La región subtropical húmeda de la provincia de Formosa, en el Nordeste Argentino (Lat. -25,2024130; Long. -58,1212980), presenta una zona de condiciones climáticas para el cultivo de banana (Mussa ...spp.). Los materiales de este cultivo son una mezcla de clones indiferenciados del subgrupo Cavendish. En la selección de material genético adaptado, el primer enfoque fue el análisis sobre las condiciones agroclimáticas en las cuales deberá desarrollarse el material, en producción hacía el 2025–2030. El segundo enfoque fue determinar el grado de polimorfismo fenotípico y molecular existente entre los clones cultivados por Agricultores Familiares. En 2012 se marcaron, en la región subtropical norte de Formosa, 684 clones que mostraron estabilidad de rendimiento. Los criterios de selección fueron resiliencia, ciclo, rendimiento y forma de las manos. Un total de 140 clones seleccionados se implantaron en diseño estadístico aumentado. Con cuatro ciclos de producción, 36 variables (fenológicas, comportamiento a campo y productivas) registradas, marcadores moleculares y datos climáticos se construyó un índice de selección, del cual se desprenden tres Variedades Sintéticas, cada una de ellas conformadas por cuatro Líneas Avanzadas Inta (LAI). En las tres variedades se ha tenido especial atención a las características comerciales, algo esencial para llegar a los mercados. La selección de materiales con características distintas es muy importante en un ambiente variable, las variedades sintéticas nos parecen adecuadas para este tipo de situación, otorgándole mayor resiliencia
Banana micropropagation for obtaining free-virus plants frequently provokes somaclonal variation that could increase useful genetic variability in this asexually propagated crop. Both exploring the ...cycle of in vitro culture in which somaclonal variation occurs and the amount of generated polymorphism, are necessary. In this work, preliminary results of somaclonal variation during early cycles of banana in vitro culture are reported. Four randomly selected regenerated plants from the fifth cycle and two samples from the mother plant were analyzed. A total of 36 AFLP primer combinations were assayed, and 24 of them produced amplicons varying among 50- 500 bp. The mother plant presented a total of 125 different amplicons while the regenerated plants jointly showed 131 different amplicons with a mean of 119.75 ± 3.97 per individual. High level of DNA polymorphism (24.43 %) was found among micropropagated plants and, additionally, the occurrence of somaclonal variation at earlier cycles was suggested by multivariate analysis of Principal Coordinates. In this study, somaclonal variation at early cycles of banana micropropagation was validated and the adequacy of AFLP technique to assess it at the molecular level was verified. The phenotypic effects of the detected somaclonal variations remain to be evaluated.
Intestinal and free-living protozoa, such as Giardia lamblia, express a dense coat of variant-specific surface proteins (VSPs) on trophozoites that protects the parasite inside the host's intestine. ...Here we show that VSPs not only are resistant to proteolytic digestion and extreme pH and temperatures but also stimulate host innate immune responses in a TLR-4 dependent manner. We show that these properties can be exploited to both protect and adjuvant vaccine antigens for oral administration. Chimeric Virus-like Particles (VLPs) decorated with VSPs and expressing model surface antigens, such as influenza virus hemagglutinin (HA) and neuraminidase (NA), are protected from degradation and activate antigen presenting cells in vitro. Orally administered VSP-pseudotyped VLPs, but not plain VLPs, generate robust immune responses that protect mice from influenza infection and HA-expressing tumors. This versatile vaccine platform has the attributes to meet the ultimate challenge of generating safe, stable and efficient oral vaccines.
La producción de banana sobre bases científicas es relativamente nueva en Argentina. Para evaluar la productividad potencial en la provincia de Formosa, se ensayaron cuatro variedades internacionales ...de banana durante cuatro campañas en el campo experimental de la Estación Experimental Agropecuaria de INTA Chaco-Formosa. También se aplicaron datos para determinar el tamaño de parcela óptimo para conferir robustez estadística a los ensayos de campo. Se detectaron diferencias entre variedades y entre campañas, pero su interacción no fue significativa. No obstante, un análisis biplot identificó patrones de rendimientos diferenciales y combinaciones específicas de variedad-campaña. Según el método de la curvatura máxima, el tamaño de la parcela debe incluir de 6 a 8 plantas de cada variedad para una confianza estadística óptima de los ensayos de campo. Sin embargo, dado que la banana es un cultivo perenne y que el medioambiente argentino no es óptimo para su producción, no todas las plantas se cultivan todos los años. Por lo tanto, se propone un número óptimo de 10 plantas para asegurar la confianza estadística en los ensayos de campo de la provincia de Formosa.
Abstract
Background
Nivolumab is a monoclonal antibody targeting programmed cell death protein 1 (PD-1), with a demonstrated clinical efficacy against metastatic cancer. Immunotherapy cardiovascular ...toxicity is rare, but recent scientific literature demonstrated possible and different cardiovascular side effects. Nivolumab was found to be associated with fatal acute myocarditis with diffuse myocardial necrosis and heart failure. To our knowledge no case of Nivolumab induced Tako-tsubo syndrome has ever been reported.
Case presentation
A 76-year-old woman was admitted to the emergency department for dyspnoea with electrocardiographic evidence of extensive anterior ST segment elevation (Figure 1A); the patient was hemodynamically unstable with increasing shortness of breath and oxygen desaturation (arterial blood pressure 90/50 mmHg, heart rate 120 beats/min, O2 Sat. 87%). She was scheduled for urgent coronary angiography which eventually demonstrated no significant coronary artery disease. The ventriculography revealed dyskinesis of the left apex and peri-apical segments and basal hyperkinesis (Figure 1B). The final diagnosis was stress cardiomyopathy or Tako-tsubo syndrome. The echocardiogram performed in the acute setting revealed severe left ventricular impairment (ejection fraction, EF = 30%) confirming the typical apical ballooning pattern of the syndrome (Figure 1C). Left ventricular outflow tract obstruction was not found. At admission, the level of TroponinT was mildly elevated (745 ng/L) and NT-proBNP was 35 000 pg/ml. The patient was treated with optimal heart failure medical therapy with gradual and complete left ventricular function recovery (EF at discharge = 55%). Of note, the patient had a history of primary lung adenocarcinoma firstly treated in 2017 with carboplatin; due to cancer progression she had undergone Nivolumab therapy in October 2018 with a total of three cycles, the last one interrupted one month before the cardiovascular event due to ipokaliemia and mild renal impairment. At that time the patient was defined as having a good functional status. Apart from the oncologic treatment, patient’s history did not reveal any "acute" stressful event.
Conclusions
To the best of our knowledge this is the first Takotsubo cardiomyopathy ever detected after Nivolumab therapy. Stress cardiomyopathy is a rare but possibly severe complication that could appear in the course of oncological treatment and, in this backdrop, its aetiology is not well understood. As a matter of fact, cardiac function monitoring and strict clinical follow-up for early detection of complications is mandatory in these patients. Favourable outcomes may be achieved with early diagnosis and prompt treatment introduction.
Abstract P710 Figure. Diagnostic evaluation of Takotsubo Sdr
Abstract Background telemedicine plays a crucial role in managing patients with Cardiac Implantable Electronic Devices (CIEDs), offering unique technical and clinical benefits. This study explores ...the characteristics of a real–world population of CIED recipients undergoing entirely remote follow–up. Methods and Results in a prospective evaluation of 808 consecutive CIED patients from two Italian Cardiology Centers (2021–2023), initial on–site assessments were followed by remote evaluations, either scheduled or alert–triggered. The majority received pacemakers (68.8%), with others having Implantable Defibrillators (19.3%) or Implantable Loop Recorders (11.9%). The average age was 75.6±12.6 years, and 42% were female. Most of the patients were retired (83.3%), and 73% required at least one caregiver. The EQ–5D score indicated a lower quality of life (8.9±4.3) compared to the Italian general population. During the observation period (20.6 months), 34.9% of patients were admitted to the hospital, with 50% of cases being cardiovascular–related. Heart failure was the most common cause (13.2%). Device–related issues prompted outpatients’ cardiology clinic Department evaluations in 13.4% of cases. The telemedicine program produced 2780 remote transmissions, with 23% being automatic alerts. In–clinic evaluations were 1313, with a mean duration of 19.2 minutes. Atrial fibrillation (AF) history was prevalent (40.2%), and 719 AF episodes occurred during the observation period. Conclusions Managing CIED patients via telemedicine is feasible but requires structured organization considering patient characteristics and possible outcomes. AF management is crucial, given its high prevalence. Older age and compromised quality of life are significant factors, partly mitigated by the widespread presence of caregivers. Despite remote follow–up, many patients access healthcare structures for cardiovascular reasons, emphasizing the need for distinct pathways for device–related and general care necessities.
Abstract
Background
Current guidelines recommend implantable cardioverter defibrillator (ICD) for primary prevention of sudden cardiac death in patients with left ventricular ejection fraction (2DE ...LVEF) by two-dimensional echocardiography≤ 35%. However, new echocardiography parameters of LV function such as the mechanical dispersion (MD), the LVEF by three-dimensional echocardiography (3DE) and the global myocardial work index (GWI) have been reported to provide a more accurate stratification of the arrhythmic risk, and potentially improve ICD patient selection.
Purpose
We wanted to compare the arrhythmic risk predictive power of the new parameters of LV function with the conventional 2DLVEF.
Material and Methods
we prospectively enrolled 216 patients (63 ± 12 years, 88% men) with organic heart diseases and 2DE LVEF <50%, in whom we re-measured LVEF using 3DE, and obtained MD and GWI using 2DE speckle tracking. Major arrhythmic events were defined as sudden cardiac death, sustained ventricular tachycardia, ventricular fibrillation and appropriate ICD shocks. We assessed the predictive power of 4 different parameters: 2DE LVEF< 35%; 3DE LVEF< 35%; MD > 80 ms; and GWI< 672 mmHg% to identify patients at risk of major arrhythmic events.
Results
During a mean follow-up of 27 ± 24 months, 24 patients (10%) experienced sudden cardiac death, whereas 28 patients (13%) presented major arrhythmic events. The predictive power in terms of major arrhythmic events prediction (Harrel C statistics) improved from 0.67 (95%CI 0.57-0.76) for 2DE LVEF< 35%, to 0.73 (95%CI 0.64-0.82) for 3DE LVEF< 35%, and 0.77 (95%CI 0.68-0.86) for GWI < 672 mm Hg%. Whereas, MD > 80 ms showed a limited predictive power (HCS= 0.53, 95%CI 0.41-0.76)).
Conclusions
GWI< 672 mm Hg% was the most accurate predictor of major arrhythmic events among echocardiography parameters in patients with organic heart disease and LVEF < 50%.
Abstract
BACKGROUND
New automated approaches for left heart chamber quantification based on adaptive analytics algorithms have been introduced for both two- (2DE) and three-dimensional (3DE) ...echocardiography. These algorithms measure a left ventricular ejection fraction (LVEF) and reduce the intra- and inter-observer variability associated with the conventional manual tracing of LV endocardial borders. However, the clinical utility of these algorithms in the sudden cardiac death (SCD) risk stratification of patients with organic heart disease remains to be clarified.
PURPOSE
We sought to test the feasibility and the accuracy of two automated algorithms that measure 2DE and 3DE LVEF in patients with impaired LV systolic function and to define the cut-off values for fully automated 2DE and 3DE LVEF that could predict major arrhythmic events (MAE). We wanted also to assess the feasibility of replacing manual 2DE and semi-automated (SA) 3DE LVEF with fully-automated (FA) 2DE and 3DE LVEF respectively, in the stratification of high arrhythmic risk patients.
METHODS
We prospectively enrolled 240 patients (63 ± 13 years, 81% men) with both ischemic and non-ischemic cardiomyopathy with 2DE LVEF < 50%, no previous MAE or coronary artery revascularization < 90 days, after at least 3 months of optimal medical therapy for heart failure. MAE were defined as SCD, resuscitated cardiac arrest (CA), ventricular fibrillation, sustained ventricular tachycardia and appropriate ICD shocks. The risk detection cut-off values for 2DE and 3DE FA LVEF were computed using the maximally selected rank statistics method. In order to predict the risk of MAE we created four different risk models, including both clinical characteristics (age, NYHA class, aetiology of the LV dysfunction) and imaging-derived data (2DE manual LVEF, 2DE FA LVEF, 3DE SA LVEF and 3DE FA LVEF), analyzed by a ROC curve.
RESULTS
During a 27 ± 25months follow-up period, 31 patients (13%) presented MAE including SCD (n= 22; 9%), resuscitated CA (n = 3; 1%) and appropriate ICD shocks (n = 6; 2%). Both 2DE and 3DE FA LVEF showed high feasibility (92% and 95%, respectively), and good agreement with conventional LVEF (2DE mean difference 4 ± 7%, and 3DE mean difference 4 ± 7%). We identified two FA LVEF cut-offs for the MAE detection: 2DE <39% (p = 0.006) and 3DE <37% (p = 0.005). The model including the 2DE FA LVEF showed an area under the curve (AUC) larger than the one including conventional 2DE LVEF (0.83 vs 0.80). Conversely, the AUC obtained with FA 3DE LVEF model was slightly lower than the one obtained using SA 3DE LVEF model (0.80 vs 0.84).
CONCLUSIONS
Both 2DE and 3DE FA LVEF are feasible and accurate alternative to the conventional (manual) or SA endocardial border tracing. The use of specific FA 2DE LVEF cut-off values showed a comparable predictive power in the MAE risk stratification compared to the conventional one with the advantage of very low intra- and inter-observer variability.
Intestinal and free-living protozoa, such as Giardia lamblia, express a dense coat of variantspecific surface proteins (VSPs) on trophozoites that protects the parasite inside the host's intestine. ...Here we show that VSPs not only are resistant to proteolytic digestion and extreme pH and temperatures but also stimulate host innate immune responses in a TLR-4 dependent manner. We show that these properties can be exploited to both protect and adjuvant vaccine antigens for oral administration. Chimeric Virus-like Particles (VLPs) decorated with VSPs and expressing model surface antigens, such as influenza virus hemagglutinin (HA) and neuraminidase (NA), are protected from degradation and activate antigen presenting cells in vitro. Orally administered VSP-pseudotyped VLPs, but not plain VLPs, generate robust immune responses that protect mice from influenza infection and HA-expressing tumors. This versatile vaccine platform has the attributes to meet the ultimate challenge of generating safe, stable and efficient oral vaccines.
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