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The purpose of this study was to evaluate the inductive effect of starch and maltose, and the repressive/inhibitory effect of glucose, on amy-1 gene expression and α-amylase production by Wickerhamia sp., using continuous culture under transient-state conditions at a dilution rate (D) of 0.083 h−1. Induction and repression kinetics of α-amylase were studied by changing the medium feed from glucose to maltose or starch in the induction experiments and vice versa in the repression experiments. Expression levels of amy-1 gene were measured by RT-qPCR. Results showed that starch was a more efficient inducer of α-amylase synthesis compared to maltose, with maximum accumulation rate constants of 0.424 and 0.191 h−1, respectively. In contrast, α-amylase synthesis in starch and maltose cultures was partially repressed by glucose as indicated by a specific activity close to basal levels and a decay constant rate (− 0.065 and − 0.069 h−1, respectively) higher than − D. A linear dependence of the specific rate of α-amylase production on mRNA relative abundance of amy-1 gene was observed. An inhibitory effect of glucose was not observed even at a concentration of 30 g L−1. In conclusion, the transient continuous culture is a useful tool to determine the qualitative and quantitative effects of maltose and starch on α-amylase induction and of glucose on enzyme repression, as well as to obtain a detailed understanding of the dynamic behavior of the yeast culture. Furthermore, results showed that amylaceous substrates can be very effective carbon sources for the production of α-amylase without being inhibited by glucose.

[EN] Objective: To identify preoperative parameters of anatomo-electrical atrial remodelling in order to identify the subgroup of patients more favourable to long-term sinus rhythm (SR) re-establishment after concomitant ablation of persistent-permanent atrial fibrillation (AF). Methods: The study included 50 consecutive patients undergoing concomitant surgical ablation of persistent-permanent AF with cryoablation and bipolar radiofrequency Maze IV pattern. The variables collected before the operation were: demographic variables, morbidity, AF evolution time, transthoracic echocardiographic study, and digital electrocardiogram register for f-wave signal organisation analysis (sample entropy [SampEn]). An assessment was also made of the individual and combined association of atrial remodelling parameters with SR restoration by area under ROC curve (AUC). Results: Follow-up 22.32 +/- 3.19 months. Mean AF onset time 4.00 +/- 4.28 years. Mean left atrium diameter 49.90 +/- 8.18 mm (range = 32 - 81 mm), and SR restoration of 62% at the end of follow-up. Parameters best linked to postoperative SR restoration were left atrium diameter (AUC = 0.848)and SampEn (AUC = 0.845). Cut-off points were 50 mm and 0.0857, respectively, obtaining a model with a predictive accuracy when both parameters combined with an AUC = 0.893. Conclusions: Preoperative anatomo-electrical remodelling analysis through indirect non-nvasive variables could be useful to select patients more favourable to SR restoration after concomitant ablation of AF., [ES] Objetivo: Identificación de parámetros de remodelado auricular anatomoeléctrico preoperatorios que permitan seleccionar un subgrupo de pacientes favorable al restablecimiento del ritmo sinusal (RS) a largo plazo tras ablación quirúrgica concomitante de fibrilación auricular (FA) persistente-permanente. Métodos: Cincuenta pacientes consecutivos sometidos a ablación quirúrgica concomitante de FA persistente-permanente por patrón Maze IV mediante crioblación y radiofrecuencia bipolar. Preoperatorio: se consideraron variables demográficas, morbilidad, tiempo de evolución de FA, estudio de ecocardiografía transtorácica y registro de electrocadiograma digital para análisis de organización de señal de ondas f (entropía muestral [SampEn]). Valoración de la asociación individual y conjunta de los parámetros de remodelado auricular con la restauración de RS mediante área bajo la curva ROC (ABC). Resultados: Seguimiento medio 22,32 ± 3,19 meses. Tiempo medio de evolución de FA 4,00 ± 4,28 años. Diámetro auricular izquierdo medio 49,90 ± 8,18 mm (rango = 32–81 mm). Restauración RS 62% al cierre del seguimiento. Los parámetros que mejor se asociaron con la restauración de RS postoperatorio fueron el diámetro auricular izquierdo (ABC = 0,848) y SampEn (ABC = 0,845). Hallados puntos de corte para ambos en 50 mm y 0,0857, respectivamente; se obtuvo un modelo con capacidad predictiva ABC = 0,893. Conclusiones: El análisis del grado de remodelado auricular anatomoeléctrico preoperatorio mediante variables indirectas incruentas podría ser útil para seleccionar los pacientes más favorables para el restablecimiento de RS tras ablación concomitante de FA.

et al., [Objective]: Peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α) is a transcriptional coactivator that has been proposed to play a protective role in mouse models of cardiac ischemia and heart failure, suggesting that PGC-1α could be relevant as a prognostic marker. Our previous studies showed that the estimation of peripheral mRNA PGC-1α expression was feasible and that its induction correlated with the extent of myocardial necrosis and left ventricular remodeling in patients with myocardial infarction. In this study, we sought to determine if the myocardial and peripheral expressions of PGC-1α are well correlated and to analyze the variability of PGC-1α expression depending on the prevalence of some metabolic disorders. [Methods]: This was a cohort of 35 consecutive stable heart failure patients with severe aortic stenosis who underwent an elective aortic valve replacement surgery. mRNA PGC-1α expression was simultaneously determined from myocardial biopsy specimens and blood samples obtained during surgery by quantitative PCR, and a correlation between samples was made using the Kappa index. Patients were divided into two groups according to the detection of baseline expression levels of PGC-1α in blood samples, and comparisons between both groups were made by chi-square test or unpaired Student’s t-test as appropriate. [Results]: Based on myocardial biopsies, we found that mRNA PGC-1α expression in blood samples showed a statistically significant correlation with myocardial expression (Kappa index 0.66, p, Grant from Sociedad Valenciana de Cardiología, 2013 to Óscar Fabregat-Andrés.

ResumenIntroducción y objetivosComparar requerimientos transfusionales intra y postoperatorios inmediatos entre pacientes sometidos a recambio valvular aórtico por miniesternotomía en «J» y por esternotomía media longitudinal.MétodosEstudiados 655 pacientes sometidos a recambio valvular aórtico entre 2005 y 2013, 498 por abordaje convencional (grupoC) y 120 por abordaje mínimamente invasivo (grupoM). Confeccionados 120 emparejamientos mediante propensity score matching, basado en 18 variables preoperatorias. Analizado número de transfusiones de hemoderivados intraoperatoriamente y hasta 72 h del postoperatorio.ResultadosNo se encontraron diferencias significativas en variables preoperatorias, incluidos valores de hemoglobina, hematocrito y recuento de plaquetas. El porcentaje de pacientes transfundidos del grupo M fue menor: 52,5% vs. 63,3% (p = 0,089) para concentrado de hematíes 11,6% vs. 24,1% (p = 0,012) para unidades de plaquetas y 14,5% vs. 27,5% (p = 0,011) para plasma fresco congelado. La cantidad de hemoderivados transfundidos también fue menor en el grupo M: 1,74±2,17 vs. 2,23±2,57 (p = 0,112) para concentrado de hematíes; 0,13±0,38 vs. 0,32±0,38 (p = 0,007) para unidades de plaquetas y 0,30±0,77 vs. 0,59±1,12 (p = 0,002) para plasma fresco congelado. El abordaje mínimamente invasivo se presenta como factor protector ante la necesidad transfusional de unidades de plaquetas y plasma fresco congelado: OR 0,414 (0,206-0,832) p = 0,013 y OR 0,435 (0,227-0,834) p = 0,012. En el análisis de morbimortalidad, la transfusión de plasma fresco congelado se presenta como factor de riesgo positivo: OR 4,182 (1,287-13,588), p = 0,017.ConclusiónEl abordaje mínimamente invasivo disminuye las necesidades transfusionales de hemoderivados y de esta manera las complicaciones asociadas a las mismas.AbstractIntroduction and objectivesTo compare intraoperative and postoperative transfusion requirements in patients undergoing aortic valve replacement by mini-sternotomy in “J” vs conventional sternotomy.MethodsThe study included 655 patients who underwent aortic valve replacement between 2005 and 2013, with 498 patients by the conventional approach (groupC) and 120 by a minimally invasive approach (groupM). A propensity score matching was performed to find 120 matched pairs based on 18 preoperative variables. An analysis was made of the number of blood units transfused intraoperatively and up to 72hours postoperatively.ResultsNo significant differences were found in preoperative variables, including hemoglobin, hematocrit, and platelet count. The percentage of transfused patients in group M was lower: 52.5% vs 63.3% (P=.089) for packed red blood cells (RBC); 11.6% vs 24.1% (P=.012) for platelet pool, and 14.5% vs 27.5% (P=.011) for fresh frozen plasma (FFP). The number of units of blood transfused was also lower in the M group: 1.74±2.17 vs 2.23±2.57 (P=.112) for RBC; 0.13±0.38 vs 0.32±0.38 (P=.007) for platelet units and 0.30±0.77 vs 0.59±1.12 (P=.002) for FFP. The minimally invasive approach shows to be a protective factor for platelets and FFP transfusion: OR 0.414 (0.206 to 0.832), P=.013 and OR 0.435 (0.227 to 0.834), P=.012, respectively. In the analysis of mortality, FFP transfusion was a risk factor for mortality: OR 4.182 (1.287 to 13.588) P=.017.ConclusionThe minimally invasive approach reduces blood transfusion requirements and thus the complications related to it.