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Introduction: Coronary Ectasia (CE) is a pathological remodeling with a low worldwide prevalence. It is defined as a diffuse dilatation greater than 1.5 times the diameter of the adjacent segments of the same or different coronary arteries., Objective: To document the clinical and angiographic characteristics, and medical treatment at the discharge of patients diagnosed with coronary ectasia who attended the National Institute of Cardiology (INC)., Methods: Cross-sectional study with a non-experimental descriptive design, with a non-probabilistic convenience sampling., Results: Of 69 patients who attended the INC with a diagnosis of CD, most were men, with a mean age of 56 + 11 years, the most common coronary risk factor in patients with CE was smoking 58% (40); it was associated mostly with an acute myocardial infarction ST-segment elevation (STEMI) 65.2% (45), of frequent location in the lower face 40% (18), correlated with the most affected artery is the Right Coronary Artery (CD) 69.6% (48), followed by the circumflex (Cx) 56.5% (39). A mean LVEF of 47 + 9.72 was evident within the ventricular function. As well as the preferential use of dual antiplatelet therapy with anticoagulant (DAP + OAC) in 58% (40) at the discharge of each patient from the INC., Conclusion: CE is a not uncommon pathological remodeling in INC. This study showed that STEMI is the most typical manifestation of CE, diagnostic coronary angiography identified a type 3 Markis, so a low rate of mortality and recurrence of cardiovascular events would be expected, and despite the lack of consensus on the ideal therapy, at the INC individualized treatment is preferred, recommending lifestyle changes, and using triple therapy (DAP + OAC) as a medical treatment only at the time of patient discharge., (Copyright: © 2023 Permanyer.)

Background: Canine monocytic ehrlichiosis (CME) is caused by the tick-borne pathogen Ehrlichia canis, an obligate intracellular Gram-negative bacterium of the family Anaplasmataceae with tropism for canine monocytes and macrophages. The trp36 gene, which encodes for the major immunoreactive protein TRP36 in E. canis, has been successfully used to characterize the genetic diversity of this pathogen in different regions of the world. Based on trp36 sequence analysis, four E. canis genogroups, United States (US), Taiwan (TWN), Brazil (BR) and Costa Rica (CR), have been identified. The aim of this study was to characterize the genetic diversity of E. canis in Cuba based on the trp36 gene., Methods: Whole blood samples (n = 8) were collected from dogs found to be infested with the tick vector Rhipicephalus sanguineus sensu lato (s.l.) and/or presenting clinical signs and symptoms of CME. Total DNA was extracted from the blood samples and trp36 fragments were amplified by PCR. Nucleotide and protein sequences were compared using alignments and phylogenetic analysis., Results: Four of the trp36 sequences obtained (n = 8) fall within the phylogenetic cluster grouping the US genogroup E. canis strains. The other E. canis trp36 sequences formed a separate and well-supported clade (94% bootstrap value) that is phylogenetically distant from the other major groups and thus represents a new genogroup, herein designated as the 'Cuba (CUB) genogroup'. Notably, dogs infected with the CUB genogroup presented frequent hemorrhagic lesions., Conclusions: The results of this study suggest that genetic diversification of E. canis in Cuba is associated with the emergence of E. canis strains with increased virulence., (© 2022. The Author(s).)

Introduction: In current European guidelines for the management of myocardial infarction after coronary stent placement, there is no consensus on dual antiplatelet therapy (DAPT) ideal duration to prevent stent thrombosis-restenosis without significantly increasing the bleeding risk., Objective: To report the percentage of major bleeding and presence of major cardiovascular events associated with prolonged DAPT in patients recruited at the National Institute of Cardiology, treated with primary percutaneous coronary intervention and stent., Methods: A longitudinal, prospective, observational, non-experimental, descriptive study was carried out. Patients were recruited from November 2016 to December 2017., Results: One hundred and thirty-five patients with a mean age of 57 ± 10 years who completed the three-year follow-up were selected. Obesity and hypertension stood out as the main risk factors. After using DAPT for three years, 3.7% of mortality, 1.48% of major bleeding, and 4.4% of thrombosis-restenosis were recorded., Conclusions: Prolonged use of DAPT would be justified by the high incidence of thrombosis-restenosis, without a significant increase in bleeding risk, as well as a decrease in major cardiovascular events., (Copyright: © 2022 Permanyer.)

This study aimed to verify the presence of IgG antibodies against Borrelia burgdorferi sensu lato (s.l) in domestic dogs in western Cuba. Serum samples were analyzed by indirect enzyme-linked immunosorbent assay (ELISA), using crude antigens of a B. burgdorferi strain of North American origin. To verify the presence of Borrelia spp., deoxyribonucleic acid (DNA) extracted from individual blood samples was analyzed by nested-PCR, with markers targeted for amplification of portions of the flagellin B gene (flaB) present in Borrelia spirochetes. Ticks were also collected through inspection of the animals. Sera from 93 of 176 (52.84%) dogs were reactive to the indirect ELISA. Geographic prevalence varied from 54.35% (25/46) in Boyeros, 44.44% (20/45) in Cotorro, 66.67% (22/33) in Habana del Este, and 50% (26/52) in San José de las Lajas. There was no statistical difference between these tested variables. No blood samples analyzed were positive for the Borrelia flaB gene.

Ehrlichia canis is a rickettsia transmitted by the tick, Rhipicephalus sanguineus, and is the causative agent of canine monocytic ehrlichiosis (CME). In Cuba, the first diagnosis of CME was made in 2001, but few studies have since investigated this disease locally. The objective of this study was to estimate the prevalence of E. canis in dogs domiciled in four municipalities within the western region of Cuba and determine the associated risk factors. Blood was drawn from 378 selected dogs living in four municipalities in two provinces of western Cuba. From the total number of samples, 206 plasma samples were selected to perform an enzyme-linked immunosorbent assay (ELISA) to detect antibodies against E. canis. Using the original 378 samples of extracted DNA, a nested polymerase chain reaction (nPCR) was performed to amplify a specific fragment of the 16S rRNA gene of E. canis. Analysis of the 206 plasma samples revealed a total of 162 animals that were seropositive for E. canis (78.64%) with a density index between 109.5 and 970.7. In contrast, 179 samples were positive based on the nPCR assay (47.35%). As well, there was a high concordance (kappa = 0.7), calculated through the Kappa index, between the animals found to be positive based on nPCR and those determined based on ELISA. The analysis of risk factors showed that residing in the municipality of Boyeros in addition to having a history of infestation by ticks increases the probability of having a positive result based on nPCR., (Copyright © 2018 Elsevier B.V. All rights reserved.)

We investigated the prevalence of IgG antibodies to Toxoplasma gondii in 176 dogs from Havana Province and Mayabeque Province, Cuba, by indirect enzyme-linked immunosorbent assay (iELISA). The overall prevalence was 72.72% (128/176). Dogs living on the cemented floor environment were significantly higher (p=0.01) in being positive for T. gondii. The high detection of antibodies to T. gondii parasite confirms the outstanding dogs in the West of the Cuban provinces, which is a potential hazard in the region, not only for dogs, but also for public health, considering it is a zoonosis of great importance., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Canine cyclic thrombocytopenia, an infectious disease caused by Anaplasma platys is a worldwide dog health problem. This study aimed to detect and characterize A. platys deoxyribonucleic acid (DNA) in dogs and ticks from Cuba using molecular methods. The study was conducted in four cities of Cuba (Habana del Este, Boyeros, Cotorro and San José de las Lajas). Blood samples were collected from 100 dogs in these cities. The animals were inspected for the detection of tick infestation and specimens were collected. Genomic DNA was extracted from dog blood and ticks using a commercial kit. Genomic DNA samples from blood and ticks were tested by a nested polymerase chain reaction (nPCR) to amplify 678 base pairs (bp) from the 16S ribosomal DNA (rDNA) of A. platys. Positive samples in nPCR were also subjected to PCR to amplify a fragment of 580bp from the citrate synthase (gltA) gene and the products were sequenced. Only Rhipicephalus sanguineus sensu lato (s.l.) was found on dogs, and 10.20% (n=5/49) of these ticks plus sixteen percent (16.0%, n=16/100) of dogs were considered positive for A. platys by nPCR targeting the 16S rDNA gene. All analyzed gltA and 16S rDNA sequences showed a 99-100% identity with sequences of A. platys reported in around the world. Phylogenetic analysis showed two defined clusters for the 16S rDNA gene and three defined clusters for the gltA gene. Based on the gltA gene, the deduced amino acid sequence showed two mutations at positions 88 and 168 compared with the sequence DQ525687 (GenBank ID from Italian sample), used as a reference in the alignment. A preliminary study on the epidemiological aspects associated with infection by A. platys showed no statistical association with the variables studied (p>0.05). This is the first evidence of the presence of A. platys in dogs and ticks in Cuba. Further studies are needed to evaluate the epidemiological aspects of A. platys infection in Cuban dogs., (Copyright © 2016 Elsevier GmbH. All rights reserved.)

Brain vascular malformations are relatively common lesions that cause serious neurologic disability or death in a significant proportion of individuals bearing them. The purpose of this study was to analyze the clinicopathologic and immunohistochemistry these lesions, looking for common antibodies expressed such as CD31, CD34, CD15, factor VIII, nestin, vimentin, vascular endothelial grow factor (VEGF), vascular endothelial grow factor receptor-2 (VEGF-R2), glial fibrillar acidic protien (GFAP), and fibroblastic grow factor β (β-FGF) and ultrastructure in endothelial cells as well as in vessel walls. Fifty cases of vascular lesions were included in this study: 29 (58%) of them were arteriovenous malformations and 21 (52%) were brain cavernomas. Twenty-six (52%) patients were women and 24 (48%) men. The age range was from 13 to 68 years (mean age, 35.86 ± 15.19 years). The size of the lesions ranged between 1 and 8 cm (3 ± 1.65 cm), and parieto-occipital lesions had a bigger size. Evolution time varied from 1 month to 1 year (mean, 7.5 months). There was a significant statistical correlation between age and sex (P = -035), rupture of lesion (P = .015), brain hemorrhage (P = .033), necrosis (P = .011), hemosiderin deposit (P = .042), VEGF (P = .015), and VEGFR (P = .037), as well as localization of rupture (P = .017), loss of consciousness (P = .000), visual deficit (P = .026), hyaline vessels (P = .000), and CD31 (.009). Interactions between endothelial cells and mural cells (pericytes and vascular smooth muscle cells) in blood vessel walls have recently come into focus as central processes in the regulation of vascular formation, stabilization, remodeling, and function in brain vascular lesions. However, the molecular mechanisms that underlie the formation and growth of brain arteriovenous malformations are still poorly understood., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Despite a population of close to 40 million Hispanics/Latinos in the USA who have at least some level of Spanish/English bilingualism, there are few neuropsychological tests and norms available for this group, especially when assessing Spanish/English bilingual children. The purpose of the present research was to provide preliminary normative data for a bilingual population on a comprehensive neuropsychological battery developed for Spanish-speaking children (Evaluación Neuropsicológica Infantil). Norms by age are presented on the performance of 108 Spanish/English bilingual children (ages 5-14 years) and are expected to be useful when testing other Spanish/English bilingual children in the USA.

In a national survey, 82% of U.S. neuropsychologists who offered services to Hispanics self-reported inadequate preparation to work with this population (Echemendia, Harris, Congett, Diaz, & Puente, 1997). The purpose of this paper is to improve the quality and accessibility of neuropsychological services for Hispanic people living in the United States by giving guidance for service delivery, training, and organizational policy. General guidance towards this end comes from professional ethics for psychologists and interpreters/translators, federal civil rights law, the International Test Commission, and the Office of Minority Health of the U.S. Department of Health and Human Services, among others. This guidance is specifically applied here to cover professional cultural and linguistic competence of neuropsychologists, psychometrists, interpreters, translators, and consultants; languages of evaluation; use of interpreters; evaluation of acculturation; test translation, adaptation, and interpretation; application of test norms; intervention issues; reimbursement; and organizational issues.

Beak and feather disease (psittacine circovirus) and Budgerigar fledgling disease (avian polyomavirus) are viral diseases that can frequently affect captive psittacine birds. We designed the first survey to investigate the presence of beak and feather disease virus (BFDV) and Avian polyomavirus (APV) inside the population of captive psittacine birds in Italy. Samples were collected in 18 Italian psittacine breeding centres and four trade centres over a 4-year period. A total of 1516 birds were tested for BFDV and 877 birds were tested for APV by means of a polymerase-chain-reaction (PCR) assay. BFDV was found in 122 (8.05%) and APV in 7 (0.79%) birds. No significant difference in infection rate was found between imported and locally raised parrots. We report the first BFDV DNA isolation in wild birds imported to Italy from Papua New Guinea.

Patients with systemic lupus erythematosus (SLE) often show cognitive impairment on traditional neuropsychological tests; however, many of these tests are unsuitable for use with mixed ethnic populations. Computer-administered cognitive tests are promising, but have not been validated against traditional tests or with predominantly Hispanic samples. We gave 67 lupus patients a computer-administered test battery (Automated Neuropsychological Assessment Metrics--ANAM) and a battery of traditional neuropsychological tests. The two batteries were compared using correlation and multiple regression analyses. All patients were fluent in English, 54% were Hispanic and 13% were bilingual. Non-Hispanic patients were predominantly European American (37%). About 80% of patients were rated as impaired on traditional tests. Hispanics were younger, had less education and more current SLE disease activity than non-Hispanics; but did not differ in lifetime SLE-related organ damage or current steroid use. Hispanics and younger patients were more impaired on many of the traditional tests, while ANAM was not affected by Hispanic ethnicity or education. ANAM tests were moderately correlated with analogous traditional tests. Age and selected ANAM scores accounted for about 60% of the variance in the traditional battery. These results replicate the high prevalence of cognitive deficits in SLE found by others and suggest that computer-administered tests like ANAM may be useful for assessment of cognitive impairment in mixed-ethnic samples. Confounding variables such as age, education, English language fluency and prior experience with tests were identified and need to be controlled statistically or with comparison groups in future studies.

Objective: The San Antonio Lupus Study of Neuropsychiatric Disease is a longitudinal study designed to characterize the spectrum of and important risk factors for specific neuropsychiatric systemic lupus erythematosus (NPSLE) syndromes., Methods: Subjects must meet criteria for SLE and must be at least 18 years of age. A standardized medical history, neurologic, rheumatologic, and psychiatric examinations, computerized neuropsychological evaluation, and serologic testing are performed., Results: This report is based on the first 128 subjects (120 women and 8 men) who completed the initial study visit. Data from this initial study visit were evaluated for the prevalence of NPSLE using the American College of Rheumatology case definitions for 19 NPSLE syndromes. One or more NPSLE syndromes were present in 80% of subjects: cerebrovascular disease (2, 2%; ischemic stroke); headaches (73, 57%); mononeuropathy (9, 8%; median 8, ulnar 1); movement disorder (1, 1%; chorea); neuropathy, cranial (2, 2%; trigeminal); polyneuropathy (29, 22%; sensorimotor); seizures (21, 16%; partial); anxiety disorder (27, 24%); major depressive-like episode (37, 28%); mood disorder with depressive features (21, 19%); mood disorder with manic features (3, 3%); mood disorder with mixed features (1, 1%); psychosis (6, 5%). In a subset of 67 patients who received standardized neuropsychological testing, 21% had normal results. In the remainder, the following levels of impairment were seen: 43% mild, 30% moderate, and 6% severe., Conclusions: The prevalence of NPSLE was high in this cohort of unselected patients with SLE. Headaches, cognitive dysfunction, and psychiatric disorders were the most common NPSLE syndromes seen. These results will be easily comparable to other studies also using standardized diagnostic criteria. However, the lack of ethnicity and language-matched normative neuropsychological data may make comparisons of cognitive dysfunction in SLE populations difficult.

The treatment of patients with neuropsychiatric systemic lupus erythematosus (NPSLE) can be difficult and complex owing to the variety of nervous system manifestations that can occur, which include peripheral nerve disease, headaches, seizures, cerebrovascular disease, chorea, transverse myelitis, and psychiatric and cognitive disorders. Many of these manifestations can result from metabolic abnormalities or infection or as side effects of medications. Thus, in any patient with suspected NPSLE, it is crucial to exclude secondary causes of the presenting symptoms before assuming that they are due to NPSLE. It is especially important to exclude infection because this is a common cause of both morbidity and mortality in patients with systemic lupus erythematosus (SLE). Symptoms such as anxiety and depression may or may not be related to disease activity. Treatment decisions are based on accurate diagnosis of the specific NPSLE manifestation, which is usually made using tools such as brain imaging, electroencephalography, cerebrospinal fluid analysis, nerve conduction studies, or special serologic tests (eg, determination of antiphospholipid or antiribosomal P antibody levels). It is also important to assess the degree of other SLE- mediated systemic disease activity in a patient with neurologic manifestations to determine if activation of systemic disease activity is also occurring. This is done by measuring complement levels, anti-double-stranded DNA levels, complete blood count, and urinalysis. For some NPSLE manifestations (eg, infrequent seizures, headaches, depression, anxiety, or peripheral neuropathy) that appear without activation of systemic disease, symptomatic treatment is appropriate. For others (eg, psychosis, delirium, or transverse myelopathy without other obvious cause), treatment with high-dose glucocorticoids with or without cyclophosphamide is appropriate whether there is evidence of other systemic disease activity or not. In general, the activity and severity of the leading organ manifestations dictate pharmacologic treatment.