Occult arterial bleeding associated with cardiac device implantation.

The appearance of hematomas or hemorrhages after the implantation of a cardiac implantable electronic device (CIEDs) is a well-known early complication, which can be associated with reinterventions, infections, readmissions, and longer hospital stays. Occasionally, these bleedings may correspond to arterial hemorrhages, which require early identification and specific treatment. We reviewed two clinical cases of inadvertent arterial bleeding after Pacemaker implantation that required a high clinical suspicion together with a multidisciplinary evaluation of cardiologists, radiologists and interventional medicine that allowed a fast and effective endovascular approach.

[Long-term survival of patients with severe aortic stenosis undergoing transcatheter aortic valve implantation].

Background: Transcatheter aortic valve implantation (TAVI) is an effective and safe option for low, medium and high-risk patients with severe aortic stenosis (SAS).

Aim: To analyze the clinical results and long-term survival of TAVI in our center.

Material And Methods: Prospective analysis of 53 patients aged 73 ± 10 years with a Society of Thoracic Surgeons (STS) score of 7.

Age-Related Changes in the Anatomy of the Triangle of Koch: Implications for Catheter Ablation of Atrioventricular Nodal Re-entry Tachycardia.

Background: Atrioventricular nodal re-entrant tachycardia is the most common type of paroxysmal supraventricular tachycardia. We sought to assess whether important anatomic factors, such as the location of the slow pathway, proximity to the bundle of His, and coronary sinus ostium dimensions, varied with patient age, and whether these factors had an impact on procedural duration, acute success, and complications.

Methods: Baseline demographic and procedural data were collected, and the maps were analyzed.

Perinatal cardiopulmonary adaptation to the thin air of the Alto Andino by a native dweller, the llama.

Most mammals have a poor tolerance to hypoxia, and prolonged O restriction can lead to organ injury, particularly during fetal and early postnatal life. Nevertheless, the llama () has evolved efficient mechanisms to adapt to acute and chronic perinatal hypoxia. One striking adaptation is the marked peripheral vasoconstriction measured in the llama fetus in response to acute hypoxia, which allows efficient redistribution of cardiac output toward the fetal heart and adrenal glands.

[Experience of continuing online education in gastroenterology for non specialist medical doctors].

Background: Continuing education is essential for health professions and online courses can be a good way for professional development.

Aim: To describe the experience with online courses for continuing education in hepatology and gastroenterology and to analyze their educational impact.

Material And Methods: A three years' experience in courses on liver diseases and digestive tract is described.

The role of nitric oxide signaling in pulmonary circulation of high- and low-altitude newborn sheep under basal and acute hypoxic conditions.

Nitric oxide (NO) is the main vasodilator agent that drives the rapid decrease of pulmonary vascular resistance for the respiratory onset during the fetal to neonatal transition. Nevertheless, the enhanced NO generation by the neonatal pulmonary arterial endothelium does not prevent development of hypoxic pulmonary hypertension in species without an evolutionary story at high altitude. Therefore, this study aims to describe the limits of the NO function at high-altitude during neonatal life in the sheep as an animal model without tolerance to perinatal hypoxia.

The role of nitric oxide in the cardiopulmonary response to hypoxia in highland and lowland newborn llamas.

Key Points: Perinatal hypoxia causes pulmonary hypertension in neonates, including humans. However, in species adapted to hypoxia, such as the llama, there is protection against pulmonary hypertension. Nitric oxide (NO) is a vasodilatator with an established role in the cardiopulmonary system of many species, but its function in the hypoxic pulmonary vasoconstrictor response in the newborn llama is unknown.

[Comparative evaluation of survival prognosis using MELD or Child-Pugh scores in patients with liver cirrhosis in Chile].

Background: Currently, most liver units use the Child-Pugh (CP) or the Model for End-Stage Liver Disease (MELD) scores to establish survival prognosis among patients with liver cirrhosis. Which classification is superior, is not well defined.

Aim: To compare CP and MELD classification scores to predict survival among adult patients with liver cirrhosis in Chile.

Association between cagA, vacAi, and dupA genes of Helicobacter pylori and gastroduodenal pathologies in Chilean patients.

In addition to the already known cagA gene, novel genetic markers have been associated with Helicobacter pylori (H. pylori) virulence: the dupA and vacAi genes. These genes might play an important role as specific markers to determine the clinical outcome of the disease, especially the vacAi gene, which has been expected to be a good marker of severe pathologies like gastric adenocarcinoma.

Microbiota dysbiosis: a new piece in the understanding of the carcinogenesis puzzle.

Cancer is defined as an uncontrolled proliferation of malignant cells in a host and it is one of the main causes of death worldwide. Genetic and environmental factors play an important role in its development, and the involvement of microbial communities has also recently been recognized. The close relationship that characterizes the colonization by human commensal communities involves health risks, particularly when the homeostasis is disturbed.

Probiotic Lactobacillus fermentum UCO-979C biofilm formation on AGS and Caco-2 cells and Helicobacter pylori inhibition.

The ability of the human isolate Lactobacillus fermentum UCO-979C to form biofilm and synthesize exopolysaccharide on abiotic and biotic models is described. These properties were compared with the well-known Lactobacillus casei Shirota to better understand their anti-Helicobacter pylori probiotic activities. The two strains of lactobacilli synthesized exopolysaccharide as detected by the Dubois method and formed biofilm on abiotic and biotic surfaces visualized by crystal violet staining and scanning electron microscopy.

Management of nonalcoholic fatty liver disease: an evidence-based clinical practice review.

Aim: To build a consensus among Chilean specialists on the appropriate management of patients with nonalcoholic fatty liver disease (NAFLD) in clinical practice.

Methods: NAFLD has now reached epidemic proportions worldwide. The optimal treatment for NAFLD has not been established due to a lack of evidence-based recommendations.

High-frequency, low-intensity vibrations increase bone mass and muscle strength in upper limbs, improving autonomy in disabled children.

Disuse osteoporosis in children is a progressive disease that can affect quality of life. High-frequency, low-magnitude vibration (HFLMV) acts as an anabolic signal for bone and muscle. We undertook a prospective, randomized, double-blind, placebo-controlled clinical trial to assess the efficacy and safety of regional HFLMV in disabled children.

Application of cost-effectiveness analysis to demonstrate the potential value of companion diagnostics in chronic myeloid leukemia.

Aim: A cost-effectiveness analysis was performed to assess the potential value of companion diagnostics in supporting treatment decisions for dasatinib and nilotinib in chronic myeloid leukemia.

Materials & Methods: A decision model was developed, and model inputs were taken from the literature and publicly available sources. The perspective of the healthcare sector in the Netherlands was used.

Liver transplantation results for hepatocellular carcinoma in Chile.

Unlabelled: Hepatocellular carcinoma (HCC) is the most common malignant tumor of the liver. Liver transplantation is the best treatment for HCC; it improves survival, cures cirrhosis, and abolishes local recurrence. We describe the outcomes of patients with HCC who underwent liver transplantation in two liver transplantation centers in Chile.

Bridge therapy in hepatocellular carcinoma before liver transplantation: the experience of two Chilean centers.

Background: Orthotopic liver transplantation (OLT) is currently an established therapy for small, early-stage hepatocellular carcinoma (HCC) within the Milan criteria. Long waiting times due to the shortage of donor organs can result in tumor progression and drop-out from OLT candidacy. Therefore a wide variety of procedures are necessary before OLT.

[General considerations, indications and contraindications for liver transplantation in Chile: a multicenter consensus development document].

Liver transplantation is an excellent therapeutic option for terminal liver disease. During the last decades the results of liver transplantation have improved significantly with a patient survival rate of nearly 90% at one year and 80% at 5 years of follow-up. The main indications for liver transplantation include: end-stage liver disease associated to cirrhosis, acute liver failure, and hepatic tumors (mainly hepatocarcinoma).

Carbon monoxide: a novel pulmonary artery vasodilator in neonatal llamas of the Andean altiplano.

Aims: To study the nitric oxide (NO) and carbon monoxide roles in the regulation of the pulmonary circulation in lowland and highland newborn sheep and llamas.

Methods And Results: We used neonatal sheep (Ovis aries) and llamas (Lama glama) whose gestation and delivery took place at low (580 m) or high (3600 m) altitude. In vivo, we measured the cardiopulmonary function basally and with a NO synthase (NOS) blockade and calculated the production of carbon monoxide by the lung.

Evolving in thin air--lessons from the llama fetus in the altiplano.

Compared with lowland species, fetal life for mammalian species whose mothers live in high altitude is demanding. For instance, fetal llamas have to cope with the low fetal arterial PO2 of all species, but also the likely superimposition of hypoxia as a result of the decreased oxygen environment in which the mother lives in the Andean altiplano. When subjected to acute hypoxia the llama fetus responds with an intense peripheral vasoconstriction mediated by alpha-adrenergic mechanisms plus high plasma concentrations of catecholamines and neuropeptide Y (NPY).