Tratamiento de infecciones graves por Acinetobacter baumannii / Treatment of Acinetobacter baumannii severe infections

El Acinetobacter baumannii es un patógeno gramnegativo, multirresistente (MR) que causa infecciones nosocomiales, especialmente en las unidades de cuidados intensivos (UCI) y en los pacientes inmunocomprometidos. El A. baumannii ha desarrollado una resistencia antibiótica de amplio espectro, asociada con alta tasa de mortalidad entre los pacientes infectados comparada con las otras especies de Acinetobacter no baumannii. En relación con el impacto clínico, las cepas resistentes están asociadas con incremento de la estadía hospitalaria y de la mortalidad. El A. baumannii puede causar diferentes infecciones, especialmente neumonía asociada a la ventilación mecánica, bacteriemia, e infección de piel y partes blandas, entre otras. Los factores de riesgo más frecuentes para la adquisición de A. baumannii MR son el uso previo de antibióticos, la asistencia respiratoria mecánica, la estadía en la UCI y en el hospital, la severidad de la enfermedad y el uso de dispositivos médicos. Los esfuerzos actuales están focalizados en determinar todos los mecanismos de resistencia descritos en el A. baumannii, con el objetivo de identificar esquemas terapéuticos más efectivos (AU)

Acinetobacter baumannii is a Gram-negative, multidrug-resistant (MDR) pathogen that causes nosocomial infections, especially in intensive care units (ICUs) and immunocompromised patients. A. baumannii has developed a broad spectrum of antimicrobial resistance, associated with a higher mortality rate among infected patients compared with other non-baumannii species. In terms of clinical impact, resistant strains are associated with increases in both in-hospital length of stay and mortality. A. baumannii can cause a variety of infections, especially ventilator-associated pneumonia, bacteremia, and skin wound infections, among others. The most common risk factors for the acquisition of MDR A. baumannii are previous antibiotic use, mechanical ventilation, length of ICU and hospital stay, severity of illness, and use of medical devices. Current efforts are focused on addressing all the antimicrobial resistance mechanisms described in A. baumannii, with the objective of identifying the most promising therapeutic scheme (AU)

Treatment of Acinetobacter baumannii severe infections.

Acinetobacter baumannii is a Gram-negative, multidrug-resistant (MDR) pathogen that causes nosocomial infections, especially in intensive care units (ICUs) and immunocompromised patients. A. baumannii has developed a broad spectrum of antimicrobial resistance, associated with a higher mortality rate among infected patients compared with other non-baumannii species. In terms of clinical impact, resistant strains are associated with increases in both in-hospital length of stay and mortality. A. baumannii can cause a variety of infections, especially ventilator-associated pneumonia, bacteremia, and skin wound infections, among others. The most common risk factors for the acquisition of MDR A. baumannii are previous antibiotic use, mechanical ventilation, length of ICU and hospital stay, severity of illness, and use of medical devices. Current efforts are focused on addressing all the antimicrobial resistance mechanisms described in A. baumannii, with the objective of identifying the most promising therapeutic scheme.

Magnetization Process of Atacamite: A Case of Weakly Coupled S=1/2 Sawtooth Chains.

We present a combined experimental and theoretical study of the mineral atacamite Cu_{2}Cl(OH)_{3}. Density-functional theory yields a Hamiltonian describing anisotropic sawtooth chains with weak 3D connections. Experimentally, we fully characterize the antiferromagnetically ordered state. Magnetic order shows a complex evolution with the magnetic field, while, starting at 31.5 T, we observe a plateaulike magnetization at about M_{sat}/2. Based on complementary theoretical approaches, we show that the latter is unrelated to the known magnetization plateau of a sawtooth chain. Instead, we provide evidence that the magnetization process in atacamite is a field-driven canting of a 3D network of weakly coupled sawtooth chains that form giant moments.

A systematic review of population-based studies on lipid profiles in Latin America and the Caribbean.

We aimed to study time trends and levels of mean total cholesterol and lipid fractions, and dyslipidaemias prevalence in Latin America and the Caribbean (LAC). Systematic-review and meta-analysis of population-based studies in which lipid (total cholesterol [TC; 86 studies; 168,553 people], HDL-Cholesterol [HDL-C; 84 studies; 121,282 people], LDL-Cholesterol [LDL-C; 61 studies; 86,854 people], and triglycerides [TG; 84 studies; 121,009 people]) levels and prevalences were laboratory-based. We used Scopus, LILACS, Embase, Medline and Global Health; studies were from 1964 to 2016. Pooled means and prevalences were estimated for lipid biomarkers from ≥2005. The pooled means (mg/dl) were 193 for TC, 120 for LDL-C, 47 for HDL-C, and 139 for TG; no strong trends. The pooled prevalence estimates were 21% for high TC, 20% for high LDL-C, 48% for low HDL-C, and 21% for high TG; no strong trends. These results may help strengthen programs for dyslipidaemias prevention/management in LAC.

Cholesterol and triglycerides are fatty substances found in the blood. They are crucial components of cell membranes and important for a variety of processes in the body. But, too much, or too little blood fat can damage the blood vessels. For example, high levels of fat in the blood can clog arteries, which can increase the chances of heart disease, heart attacks and strokes. Fat starts to build up if 'bad' fats, such as triglycerides and LDL cholesterol, are too high. But it can also happen if levels of 'good' fats, like HDL cholesterol, are too low. The causes of, and treatments for, these different types of dyslipidaemia (or fat levels outside normal ranges) are not the same. So, to plan interventions effectively, public health authorities need to know which type of blood fat imbalance is most common in the local population, and whether this has changed over time. In many parts of the world, this kind of information is available, but in Latin America and the Caribbean the data is incomplete. To address this, Carrillo-Larco et al. reviewed around 200 previous studies from across Latin America and the Caribbean. This revealed that, since 2005, low HDL cholesterol has been the most common type of dyslipidaemia in this region, followed by elevated triglycerides, and third, high LDL cholesterol. These patterns have changed little over the years. In many parts of the world, public health guidelines for dyslipidaemia focus on treatment specifically for high LDL cholesterol. But this new data suggests that guidelines should also include recommendations for HDL cholesterol, in particular in Latin America and the Caribbean. And, with a clearer understanding of the current pattern of blood fat imbalances in this region, researchers now have a baseline against which to measure the success of any new health policies. In the future, a multi-country study to measure blood fats in the general population could provide even more detail. But, until then, this work provides a starting point for customised health interventions.

Is the ISAC 112 Microarray Useful in the Diagnosis of Pollinosis in Spain?

BACKGROUND: Multiple sensitization is frequent among pollen-allergic patients. The goal of this study was to determine the diagnostic accuracy of the ImmunoCAP ISAC 112 (ISAC112) microarray in allergy to pollen from several taxa and its clinical utility in a Spanish population. METHODS: Specific IgE was determined in 390 pollen-allergic patients using the ISAC112 microarray. Diagnostic accuracy (sensitivity, specificity, predictive values, and area under the ROC curve) was calculated for the diagnosis of allergy to pollen from grass (n=49), cypress (n=75), olive tree (n=33), plane tree (n=63), and pellitory of the wall (n=17) and compared with that of the singleplex ImmunoCAP immunoassay. RESULTS: The sensitivity of the ISAC112 microarray ranged from 68.2% for allergy to plane tree pollen to 93.9% for allergy to grass pollen. The specificity was >90%. The AUC for the diagnosis of allergy to plane tree pollen was 0.798, whereas the AUC for the remaining cases was ≥0.876. The accuracy of ISAC112 was higher than that of ImmunoCAP for plane tree pollen and similar for the remaining pollens. The frequency of sensitization to most species-specific allergenic components and profilins varied between the different geographical regions studied. A total of 73% of pollen-allergic patients were sensitized to species-specific components of more than 1 pollen type. CONCLUSIONS: The ISAC112 microarray is an accurate tool for the diagnosis of allergy to pollen from grass, cypress, olive tree, plane tree, and pellitory of the wall. The features of the ISAC112 microarray are similar or superior (in the case of plane tree pollen) to those of ImmunoCAP. This microarray is particularly useful for the etiologic diagnosis of pollinosis in patients sensitized to multiple pollen species whose pollination periods overlap.

Is Microarray Analysis Really Useful and Sufficient to Diagnose Nut Allergy in the Mediterranean Area?

BACKGROUND: Component-based diagnosis on multiplex platforms is widely used in food allergy but its clinical performance has not been evaluated in nut allergy. OBJECTIVE: To assess the diagnostic performance of a commercial protein microarray in the determination of specific IgE (sIgE) in peanut, hazelnut, and walnut allergy. METHODS: sIgE was measured in 36 peanut-allergic, 36 hazelnut-allergic, and 44 walnut-allergic patients by ISAC 112, and subsequently, sIgE against available components was determined by ImmunoCAP in patients with negative ISAC results. ImmunoCAP was also used to measure sIgE to Ara h 9, Cora 8, and Jug r 3 in a subgroup of lipid transfer protein (LTP)-sensitized nut-allergic patients (positive skin prick test to LTP-enriched extract). sIgE levels by ImmunoCAP were compared with ISAC ranges. RESULTS: Most peanut-, hazelnut-, and walnut-allergic patients were sensitized to the corresponding nut LTP (Ara h 9, 66.7%; Cor a 8, 80.5%; Jug r 3, 84% respectively). However, ISAC did not detect sIgE in 33.3% of peanut-allergic patients, 13.9% of hazelnut-allergic patients, or 13.6% of walnut-allergic patients. sIgE determination by ImmunoCAP detected sensitization to Ara h 9, Cor a 8, and Jug r 3 in, respectively, 61.5% of peanut-allergic patients, 60% of hazelnut-allergic patients, and 88.3% of walnut-allergic patients with negative ISAC results. In the subgroup of peach LTP-sensitized patients, Ara h 9 sIgE was detected in more cases by ImmunoCAP than by ISAC (94.4% vs 72.2%, P < .05). Similar rates of Cora 8 and Jug r 3 sensitization were detected by both techniques. CONCLUSIONS: The diagnostic performance of ISAC was adequate for hazelnut and walnut allergy but not for peanut allergy. sIgE sensitivity against Ara h 9 in ISAC needs to be improved.

Is microarray analysis really useful and sufficient to diagnose nut allergy in the mediterranean area?

Background: Component-based diagnosis on multiplex platforms is widely used in food allergy but its clinical performance has not been evaluated in nut allergy. Objective: To assess the diagnostic performance of a commercial protein microarray in the determination of specific IgE (sIgE) in peanut, hazelnut, and walnut allergy. Methods: sIgE was measured in 36 peanut-allergic, 36 hazelnut-allergic, and 44 walnut-allergic patients by ISAC 112, and subsequently, sIgE against available components was determined by ImmunoCAP in patients with negative ISAC results. ImmunoCAP was also used to measure sIgE to Ara h 9, Cor a 8, and Jug r 3 in a subgroup of lipid transfer protein (LTP)-sensitized nut-allergic patients (positive skin prick test to LTP-enriched extract). sIgE levels by ImmunoCAP were compared with ISAC ranges. Results: Most peanut-, hazelnut-, and walnut-allergic patients were sensitized to the corresponding nut LTP (Ara h 9, 66.7%; Cor a 8, 80.5%; Jug r 3, 84% respectively). However, ISAC did not detect sIgE in 33.3% of peanut-allergic patients, 13.9% of hazelnut-allergic patients, or 13.6% of walnut-allergic patients. sIgE determination by ImmunoCAP detected sensitization to Ara h 9, Cor a 8, and Jug r 3 in, respectively, 61.5% of peanut-allergic patients, 60% of hazelnut-allergic patients, and 88.3% of walnut-allergic patients with negative ISAC results. In the subgroup of peach LTP-sensitized patients, Ara h 9 sIgE was detected in more cases by ImmunoCAP than by ISAC (94.4% vs 72.2%, P<.05). Similar rates of Cor a 8 and Jug r 3 sensitization were detected by both techniques. Conclusions: The diagnostic performance of ISAC was adequate for hazelnut and walnut allergy but not for peanut allergy. sIgE sensitivity against Ara h 9 in ISAC needs to be improved (AU)

Introducción: La utilidad clínica del diagnóstico por componentes no ha sido evaluada en el estudio de la alergia a frutos secos (FS). Objetivo: Evaluar la capacidad diagnóstica de una micromatriz comercial de proteínas alergénicas en la alergia a cacahuete, avellana y nuez. Métodos: Se determinó la sIgE en pacientes alérgicos a FS mediante la micromatriz ISAC 112, e ImmunoCAP en los pacientes con sIgE negativa frente a los componentes de ISAC. Además, se realizó ImmunoCAP frente a Ara h 9, Cor a 8 y Jug r 3 en un subgrupo de pacientes sensibilizados a LTP. La sIgE detectada por ImmunoCAP fue comparada con los rangos de ISAC. Resultados: La mayoría de los alérgicos a cacahuete (66,7%), avellana (80,5%) y nuez (84%) estaba sensibilizados a su LTP. Sin embargo, no se detectó sIgE frente a los componentes de ISAC en el 33,3% de alérgicos a cacahuete, 13,9% de alérgicos a avellana y 13,6% de los alérgicos a nuez. El ImmunoCAP permitió detectar sIgE a Ara h 9 en 61,5%, Cor a 8 en 60% y Jug r 3 en 83,3% de los ISAC negativo. En el subgrupo LTP, ImmunoCAP (94,4%) fue superior a ISAC (72,2%) en la detección de sIgE a Ara h 9 (p<0,05). La sIgE frente a Cor a 8 y Jug r 3 fue detectada de forma similar por ambas técnicas. Conclusiones: La micromatriz ISAC es adecuada para el diagnóstico de alergia a avellana y nuez. La sensibilidad del componente Ara h 9 de ISAC debe ser mejorada (AU)

Is the ISAC 112 microarray useful in the diagnosis of pollinosis in Spain?

Background: Multiple sensitization is frequent among pollen-allergic patients. The goal of this study was to determine the diagnostic accuracy of the ImmunoCAP ISAC 112 (ISAC112) microarray in allergy to pollen from several taxa and its clinical utility in a Spanish population. Methods: Specific IgE was determined in 390 pollen-allergic patients using the ISAC112 microarray. Diagnostic accuracy (sensitivity, specificity, predictive values, and area under the ROC curve) was calculated for the diagnosis of allergy to pollen from grass (n=49), cypress (n=75), olive tree (n=33), plane tree (n=63), and pellitory of the wall (n=17) and compared with that of the singleplex ImmunoCAP immunoassay. Results: The sensitivity of the ISAC112 microarray ranged from 68.2% for allergy to plane tree pollen to 93.9% for allergy to grass pollen. The specificity was >90%. The AUC for the diagnosis of allergy to plane tree pollen was 0.798, whereas the AUC for the remaining cases was ≥0.876. The accuracy of ISAC112 was higher than that of ImmunoCAP for plane tree pollen and similar for the remaining pollens. The frequency of sensitization to most species-specific allergenic components and profilins varied between the different geographical regions studied. A total of 73% of pollen-allergic patients were sensitized to species-specific components of more than 1 pollen type. Conclusions: The ISAC112 microarray is an accurate tool for the diagnosis of allergy to pollen from grass, cypress, olive tree, plane tree, and pellitory of the wall. The features of the ISAC112 microarray are similar or superior (in the case of plane tree pollen) to those of ImmunoCAP. This microarray is particularly useful for the etiologic diagnosis of pollinosis in patients sensitized to multiple pollen species whose pollination periods overlap (AU)

Introducción: La sensibilización a múltiples pólenes es frecuente entre los pacientes alérgicos a polen. El objetivo de este estudio fue determinar la exactitud diagnóstica de la micromatriz ImmunoCAP ISAC 112 (ISAC112) en alergia a polen de diversos taxones y su utilidad clínica en una población española. Métodos: Se determinó IgE específica mediante ISAC112 en 390 pacientes polínicos. Se calculó su exactitud diagnóstica (sensibilidad, especificidad, valores predictivos y área bajo la curva ROC) para el diagnóstico de alergia a polen de gramíneas (n=49), ciprés (n=75), olivo (n=33), plátano de sombra (n=63) y parietaria (n=17) y se comparó con la de ImmunoCAP monocomponente (CAP). Resultados: La sensibilidad de ISAC112 osciló entre 68,2% para alergia a polen de plátano de sombra y 93,9% a polen de gramíneas. La especificidad se situó por encima del 90% en todos los casos. El área bajo la curva (AUC) de la curva ROC para diagnóstico de alergia a polen de plátano fue de 0,798. El resto de AUC fueron ≥ 0,876. La exactitud diagnóstica de ISAC112 fue superior a la de CAP para la alergia a polen de plátano de sombra y similar para el resto de pólenes estudiados. La frecuencia de sensibilización a la mayoría de componentes alergénicos genuinos y a profilinas varió entre las diferentes zonas. El 73 % de los pacientes polínicos estaban sensibilizados a componentes genuinos de más de un tipo polínico. Conclusiones: ISAC112 es una herramienta exacta para el diagnóstico de alergia al polen de gramíneas, ciprés, olivo, plátano de sombra y parietaria, con prestaciones similares o superiores, en el caso de alergia a polen de plátano de sombra, a las de CAP. Es especialmente útil para el diagnóstico etiológico de la polinosis en pacientes con sensibilizaciones a múltiples pólenes con periodos de polinización solapados (AU)

Clinical performance of commercial ISAC 112 allergen microarray versus noncommercial RIRAAF platform for the diagnosis of plant food and olive pollen allergies

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A Comprehensive Comparison of the IEFPCM and SS(V)PE Continuum Solvation Methods with the COSMO Approach.

Dielectric continuum models are popular for modeling solvent effects in quantum chemical calculations. The polarizable continuum model (PCM) was originally published exploiting the exact dielectric boundary condition. This is nowadays called DPCM. The conductor-like screening model (COSMO) introduced a simplified and slightly empirical scaled conductor boundary condition, which turned out to reduce the errors resulting from outlying charge. This was implemented in PCM as CPCM. Later, the integral equation formalism (IEFPCM) and the formally identical SS(V)PE model of Chipman introduced a modified dielectric boundary condition combining the dielectric exactness of DPCM with the reduced outlying charge sensitivity of COSMO. In this paper, we demonstrate on two huge data sets of neutral and ionic solutes that no significant difference can be observed between the COSMO and IEFPCM, if the correct scaling factor is chosen for COSMO.

SiO2 coating effects in the magnetic anisotropy of Fe3-xO4 nanoparticles suitable for bio-applications.

We present radio frequency transverse susceptibility (TS) measurements on oleic acid-coated and SiO2-coated Fe3-xO4 magnetite nanoparticles. The effects of the type of coating on the interparticle interactions and magnetic anisotropy are evaluated for two different particle sizes in powder samples. On the one hand, SiO2 coating reduces the interparticle interactions as compared to oleic acid coating, the reduction being more effective for 5 nm than for 14 nm diameter particles. On the other hand, the magnetic anisotropy field at low temperature is lower than 1 kOe in all cases and independent of the coating used. Our results are relevant concerning applications in biomedicine, since the SiO2 coating renders 5 and 14 nm hydrophilic particles with very limited agglomeration, low anisotropy, and superparamagnetic behavior at room temperature. The TS technique also allows us to discriminate the influence on the anisotropy field of interparticle interactions from that of the thermal fluctuations.

Tendinitis calcificante prevertebral aguda: a propósito de un caso y revisión de la literatura / Acute calcific prevertebral tendinitis: case report and literature review

La tendinitis calcificante prevertebral es una causa poco frecuente de cervicalgia aguda, caracterizada por la identificación de calcificaciones a nivel de C1-C2 y, la presencia de una colección líquida en el espacio prevertebral, que ocasiona un desplazamiento de la línea radiográfica prevertebral en los estudios de imagen. Resulta de gran importancia identificar esta rara entidad, benigna y autolimitada, y no confundirla con otros procesos que erróneamente propiciasen actitudes terapéuticas inadecuadas (AU)

Prevertebral calcific tendinitis is an uncommon cause of acute neck pain characterized by the identification of calcifications at C1-C2 level and the presence of a liquid collection at the prevertebral space which causes the displacement of the prevertebral radiographic line in imaging studies. It is very important to identify this rare, benign and self-limiting pathology, in order not to confuse it with other diseases that could erroneously lead to inappropriate treatment (AU)

[Acute calcific prevertebral tendinitis: case report and literature review]. / Tendinitis calcificante prevertebral aguda: a propósito de un caso y revisión de la literatura.

Prevertebral calcific tendinitis is an uncommon cause of acute neck pain characterized by the identification of calcifications at C1-C2 level and the presence of a liquid collection at the prevertebral space which causes the displacement of the prevertebral radiographic line in imaging studies. It is very important to identify this rare, benign and self-limiting pathology, in order not to confuse it with other diseases that could erroneously lead to inappropriate treatment.

Parasitisation by Bathycreadium elongatum (Digenea, Opecoelidae) in pyloric caeca of Trachyrincus scabrus (Teleostei, Macrouridae).

A novel process of transmural passive displacement of a digenean parasite was studied in the digestive tract of the roughsnout grenadier Trachyrincus scabrus, which is found in the northwestern Mediterranean Sea. This mechanism seems to facilitate the elimination of a significant portion of intestinal parasites. The digenean parasite Bathycreadium elongatum was found in the intestine, mainly within pyloric caeca, in 74.4% of T. scabrus, with a mean abundance of 44 individuals per fish. Nodule-like lesions were also found in the mesentery of pyloric caeca of infected T. scabrus. Histological sections of the nodules revealed granulomatous inflammatory responses surrounding degraded digeneans. Partial nucleotide sequences of the 28S rRNA gene obtained from intracaecal B. elongatum and from the core of the nodules of the mesentery of pyloric caeca showed 100% mutual identity with an overlap of 971 bp. The greatest abundance of both intracaecal B. elongatum and nodules occurred in spring. During summer, and especially autumn, the abundance of intracaecal B. elongatum decreased. Prevalence and abundance of nodules increased in autumn. In winter intracaecal parasite abundance and prevalence began to increase, but decreased again in nodules. During spring and summer, parasites pass into the visceral cavity, hypothetically owing to the fragility of the wall of pyloric caeca in their apical zone, and become degraded through a granulomatous inflammatory response. This process seems to have a detrimental effect on the B. elongatum cycle since some of parasites are trapped and degrade in the connective tissue in which they are unable to complete their life cycle.