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El presente estudio evaluó el efecto de la temperatura en la lixiviación de plata (Ag) y cobre (Cu) contenidos en relaves, implementando el sistema Tiourea-Oxalato. El análisis químico realizado por la técnica de Espectrometría de Absorción Atómica (EAA) indica que la muestra contiene un promedio de 41 g t-1 Ag y 111.5 g t-1 Cu. Por otro lado el análisis mineralógico realizado por Difracción de Rayos x (DRX) y Microscopia Electrónica de Barrido con Análisis de Energía Dispersiva (MEB-EDS) revelaron la especie mineral que contiene la plata y el cobre correspondiendo a la sulfosal polibasita ((Ag, Cu)16Sb2S11). Para los experimentos de lixiviación se utilizó 0.1 mol L-1 de Tiourea (CH4N2S) y de Oxalato de Potasio (K2C2O4·H2O), el rango de temperaturas propuesto fue de 20, 25, 30 y 35 °C. Alcanzando una disolución máxima del 80% Ag y 39% Cu, a 20°C.

Se presenta un estudio electroquímico para evaluar una aleación base Ni empleada como cátodo y determinar su viabilidad en la producción de hidrógeno en un medio electrolítico básico y ácido. Se aplicó un tratamiento a la superficie de la aleación de Ni utilizando una solución 0.6 M de FeCl3 con la finalidad de suministrar una mayor área superficial. Con fines comparativos se usó también un electrodo de acero inoxidable A304 como cátodo. Se realizaron pruebas de voltamperometría cíclica y cronoamperometría en un rango de potenciales entre -2.0 a 0.0 V, para evaluar la densidad de corriente durante la evolución de hidrógeno. Se determinó que la densidad de corriente obtenida en el medio básico fue mucho menor que con el medio ácido, en ambos electrodos analizados. Mientras que, con la aleación base Ni se presentó menores sobrepotenciales para el inicio de la reacción de evolución de hidrógeno, así como una mayor densidad de corriente que con el acero inoxidable A304. Además, se observó un aumento en la densidad de corriente cuando se aplicó el tratamiento a la aleación base Ni, atribuido a un incremento en el área superficial catalítica de la aleación.

Metalloporphyrins (MP) and metallophtalocyanines (MPc) are innovative materials with catalytic properties that have attracted attention for their application for diverse electrochemical purposes. The presence of metallic centers in their structure offers a redox-active behavior that is being applied in the design of solid electrodes for the quantification of biomolecules, water contaminants, and pharmaceuticals, among others. Herein, we collect the recent information about porphyrin and phthalocyanine complexes as modifiers of electrodes, and the important aspects of the design, characterization, and application of these electrodes.

BackgroundOver the past years, information about the crosstalk between the epicardial adipose tissue (EAT) and the cardiovascular system has emerged. Notably, in the context of acute myocardial infarction (AMI), EAT might have a potential role in the pathophysiology of ventricular structural changes and function, and the clinical evolution of patients. This study aims to assess the impact of EAT on morpho-functional changes in the left ventricle (LV) and the outcome of patients after an AMI.MethodsWe studied prospectively admitted patients to our hospital with a first episode of AMI. All patients underwent percutaneous coronary intervention (PCI) during admission. Transthoracic echocardiography (TTE) was performed within 24–48 h after PCI, as well as blood samples to assess levels of galectin-3 (Gal-3). Cardiac magnetic resonance (CMR) was performed 5–7 days after PCI. Clinical follow-up was performed at 1 and 5 years after MI.ResultsMean age of our cohort (n = 41) was 57.5 ± 10 years, and 38 (93%) were male. Nine patients had normal BMI, 15 had overweight (BMI 25–30), and 17 were obese (BMI > 30). Twenty three patients (56%) had ≥ 4 mm thickness of EAT measured with echo. In these patients, baseline left ventricular ejection fraction (LVEF) after AMI was significantly lower, as well as global longitudinal strain. EAT thickness ≥ 4 m patients presented larger infarct size, higher extracellular volume, and higher T1 times than patients with EAT < 4 mm. As for Gal-3, the median was 16.5 ng/mL [12.7–25.2]. At five-year follow-up 5 patients had major cardiac events, and all of them had EAT ≥ 4 mm.ConclusionsPatients with EAT >4 mm have worse LVEF and GLS, larger infarct size and longer T1 values after a MI, and higher levels of Gal-3. EAT >4 mm was an independent predictor of MACE at 5-year follow-up. EAT thickness is a feasible, noninvasive, low-cost parameter that might provide important information regarding the chronic inflammatory process in the myocardium after an infarction.

Following the spread of the SARS-CoV-2 coronavirus, an unprecedented burden has been placed on health care systems, with health care workers (HCWs) being most at risk of COVID-19 infection. The effect of the probiotic

Myocardial strain analysis could provide additional information to left ventricular ejection fraction (LVEF) in nonischemic dilated cardiomyopathy (NIDC). Our aim was to analyze the feasibility of left ventricular strain evaluation using cardiac magnetic resonance feature tracking (FT) in NIDC, and to determine its clinical and prognostic impact.We retrospectively included consecutive patients with NIDC who underwent cardiac magnetic resonance. Left ventricular global longitudinal, circumferential and radial strain were obtained from standard cine sequences using FT analysis software. We evaluated their association with a composite endpoint (heart failure, implantable cardioverter-defibrillator in secondary prevention, or death).FT analysis could be performed in all of the 98 patients (mean age 68±13 years, 72% men). Intra- and interobserver concordance was good for global longitudinal and circumferential strain but was worse for radial strain. Global circumferential strain was independently associated (OR, 1.16; P=.045) with LVEF normalization during follow-up and was the only morphological parameter independently associated with the composite endpoint (OR, 1.15; P=.038). A cutoff value-8.2% was able to predict the incidence of this event during follow-up (log-rank 4.6; P=.032).Left ventricular strain analysis with FT is feasible and reproducible in NIDC. Global circumferential strain was able to predict LVEF recovery and the appearance of major cardiovascular events during follow-up.

Resumen Introduccion y objetivos El analisis de la deformacion miocardica puede aportar informacion adicional a la fraccion de eyeccion del ventriculo izquierdo (FEVI) en la miocardiopatia dilatada no isquemica (MDNI). El objetivo es analizar la factibilidad del estudio del strain del ventriculo izquierdo mediante feature tracking (FT) de cardiorresonancia magnetica en la MDNI y determinar su relevancia clinica y pronostica. Metodos Se incluyo retrospectivamente a los pacientes consecutivos con MDNI sometidos a cardiorresonancia magnetica. Se obtuvieron el strain global longitudinal, circunferencial y radial del ventriculo izquierdo de secuencias convencionales de cine mediante un software de analisis de FT. Se evaluo su asociacion con el evento combinado (insuficiencia cardiaca, implante de desfibrilador en prevencion secundaria y muerte). Resultados Se pudo realizar el FT en los 98 pacientes evaluados (edad, 68 ± 13 anos; el 72% varones). La concordancia intraobservador e interobservadores fue buena para el strain global longitudinal y circunferencial, y mas limitada para el radial. El strain global circunferencial se asocio de manera independiente (OR = 1,16; p = 0,045) con la normalizacion de la FEVI en el seguimiento y fue el unico parametro morfologico con asociacion independiente (OR = 1,15; p = 0,038) con el evento combinado. Un valor Conclusiones El analisis del strain del ventriculo izquierdo mediante FT es factible y reproducible en MDNI. El strain global circunferencial fue capaz de predecir la recuperacion de la FEVI y la aparicion de eventos cardiovasculares mayores en el seguimiento.

El electrodepósito de manganeso es un proceso sumamente energético, dado que se requieren corrientes y potenciales considerablemente altos; al mismo tiempo, el control sobre estas condiciones debe ser sumamente estricto, dado que las propiedades reactivas del manganeso lo hacen propenso a formar otras especies. Entre los elementos más importantes para la obtención de manganeso están las membranas aniónicas, pues son vitales para asegurar la eficiencia del proceso y la pureza del producto obtenido. Actualmente, se desconoce la forma como las membranas pueden variar su comportamiento a lo largo del proceso. Es por ello que en el presente trabajo se realizaron estudios potenciostáticos y potenciodinámicas con el propósito de diferenciar como dos membranas aniónicas diferentes modifican su efecto sobre los procesos electroquímicos relacionados con la reducción del Mn2+; los resultados mostraron que las membranas sufren modificaciones que incrementan la variabilidad, capacidad de transformación de materia y la selectividad del proceso.

Different studies carried out in the last three decades on the magnetic susceptibility of the spinel ZnFe

Se obtiene un material cerámico poroso para la adsorción de iones metálicos en soluciones acuosas, este material es elaborado con los desechos de una cocina doméstica, llevándolos a una carbonización controlada a 600 °C, este proceso es caracterizado por dejar la presencia de enlaces de carbono libres que permiten la adsorción de los iones metálicos en el material. El material cerámico poroso elaborado puede utilizarse para la adsorción de algunos metales pesados en soluciones acuosas contaminadas principalmente Pb y Se, ya que es selectivo con estos iones, sin descartar la adsorción de otros metales.

Different studies carried out in the last three decades on the magnetic susceptibility of the spinel ZnFeO ferrite have revealed the positive character of its Curie–Weiss temperature, contradicting its observed antiferromagnetic behavior which is characterized by a well-defined susceptibility peak centered around the Neel temperature (10 K). Some approaches based on ab initio calculations and mixture of interactions have been attempted to explain this anomaly. This work shows how for very low values of the inversion parameter, the small percentage of Fe atoms located in tetrahedral sites gives rise to the appearance of ferrimagnetic clusters around them. Superparamagnetism of these clusters is the main cause of the anomalous Curie–Weiss behavior. This finding is supported experimentally from the thermal dependence of the inverse susceptibility and its evolution with the degree of inversion., This research was funded by Spanish Ministries of Science Innovation and Universities and of Economy and Competitiveness by means of the AFORMAR (PID2019-109334RB), RTI2018-095303-B-C51 and RTI2018-095856-B-C21 projects. The support of the grants from the Community of Madrid numbers S2018/NMT-4381-MAT4.0-CM and P2018/NMT-4321 is also recognized.

The term ‘superfoods’, used frequently with marketing purposes, is usually associated with foodstuffs with beneficial health properties. ‘Superfoods’ appears in many information sources, including digital media. The information they provide is easily accessible for consumers through Internet search engines. The objective of this work is to investigate the data that web pages offer to consumers and their accuracy according to current scientific knowledge. The two main search engines were utilized for English language websites search, introducing the term ‘superfoods’. In total, 124 search results were found. After applying the selection criteria, 45 web pages were studied. A total of 136 foods were considered as ‘superfoods’ by sites; 10 of them (kale, spinach, salmon, blueberries, avocado, chia, walnuts, beans, fermented milks and garlic) were mentioned on at least 15 sites. Nutritional and healthy properties displayed on sites were compared to scientific information. In conclusion, websites present the information in a very simplified manner and it is generally not wrong. However, they should offer to consumers comprehensible information without raising false expectations regarding health benefits. In any case, ‘superfoods’ consumption can have salutary effects as part of a balanced diet.

Introduction Prosthesis under-expansion has been associated with higher rates of complications and worse long term outcome after transcatheter aortic valve replacement (TAVR). The objective of the current study was to assess the value of a new “Discongruence index”, to predict the percentage of prosthesis size loss (compared to its nominal size). The “discongruence index” is obtained from the relation between transcatheter valve size and the patient body surface area. Methods A total of 247 consecutive patients with severe aortic stenosis that underwent TAVR with balloon expandable Edwards-Sapiens prosthesis or CoreValve Revalving system at our institution were included. The “Discongruence index” was calculated pre-procedurally as the ratio: selected transcatheter valve size (mm) / body surface area (cm2). Two-dimensional transesophageal echocardiography images were studied in the 120–135° plane after the prosthesis deployment, and the maximum anteroposterior diameter was measured (in millimeters). From this measurement was obtained the percentage of prosthesis size loss (compared to the prosthesis nominal size). Results Mean age was 82±6 years and 102 patients (41.3%) were men. Mean aortic valvular area before TAVR was 0,87±3,8 cm2, (indexed 0,36±0,1 cm2) and the mean aortic gradient 49,1±16,9 mmHg. Mean prosthesis maximum deployment was 18,9±2,7 mm; absolute loss of prosthesis size compared to nominal 6,5±2,8 mm and the percentage loss of prosthesis size 25.1±9,5%. The “Discongruence index” was predictor of the percentage of prosthesis size loss (y = 5,7650 + 1,3010x, p Conclusions The “Discongruence index” is a useful tool to predict the percentage of prosthesis size loss after TAVR. This new index should be taken into consideration in the selection of transcatheter valve sizes to avoid prosthesis under-expansion. Funding Acknowledgement Type of funding sources: None. Figure 1

Background Left ventricular (LV) strain from echocardiography is a known useful predictor of LVEF recovery in non-ischemic dilated cardiomyopathy (NIDCM). More recently, feature tracking (FT) has allowed LV myocardial deformation analysis using conventional cardiac magnetic resonance (CMR) cine sequences. Purpose Our aim is to establish the correlation between LV strain values from CMR-FT at diagnosis and morphological parameters at baseline and during follow-up. Methods Consecutive patients with NIDCM who underwent CMR were retrospectively collected. All the studies were performed in a 1.5 Tesla magnet following a standard acquisition protocol of conventional SSFP cine sequences in long and short axis. Global longitudinal, circumferential and radial strain (GLS, GCS and GRS, respectively) were obtained with a dedicated FT software. Correlation with CMR morphological parameters at baseline were evaluated. Likewise, in the cases with follow-up echocardiogram association between FT LV strain and evolution of morphofunctional variables was explored. Results CMR-FT strain analysis was performed in 98 patients (age 68±13 years, 72% males) with NIDCM. They showed severe LV dilatation (LVEDVi= 133.6±33.4 mL/m2) and systolic dysfunction (LVEF= 29.5±9.6%) at baseline. Myocardial fibrosis was detected in 38.8% of the patients with late gadolium enhancement (LGE) sequence. All the basal CMR morphological characteristics were significantly correlated with FT strain analysis (Table), even more markedly for GCS. However, there was no association of baseline morphofunctional parameters with LGE. An echocardiogram was performed in 85.7% of the patients during the follow-up (2.4 [1.8–3.4] years), with an LVEF >50% in the 25.5% of the cases. These patients with preserved LVEF in the evolution showed better GCS (−9 vs −7.1%; p=0.019) at baseline, with no differences in the other FT LV strain parameters. Despite less fibrosis in LGE (16.1% vs 37.7%; p=0.037), none of the baseline morphofunctional CMR parameters (LVEF, LVEDVi...) were associated with systolic function restoration. In multivariate analysis, GCS was the only independent predictor (OR 1.16; p=0.045) of LVEF recovery among imaging variables. Conclusions All the FT derived LV strain values were correlated with the degree of basal morphofunctional involvement in NIDCM. Furthermore, GCS emerged as an independent imaging predictor of LV systolic function restoration in our series. Funding Acknowledgement Type of funding sources: None. Table 1. Correlation between myocardial deformation values by feature tracking and morphofunctional variables in basal CMR.

Resumen Introduccion y objetivos El desarrollo tardio de insuficiencia tricuspide funcional tras cirugia valvular izquierda de origen reumatico es un importante predictor de mal pronostico. Este estudio investiga la utilidad y precision diagnostica del area tricuspide evaluada por ecocardiografia transtoracica tridimensional en comparacion con el diametro bidimensional (D2D) convencional para evaluar la dilatacion significativa del anillo tricuspide, proporcionando puntos de corte que podrian utilizarse en la practica clinica para mejorar la seleccion de pacientes para cirugia. Metodos Se incluyeron prospectivamente 109 pacientes con valvulopatia reumatica en ausencia de reemplazo valvular previo. La insuficiencia tricuspide se dividio en tres grupos: leve, moderado y grave. Se obtuvieron los puntos de corte optimos del area tridimensional (A3D) y del D2D para la identificacion de la dilatacion significativa del anillo tricuspide y se compararon con los umbrales de las guias actuales. Tambien se evaluaron los factores predictivos de la dilatacion del A3D. Resultados Se identificaron los puntos de corte optimos, absolutos y ajustados por el area de superficie corporal (ASC), de ambos parametros (A3D: 10,4 cm2, 6,5 cm2/m2, D2D: 35 mm, 21 mm/m2) siendo el parametro A3D/ASC el que obtuvo el mejor rendimiento diagnostico (ABC = 0,83). El area tricuspide por ecocardiografia transtoracica tridimensional ayudo a reclasificar la indicacion quirurgica en el 14% de pacientes con insuficiencia tricuspide leve (IC95%, 1-15%; p = 0,03) y en el 37% con insuficiencia tricuspide moderada (IC95%, 22-37%; p Conclusiones El umbral del D2D actual propuesto de 40 mm infraestima la dilatacion del anillo tricuspide. Aunque 21 mm/m2 podria ser un criterio de seleccion razonable, la combinacion con la evaluacion del A3D mejora la seleccion de pacientes candidatos para cirugia.

This work presents a novel electrochemical sensor for methanol, based on a Cu(II) Metal-Organic Framework. The copper (II) benzenetricarboxylic metal-organic framework (Cu-BTC) was synthesized in mild condition at room temperature, and the obtained crystals were characterized by X-ray powder diffraction (XRD), scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX). The obtained Cu-BTC was incorporated at different ratios (7, 15, 30 wt%) in carbon paste electrodes to determine its electrocatalytic activity in the absence and the presence of methanol. The electrodes were characterized by cyclic voltammetry (CV) and differential pulse voltammetry (DPV). An anodic peak response toward methanol was observed at 1.25 V using 0.1 M NaOH as supporting electrolyte, with a maximum current density of 10 mA. Also, the oxidation signal of methanol in the presence of ethanol was studied by DPV. The quantitative analysis of methanol in the presence of ethanol using the modified electrode presented a LOD, LOQ and sensitivity values of 0.0511 mM, 0.1549 mM, and 19.8 mA mM−1 cm−2, respectively. The results demonstrated the high potential of Cu-BTC as part of electrochemical sensors for the determination of methanol in actual samples.

The benefit of noble metals, such as silver contained in mining-metallurgical waste, is considered a challenge for the metallurgist because they are low-grade minerals, fine granulometry, and complex minerals by their refractoriness. To address this problem, a tailings characterization of the state of Morelos was carried out, using techniques such as atomic absorption spectrophotometry and Induction Coupled Plasma Emission Spectrometry that gave similar silver concentrations of 104.8 and 106 g ton−1, respectively. In addition, a XRD study was carried out, which identified the presence of Xancotonite, in addition to Cu and Fe sulfides, and both species are contained in a silicon matrix. To abound in the mineralogical study, samples were observed in optical microscopy revealing mainly pyrite associated with quartz, sphalerite, arsenopyrite, and some particles with the appearance of a sulfosal, which were confirmed through SEM since elements such as S, Ag, As, and Sb were revealed through microanalysis to different particles.

Background Early recognition and treatment of ST-elevation myocardial infarction (STEMI) results in better outcomes. Objectives To describe a novel technique using the Apple Watch 4 (Apple Inc, Cupertino, CA) to obtain a 3-lead electrocardiogram (ECG) and confirm the watch's feasibility to detect cardiac ischemia in selective cases with a particular injury pattern. Methods Two male patients in the Emergency Department had STEMI apparent on their ECGs. These findings were compared with those from the Apple Watch 4, whose positioning was adjusted for 3-lead ECG. Results The patients' real-time, watch-based, 3-lead ECG tracings matched the traditional ECGs demonstrating STEMI, confirming the potential ability of this device to uncover myocardial ischemia. In each patient, cardiac catheterization revealed severe, 100% occlusion of the right coronary artery. Conclusion The Apple Watch 4 could lead to earlier detection of acute coronary artery disease, but sensitivity and specificity remain unknown.

Coordination complexes and metal–organic frameworks are compounds with unlimited applications in electrochemistry. Those based on Co, Ni, and Cu offer redox-active properties that can be an advantage for the electro-oxidation of short-chain alcohols in alkaline media. At the present, there is a crescent interest for its application in direct methanol fuel cells and a big effort is being carried out to improve the oxidation potentials obtained with these compounds before their practical uses as DMFCs anodes. Herein, we collected the recent advance on the use of coordination compounds (coordination complexes and Metal-Organic Frameworks) as modifiers for electrodes and their evaluation on methanol electro-oxidation in alkaline media. Fundamental aspects of the key role of coordination compounds in electro-oxidation, the fabrication of modified electrodes containing coordination compounds, and diverse examples of its use of methanol electro-oxidation will be discussed.

The use of flours as a material for biopolymer-based film preparation has gained interest due to the fact that they are a natural mixture of compatible macromolecules and due to their low cost. Chickpea flour shows a promising composition for the development of edible films. The aim of this study was to characterize and evaluate the properties of chickpea flour films as affected by pH (7 or 10) and plasticizer concentration (1% or 3% w/v) of film-forming solutions. Water vapor permeability, solubility, color, opacity, mechanical properties, thermal stability, structural changes by Fourier transform infrared analysis, and microstructure of the films were determined. Glycerol content and pH influenced chickpea flour film properties, microstructure and structural organization; interactions were also observed. The 1% glycerol films showed lower water vapor permeability, thickness, radical scavenging capacity, elongation at break and puncture deformation, and higher dry matter content, swelling, opacity, elastic modulus, and tensile and puncture strengths than 3% glycerol films. Film-forming solutions at pH 10 produced films with higher thickness and swelling, and were greener than those from solutions at neutral pH. The changes were more intense in 1% glycerol films. Glycerol concentration and pH could be combined in order to obtain chickpea flour films with different properties according to different food packaging requirements.

Introduction and objectives: Late functional tricuspid regurgitation after rheumatic left-sided valve surgery is an important predictor of poor prognosis. This study investigated the usefulness and accuracy of 3-dimensional transthoracic echocardiography tricuspid area compared with conventional 2-dimensional diameter (2DD) for assessing significant tricuspid annulus dilatation, providing cutoff values that could be used in clinical practice to improve patient selection for surgery. Methods: We prospectively included 109 patients with rheumatic heart disease in the absence of previous valve replacement. Tricuspid regurgitation was divided into 3 groups: mild, moderate, and severe. Optimal 3-dimensional area (3DA) and 2DD cutoff points for identification of significant tricuspid annulus dilatation were obtained and compared with current guideline thresholds. Predictive factors for 3DA dilatation were also assessed. Results: Optimal cutoff points for both absolute and adjusted to body surface area (BSA) tricuspid annulus dilatation were identified (3DA: 10.4 cm2, 6.5 cm2/m2; 2DD: 35 mm, 21 mm/m2); 3DA/BSA had the best diagnostic performance (AUC = 0.83). Three-dimensional transthoracic echocardiography tricuspid area helped to reclassify surgical indication in 14% of patients with mild tricuspid regurgitation (95%CI, 1%-15%; P = .03) and 37% with moderate tricuspid regurgitation (95%CI, 22%-37%; P < .0001), whereas 3DA/BSA changed surgery criteria in cases of mild tricuspid regurgitation (17%; 95%CI, 3%-17%; P = .01) compared with 2DD/BSA. On multivariable analysis, right and left atrial volumes and basal right ventricle diameter were independently correlated with 3DA. Conclusions: The current 40 mm threshold underestimates tricuspid annulus dilatation. Although 21 mm/m2 seems to be a reasonable criterion, the combination with 3DA assessment improves patient selection for surgery. Full English text available from:www.revespcardiol.org/en

En el programa de la asignatura de Física y Química de superficies se contemplan los fenómenos electrocinéticos, donde figura la electroforesis; la cual es una técnica útil para caracterizar cambios atribuidos a la transformación de biomoléculas como es el caso de las proteínas. Por ello, en el presente trabajo se evaluó la modificación del perfil proteico de lactosuero tratado en un sistema biolectroquímico, haciendo uso de la electroforesis en gel de poliacrilamida (SDS-PAGE). El sistema bioelectroquímico consistió en un electrodo de grafito con una superficie modificada con bacterias (electrodo microbiano), el cual fue puesto en marcha utilizando una técnica cronoamperométrica realizada en un período de 12 horas. Los resultados obtenidos a partir de los perfiles electroforéticos del estado inicial y final del lactosuero indican la presencia de 7 proteínas con pesos moleculares promedio entre 11.83 y 126.50 kDa en ambas muestras. Posteriormente, el análisis estadístico realizado a dichos resultados permitió determinar la transformación de 2 de las 7 proteínas identificadas en el lactosuero.

Introduccion y objetivos La incidencia por infarto de miocardio en Espana es baja y la mortalidad esta disminuyendo en las ultimas decadas. Hemos analizado las tendencies en las tasas de mortalidad, incidencia y ataque, y en la letalidad a 28 dias por infarto de miocardio entre 1990 y 1999 en la poblacion de 35 a 74 anos de Girona. Metodos Se incluyeron todos los casos de infarto de miocardio de Girona clasificados segun el algoritmo MONICA. Se calcularon las tasas de ataque, incidencia y mortalidad, y la letalidad, asi como el porcentaje de cambio annual en cada uno de los indicadores durante el periodo analizado. Resultados La tasa anual media de ataque fue de 258 (intervalo de confianza [IC] del 95%, 249-267) y 55 (IC del 95%, 51-59) por 100.000 habitantes para varones y mujeres, respectivamente, y la de mortalidad de 99 (IC del 95%, 93-104) por 100.000 en varones y de 25 (IC del 95%, 22-28) por 100.000 en mujeres. Las tasas de ataque, incidencia y recurrencia disminuyeron significativamente en varones de 35 a 64 anos durante el periodo 1990-1999, pero no en los de 65 a 74 anos ni en las mujeres. Conclusiones La incidencia y la mortalidad por IAM fueron bajas en la poblacion de 35 a 64 anos, y mejoraron en los varones de 35 a 64 anos durante el periodo 1990-1999, pero no en los de 65 a 74 anos, lo que indica que la combinacion de prevencion primaria y secundaria ha retrasado la edad de aparicion del infarto de miocardio o de las recurrencias. Las tasas en mujeres fueron inferiors y no cambiaron durante el periodo estudiado.

Introduction and objectives The incidence of myocardial infarction in Spain is low, and mortality has been decreasing over the last few decades. The objective of this study was to analyze trends in myocardial infarction mortality, incidence, attack rates, and 28-day case-fatality attack rates between 1990 and 1999 in the general population aged 35-74 years in Girona, Spain. Methods The study included all myocardial infarction cases in Girona classified according to the MONICA algorithm. Attack, incidence, mortality rates and case- fatality were calculated. In addition, the annual percentage change in each of these indicators during the study period was also calculated. Results The mean attack rate per 100,000 inhabitants was 258 (95% CI, 249-267) in men and 55 (95% CI, 51- 59) in women. The mean mortality rate per 100,000 was 99 (95% CI, 93-104) in men and 25 (95% CI, 22-28) in women. Significant reductions in attack, incidence and recurrence rates were observed in men aged 35-64 years during the period 1990-1999, but not in men aged 65-74 years, nor in women. Conclusions Myocardial infarction incidence and mortality rates were low in the general population aged 35- 64 years. Rates improved in men aged 35-64 years during the period 1990-1999, but not in those aged 65-74 years, which indicates that a combination of primary and secondary prevention has increased the age at which a myocardial infarction or its recurrence is observed. Rates in women were lower and did not change during the study period.

To assess the value of colour M-mode Doppler of the mitral valve in patients with acute myocardial infarction complicated by pulmonary edema.Case-control, clinical.Coronary care unit in a university hospital.28 patients admitted because of acute myocardial infarction, and who developed pulmonary edema (group P, cases); 39 patients with uncomplicated myocardial infarction (group C, controls).Patients in group P showed higher E wave (77+/-20 vs. 64+/-16 cm/s, p=0.007), E/A ratio (1.5+/-1.0 vs. 1.0+/-0.4, p=0.014), lower time of deceleration of the E wave (153+/-40 vs. 196+/-53 ms, p=0.001) and lower Ejection Fraction (35+/-10 vs. 49+/-11, p0.001). There were no differences in the velocity of the colour M-mode Doppler of the mitral valve (Vp: 36.2+/-11 vs. 34.0+/-12 cm/s). Excluding patients with abnormal relaxation or restrictive pattern of the pulsed Doppler, Vp was identical (group P 34+/-10, group C 34+/-12).M-mode colour Doppler of the mitral valve was not useful to differentiate patients with acute pulmonary edema complicating myocardial infarction. Measurement of Vp is not warranted as a routine in these patients.

Certain chemotherapy drugs for breast cancer may induce cardiotoxicity and these patients should be echocardiographically monitored. The performance of a focused echocardiographic evaluation (echoscopy) at the patient's location by a non-cardiologist appears to be feasible. The aim of the present study was to assess the accuracy of echoscopy performed by medical oncologists in an outpatient clinic using hand-held echocardiography devices. The study cohort comprised consecutive unselected patients who attended an oncology outpatient clinic. Two medical oncologists attended a one-week training period, which included theoretical and practical teaching by an expert cardiologist. Every subject underwent two echo examinations. The first examination was performed by an oncologist using a hand-held echo device and the second was performed by a cardiologist using a ‘premium’ device. Out of the 101 enrolled patients, 32 were men (31.7%) and the mean age was 56.03±16.88 years. There was a good global agreement [intra-class correlation coefficient (ICC): 0.65 for left ventricular ejection fraction (LVEF)]. When the results were analyzed depending on the period of time when the echo studies were performed, a clear and short learning curve was observed: LVEF started at ICC=0.58 and increased to 0.66 and 0.77 in the second and third period, respectively. There were extremely few clinically significant differences and a learning curve was also evident. In conclusion, cardiac echoscopy performed by an oncologist with a hand-held device may lead to a similar clinical management as a study performed by an expert cardiologist with a ‘premium’ system in patients under chemotherapy following a short training period.

Aim: The hypothesis that patients with hyperglycaemia during admission, regardless of previous diagnosis of diabetes, have worse prognosis than those with normal glucose values is controversial. The objective was to assess the role of hyperglycaemia on short-term mortality after myocardial infarction (MI). Methods and Results: A cohort study nested in a prospective registry of MI patients in the reference hospital of Gerona, Spain was performed. All consecutive MI patients under 75 were registered between 1993 and 1996. Patient and clinical characteristics, including previous diagnosis of diabetes, glycaemia on admission and in the next four days, were recorded. Patients with glycaemia on admission or four day mean glycaemia >6.67 mmol/l were considered hyperglycaemic. The main outcome measure was mortality at 28 days. Of 662 patients with MI included, 195 (29.7%) had previously known diabetes mellitus, but 457 (69.0%) had glycaemia >6.67 mmol/l on admission. Patients with hyperglycaemia on admission were older, more often female, more frequently had a previous diagnosis of diabetes, developed more complications, and had higher 28 day mortality. The effect of admission glycaemia >6.67 mmol/l on 28 day mortality was independent of major confounding factors, particularly previous diagnosis of diabetes (OR=4.20, 95% confidence intervals 1.18 to 14.96). Conclusions: Higher 28 day mortality was observed among MI patients with glycaemia on admission >6.67 mmol/l compared with patients with lower levels, independently of major confounding variables and, particularly, previous diagnosis of diabetes. This early, simple, and inexpensive marker of bad prognosis after MI should prompt the application of more aggressive treatment of MI and risk factors and, probably, of glycaemia during admission.