Micafungin as antifungal prophylaxis in non-transplanted haemotological patients.

OBJECTIVE: Fungal infections are a major cause of morbidity and mortality in the haematological patients. These infections are mainly due to Candida spp. and Aspergillus spp. Mortality by these infections is high, but rates have descended in the latest series due to better antifungal agents. Echinocan-dins are, in vitro, very active against Candida and Aspergillus spp. The objective of the study is to analyse the efficacy and safety of micafungin in the antifungal prophylaxis of haema-tological patients on chemotherapy. METHODS: A multicentre, observational retrospective study was performed in 7 Haematology Depart-ments in Spain. Patients admitted to these departments with chemotherapy or immunosuppressive treatment, and who had received antifungal prophylaxis with micafungin between 1 January 2009 and 31 December 2014 were included. RESULTS: There were 5 cases of probable or proven fun-gal infection (4.8%) according to the 2008 EORTC criteria: 2 proven, 3 probable. The types of fungal infection were 3 as-pergillosis and 2 candidiasis. There were no drop-outs from the prophylaxis with micafungin due to toxicity. CONCLUSIONS: Micafungin is an antifungal agent which, used in prophylaxis, has demonstrated good efficacy and an excellent toxicity profile, making it an apparently interesting option in patients requiring antifungal prophylaxis during their hospitalisation episode.

Multiple myeloma patients in long-term complete response after autologous stem cell transplantation express a particular immune signature with potential prognostic implication.

The proportion of multiple myeloma patients in long-term complete response (LTCR-MM) for more than 6 years after autologous stem cell transplantation (ASCT) is small. To evaluate whether this LTCR is associated with a particular immune signature, peripheral blood samples from 13 LTCR-MM after ASCT and healthy blood donors (HBD) were analysed. Subpopulations of T-cells (naïve, effector, central memory and regulatory), B-cells (naïve, marginal zone-like, class-switched memory, transitional and plasmablasts) and NK-cells expressing inhibitory and activating receptors were quantified by multiparametric flow cytometry (MFC). Heavy/light chains (HLC) were quantified by nephelometry. The percentage of CD4+ T-cells was lower in patients, whereas an increment in the percentage of CD4+ and CD8+ effector memory T-cells was associated with the LTCR. Regulatory T-cells and NK-cells were similar in both groups but a particular redistribution of inhibitory and activating receptors in NK-cells were found in patients. Regarding B-cells, an increase in naïve cells and a corresponding reduction in marginal zone-like and class-switched memory B-cells was observed. The HLC values were normal. Our results suggest that LTCR-MM patients express a particular immune signature, which probably reflects a 'high quality' immune reconstitution that could exert a competent anti-tumor immunological surveillance along with a recovery of the humoral immunity.

Otsc clip lost in abdomen 3 years

OTSC is a safe and effective endoscopic method used in the treatment of gastrocutaneous or esophageal fistulas. The authors describe a clinic case which an intraabdominal clip was found 3 years after she was managed with an over-the-scope-clip (OTSC) to repair a gastrocutaneous fistula.In this case, the abdominal pain could be related to a self-limited localized peritonitis that resolved without the need of any medical treatment. Efficacy and safety of over-the-scope clip, including complications after endoscopic submucosal dissection are discussed

No disponible

High pressure elastic properties of minerals from ab initio simulations: the case of pyrope, grossular and andradite silicate garnets.

A computational strategy is devised for the accurate ab initio simulation of elastic properties of crystalline materials under pressure. The proposed scheme, based on the evaluation of the analytical stress tensor and on the automated computation of pressure-dependent elastic stiffness constants, is implemented in the CRYSTAL solid state quantum-chemical program. Elastic constants and related properties (bulk, shear and Young moduli, directional seismic wave velocities, elastic anisotropy index, Poisson's ratio, etc.) can be computed for crystals of any space group of symmetry. We apply such a technique to the study of high-pressure elastic properties of three silicate garnet end-members (namely, pyrope, grossular, and andradite) which are of great geophysical interest, being among the most important rock-forming minerals. The reliability of this theoretical approach is proved by comparing with available experimental measurements. The description of high-pressure properties provided by several equations of state is also critically discussed.

Melting of α-Al2O3 and vitrification of the undercooled alumina liquid: ab initio vibrational calculations and their thermodynamic implications.

We present the results of a computational investigation of the structure-energy and vibrational properties of alumina under various aggregation states (crystalline, glassy, and liquid) with ab initio procedures. IV-fold, V-fold, and VI-fold oxygen-coordinated aluminum monomeric forms in a dielectric continuum with dielectric constant ε = 4.575 were investigated through DFT/B3LYP gas-phase calculations coupled with a Polarized Continuum Model approach and those of the periodical structure D(6)(3d) (R-3c) which leads to the α-Al(2)O(3) polymorph of alumina, when subjected to symmetry operations, were investigated with the same functional within the LCAO approximation and in the framework of Bloch's theorem. Based on the computed energies and vibrational features, an aggregate of the D(6)(3d) positively charged cluster [Al(12)O(11)](14+) contoured by [AlO(4)](5-) units in an approximate 1:3 proportion to achieve neutrality satisfactorily reproduce the heat capacity of the liquid within experimental uncertainty. The glass is seen as a wrong accretionary form induced by fast cooling rates and subjected to steric forces that locally modify the coordination state of the central atom. Cessation of rotational and translational movements, only partly counterbalanced by acoustic sine-wave-dispersed and excess phonons, gives rise to the huge heat-capacity gap observed at the glass transition (~5.3R). When cooling rates are sufficiently slow, the accretion around the D(6)(3d) seeds follows the structural constraints and the heat capacity of α-alumina is almost perfectly reproduced by the 27 Einstein oscillators coupled with the 3 acoustic terms and the anharmonic corrections.

The vibrational behavior of silica clusters at the glass transition: Ab initio calculations and thermodynamic implications.

We present the results of a computational investigation with ab initio procedures of the structure-energy and vibrational properties of silica clusters in a dielectric continuum with dielectric constant ε=3.8, through density functional theory/B3LYP gas phase calculations coupled with a polarized continuum model approach [integral equation formalism applied to a polarized continuum (IEFPCM)] and those of the periodical structure D(6h) which leads to the α-cristobalite polymorph of silica when subjected to symmetry operations with the same functional within the linear combination of atomic orbitals (LCAO) approximation and in the framework of Bloch's theorem. Based on the computed energies and vibrational features, an aggregate of the D(6h) network and the monomer locally ordered in the short-medium range and both present in the glass in a mutual arrangement lacking of spatial continuity reproduces satisfactorily the experimentally observed low T heat capacity and the deviation from the Debye T(3) law. Above T(g), the experimental heat capacity of the liquid is perfectly reproduced summing to the internal modes the translational and rotational contributions to the bulk heat capacity and subtracting the (acoustic) terms arising from coherent motion (no longer existent).

Dysplasia ectodérmica hipohidrótica: causa inusual de fiebre de origen desconocido / No disponible

La displasia ectodérmica hipohidrótica (DEH) es una patología que debe considerarse dentro del diagnóstico diferencial de los procesos febriles en la infancia, sobre todo sin son recurrentes o de origen desconocido. Se presenta un nuevo caso de DEH en un lactante varón de 13 meses con cuadro febriles de repetición sin foco y con el fenotipo característico, consistente en un pelo ralo y escaso, hipodoncia, piel fina y seca y una facies peculiar. El conocimiento de las características clínicas tan específicas de esta entidad nos puede permitir un diagnóstico precoz y relativamente sencillo, minimizando así la iatrogenia asociada a la demora diagnostica (AU)

Hypohidrotic ectodermal displasia (HED( is a pathology that must be considered in the differential diagnosis of childhood´s febril processes, mainly if they are recurrent or of unknown origin. We present here a new case of HED in a 13 months old boy with recurrent fevers without focus, exhibiting a particular phenotype consisting of fine and scarce hair, oligodontia, smooth and dry skin and a particular facies. The knowledge of these particular clinical features allow an early and relative simple diagnosis, minimizing the iatrogenia associated to delays in diagnosis (AU)

Impact of logging on a mangrove swamp in south Mexico: cost/benefit analysis

Environmental changes caused by logging in a mangrove swamp were studied in Barra de Tecoanapa, Guerrero, Mexico. Original forest included Rhizophora mangle, Laguncularia racemosa, Avicennia germinans and halophytic vegetation, and produced wood (164.03 m3/ha) and organic matter (3.9 g/m2/day). A total of 3.5 tons of wood per year were harvested from this area. Later, an average of 2,555 kg of maize per planting cycle were obtained (market value of 88 USD). Succession when the area was abandoned included strictly facultative and glycophyte halophytes (16 families, Cyperaceae and Poaceae were the best represented). After logging, temperatures increased 13 degrees C in the soil and 11 degrees C in the air, whereas salinity reached 52 psu in the dry season. These modified soil color and sand content increased from 42.6 to 63.4. Logging was deleterious to species, habitat, biogeochemical and biological cycles, organic matter production, seeds, young plants, genetic exchange conservation of soil and its fertility, coastal protection, and aesthetic value; 3,000 m2 had eroded as the river advanced towards the deforested area (the cost/benefit analysis showed a ratio of 246:1). There was long-term economic loss for the community and only 30 of the site has recovered after five years.

Impact of logging on a mangrove swamp in south Mexico: cost/benefit analysis.

Environmental changes caused by logging in a mangrove swamp were studied in Barra de Tecoanapa, Guerrero, Mexico. Original forest included Rhizophora mangle, Laguncularia racemosa, Avicennia germinans and halophytic vegetation, and produced wood (164.03 m3/ha) and organic matter (3.9 g/m2/day). A total of 3.5 tons of wood per year were harvested from this area. Later, an average of 2,555 kg of maize per planting cycle were obtained (market value of 88 USD). Succession when the area was abandoned included strictly facultative and glycophyte halophytes (16 families, Cyperaceae and Poaceae were the best represented). After logging, temperatures increased 13 degrees C in the soil and 11 degrees C in the air, whereas salinity reached 52 psu in the dry season. These modified soil color and sand content increased from 42.6 to 63.4%. Logging was deleterious to species, habitat, biogeochemical and biological cycles, organic matter production, seeds, young plants, genetic exchange conservation of soil and its fertility, coastal protection, and aesthetic value; 3,000 m2 had eroded as the river advanced towards the deforested area (the cost/benefit analysis showed a ratio of 246:1). There was long-term economic loss for the community and only 30% of the site has recovered after five years.

Organ-tissue mass measurement allows modeling of REE and metabolically active tissue mass.

Investigators have expressed interest in the associations between resting energy expenditure (REE) and body mass for over a century. Traditionally, descriptive models using regression analysis are applied, linking REE with metabolically active compartments such as body cell mass (BCM) and fat-free body mass (FFM). Recently developed whole body magnetic resonance imaging (MRI) and echocardiography methods now allow estimation of all major organs and tissue volumes in vivo. Because measured values are available for REE, BCM, and FFM content of individual organs and tissues, it should now be possible to develop energy expenditure-body composition estimation models based on MRI-measured organ-tissue volumes. Specifically, the present investigation tested the hypothesis that in vivo estimation of whole body REE, BCM, and FFM is possible using MRI- and echocardiography-derived organ volumes combined with previously reported organ-tissue metabolic rates and chemical composition. Thirteen subjects (5 females, 8 males) had REE, BCM, and FFM measured by indirect calorimetry, whole body 40K counting, and dual-energy X-ray absorptiometry, respectively. Models developed from estimated and measured variables were highly correlated, with no significant differences between those estimated and measured [e.g., calculated vs. measured REE: r = 0.92, P < 0. 001; (mean +/- SD) 6,962 +/- 1,455 and 7,045 +/- 1,450 kJ/day, respectively (P = not significant)]. Strong associations were observed between REE, individual or combined organ weights, BCM, and FFM that provide new insights into earlier observed metabolic phenomona. The present approach, the first to establish an energy expenditure-body composition link with a mechanistic model in vivo, has the potential to greatly expand our knowledge of energy expenditure-body size relationships in humans.

Regulation of the renal response to atrial natriuretic peptide by sodium intake in preweaned rats.

The neonate conserves sodium avidly, and sodium intake is normally limited to that present in maternal milk. To evaluate the role of atrial natriuretic peptide (ANP) in this adaptation, preweaned rat pups were artificially reared and fed a formula with either normal sodium (25 mEq/L) or high sodium (145 mEq/L) for 7-8 d. To determine whether increased dietary sodium decreases ANP clearance receptor activity, animals were anesthetized, and the plasma ANP concentration (ANPp), urine flow (V), urinary sodium (UNa V), and cGMP excretion (UcGMP V) were measured before and after infusion of ANF(4-23), an ANP clearance receptor inhibitor (C-ANF), at 50 micrograms/kg/ min. Infusion of C-ANF increased ANPp 10-fold in both normal and high sodium groups, but V, UNa V, and UcGMP V increased only in animals receiving the high sodium diet (p < 0.05). Incubation of isolated glomeruli with 0.1 microM ANP increased extracellular cGMP more in high sodium than normal sodium groups (p < 0.05). We conclude that ANP clearance receptors in the neonate are highly activated regardless of sodium intake. Increased dietary sodium increases the renal diuretic and natriuretic response to circulating ANP through enhanced generation of cGMP.

Endogenous angiotensin II inhibits natriuresis after acute volume expansion in the neonatal rat.

Compared with the adult, the neonatal renal natriuretic response to acute volume expansion (VE) is attenuated. To test the hypothesis that antinatriuresis is mediated by endogenous angiotensin I (ANG II), Sprague-Dawley rats were given losartan, an ANG II type 1 (AT1)-receptor inhibitor (40 mg.kg-1.day-1) from birth to 14-17 days. Control littermates received saline vehicle. Anesthetized rats underwent acute saline VE for measurement of mean arterial blood pressure (MAP), plasma aldosterone concentration (Paldo), plasma atrial natriuretic peptide (PANP), glomerular filtration rate (GFR), sodium excretion (UNaV), potassium excretion (UKV), and urine guanosine 3',5'-cyclic monophosphate excretion (UcGMPV). Losartan increased basal urine flow fivefold, UNaV 10-fold, and UKV twofold. Acute VE induced marked diuresis, natriuresis, and kaliuresis in the losartan but not in the saline group. This occurred without change in Paldo and PANP and despite lower MAP, GFR, and UcGMPV. In addition, losartan did not affect release of cGMP from isolated glomeruli stimulated by ANP or sodium nitroprusside. We conclude that the limited renal response to acute VE in the neonate results from stimulation of tubular Na reabsorption by ANG II acting on the AT1 receptor.

Chronic sodium loading augments natriuretic response to acute volume expansion in the preweaned rat.

Positive sodium balance is necessary for normal somatic growth of the neonate, and the neonatal renal response to volume expansion (VE) is attenuated compared with the adult. To test the hypothesis that dietary sodium modulates the developmental response to VE, preweaned rats were artificially reared with either a normal (25 meq/l)- or high-sodium (145 meq/l) diet for 7-8 days and were compared with adult rats receiving normal or high sodium. Serum sodium concentration remained normal in adults on high sodium, whereas neonates became hypernatremic. Glomerular filtration rate (GFR), urinary flow (V), and urinary sodium (UNaV) were measured before and after acute saline VE (1% body wt). While remaining constant in preweaned rats, GFR increased > 50% in adult rats after VE (P < 0.05). High sodium intake augmented V and UNaV after VE but was not sustained in neonates as in adults. Plasma atrial natriuretic peptide (ANP) and guanosine 3',5'-cyclic monophosphate excretion (UcGMPV) were measured, and baseline UcGMPV was lower in preweaned rats receiving normal sodium but increased to levels similar to adult levels after VE. Postexpansion plasma ANP was higher in preweaned rats than in adult rats and was not affected by dietary sodium regardless of age. We conclude that the attenuated postexpansion natriuresis in the neonate is due in part to an adaptive response to limited sodium intake. However, neonatal compensation to increased sodium intake is incomplete and independent of plasma ANP.

Dietary sodium modulates neonatal but not adult cardiac atrial natriuretic peptide in rats.

After an initial postnatal diuresis, neonates are in positive sodium balance. Because atrial natriuretic peptide (ANP) contributes to sodium homeostasis, this study was designed to evaluate the maturational effects of increased dietary sodium intake on cardiac ANP production. Preweaned Sprague-Dawley rat pups were artificially reared by feeding them either a normal-sodium or high-sodium diet for 7 d and were compared with maternally reared rat pups. Adult rats were divided into three groups: the first group was given ad libitum rat food and 1% sodium chloride to drink, the second group was pair-fed with this group but given tap water to drink, and the third group was fed ad libitum rat food and water for 10 d. Atrial and ventricular pro-ANP and ANP contents and plasma ANP concentrations were measured by RIA. Steady state atrial and ventricular ANP mRNA expression was determined by Northern and dot-blot analysis. There was a 2-fold increase in atrial pro-ANP and ANP content and a 50% decrease in plasma ANP concentration in preweaned rat pups fed a high-salt diet. In contrast, atrial pro-ANP and ANP content and plasma ANP concentration were not affected by increased sodium intake in adult rats. Atrial and ventricular ANP mRNA levels and ventricular pro-ANP and ANP contents were not altered by dietary sodium at either age. We conclude that chronic increase in sodium intake in the preweaning period results in increased storage of atrial pro-ANP. The decrease in plasma ANP concentration in these preweaned rats may be due to reduced basal secretion or enhanced degradation of the peptide.

[AIDS and the community. Preliminary data of an epidemiological study]. / A.I.D.S. e comunità. Dati preliminari di uno studio epidemiologico.

An epidemiological study into the prevalence and incidence of anti-H.I.V. antibody seropositivity in closed communities produced preliminary data on 746 subjects, the majority of whom admitted potentially dangerous behaviour. These results demonstrated that residence in a closed community in which one can limit the use of drugs and sexual contacts reduces the risk of infection.