Current status of the rheumatologists’ workforce in Latin America: a PANLAR collaborative study

Clinical Rheumatology - Studies conducted by various scientific societies have shown that the demand for specialized rheumatology care is greater than the projected growth of the workforce. Our...     

Myocardial expression of survivin, an apoptosis inhibitor, in aging and heart failure. An experimental study in the spontaneously hypertensive rat

BACKGROUND: Apoptosis plays a major role in the transition to heart failure (HF) in systemic hypertension although the underlying mechanisms are still unclear. The aim of this study was to determine the relationship between apoptosis, left ventricular remodeling, heart failure and the myocyte expression of survivin, an inhibitor of apoptosis. METHODS: Spontaneously hypertensive rats (SHR) were used as a model of hypertensive cardiopathy, and Wistar Kyoto Stars rats (WKY) were used as controls. Animals were allowed to survive up to 18 months of age. The animals underwent echocardiography (EDD, ESD and FS were measured). The median section of the heart was processed for in situ end-labeling of DNA fragmentation (TUNEL) and for survivin expression by immunohistochemistry. RESULTS: All SHR presented features of adverse cardiac remodeling. Apoptotic cells were increased in SHR compared with WKY, measured as apoptotic cells per high power field (1.08+/-0.43 vs. 0.27+/-0.15, P<0.001), and as apoptotic rate (0.16+/-0.06% vs. 0.04+/-0.02%, P<0.001). The incidence of apoptosis showed a positive correlation with unfavorable ventricular remodeling, assessed by echocardiogram. Survivin expression was found in all cases, but the survivin expression index was significantly lower in SHR vs. WKY (43+/-40% vs. 86+/-18%, respectively, P=0.014). Moreover the survivin expression index was inversely correlated with features of adverse remodeling (i.e., Heart Weight, R=-0.79, P<0.001) and with apoptosis (i.e., apoptotic rate, R=-0.52, P=0.050). CONCLUSION: Survivin myocardial expression in aging SHR is associated with reduced apoptosis and more favorable cardiac remodeling. Modulation of this pathway may prove beneficial in preventing pressure overload cardiac remodeling and heart failure.     

Effects of the early administration of losartan on the functional and morphological aspects of postmyocardial infarction ventricular remodeling in rabbits.

BACKGROUND: The effects of losartan (Los) on ventricular remodeling (VR) remain controversial. The objective was to determine whether early administration of Los to rabbits with myocardial infarction (MI) modifies VR. METHODS: New Zealand rabbits underwent left coronary artery ligation. Four groups were analyzed: Sham (G(1); n = 13), MI (G(2); n = 13), Sham+Los (G(3); n = 13), and MI+Los (G(4); n = 13). Los (12.5 mg/kg/day) was administered from 3 h post-MI and during 35 days. At the end of the protocol, the hearts were isolated and perfused to determine pressure-volume curves (P/V). Hearts were weighed, cut, and stained with picrosirius red. The heart weight (HW)/body weight (BW) ratio was determined. Infarct size (IS;%), septum (SeT, mm) and scar thickness (ST, mm), myocyte area (microm(2)), and width (mum) were measured. RESULTS (X +/- S.E.M.): Los shifted the diastolic left ventricular (LV) P/V relationship to the right in sham and MI (P < .05 vs. sham), with no changes in the systolic relation. IS was G(2) = 25.38 +/- 5.31 and G(4) = 21.85 +/- 4.13 (NS); HW/BW was 0.34+/-0.01, 0.35 +/- 0.02, 0.29 +/- 0.02 (P < .05 vs. G(1) and G(2)), and 0.32 +/- 0.02 in G(1), G(2), G(3), and G(4), respectively. Scar collagen concentration (%) was lower in G(4) (P < .05 vs. G(2)). SeT was lower in G(3) and G(4) (P < .05 vs. G(2)). The width and area of the septum myocytes increased in the untreated infarct, and Los suppressed that increase. CONCLUSION: The early administration of Los unfavorably modified post-MI VR, increasing ventricular dilation, reducing scar collagen concentration and thickness, and inhibiting myocytes width and area increase. The dilation observed in sham animals' hearts suggests that infarct was not the main factor in the dilation of the cavity.     

Patrones radiológicos en la enfermedad pulmonar intersticial

Interstitial lung disease (ILD), or diffuse infiltrative lung disease, includes a heterogeneous group of processes characterized by the appearance of an inflammatory reaction in the alveolar wall, triggered by different antigens.This group represents a spectrum of diseases with distinct causes; furthermore, there is confusing variation in the use of nomenclature.The imaging method of choice in the evaluation and diagnosis of ILD is high-resolution computed tomography (HRCT), as it confirms the presence of lung disease and establishes the correct diagnosis of associated complications. However, the definitive diagnosis of these diseases requires consistency between the clinical and pathological findings. The radiologic images obtained by HRCT in this group of diseases are highly useful, especially to avoid unnecessary biopsies. For these reasons, clinicians should be familiar with the basic radiologic patterns associated with this special group of lung diseases: septal, reticular, nodular, ‘ground glass’, cystic, and condensation. This article describes the characteristics and presentation of these patterns and reviews some of the most frequent ILD, with special emphasis on their main radiological patterns.