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Cerebral white-matter lesions (cWML) can be caused by dilation of Virchow–Robin spaces or may correspond to true lacunar ischemic lesions. The aim of our study was to evaluate in asymptomatic divers the relationship between the presence of patent foramen ovale (PFO) and cWML, as well as their possible effects on cortical cerebral blood flow (CBF) by magnetic resonance (MRI) through the arterial spin labeling (ASL) sequence. Transthoracic echocardiography was performed for the identification of PFO, and cerebral magnetic resonance including the 3D-ASL sequence for CBF quantification. Thirty-eight divers, with a mean age 45.8 ± 8.6 years, were included. Nineteen healthy volunteers, mean age 41 ± 15.2 years, served as the control group. A total of 28.9% of divers had completed more than 1000 dives. It was found that 26.3% of divers presented with PFO in the echocardiographic study. cWML was evidenced in 10.5% of diver MRI studies. There was no statistically significant relationship between the presence of PFO and cWML (p = 0.95). We observed a lower blood flow in all brain areas assessed by the 3D-ASL sequence in the group of divers, compared with the control group. We did not find statistical differences in CBF as a function of the presence or absence of PFO, number of dives, or cWML evidence.

BACKGROUND: Cardiovascular magnetic resonance (CMR) is a precise tool for the assessment of cardiac anatomy, function, and tissue composition. However, studies providing CMR reference values in adolescence are scarce. We aim to provide sex-specific CMR reference values for biventricular and atrial dimensions and function and myocardial relaxation times in this population. METHODS: Adolescents aged 15–18 years with no known cardiovascular disease underwent a non-contrast 3-T CMR scan between March 2021 and October 2021. The imaging protocol included a cine steady-state free-precession sequence for the analysis of chamber size and function, as well as T2-GraSE and native MOLLI T1-mapping for the characterization of myocardial tissue. FINDINGS: CMR scans were performed in 123 adolescents (mean age 16 ± 0.5 years, 52% girls). Mean left and right ventricular end-diastolic indexed volumes were higher in boys than in girls (91.7 ± 11.6 vs 78.1 ± 8.3 ml/m(2), p

This study sought to examine the correlation between left ventricular (LV) myocardial feature tracking (FT) and deep learning-based strain (DLS) analysis in the diagnostic (CMRd) and follow-up (CMRf) cardiac magnetic resonance imaging of patients with acute myocarditis. The retrospective study included 17 patients with acute myocarditis and 20 healthy controls. The CMRd took place within 14 days of symptom onset, while the CMRf took place at least 2 months after the event. The global-circumferential FT (FTc) and global-circumferential DLS (DLSc) were analyzed. The continuous variables were compared using paired t-tests or the Wilcoxon test, whereas Pearson’s test or Spearman’s test was used to evaluate the correlation between the continuous variables. The time between the CMRd and CMRf was 5 months [3–11]. The LV ejection fraction (LVEF) was 55 ± 6 and 59 ± 4%, p = 0.008, respectively, and 94.1% of the patients showed late gadolinium enhancement (LGE) and myocardial edema on the CMRd. Significantly lower FTc (−16.1 ± 2.2% vs. −18.9 ± 1.9%, p = 0.001) and DLSc (−38.1 ± 5.2% vs. −41.3 ± 4.5%, p = 0.015) were observed with respect to the controls. Significant increases in the FTc (−16.1 ± 2.2 vs. −17.5 ± 1.9%, p = 0.016) and DLSc (−38.1 ± 5.2 vs. −39.8 ± 3.9%, p = 0.049) were found between the CMRd and CMRf, which were unrelated to the LGE. The LVEF correlated well with the FTc (r = 0.840) and DLSc (r = 0.760). Both techniques had excellent reproducibility, with high intra- (FTc = 0.980, DLSc = 1.000) and inter-observer (FTc = 0.970, DLSc = 0.980) correlation. There was correlation between the LV DLSc/FTc and LVEF in the patients with acute myocarditis according to the CMRd and CMRf.

INTRODUCTION AND OBJECTIVES According to the wavefront phenomenon described in the late 1970s, myocardial infarction triggered by acute coronary occlusion progresses with increasing duration of ischemia as a transmural wavefront from the subendocardium toward the subepicardium. However, whether wavefront progression of necrosis also occurs laterally has been disputed. We aimed to assess the transmural and lateral spread of myocardial damage after acute myocardial infarction in humans and to evaluate the impact of metoprolol on these. METHODS We assessed myocardial infarction in the transmural and lateral dimensions in a cohort of 220 acute ST-segment elevation myocardial infarction (STEMI) patients from the METOCARD-CNIC trial (Effect of Metoprolol in Cardioprotection During an Acute Myocardial Infarction). The patients underwent cardiac magnetic resonance imaging at 5 to 7 days and 6 months post-STEMI. RESULTS On day 5 to 7 post-STEMI cardiac magnetic resonance, there was a strong linear correlation between the transmural and lateral extent of infarction (delayed gadolinium enhancement) (r=-0.88; P

Resumen Introduccion y objetivos Esta establecido que la necrosis secundaria a una oclusion coronaria se inicia en el subendocario y progresa hacia el subepicardio. Sin embargo, hay controversia sobre la posibilidad de que la onda de progresion del infarto sea lateral, ademas de transmural, y es el objetivo de este trabajo. Metodos Se estudio la extension del infarto en las dimensiones transmural y lateral en 220 pacientes con infarto agudo de miocardio del ensayo METOCARD-CNIC (Efecto del metoprolol en la cardioproteccion durante un infarto agudo de miocardio). Los pacientes se sometieron a 2 resonancias magneticas. Resultados En la resonancia de los dias 5-7 posinfarto, se encontro una fuerte correlacion lineal entre las extensiones transmural y lateral del infarto (realce tardio de gadolinio) (r = -0,88; p Conclusiones Nuestros hallazgos cuestionan el dogma de que la progresion del infarto solo se produce en sentido transmural. Mostramos que el infarto progresa de forma circunferencial (en sentido tanto transmural como lateral). Esto implica que las terapias cardioprotectoras pueden asociarse con miocardio salvado en los bordes laterales del infarto. Este estudio ha sido registrado en ClinicalTrial.gov (Identificador: NCT01311700).

Microbially influenced corrosion (MIC) is an aggressive type of corrosion that occurs in aquatic environments and is sparked by the development of a complex biological matrix over a metal surface. In marine environments, MIC is exacerbated by the frequent variability in environmental conditions and the typically high diversity of microbial communities; hence, local and in situ studies are crucial to improve our understanding of biofilm composition, biological interactions among its members, MIC characteristics, and corrosivity. Typically, material performance and anticorrosion strategies are evaluated under controlled laboratory conditions, where natural fluctuations and gradients (e.g., light, temperature, and microbial composition) are not effectively replicated. To determine whether MIC development and material deterioration observed in the laboratory are comparable to those that occur under service conditions (i.e., field conditions), we used two testing setups, in the lab and in the field. Stainless steel (SS) AISI 316L coupons were exposed to southeastern Pacific seawater for 70 days using (i) acrylic tanks in a running seawater laboratory and (ii) an offshore mooring system with experimental frames immersed at two depths (5 and 15 m). Results of electrochemical evaluation, together with those of microbial community analyses and micrographs of formed biofilms, demonstrated that the laboratory setup provides critical information on the early biofilm development process (days), but the information gathered does not predict deterioration or biofouling of SS surfaces exposed to natural conditions in the field. Our results highlight the need to conduct further research efforts to understand how laboratory experiments may better reproduce field conditions where applications are to be deployed, as well as to improve our understanding of the role of eukaryotes and the flux of nutrients and oxygen in marine MIC events.

Resumen Introduccion El diagnostico de enfermedad inflamatoria intestinal (EII) se realiza, en un alto porcentaje, durante la edad reproductiva. La EII en remision es el mejor escenario para planificar el embarazo. Objetivos Describir las caracteristicas clinicas del embarazo y del recien nacido, evaluando la actividad de la enfermedad en el momento de la concepcion y en la evolucion del embarazo en un centro terciario en Chile. Metodos Estudio observacional, retrospectivo, incluyo a mujeres con EII que habian tenido un parto durante 2017-2020. Los datos demograficos, clinicos y obstetricos se obtuvieron del Registro de EII. Se realizo analisis estadistico descriptivo y de asociacion (χ2, p ≤ 0,05). Resultados Se incluyeron 60 mujeres en el estudio. Al inicio del embarazo, 21 (35%) presentaban actividad inflamatoria y 39 (65%) estaban en remision. Del grupo con actividad, 16 (66%) permanecieron activas y seis tuvieron un aborto espontaneo. Aquellas en remision, 26 (69%) permanecieron en esta condicion; nueve pacientes (15%) habian suspendido el tratamiento, seis de las cuales presentaron actividad durante el embarazo. El consejo preconcepcional fue realizado en 23/60 pacientes, siendo mayor en el grupo que permanecio en remision durante el embarazo (65% vs. 35%, p = 0,02). Pacientes con brotes durante el embarazo tuvieron mayor probabilidad de embarazo pretermino ( Conclusion La remision durante el embarazo presenta los mejores resultados y el consejo preconcepcional permite un mejor control de la EII durante el embarazo.

espanolIntroduccion El tratamiento de la enfermedad inflamatoria intestinal (EII) puede aumentar el riesgo de infeccion. La inmunizacion es parte del manejo integral de la atencion de estos pacientes. El objetivo de este estudio es describir la prescripcion y adherencia a la vacunacion en pacientes con EII e identificar los posibles factores asociados a esta. Metodos Estudio analitico, descriptivo, transversal en pacientes de un Programa de EII de Chile, entre abril y junio de 2019. A los pacientes se les solicito responder un cuestionario acerca de la adherencia a la vacunacion. La informacion de las vacunas se obtuvo del Registro Nacional de Inmunizaciones. Se realizo analisis estadistico descriptivo y de asociacion (χ2; p Resultados Se incluyeron 243 pacientes con EII (148 colitis ulcerosa [CU], 86 enfermedad de Crohn [EC] y 9 EII no clasificable). Solo 6 pacientes (2%) recibieron el esquema de inmunizacion completo. Las vacunas con los mayores porcentajes fueron contra la influenza (67%), virus hepatitis B (40%), neumococica 13-valente (34%) y neumococica 23-polisacarida (16%), siendo las dos primeras mas frecuentes en EC vs. CU (p ≤ 0,05). La administracion de la vacuna contra la influenza ha aumentado significativamente, alcanzando un 67% el 2019. La encuesta mostro que el 23% no ha sido inmunizado con ninguna vacuna, principalmente por falta de tiempo, falta de prescripcion medica y el alto costo economico. Conclusiones En esta cohorte, aunque las tasas de vacunacion son mas altas que las reportadas previamente, la adherencia al programa de inmunizacion debe mejorar, siendo consideradas desde el diagnostico por el equipo multidisciplinario. EnglishIntroduction Inflammatory Bowel Disease (IBD) treatment may increase the risk of infections. Vaccines are part of the comprehensive IBD patient care. The aim of this study was to describe indications and adherence of immunizations in IBD and identify possible associated factors. Methods A cross-sectional, analytic study was conducted in patients from an IBD Program of a tertiary center in Chile, between April – June 2019. Patients were asked to answer a vaccine survey and information also was obtained from the National Immunization Registry. Descriptive and association statistic were used (χ2; p Results A total of 243 patients were included (148 ulcerative colitis (UC), 86 Crohn's disease (CD) and 9 non-classifiable IBD). Only six patients (2%) of IBD patients received a complete immunization schedule. The highest vaccine rates were against influenza (67%), hepatitis B virus (40%), 13-valent pneumococcal (34%) and 23-polysaccharide pneumococcal (16%). The influenza vaccine rate has significantly increased, reaching 67% in 2019. The survey showed that 23% of patients have not been immunized with any vaccine, mainly due to lack of time, lack of medical prescription and high cost. Conclusions In this cohort, although vaccination rates are higher than previously reported, adherence to IBD immunization program would be improved, being considered since diagnosis by the multidisciplinary team.

The prevalence of inflammatory bowel disease (IBD) increased in the last decades. Thus, the number of pregnant women with the condition is also increasing. Given that active disease itself is the main risk factor for complications during pregnancy, it is necessary to achieve a complete remission before planning a pregnancy. Also, pregnant women with IBD must be monitored noninvasively and be treated proactively, including escalated therapies, if needed, to prevent potential flares during pregnancy. Patients can undergo vaginal delivery in most forms of IBD. However, cesarean delivery is still preferable in women with a history of ileal pouch-anal anastomoses (IPAA) or active perianal disease.

Background Checkpoint inhibitors (CPIs) such as Pembrolizumab have recently become the standard treatment for Non-Small Cell Lung Cancers (NSCLC) in patients without Epidermal Growth Factor (EGFR) gene alterations. Previous reports suggest no significant benefit from CPI treatments among EGFR mutant NSCLC patients and recommend the use of Tyrosine Kinase Inhibitors such as Afatinib. Case presentation: Herein, we report a rare case of a 39-year old, light-smoker woman with a metastatic EGFR mutant NSCLC (exon-19 deletion) that exhibited rapid progression and an unusual clinical response to Afatinib without changes in tumor histology. Tumor was negative for PDL1. Biopsy analyses by NGS prior and after Afatinib treatment indicated an increase in focal somatic copy number alterations (fSCNAs) but no T790M or c-MET amplification, and a low Tumor Mutational Burden (TMB). Given her rapid progression and deterioration, and despite its PDL1- status and her low TMB patient started treatment with Pembrolizumab plus chemotherapy. Surprisingly, patient displayed a complete response after just 4 cycles and is soon to complete a year in remission. Conclusions We speculate intratumoral heterogeneity, the combination of radiotherapy plus immunotherapy or the concomitant use of chemotherapy plus immunotherapy could explain the observed response in this patient. Also, based in our data we suggest the SBRT/CPI combination could be an option for Tyrosine Kinase Inhibitor-refractory EGFR mutant NSCLC patients or as a second-line treatment.

El nuevo coronavirus (SARS-CoV-2) apareció en China en diciembre de 2019. Desde su inicio hasta abril de 2020 se ha expandido por todo el mundo, afectando a más de tres millones de personas. Su ascenso exponencial sigue creciendo, generando miles de muertes. Su contagiosidad es persona a persona por gotitas, pudiendo llegar a generar un cuadro clínico de infección respiratoria conocido como COVID-19. Algunos pacientes tienen más riesgos de tener un curso desfavorable; adultos mayores, pacientes con enfermedad cardiovascular, hipertensos y diabéticos. Nuestros pacientes con enfermedad inflamatoria intestinal son un grupo de pacientes con características particulares, muchos de ellos reciben tratamiento inmunosupresor por largos períodos, lo que pudiese suponer un riesgo específico. Las sociedades científicas de Europa y Norteamérica han realizado un esfuerzo conjunto para generar datos, compartir experiencias y dictar recomendaciones de buen manejo clínico. Esta es una revisión de la evidencia disponible, opiniones de expertos y formas de trabajo propuestos durante la pandemia.

The passive film depends on the alloy's composition and the exposure conditions. How the surface composition affects the selection of microbial biofilms though, has not been fully elucidated or incorporated into the analysis of corrosive biofilms. The degradation of stainless steel (SS) exposed to natural seawater was studied to understand how the oxide layer composition of SS could affect the selection and variability of the bacterial community. To accomplish this goal, austenitic and superferritic SS grades were exposed to natural seawater on the central coast of Chile. The deterioration of steel and qualitative description of biofilm formation was monitored at different exposure periods. Biofilms were evaluated based on massive sequencing analysis of the bacterial community and subsequent ecological studies. The results revealed that variability of the calculated corrosion rate correlated with the similarity of the bacterial community within samples from each SS and its corrosion inferred capacity. The associated bacterial families showed a higher representation in SSs with a more significant increase in the Fe/Cr ratio over the exposure time. These findings revealed that iron content in the oxide layer represents a key feature of the surface composition for selecting bacterial assemblages in marine environments.

Recently, contrast-enhanced mammography (CEM) has emerged as a reliable alternative to breast magnetic resonance imaging (MRI) for the assessment of pathological response in breast cancer patients. Our study sought to determine the diagnostic accuracy of CEM to predict pathological complete response (pCR) in patients who received neoadjuvant chemotherapy (NACT).We retrieved the medical records of patients who underwent NACT at our institution. Using post-surgery pCR, morphological evidence and CEM enhancement tumours were classified as follows: 1) radiologic complete response (rCR); 2) functional radiological complete response (frCR); and 3) non-complete response. Initially, we used multivariate analyses adjusted by clinical variables and frCR or rCR to determine which variables affected pathological response. Then, CEM diagnostic accuracy to discriminate pCR was assessed using receiver operating characteristic curves in univariate and multivariate models including either frCR or rCR.A total of 48 patients were included in our study. Most patients (68.7%) were hormone receptor (HR)+ and 41.6% (20) of the patients achieved pCR. Using univariate logistic regression analyses we found that HR status, HER2 status, rCR and frCR had a significant impact on CEM diagnostic accuracy. Exploratory analyses found that CEM sensitivity was higher for HR- tumours. Multivariate logistic regression analyses found 60% sensitivity, 92.9% specificity and 79.2% accuracy in a model that included clinical variables and rCR.CEM is a reliable alternative to high-cost, time-consuming breast MRI that predicts pCR in patients undergoing NACT; CEM diagnostic accuracy was higher among patients who harboured HR- tumours.

Delayed gadolinium-enhanced cardiac magnetic resonance (LGE-CMR) imaging requires novel and time-efficient approaches to characterize the myocardial substrate associated with ventricular arrhythmia in patients with ischemic cardiomyopathy. Using a translational approach in pigs and patients with established myocardial infarction, we tested and validated a novel 3D methodology to assess ventricular scar using custom transmural criteria and a semiautomatic approach to obtain transmural scar maps in ventricular models reconstructed from both 3D-acquired and 3D-upsampled-2D-acquired LGE-CMR images. The results showed that 3D-upsampled models from 2D LGE-CMR images provided a time-efficient alternative to 3D-acquired sequences to assess the myocardial substrate associated with ischemic cardiomyopathy. Scar assessment from 2D-LGE-CMR sequences using 3D-upsampled models was superior to conventional 2D assessment to identify scar sizes associated with the cycle length of spontaneous ventricular tachycardia episodes and long-term ventricular tachycardia recurrences after catheter ablation. This novel methodology may represent an efficient approach in clinical practice after manual or automatic segmentation of myocardial borders in a small number of conventional 2D LGE-CMR slices and automatic scar detection. The Centro Nacional de Investigaciones Cardiovasculares (CNIC) is supported by the Instituto de Salud Carlos III (ISCIII), the Ministerio de Ciencia e Innovación and the ProCNIC Foundation (Madrid, Spain). The CNIC and the Barcelona Supercomputing Center (BSC, Barcelona, Spain) are Severo Ochoa Centers of Excellence (SEV-2015-0505 and SEV-2011-0067, respectively). This study was also supported by grants from the Fondo Europeo de Desarrollo Regional (CB16/11/00458), the Ministerio de Ciencia e Innovación (PID2019-109329RB-I00) and the Heart Rhythm Association of the Spanish Society of Cardiology (ARC). The study was also part of a Master Research Agreement between CNIC and Philips Healthcare. The study was partially supported by the Fundación Interhospitalaria para la Investigación Cardiovascular (FIC, Madrid, Spain) and the Fundación Eugenio Rodríguez Pascual (Madrid, Spain). J.A.-S. is funded by the CompBioMed2 project grant agreement 823712, H2020-EU.1.4.1.3 European Union’s Horizon 2020 research and innovation program, the SILICOFCM project, grant agreement 777204, H2020-EU.3.1.5 and by a Ramón y Cajal fellowship (RYC-2017-22532), MINECO, Spain. L.K.G was funded by the Fundación Carolina-BBVA. Grant TEC2017-82408-R is also acknowledged. Peer Reviewed "Article signat per 25 autors/es: Susana Merino-Caviedes, Lilian K. Gutierrez, José Manuel Alfonso-Almazán, Santiago Sanz-Estébanez, Lucilio Cordero-Grande, Jorge G. Quintanilla, Javier Sánchez-González, Manuel Marina-Breysse, Carlos Galán-Arriola, Daniel Enríquez-Vázquez, Carlos Torres, Gonzalo Pizarro, Borja Ibáñez, Rafael Peinado, Jose Luis Merino, Julián Pérez-Villacastín, José Jalife, Mariña López-Yunta, Mariano Vázquez, Jazmín Aguado-Sierra, Juan José González-Ferrer, Nicasio Pérez-Castellano, Marcos Martín-Fernández, Carlos Alberola-López & David Filgueiras-Rama"

Besides its protective effect against neutrophil-mediated injury at reperfusion, intravenous (IV) metoprolol was recently shown to reduce the progression of ischemic injury in a pig model of ST-segment elevation myocardial infarction (STEMI). Here, we tested the hypothesis that IV metoprolol administration in humans with ongoing STEMI blunts the time‑dependent progression of ischemic injury assessed by serial electrocardiogram (ECG) evaluations before reperfusion. The METOCARD-CNIC trial randomized 270 anterior STEMI patients to IV metoprolol or control before reperfusion by percutaneous coronary intervention (PCI). In 139 patients (69 IV metoprolol, 70 controls), two ECGs were available (ECG-1 before randomization, ECG-2 pre-PCI). Between-group ECG differences were analyzed using univariate and multivariate regression models. No significant between-group differences were observed on ECG-1. On ECG-2, patients who received IV metoprolol had a narrower QRS than those in the control group (84 ms vs. 90 ms, p = 0.029), a lower prevalence of QRS distortion (10% vs. 26%, p = 0.017), and a lower sum of anterior and total ST-segment elevation (10.1 mm vs. 13.6 mm, p = 0.014 and 10.4 mm vs. 14.0 mm, p = 0.015, respectively). Adjusted analysis revealed similar results. Significant associations were observed between ECG-2 variables and cardiac magnetic resonance imaging measurements (extent of myocardial edema, infarct size, microvascular obstruction, and left-ventricular ejection fraction) after STEMI. In summary, IV metoprolol administration before reperfusion ameliorates ECG markers of myocardial ischemia in anterior STEMI patients. These data confirm that IV metoprolol is able to reduce ischemic injury and highlight the ability of ECG analysis to provide relevant real-time information on the effect of cardioprotective therapies before reperfusion. Spanish Ministry of Science and Innovation (MICINN) RETOS2019-107332RB-I00 to B.I. Instituto de Salud Carlos III (ISCIII) PI19/01704 to R.F-J. European Research Council ERC-CoG 819775-MATRIX to B.I. European Union Horizon 2020 research and innovation programme under Marie Skłodowska-Curie grant agreement No 707642 to R.F-J. The METOCARD-CNIC trial was sponsored by the CNIC (Translational Grant 01-2009), the Spanish National Ministry of Health and Social Policy (EC10-042), and the Mutua Madrileña Foundation (AP8695-2011). This study forms part of a Master Research Agreement between the CNIC and Philips Healthcare. The CNIC is supported by the ISCIII, the MICINN, and the Pro CNIC Foundation, and is a Severo Ochoa Center of Excellence (SEV-2015–0505). Sí

The calcified nodule has been established as the least common underlying substrate in the acute coronary syndrome; however calcium can be widely present in other acute-common scenarios. In this setting, the optical coherence tomography (OCT) study has identified 3 different types of calcification according to morphology. Former studies have already documented calcified nodules in patients with peripheral artery disease; however the different patterns that exist beyond coronary arteries remain unknown. An 80-year-old patient was referred for coronary angiography following systolic dysfunction. The coronary angiography performed through right radial approach showed a severely calcified vessel (mid portion of the left anterior descending artery) and mitral and aortic calcification. The OCT pullback performed with 6 mL of contrast at 3 mm/seg through the radial artery removed 4 cm of the radial sheath and showed multiple calcified plaques (mid portion of the artery) defined by the presence of superficial, well-established, low-backscattering and heterogeneous regions (video 1 of the supplementary data). The simultaneous angiography co-registration confirmed the presence of ulnar artery occlusion.

El nódulo calcificado se ha establecido como el último sustrato subyacente en el síndrome coronario agudo; no obstante, el calcio está presente frecuentemente en otros escenarios agudos. La tomografía de coherencia óptica (OCT) ha logrado identificar en este sentido 3 patrones distintos de calcificación atendiendo a su a morfología. Estudios previos han documentado nódulos calcificados en pacientes con enfermedad arterial periférica; sin embargo, la presencia de distintos patrones morfológicos de calcificación sigue siendo desconocida. Paciente de 80 años derivado para angiografía coronaria por presentar disfunción sistólica. La coronariografía realizada mediante abordaje radial reveló la presencia de enfermedad calcificada grave de un vaso (porción media de la descendente anterior izquierda) así como calcificación mitral y aórtica. Los pullbacks de OCT realizados desde la arteria radial (6 ml de contraste a 3 mm por segundo, retirando 4 cm la vaina radial) revelaron la presencia de varias placas calcificadas (porción media de la arteria) definidas por la presencia de regiones heterogéneas, superficiales, bien definidas y con baja retrodispersión (vídeo 1 del material adicional). El corregistro angiografíco confirmó la presencia de una oclusión en la arteria ulnar.

Although potentiodynamic polarization is a common technique for determining corrosion current, there is no consensus on the choice of scanning parameters. This study explores a 1D mathematical model of copper under oxygen reduction in a chloride containing medium to quantify the effects of scan rate, starting overpotential, and scan direction on the features of polarization curve. All the relevant tendencies of the cathodic branch are reproduced experimentally and explained by local oxygen consumption and coverage by CuCl. The corresponding effects on the precision of determining corrosion current are discussed, revealing that the largest deviation of up to 50% is obtained for the slowest scan rate and largest starting overpotential.

Objectives This study sought to evaluate the effect of early intravenous metoprolol on left ventricular (LV) strain assessed with feature-tracking cardiovascular magnetic resonance (CMR). Background Early intravenous metoprolol before primary percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI) portends better outcomes in the METOCARD-CNIC (Effect of Metoprolol in Cardioprotection During an Acute Myocardial Infarction) trial. Methods A total of 197 patients with acute anterior STEMI who were enrolled in the METOCARD-CNIC trial (100 allocated to intravenous metoprolol before primary PCI and 97 control patients) were evaluated. LV global circumferential strain (GCS) and global longitudinal strain (GLS) were measured with feature-tracking CMR at 1 week and 6 months after STEMI and compared between randomization groups. Results Patients who received early intravenous metoprolol had significantly more preserved LV strain compared with the control patients at 1 week after STEMI (GCS −13.9 ± 3.8% vs. −12.6 ± 3.9%, respectively; p = 0.013; GLS −11.9 ± 2.8% vs. −10.9 ± 3.2%, respectively; p = 0.032). In both groups, LV strain significantly improved during follow-up (mean difference between 6-month and 1-week strain for the metoprolol group: GCS −2.9%, 95% confidence interval [CI]: −3.5% to −2.4%; GLS: −2.9%, 95% CI: −3.4% to −2.4%; both p Conclusions In patients with anterior STEMI, early administration of intravenous metoprolol before primary PCI was associated with significantly fewer patients with severely depressed LV GCS and GLS, both at 1 week and 6 months. Feature-tracking CMR represents a complementary tool to evaluate the benefits of cardioprotective therapies. (Effect of METOprolol in CARDioproteCtioN During an Acute Myocardial InfarCtion [METOCARD-CNIC]: NCT01311700)

Anti-tumour necrosis factor α therapy in inflammatory bowel disease has been shown to be effective in clinical practice. After more than a decade using these therapies the question arises about whether there is an appropriate time to suspend these therapies, and how this should be done. This review aims to evaluate the current evidence on these topics concerning anti-tumour necrosis factor α therapies, and eventually identify conditions and subgroups of patients that could potentially be candidates for withdrawal.

Resumen La efectividad de la terapia con farmacos antifactor de necrosis tumoral α en la enfermedad inflamatoria intestinal ha sido probada en la practica clinica. Tras mas de una decada de uso de este tipo de farmacos, surge la interrogante acerca de si existe un momento apropiado para suspender estas terapias, y de que manera esta debiera realizarse. Esta revision tiene por objetivo evaluar la evidencia actual acerca del retiro de la terapia con antifactor de necrosis tumoral α y, eventualmente, identificar las condiciones o los subgrupos de pacientes potencialmente candidatos a la suspension o el retiro de esta.