Electron energy loss and angular asymmetry induced by elastic scattering in superfluid helium nanodroplets.

Helium nanodroplets are ideal model systems to unravel the complex interaction of condensed matter with ionizing radiation. Here we study the effect of purely elastic electron scattering on angular and energy distributions of photoelectrons emitted from He nanodroplets of variable size (10-109 atoms per droplets). For large droplets, photoelectrons develop a pronounced anisotropy along the incident light beam due to a shadowing effect within the droplets. In contrast, the detected photoelectron spectra are only weakly perturbed. This opens up possibilities for photoelectron spectroscopy of dopants embedded in droplets provided they are smaller than the penetration depth of the light and the trapping range of emitted electrons in liquid helium.

Pleurectomy and decortication are associated with better survival for bicavitary cytoreductive surgery for mesothelioma compared with extrapleural pneumonectomy.

OBJECTIVES: Mesothelioma is a nearly uniformly fatal tumor. Multimodality therapy including cytoreductive surgery and chemotherapy is associated with long-term survival in some patients. Cytoreductive surgery for thoracic disease includes a lung-sparing operation called an "extended pleurectomy/decortication" or a lung-sacrificing surgery called an "extrapleural pneumonectomy." The benefit of cytoreductive surgery for bicavitary disease (chest and abdomen) is poorly understood. Our objective was to evaluate the long-term survivals for patients undergoing cytoreductive surgery for bicavitary disease and to determine whether any prognostic factors were associated with outcome. METHODS: We reviewed our Institutional Review Board-approved, institutional, International Association for the Study of Lung Cancer Mesothelioma Staging Project database. Inclusion criteria were all patients who underwent cytoreductive surgery for bicavitary disease. Overall survival was calculated by Kaplan-Meier methodology. All International Association for the Study of Lung Cancer database elements were evaluated by univariable analysis. RESULTS: From February 2014 to August 2021, 440 patients with mesothelioma were evaluated. Fourteen patients (3%) underwent cytoreductive surgery of both chest and abdomen as a planned 2-stage operation. Most patients (13/14; 93%) underwent chest surgery before abdomen surgery. For the entire cohort, the median overall survival was 33.6 months with a 5-year survival of 20%. Extended pleurectomy/decortication was associated with a better outcome compared with extrapleural pneumonectomy, with median overall survivals of 58.2 versus 13.5 months, respectively. CONCLUSIONS: For a highly selected group of patients with bicavitary mesothelioma, long-term survival can be achieved with an aggressive, staged surgical approach. The patients who undergo extended pleurectomy/decortication with preservation of the lung appear to have more favorable outcomes compared with patients undergoing extrapleural pneumonectomy.

Arbuscular mycorrhizal fungi enhance monoterpene production in red clover (Trifolium pratense L.): a potential tool for pest control.

The possibility of modifying terpene production in plants is a defensive strategy that has been studied in conjunction with their biosynthetic pathways. A biotic factor such as Arbuscular Mycorrhizal Fungi (AMF) could modify terpene production in Trifolium pratense L. In this work, the enzymatic production of monoterpenes in Superqueli INIA cultivar with two AMF was evaluated via HeadSpace-Gas Chromatography (HS-GC). A significant increase of (S)-limonene was found in plants inoculated with Claroideoglomus claroideum as well as with the AMF mix (genera Scutellospora, Acaulospora and Glomus). Moreover, significant increases in other monoterpenes such as (-)-ß-pinene, myrcene, linalool, were observed. Results showed higher monoterpene production capacities in the Superqueli-INIA cultivar, suggesting the participation of monoterpene synthases (MTS). The significant rise of (S)-limonene in red clover plants inoculated with AMF suggests this strategy could be implemented in an agronomical manage for controlling the H. obscurus, the primary pest.

The Role of Surgery for Oligometastatic Non-Small Cell Lung Cancer.

Oligometastatic non-small cell lung cancer (NSCLC) is metastatic disease that refers to a limited number of metastatic sites. It is analogous to an intermediate stage of NSCLC, between localized and widely metastatic disease, even though no staging criteria establishes this distinction. Oligometastatic NSCLC describes a patient subgroup with limited metastasis to one or a few organs. These patients seem to have a more indolent cancer than those with diffuse metastasis. For these select patients with oligometastatic disease, the use of palliative systemic therapy over local aggressive treatment may be a missed opportunity to improve survival. The clear definition of this subgroup and identification of the best treatment remains the current challenge in the management of the disease. Surgery was the early cornerstone in the treatment of limited disease; however, as modalities such as chemotherapy, stereotactic radiosurgery, and immunotherapy have matured, the role of excision is less clearly defined. There are sparse randomized controlled trials comparing the efficacy of different treatment modalities in patients with oligometastatic NSCLC. However, there is a growing body of retrospective research detailing the prognostic factors that characterize the role of surgery in the management of these patients. This article clarifies the context and definition of the term oligometastatic, as it applies to NSCLC, and reviews the current results in the use of surgery for its management.

Optimization of enzymatic parameters for the production of formononetin from red clover (Trifolium pratense L.) through a response surface methodology.

Trifolium pratense, is a forage found worldwide, but it is negatively impacted by the clover root borer, Hylastinus obscurus. Methanolic extraction has been reported for isolating formononetin from vegetal tissues, with an antifeeding effect on H. obscurus. However, this methodology is time-consuming and also extracts other secondary metabolites, whereas enzymatic assays can provide higher specificity. Hence, the objective of this work was to determine the optimal conditions in pH, temperature, and incubation time for the activity of isoflavone synthase via a response surface model. Once these parameters were optimized, the concentration of formononetin in cultivars and experimental lines of T. pratense was evaluated enzymatically. The results showed that the best condition for developing the enzymatic assay was pH 9.1 with an incubation at 34.5 °C for 155 min. The formononetin content fluctuated between 0.74 and 1.96 mg/g of fresh weight, where Precoz-3, Precoz-1, and Superqueli-INIA presented the highest production.

Hipokalemia de gradiente transtubular alto: una propuesta práctica para su enfoque / High transtubular gradient hypokalemia: a practical proposal for its focus

Resumen El potasio es un ion de predominio intracelular involucrado en múltiples funciones esenciales para mantener la homeostasis celular. Por lo anterior, sus concentraciones a nivel plasmático se encuentran estrechamente reguladas mediante el sistema renal y endocrino, además de estar afectado ante situaciones como la acidosis, cambios en la osmolaridad plasmática y concentración de otros electrolitos. La hipokalemia es un trastorno electrolítico común en la práctica clínica causado por el aporte inadecuado o pérdidas excesivas. Su enfoque diagnóstico requiere de una apropiada historia clínica que incluya antecedentes personales patológicos, farmacológicos, y un examen físico detallado con determinación del estado de volemia e hidratación del paciente, así como la medición de otros electrolitos a nivel plasmático y ocasionalmente en orina. El gradiente transtubular de potasio es una herramienta útil para direccionar posibles causas. Dentro de las causas de hipokalemia de gradiente transtubular elevado se encuentra el síndrome de Bartter.

Abstract Potassium is a predominantly intracellular ion involved in multiple essential functions to maintain cellular homeostasis. Therefore, its variations at the plasma level are tightly regulated by the renal and the endocrine systems; in addition to being affected by situations such as acidosis, changes in plasma osmolality and concentration of another electrolytes. Hypokalemia is a common electrolyte disorder in clinical practice affected by reporting excessive damage or loss. Its diagnostic approach requires a complete medical record that includes personal pathological and pharmacological information, a specific physical examination with certain conditions like patient's blood volume and hydration status, as well as the measurement of other electrolytes at the plasma level and occasionally in urine. The transtubular potassium gradient is a useful tool to address possible causes. Bartter syndrome is one of the causes of elevated transtubular gradient hypokalemia.

Insecticidal, Repellent and Antifeedant Activity of Essential Oils from Blepharocalyx cruckshanksii (Hook. & Arn.) Nied. Leaves and Pilgerodendron uviferum (D. Don) Florin Heartwood against Horn Flies, Haematobia irritans (Diptera: Muscidae).

Haematobia irritans is a cosmopolitan obligate blood-feeding ectoparasite of cattle and is the major global pest of livestock production. Currently, H. irritans management is largely dependent on broad-spectrum pesticides, which has led to the development of insecticide resistance. Thus, alternative control methods are needed. Essential oils have been studied as an alternative due to their wide spectrum of biological activities against insects. Thus, the main aim of this study was to evaluate the insecticidal, repellent and antifeedant activity of the essential oils from Blepharocalyx cruckshanksii leaves and Pilgerodendron uviferum heartwood against horn flies in laboratory conditions. The composition of the essential oils was analyzed using gas chromatography coupled to mass spectrometry. Accordingly, α-pinene (36.50%) and limonene (20.50%) were the principal components of the B. cruckchanksii essential oil, and δ-cadinol (24.16%), cubenol (22.64%), 15-copaenol (15.46%) and δ-cadinene (10.81%) were the most abundant compounds in the P. uviferum essential oil. Mortality of flies and feeding behavior were evaluated by non-choice tests, and olfactory response was evaluated using a Y-tube olfactometer. Both essential oils were toxic to horn flies, with LC50 values for B. cruckchanksii essential oil of 3.58 µL L-1 air at 4 h, and for P. uviferum essential oil of 9.41 µL L-1 air and 1.02 µL L-1 air at 1 and 4 h, respectively. Moreover, the essential oils exhibited spatial repellency in the olfactometer using only 10 µg of each oil, and these significantly reduced the horn fly feeding at all doses evaluated. Although further laboratory and field studies related to the insectistatic and insecticide properties of these essential oils against H. irritans are necessary, B. cruckshanksii leaves and P. uviferum heartwood essential oils are promising candidates for horn fly management.

Angiotensin-(1-9) prevents vascular remodeling by decreasing vascular smooth muscle cell dedifferentiation through a FoxO1-dependent mechanism.

The renin-angiotensin system, one of the main regulators of vascular function, controls vasoconstriction, inflammation and vascular remodeling. Antagonistic actions of the counter-regulatory renin-angiotensin system, which include vasodilation, anti-proliferative, anti-inflammatory and anti-remodeling effects, have also been described. However, little is known about the direct effects of angiotensin-(1-9), a peptide of the counter-regulatory renin-angiotensin system, on vascular smooth muscle cells. Here, we studied the anti-vascular remodeling effects of angiotensin-(1-9), with special focus on the control of vascular smooth muscle cell phenotype. Angiotensin-(1-9) decreased blood pressure and aorta media thickness in spontaneously hypertensive rats. Reduction of media thickness was associated with decreased vascular smooth muscle cell proliferation. In the A7r5 VSMC cell line and in primary cultures of rat aorta smooth muscle cells, angiotensin-(1-9) did not modify basal proliferation. However, angiotensin-(1-9) inhibited proliferation, migration and contractile protein decrease induced by platelet derived growth factor-BB. Moreover, angiotensin-(1-9) reduced Akt and FoxO1 phosphorylation at 30 min, followed by an increase of total FoxO1 protein content. Angiotensin-(1-9) effects were blocked by the AT2R antagonist PD123319, Akt-Myr overexpression and FoxO1 siRNA. These data suggest that angiotensin-(1-9) inhibits vascular smooth muscle cell dedifferentiation by an AT2R/Akt/FoxO1-dependent mechanism.

Volatiles induction in response to mechanical damage is reduced by domestication in murtilla / La inducción de volátiles en respuesta al daño mecánico es reducida por la domesticación en murtilla

Volatiles compounds are involved in defensive induction against insects, playing an important role in insect-plant interaction being induced by response to mechanical damage. However, they could decrease according to the domestication degree in cultivated plants. Currently, it has been established that secondary metabolites are reduced due to the domestication process in murtilla. Hence, the follow question emerges: Are volatile organic compounds induced by mechanical damage reduced in cultivated murtilla plants in relation to wild plants? Two cultivated ecotypes and their respective wild counterparts were sampled. Volatiles compounds were obtained using Porapak-Q columns and analyzed by gas chromatography. Results showed that compounds as 2-hexanone, α-pinene, 2-thujene, 3-thujene and 1,8- cineole were more abundant in wild plants exposed to a mechanical damage than cultivated plants. Hence, these compounds have been associated to induced defense, these results suggest that domestication reduced the induction of defensive volatiles in cultivated murtilla in response to mechanical damage.

Los compuestos volátiles están implicados en la defensa inducida contra insectos, desempeñando un papel importante en esta interacción. Sin embargo, estos compuestos podrían disminuir según el grado de domesticación. Actualmente, se ha reportado que algunos metabolitos secundarios son reducidos en plantas de murtilla domesticadas. Por lo tanto, surge la siguiente pregunta de investigación: ¿Los compuestos orgánicos volátiles inducidos por el daño mecánico son reducidos en plantas cultivadas de murtilla en comparación con plantas silvestres? Para dos ecotipos cultivados y sus respectivas contrapartes silvestres, los compuestos volátiles fueron capturados usando columnas de Porapak-Q y las muestras analizadas por cromatografía gaseosa. Los resultados mostraron que compuestos tales como 2- hexanona, α-pineno, 2-tujeno, 3-tujeno y 1,8-cineol fueron más abundantes en plantas silvestres expuestas a daño mecánico que en cultivadas. Debido a que estos compuestos se han asociado a defensa inducida, estos resultados sugieren que la domesticación reduce la inducción de volátiles en plantas cultivadas sometidas a daño mecánico.

Es momento de reformar los currículos sobre investigación en el pregrado: el caso de la educación médica en Latinoamérica / It is time to reform curricula on research in undergraduate: the case of medical education in Latin America

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Differential formononetin content in cultivars and experimental lines of red clover (Trifolium pratense L. ) plants affect the feeding behaviour of Hylastinus obscurus (Coleoptera: Curculionidae) / Contenido diferencial de formononetina en cultivares y líneas experimentales de plantas de trébol rosado (Trifolium pratense L. ) afecta la conducta alimenticia de Hylastinus obscurus (Coleoptera: Curculionidae)

Red clover (Trifolium pratense L.) is a perennial plant widely used as a forage resource for several animals. This plant is the exclusive host of Hylastinus obscurus (Marsham) which causes irreparable damages to the root system affecting their persistence. It has been reported that the presence of the isoflavonoid formononetin in roots of red clover could act as an antifeedant on H. obscurus. There are not studies related to the formononetin content in red clover roots to the antifeedant effect elicited by experimental lines and cultivar of red clover. Six red clover genotypes were investigated in both formononetin content and their respective antifeedant action. The results showed to Sabtoron High and Superqueli-INIA with both the highest formononetin content in red clover roots and antifeedant effect, allowing to suggest that this secondary metabolites could be used as a chemical factor for red clover plants. Moreover, a rapid methodology for searching red clover genotypes with high formononetin content is reported.

El trébol rosado (Trifolium pratense L.) es una planta perenne ampliamente utilizada como fuente de forraje de variados animales. Esta planta es el exclusivo hospedero de Hylastinus obscurus (Marsham) el cual causa irreparables daños al sistema radical afectando seriamente su persistencia. Se ha reportado que la presencia del isoflavonoide formononetina en raíces del trébol rosado podría actuar como antialimentario sobre H. obscurus. Actualmente no existen estudios que relacionen el contenido de formononetina en raíces de trébol rosado con el efecto antialimentario elicitado por líneas experimentales y cultivares de trébol rosado. Seis genotipos de esta leguminosa fueron evaluados en cuanto a su contenido de formononetina y actividad antialimentaria. Los resultados mostraron que los cultivares Sabtoron High y Superqueli-INIA presentaron altos niveles de formononetina en sus raíces y efecto antialimentario sobre H. obscurus, lo que permite sugerir que este metabolito secundario podría ser usado como factor químico para incrementar la persistencia de plantas de trébol rosado. Además, se informa una metodología rápida para la búsqueda de genotipos con altos contenidos de formononetina.

Publicación científica de los docentes de medicina en una universidad colombiana: características y factores asociados / Scientific publication of medical teachers in a Colombian university: characteristics and associated factors

Introducción: La investigación científica es uno de los parámetros más importantes en la generación de nuevo conocimiento por parte de las instituciones de educación superior. Objetivo: Caracterizar la publicación científica y encontrar los factores asociados entre los docentes de medicina. Metodos: Se realizó un estudio transversal analítico, en la Universidad Pedagógica y Tecnológica de Colombia, de las publicaciones entre el 2000 y el 2015. La búsqueda se realizó por medio de Google Académico, PubMed y Scopus; la variable principal fue si había publicado, las secundarias: en qué base de datos, la cantidad de citas, el tipo de trabajo, la categoría de docente, si tenía algún postgrado/especialidad. Resultados: De los 88 docentes evaluados, el 71 por ciento (62) fueron hombres, el 28 por ciento (25) había publicado alguna vez y el 13 por ciento (11) había publicado en una revista internacional. Al realizar el análisis multivariado, los que tuvieron una publicación tenían una mayor frecuencia tener grado de doctor (RPa: 11,2; IC95 por ciento: 2,53-49,3; valor p:0,001) y el grado de magíster (RPa: 8,01; IC95 por ciento:1,84-34,9; valor p:0,006), en cambio, los que fueron profesores ocasionales (RPa: 0,45; IC95%: 0,26-0,80; Valor p:0,006) tuvieron una menor frecuencia de publicación. Conclusión: Aquellos docentes con un postgrado tuvieron más frecuencia de publicaciones, en cambio, los que tuvieron un cargo en la universidad presentaron menos frecuencia; por lo que se debería incentivar las publicaciones en estos grupos poblacionales(AU)

Introduction: scientific research is one of the most important parameters in generating new knowledge by higher education institutions. Objective: we aim to characterize the scientific publication and to find associated factors between medicine teachers of Universidad Pedagógica y Tecnológica de Colombia. Methods: we performed an analytical cross-sectional study of the analysis of scientific publications made by medicine teachers, performed between 2000 and 2015. We performed the research via Google Scholar, PubMed, and Scopus; the main variable was if they had published, the second ones were: in which database, the amount of cites, the type of work, the teacher's category, if they had any post-graduation/specialty. Results: out of 88 evaluated teachers, 71 por ciento (62) were male, 28 por ciento (25) had published any time and 13 por ciento (11) had published in an international journal. When performing the multivariate analysis, those who had a publication had a higher frequency of having a doctoral degree (RPa: 11.2; CI95 por ciento: 2,53-49,3; p value: 0,001) and a Master's degree (RPa: 8,01; CI95 por ciento: 1,84-34,9; p value: 0.006), on the other hand, those who were occasional teachers (RPa: 0,45; CI95%: 0,26-0,80; p value: 0,006) had a lesser frequency of publication. Conclusion: those teachers with a post-graduation degree had a higher frequency of publications, instead, those who had a position at the university presented less frequency, and thus publications should be encouraged in these population groups(AU)

Fibromatosis musculoaponeurótica agresiva: presentación de un caso / Muscleneuropatic agressive fibromatosis: a case presentation

Resumen Paciente masculino de 40 años, consulta por dolor en región glútea izquierda, asociado a masa de crecimiento progresivo; inicialmente valorado por ortopedia, donde le realizan radiografía y gammagrafía sin diagnóstico definitivo; revalorado por ortopedia y traumatología, luego de resonancia magnética y biopsia del glúteo comprometido se diagnostica fibromatosis glútea, la cual fue tratada con una resección del tejido invasivo y posteriormente radioterapia complementaria con acelerador lineal. Conclusión: Los tumores desmoides son infrecuentes y representan 0,03 % de todas las neoplasias y < 3 % de todos los tumores de tejidos; la cirugía ha sido tradicionalmente el pilar terapéutico debido a la variabilidad en el curso clínico y la importancia del sitio involucrado se asocia al tratamiento y aplicación de radioterapia.

Abstract 40 year old male patient complains about pain in left gluteal region, associated with progressive growing mass; initially valued by orthopedics, which performed x-ray scan and gammagraphy without a definitive diagnosis. He was reassessed by orthopedics and traumatology, through magnetic resonance imaging and biopsy of the committed gluteal, and was diagnosed with gluteal fibromatosis, which was treated with invasive tissue resection and subsequently additional accelerator radiotherapy. Conclusions: Desmoid tumors are rare and account for 0.03 % of all malignancies and <3 % of all tumors of tissues. Surgery has traditionally been the therapeutic mainstay due to variability in the clinical course and importance of the site of involvement is associated with the treatment and application of radiation therapy.

[Changes in the clinical presentation of Influenza A H1N1pdm09 after the pandemic]. / Cambios en la presentación clínica de la influenza A H1N1pdm09 después de la pandemia.

BACKGROUND: After the 2009 influenza pandemic the H1N1pdm09 strain circulate seasonally. In 2015, Puerto Montt Hospital in Chile faced a simultaneous outbreak of both seasonal H3N2 and H1N1pdm09 influenza A (IA). AIM: To evaluate the clinical differences between the two viral strains and recent changes in the behavior of H1N1pdm09 IA. MATERIAL AND METHODS: We set up a retrospective study including every adult hospitalized in Puerto Montt Hospital in 2015 due to IA, confirmed by reverse transcription polymerase chain reaction. We compared epidemiological data, clinical presentation, complications, and the outcome of patients with H1N1pdm09 versus those with seasonal influenza. In parallel, we compared 62 cases of thatH1N1 IA from 2015 with 100 cases who were hospitalized and analyzed in 2009. RESULTS: Between July and October 2015, 119 adults with confirmed IA were hospitalized. From 2009 to 2015, the mean age of patients with IAH1N1pdm09 increased from 40.4 ± 17 to 58.8 ± 16 years (p < 0.01). Pneumonia as the cause of hospitalization decreased from 75 to 58% of patients, (p = 0.04). Likewise, the presence of comorbidities increased from 53 to 74%, (p < 0.01). Compared with seasonal H3N2, patients with IAH1N1pdm09 IA were more likely to require intensive care (p < 0.01) and mechanical ventilation (p < 0.01) and developed septic shock (p = 0.03). Their mortality was non-significantly higher (13 and 5% respectively). CONCLUSIONS: The clinical presentation of H1N1pdm09 IA has varied over time and now affects an older population, with a greater number of comorbidities. It also appears to be adopting the clinical behavior of a classic seasonal influenza virus.

Publicación científica entre los directivos de la Asociación Científica de Estudiantes de Medicina de Colombia: características y factores asociados / Scientific publication of the directors of the Scientific Association of Medical Students of Colombia: Characteristics and associated factors

Resumen Introducción. La publicación científica se debe incentivar desde el pregrado, sobre todo en carreras de ciencias de la salud. Objetivo. Determinar las características y los factores asociados a la publicación científica entre los miembros de la Asociación Científica de Estudiantes de Medicina de Colombia (ASCEMCOL). Materiales y métodos. Se realizó un estudio transversal analítico que se basó en una encuesta presencial aplicada a los miembros de la ASCEMCOL. Se definió como publicación la realizada en una revista científica indexada; la información recolectada se cruzó con variables para obtener estadísticos de asociación. Resultados. Al realizar el análisis multivariado, se asoció a mayor participación en investigaciones científicas el encontrarse en un semestre académico superior (RPa: 1.25; IC95%: 1.01-1.56; p=0.043) y tener más cantidad de investigaciones extracurriculares (RPa: 1.26; IC95%: 1.15-1.38; p<0.001); así mismo, la menor frecuencia de publicación se asoció a la percepción de pobre apoyo por parte de la universidad (RPa: 0.28; IC95%: 0.22-0.34; p<0.001), ajustado por la cantidad de trabajos presentados a congresos y la universidad de procedencia. Conclusión. La frecuencia de publicación fue baja en esta población. Se encontraron factores de gran importancia, como estar en un mayor semestre y tener mayor número de investigaciones realizadas y publicaciones.

Abstract Introduction: The scientific publication should be encouraged from the undergraduates, especially in science health careers. Objective: To determine the features and factors associated with scientific publication among members of the Scientific Association of Medical Students of Colombia (ASCEMCOL). Materials and methods: An analytic cross-sectional study, which was based on a face survey applied to the members of the ASCEMCOL. A publication was defined as a publication made in an indexed scientific journal; and the information collected was crossed with variables to obtain a statistical association. Results: When performing multivariate analysis, it was associated with increased participation in scientific research the fact of being in a superior academic semester (RPA: 1.25; 95% CI: 1.01-1.56; p value: 0.043), more of extracurricular investigations (RPA: 1.26; 95% CI: 1.15-1.38; p value <0.001). Likewise, the lower frequency of publications associated with the perception of poor support from the university (RPA: 0.28; 95% CI: 0.22-0.34; p value <0.001), adjusted to the number of papers presented in congresses and the university of origin. Conclusion: The publication frequency was low in this population; we find important factors like being in a superior academic semester, such as having a greater number of investigations and publications.

Evaluación del riesgo de sangrado en pacientes con fibrilación auricular no valvular / Evaluation of bleeding risk in patients with non-valvular atrial fibrillation

Sr. Editor: La fibrilación auricular no valvular es una patología de gran impacto en la salud de la población mundial, además de ser la arritmia cardiaca más común y de estar asociada con una alta morbi-mortalidad. Según reportes del estudio AFINVA, en Colombia se estima una prevalencia del 2,1% en la población general, la misma que llega hasta un 8,06% en mayores de 65 años1. Por esta razón, es común enfrentarse a problemas clínicos en el momento de abordar el tratamiento de estos pacientes. En tal sentido, una de las preguntas clave es el inicio de la terapia con anticoagulación, para lo cual se tienen en cuenta dos aspectos: el riesgo de embolia sistémica valorado mediante las escalas CHADS2 y CHA2DS2VASc (esta última permite estratificar mejor el paciente de bajo riesgo) (2 y el riesgo de sangrado para cada caso en particular, tema por el cual se hace una revisión en la literatura y a continuación se muestran los resultados. Luego de explorar las principales bases de datos de ciencias biomédicas en español e inglés en búsqueda de estudios estadísticos que compararan el rendimiento de las principales escalas empleadas en la predicción de sangrado en pacientes en manejo con anticoagulantes orales en fibrilación auricular no valvular, se encontró que en algunos estudios comparativos la escala ORBIT resultó superior en la predicción de hemorragia, seguido por la escala HAS-BLED y luego por ATRIA3),(4. En otros estudios se mostró que la diferencia entre estas dos primeras escalas no fue estadísticamente significativa5),(6 mientras que en otros se halló mejor rendimiento de la escala HAS-BLED7, así como similitud en cuanto a predicción de eventos de sangrado entre HAS-BLED y HEMORR2HAGES, hecho que en que la escala ATRIA tiene menor utilidad.

Cambios en la presentación clínica de la influenza A H1N1pdm09 después de la pandemia / Changes in the clinical presentation of Influenza A H1N1pdm09 after the pandemic

Background: After the 2009 influenza pandemic the H1N1pdm09 strain circulate seasonally. In 2015, Puerto Montt Hospital in Chile faced a simultaneous outbreak of both seasonal H3N2 and H1N1pdm09 influenza A (IA). Aim: To evaluate the clinical differences between the two viral strains and recent changes in the behavior of H1N1pdm09 IA. Material and Methods: We set up a retrospective study including every adult hospitalized in Puerto Montt Hospital in 2015 due to IA, confirmed by reverse transcription polymerase chain reaction. We compared epidemiological data, clinical presentation, complications, and the outcome of patients with H1N1pdm09 versus those with seasonal influenza. In parallel, we compared 62 cases of thatH1N1 IA from 2015 with 100 cases who were hospitalized and analyzed in 2009. Results: Between July and October 2015, 119 adults with confirmed IA were hospitalized. From 2009 to 2015, the mean age of patients with IAH1N1pdm09 increased from 40.4 ± 17 to 58.8 ± 16 years (p < 0.01). Pneumonia as the cause of hospitalization decreased from 75 to 58% of patients, (p = 0.04). Likewise, the presence of comorbidities increased from 53 to 74%, (p < 0.01). Compared with seasonal H3N2, patients with IAH1N1pdm09 IA were more likely to require intensive care (p < 0.01) and mechanical ventilation (p < 0.01) and developed septic shock (p = 0.03). Their mortality was non-significantly higher (13 and 5% respectively). Conclusions: The clinical presentation of H1N1pdm09 IA has varied over time and now affects an older population, with a greater number of comorbidities. It also appears to be adopting the clinical behavior of a classic seasonal influenza virus.

[Is the scientific name important in medical journals?: Experience in a Colombian university Is the scientific name important in medical journals?]

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