Randomized Clinical Trial of the Need for Antibiotic Treatment for Low-Risk Catheter-Related Bloodstream Infection Caused by Coagulase-Negative Staphylococci.

According to clinical guidelines, the management of catheter-related bloodstream infections (CRBSI) due to coagulase-negative staphylococci (CoNS) includes catheter removal and antibiotic treatment for 5 to 7 days. However, in low-risk episodes, it remains uncertain whether antibiotic therapy is necessary. This randomized clinical trial aims to determine whether the non-administration of antibiotic therapy is as safe and effective as the recommended strategy in low-risk episodes of CRBSI caused by CoNS. With this purpose, a randomized, open-label, multicenter, non-inferiority clinical trial was conducted in 14 Spanish hospitals from 1 July 2019 to 31 January 2022. Patients with low-risk CRBSI caused by CoNS were randomized 1:1 after catheter withdrawal to receive/not receive parenteral antibiotics with activity against the isolated strain. The primary endpoint was the presence of any complication related to bacteremia or to antibiotic therapy within 90 days of follow-up. The secondary endpoints were persistent bacteremia, septic embolism, time until microbiological cure, and time until the disappearance of a fever. EudraCT: 2017-003612-39 INF-BACT-2017. A total of 741 patients were assessed for eligibility. Of these, 27 were included in the study; 15 (55.6%) were randomized to the intervention arm (non-antibiotic administration) and 12 (44.4%) to the control arm (antibiotic therapy as per standard practice). The primary endpoint occurred in one of the 15 patients in the intervention group (septic thrombophlebitis) and in no patients in the control group. The median time until microbiological cure was 3 days (IQR 1-3) in the intervention arm and 1.25 days (IQR 0.5-2.62) in the control arm, while the median time until fever resolution was zero days in both arms. The study was stopped due to the insufficient number of recruited patients. These results seem to indicate that low-risk CRBSI caused by CoNS can be managed without antibiotic therapy after catheter removal; efficacy and safety are not affected.

Dysmobility syndrome: a case-series study describing a musculoskeletal syndrome in postmenopausal Mexican women.

"Dysmobility Syndrome" (DS) is a term that correlates sarcopenia and osteoporosis together with mobility disturbances, obesity, fractures, and falls. The prevalence of DS is of 74% in this study. Further research with bigger sample sizes is needed to describe if prevalence and DS characteristics are similar in other studies. PURPOSE: "Dysmobility Syndrome" (DS) correlates sarcopenia and osteoporosis together with mobility disturbances, obesity, fractures, and falls, all of which are related to adverse outcomes in the health of the elderly; however, there are no studies of DS in Mexican patients. In this study, we aimed to describe the characteristics of DS in Mexican postmenopausal women from a private practice. METHODS: A case-series study was conducted; women of 60 years and older were invited to participate from August to December of 2019, a total of 50 patients were included. Medical history, physical tests, bone densitometry, and body composition analysis were performed; patients who met 3 or more of the following criteria were diagnosed with DS: osteoporosis: T-score ≤ -2.5, falls in a previous year, lean appendicular mass: ≤ 5.45 kg/m2, walking speed: < 1.0 m/s, grip strength: < 20 kg, and body fat percentage: > 40%. RESULTS: Out of the total 50 patients, 37 were diagnosed with DS, with a prevalence of 74% in our study. Sixteen patients had a history of a non-vertebral fragility fracture, of which 14 had a diagnosis of DS (87%). CONCLUSIONS: DS has a high frequency in our study group, and was found to be closely related to the presence of non-vertebral fragility fractures. More research is needed to describe the prevalence and characteristics of DS with a stronger statistical significance within our population, and among others across the country, to get an extensive understanding of its presentation in Mexican women. KEY POINTS: • The frequency of DS in this study is higher than the one that is described in global literature. • DS diagnosis is closely related to the antecedent of non-vertebral fragility fracture.

Constitución de sujeto político: historias de vida política de mujeres líderes afrocolombianas / Political constitution of the subject: life stories of afro-Colombian political leader women

La presente investigación está comprometida con el problema de la mujer afrocolombiana como sujeto político. El objetivo principal del estudio es caracterizar el proceso de construcción, como sujetos políticos, de tres mujeres líderes afrocolombianas: una líder comunitaria, una líder universitaria y una líder política. Para tal efecto, se recogieron historias de vida política, las cuales estuvieron cimentadas en entrevistas biográficas. Los investigadores proponen un modelo dialéctico que permita comprender el proceso de constitución de sujetos políticos, conformado por tres dimensiones: conocimiento de la realidad social, toma de posición, y acción política; así mismo tiene en cuenta las influencias personales, interpersonales, institucionales y socioculturales presentes en dicho proceso. Los resultados hacen referencia a las convergencias y divergencias encontradas en el discurso de las participantes, acerca de su construcción como sujetos políticos, lo cual permitió generar reflexiones sobre el por qué algunas personas ejercen acciones políticas y otras no.

The following investigation is concerned with the Afrocolombian women’s problem as a politic subject. The main goal of the study is to characterize the process that Afrocolombian women (a communitarian leader, a college leader and a politic leader) in order to do it will use the political self. The principal strategy to answer the previous question is life’s history using the biographic interview. The investigators created a dialectical model about the process of construction as a political being, which is constituted by the reality knowledge, the attitude in front of and the political action; in the same way manner personal, interpersonal, institutional and socio – cultural influences are include also. The results relate to the convergences and the divergences found in the participant’s speech about their construction as politic subject; which generate reflections about why some people practice politics actions and other person don’t do that.