Alterations in biochemical markers in adenovirus infection.

BACKGROUND: Analyze possible relationships between HAdV and markers for inflammation, specifically the C-reactive protein (CRP) and procalcitonin (PCT) tests, along with other haematological markers. METHODS: Retrospective study of 487 children presenting with fever and/or acute respiratory symptoms in the Paediatric Emergency Department. Analyses included viral presence/absence (both HAdV and other respiratory viruses) in respiratory exudates, CRP and PCT alterations in plasma, and haematological markers in whole blood. RESULTS: Viral load was >500 copies/103 cells of HAdV in 127 cases (26.1%), of which 66 (52%, P<0.0001) had alterations in PCT, and 112 (88.1%, P<0.0001) in CRP. Haematological markers were similar either HAdV was present or not, although many HAdV positive patients demonstrated leukocytosis (66%). Bacterial cultures from 141 samples showed altered PCT in 27 (60%) with HAdV infection, in 3 (18.7%) with bacterial infection, and 13 (26.5%) without either viral or bacterial infection (P<0.05). CRP was altered in 88.9% of HAdV infected children and in 87% infected with bacteria, although the percentage was greater than in cases where other respiratory viruses were present (61.3% P<0.05). CONCLUSIONS: Results demonstrate a clear relationship between HAdV infection and alterations in PCT and CRP which should be taken into account in paediatric patient management.

Estabilidad del ARN viral en muestras clínicas para el diagnóstico viral / Stability of viral RNA in clinical specimens for viral diagnosis

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Simultaneous detection of Dengue virus, Chikungunya virus, Zika virus, Yellow fever virus and West Nile virus.

Although certain mosquito-borne virus, such as Dengue virus (DENV), Chikungunya virus (CHIKV), Zika virus (ZIKV), Yellow fever virus (YFV) and West Nile virus (WNV), are an important public health concern in those countries where transmitter mosquitoes are endemic, several cases of travelers from those endemic countries have been recently reported in Europe. Thus, early diagnosis of these viruses is essential for patient management and adoption of preventive measures. An assay for the simultaneous detection of DENV, CHIKV, ZIKV, YFV and WNV based on a multiplex real-time (RT)-PCR and its usefulness for diagnosis in infection screenings and surveillance of arbovirus in non-endemic countries are described.

Human respiratory syncytial virus load normalized by cell quantification as predictor of acute respiratory tract infection.

Human respiratory syncytial virus (HRSV) is a common cause of respiratory infections. The main objective is to analyze the prediction ability of viral load of HRSV normalized by cell number in respiratory symptoms. A prospective, descriptive, and analytical study was performed. From 7307 respiratory samples processed between December 2014 to April 2016, 1019 HRSV-positive samples, were included in this study. Low respiratory tract infection was present in 729 patients (71.54%). Normalized HRSV load was calculated by quantification of HRSV genome and human ß-globin gene and expressed as log10 copies/1000 cells. HRSV mean loads were 4.09 ± 2.08 and 4.82 ± 2.09 log10 copies/1000 cells in the 549 pharyngeal and 470 nasopharyngeal samples, respectively (P < 0.001). The viral mean load was 4.81 ± 1.98 log10 copies/1000 cells for patients under the age of 4-year-old (P < 0.001). The viral mean loads were 4.51 ± 2.04 cells in patients with low respiratory tract infection and 4.22 ± 2.28 log10 copies/1000 cells with upper respiratory tract infection or febrile syndrome (P < 0.05). A possible cut off value to predict LRTI evolution was tentatively established. Normalization of viral load by cell number in the samples is essential to ensure an optimal virological molecular diagnosis avoiding that the quality of samples affects the results. A high viral load can be a useful marker to predict disease progression.

Detection and quantification of Merkel cell polyomavirus. Analysis of Merkel cell carcinoma cases from 1977 to 2015.

This study investigates the presence of Merkel cell polyomavirus (MCPyV) in skin lesions of patients with Merkel cell carcinoma (MCC). MCPyV was quantified using quantitative Real-Time-PCR (qRT-PCR) in 34 paraffinized MCC samples (resected/biopsied) originally taken between 1977 and 2015, and six non-MCC samples. In 31 (91.2%) MCC-individuals, MCPyV was detected. No virus was observed in any non-MCC tumor. Average age at diagnosis was 78.2 ± 9.35 (55-97) years for women (n = 19) and 69.5 ± 14.7 (45-91) for men (n = 15) (P = 0.04). MCC tumor location, known in 25 cases, was: 11 (44%) in the head region, 6 (24%) in upper limbs, 4 (16%) in lower limbs, and 4 (16%) in the trunk. All but one patient had received some sort of treatment: 15 (45.45%) underwent both radio and chemotherapy, 13 (39.39%) only surgery, 2 (6.06%) surgery, plus radio and chemotherapy, 2 (6.06%) surgery and chemotherapy, and 1 (3.03%) only radiotherapy. Follow up data were available for 21/34 patients: recurrence was recorded for 4 (19.04%), and metastasis for 13 (61.9%). Recorded data showed that 10 men and 5 women (total 44.1%) died during follow up, 7 (46.7%) of them within 2 years of diagnosis. Viral load was 5.8 ± 1.4 log copies/105 cells (3.1-8.6), independent of any variable. MCPyV was very frequent in MCC. It was principally associated with head and limb tumors, it more commonly affected men, who in this study were, on average, younger than women, and had high rates of recurrence and mortality. The amplification techniques described here are easily applied and suitable for detecting the presence of MCPyV virus in MCC.

Utility of normalized genome quantification of Helicobacter pylori in gastric mucosa using an in-house real-time polymerase chain reaction.

Traditional diagnostic assays for Helicobacter pylori detection have their limitations. Molecular methods can improve both diagnosis and understanding of gastric diseases. Here we describe an in-house quantitative real-time polymerase chain reaction (q-rt-PCR) for the detection of H. pylori in gastric biopsies which has been developed and has a detection limit of 10 copies, the specificity of which was tested against other gastric colonizer bacteria. In this study, 199 gastric biopsies from adults with different clinical gastric symptoms were examined. Biopsies were obtained during endoscopy and the following tests performed: rapid urease testing (RUT), culture and q-rt-PCR. H. pylori bacterial load expressed as bacterial load per 105 cells was calculated using a standard curve. H. pylori was isolated in 41% of patients, RUT was positive in 32% and bacterial genome was detected in 45% (p = 0.010). Concordance between traditional invasive microbiological methods used together and q-rt-PCR was almost 100%. Bacterial load in patients with positive RUT was significantly higher than those where it was negative (p<0.0001). There were also significant differences between bacterial load in patients with more than one positive assay versus those where only one method was positive (p = 0.006). The in-house q-PCR developed here is quick and inexpensive, and allows accurate diagnosis of H. pylori infection. It also permits normalized bacterial load quantification, which is important to differentiate between asymptomatic colonisation and infection.

Clinical characteristics, beliefs, and coping strategies among older patients with overactive bladder.

AIMS: To describe clinical characteristics and assess beliefs and coping strategies in older patients with overactive bladder (OAB) attending urology and gynecology clinics in Spain. METHODS: This non-interventional, multicenter, cross-sectional study collected demographic and clinical details from individuals aged ≥60 years with a diagnosis of OAB and score ≥3 on the Patient Perception of Intensity of Urgency Scale. Symptoms were assessed using the Bladder Control Self-Assessment Questionnaire (B-SAQ) and Health-Related Quality of Life (HRQoL) rated using a simple visual analogue scale. Coping strategies and OAB beliefs were assessed using two specially designed questionnaires. RESULTS: Patients (n = 786) reported a mean (±SD) of 4.9 ± 2.9 urinary urgency episodes and 2.9 ± 2.3 urgency urinary incontinence (UUI) episodes per 24 hr. Mean times since diagnosis and symptom onset were 18 ± 34 and 38 ± 46 months, respectively. B-SAQ symptom and bother scores were 7.5 ± 2.3 and 8.3 ± 2.5, respectively. Most patients (92%) reported worse HRQoL after symptom onset. Approximately, 50% of patients considered their symptoms normal for their age/gender and most (71.5%) expected symptoms to worsen with age/time. However, 80% believed that symptoms would improve with treatment. For coping strategies, 81% of patients changed their urinary frequency, 71% controlled fluid intake, and 64% used pads. Use of coping strategies was associated with UI severity. CONCLUSIONS: Many older individuals view their OAB symptoms as a normal feature of age, which may delay diagnosis. Reduced HRQoL and adoption of coping strategies are also common. The results support the need for improved patient education, earlier recognition, and effective intervention in the older OAB population. Neurourol. Urodynam. 36:774-779, 2017. © 2016 Wiley Periodicals, Inc.

A Framework to Move Forward on the Path to Eco-innovation in the Construction Industry: Implications to Improve Firms' Sustainable Orientation.

This paper examines key aspects in the innovative behavior of the construction firms that determine their environmental orientation while innovating. Structural equation modeling was used and data of 222 firms retrieved from the Spanish Technological Innovation Panel (PITEC) for 2010 to analyse the drivers of environmental orientation of the construction firms during the innovation process. The results show that the environmental orientation is positively affected by the product and process orientation of construction firms during the innovation process. Furthermore, the positive relation between the importance of market information sources and environmental orientation, mediated by process and product orientation, is discussed. Finally, a model that explains these relations is proposed and validated. Results have important managerial implications for those companies worried about their eco-innovative focus as the types of actions and relations within firms most suitable for improving their eco-innovative orientation are highlighted.

Prevalence of HPV 16 and HPV 18 lineages in Galicia, Spain.

Genetic variants of human papillomavirus types 16 and 18 (HPV16/18) could differ in their cancer risk. We studied the prevalence and association with high-grade cervical lesions of different HPV16/18 variant lineages in a case-control study including 217 cases (cervical intraepithelial neoplasia grade 2 or grade 3 or worse: CIN2 or CIN3+) and 116 controls (no CIN2 or CIN3+ in two-year follow-up). HPV lineages were determined by sequencing the long control region (LCR) and the E6 gene. Phylogenetic analysis of HPV16 confirmed that isolates clustered into previously described lineages: A (260, 87.5%), B (4, 1.3%), C (8, 2.7%), and D (25, 8.4%). Lineage D/lineage A strains were, respectively, detected in 4/82 control patients, 19/126 CIN3+ cases (OR = 3.1, 95%CI: 1.0-12.9, p = 0.04), 6/1 glandular high-grade lesions (OR = 123, 95%CI: 9.7-5713.6, p<0.0001), and 4/5 invasive lesions (OR = 16.4, 95%CI: 2.2-113.7, p = 0.002). HPV18 clustered in lineages A (32, 88.9%) and B (4, 11.1%). Lineage B/lineage A strains were respectively detected in 1/23 control patients and 2/5 CIN3+ cases (OR = 9.2, 95%CI: 0.4-565.4, p = 0.12). In conclusion, lineages A of HPV16/18 were predominant in Spain. Lineage D of HPV16 was associated with increased risk for CIN3+, glandular high-grade lesions, and invasive lesions compared with lineage A. Lineage B of HPV18 may be associated with increased risk for CIN3+ compared with lineage A, but the association was not significant. Large well-designed studies are needed before the application of HPV lineage detection in clinical settings.

Human papillomavirus infection in a male population attending a sexually transmitted infection service.

OBJECTIVE: Human Papillomavirus (HPV) infection in men may produce cancer and other major disorders. Men play an important role in the transmission of the virus and act as a reservoir. The aim of this study was to determine the HPV-genotypes and their prevalence in a group of men attending a Sexually Transmitted Infection service. PATIENTS AND SAMPLES: Between July 2002 and June 2011, 1392 balanopreputial, 435 urethral, 123 anal, and 67 condyloma lesions from 1551 men with a mean age of 35.8±11.3 years old (range: 17-87) were collected for HPV-DNA testing. METHODS: A fragment of the L1-gene and a fragment of the E6/E7-genes were amplified by PCR. Positive samples were typed by hybridization. RESULTS: The HPV genome was detected in 36.9% (486/1318) balanopreputial and in 24.9% (101/405) urethral (p<0.0001) swabs from 38.1% (538) of 1469 men. Co-infections were present in 5.4% (80/1469) of cases. HPV was found in 43.9% (373/850) of men younger than 35 vs. 31.7% (187/589) of men aged >35. HPV was found in 59.4% (104) of 165 men with lesions (macroscopic or positive peniscopy), and in 22.8% (61/267) without clinical alterations. HPV was also detected in 71.4% (40/56) men with condylomata and in 58.7% (64/109) of men with positive peniscopy. CONCLUSIONS: HPV prevalence in men was high and decreased with age. HPV was found more frequently in balanopreputial than in urethral swabs. There was a low rate of co-infections. Low-risk HPV vaccine genotypes were the most recurrent especially in younger. Although HPV has been associated with clinical alterations, it was also found in men without any clinical presentation. Inclusion of men in the national HPV vaccination program may reduce their burden of HPV-related disease and reduce transmission of the virus to non-vaccinated women.

MAVS: a new weapon in the fight against viral infections.

In addition to their participation in metabolic processes and control of programmed cell death, the role of mitochondria as a fundamental hub for innate anti-viral immunity is now emerging. The participation of the mitochondrial antiviral signaling protein (MAVS) as a central regulator of a complex signaling cascade, which results in the induction of antiviral and inflammatory responses has been described. A patent based on this role of MAVS is highlighted in this review.

Overview of molecular biological methods for the detection of pathogens causing sexually transmitted infections.

We review here different state-of-the-art molecular methods currently used in the diagnosis of sexually transmitted infections.

The role of the clinical microbiology laboratory in solid organ transplantation programs.

Infections remain a major complication of solid organ transplantation. For this reason, the clinical microbiology laboratory plays a key role in the success of transplant programs, which must have the support of a qualified laboratory, both technically and professionally. Transplant programs strongly condition the structure and functionality of microbiology laboratories, but at the same time, benefit greatly from the knowledge generated from these programs. The laboratory must make a special effort to implement rapid methods that can respond to the broad spectrum of potential pathogens in solid organ transplant patients. The integration of microbiologists in multidisciplinary teams is highly recommended, as only then can they obtain the highest quality and efficiency in the diagnostic process. This article provides an updated review of the techniques to be used once transplantation has occurred. The role of the microbiologist is also crucial in the pretransplant period, as good microbiological candidate evaluation at this time strongly conditions the success of the transplantation program.

The role of the clinical microbiology laboratory in solid organ transplantation programs

Las infecciones siguen siendo una importante complicación del trasplante de órgano sólido. Por esta razón, el laboratorio de microbiología clínica desempeña un papel clave en el éxito de los programas de trasplante. Estos programas deben tener el apoyo de un laboratorio cualificado, tanto técnica como profesionalmente. Los programas de trasplante condicionan fuertemente la estructura y funcionalidad de los laboratorios de microbiología, pero al mismo tiempo se benefician enormemente del conocimiento generado alrededor de dichos programas. El laboratorio debe hacer un esfuerzo especial en la puesta en marcha de métodos rápidos que den respuesta al amplio espectro de potenciales patógenos en los pacientes de trasplantes sólidos. La integración del microbiólogo en los equipos multidisciplinares es muy recomendable y sólo así se puede obtener la calidad y mayor eficiencia del proceso diagnóstico. En este artículo se lleva a cabo una puesta al día de las técnicas utilizables una vez que se ha realizado el trasplante. No obstante, el papel del microbiólogo es también crucial en el período previo al trasplante, ya que una buena evaluación microbiológica del candidato en este momento condiciona fuertemente el éxito del programa de trasplante (AU)

Infections remain a major complication of solid organ transplantation. For this reason, the clinical microbiology laboratory plays a key role in the success of transplant programs, which must have the support of a qualified laboratory, both technically and professionally. Transplant programs strongly condition the structure and functionality of microbiology laboratories, but at the same time, benefit greatly from the knowledge generated from these programs. The laboratory must make a special effort to implement rapid methods that can respond to the broad spectrum of potential pathogens in solid organ transplant patients. The integration of microbiologists in multidisciplinary teams is highly recommended, as only then can they obtain the highest quality and efficiency in the diagnostic process. This article provides an updated review of the techniques to be used once transplantation has occurred. The role of the microbiologist is also crucial in the pretransplant period, as good microbiological candidate evaluation at this time strongly conditions the success of the transplantation program (AU)

[Microbiology of transplants]. / Microbiología del trasplante.

Infections are one of the main complications that decisively affect the final outcome of transplants. Clinical microbiology laboratory has a key role in diagnosis, treatment and prevention of these complications. Centres with transplant programs must be technically supported with a well developed laboratory with special emphasis in rapid diagnostic techniques. In this article, we review the clinical background for the laboratory, its role in the evaluation of both donors and recipients, and the diagnostic methods for the main pathogens infecting transplant patients.

Noroviruses as cause of gastroenteritis in elderly patients.

BACKGROUND AND AIMS: Gastroenteritis is one of the infections which are particularly important in elderly people. Knowledge of the main pathogens causing gastroenteritis in this group of patients, whose number will dramatically increase in coming decades, is essential. The contribution of group A rotavirus, adenovirus types 41 and 42, norovirus and astrovirus as causes of gastroenteritis among patients of all ages, especially those with over 65 was evaluated over an extended time period. METHODS: A total of 4024 fecal samples, collected during seven seasons (October 2000 to September 2007), were tested with a commercial immunoassay (rotavirus) and an "in house" nested RT-PCR (adenovirus, norovirus and astrovirus). RESULTS: Although norovirus was the second most common cause of gastroenteritis (7.9%) in the total population, it was predominant in the age group over the age of 6, causing 7.2% of gastroenteritis in the 6-16-year-old group, 8.6% in the 16-64-year-old group, and 11.1% in the >65-year group (p=0.001). In the last age group, norovirus was the most frequently detected (11.1%), followed by adenovirus (7.4%), astrovirus (3.6%) and rotavirus (3.3%) (p<0.0001). In addition, norovirus was rarely found in association with other viruses. CONCLUSIONS: Our data suggest that the elderly are highly vulnerable to certain infections, and indicate the need to introduce simple tests for an early identification of norovirus in cases of gastroenteritis affecting elderly patients, improving patient care by reducing unnecessary treatments and hospital stays.

Microbiología del trasplante / Microbiology of transplants

Las infecciones constituyen una de las complicaciones más importantes que afectan decisivamente al éxito de los trasplantes. El laboratorio de microbiología clínica ocupa un papel central en el diagnóstico, tratamiento y prevención de las complicaciones infecciosas. Los centros con programa de trasplantes deben contar con el soporte de un laboratorio de microbiología bien capacitado tecnológicamente y con una amplia cartera de servicios que ponga énfasis en las pruebas de diagnóstico rápido. En esta revisión se resumen los fundamentos clínicos que orientan la labor del laboratorio, el papel que desempeña en la evaluación de donantes y receptores y las técnicas diagnósticas a aplicar para los patógenos más relevantes (AU)

Infections are one of the main complications that decisively affect the final outcome of transplants. Clinical microbiology laboratory has a key role in diagnosis, treatment and prevention of these complications. Centres with transplant programs must be technically supported with a well developed laboratory with special emphasis in rapid diagnostic techniques. In this article, we review the clinical background for the laboratory, its role in the evaluation of both donors and recipients, and the diagnostic methods for the main pathogens infecting transplant patients (AU)

Prevalence, evolution, and features of infection with human papillomavirus: a 15-year longitudinal study of routine screening of a women population in the north of Spain.

Determination of the prevalence of type-specific human papillomavirus (HPV) is important for the development of new vaccines and to prevent malignancy. The objective of this study was to determine HPV infection in two areas in the north of Spain, and their evolution in the last 15 years. Between 1991 and 2007, 7,930 fresh cervical swabs were obtained from 5,554 women (37.8 +/- 11.8 years old). From them, 425 have been followed-up for an average of 3.7 +/- 2.08 years after sampling (range 2-14.6), and 71 for 7.7 +/- 2.2 years (range 5-14). Methods based on polymerase chain reaction (PCR) were carried out. Samples from 1,598 (28.8%) women were positive for HPV: 40.9% were under 25 years of age, 34.2% in the 25-35 year age group, 27.2% in the 36-45 year age group, and 19.6% older than 45 years (P < 0.001). HPV was found in 34.4% of the women with cytological alterations versus 23% of women without cervical changes (P < 0.0001). HPV-16 was present in 25.8% of the women, although the study identified 26 different HPV genotypes. After 3 years of follow-up, HPV remained or became undetectable in 87% of the cases, and in 5 years 70.3%. The prevalence of HPV is associated with younger women and women with cytological changes in the cervix. Although HPV-16 is more prevalent, HPV types not included in available vaccines were found the most commonly. The low 3-year (even 5-year) cumulative incidence rate of HPV infection suggests that cervical screening every 3 (or even 5) years is safe and effective.

Las infecciones por virus herpes simplex, Epstein-Barr, varicela zoster, papiloma humano, citomegalovirus o adenovirus no tienen relación con los adenocarcinomas nasosinusales / Viral infection of Herpes simplex, Epstein-Barr, Varicela Zoster, Human Papilloma, Cytomegalovirus, or Adenovirus are not related to sinonasal adenocarcinomas

Objetivo: Se ha relacionado a diversos virus con el desarrollo de tumores epidermoides de cabeza y cuello. No obstante, no existen estudios previos que relacionen a los adenocarcinomas nasosinusales (ACN) con la presencia de virus. El objetivo de este estudio es determinar, en una serie de ACN, la presencia de virus que se sabe desempeñan un papel en el cáncer. Material y método: Se estudió mediante PCR 37 ACN, para determinar la presencia de ADN de virus de papiloma humano, virus de Epstein-Barr (VEB), virus herpes simplex, virus de la varicela zoster, adenovirus y citomegalovirus. Resultados: Se detectó ADN de VEB en 3 (8,1 %) de las 37 muestras tumorales y ADN de citomegalovirus en 1 (2,7 %) de los 37 casos analizados. Conclusiones: Nuestros resultados indican que los virus estudiados no desempeñan papel alguno en la etiología de los ACN

Objective: Several types of virus have been implicated in the development of head and neck tumors. However, until now sinonasal adenocarcinomas (ACN) have not been studied. The aim of this study is to screen a series of ACN for the presence of a number of viruses known to play a role in cancer. Material and method: Viral DNA sequences of herpes simplex virus, Epstein-Barr, varicela zoster, human papilloma, cytomegalovirus, and adenovirus were analysed by PCR in 37 primary ACN. Results: Three tumors (8.1 %) were positive for Epstein-Barr virus and 1 case (2.7 %) for cytomegalovirus. Conclusions: Viral infections do not seem to play a role in the etiology of ACN