First ocular report of Gurltia paralysans (Wolffhügel, 1933) in cat.

A two-year-old cat from Tenerife, Canary Islands (Spain), presented with two months history of uveitis in the left eye. It had been treated for two months but still showed an active uveitis. After new treatment, eye examination showed a mobile worm in the anterior chamber. Following surgical removal, the worm was obtained. Morphological study revealed that it was a male metastrongyloid nematode (Nematoda: Metastrongyloidea) with caudal bursa and two similar spicules. Molecular tools based on the 18Sr RNA gene sequence identified the parasite as Gurltia paralysans, which is a neurotropic nematode previously found in South America. Therefore, this article describes the first report of ophthalmic case of parasitism by G. paralysans, and cites for first time this species out of South America.

[Interleukin 8 concentrations in donor bronchoalveolar lavage: impact on primary graft failure in double lung transplant]. / Interleucina-8 en el lavado broncoalveolar del donante y su impacto en la disfunción primaria del injerto en el trasplante bipulmonar.

BACKGROUND AND OBJECTIVE: The purpose of this study was to determine concentrations of interleukin 8 (IL-8) in the bronchoalveolar lavage (BAL) fluid from donor lungs and assess the role of IL-8 levels in the development of primary graft failure. PATIENTS AND METHOD: Twenty patients who received a double lung transplant were studied. A series of data, including BAL fluid concentrations of IL-8, were collected for the donors. Data collected for the recipients included arterial blood gases after 6, 24, and 48 hours, and intubation time. Patients with a ratio of PaO(2) to the fraction of inspired oxygen (FiO(2)) of less than 300 during the first 48 hours were diagnosed with primary graft failure. IL-8 levels were determined by enzyme-linked immunosorbent assay. Associations between the donor variables and IL-8 concentrations were evaluated using the Spearman rank correlation coefficient (rho) and the Mann-Whitney test for categorical and continuous variables, respectively. Logistic regression was used for multivariate analysis. RESULTS: Fifteen of the 20 donors were men. The cause of brain death was trauma in 9 donors, 7 were smokers, 13 required inotropic support, and pathogens were isolated in the BAL fluid of 18. The median age was 35 years (interquartile range [IQR], 23.5-51.25y), the median ventilation time was 1 day (IQR, 1-2d), the median PaO(2)/FiO(2) was 459.5 (IQR, 427-510.25), and the median IL-8 concentration in BAL fluid was 49.01ng/L (IQR, 7.86-94.05ng/mL). Ten of the recipients were men and the median age was 48.43 years (IQR, 25.4-56.81y). The median ischemic time was 210 minutes (IQR, 176.25-228.75 min) for the first lung and 300 minutes (IQR, 273.75-333.73 min) for the second lung. The median PaO(2)/FiO(2) ratio for the implant at 6, 14, and 48 hours was 329 (IQR, 190.25-435), 363.5 (IQR, 249-434.75), and 370.5 (IQR, 243.25-418.25), respectively. The median intubation time was 39.5 hours (IQR, 19.25-68.5h) and the correlation with IL-8 values was positive: higher IL-8 concentrations in BAL fluid correlated with longer ventilation times (Spearman rank correlation, P=.007; rho=0.583). Five patients developed primary graft failure; IL-8 concentrations were significantly higher in these patients than in those whose grafts did not fail (Mann-Whitney test, P=.003). CONCLUSION: High IL-8 concentrations in donor BAL fluid lead to longer ventilation time in the recipients and favor the development of primary graft failure after lung transplant.

Interleucina-8 en el lavado broncoalveolar del donante y su impacto en la disfunción primaria del injerto en el trasplante bipulmonar / Interleukin 8 Concentrations in Donor Bronchoalveolar Lavage: Impact on Primary Graft Failure in Double Lung Transplant

La disfunción primaria del injerto pulmonar (DPIP) contin¨²a siendo la principal causa de mortalidad perioperatoria y precoz en los receptores de un trasplante pulmonar (TP)1. La DPIP es una lesi¨®n pulmonar aguda, que acontece en el per ...(AU)

Background and Objective The purpose of this study was to determine concentrations of interleukin 8 (IL-8) in the bronchoalveolar lavage (BAL) fluid from donor lungs and assess the role of IL-8 levels in the development of primary graft failure.Patients and MethodTwenty patients who received a double lung transplant were studied. A series of data, including BAL fluid concentrations of IL-8, were collected for the donors. Data collected for the recipients included arterial blood gases after 6, 24, and 48hours, and intubation time. Patients with a ratio of PaO2 to the fraction of inspired oxygen (FiO2) of less than 300 during the first 48hours were diagnosed with primary graft failure. IL-8 levels were determined by enzyme-linked immunosorbent assay. Associations between the donor variables and IL-8 concentrations were evaluated using the Spearman rank correlation coefficient (¦Ñ) and the Mann-Whitney test for categorical and continuous variables, respectively. Logistic regression was used for multivariate analysis(AU)

Results Fifteen of the 20 donors were men. The cause of brain death was trauma in 9 donors, 7 were smokers, 13 required inotropic support, and pathogens were isolated in the BAL fluid of 18. The median age was 35 years (interquartile range [IQR], 23.5¨C51.25y), the median ventilation time was 1 day (IQR, 1¨C2d), the median PaO2/FiO2 was 459.5 (IQR, 427¨C510.25), and the median IL-8 concentration in BAL fluid was 49.01ng/L (IQR, 7.86¨C94.05ng/mL).Ten of the recipients were men and the median age was 48.43 years (IQR, 25.4¨C56.81y). The median ischemic time was 210minutes (IQR, 176.25¨C228.75min) for the first lung and 300minutes (IQR, 273.75¨C333.73min) for the second lung. The median PaO2/FiO2 ratio for the implant at 6, 14, and 48hours was 329 (IQR, 190.25¨C435), 363.5 (IQR, 249¨C434.75), and 370.5 (IQR, 243.25¨C418.25), respectively. The median intubation time was 39.5hours (IQR, 19.25¨C68.5h) and the correlation with IL-8 values was positive: higher IL-8 concentrations in BAL fluid correlated with longer ventilation times (Spearman rank correlation, P=.007; ¦Ñ=0.583). Five patients developed primary graft failure; IL-8 concentrations were significantly higher in these patients than in those whose grafts did not fail (Mann-Whitney test, P=.003).ConclusionHigh IL-8 concentrations in donor BAL fluid lead to longer ventilation time in the recipients and favor the development of primary graft failure after lung transplant(AU)

The utility of a specific measure for heart transplant patients: reliability and validity of the Kansas City Cardiomyopathy Questionnaire.

BACKGROUND: Health-Related Quality of Life of patients with heart transplantation is an important variable; however, it has received little attention so far, and only two Spanish validated measurement instruments are available. The aim of our study was to validate the Spanish version of the Kansas City Cardiomyopathy Questionnaire (KCCQ) in heart transplant patients. METHODS: A prospective study was performed in 186 patients awaiting heart transplantation in nine transplant hospitals. Hundred transplant recipients filled out the KCCQ, the Euroqol 5-D (EQ5D), and the Short Form-36 (SF-36) Health Survey at pretransplant, after 3 months, 6 months, and 1 year of follow-up. A complete set of sociodemographic and clinical data were also collected. The validity, reliability, sensitivity to change, and effect size were studied. Two questionnaires, the SF-36 and EQ5D, were used to evaluate the validity. RESULTS: Mean age of patients was 56.0 years, and 80.5% were men. Twenty-six percent had acute rejection. A five-dimensional factorial structure could be discerned. The questionnaire presented a Cronbach's alpha coefficient of more than 0.7. Correlations between the KCCQ and the other questionnaires and clinical variables were satisfactory. CONCLUSIONS: The KCCQ features adequate psychometric properties. The KCCQ offers several advantages over other questionnaires because it quantifies symptoms (frequency, severity, and stability) and it is much more sensitive to change, even when compared with the SF-36. The specific questionnaire for heart transplant patients is a useful and user-friendly instrument for measuring the Health-Related Quality of Life related to functional status, quality of life, and social limitation more accurately.

Influence of antiretroviral therapy on oxidative stress and cardiovascular risk: a prospective cross-sectional study in HIV-infected patients.

BACKGROUND: Oxidative stress (OS) results from excessive free radical production, exceeding endogenous antioxidant defense mechanisms, which can damage a wide variety of cellular components. One of the main consequences is the attack of free radicals on polyunsaturated fatty acids contained in low-density lipoprotein (LDL) lipids, causing lipid peroxidation and subsequent elevated concentrations of lipid peroxides and their metabolites, which are strongly suggestive of oxidative damage. OS is increased among HIV-infected patients, but whether it implicates a higher risk for cardiovascular disease or the influence of antiretroviral therapy (ART) on OS remains unknown. OBJECTIVE: The aim of this study was to assess the relationship of OS with established cardiovascular risk factors and with ART as measured by total peroxide concentration. METHODS: A prospective cross-sectional study was conducted in 245 consecutive HIV-infected patients during a 2-month period (September 15, 2003-November 15, 2003) at the HIV clinic of the Infectious Disease Unit, Hospital General Universitario de Elche, Universidad Miguel Hernández, Elche, Spain. Laboratory measurements included total peroxide concentrations, C-reactive protein (CRP) levels, fasting lipid levels, white blood cell type CD4(+) T-lymphocyte counts, plasma HIV RNA, and routine blood tests. To measure OS, total peroxide concentration was determined quantitatively with a colorimetric assay. The association of peroxide concentrations with HIV-related variables and cardiovascular risk factors was examined using univariate and multivariate analyses. RESULTS: Two hundred forty-five patients were screened and enrolled in the study; no patients refused enrollment. Median (interquartile range [IQR]) age of the patients was 40.2 (35.4-46.2) years; 194 (79.2%) were male, and 238 (97.1%) white. Median (IQR) weight was 67.5 (60.4-76.0). Ninety-five (38.8%) patients were receiving a non-nucleoside reverse-transcriptase inhibitor (NNRTI)-based regimen at the time of enrollment; 52 (21.2%) were on a protease inhibitor (PI)-based regimen. Peroxide concentrations were above reference values (< 400 micromol/L) in 121 (49.4%) patients. Peroxide levels correlated positively with CRP (P < 0.001) and LDL-cholesterol (LDL-C) (P = 0.003), and negatively with age (P = 0.002) and body mass index (P < 0.001). Among patients on ART, peroxide concentrations were significantly lower in those treated with NNRTI-based regimens than in those receiving PIs (median [IQR], 331.2 [196.2-495.7] vs 472.8 [302.5-586.5] micromol/L; P = 0.003). In multivariate analysis, when peroxide concentration was dichotomized according to reference values (< 400 micromol/L), age (odds ratio [OR], 0.96; 95% CI, 0.93-0.99; P = 0.007) and ART including NNRTI (OR, 0.52; 95% CI, 0.28-0.95; P = 0.03) were associated with low peroxide concentrations, while LDL-C (OR, 1.01; 95% CI, 1.00-1.02; P = 0.03) predicted the highest values. CONCLUSIONS: The results from this study suggest that, among this cohort of HIV-infected patients, peroxide concentration used as a marker of OS was associated with other established cardiovascular risk factors. Antiretroviral regimens based on NNRTIs were associated with low peroxide concentrations. In contrast, high peroxide levels were found in patients receiving PI-based regimens.

The role of C-reactive protein as a marker for cardiovascular risk associated with antiretroviral therapy in HIV-infected patients.

C-reactive protein (CRP) has been associated with prognosis of HIV-infection, but its relationship with cardiovascular disease remains unknown. We aimed to evaluate whether CRP may be a marker of cardiovascular risk in HIV-infected patients, and to determine the influence of antiretroviral therapy (ART) on CRP levels. We conducted a cross-sectional study on 245 consecutive HIV-infected patients during a 2-month period. An extensive workup for cardiovascular risk was performed, including determination of CRP levels measured by an ultrasensitive immunoturbidimetric assay (detection limit, 0.003 mg/dl). Ninety-nine (40.4%) patients had serum CRP concentrations above 0.3 mg/dl, considered to represent individuals at high risk for developing cardiovascular complications. In univariate analysis, CRP levels correlated positively with total cholesterol (p=0.01), LDL cholesterol (p=0.001), triglycerides (p=0.04) and Framingham risk score (p=0.006), and negatively with HDL cholesterol (p=0.004). Concentrations of CRP were higher in males (p=0.05) and smokers (p=0.002). No correlation was found between CRP levels and HIV-viral load or CD4 cell counts. In multivariate analysis, independent factors associated with the highest quartile of serum CRP concentrations (0.49 mg/dl) were LDL-cholesterol (p<0.001), HDL-cholesterol (p=0.001), cigarette smoking (p=0.019) and current ART (p=0.021). Our results show that C-reactive protein is associated with traditional cardiovascular risk factors, and may then be a marker for cardiovascular risk linked to HIV infection and ART.