Last night’s terrorist attack took place in the first district of one of the safest cities in the world
An attack anywhere in the world is horrible. It is sad that this type of thing happens with a higher frequency than we think or than it reaches us. But also, if that attack takes place in a corner where you have walked, have had a coffee or have simply seen regularly, it touches your heart more. Oh Vienna …
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Javier Clemente made a positive reading of the performance of his players in the match against Costa Rica. The coach highlighted the start of the match by the Euskal Selekzioa, because «we have had a great first big game. Later, the changes of the second part have upset us until we have recovered the thread and we have created chances at the end », he summarized.
The Tricolor coach highlighted the potential of the team that was ahead in Ipurua, because “they are very prepared, a lot has been demanded of us and the kids have responded to that demand,” said Clemnente. “Costa Rica is a great team, they have high quality players, very powerful and dangerous because they have a lot of scope. They are very prepared and I really liked it ».
For the Barakaldo coach, “the match was very tough. As a friendly I only had that here they do not give points. We agreed that we were playing as if it were an official championship, giving our best. I have to emphasize that our players have beaten each other for the heart, while Costa Rica has done it for the possibility of going to the World Cup ».
Clemente also referred to that victory in the last second, when in the second half it seemed that Costa Rica was better at those final moments of the match. “Looking from the outside, it gives the feeling that we were pissed off not winning the game and we shot up. In addition, the more defenses we have had more strength we have taken in front. We have been in six changes and the circumstances of the game have not allowed me to put Agirregabiria, I feel sorry for him.
The Basque coach, who settled the controversy over the call by recalling that “I summon those I can and then I bring the team that I consider the best”, stressed that “it is a beautiful victory for us thinking that in the future we can play more games and have more classification commitments’. And in this regard, he acknowledged that “I have nothing in perspective. For me I would play every month, but it is not easy to hire a rival and to find some free dates where the clubs can give us the players ».
These are not easy days for the Spanish Isabel Pantoja or her son Kiko Rivera (Francisco José Rivera Pantoja, also known as Paquirrín). After 36 years of love, something broke. The link was marred by an economic tug of war …
At 64, the Seville-born singer has no peace. He was imprisoned for almost two years and when he managed to recover, more problems came. The last, linked to his offspring.
In 2007 Pantoja had been involved in the scandal of the so-called Malaya Case, a name that received an operation against urban corruption in Spain -which had been committed by some leaders of the Marbella City Council and various businessmen and lawyers-. His sentimental partner, Julián Muñoz, former mayor of that town, was one of the main defendants.
Entered prison to serve a two-year sentence after being found guilty of a money laundering crime, she was finally released on October 28, 2016.
Kiko Rivera, the son of Isabel Pantoja (TV Capture)
Kiko decided to break the silence on TV and in Spain the issue took on a great media dimension. In a Telecinco special Singer, the poisoned inheritance, the man confessed: “On the scale of values of my mother, money comes before her children, she is blinded and has a problem. They have deceived me and have knowingly robbed me of what they were doing since he was two years old. I’m not going to be able to forgive my mother and father from wherever I am, either. “
What is Kiko talking about? That his mother has “betrayed” him with the will of his father, Paquirri, the Spanish bullfighter who died in 1984. “He accuses his mother of mortgaging the Cantora farm twice without legitimation (85 million pesetas when he was two years old and 2,700,000 euros in 2002 when he turned 18)”, it is read in The vanguard.
“My mother has not paid the mortgage on the Cantora farm for 14 months,” Rivera said. And he assured that he brought “buyers for the farm who were willing to pay a price higher than what it is worth, specifically 7 million euros, and that the operation was not closed because his mother and uncle wanted 14 million euros” publishes The vanguard.
Kiko Rivera, the son of Isabel Pantoja, in the special of the Spanish TV.
The first 40 minutes of the program were terrible: “I will never forgive my mother”, “My mother does not have a heart”, “I was her credit card”, “Now she is alone”, “My mother has not been a good person to me for 34 years”, vomitó Kiko.
Before the broadcast of that documentary in which her son made tremendous statements, Pantoja was “dejected”, according to Spanish media signals. “The tonadillera would be going through one of its worst moments”, publishes The vanguard. “Locked up in her house, she doesn’t want anyone’s visit.”
“I feel cheated since my father left. I feel immense pain and I am devastated; my mind does not assimilate all this and I am very lost “, added Kiko, who confessed relapses in your attempt to quit addictions.
Isabel Pantoja at the Viña del Mar Festival, in 2017. (Reuters).
In May, the news about Pantoja was brighter than today: “He dedicates every afternoon to making masks, managing to carry out a large daily production that he donates to people in need in Cádiz”, according to the Spanish magazine Ten minutes. “The rest of the day is monotonous, with little more entertainment than babysitting her mother and watching TV. Everything changes when he video calls with his grandchildren. “
On February 14, Isabel released her new single, Fall in love, on all digital platforms. With that theme he returned to music after four years without unpublished material.
Echocardiograms, also called cardiac ultrasounds, show the devastating effects of covid-19 on the heart of patients. It has been seen by researchers at the Icahn School of Medicine at Mount Sinai Hospital in New York (USA) in a study published today in The Journal of the American College of Cardiology (JACC), which identifies different types of damage to the structure of the heart that COVID-19 patients experience after heart injury that can be associated with life-threatening conditions including heart attack, pulmonary embolism, heart failure, and myocarditis. These abnormalities are associated with an increased risk of death among hospitalized patients.
The findings offer new information that can help healthcare professionals better understand the mechanism of cardiac injury, leading to earlier identification of patients at higher risk and the application of the most suitable futures.
“Early detection of structural cardiac abnormalities can make it easier for us to apply the most appropriate treatments, including the use of anticoagulant drugs, for hospitalized and post-hospital patients,” says research author Valentín Fuster, from Mount Sinai Hospital in New York and director of the National Center for Cardiovascular Research (CNIC).
This international retrospective study expands on the results of a previous investigation from this same medical center that showed that myocardial injury (heart damage) is common among hospitalized patients with Covid-19 and was associated with an increased risk of mortality.
In this case, the work focused on the levels of troponin, proteins that are released when an injury occurs in the heart muscle, which when elevated shows the level of heart damage.
The researchers analyzed the relationship between elevated levels of cardiac troponin and the presence of echocardiographic abnormalities. Thus, they found that the combination was associated with a worse prognosis and mortality than troponin elevations alone.
“This is one of the first studies to provide detailed echocardiographic and electrocardiographic data in hospitalized patients with COVID-19 and laboratory evidence of myocardial injury,” explains the researcher Gennaro Giustino. “We have seen that in patients with COVID-19 who underwent transthoracic echocardiography, there were different structural cardiac abnormalities that were present in almost two-thirds of the patients.”
Researchers observed transthoracic echocardiographic (TTE) and electrocardiographic (ECG) scans of 305 confirmed COVID-19-positive adult patients admitted to four New York hospitals and two hospitals in Milan, Italy, between March and May 2020. The mean age was 63 years old and 67.2% were men.
The results showed that 190 patients (62.6%) had myocardial injury; of these, 118 had heart damage at the time of hospitalization and 72 developed damage during hospitalization. The investigators further found that patients with myocardial injury had more electrocardiographic abnormalities, higher inflammatory biomarkers, and a higher prevalence of TTE abnormalities compared to patients without cardiac injury.
The study shows that: 26.3% of the patients had right ventricular dysfunction (which may be associated with pulmonary embolism and severe respiratory failure); 23.7% regional left ventricular wall motion abnormalities (which may be associated with heart attacks); 18.4% diffuse left ventricular dysfunction (which may be associated with heart failure / myocarditis); 13.2% had grade II or III diastolic dysfunction (a condition that leads to stiffer heart chambers), and 7.2% had pericardial effusions (extra fluid around the heart that causes abnormal pumping of the heart).
When in-hospital mortality and troponin elevation were analyzed, it was observed that the increase in troponin was 5.2% among patients without cardiac injury, compared with 18.6% of patients with myocardial injury, but without echocardiographic abnormalities, and 31.7% of the patients had myocardial injury and echocardiographic abnormalities.
«Our study shows that an echocardiogram performed is a useful and important tool in the early identification of COVID-19 patients at increased risk of COVID-19-related cardiac injury, who may benefit from a more aggressive and earlier therapeutic approach in their hospitalization ”he assures Martin Goldman. And he adds: “In addition, because this is a new disease with persistent symptoms, we are going to closely monitor these patients using images to assess the evolution and, hopefully, the resolution of their heart problems.”
The findings, they conclude, “They will help guide the care of patients with Covid-19 during a critical time.”
It is celebrated today, October 25, World Opera Day, an initiative launched by the Royal Theatre last year and that, in the absence of Unesco giving it a letter of nature, it is celebrated with the support of the most important opera and international associations. There are still few opera houses that are fully operational due to, of course, the pandemic. Precisely, the Madrid coliseum was the first in the West to regain a “medium normality”, with the staging of a schematic production of “La traviata” last July and the opening of this course with “Un ballo in maschera” .
opera, on the stage of the Real many singers have left their hearts and throats. Some even literally. For a time, the Madrid Coliseum housed organs by two illustrious tenors from the late 19th and early 20th centuries: Julián Gayarre’s larynx and Giuseppe Anselmi’s heart, which constitute what Andrés Peláez, former director of the National Museum of the Almagro Theater, defined as the “offal section.”
Julián Gayarre’s larynx
Julián Gayarre is one of the great legends of opera in Spain. Born in El Roncal, Navarra, on January 9, 1844, he was an idol at the Teatro Real since his debut as Fernando in «The favourite“By Donizetti, October 4, 1877. His voice was compared to that of» an angel «.
«With a manly, vibrant, extremely beautiful timbre, when it rests on the chest, it exerts an irresistible influence, penetrates the ear and the soul like an ocean of sound that deeply stirs all the fibers of enthusiasm. It is a true hurricane that drags everything in its path ». Thus defined Antonio Peña and Goñi in his work «Art and Patriotism» the voice of Julián Gayarre.
José Letamendi He also wrote about the Roncal tenor: «The voice of our ill-fated compatriot was an exceptional combination of skill, energy and harmonious perfection. One could, in the last synthesis, say of her, as a total artistic result, that brought together the integrity of the white voices, or of pure fundamental, all the density of virile voices, or of harmonized fundamental. Hence its great, universal and unanimous esteem: that of the very rare for its excellence«.
They are just two of the usually hyperbolic testimonies left by those who heard Julián Gayarre sing (of which there is no recorded testimony). It is not strange that at his death science wanted to know the secrets of that voice.
The death of the tenor had an air of legend. Gayarre had agreed, despite feeling discomfort from a laryngeal condition, to sing a performance of «The Pearl Fishermen“, By Bizet (” Les Pêcheurs de perles “, which was frequently sung in Italian) on December 8, 1889. When singing the famous romanza”I seem to hear again“(” I think I still hear “) se le quebró la voz.
This is how he narrates it Julio Enciso In his biography “Memories of Gayarre”: “The romance came, and some began to notice something strange in his way of emitting his voice, and so much so that at the end of a sharp note of the romance, it broke in his larynx, making him mute. It was the first note to break. Gayarre then, full of anguish, put his hands to his forehead, saying with deep sadness: “I cannot sing!” And he withdrew at once, almost feigned of a syncope. The persons on the scene rushed to his aid and accompanied him to his room. It is useless to increase the anxiety of his friends and the public in those minutes, which seemed centuries. Gayarre, thanks to the care and medicine that was provided, was soon well, and said that not only would the performance continue, but that he would sing the romance in the last act. He arrived and began, indeed, to sing his romance; But when he reached the same note, Gayarre saw that he could not, and with a supreme effort he finally gave it up, albeit smooth and not with the purity and clarity of always. The audience, however, applauded with greater enthusiasm than ever, giving him an almost frenzied applause and bringing him to the stage countless times. But these displays of affection did not calm that spirit, already saddened; and when the curtain fell, Gayarre, with a sore accent, torn from the depths of his soul, said: “This is over!”
Julian Gayarre would die on January 2, 1890 due to a flu-like bronchopneumonia – Spain was then suffering from a flu epidemic-; His last weeks were spent at home (at number 6 in the Plaza de Oriente, next to the Royal Theater itself), mired in sadness, according to his friends. After his death, the doctors who treated him asked his nephews for permission to remove his larynx in order to study it. One of those doctors, Amalio Jimeno, wrote an article after the examination in which, among other things, he said:
Gayarre’s larynx does not at first glance offer extraordinary characters, nor was it possible that it did. The amplitude, the intensity, the timbre, the beauty of a voice, does not depend only on the organization of the larynx or its way of functioning. Do not the broad lung, like a powerful bellows, and the muscles that assist in breathing, do not contribute to giving it its character? Are they not the pharynx, with its high vault; the base of the tongue, so movable at will; the veil of the same palate; the mouth and the resonance box of the nostrils, indispensable factors? (…) In spite of everything, the larynx is after all the place where the voice is produced by the vigorous blowing of the lungs; But what is the scrutinizing eye of the physiologist to say, the poor dead organ, that serves to point out the admirable mechanism that gave character to those nuances of phonation, rarely equaled and never surpassed? (…) Gayarre’s larynx seemed large, without being remarkable for its magnitude. The muscles that attended its formation, the intrinsic and the extrinsic, developed, strong, thick, powerful, as well as all those of the neck, robust, and those of the chest. Only by looking at that thorax and collecting the measurements of its diameters, one can understand how the voice of the eminent tenor had that incomparable intensity and amplitude, which even in a very sweet song and in head register made it reach the farthest part of the theater.
There were more studies of Julián Gayarre’s larynx, which he traveled before reaching his current destination. The researchers tell it Begoña Torres Gallardo and Chloe Sharpe in a work on the tenor (“The larynx of Julián Gayarre (1844-1890). The symbol of the voice of a genius”. “After completing the study of the larynx, Gayarre’s nephews gave it to the doctor Cortezo, who later donated it to the Theater Archive Museum that Luis París was then creating at the Royal Theater in Madrid. He recovered it before the outbreak of the Spanish Civil War in 1936, keeping it until his death. His son donated it to the Provincial Council of Navarra in 1950, and this gave it in 1993 to the already created Gayarre Foundation. Since then, this “relic” has been exhibited in the Julián Gayarre de Roncal Museum«.
On January 27, 1907, seventeen years after the death of Julián Gayarre, he made his debut at the Teatro Real, as Des Grieux in the opera “Manon”, by Jules Massenet, an Italian tenor named Giuseppe Anselmi. Born in Sicily on November 16, 1876, the singer became from his presentation one of the favorites of the Madrid public.
Madrid’s love for Anselmi was reciprocalor; the tenor loved Madrid and enjoyed its festivals and popular festivals in which he used to see him. It is not strange therefore that Louis Paris, titular stage director of the Teatro Real in Madrid, would go to him and ask for some of his objects for the small museum he was preparing at the Real. But surely he was not expecting Anselmi’s reply in a letter dated June 12, 1925 – the Theater had offered only two months before what, although it was not known at the time, would be its last performance before its closing: «For Regarding your kind invitation to send some memory of my modest person to the Museo del Real, I will have to answer you very simply: I am still alive. My chest still houses that muscular and impulsive dynamo that we call the heart; In it are engraved the words: “Spain, Faith, Gratitude, Love” that summarize its four cardinal points. As well: I dictate testamentary provisions for you to deposit it next to the bust of the divine Gayarre«.
Giuseppe Anselmi died four years later, on May 27, 1929, in the Genoese town of Zoagli, in Italy. He had written in his own handwriting in his will these words: «I order my (dead) body to be cremated. Before cremation my heart will be removed from my chest and taken to the Royal Theater from Madrid so that it is kept (as I have promised) in an urn next to the bust of the great tenor Julián Gayarre «.
After Anselmi passed away, his heart was removed. It was Pedro José Pidal and Bernaldo de Quirós, Marquis of Villaviciosa de Asturias, who was in charge of the transfer of the viscera to Madrid in the summer of 1929; It was not easy, the customs authorities did not make it easy, and put as a condition for his entry into Spain that he be taken to the Anthropology Museum -where some anatomical pieces were kept-.
There he remained for a year – in that period he was dissected by Dr. Carlos Maria Cortezo-, after which it was moved to the Museo del Teatro Real. The conversion of the Royal Theater into a military compound and powder magazine during the turbulent years of the civil war meant that, at the end of the war, the heart was given for lost in the rubble.
The then director of the Museo del Teatro Real, Fernando José de Larra, he insisted on finding the viscera of the Italian tenor. This is how his finding counts José will rise In his book «History and anecdote of the Royal Theater»: «Searching incessantly among the debris for the place where before the war that human relic was kept, he found, under a mahogany lintel, the mouth of a bottle. That vessel had protected Anselmi’s heart preserved in alcohol. And nearby he found shortly afterwards, bruised and tiny, a lump where the aorta artery stood out. It was Anselmi’s heart, saved at last!«
It was not until 1989 that he found a definitive rest. Saved in different dependencies and moved from place to place on different occasions, Andrés Peláez, first director of the National Theater Museum of Almagro (and one of the wisest historians of our scene), claimed the viscera for the newly created institution. He has been there ever since.
The cardiovascular diseases are already the leading cause of death in the world, ahead of other much better known pathologies such as cancer. It is estimated that more than 20 million people die each year due to cardiovascular diseases, renal and metabolic, a complex network of pathologies not always well known, but closely related to each other.
Ischemic heart disease, heart failure, kidney failure or diabetes, to give four of the most common examples, share risk factors that, in many cases and despite medical advances, remain undiagnosed or untreated 3 or, when they do, it is already too late.
Coinciding with the commemoration of World Heart Day, the AstraZeneca company, wants reaffirm its commitment to all those who suffer or are at risk of suffering from cardiovascular, kidney and metabolic diseases. And also with the health professionals who attend them. «We work in close collaboration with the world’s leading specialists in these pathologies to launch, always hand in hand with research and science, a new approach to tackling these diseases. We have gone from treating the disease to treating the person, from treating a single pathology to treating them in an integrated way, aware of the common risk factors that occur in many of these diseases, ”he highlights Ana Pérez Domínguez, Director of Medical and Regulatory Affairs at AstraZeneca.
“Our company has always stood out for taking a very ambitious approach to world-class clinical research. Thanks to this, we have been able to understand the interactions between two or more pathologies and to see how the worsening of one disease could negatively affect the others, “adds Ana Pérez Domínguez.
In this paradigm shift, AstraZeneca has made a very ambitious commitment. “Our goal is to help protect, by 2025, more than 130 million people around the world from the often very serious consequences of cardiovascular, kidney and metabolic pathologies,” says the company’s chief medical officer. . In this endeavor, AstraZeneca is not alone. The pharmaceutical company walks hand in hand with academic institutions, leading research organizations or patient support groups in order to offer health professionals and health systems the best possible solutions to improve the comprehensive care received by those affected by these diseases. “Ultimately, thanks to this alliance, our ultimate goal is to protect patients with cardiovascular, metabolic and kidney pathologies to improve their health and, thus, save the lives of millions of people living with these conditions”, says the medical director by AstraZeneca.
To this end, AstraZeneca has deployed a wide range of programs and resources, in many cases in collaboration with scientific societies and patient associations, which allow a comprehensive response to these diseases. Some of the most prominent are the following:
Acute coronary syndrome. The life ahead
Acute coronary syndrome (ACS) is the technical name that cardiologists use to refer to what is popularly known as a heart attack or angina pectoris. It is the most common manifestation of coronary heart disease and leads more than 30 years being the main cause of death in the Spanish population .
Acute coronary syndrome usually presents as an acute myocardial infarction or unstable angina. The infarction is characterized by the occlusion of an artery that supplies the heart and that causes an interruption of blood flow in a certain area of the heart tissue, which causes a injury to the heart muscle. Angina is sudden chest pain and that often gets worse over time. Usually be a sign of a very high risk of acute myocardial infarction or sudden death. Unstable angina is triggered in the same way as heart attack, but in this case, cardiac cell death has not occurred.
Clinical estimates suggest that acute coronary syndrome will continue to grow in Spain in the coming decades, with the fact that the risk of cardiovascular events is especially high after having suffered an episode of acute coronary syndrome, especially during the first year.
There are different risk factors that help explain why 1 in 6 people with acute coronary syndrome dies within the first year after suffering the first event. 6 Many of these risk factors they are avoidable. High blood pressure, hypercholesterolemia, stress, diabetes, smoking, being overweight or obese, and being sedentary are some of the most prominent.
Taking care of your diet and doing physical exercise on a regular basis is the best guarantee of preventing an event or a relapse. To understand that there is a lot of life ahead after an acute coronary syndrome, or to prevent it, AstraZeneca has been developing the Life ahead program for years, a platform with useful information and tips to get back to life after suffering a heart attack. A fundamental piece in the gear of this tool are cardiowaking, a fun exercise designed to take care of the heart. In the last edition of the program, which had to be developed virtually due to COVID-19, patients with cardiovascular diseases and AstraZeneca employees traveled together more than 39,000 virtual kilometers, exceeding the initial goal of completing the Camino de Santiago and extending it to Paris and Rome.
Precisely in these times of COVID, AstraZeneca wants to express its support to patients who are or have suffered from the disease and also to those others who have been affected in their care as a result of the pandemic. The figures point delays in medical care and increased mortality among patients with acute myocardial infarction derived from the healthcare problems caused by the coronavirus.
Heart failure. Carabela Project
Heart failure, despite the magnitude of its prevalence and incidence data, remains an unknown disease, much more than other pathologies such as cancer, diabetes or Alzheimer’s. However, heart failure is the first cause of hospital admission in Spain in people over 65 years of age and half of the diagnosed population can die within 5 years. To try to reverse these figures, the Spanish Society of Cardiology and the Spanish Society of Internal Medicine have just launched, with the collaboration of AstraZeneca, the Carabela Project, an initiative that end inequity in the healthcare approach to heart failure in Spain, so that the place of residence of patients does not influence the care they receive. Ten hospitals in the country have joined this project, which will soon produce its first conclusions, and then share and extend the experience throughout the country.
Diabetes. Zero counts in diabetes
Type 2 diabetes mellitus or adult diabetes is a pathology that will be the seventh leading cause of death in the world in 2030, according to WHO estimates, and is expected to affect 592 million people in 2035. In addition to its own implications, this disease stands out for the large number of associated ailments such as myocardial infarction, heart failure, cerebrovascular accident, kidney failure, blindness and amputation of the lower limbs.
#EnDiabetesElCeroCuenta is a health awareness campaign fruit of AstraZeneca’s commitment to people with type 2 diabetes. The initiative aims to disseminate a clear and rigorous information on how to prevent a disease or, where appropriate, avoid its cardiovascular and / or kidney complications. The final objective is none other than to make all the necessary tools available to patients to reduce all doubts to zero, complications or excuses associated with this disease that already affects one in seven adult Spaniards. To this end, AstraZeneca relies on healthcare professionals who provide support to achieve goals, with practical advice and helpful information.
In short, through very different initiatives, AstraZeneca reaffirms on this World Heart Day its commitment to the health and well-being of people fulfilling its objective of placing patients and their needs always in the first place.
An algorithm, developed by the National Center for Cardiovascular Research (CNIC), is capable of personalizing the cardiovascular risk of healthy people, based on their age, blood pressure, diet and measurable markers in blood and urine tests.
The algorithm, which has been dubbed IN-PESA, could serve as an inexpensive and easy tool to calculate the degree of subclinical atherosclerosis, that is, the amount of fat deposited on the walls of the arteries, especially for people at higher risk.
In other words, the researchers say, «help to further personalize cardiovascular risk, leading to more personalized treatment and follow-up plans».
The study is published in The Journal of American College of Cardiology (JACC), it is part of the collaborative project PESA-CNIC-SANTANDER, a pioneering trial in Spain that collects data from more than 4,000 young participants (between 40 and 55 years old) and healthy. Thanks to the detailed information, says Enrique Lara, a CNIC researcher, “we have been able to develop this algorithm, which has later been validated in another 1,000 individuals from another independent group with similar ages to the participants in the PESA study.” The next step, Lara adds, will be to test the algorithm in other large “more heterogeneous cohorts and to follow the participants for a longer time.”
This new information, says Lara, would allow proposing its use in primary care, “because they are people who have not yet had any cardiovascular pathology and therefore do not visit the cardiologist.”
Thus, in this study, in addition, we have tried to use variables that are easily measurable in primary care through blood or urine tests or diet questionnaires. In other words, says the cardiologist and CNIC researcher Xavier Roselló, “depending on the result of our ‘score’, healthy and asymptomatic patients could receive recommendations from their family doctor to make changes in their lifestyle or be referred to cardiologists for more detailed tests. ‘
In this sense, the researchers point out, one of the most interesting results of the study, which has been deepened in another publication not yet publishedis how the level of glycosylated hemoglobin, a parameter used to define diabetes, has a very important role in predicting the extent of subclinical atherosclerosis even at prediabetic levels.
In a previous work, a similar pattern was seen with LDL cholesterol levels at levels called “healthy”. The authors emphasize that developing preventive policies on these risk factors in the healthy and young population (
Machine-Learning algorithms, the researchers write, are called to revolutionize clinical practice in the coming years, from diagnosis to prevention and treatment, thanks to a better quantification of risk, which can be calculated in a personalized and very precise way. using all available information of the individual.
The most common is that atherosclerotic disease is detected in advanced stages, when it has already caused clinical events such as myocardial infarction, stroke or other. The treatment of this type of pathology, when it has already produced symptoms, is limited since a high percentage of affected individuals see their quality of life diminished and, on the other hand, it involves a high economic cost for the health system. Hence the relevance of early detection.
Parameters include age, blood pressure, and information routinely collected from blood and urine tests and dietary questionnaires.
“EN-PESA uses a machine learning model called Elastic Net that allows a high number of variables to be used in an unbiased manner, which makes it possible to identify new predictors beyond the traditional risk factors”, says Fátima Sánchez Cabo, chief of the Bioinformatics Unit of the CNIC. The information from these predictors, she adds, is also used quantitatively, «.without the need for dichotomous simplifications like “high cholesterol: yes / no“, Which improves prediction and takes into account the specific characteristics of each person to personalize their cardiovascular risk profile.”
The authors conclude that this algorithm can improve the clinical management of apparently healthy people with a low cardiovascular risk according to traditional markers, but who present a generalized extension of subclinical atherosclerosis or a high probability that the disease progresses significantly in the short term. term.
A team of researchers has created a detailed cellular and molecular map of the healthy human heart to understand how this vital organ works and shed light on the problems of cardiovascular disease.
The work, published today in “Nature”, is the result of the collaboration of researchers from Harvard Medical School, Brigham and Women’s Hospital, the Wellcome Sanger Institute and the Max Delbrück Center for Molecular Medicine (Germany), among others.
The team has analyzed nearly half a million individual cells to design the most extensive cell atlas of the human heart to date. The atlas shows the enormous diversity of cells and reveals the types of cells of the heart muscle, the protective immune cells of the heart and an intricate network of blood vessels. It also predicts how cells communicate to keep the heart working..
The research is part of the Human Cell Atlas initiative. The new molecular and cellular knowledge of the heart will allow a better understanding of heart disease and guide the development of individualized treatments. The work also sets the stage for regenerative medicine-based therapies in the future.
According to Carlos Talavera-López, from the Wellcome Sanger Institute, “this is the first large-scale study to analyze six cardiac regions in humans. This will serve as a reference for cellular behavior and provides an invaluable resource for applying sophisticated artificial intelligence techniques to study how changes occur in cardiovascular disease.
Each day, the heart beats about 100,000 times in a one-way flow through four different chambers, varying in speed with rest, exercise, and stress. Each beat requires an exquisitely complex, but perfect, synchronization between various cells in different parts of the heart. When this complex coordination fails, it can lead to cardiovascular disease, the world’s leading cause of death, killing approximately 17.9 million people each year.
To understand what is wrong with different heart disease, “we must first know what is normal,” says author Christine Seidman, of the Howard Hughes Medical Institute.
Cardiac cells are especially difficult to study. Unlike some cancer cells and other tissues, there are no heart cells that can be grown indefinitely in the laboratory and studied. That means that much of the cardiac research is done with mice, whose hearts are quite different from those of human hearts.
In addition, it is very complex to work with healthy human hearts, since most are used in transplants. On this occasion, the team had the ‘fortuna‘to dispose of those rare cases in which healthy hearts have been rejected for transplantation and have been able to be frozen for use in research.
In a first phase, the researchers used a high-throughput sequencing method to define the individual characteristics of each heart cell. They then mapped these cells into six regions of 14 human hearts, seven from men and seven from women.
Furthermore, they analyzed the RNA levels of heart cells using fluorescent markers to obtain molecular details of their function.
The researchers write that identifying not only where the cells are, but what proteins they are making, will be of great help to the research. For example, by comparing cells from diseased hearts with those from healthy hearts using the atlas, differences could be identified and new therapies for heart disease could be designed.
This work, says Vicente Andrés, from the National Center for Cardiovascular Research (CNIC), “provides unprecedented detail on gene expression patterns in abundant cell types in the heart, how they interact with each other, and how these parameters differ in different areas of the human heart.
“The study of the communication of the cells of the heart is important to understand how these cells are coordinated to keep the heart working, and it gives us clues to understand what happens in the disease”, explains Talavera.
Andres thinks the same. “It’s fundamental. Consider a car engine, made up of multiple parts (cells) that must ‘communicate’ perfectly for proper operation. If, for example, an electrical component of the engine breaks down, the communication fails and the engine does not work or malfunctions.
The same thing happens with the heart, he explains. ‘When cell-to-cell communication doesn’t work, other cells are affected and cause dysfunction in the heart. To avoid this, or correct it, you have to understand well how the cells of the heart communicate.
“This is the first time someone has observed individual cells in the human heart on this scale,” says Norbert Hübner of the Max Delbrück Center. And he adds: «the knowledge of the full range of cardiac cells and their genetic activity it is a fundamental need to understand how the heart works and to begin to unravel how it responds to stress and illness.
Although the researchers studied a relatively small group of hearts, the atlas reveals some biological surprises by uncovering previously unknown cellular diversity in various parts of the heart.
It also showed differences between the healthy hearts of men and women; women had a higher proportion of heart muscle cells, called cardiomyocytes, than men. An intriguing piece of information, because «Those cells could hold clues to differences in heart disease between the sexes», dice Seidman.
But what is really surprising, comments Hugh Watkins of the University of Oxford, “is the great heterogeneity, in terms of the various types of cells that we now know make up human heart tissue and in terms of regional differences within the heart.” The information, Watkins notes, indicates the heart is a much more complicated organ than many might have imagined.
The researchers also focused on understanding cardiac repair, observing how immune cells interact and communicate with other cells in the healthy heart, and how it differs from musculoskeletal.
For Vicente Andrés, «this Atlas of the healthy heart is a starting point to be able to compare it in the future, for example with that of the heart that has suffered a heart attack, or with that of organs with a greater capacity for self-regeneration. Knowledge of the changes in gene expression and intercellular communication identified in these studies can help to develop new cardiac regeneration therapies based, for example, on the reprogramming of heart cells.
“It is not yet possible to induce human heart cells to repair themselves,” Talavera acknowledges, “but we hope that our study will provide researchers with information to design more specific and advanced therapies in the future.”
And he concludes: “Now that we begin to understand the cellular composition of the human heart, the next step is to project cellular behavior directly onto healthy tissue and compare it with the cellular changes that occur in disease.”
Future research will help elucidate whether heart cells can be induced to repair themselves.
Comer chocolate at least once a week is related to a lower risk of heart disease, according to research published in “European Journal of Preventive Cardiology”, the journal of the European Society of Cardiology (ESC).
«Our study suggests that chocolate helps keep blood vessels healthy of the heart, ”says study author Dr. Chayakrit Krittanawong of Baylor College of Medicine in Houston, Texas.
“In the past, clinical studies have shown that chocolate is beneficial for both blood pressure and the lining of blood vessels. I wanted to see if it affects the blood vessels supplying the heart (the coronary arteries) or not. And if it does, is it beneficial or harmful? ”Explains Dr. Krittanawong.
The researchers conducted a combined analysis of studies from the past five decades examining the association between chocolate consumption and coronary artery disease. The analysis included six studies with a total of 336,289 participants reporting their chocolate consumption.
During a median follow-up of almost nine years, 14,043 participants developed coronary artery disease and 4,667 suffered a heart attack because when coronary artery disease progresses, blood flow to the heart is suddenly blocked.
Compared to consuming chocolate less than once a week, eating chocolate more than once a week was associated with a 8% decrease in risk of coronary heart disease.
“Chocolate contains heart-healthy nutrients like flavonoids, methylxanthines, polyphenols, and stearic acid they can reduce inflammation and increase good cholesterol, “explains Dr. Krittanawong.
This research did not examine whether any particular type of chocolate is more beneficial than another and whether there is an ideal serving size. “Chocolate looks promising for preventing coronary artery disease, but more research is needed to determine how much and what type of chocolate might be recommended,” he says.
However, Dr. Krittanawong cautions that overeating would not be beneficial. “Moderate amounts of chocolate seem to protect the coronary arteries, but large numbers are unlikely to. Take into account the calories, sugar, milk and fat in the products available on the market, especially in diabetic and obese people, “he warns.
The covid-19 pandemic is associated with a significant increase in patients experiencing stress cardiomyopathy, also known as broken heart syndrome. Researchers from the Cleveland Clinic (USA) have seen it and they publish it today in «JAMA Network Open».
He broken heart syndrome occurs in response to the physical or emotional distress and causes dysfunction or failure in the heart muscle. Patients experience symptoms similar to a heart attack, such as chest pain and shortness of breath, but their coronary arteries are usually not blocked. However, the left ventricle of the heart may show enlargement.
Other symptoms include irregular heartbeat, fainting, low blood pressure and cardiogenic shock (inability of the heart to pump enough blood to meet the body’s demands due to the impact of stress hormones on heart cells).
«The pandemic has caused multiple levels of stress in the lives of people around the worldor. People are not only concerned about themselves or their families, but also face economic, emotional or social problems and loneliness and isolation, “she says. ( who led the study. “Stress can have physical effects on our bodies and hearts, as evidenced by the growing diagnoses of stress cardiomyopathy that we are experiencing.”
The causes of stress cardiomyopathy, also known as Takotsubo cardiomyopathy, have not been fully determined. However, doctors believe that a person’s reaction to stressful events physically or emotionally causes a release of stress hormones They temporarily reduce the heart’s ability to pump, causing it to contract less efficiently or irregularly rather than in a constant normal pattern.
Cardiologists, in this work, observed 258 patients who entered with cardiac symptoms known as acute coronary syndrome (ACS) between March 1 and April 30 and compared them with four control groups of patients with ACS before the pandemic .
Thus, they found a significant increase in patients diagnosed with stress cardiomyopathy, reaching 7.8% compared to the pre-pandemic incidence of 1.7%.
Patients with stress cardiomyopathy during the covid-19 t pandemichad a longer hospital stay compared to those hospitalized in the pre-pandemic period; however, there was no significant difference in mortality between the groups. All patients diagnosed with stress cardiomyopathy were negative for covid-19.
“As the pandemic continues to evolve, self-care during this difficult time is critical to our heart health and our overall health,” says Grant Reed, lead author of the study. «People who feel overwhelmed by stress, they have to contact a family doctor. Exercise, meditation, and connecting with family and friends, while maintaining physical distance and safety measures, can also help alleviate anxiety. ”
Most patients with stress cardiomyopathy recovers his heart function in a matter of days or weeksAlthough the condition can occasionally cause significant adverse cardiac and cerebrovascular events, it can even be fatal. Stress cardiomyopathy is usually treated with heart medications to decrease blood pressure and lower heart rate. Other medications may be prescribed to help manage stress.