Noninvasive prognostic markers for cardiac death and ventricular arrhythmia in long-term follow-up of subjects with chronic Chagas' disease

The objective of the present study was to investigate clinical, echocardiographic and electrocardiographic (12-lead resting ECG, 24-h ambulatory ECG monitoring and signal-averaged ECG (SAECG)) parameters in subjects with chronic Chagas' disease in a long-term follow-up as prognostic markers for adverse outcomes. Fifty adult outpatients (34 to 74 years old, 31 females) staged according to Los Andes class I, II or III and complaining of palpitation were enrolled in a longitudinal study. SAECG was analyzed in time and frequency domains and the endpoint was a composite of cardiac death and ventricular tachycardia. During a follow-up of 84.2 ± 39.0 months, 34.0% of the patients developed adverse outcomes (9 cardiac deaths and 11 episodes of ventricular tachycardia). After optimal dichotomization, in a stepwise multivariate Cox-hazard regression model, apical aneurysm (HR = 3.7; 95% CI = 1.2-1.3; P = 0.02), left ventricular ejection fraction <62% (HR = 4.60; 95% CI = 1.39-15.24; P = 0.01) and incidence of ventricular premature contractions >614 per 24 h (hazard ratio = 6.1; 95% CI = 1.7-22.6; P = 0.006) were independent predictors of the composite endpoint. Although a high frequency content in SAECG demonstrated association with the presence of left ventricular dysfunction and myocardial fibrosis, its predictive value for the composite endpoint was not significant. Apical aneurysms, reduced left ventricular function and a high incidence of ventricular ectopic beats over a 24-h period have a strong predictive value for a composite endpoint of cardiac death and ventricular tachycardia in subjects with chronic Chagas' disease.

Mechanical cardiac remodeling and new-onset atrial fibrillation in long-term follow-up of subjects with chronic Chagas' disease

Atrial fibrillation (AF) affects subjects with Chagas' disease and is an indicator of poor prognosis. We investigated clinical, echocardiographic and electrocardiographic variables of Chagas' disease in a long-term longitudinal study as predictors of a new-onset AF episode lasting >24 h, nonfatal embolic stroke and cardiac death. Fifty adult outpatients (34 to 74 years old, 62% females) staged according to the Los Andes classification were enrolled. During a follow-up of (mean ± SD) 84.2 ± 39.0 months, 9 subjects developed AF (incidence: 3.3 ± 1.0%/year), 5 had nonfatal stroke (incidence: 1.3 ± 1.0%/year), and nine died (mortality rate: 2.3 ± 0.8%/year). The progression rate of left ventricular mass and left ventricular ejection fraction was significantly greater in subjects who experienced AF (16.4 ± 20.0 g/year and -8.6 ± 7.6%/year, respectively) than in those who did not (8.2 ± 8.4 g/year; P = 0.03, and -3.0 ± 2.5%/year; P = 0.04, respectively). In univariate analysis, left atrial diameter ≥3.2 cm (P = 0.002), pulmonary arterial hypertension (P = 0.035), frequent premature supraventricular and ventricular contraction counts/24 h (P = 0.005 and P = 0.007, respectively), ventricular couplets/24 h (P = 0.002), and ventricular tachycardia (P = 0.004) were long-term predictors of AF. P-wave signal-averaged ECG revealed a limited long-term predictive value for AF. In chronic Chagas' disease, large left atrial diameter, pulmonary arterial hypertension, frequent supraventricular and ventricular premature beats, and ventricular tachycardia are long-term predictors of AF. The rate of left ventricular mass enlargement and systolic function deterioration impact AF incidence in this population.

Efecto de gelificantes en la formulación de dulce de yacón

El yacón (Smallanthus sonchifolius) es un tubérculo andino cultivado en las laderas de los Andes. Es una planta perenne que llega a su madurez entre 6-7 meses hasta 1 año, según la altura sobre el nivel del mar. Este trabajo propone la formulación de un producto alimenticio a partir de yacón por agregado de solutos: glucosa y sacarosa y combinación de barreras de estrés. Se estudió el efecto de gelificantes: agar-agar, pectina y goma arábiga, en tres concentraciones: 0,30, 0,41 y 0,48%. Se agregó benzoato de sodio, metabisulfito de sodio y ácido cítrico. Se desarrolló un dulce tipo pan. Se registró la evolución de temperatura durante la cocción. Se empacó y envasó el dulce en bandejas. Se analizaron parámetros de textura principales y secundarios. La formulación que alcanzó valores de textura similares a la referencia fue: 0,48% de agar-agar; 12% de sacarosa; 17% de glucosa; 23% de agua; 996,75 ppm de metabisulfito; 498,50 ppm de ácido cítrico y 1435,7 ppm de benzoato de sodio. Se realizó una prueba sensorial a través de la evaluación de los parámetros más representativos de la textura, utilizando para ello una escala hedónica, determinando la aceptación de la formulación seleccionada.

El escepticismo radical de Pierre Gassendi contra la filosofía natural de los aristotélicos

Este artículo tiene como objetivo dar cuenta del escepticismo radical de Pierre Gassendi propuesto en el Exercitationes paradoxicae Adversus Aristoteleos (Disertaciones paradójicas contra los aristotélicos). Para dar cuenta de ello nuestro artículo se divide en tres momentos: Primero, damos cuenta de la estructura de la obra; segundo, se presentan los argumentos centrales propuestos por Gassendi para comprender su actitud crítica al escolasticismo. Y tercero, se muestra la crítica que realiza a la lógica aristotélica. La idea fundamental que sostenemos en este trabajo es que la actitud crítica y de libre pensador que caracterizó a Gassendi tuvo su origen directo en la actitud escéptica. Además, revisar su obra de juventud y su actitud filosófica nos permite comprender una parte importante del alcance del escepticismo en la reforma de la filosofía natural del siglo XVII.