ABSTRACT Therapeutic options are limited for patients with advanced heart failure who become refractory to conventional drug therapies. Knowing the non-pharmacological alternatives in the management of these patients is essential in their comprehensive evaluation, and it is the second therapeutic option in this group of increasingly prevalent patients.

RESUMEN Las opciones terapéuticas son limitadas para los pacientes con insuficiencia cardíaca avanzada que se vuelven refractarios a las terapias farmacológicas convencionales. Conocer las alternativas no farmacológicas en el tratamiento de estos enfermos resulta imprescindible en su evaluación integral, y es la segunda opción terapéutica en este grupo de enfermos cada vez más prevalentes.

ABSTRACT Heart failure is an increasingly prevalent disease, which requires additional blood tests that not only confirm what is clinically presumed, but also be useful in the prognostic evaluation of those who suffer from it. In this context, biomarkers with practical utility appeared in the heart failure guidelines, at the beginning of the year 2000. With diagnostic, prognostic and evolutionary indications in each clinical stage of this disease, both in acute and chronic stages, its use draws guidelines and strategies in the adequate treatment of these patients. In this review article, a brief approach to the subject is made.

RESUMEN La insuficiencia o falla cardíaca es una enfermedad cada día más prevalente y precisa de complementarios que no solo confirmen lo presumido clínicamente, sino que también sean útiles en la evaluación pronóstica de quienes la padecen. En ese contexto aparecen en las guías de insuficiencia cardíaca, a inicios del año 2000, los biomarcadores con utilidad práctica. Con indicaciones diagnósticas, pronósticas y evolutivas, en cada momento clínico de esta enfermedad, tanto en fase aguda como crónica, su utilización traza pautas y estrategias en el tratamiento adecuado de estos enfermos. En este artículo de revisión se hace un breve acercamiento al tema.

The distribution and frequency of Escherichia coli virotypes can vary considerably from region to region, due to the geographical characteristics, the degree of social lag as well as the population of each region. Therefore, the objective of the present work was to compare Escherichia coli isolated from children with diarrhea obtained from two states with different levels of social lag and establish virotypes, adhesion to HEp-2 cells, biofilm formation, and antimicrobial resistance of this bacterium. In the present work, we compared E. coli isolated from children with diarrhea obtained from the City of San Luis Potosí (S.L.P.) with E. coli isolated from children with diarrhea of Mexico (City CDMX), with the purpose of identifying and establishing virotypes, adherence to HEp-2 cells, formation of biofilms, and antimicrobial resistance of these bacteria. The results showed that the percentage of virotypes found in S.L.P., were higher with respect to the virotypes found in the CDMX, being enterotoxigenic the most frequent virotype for both populations. The incidence of this virotype was higher for E. coli isolated from S.L.P., and the statistical analysis showed p < 0.000. The incidence of the enteroinvasive and EHEC virotypes was higher in the state of S.L.P., with p < 0.000. The adhesion phenotype, both aggregative and diffuse, was related to the presence of the aat and astA genes. The tests to determine the production of biofilms in strains of E. coli, allowed us to determine that the method in Congo red agar, were the most effective for its evaluation. In relation to the antimicrobials tested, a higher percentage of resistance of the E. coli strains of the CDMX was observed, in relation to the strains of S.L.P., with a statistically significant difference of p < 0.05.

At birth, mammals make the transition from aseptic surroundings to a pathogen-filled environment, it is known that different factors modulate immune responses, but in the digestive tract breast milk (BM) may play an important role in the maturation of the immune response, mainly in relation to the gut. In this sense, it has been demonstrated that besides nutrients and antibodies, BM contains cells, hormones, cytokines, and growth factors. The objective of this work was to evaluate the importance of BM in the development of both the piglet and the intestinal microbiota. For this, two groups of piglets were formed; one suckled with the saw and the other suckled with BM substitute. Stool samples were taken for bacterial identification, this was done through the VITEK-system, and subsequently, the serotype was identified. The results showed that the piglets suckled with BM substitute 18 (100%) presented diarrheal episodes from the 2nd day, of this group two piglets presented bloody diarrhea, and the group fed with the mother only 7 (38.8%) had diarrheic episodes from the 5th day. All isolates 285 were Escherichia coli. The largest number of isolates obtained of piglets suckled with BM belonged to serotype O103:H28 and largest number of isolates obtained of piglets suckled with milk substitute belonged to serotype O166:H21. Serotypes belonged to bloody diarrhea were O103:H28 and O166:H21. The present work showed the importance of BM both in the body development of the piglet and in the protection against infections.

At birth, mammals make the transition from aseptic surroundings to a pathogen-filled environment; hence, the gut is constantly exposed to high antigenic. The mucosal epithelial layer of the gut forms the interface between the external and internal environments of the gastrointestinal tract (GIT) that in newborns allows the passage of nutrients for the maturation of cells in different tissues. In addition to this physiological barrier, an immunological barrier is created and maintained by immune cells located in the gut-associated lymphoid tissue (GALT). The first contact of the pathogens with the host is carried out through the GALT, and it constitutes the most extensive and complex part of the immune system. Aim: The aim of the study was to investigate the development of the intestinal immune response in the suckling rat model. Methods: The location and temporal appearance of the different subsets of B-cells in the GALT and the spleen of suckling and weaning rats were studied histologically using the immunoperoxidase method. Results: The results showed that the number of B-cells of the suckling and weaning rats increases progressively with age; on day 21 when weaning took place, there was an important increase in all B-cells subsets. Mesenteric lymph nodes (MLN) showed the most apparent B-cell subset changes. Interestingly, subpopulations of IgA B-cells and IgG B-cells appear early at 3 days old in NLM unlike Peyer's patches where these subpopulations appear at 12 and 6 days, respectively, which may indicate that the immune response is originally triggered in intestinal MLN.

Diarrheal diseases continue to be a public health problem worldwide. Escherichia coli is one of the main etiological agents of diarrhea. The aim of the present work was to identify, through the polymerase chain reaction assay, the main virulence genes that characterize the different E. coli pathotypes that cause diarrhea in children under 5 years of age. A total of 151 stool samples from children with diarrhea were analyzed, of which 284 strains of E. coli were identified and DNA extracted. The virulence genes LT, STx1, STx2, EAST1, eaeA, bfpA, ial, aat, and astA were identified. Of the 284 strains analyzed, 179 (63.1%) were positive for at least one of the genes and 105 (36.9%) were negative for the nine genes studied. Of the 63%, enterotoxigenic E. coli was identified in a total of 63%, enterohemorrhagic E. coli in 25.0%, enteroaggregative E. coli in 25%, enteroinvasive E. coli in 20.7%, and enteropathogenic E. coli in 11.4%; These data are due to a strain of E. coli sharing genes with another strain. Children under 2 years old were the most affected. The adhesion phenotype, both aggregative and diffuse, was related to the presence of the aat and astA genes. The antibiogram showed that the strains of E. coli were resistant to more than three antibiotics, mainly ampicillin, cephalothin, amoxicillin/clavulanic acid, sulfamethoxazole-trimethoprim, and sensitive to amikacin, cefotaxime, and cefoxitin.

ABSTRACT In this research is presented an overview of heart failure related to arrhythmias and sudden death, which can coexist, worsen, or be cause or consequence of one another. Here are discussed the premonitory electrical signs that allow to stratify risk in patients with previous events, with a possible approach to reality, and in those who have not presented them (most of them, the unprotected ones) and where a prognosis is very difficult, or impossible, to be established. These signs are numerous, elusive, with low specificity and sensitivity, none is absolute or negligible, in order to interpret them, a comprehensive vision is required. Premature ventricular contractions are discussed as predictors and triggers of arrhythmias, sudden death and cardiomyopathy, as well as the usefulness of ablative procedures versus medications. Electrical signs are good for identifying large risk groups but not for identifying high risk individuals inside the large low risk group (the majority).

RESUMEN Se presenta una panorámica de la falla cardíaca ligada a las arritmias y a la muerte súbita, que pueden coexistir, agravarse, o ser causa o consecuencia una de otra. Se discuten los signos eléctricos premonitorios que permiten estratificar riesgo en pacientes con eventos previos, con posible acercamiento a la realidad, y en quienes no los han presentado (la mayoría, los no protegidos), y resulta muy difícil o imposible establecer un pronóstico. Estos signos son numerosos, esquivos, de baja especificidad y sensibilidad, ninguno es absoluto ni despreciable, para interpretarlos se requiere una visión integral. Se discuten las extrasístoles ventriculares como predictoras y desencadenantes de arritmias, de muerte súbita y de miocardiopatía, y la utilidad de los procedimientos ablativos frente a los medicamentosos. Los signos eléctricos son buenos para identificar grandes grupos de riesgo pero no lo son tanto para, dentro del gran grupo de bajo riesgo (la mayoría), identificar los individuos de alto riesgo.

The aim of the current research was to assess the plant responses of wheat lines and differential cultivars carrying Diuraphis noxia Kurdjumov resistance genes when subjected to aphid infestation, in order to determine the biotypic composition of RWA populations in Argentina. Eighteen lines and differential cultivars were sown in a greenhouse in a randomized design with two replicates. Two recordings of the chlorotic damage and the level of leaf rolling were made after 21 and 51 days from the infestation onset. The results were analyzed with an ANOVA and Tuckey Test (a=0.05). After 21 days of infestation, two novel lines (14 and 1) showed the highest level of tolerance, with minor chlorotic damage. The differential cultivars carrying Dn2 and Dn7 resistance genes also were highly tolerant, Dn1 and dn3 resistance genes were moderately tolerant and those ones carrying Dn4 and Dn5 genes resulted seriously damaged. After 51 days of infestation, only the differential cultivar carrying Dn7 and the novel lines 14 and 1 maintained a high level of tolerance. Based on the current results, the RWA biotypes 1, 2* and 5* are present in Argentina, the last ones with different characteristics from biotypes 2 and 5 identified in EEUU. We conclude that improved cultivars in other countries can behave as susceptible against local populations.

El objetivo del trabajo fue evaluar el comportamiento de líneas de trigo y cultivares diferenciales, portadores de genes de resistencia, a fin de determinar la composición biotípica del áfido Diuraphis noxia Kurdjumov, "Pulgón Ruso del Trigo" (PRT), en Argentina; y se identifican aquellos hospederos con resistencia genética al PRT. Los 18 cultivares diferenciales y líneas Novel, se sembraron en invernáculo, en un diseño aleatorio con 2 repeticiones. Las observaciones se realizaron a los 21 y 51 días de la infestación, se determinó el grado de clorosis y de enrollamiento foliar. Los resultados se analizaron con ANOVA y el Test de Tuckey (a=0,05). A los 21 días, las líneas 14 y 1 (Noveles) presentaron el mejor comportamiento, pero se desconocen sus genes de resistencia. Los cultivares portadores de Dn2 y Dn7 resultaron con un alto nivel de tolerancia, mientras que Dn1 y dn3 fueron moderadamente tolerantes y las portadoras de Dn4 y Dn5, muy dañados por las poblaciones Argentinas de PRT. A los 51 días, solo Dn7 y las líneas 14 y 1 mantuvieron un comportamiento de tolerancia al áfido. Se infiere que en el país se encontrarían los biotipos 1, 2* y 5*, estos dos últimos con características diferentes a los identificados en EE.UU. Se concluye que los cultivares mejorados en otros países, pueden comportarse como susceptibles frente a las poblaciones locales.

Greenbug, Schizaphis graminum (Rondani) is one of the major pests of cereals around the world that is present in Argentina. Chemical control is the most widely used practice; however, the use of resistant varieties, one of the main components in IPM, is the most effective and environmentally sustainable strategy of control. Since plants have different types of insect resistance that allow them to defend against pests, the aim of the current study was to characterize the resistance to Schizaphis graminum in a population of recombinant inbred lines of barley and to identify lines with improved characteristics that enable the development of commercial cultivars. Antixenosis was studied by the host free choice test. Antibiosis was assessed by means of aphid life cycle and developmental traits. Tolerance mechanism was analyzed by plant growth parameters. At least eight lines carrying antibiosis were more tolerant than their controls, with similar dry weight, leaf area and chlorophyll contents, under infestation. These lines could provide resistance genes against this aphid pest and would be useful in plant breeding programs.

El pulgón verde de los cereales, Schizaphis graminum (Rondani), es una de las principales plagas de estos cultivos en el mundo y también presente en Argentina. Si bien el control químico es la práctica más utilizada, el uso de variedades resistentes (uno de los componentes principales del MIP) es la estrategia más efectiva y ambientalmente más amigable para el control de plagas. Dado que las plantas presentan distintos mecanismos que les permiten defenderse de los insectos, el objetivo de este trabajo fue caracterizar la resistencia a Schizaphis graminum en una población de líneas recombinantes de cebada, e identificar aquellas con mejores características, portadoras de genes de resistencia a este insecto. La antixenosis fue analizada por la prueba de libre selección de hospederos. La antibiosis se evaluó por los parámetros del ciclo y el desarrollo del áfido y la tolerancia por características de crecimiento de las plantas bajo infestación. Al menos ocho líneas antibióticas fueron más tolerantes que sus testigos, presentando similares pesos secos, área foliar y contenido de clorofila bajo infestación. Estas líneas portadoras de genes de resistencia pueden ser de utilidad en los planes de mejora de la cebada.

Twenty-nine Schizaphis graminum (Rondani) populations and sixty clones collected from very contrasting regions of Argentina and Chile were investigated electrophoretically. A high degree of enzymatic polymorphism was found. The enzymatic structure was described for the esterase system, finding nine different loci. Latitudinal stratification was determined and populations were associated into three groups, according to the latitude they were collected from. The 90% of loci resulted polymorphic in the first group and 100% of loci were polymorphic in the rest. Observed heterozygosity was lower than expected. No group had fixed alleles according to Fsr values; group one had a slight heterozygous excess, while the other groups showed slight positive Fsr values, because there was a homozygous excess. According to Frt, the third group showed the highest value that was in concordance with the highest gene flow value. Three populations could not be included in any group. The α-carboxyl-esterase was always present, also in clones and populations which were located in non agricultural zones, implicating that the insecticide resistance is well spread throughout the Argentinean and Chilean territory. No relationship was found between the enzymatic patterns and the biotype or with the host species where the aphids were collected from.

Veintitrés poblaciones de Schizaphis graminum (Rondani) y sesenta clones colectados en regiones muy contrastantes de la Argentina y Chile fueron investigadas electroforéticamente. Se encontró un alto grado de polimorfismo enzimático. La estructura enzimática fue descripta para el sistema estearasa y se encontraron nueve loci diferentes. Se determinó que existe estratificación latitudinal, las poblaciones fueron asociadas en tres grupos de acuerdo a la latitud donde fueron colectadas. El 90% de los loci resultaron polimórficos en el primer grupo y el 100% de los loci lo fueron en el resto. La heterocigosidad observada fue menor que la esperada. Ningún alelo fue fijado, de acuerdo con el valor del Fsr. El primer grupo tuvo un ligero exceso de heterocigosis, mientras que los demás grupos mostraron valores ligeramente positivos de Fsr, debido al exceso de homocigosis. Con respecto a Frt, el tercer grupo mostró un valor alto que estuvo en concordancia con el alto valor de flujo génico. Tres poblaciones no pudieron ser incluidas en ningún grupo. Las α-carboxil- estearasas siempre estuvieron presentes incluso en clones y poblaciones colectadas en zonas no agrícolas, lo que implica que la resistencia a insecticidas está ampliamente extendida a lo largo del territorio argentino y chileno. No se encontró relación entre el patrón enzimático y el biotipo, así como tampoco con la especie hospedera de donde fueron colectados los áfidos.

The immune response is crucial for protection against disease; however, immunological imbalances can lead to heart and digestive tract lesions in chagasic patients. Several studies have evaluated the cellular and humoral immune responses in chagasic patients in an attempt to correlate immunological findings with clinical forms of Chagas disease. Moreover, immunoglobulins and cytokines are important for parasitic control and are involved in lesion genesis. Here, cytokine and IgG isotype production were studied, using total epimastigote antigen on sera of chagasic patients with indeterminate (IND, n = 27) and cardiac (CARD, n = 16) forms of the disease. Samples from normal, uninfected individuals (NI, n = 30) were use as controls. The results showed that sera from both IND and CARD patients contained higher levels of Trypanosoma cruzi-specific IgG1 (IgG1) antibodies than sera from NI. No difference in IgG2 production levels was observed between NI, IND and CARD patients, nor was a difference in IL-10 and IFN-³ production detected in the sera of IND, CARD and NI patients. However, IND patients displayed a positive correlation between IL-10 and IFN-³ levels in serum, while CARD patients showed no such correlation, indicating an uncontrolled inflammatory response in CARD patients. These findings support the hypothesis that a lack of efficient regulation between IFN-³ and IL-10 productions in CARD patients may lead to cardiac immunopathology.