.1%; unadjusted OR, 1.50; 95%CI, 1.07-2.11; P <.001); this association remained after adjustment for confounders (risk-adjusted OR, 1.88; 95%CI, 1.12-3.14; P=.017). In the 2020 cohort, there was a 6.3% incidence of confirmed SARS-CoV-2 infection during hospitalization. CONCLUSIONS: The number of STEMI patients treated during the current COVID-19 outbreak fell vs the previous year and there was an increase in the median time from symptom onset to reperfusion and a significant 2-fold increase in the rate of in-hospital mortality. No changes in reperfusion strategy were detected, with primary percutaneous coronary intervention performed for the vast majority of patients. The co-existence of STEMI and SARS-CoV-2 infection was relatively infrequent.

Assessing the Surface Oxidation State of Free-Standing Gold Nanoparticles Produced by Laser Ablation.

The surface chemistry of gold nanoparticles produced by the pulsed laser ablation in liquids method is investigated by X-ray photoelectron spectroscopy (XPS). The presence of surface oxide expected on these systems is investigated using synchrotron radiation in conditions close to their original state in solvent but free from substrate or solvent effects which could affect the interpretation of spectroscopic observations. For that purpose we performed the experiment on a controlled free-standing nanoparticle beam produced by combination of an atomizer and an aerodynamic lens system. These results are compared with those obtained by the standard situation of deposited nanoparticles on silicon substrate. An accurate analysis based on Bayesian statistics concludes that the existence of oxide in the free-standing conditions cannot be solely confirmed by the recorded core-level 4f spectra. If present, our data indicate an upper limit of 2.15 ± 0.68% of oxide. However, a higher credence to the hypothesis of its existence is brought by the structureless valence profile of the free-standing beam. Moreover, the cross-comparison with the deposited nanoparticles case clearly evidences an important misleading substrate effect. Experiment with free-standing nanoparticles is then demonstrated to be the right way to further investigate oxidation states on Au nanoparticles.

Association between post-procedural hyperoxia and poor functional outcome after mechanical thrombectomy for ischemic stroke: an observational study.

BACKGROUND: The actual effects of oxygen therapy on patients who have suffered a stroke are still unknown, and its recommendation as a routine measure in emergency services remains controversial. The aim of this study is to determine the effect of hyperoxia in functional recovery in patients with ischemic stroke who underwent intra-arterial mechanical thrombectomy (IAMT). METHODS: A prospective observational cohort study that included all adult patients consecutively admitted to the intensive care unit (ICU) due to an ischemic stroke in the anterior cerebral circulation and following an IAMT intervention, between 2010 and 2015. All patients were intubated and connected to mechanical ventilation for the intra-arterial therapy, receiving supplementary oxygen to achieve saturations above 94%. Two groups were established regarding oxygen partial pressure (paO2) reached. It was based on a single ICU admission blood gas analysis. The hyperoxia group was defined as paO2 > 120 mmHg. We measured functional recovery in each of the groups according to the modified Rankin scale after 90 days. RESULTS: For the analysis, a total of 333 patients were included. High levels of paO2 were mostly related to higher scores in modified Rankin scale (mRS) after 90 days. There were 60.6% cases with mRS ≥ 4 and 70.6% with mRS ≥ 3 in the hyperoxia group, compared to 43.0% and 56.1% in the paO2 ≤ 120 group, p < 0.01, respectively. Mortality was higher in the hyperoxia group, 28.6% vs 18.7%, p = 0.04. After regression adjustment by confounding factors, poor functional outcome was still significantly higher in the hyperoxia group, for both mRS ≥ 4 and mRS ≥ 3: OR 2.2.7, IC 95%, 1.22-4.23, p = 0.01 and OR 2.07, IC 95%, 1.05-4.029, p = 0.04, respectively. Both the National Institute of Health Stroke Scale Score (NIHSS) values at 24 h after the IAMT and the days of ICU stay were significantly higher in the hyperoxia group. CONCLUSIONS: In patients with ischemic stroke in the anterior cerebral circulation treated with IAMT, we found an association between admission PaO2 > 120 mmHg and worse functional outcome 90 days after ischemic stroke, but this association needs further confirmation by other studies.

Study of Colombia North Wiwa El Encanto Amerindians HLA- genes: Pacific Islanders relatedness.

We have studied Wiwa/Sanja Amerindians HLA-A, -B, -C, -DRB1 and DQB1 allele frequencies and extended haplotypes in 52 unrelated individuals from "El Encanto" town at Guanachaca riverside. High frequency alleles were in general present in other Amerindian populations. Also, three extended haplotypes and eight ones were respectively both "new found" and already described in Amerindians from North, Central and South America, including Lakota-Sioux, Mayas, Teeneks, Quechua and Aymaras. Analyses of HLA-A*24:02 and -C*01:02 Wiwa high frequency alleles suggested a specific relatedness with another Amerindian and Pacific Islander ethnic groups (these two particular alleles bearing in high frequencies); they include New Zealand Maoris, Taiwanese, Japanese, Papua New Guinea, and Samoans among others. This may indicate that selective forces are maintaining these two alleles high frequency within this wide American/Pacific area.

Perceptions of the use of intelligent information access systems in university level active learning activities among teachers of biomedical subjects.

BACKGROUND: Student participation and the use of active methodologies in classroom learning are being increasingly emphasized. The use of intelligent systems can be of great help when designing and developing these types of activities. Recently, emerging disciplines such as 'educational data mining' and 'learning analytics and knowledge' have provided clear examples of the importance of the use of artificial intelligence techniques in education. OBJECTIVE: The main objective of this study was to gather expert opinions regarding the benefits of using complementary methods that are supported by intelligent systems, specifically, by intelligent information access systems, when processing texts written in natural language and the benefits of using these methods as companion tools to the learning activities that are employed by biomedical and health sciences teachers. METHODS: Eleven teachers of degree courses who belonged to the Faculties of Biomedical Sciences (BS) and Health Sciences (HS) of a Spanish university in Madrid were individually interviewed. These interviews were conducted using a mixed methods questionnaire that included 66 predefined close-ended and open-ended questions. In our study, three intelligent information access systems (i.e., BioAnnote, CLEiM and MedCMap) were successfully used to evaluate the teacher's perceptions regarding the utility of these systems and their different methods in learning activities. RESULTS: All teachers reported using active learning methods in the classroom, most of which were computer programs that were used for initially designing and later executing learning activities. All teachers used case-based learning methods in the classroom, with a specific emphasis on case reports written in Spanish and/or English. In general, few or none of the teachers were familiar with the technical terms related to the technologies used for these activities such as "intelligent systems" or "concept/mental maps". However, they clearly realized the potential applicability of such approaches in both the preparation and the effective use of these activities in the classroom. Specifically, the themes highlighted by a greater number of teachers after analyzing the responses to the open-ended questions were the usefulness of BioAnnote system to provide reliable sources of medical information and the usefulness of the bilingual nature of CLEiM system for learning medical terminology in English. CONCLUSIONS: Three intelligent information access systems were successfully used to evaluate the teacher's perceptions regarding the utility of these systems in learning activities. The results of this study showed that integration of reliable sources of information, bilingualism and selective annotation of concepts were the most valued features by the teachers, who also considered the incorporation of these systems into learning activities to be potentially very useful. In addition, in the context of our experimental conditions, our work provides useful insights into the way to appropriately integrate this type of intelligent information access systems into learning activities, revealing key themes to consider when developing such approaches.

HLA in North Colombia Chimila Amerindians.

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.

Percutaneous coronary intervention in octogenarian patients / Intervención coronaria percutánea en pacientes octogenarios

Abstract: Introduction: Octogenarian patients are usually excluded from studies in which the effectiveness of percutaneous coronary intervention (PCI) is compared. Objective: Our aim is to compare this procedure among octogenarians and those younger; in addition to comparing the radial access (RA) and femoral access (FA) in patients older than 80 years. Material and methods: This is a retrospective, observational, comparative, longitudinal, single-center study. Patients who have been referred for PCI, from 2010 to 2016 in Monterrey, Nuevo Leon, Mexico were included. The groups were divided into the octogenarians group (OG) and a group of younger than 80 years (YG). Results: A total of 1,282 patients were collected, of whom 92 were of the OG and 1,190 were of the YG. The FA was the most used. Similar levels of radiation time (RT), radiation dose (DR), and amount of administered contrast medium (CM), vascular complications (VC) and mortality between the two groups were found. However, the OG had more length of hospital stay (LHS). Comparing the FA against RA in the OG there were no differences in RT, RD, amount of CM, VC, death and LHS. Conclusion: The results are similar between the two groups, with a greater tendency to more LHS in the OG. There were not significant differences between the RA and FA in the OG, except that LHS in the FA.

Resumen: Introducción: Los pacientes octogenarios son usualmente excluidos de los estudios en los cuales se compara la efectividad de las intervenciones coronarias percutáneas. Objetivo: Nuestro objetivo es comparar este procedimiento entre los pacientes octogenarios y aquéllos más jóvenes; además se compara el abordaje radial y el abordaje femoral en los pacientes octogenarios. Material y métodos: Éste es un estudio retrospectivo, observacional, comparativo, longitudinal, unicéntrico. Se realizó con aquellos pacientes que se refirieron para realización de un intervencionismo coronario percutáneo, en Monterrey, Nuevo León, México del 2010 al 2016. Los grupos se dividieron en el grupo de pacientes octogenarios y el grupo de pacientes menores de 80 años. Resultados: Se recabó un total de 1,282 pacientes, de los cuales 92 eran pacientes octogenarios, mientras que 1,190 fueron más jóvenes. En ambos el abordaje femoral fue el más utilizado. Se encontraron valores similares de dosis de radiación, tiempo de radiación, cantidad de contraste administrado, complicaciones vasculares y mortalidad entre los dos grupos. Sin embargo, los pacientes octogenarios tuvieron más días de estancia hospitalaria. Al comparar el abordaje femoral y el radial en octogenarios no se encontraron diferencias en dosis de radiación, tiempo de radiación, cantidad de medio de contraste, complicaciones vasculares, muerte y días de estancia hospitalaria. Conclusiones: Los resultados fueron similares entre ambos grupos de edad, con una mayor tendencia de estancia hospitalaria en octogenarios. No se encontraron diferencias significativas entre ambos abordajes en pacientes octogenarios, a excepción de mayores días de estancia hospitalaria en el abordaje femoral.

Energy transfer from colloidal nanocrystals to strongly absorbing perovskites.

Integration of colloidal nanocrystal quantum dots (NQDs) with strongly absorbing semiconductors offers the possibility of developing optoelectronic and photonic devices with new functionalities. We examine the process of energy transfer (ET) from photoactive CdSe/ZnS core/shell NQDs into lead-halide perovskite polycrystalline films as a function of distance from the perovskite surface using time-resolved photoluminescence (TRPL) spectroscopy. We demonstrate near-field electromagnetic coupling between vastly dissimilar excitation in two materials that can reach an efficiency of 99% at room temperature. Our experimental results, combined with electrodynamics modeling, reveal the leading role of non-radiative ET at close distances, augmented by the waveguide emission coupling and light reabsorption at separations >10 nm. These results open the way to combining materials with different dimensionalities to achieve novel nanoscale architectures with improved photovoltaic and light emitting functionalities.

Genetic HLA Study of Kurds in Iraq, Iran and Tbilisi (Caucasus, Georgia): Relatedness and Medical Implications.

Kurds from Iraq (Dohuk and Erbil Area, North Iraq) have been analyzed for HLA genes. Their HLA genetic profile has been compared with that of other Kurd groups from Iran and Tbilisi (Georgia, Caucasus) and also Worldwide populations. A total of 7,746 HLA chromosomes have been used. Genetic distances, NJ dendrograms and correspondence analyses have been carried out. Haplotype HLA-B*52-DRB1*15 is present in all three analyzed Kurd populations. HLA-A*02-B*51-DRB1*11 is present in Iraq and Georgia Kurds. Haplotypes common to Iran and Iraq Kurds are HLA DRB1*11-DQB1*03, HLA DRB1*03-DQB1*02 and others in a lower frequency. Our HLA study conclusions are that Kurds most probably belong to an ancient Mediterranean / Middle East / Caucasian genetic substratum and that present results and those previously obtained by us in Kurds may be useful for Medicine in future Kurd transplantation programs, HLA Epidemiology (HLA linked diseases) and Pharmacogenomics (HLA-associated drug side effects) and also for Anthropology. It is discussed that one of the most ancient Kurd ancestor groups is in Hurrians (2,000 years BC).

Acute pulmonary thromboembolism: risk stratification, treatment modalities, mortality and adherence to clinical guidelines / Tromboembolismo pulmonar agudo: estratificación del riesgo, modalidades de tratamiento, mortalidad y apego a guías clínicas

Abstract: Introduction: Pulmonary thromboembolism (PTE) is a cardiovascular emergency threatening life. It is classified at low, intermediate and high risk of mortality. By the above, it allows to establishing conservative treatment for low-intermediate risk PTE and more intense treatment for high risk PTE. Objective: To report the number of cases of acute PTE, risk stratification and prognosis in those treated with adherence to clinical guidelines. Material and methods: Review of clinical records with a diagnosis of acute PTE by confirmatory diagnostic test. The type of treatment was determined by: oral anticoagulation (OAC) or parenteral anticoagulation (PAC), percutaneous thrombectomy, supraselective thrombolysis, systemic thrombolysis, surgical thrombectomy or combinations. The type of initial anticoagulation and maintenance therapy. Hard results: TIMI major bleeding, re-thrombosis, death and brain stroke (BS). Normality was verified by Kolmogorov-Smirnov test. Then was compared with Student t or U Mann-Whitney. Results: A sample of 36 patients was obtained, the mean age was 67.24 ± 18.83 years, 62.2% were females. The 29.7% were low-risk PTE, 51.4% were intermediate risk and 18.9% were high risk. The 70.3% received OAC, 8.1% percutaneous trombectomy, 8.1% systemic thrombolysis, 10.8% systemic thrombolysis + percutaneous thrombolysis, 2.7% percutaneous trombectomy + supraselective thrombolysis. There is increased risk of death in this group OR = 2.63 (95% CI 0.45-16.08) but not significant (p = 0.255). Conclusions: Lack of adherence to clinical guidelines confers increased risk of death in patients with acute PTE, this difference is not statistically significant.

Resumen: Introducción: La tromboembolia pulmonar (TEP) es una urgencia cardiovascular que pone en riesgo la vida. Se cataloga en riesgo bajo de mortalidad, intermedio y alto. Lo anterior permite establecer estrategias terapéuticas conservadoras para la TEP de riesgo bajo-intermedio y más intensas para alto riesgo. Objetivo: Reportar el número de casos de TEP aguda, la estratificación de riesgo y el pronóstico en quienes recibieron tratamiento con apego a guías clínicas. Material y métodos: Revisión de expedientes clínicos con diagnóstico de TEP aguda, mediante prueba diagnóstica confirmatoria. Se determinó el tipo de tratamiento: anticoagulación (ACO), oral o parenteral (ACP), trombectomía percutánea(TBTP), trombolisis supraselectiva (TBLSU), trombolisis sistémica (TBLSIS), trombectomía quirúrgica (TBTQ) o sus combinaciones. El tipo de anticoagulación inicial y de mantenimiento. Los resultados duros: sangrado TIMI mayor, retrombosis, muerte y evento vascular cerebral (EVC). Se verificó la normalidad mediante prueba de Kolmogorov-Smirnov. Posteriormente se comparó con t Student o U de Mann-Whitney. Resultados: Se obtuvo una muestra de 36 pacientes, la edad media fue 67.24 ± 18.83 años, el 62.2% fueron del género femenino. El 29.7% correspondía a TEP de riesgo bajo, 51.4% riesgo intermedio y 18.9% a riesgo alto. El 70.3% se dio ACO y ACP, 8.1% TBTP, 8.1% TBLSIS, 10.8% TBLSIS + TBTP y 2.7% TBTP + TBLSU. Existe mayor riesgo de muerte en el grupo de falta de apego a guías OR = 2.63 (IC 95% 0.45-16.08), sin embargo, no es significativo (p= 0.255). Conclusiones: La falta de apego a guías clínicas confiere mayor riesgo de muerte en pacientes con TEP aguda, esta diferencia no es estadísticamente significativa.

Contrast-induced nephropathy in patients undergoing percutaneous coronary intervention / Nefropatía inducida por medio de contraste en angiografías coronarias

Abstract: Introduction: Contrast-induced nephropathy (CIN) is defined as the impairment of renal function and is measured as either a 25% increase in serum creatinine (SCr) from baseline or 0.5 mg/dL increase in absolute value, within 48-72 hours of intravenous contrast administration. Objectives: Objectives were to calculate incidence of CIN and to describe the clinical and periprocedural risk factors for patients receiving contrast media. Secondary objective was to compare mortality between group 1 and group 2. Material and methods: In a retrospective, observational, descriptive cohort study, patients who were admitted to the hospital for diagnostic and/or therapeutic coronary angiography between January 2014 to September 2015, the serum creatinine and glomerular filtration rate (GFR) prior to angiography and 72 hours later was measured. Results: 70 patients were included, of which 14.2% developed CIN. The leading risk factors for developing AKI were: age > 65 years (OR 12.6, CI95 1.6-105.9, p = 0.03); the presence of anemia (OR 7.5, CI95 1.8-31.2, p = 0.006); and procedural time more than 90 minutes (OR 16, CI95 3.1-85.3, p = 0.001). Higher mortality was observed in the NIC group (30% vs. 1.6%, p = 0.004). Conclusions: The incidence is higher than in the literature review. The leading associated risk factors were age > 65, anemia and procedural time > 90 minutes. The development of CIN carries a higher mortality.

Resumen: Introducción: Se define como nefropatía inducida por medio de contraste (NIC) a un aumento absoluto de la creatinina sérica mayor a 0.5 mg/dL o un aumento relativo de la creatinina sérica mayor al 25%, 48-72 horas posteriores a la exposición al medio de contraste en comparación con los niveles previos después de haber excluido otras causas de lesión renal aguda (LRA). Objetivo: Determinar la incidencia de NIC y analizar los factores de riesgo asociados en los pacientes que desarrollaron LRA posterior a un procedimiento de angiografía coronaria. Se determinó mortalidad entre ambos grupos como objetivo secundario. Material y métodos: Se realizó un estudio de cohortes, observacional, descriptivo y retroelectivo. Se analizaron los pacientes que ingresaron en enero de 2014 a septiembre de 2015, para angiografía coronaria diagnostica y/o terapéutica. Se determinó la creatinina sérica y tasa de filtración glomerular (TFG) previa a la angiografía y 72 horas; además se identificaron los factores de riesgo asociados al desarrollo de NIC. Resultados: Se incluyeron 70 pacientes, de los cuales 14.2% desarrollaron NIC. Los factores de riesgo predictores más importantes para desarrollar FRA fueron la edad > 65 años (OR 12.6; IC95 1.6-105.9, p = 0.03); la presencia de anemia (OR 7.5; IC95 1.8-31.2, p = 0.006); y una duración de procedimiento mayor a 90 minutos (OR 16; IC95 3.1-85.3, p = 0.001). Se observó mayor mortalidad en el grupo NIC (30 versus 1.6%, p = 0.004). Conclusiones: La incidencia reportada es mayor que la literatura. Los factores de riesgo asociados más importantes fueron la edad > 65, anemia y procedimiento > 90 minutos. El desarrollo de NIC conlleva una mayor mortalidad.