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1.
Analyst ; 148(21): 5445-5455, 2023 Oct 23.
Article in English | MEDLINE | ID: mdl-37750047

ABSTRACT

We report for the first time the whole development of a biosensing system based on the Interferometric Optical Detection Method (IODM) enriched with gold nanoparticles (AuNPs), acting as interferometric enhancers for improving the performance of immunoassays. For this purpose, the Lactoferrin sandwich immunoassay model was employed. We describe in detail the entire value chain from the AuNPs production, its functionalization, and characterization with anti-Lactoferrin (anti-LF), the biosensing response of these conjugates as well as their corresponding calculation of the kinetic constants, performance comparison of the readout interferometric signals versus Scanning Electron Microscopy (SEM) and the percentage of the sensing surface covered. Finally, a Lactoferrin sandwich immunoassay was carried out and correlated with Enzyme-Linked ImmunoSorbent Assay (ELISA), and the Limit of Detection and sensitivity figures were obtained. As a result, we demonstrate how the AuNPs act as interferometric amplifiers of the IODM for improving the biosensing response, opening the possibility of being applied in multiple biological detection applications.

2.
Microb Genom ; 9(5)2023 05.
Article in English | MEDLINE | ID: mdl-37133905

ABSTRACT

Campylobacter is a leading causing of bacterial foodborne and zoonotic illnesses in the USA. Pulsed-field gene electrophoresis (PFGE) and 7-gene multilocus sequence typing (MLST) have been historically used to differentiate sporadic from outbreak Campylobacter isolates. Whole genome sequencing (WGS) has been shown to provide superior resolution and concordance with epidemiological data when compared with PFGE and 7-gene MLST during outbreak investigations. In this study, we evaluated epidemiological concordance for high-quality SNP (hqSNP), core genome (cg)MLST and whole genome (wg)MLST to cluster or differentiate outbreak-associated and sporadic Campylobacter jejuni and Campylobacter coli isolates. Phylogenetic hqSNP, cgMLST and wgMLST analyses were also compared using Baker's gamma index (BGI) and cophenetic correlation coefficients. Pairwise distances comparing all three analysis methods were compared using linear regression models. Our results showed that 68/73 sporadic C. jejuni and C. coli isolates were differentiated from outbreak-associated isolates using all three methods. There was a high correlation between cgMLST and wgMLST analyses of the isolates; the BGI, cophenetic correlation coefficient, linear regression model R 2 and Pearson correlation coefficients were >0.90. The correlation was sometimes lower comparing hqSNP analysis to the MLST-based methods; the linear regression model R 2 and Pearson correlation coefficients were between 0.60 and 0.86, and the BGI and cophenetic correlation coefficient were between 0.63 and 0.86 for some outbreak isolates. We demonstrated that C. jejuni and C. coli isolates clustered in concordance with epidemiological data using WGS-based analysis methods. Discrepancies between allele and SNP-based approaches may reflect the differences between how genomic variation (SNPs and indels) are captured between the two methods. Since cgMLST examines allele differences in genes that are common in most isolates being compared, it is well suited to surveillance: searching large genomic databases for similar isolates is easily and efficiently done using allelic profiles. On the other hand, use of an hqSNP approach is much more computer intensive and not scalable to large sets of genomes. If further resolution between potential outbreak isolates is needed, wgMLST or hqSNP analysis can be used.


Subject(s)
Campylobacter coli , Campylobacter jejuni , United States/epidemiology , Multilocus Sequence Typing , Campylobacter coli/genetics , Phylogeny , Disease Outbreaks
3.
MMWR Morb Mortal Wkly Rep ; 72(9): 223-226, 2023 Mar 03.
Article in English | MEDLINE | ID: mdl-36862586

ABSTRACT

Cronobacter sakazakii, a species of gram-negative bacteria belonging to the Enterobacteriaceae family, is known to cause severe and often fatal meningitis and sepsis in young infants. C. sakazakii is ubiquitous in the environment, and most reported infant cases have been attributed to contaminated powdered infant formula (powdered formula) or breast milk that was expressed using contaminated breast pump equipment (1-3). Previous investigations of cases and outbreaks have identified C. sakazakii in opened powdered formula, breast pump parts, environmental surfaces in the home, and, rarely, in unopened powdered formula and formula manufacturing facilities (2,4-6). This report describes two infants with C. sakazakii meningitis reported to CDC in September 2021 and February 2022. CDC used whole genome sequencing (WGS) analysis to link one case to contaminated opened powdered formula from the patient's home and the other to contaminated breast pump equipment. These cases highlight the importance of expanding awareness about C. sakazakii infections in infants, safe preparation and storage of powdered formula, proper cleaning and sanitizing of breast pump equipment, and using WGS as a tool for C. sakazakii investigations.


Subject(s)
Cronobacter sakazakii , Enterobacteriaceae Infections , Female , Infant , Humans , Infant Formula , Cronobacter sakazakii/genetics , Enterobacteriaceae Infections/diagnosis , Enterobacteriaceae , Milk, Human , Powders
4.
Farm. comunitarios (Internet) ; 14(Supl 1): 1, junio 2022. graf, mapas
Article in Spanish | IBECS | ID: ibc-209364

ABSTRACT

JUSTIFICACIÓN: el radón es un gas radiactivo que se emite desde la corteza terrestre, se acumula en el interior de los edificios y está clasificado como cancerígeno del Grupo 1 por el IARC. Se ha observado epidemiológicamente una relación entre la exposición a radón en interiores y el desarrollo de neoplasias pulmonares. La OMS atribuye entre el 3 y 14 % de ellas a esta causa. 87 municipios de la Comunidad de Madrid (Sierra de Guadarrama) han sido clasificados zona 2 (>5 % del tejido urbano en áreas con potencial de radón superior a 300 Bq/m³). A los farmacéuticos comunitarios les corresponden no solamente actividades dirigidas a producción, conservación y dispensación de medicamentos, sino aquellas ligadas a la vigilancia de la salud pública.OBJETIVOS: conocer la disposición del farmacéutico comunitario a ser promotor de pautas de prevención a la exposición del gas radón entre los pacientes y personas que se lo demanden y cuantificar la opinión que tienen en cuanto a la percepción del riesgo al radón de sus pacientes.MATERIAL Y MÉTODOS: estudio epidemiológico transversal en el que participaron 48 farmacias de municipios de la zona 2 de la Comunidad de Madrid. La captación de las farmacias se hizo a través del Colegio Oficial de Farmacéuticos de Madrid. Se realizó una encuesta a los farmacéuticos comunitarios participantes en el estudio respecto a variables sociodemográficas y ambientales (sexo, edad, valoración de la percepción del riesgo a la exposición de radón por parte de los pacientes y disposición de los farmacéuticos comunitarios de participar en una posible campaña de información y concienciación). (AU)


Subject(s)
Humans , Radon , Public Health , Pharmacy , Risk Factors , Patients
5.
Farm. comunitarios (Internet) ; 14(Supl 1): 1, junio 2022. graf, ilus
Article in Spanish | IBECS | ID: ibc-209365

ABSTRACT

JUSTIFICACIÓN: en una primera fase del estudio, se determinó a través de un estudio epidemiológico de tipo transversal, que los farmacéuticos comunitarios de la zona 2 de la Comunidad de Madrid estaban dispuestos a informar a la población acerca de los riesgos que entraña la exposición al radón. Al estar interesados en el proyecto, se les propuso realizar mediciones en las farmacias, lo cual podía proporcionarles un estado de situación del nivel de radón en el lugar de trabajo.OBJETIVOS: registrar niveles de concentración de radón en farmacias comunitarias en áreas con posible riesgo para localizar puntos de especial riesgo de exposición.MATERIAL Y MÉTODOS: estudio epidemiológico transversal en el que participaron 48 farmacias de municipios de la zona 2 de la Comunidad de Madrid. La captación de las farmacias se hizo a través del Colegio Oficial de Farmacéuticos de Madrid. Se mantuvo una reunión online para explicar el estudio y resolver dudas. Seleccionada la muestra, se ubicaron 55 captadores pasivos de tipo electrete en una sala interior de la farmacia durante tres meses. Las lecturas mensuales expresadas en Bq/m³ se hicieron en el Laboratorio de medidas de radón (CIEMAT).RESULTADOS/DISCUSIÓN: se colocó un detector por farmacia; dos en algunos casos, uno en la planta principal y otro en el sótano. El valor medio de radón detectado en las farmacias estudiadas fue de 99,5 Bq/m³ (DE 79,3) con un rango de concentración 26 a 409 Bq/m³. En dos farmacias (3,6 %) se observó una concentración superior a 300 Bq/m³. (AU)


Subject(s)
Humans , Radon , Public Health , Pharmacy , Risk Factors , Patients
6.
Farm. comunitarios (Internet) ; 14(Supl 1): 1, junio 2022. ilus
Article in Spanish | IBECS | ID: ibc-209366

ABSTRACT

JUSTIFICACIÓN: en una parte preliminar de este estudio, se detectaron farmacias situadas en regiones donde los niveles de radón superaban los considerados seguros. Una vez comprobado el interés de los farmacéuticos en el proyecto, se les proporcionó la oportunidad de realizar mediciones. Los farmacéuticos comunitarios como profesionales de la salud, deben ser capaces de proporcionar a los pacientes las herramientas adecuadas para prevenir la enfermedad, por ello, se les ofreció participar en una campaña de información y concienciación sobre el radón.OBJETIVOS: diseño e implementación de una serie de recomendaciones adicionales respecto la prevención a la exposición de radón en la práctica clínica de un grupo de farmacias comunitarias en zonas de alto riesgo.MATERIAL Y MÉTODOS: se realizó una revisión bibliográfica utilizando las plataformas de PubMed y Google Scholar. Los términos MeSH empleados fueron los siguientes: Radon, Environmental Exposure, Public Health, Radiation Protection, Prevention and Control. Por otro lado, se revisaron guías publicadas por organismos de carácter internacional como la OMS o la Comisión Internacional de Protección Radiológica (ICRP), además de recopilar información del Código Técnico de Edificación y reglamentos nacionales y europeos.RESULTADOS/DISCUSIÓN: con la información recabada se elaboró una formación para los farmacéuticos participantes en el estudio. Además se prepararon folletos informativos para que los farmacéuticos los repartieran a los pacientes que acudían a las farmacias en zonas de riesgo. Las medidas más esenciales a aplicar se relacionan con la ventilación, bien favoreciendo corrientes de aire (abriendo las ventanas y usando ventiladores) o bien instalando sistemas de ventilación mecánica controlada (más eficaz). Dentro de estos existen sistemas de control automático que favorecen el ahorro energético al responder en tiempo real al nivel de radón, monitorizado por un sensor de forma continua. (AU)


Subject(s)
Humans , Radon , Public Health , Pharmacy , Risk Factors , Patients
7.
JAMA Netw Open ; 4(9): e2125203, 2021 09 01.
Article in English | MEDLINE | ID: mdl-34524434

ABSTRACT

Importance: Extensively drug-resistant Campylobacter jejuni infections cannot be treated with any commonly recommended antibiotics and pose an increasing public health threat. Objectives: To investigate cases of extensively drug-resistant C jejuni associated with pet store puppies and describe the epidemiologic and laboratory characteristics of these infections. Design, Setting, and Participants: In August 2017, health officials identified, via survey, patients with C jejuni infections who reported contact with puppies sold by pet stores. In conjunction with state and federal partners, the Centers for Disease Control and Prevention investigated cases of culture-confirmed C jejuni infections in US patients with an epidemiologic or molecular association with pet store puppies between January 1, 2016, and February 29, 2020. Available records from cases occurring before 2016 with genetically related isolates were also obtained. Main Outcomes and Measures: Patients were interviewed about demographic characteristics, health outcomes, and dog exposure during the 7 days before illness onset. Core genome multilocus sequence typing was used to assess isolate relatedness, and genomes were screened for resistance determinants to predict antibiotic resistance. Isolates resistant to fluoroquinolones, macrolides, and 3 or more additional antibiotic classes were considered to be extensively drug resistant. Cases before 2016 were identified by screening all sequenced isolates submitted for surveillance using core genome multilocus sequence typing. Results: A total of 168 patients (median [interquartile range] age, 37 [19.5-51.0] years; 105 of 163 female [64%]) with an epidemiologic or molecular association with pet store puppies were studied. A total of 137 cases occurred from January 1, 2016, to February 29, 2020, with 31 additional cases dating back to 2011. Overall, 117 of 121 patients (97%) reported contact with a dog in the week before symptom onset, of whom 69 of 78 (88%) with additional information reported contact with a pet store puppy; 168 isolates (88%) were extensively drug resistant. Traceback investigation did not implicate any particular breeder, transporter, distributer, store, or chain. Conclusions and Relevance: Strains of extensively drug-resistant C jejuni have been circulating since at least 2011 and are associated with illness among pet store customers, employees, and others who come into contact with pet store puppies. The results of this study suggest that practitioners should ask about puppy exposure when treating patients with Campylobacter infection, especially when they do not improve with routine antibiotics, and that the commercial dog industry should take action to help prevent the spread of extensively drug-resistant C jejuni from pet store puppies to people.


Subject(s)
Bacterial Zoonoses/epidemiology , Campylobacter Infections/epidemiology , Campylobacter jejuni , Disease Outbreaks , Dog Diseases/transmission , Pets , Adult , Animals , Campylobacter Infections/microbiology , Campylobacter Infections/veterinary , Dogs , Drug Resistance, Bacterial , Female , Humans , Male , Middle Aged , Retrospective Studies , United States/epidemiology
8.
J Clin Microbiol ; 58(10)2020 09 22.
Article in English | MEDLINE | ID: mdl-32719029

ABSTRACT

Campylobacter jejuni is a leading cause of enteric bacterial illness in the United States. Traditional molecular subtyping methods, such as pulsed-field gel electrophoresis (PFGE) and 7-gene multilocus sequence typing (MLST), provided limited resolution to adequately identify C. jejuni outbreaks and separate out sporadic isolates during outbreak investigations. Whole-genome sequencing (WGS) has emerged as a powerful tool for C. jejuni outbreak detection. In this investigation, 45 human and 11 puppy isolates obtained during a 2016-2018 outbreak linked to pet store puppies were sequenced. Core genome multilocus sequence typing (cgMLST) and high-quality single nucleotide polymorphism (hqSNP) analysis of the sequence data separated the isolates into the same two clades containing minor within-clade differences; however, cgMLST analysis does not require selection of an appropriate reference genome, making the method preferable to hqSNP analysis for Campylobacter surveillance and cluster detection. The isolates were classified as sequence type 2109 (ST2109)-a rarely seen MLST sequence type. PFGE was performed on 38 human and 10 puppy isolates; PFGE patterns did not reliably predict clustering by cgMLST analysis. Genetic detection of antimicrobial resistance determinants predicted that all outbreak-associated isolates would be resistant to six drug classes. Traditional antimicrobial susceptibility testing (AST) confirmed a high correlation between genotypic and phenotypic antimicrobial resistance determinations. WGS analysis linked C. jejuni isolates in humans and pet store puppies even when canine exposure information was unknown, aiding the epidemiological investigation during the outbreak. WGS data were also used to quickly identify the highly drug-resistant profile of these outbreak-associated C. jejuni isolates.


Subject(s)
Campylobacter Infections , Campylobacter jejuni , Pharmaceutical Preparations , Animals , Anti-Bacterial Agents/pharmacology , Campylobacter Infections/epidemiology , Campylobacter Infections/veterinary , Campylobacter jejuni/genetics , Disease Outbreaks , Dogs , Drug Resistance, Bacterial , Electrophoresis, Gel, Pulsed-Field , Genotype , Humans , Multilocus Sequence Typing
10.
Front Public Health ; 7: 172, 2019.
Article in English | MEDLINE | ID: mdl-31316960

ABSTRACT

Infections caused by pathogens commonly acquired from consumption of food are not always transmitted by that route. They may also be transmitted through contact to animals, other humans or the environment. Additionally, many outbreaks are associated with food contaminated from these non-food sources. For this reason, such presumed foodborne outbreaks are best investigated through a One Health approach working across human, animal and environmental sectors and disciplines. Outbreak strains or clones that have propagated and continue to evolve in non-human sources and environments often show more sequence variation than observed in typical monoclonal point-source outbreaks. This represents a challenge when using whole genome sequencing (WGS), the new gold standard for molecular surveillance of foodborne pathogens, for outbreak detection and investigation. In this review, using recent examples from outbreaks investigated in the United States (US) some aspects of One Health approaches that have been used successfully to solve such outbreaks are presented. These include using different combinations of flexible WGS based case definition, efficient epidemiological follow-up, traceback, surveillance, and testing of potential food and environmental sources and animal hosts.

11.
Psychopharmacology (Berl) ; 236(11): 3291-3300, 2019 Nov.
Article in English | MEDLINE | ID: mdl-31201475

ABSTRACT

It has been shown that dystrobrevin-binding protein 1 gene that encodes the protein dysbindin-1 is associated with risk for cognitive deficits, and studies have shown decreases in glutamate and correlated decreases in dysbindin-1 protein in the prefrontal cortex (PFC) and hippocampus of post-mortem tissue from schizophrenia patients. The PFC and the hippocampus have been shown to play a fundamental role in cognition, and studies in dysbindin-1 null mice have shown alterations in NMDAR located in pyramidal neurons as well as perturbation in LTP and cognitive deficits. The balance between excitatory and inhibitory transmission is crucial for normal cognitive functions; however, there is a dearth of information regarding the effects of loss of dysbindin-1 in GABAergic transmission. Using in vitro whole-cell clamp recordings, Western blots, and immunohistochemistry, we report here that dysbindin-1-deficient mice exhibit a significant decrease in the frequency of sIPSCs and in the amplitude of mIPSCs and significant decreases in PV staining and protein level. These results suggest that loss of dysbindin-1 affects GABAergic transmission at pre- and postsynaptic level and decreases parvalbumin markers.


Subject(s)
Dysbindin/deficiency , GABAergic Neurons/metabolism , Prefrontal Cortex/metabolism , Synaptic Transmission/physiology , Animals , Inhibitory Postsynaptic Potentials/physiology , Male , Mice , Mice, Inbred C57BL , Mice, Knockout , Patch-Clamp Techniques/methods , Pyramidal Cells/metabolism , Receptors, N-Methyl-D-Aspartate/metabolism
12.
Foodborne Pathog Dis ; 16(7): 457-462, 2019 07.
Article in English | MEDLINE | ID: mdl-31066584

ABSTRACT

PulseNet USA is the molecular surveillance network for foodborne disease in the United States. The network consists of state and local public health laboratories, as well as food regulatory agencies, that follow PulseNet's standardized protocols to perform pulsed-field gel electrophoresis (PFGE) and whole genome sequencing (WGS) and analyze the results using standardized software. The raw sequences are uploaded to the GenomeTrakr or PulseNet bioprojects at the National Center for Biotechnology Information. The PFGE patterns and analyzed sequence data are uploaded in real time with associated demographic data to the PulseNet national databases managed at the Centers for Disease Control and Prevention. The PulseNet databases are organism specific and provide a central storage location for molecular and demographic data related to an isolate. Sequences are compared in the databases, thereby facilitating the rapid detection of clusters of foodborne diseases that may represent widespread outbreaks. WGS genotyping data, for example, antibiotic resistance and virulence profiles, are also uploaded in real time to the PulseNet databases to improve food safety surveillance activities.


Subject(s)
Databases as Topic , Disease Outbreaks/prevention & control , Foodborne Diseases/epidemiology , Laboratories , Public Health , Databases, Factual , Electrophoresis, Gel, Pulsed-Field , Humans , Public Health Surveillance , United States/epidemiology , Whole Genome Sequencing
13.
MMWR Morb Mortal Wkly Rep ; 67(37): 1032-1035, 2018 Sep 21.
Article in English | MEDLINE | ID: mdl-30235182

ABSTRACT

Campylobacter causes an estimated 1.3 million diarrheal illnesses in the United States annually (1). In August 2017, the Florida Department of Health notified CDC of six Campylobacter jejuni infections linked to company A, a national pet store chain based in Ohio. CDC examined whole-genome sequencing (WGS) data and identified six isolates from company A puppies in Florida that were highly related to an isolate from a company A customer in Ohio. This information prompted a multistate investigation by local and state health and agriculture departments and CDC to identify the outbreak source and prevent additional illness. Health officials from six states visited pet stores to collect puppy fecal samples, antibiotic records, and traceback information. Nationally, 118 persons, including 29 pet store employees, in 18 states were identified with illness onset during January 5, 2016-February 4, 2018. In total, six pet store companies were linked to the outbreak. Outbreak isolates were resistant by antibiotic susceptibility testing to all antibiotics commonly used to treat Campylobacter infections, including macrolides and quinolones. Store record reviews revealed that among 149 investigated puppies, 142 (95%) received one or more courses of antibiotics, raising concern that antibiotic use might have led to development of resistance. Public health authorities issued infection prevention recommendations to affected pet stores and recommendations for testing puppies to veterinarians. This outbreak demonstrates that puppies can be a source of multidrug-resistant Campylobacter infections in humans, warranting a closer look at antimicrobial use in the commercial dog industry.


Subject(s)
Campylobacter Infections/epidemiology , Campylobacter jejuni/drug effects , Disease Outbreaks , Dogs/microbiology , Drug Resistance, Multiple, Bacterial , Adolescent , Adult , Aged , Aged, 80 and over , Animals , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Campylobacter Infections/drug therapy , Campylobacter Infections/prevention & control , Campylobacter jejuni/isolation & purification , Child , Child, Preschool , Contact Tracing , Disease Outbreaks/prevention & control , Feces/microbiology , Female , Humans , Infant , Male , Middle Aged , United States/epidemiology , Young Adult , Zoonoses
14.
J Neurosci Res ; 95(5): 1174-1181, 2017 05.
Article in English | MEDLINE | ID: mdl-27439747

ABSTRACT

Notwithstanding recent advances, cognitive impairments are among the most difficult-to-treat symptoms in neuropsychiatric disorders. Deficits in information processing contributing to memory and sociability impairments are found across neuropsychiatric-related disorders. Previously, we have shown that mutations in the DTNBP1 gene (encoding dystrobrevin-binding protein 1 [dysbindin-1]) lead to abnormalities in synaptic glutamate release in the prefrontal cortex (PFC) and hippocampus and to cognitive deficits; glutamatergic transmission is important for cortical recurrent excitation that allows information processing in the PFC. To investigate possible means of restoring glutamate release and improving cognitive impairments, we assess the effects of increasing endogenous levels of brain-derived neurotrophic factor (BDNF) in a dysbindin-1-deficient mouse model. Increasing endogenous levels of BDNF may aid in remediating cognitive deficits, given the roles of BDNF in synaptic transmission, plasticity, and neuroprotection. To increase BDNF, we use a novel strategy, repeated intraperitoneal injections of fingolimod (Gilenya). Sphingolipids have recently been shown to have therapeutic value in several neurology-related disorders. Both wild-type (WT) and mutant (MUT) genotypes were tested for sociability and recognition memory, followed by measuring endogenous BDNF levels and presynaptic [Ca2+ ]i within the PFC. Both genotypes were treated for 1 week with either saline or fingolimod. Relative to WT mice, MUT mice demonstrated impairments in sociability and recognition memory and lower presynaptic calcium. After fingolimod treatment, MUT mice exhibited significant improvements in sociability and recognition memory and increases in presynaptic calcium and endogenous concentrations of BDNF. These results show promise for counteracting the cognitive impairments seen in neuropsychiatric disorders and may shed light on the role of dysbindin-1. © 2016 Wiley Periodicals, Inc.


Subject(s)
Cognition Disorders/drug therapy , Cognition Disorders/genetics , Dysbindin/genetics , Fingolimod Hydrochloride/therapeutic use , Immunosuppressive Agents/therapeutic use , Animals , Brain-Derived Neurotrophic Factor/metabolism , Calcium/metabolism , Cerebral Cortex/drug effects , Cerebral Cortex/metabolism , Cerebral Cortex/pathology , Cognition Disorders/pathology , Disease Models, Animal , Enzyme-Linked Immunosorbent Assay , Gene Expression Regulation/drug effects , Gene Expression Regulation/genetics , Male , Memory/drug effects , Mice , Mice, Inbred C57BL , Mice, Transgenic , Mutation/genetics , Social Behavior , Synaptosomes/drug effects , Synaptosomes/metabolism
15.
Gastroenterol. hepatol ; 39(10): 697-721, dec. 2016.
Article in Spanish | BIGG - GRADE guidelines | ID: biblio-966088

ABSTRACT

Helicobacter pylori approximately infect 50% of Spanish population and causes chronic gastritis, peptic ulcer and gastric cancer. Until now, three consensus meetings on H.pylori infection had been performed in Spain (the last in 2012). The changes in the treatment schemes, and the increasing available evidence, have justified organizing the IVSpanish Consensus Conference (March 2016), focused on the treatment of this infection. Nineteen experts participated, who performed a systematic review of the scientific evidence and developed a series of recommendation that were subjected to an anonymous Delphi process of iterative voting. Scientific evidence and the strength of the recommendation were classified using GRADE guidelines. As starting point, this consensus increased the minimum acceptable efficacy of recommended treatments that should reach, or preferably surpass, the 90% cure rate when prescribed empirically. Therefore, only quadruple therapies (with or without bismuth), and generally lasting 14 days, are recommended both for first and second line treatments. Non-bismuth quadruple concomitant regimen, including a proton pump inhibitor, clarithromycin, amoxicillin and metronidazole, is recommended as first line. In the present consensus, other first line alternatives and rescue treatments are also reviewed and recommended


La infección por Helicobacter pylori afecta aproximadamente al 50% de la población española y es causante de la gastritis crónica, la úlcera péptica y el cáncer gástrico. Se han llevado a cabo hasta el momento, en nuestro país, 3 reuniones de Consenso sobre el manejo de la infección por H. pylori (la última de ellas en 2012). Los cambios en los esquemas de tratamiento y la creciente evidencia disponible al respecto han justificado la organización de esta IV Conferencia Española de Consenso en marzo de 2016, centrada en el tratamiento de esta infección. Participaron 19 expertos sobre el tema, que realizaron una búsqueda sistemática de la evidencia científica y elaboraron una serie de recomendaciones que fueron sometidas a un proceso de interacción de votaciones anónimas seriadas mediante metodología Delphi. Para clasificar la evidencia científica y la fuerza de las recomendaciones se utilizó el sistema GRADE. Este consenso establece, como punto de partida, un aumento de la exigencia en la eficacia de los tratamientos recomendados, que deben alcanzar, o preferiblemente superar, el 90% de curación al ser administrados de forma empírica. De este modo, tanto en primera como en segunda línea se recomiendan tratamientos cuádruples con o sin bismuto, generalmente prescritos durante 14 días. El tratamiento cuádruple sin bismuto concomitante, que incluye un inhibidor de la bomba de protones, claritromicina, amoxicilina y metronidazol, se recomienda como primera línea. En el presente consenso se revisan también con detalle otras alternativas de tratamiento tanto de primera línea como de rescate.


Subject(s)
Humans , Helicobacter pylori , Gastritis/drug therapy , Recurrence , Stomach Neoplasms , Stomach Ulcer , Bismuth/therapeutic use , Algorithms , Helicobacter pylori/drug effects , Helicobacter Infections , Helicobacter Infections/drug therapy , Delphi Technique , Salvage Therapy , Treatment Failure , Probiotics , Drug Therapy, Combination , Proton Pump Inhibitors , Proton Pump Inhibitors/therapeutic use , Gastritis/complications , Anti-Bacterial Agents/therapeutic use
16.
Bioresour Technol ; 216: 36-43, 2016 Sep.
Article in English | MEDLINE | ID: mdl-27233095

ABSTRACT

The aim of this work is to provide a wide database of kinetic data for the most common biomass by thermogravimetric analysis (TGA) and differential thermogravimetry (DTG). Due to the characteristic parameters of DTG curves, a two-stage reaction model is proposed and the kinetic parameters obtained from model-based methods with energy activation values for first and second stages in the range 1.75·10(4)-1.55·10(5)J/mol and 1.62·10(4)-2.37·10(5)J/mol, respectively. However, it has been found that Flynn-Wall-Ozawa and Kissinger-Akahira-Sunose model-free methods are not suitable to determine the kinetic parameters of biomass combustion since the assumptions of these two methods were not accomplished in the full range of the combustion process.


Subject(s)
Biomass , Models, Theoretical , Thermogravimetry/methods , Kinetics
17.
Appl Environ Microbiol ; 82(3): 928-38, 2016 02 01.
Article in English | MEDLINE | ID: mdl-26590286

ABSTRACT

We used whole-genome sequencing to determine evolutionary relationships among 20 outbreak-associated clinical isolates of Listeria monocytogenes serotypes 1/2a and 1/2b. Isolates from 6 of 11 outbreaks fell outside the clonal groups or "epidemic clones" that have been previously associated with outbreaks, suggesting that epidemic potential may be widespread in L. monocytogenes and is not limited to the recognized epidemic clones. Pairwise comparisons between epidemiologically related isolates within clonal complexes showed that genome-level variation differed by 2 orders of magnitude between different comparisons, and the distribution of point mutations (core versus accessory genome) also varied. In addition, genetic divergence between one closely related pair of isolates from a single outbreak was driven primarily by changes in phage regions. The evolutionary analysis showed that the changes could be attributed to horizontal gene transfer; members of the diverse bacterial community found in the production facility could have served as the source of novel genetic material at some point in the production chain. The results raise the question of how to best utilize information contained within the accessory genome in outbreak investigations. The full magnitude and complexity of genetic changes revealed by genome sequencing could not be discerned from traditional subtyping methods, and the results demonstrate the challenges of interpreting genetic variation among isolates recovered from a single outbreak. Epidemiological information remains critical for proper interpretation of nucleotide and structural diversity among isolates recovered during outbreaks and will remain so until we understand more about how various population histories influence genetic variation.


Subject(s)
Disease Outbreaks , Evolution, Molecular , Genetic Variation , Listeria monocytogenes/genetics , Listeriosis/epidemiology , Listeriosis/microbiology , Gene Transfer, Horizontal , Genome, Bacterial , Humans , Listeria monocytogenes/isolation & purification , Phylogeny , Point Mutation , Sequence Analysis, DNA , Serogroup , Serotyping , United States/epidemiology
18.
Pediatrics ; 137(1)2016 Jan.
Article in English | MEDLINE | ID: mdl-26704086

ABSTRACT

OBJECTIVE: Turtle-associated salmonellosis (TAS), especially in children, is a reemerging public health issue. In 1975, small pet turtles (shell length <4 inches) sales were banned by federal law; reductions in pediatric TAS followed. Since 2006, the number of multistate TAS outbreaks has increased. We describe 8 multistate outbreaks with illness-onset dates occurring in 2011-2013. METHODS: We conducted epidemiologic, environmental, and traceback investigations. Cases were defined as infection with ≥ 1 of 10 molecular subtypes of Salmonella Sandiego, Pomona, Poona, Typhimurium, and I 4,[5],12:i:-. Water samples from turtle habitats linked to human illnesses were cultured for Salmonella. RESULTS: We identified 8 outbreaks totaling 473 cases from 41 states, Washington DC, and Puerto Rico with illness onsets during May 2011-September 2013. The median patient age was 4 years (range: 1 month-94 years); 45% percent were Hispanic; and 28% were hospitalized. In the week preceding illness, 68% (187 of 273) of case-patients reported turtle exposure; among these, 88% (124 of 141) described small turtles. Outbreak strains were isolated from turtle habitats linked to human illnesses in seven outbreaks. Traceback investigations identified 2 Louisiana turtle farms as the source of small turtles linked to 1 outbreak; 1 outbreak strain was isolated from turtle pond water from 1 turtle farm. CONCLUSIONS: Eight multistate outbreaks associated with small turtles were investigated during 2011-2013. Children <5 years and Hispanics were disproportionately affected. Prevention efforts should focus on patient education targeting families with young children and Hispanics and enactment of state and local regulations to complement federal sales restrictions.


Subject(s)
Salmonella Infections/epidemiology , Salmonella/isolation & purification , Adolescent , Adult , Aged , Aged, 80 and over , Animals , Child , Child, Preschool , Disease Outbreaks , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Public Health , Turtles , United States/epidemiology , Young Adult
19.
Opt Lett ; 40(10): 2370-2, 2015 May 15.
Article in English | MEDLINE | ID: mdl-26393742

ABSTRACT

In this Letter, we demonstrate for the first time the experimental capability for the biochemical sensing of resonant nanopillars (RNPs) arrays. These arrays are fabricated over a glass substrate and are optically integrated from the backside of this substrate. The reflectivity profiles of the RNPs arrays are measured by infiltrating different ethanol fractions in water in order to evaluate the optical response for the different refractive indexes, which range from 1.330 to 1.342. A linear fit of the resonant modes shift is observed as a function of the bulk refractive index of the liquid infiltrated. For the type of transducer analyzed, a relative sensitivity of 10017 cm(-1)/Refractive Index Unit (RIU) is achieved, allowing us to reach a competitive Limit of Detection (LoD) in the order of 1×10(-5) RIU.


Subject(s)
Ethanol/analysis , Nanotechnology/instrumentation , Optical Phenomena , Limit of Detection , Microscopy , Water/chemistry
20.
Opt Express ; 23(10): 12544-54, 2015 May 18.
Article in English | MEDLINE | ID: mdl-26074509

ABSTRACT

In this work we present an optical technique for characterizing sub-micrometric areas based on reflectivity of the light as a function of angle of incidence for the two pure polarizations s and p, covering a range of angles of incidence from -71.80° to 71.80° with a resolution of 0.1°. Circular areas with a diameter in the order of 600 nm can be characterized, and the spectra for the two polarizations can be obtained with a single measurement. For biosensing purposes, we have fabricated several Bio Photonic Sensing Cells (BICELLs) consisting of interferometers of 1240 nm of SU-8 polymer over silicon. An indirect immunoassay is performed over these BICELLs and compared experimentally with FT-VIS-NIR spectrometry and theoretical calculations. The Limit of Detection (LoD) achieved is comparable with standard high resolution spectrometry, but with the capability of analyzing sub-micrometric domains for immunoassays reactions onto a sensing surface.

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