Comparison between five PCR techniques for the diagnosis of SARS-CoV-2.

OBJECTIVE: Since the first cases of SARS-CoV-2 appeared, there have been numerous techniques that have been developed for the diagnosis or monitoring of infection, both direct and serological techniques. Choosing a good diagnostic tool is essential for epidemiological control. The objective was to compare five commercialized RT-PCR techniques in real time, in sensitivity, specificity and agreement for the detection of SARS-CoV-2. METHODS: Five commercial RT-PCR kits for the detection of SARS-CoV-2 were compared. Eight known positive samples were taken and subjected to seven different dilutions or concentrations, and another 135 negative samples were used to determine sensitivity, specificity, and agreement values. RESULTS: The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the Palex, Roche and GeneXpert techniques with respect to Seegene were identical, corresponding to 98.21%, 100%, 100% and 99.26% respectively. For Becton Dickinson the sensitivity was 89.28%, the specificity of 100%, the PPV of 100% and the NPV of 95.74%. The agreement using the Kappa index for Palex, Roche and GeneXpert was 0.9892, while the agreement for Becton Dickinson was with a Kappa index of 0.9215. CONCLUSIONS: All commercial RT-PCR kits had high sensitivities and specificities, as well as PPV, NPV, and concordance.

Effect of Bifidobacterium infantis NLS super strain in symptomatic coeliac disease patients on long-term gluten-free diet - an exploratory study.

Bifidobacterium infantis NLS super strain (B. infantis NLS-SS) was previously shown to alleviate gastrointestinal symptoms in newly diagnosed coeliac disease (CD) patients consuming gluten. A high proportion of patients following a gluten-free diet experiences symptoms despite dietary compliance. The role of B. infantis in persistently symptomatic CD patients has not been explored. The aim of the study was to evaluate the effect of B. infantis NLS-SS on persistent gastrointestinal symptoms in patients with CD following a long-term GFD. We conducted a randomised, cross-over, double-blind, placebo-controlled trial in symptomatic adult CD patients on a GFD for at least two years. After one-week run-in, patients were randomised to B. infantis NLS-SS or placebo for 3 weeks with cross-over after a 2-week wash-out period. We estimated changes (Δ) in celiac symptom index (CSI) before and after treatment. Stool samples were collected for faecal microbiota analysis (16S rRNA sequencing). Gluten immunogenic peptide (GIP) excretion in stool and urine samples was measured at each study period. Eighteen patients were enrolled; six patients were excluded due violations in protocol. For patients with the highest clinical burden, CD symptoms were lower in probiotic than in placebo treatment (P=0.046). B. infantis and placebo treated groups had different microbiota profiles as assessed by beta diversity clustering. In probiotic treated groups, we observed an increase in abundance of B. infantis. Treatment with B. infantis was associated with decreased abundance of Ruminococcus sp. and Bifidobacterium adolescentis. GIP excretion in stools and urine was similar at each treatment period. There were no differences in adverse effects between the two groups. B. infantis NLS-SS improves specific CD symptoms in a subset of highly symptomatic treated patients (GFD). This is associated with a shift in stool microbiota profile. Larger studies are needed to confirm these findings. ClinicalTrials.gov: NCT03271138.

Chronic dacryocystitis caused by sarcoidosis. / Dacriocistitis crónica causada por sarcoidosis.

Sarcoidosis of lacrimal sac is a very uncommon disease. When the patient has symptoms of lacrimal sac diseases, it is necessary to take into account the histological evaluation, to demonstrate the involvement of the lacrimal sac by this pathology. In patients with sarcoidosis history, the treatment is surgical and it is suggested to do an external dacryocystorhinostomy, in order to take a biopsy, to get a diagnosis and to establish the incidence of this pathology. The case is presented of a 44 year-old female, with a history of sarcoidosis lymph nodes, who presented with a right chronic dacryocystitis of one year onset.

[Use of Digital Health Records and "WebMovil" corporate service in the communication management of critical results of Microbiology, in the context of a primary health care area]. / Utilización de la Historia Digital de Salud y la aplicación "WebMovil" corporativa en la gestión de la comunicación de resultados críticos de Microbiología, en el ámbito de Atención Primaria de un Área Sanitaria.

INTRODUCTION: The objective was to describe and evaluate a new communication protocol of reporting critical results applied to Microbiology in a health area of Andalusia. MATERIAL AND METHODS: The size and type of the critical values of Microbiology are analyzed for primary care patients. A new computerized reporting system was analyzed, in real time, through Diraya Digital Health Records, which integrates the analytical test module (MPA). The protocol is complemented, in collaboration with the Information Technology (IT), with the Junta de Andalucía short message service (SMS) "WebMovil". RESULTS: The total number of notices of critical results by the new protocol in 2012 was 817. The number of critical values for primary care was 570, of which 90 were for Microbiology. The most frequent notice was by isolation in the stool culture (n = 51; 56.67%). The prevalence of the critical values of Microbiology in primary care was 0.45/100. The average time of notifications was 13 minutes. The success rate of notifications was 97.7% and 0% obtained in the number of withdrawals. In 99.93% of cases the contact with the patient was stated and in 98.55% the medical intervention was also confirmed. CONCLUSIONS: Communication by a computerized system linked to the SMS technology showed a reduction in the time of notification, and produced additional benefits, such as eliminating the risk of error when there is no repetition of information from the recipient received by the laboratory. Furthermore, the use of SMS messages ensures that doctors on duty always receive information immediately.

Nyctiphanes couchii as intermediate host for Rhadinorhynchus sp. (Acanthocephala, Echinorhynchidae) from NW Iberian Peninsula waters.

In the mesozooplanktonic community of the coastal upwelling system of the Ría de Vigo (NW Spain), the euphausiid Nyctiphanes couchii has been identified for the first time in temperate waters of the NE Atlantic as the intermediate host for cystacanths of Rhadinorhynchus sp. Parasites were identified using morphological characters described in 20 cystacanths. The hooks of the proboscis were arranged in 14 rows of 26 hooks each, while the hooks of the basal circle were only slightly erected and were longer than remaining spines. A maximum-likelihood estimation (ML) tree inferred from the 18S rRNA data set of Palaeacantocephala revealed that our specimens belong to a highly supported clade with Rhadinorhynchus sp., Pararhadinorhynchus sp. and Transvena annulospinosa. Nonetheless, our morphological and phylogenetic analyses suggested that the status of Rhadinorhynchus pristis should be re-examined. The prevalences of parasites were 0.0019% and 0.0001% for frontal and coastal summer communities, and 0.0068% and 0.0008% for coastal and oceanic autumn communities, respectively. The presence of these cystacanths in different mesozooplankton communities throughout the study suggests that the recruitment of parasites may be affected by the oceanography.

Nyctiphanes couchii as intermediate host for the acanthocephalan Bolbosoma balaenae in temperate waters of the NE Atlantic.

Cystacanths of the acanthocephalan Bolbosoma balaenae (Gmelin, 1790) were found encapsulated in the cephalothorax of the euphausiid Nyctiphanes couchii (Bell, 1853) from temperate waters in the NE Atlantic Ocean. Euphausiids were caught in locations outside the Ría de Vigo in Galicia, NW Spain, and prevalence of infection was up to 0.1%. The parasite was identified by morphological characters. Cystacanths were 8.09 ± 2.25 mm total length (mean ± SD) and had proboscises that consisted of 22 to 24 longitudinal rows of hooks, each of which had 8 or 9 hooks per row including 2 or 3 rootless ones in the proboscis base and 1 field of small hooks in the prebulbar part. Phylogenetic analyses of 18S rDNA and cytocrome c oxidase subunit I revealed a close relationship with other taxa of the family Polymorphidae (Meyer, 1931). The results extend northwards ot the known distribution of B. balaenae. Taxonomic affiliation of parasites and trophic ecology in the sampling area suggest that N. couchii is the intermediate host for B. balenae, and we suggest that the whales Balaenoptera physalus (Linnaeus, 1758) and B. acutorostrata (Lacepède, 1804) are its definitive hosts. This life cycle is probably completed with or without paratenic hosts.

Sperm ultrastructure of the hydrothermal vent octopod Vulcanoctopus hydrothermalis.

Sperm ultrastructure of the deep-sea hydrothermal vent octopod Vulcanoctopus hydrothermalis has been carried out by transmission electron microscopy. Spermatozoa of this species have the shortest head observed so far in octopodids. The acrosome possesses a helix with six gyres. The rod-shaped nucleus is short and wide in relation with other octopodids. Noteworthy features along the nucleus are the regularly disposed dense bands of cytoplasm, which have not been observed before in octopodids. The nuclear fossa is very short and wavy. Mitochondrial sheath has 10 elongated mitochondria running parallel to the axoneme-coarse fibers complex. Sperm morphology of V. hydrothermalis resembles that of Enteroctopus dofleini, suggesting a close phylogenetic relationship.

Metal and metalloid concentrations in the giant squid Architeuthis dux from Iberian waters.

This study investigated 14 trace elements (Ag, As, Cd, Co, Cr, Cu, Fe, Hg, Mn, Ni, Pb, Se, V and Zn) in the tissues of the giant squid Architeuthis dux from the Mediterranean and Atlantic Spanish waters. As for other families of cephalopods, the digestive gland and the branchial hearts of Architeuthis showed the highest concentrations of Ag, Cd, Co, Cu, Fe, Ni, Se, V and Zn, highlighting their major role in the bioaccumulation and detoxification processes. With the exception of Hg, the muscles showed relatively low trace element concentrations. Nevertheless, this tissue contained the main proportion of the total As, Cr, Hg, Mn, Ni, and Zn body burden because muscles represent the main proportion of the squid mass. These findings suggest that the metal metabolism is overall the same as other cephalopod families from neritic waters. In females, Zn concentrations increased in the digestive gland with the squid's weight likely reflecting physiological changes during sexual maturation. Comparing the trace element concentrations in the tissues of Architeuthis, higher Ag, Cu, Hg and Zn concentrations in the squid from the Mediterranean reflected different exposure conditions. In comparison to other meso-pelagic squids from the Bay of Biscay, Cd concentrations recorded in the digestive gland suggest that Architeuthis might feed on more contaminated prey or that it displays a longer life span that other cephalopods.

Bioaccumulation of persistent organic pollutants in female common dolphins (Delphinus delphis) and harbour porpoises (Phocoena phocoena) from western European seas: geographical trends, causal factors and effects on reproduction and mortality.

Concentrations of polychlorinated biphenyls (PCBs) in blubber of female common dolphins and harbour porpoises from the Atlantic coast of Europe were frequently above the threshold at which effects on reproduction could be expected, in 40% and 47% of cases respectively. This rose to 74% for porpoises from the southern North Sea. PCB concentrations were also high in southern North Sea fish. The average pregnancy rate recorded in porpoises (42%) in the study area was lower than in the western Atlantic but that in common dolphins (25%) was similar to that of the western Atlantic population. Porpoises that died from disease or parasitic infection had higher concentrations of persistent organic pollutants (POPs) than animals dying from other causes. Few of the common dolphins sampled had died from disease or parasitic infection. POP profiles in common dolphin blubber were related to individual feeding history while those in porpoises were more strongly related to condition.

A review of reproductive strategies in cephalopods.

Cephalopod reproductive strategies are reviewed in order to clarify their current, confusing status. Based on the type of ovulation, spawning pattern and growth between egg batches or spawning periods, five comprehensive and flexible cephalopod reproductive strategies are defined. Accordingly, with these three factors the following classification is proposed. (a) Spawning once (formerly semelparity) consisting of simultaneous terminal spawning, with synchronous ovulation, monocyclic spawning and absence of growth between egg batches. (b) Spawning more than once (formerly iteroparity) including: (i) polycyclic spawning with egg-laying occurring in separate batches during the spawning season and growth occurring between production of egg batches and spawning seasons; (ii) multiple spawning, with group-synchronous ovulation, monocyclic spawning and growth between egg batches; (iii) intermittent terminal spawning, with group-synchronous ovulation, monocyclic spawning and no growth between egg batches; (iv) continuous spawning, with asynchronous ovulation, monocyclic spawning and growth between egg batches. Examples of species exhibiting each of these reproductive strategies are given. The large amount of inter-species variation in several life-history traits related to reproductive events is discussed.

N-(3-acyloxy-2-benzylpropyl)-N'-dihydroxytetrahydrobenzazepine and tetrahydroisoquinoline thiourea analogues as vanilloid receptor ligands.

The vanilloid receptor represents a promising target for drug development. Building on our previous strategies which have generated potent agonists for VR1, we now describe a series of novel N-(3-acyloxy-2-benzylpropyl)-N'-dihydroxytetrahydrobenzazepine and tetrahydroisoquinoline thiourea analogues, several of which are potent VR1 antagonists. We report here the rationale for the design, the synthesis, and the in vitro characterization of activity in assays for [(3)H]resiniferatoxin binding and (45)Ca influx using heterologously expressed rat VR1.

Hb Johnstown [beta 109 (G11) Val-->Leu]: second case described and associated for the first time with beta(0)-thalassemia in two Spanish families.

Hb Johnstown, a high oxygen affinity hemoglobin, was identified in four members from two unrelated Spanish families with erythrocytosis and left-shifted hemoglobin-oxygen dissociation curve. This hemoglobin variant, electrophoretically silent, was analyzed by reverse-phase high-performance liquid chromatography, and the mutation was characterized at the DNA level by beta gene sequencing. In one of these families, two members are affected with Hb Johnstown in association with beta(0)-thalassemia. In these cases the erythrocytosis and low values for P(50) due to Hb Johnstown remain in spite of the beta-thalassemia.

Muscle infarction in diabetes: clinical manifestations and course.

OBJECTIVE: To characterize the initial manifestations and course of muscle infarction in diabetes, a rarely diagnosed condition. METHODS: We describe two patients with this disorder and review the clinical characteristics of previously reported cases. RESULTS: Usually, the initial complaint in patients with muscle infarction in diabetes is swelling of the thigh or calf that has evolved over days to months. Biopsy of the muscle is often necessary for diagnosis and reveals extensive muscle necrosis. Although the pathogenesis is unknown, hypercoagulability may have a role. Bilateral involvement and recurrent disease are common. Treatment is supportive; our patients required narcotics for alleviation of pain. CONCLUSION: Muscle infarction in diabetes may mimic thrombophlebitis, soft tissue infection, or a neoplasm. Medical evaluation may be directed toward these entities, and the diagnosis of a diabetes-associated disorder may be completely overlooked. The presence of atraumatic swelling of an extremity in a patient with diabetes should suggest diabetes-related muscle infarction.