Incidence and predictive biomarkers of Clostridioides difficile infection in hospitalized patients receiving broad-spectrum antibiotics.

Trial enrichment using gut microbiota derived biomarkers by high-risk individuals can improve the feasibility of randomized controlled trials for prevention of Clostridioides difficile infection (CDI). Here, we report in a prospective observational cohort study the incidence of CDI and assess potential clinical characteristics and biomarkers to predict CDI in 1,007 patients ≥ 50 years receiving newly initiated antibiotic treatment with penicillins plus a beta-lactamase inhibitor, 3rd/4th generation cephalosporins, carbapenems, fluoroquinolones or clindamycin from 34 European hospitals. The estimated 90-day cumulative incidences of a first CDI episode is 1.9% (95% CI 1.1-3.0). Carbapenem treatment (Hazard Ratio (95% CI): 5.3 (1.7-16.6)), toxigenic C. difficile rectal carriage (10.3 (3.2-33.1)), high intestinal abundance of Enterococcus spp. relative to Ruminococcus spp. (5.4 (2.1-18.7)), and low Shannon alpha diversity index as determined by 16 S rRNA gene profiling (9.7 (3.2-29.7)), but not normalized urinary 3-indoxyl sulfate levels, predicts an increased CDI risk.

Donor selection for faecal microbiota transplantation. Consensus document of the Catalan Society of Gastroenterology and the Catalan Society of Infectious Diseases and Clinical Microbiology. / Selección del donante para la transferencia de microbiota fecal. Documento de posicionamiento de la Societat Catalana de Digestologia y de la Societat Catalana de Malalties Infeccioses i Microbiologia Clínica.

Faecal microbiota transplantation (FMT) is an effective and safe treatment of recurrent Clostridioides difficile infection. It is essential to make every effort to perform FMT rigorously and based on scientific knowledge. Selection of the faecal microbiota donor is a key part of the process to ensure recipient safety. Protocols of action must be implemented that allow clinicians to act with the maximum guarantees and to minimise the risks of the procedure. In this regard, a multidisciplinary working group has been set up with the aim of establishing recommendations for selecting the faecal microbiota donor.

Values, Environmental Beliefs, and Connection With Nature as Predictive Factors of the Pro-environmental Vote in Spain.

This research analyzes the predictive capacity of psychosocial variables that can influence the decision to vote for political parties that include pro-environmental measures in their program. To this end, a study was carried out with a sample of 414 people of legal age who could exercise their right to vote (mean age = 26.92, SD = 10.53). The participants were divided into two groups: (1) Pro-environmental voters, those who during the last elections in Spain based their voting decision on whether the political party included pro-environment measures in its electoral program (n = 190), and (2) Non-pro-environmental voters, those other people who voted for a political party without considering whether pro-environment measures were included in its electoral program (even if such environmental protection measures had been included) (n = 224). The results indicate that, in comparison with their counterparts who do not vote for pro-environmental parties, those who voted for political parties during the last elections by considering the inclusion of pro-environment measures in their electoral program showed the highest scores on the biospheric and socio-altruistic values of ecocentrism, anthropocentrism, connectivity with nature and environmental concern, and scored lower on self-centered values. With the exception of connectivity with nature, biospheric values and beliefs were good predictors of pro-environmental voting behavior.

Validation and comparison of microsatellite markers derived from Senegalese sole (Solea senegalensis, Kaup) genomic and expressed sequence tags libraries.

In this work, we tested 100 potential new microsatellites (SSRs) equally derived from expressed sequence tag (EST) and enriched genomic-DNA libraries from Senegalese sole (Solea senegalensis, Kaup), a valuable cultured flatfish species. A final set of 69 new polymorphic microsatellites were validated after a population analysis, 37 of which corresponded to the first EST library constructed for Senegalese sole (EST-SSR). Although differences were not significant, EST sequences provided a higher proportion of quality markers (74%) than anonymous ones (64%). Most of the rejected anonymous SSRs (17 loci) were discarded because they did not generate PCR products; only one was monomorphic. On the contrary, all EST-SSRs gave PCR products, although monomorphism was more frequent (26%). Altogether, the number of alleles per locus was fairly similar in both SSR types, ranging from 2 to 19. The observed and expected heterozygosities varied from 0.105 to 1 and from 0.108 to 0.937, respectively. The main difference between the two sets was the percentage of annotated loci, being higher in EST-SSRs, as expected. Within the EST-SSRs, 46% of them showed flanking regions that significantly matched with EST sequences from other three flatfish species; however, the microsatellite itself was present only on half of these cases. These two new SSR sets constitute a suitable tool for fingerprinting, gene flow, genetic diversity, genome mapping studies and molecular-assisted breeding in this species.

Exploitation of a turbot (Scophthalmus maximus L.) immune-related expressed sequence tag (EST) database for microsatellite screening and validation.

In this study, we identified and characterized 160 microsatellite loci from an expressed sequence tag (EST) database generated from immune-related organs of turbot (Scophthalmus maximus). A final set of 83 new polymorphic microsatellites were validated after the analysis of 40 individuals of Atlantic origin including both wild and farmed individuals. The allele number and the expected heterozygosity ranged from 2 to 18 and from 0.021 to 0.951, respectively. Evidences of null alleles at moderate-high frequencies were detected at six loci using population data. None of the analysed loci showed deviations from Mendelian segregation after the analysis of five full-sib families including approximately 92 individuals/family. The markers are used to consolidate the turbot genetic map, and because they are mostly EST-derived, they will be very useful for comparative genomic studies within flatfishes and with model fish species. Using an in silico approach, we detected significant homologies of microsatellite sequences with the EST databases of the flatfish species with highest genomic resources (Senegalese sole, Atlantic halibut, bastard halibut) in 31% of these turbot markers. The conservation of these microsatellites within Pleuronectiformes will pave the way for anchoring genetic maps of different species and identifying genomic regions related to productive traits.

A model for flexible tools used in minimally invasive medical virtual environments.

Within the limits of current technology, many applications of a virtual environment will trade-off accuracy for speed. This is not an acceptable compromise in a medical training application where both are essential. Efficient algorithms must therefore be developed. The purpose of this project is the development and validation of a novel physics-based real time tool manipulation model, which is easy to integrate into any medical virtual environment that requires support for the insertion of long flexible tools into complex geometries. This encompasses medical specialities such as vascular interventional radiology, endoscopy, and laparoscopy, where training, prototyping of new instruments/tools and mission rehearsal can all be facilitated by using an immersive medical virtual environment. Our model recognises and uses accurately patient specific data and adapts to the geometrical complexity of the vessel in real time.

Valores laborales individualistas y colectivistas de enfermeras y enfermeros en un entorno multicultural / Individualistic and collectivistic work values of female and male nurses in multicultural environment

Objetivos: Comprobar si en los profesionales de enfermería predominan los valores individualistas o los colectivistas y si el perfil de valores predominante se mantiene tanto en las mujeres como en los hombres. Comprobar si existen diferencias de género en el grado en el que estos profesionales participan de los valores individualistas y colectivistas. Material y Métodos: La escala de medida utilizada es la EVAT-30. Los participantes fueron 186 enfermeros de un hospital público ubicado al Sur de España. Se realizaron análisis de diferencias de media, prueba t y análisis MANOVA. Resultados: Ambos géneros valoran más los valores laborales individualistas que los colectivistas. Las enfermeras prefieren más los valores individualistas que los enfermeros, no existiendo diferencias de género en los valores colectivistas. Conclusiones: Se sugiere la necesidad de profundizar en el análisis de estos valores relacionándolos con la eficacia de los equipos de trabajo en enfermería e identificando los factores que determinan las diferencias de género (AU)

Objectives: Identify whether individualistic or collectivistic values prevail within the nursing profession and whether the profile of prevailing values remains the same for both men and women. Check whether there exist gender differences in the degree to which these professionals participate in both individualistic and collectivistic values. Material and Methods: The scale of measure used is the EVAT-30. The participants were 186 female and male nurses from an public hospital, located in the South of Spain. analyses of mean difference, t tests, and MANOVA analyses were carried out. Results: Both genders value more individualistic work values than collectivistic values. Female nurses show a higher preference for individualistic values than male nurses, there being no gender differences in respect to collectivistic values. Conclusions: We suggest the necessity to explore in greater depth the analysis of these values relating them with the efficency of nursing workgroups and to identify the factors that determine the gender differences (AU)

Valores laborales y percepción del estilo de liderazgo en personal de enfermería / Work values and perception of leadership style in nursing staff

OBJETIVO: Identificar el perfil de los valores laborales de los profesionales de enfermería y analizar si se relacionan con el estilo de liderazgo percibido. MATERIAL Y MÉTODOS: Se utilizaron las escalas de medida EVAT-30 y l SBDQ. Participaron 160 enfermeros/as de un hospital público de Almería, España. El estudio se realizó en octubre de 2005. RESULTADOS: Los valores más apreciados por estos profesionales son: autoridad/poder, tradición, logro y autodirección. La percepción del estilo de liderazgo orientado hacia la tarea, correlaciona positivamente con los valores autoridad/poder, seguridad y logro, y negativamente con los valores benevolencia y universalismo. La percepción del estilo de liderazgo orientado hacia la relación correlaciona positivamente con los valores universalismo, logro, tradición y autodirección. CONCLUSIONES: Los resultados sugieren que el estilo de liderazgo adoptado por el supervisor puede influir en el perfil de valores de los subordinados.

OBJECTIVE: To identify the profile of work values according to nursing professionals and analyze the relationship, if any, of such values with the perception of leadership styles. MATERIAL AND METHODS: The EVAT-30 and the SDBQ questionnaires were used in this study. The sample comprised 160 nurses of an Almería public hospital, in the south of Spain. This study was carried out in October 2005. RESULTS: Values associated with authority/power, tradition, achievement and self-direction are deemed most important by nursing professionals. Perception of the task-oriented leader’s behavior positively correlates with values of authority/power, confidence and achievement, and negatively correlates with values of benevolence and universalism. Perception of the relationship/consideration-oriented leader’s behavior positively correlates with values of universalism, achievement, tradition and self-direction. CONCLUSION: These results suggest that the perception of leadership styles may influence the set of values held in high esteem by subordinates.

Relación entre burnout e inteligencia emocional y su impacto en salud mental, bienestar y satisfacción laboral en profesionales de enfermería / Reationship between burnout and emotinal intelligence and its influence onmetnal health, wll-being and work satisfaction among nursing proffesionals

El presente estudio analiza la relacion entre Intelgenica Emocional Percibida (IEP), y el Burnout en profesionales de enfermería. Analizamos la capacidad predictiva de la IEP para explicar los niveles de burout y salud mental en la práctica de la enfermería. Los anáisis de correlación mostraron asociaciones significativas entre Atención que se relacionó positivamente con Despersonalización. Claridad se asoció positivamente con realización personal, con buena salud metnal yalta satifacción en el rabajo. Ls análisis de regresión jerárquica confiraron estos resultados e indicaron que la IEP EXPLICA PARTE DE LA VIARIANZA DE Burnut no explicada or variables sociodemográficas Además la IEP influyó de dos manera diferentes sobre el burnout: directamente sobre las dimensiones del síndrome e indirenctamete vía escala afecto. Por último, comprobamos que tener bajas puntuaciones en el síndrome influye en unmayor bienestar y satisfacción con el trabajo. Estos hallazgos evidencian que ciertos factores cognitivos y emocionales deben ser tenido en cuenta para explicar el síndrome burnout en los profesionales de enfermería(AU)

In this study, we analize the relationship between Perceived Eotinal Intelligence (PEI) and Burnout among nrsing proffesionals. Specifically, we analize the PEI predictive capacity to explan burnout levels and emntal health among nursing professionals Correlational anayses yielded positivite significant relationships between Emotional Attntion and Despersonalization. Emotional Clarity was positively correlated to Personal accomplishment, mental health and work satisfation. On the other hand, regression analyses verified these results and showed that PEI explained part of the vairance that was not explained by sociodemographic variables. Moreover. PEI influenced burnout in two different ways: a directly on burnout dimensions and inderectly by the affect scale. Finally, we found that a lower score on burnout mplied being more satisfied with work and higher bell-being than a higher score. These findings demosntrate that certain cognitives and emotional factors should be considered to exlain burnout in nursing professionals(AU)

Development of a multilocus sequence typing scheme for characterization of clinical isolates of Acinetobacter baumannii.

In this study a multilocus sequence typing (MLST) scheme for Acinetobacter baumannii was developed and evaluated by using 40 clinical A. baumannii isolates recovered from outbreaks in Spanish and German hospitals during the years 1990 to 2001, as well as isolates from other European hospitals and two DSMZ reference strains of A. baumannii. For comparison, two isolates of Acinetobacter species 13 (sensu Tjernberg and Ursing), two clinical isolates, and three DSMZ strains of A. calcoaceticus (both belonging to the A. calcoaceticus-A. baumannii complex) were also investigated. Primers were designed for conserved regions of housekeeping genes, and 305- to 513-bp internal fragments of seven such genes-gltA, gyrB, gdhB, recA, cpn60, gpi, and rpoD-were sequenced for all strains. The number of alleles at individual loci ranged from 6 to 12, and a total of 20 allelic profiles or sequence types were distinguished among the investigated A. baumannii strains. The MLST data were in high concordance with the epidemiologic typing results generated by pulsed-field gel electrophoresis and amplified fragment length polymorphism fingerprinting. The MLST scheme provides a high level of resolution and an excellent tool for studying the population structure and long-term epidemiology of A. baumannii.

Valores hacia el trabajo del personal de enfermería. Un análisis descriptivo / Values toward the infirmary personnel's work: a descriptive analysis

La moderna gestión de los servicios de salud de la comunidad hace necesarios reajustes y modificaciones de la cultura organizacional para lograr una mayor cohesión de los equipos de trabajo que repercuta positivamente en los usuarios de estos servicios. En este sentido, uno de los factores a tener en cuenta, por sus implicaciones en el clima laboral y en el desarrollo de los objetivos de la organización, sería la congruencia entre los valores hacia el trabajo de supervisores y profesionales a su cargo. Sobre esta base, el presente trabajo se plantea como objetivos, por una parte, identificar el perfil de valores en el trabajo que presentan los supervisores y sus respectivos equipos de enfermeros y, por otra, comprobar si existe congruencia entre los perfiles de valores de ambos grupos. Para ello, se ha seleccionado una muestra de 53 enfermeros y 4 supervisores de cuatro áreas distintas de enfermería de un hospital de la comunidad andaluza. Todos ellos contestaron el cuestionario de valores laborales EVAT-30. Los resultados obtenidos indican que supervisores y enfermeros establecen jerarquías de valores semejantes y, por tanto, con un alto grado de congruencia. Por otra parte, las dimensiones de orden superior más valoradas por ambos grupos han sido las de Auto-promoción y Conservación (AU)

Importancia del valor Salud frente a otros valores sociales. En una muestra de adolescentes / Importance of the value Health as opposed to other social values in a sample of adolescents

La adolescencia se considera una etapa fundamental en la adquisición de hábitos que, saludables o no, van a condicionar el futuro de los jóvenes. De acuerdo con distintos autores, adolescentes y jóvenes muestran menor interés que los adultos en comportarse de forma "saludable", lo que ha llevado a considerarlos un grupo de alto riesgo en relación con la salud. Por otra parte, los estilos de vida y las pautas de conducta que afectan a la salud de los jóvenes, van a estar influidos por sus creencias y valores en relación con el entorno social en el que desarrollan su vida. Desde estos supuestos, cabría pensar que, en el sistema de valores de los jóvenes, el valor salud ocuparía un espacio reducido si se comparara con otros valores, a los que parece darse mayor importancia en esta etapa de la vida (libertad, amistad, paz, por citar algunos). Con el fin de comparar si efectivamente esto es así, en el presente trabajo se pidió a una muestra de 653 adolescentes, entre 13 y 15 años, que estimaran la importancia de los siguientes valores como guías de comportamiento en su vida: educación, igualdad, felicidad, libertad, trabajo, amor, paz, amistad, seguridad, justicia, religiosidad, prestigio, riqueza y salud. Para ello, cada uno de estos valores, iba seguido de una escala de siete puntos, en la que debían situarse de acuerdo con su valoración: desde 1 (nada o muy poco importante) hasta 7 (muy importante). Los resultados indican que el valor considerado más importante por los adolescentes es el valor salud. Realizados análisis posteriores para comprobar si había diferencias entre chicas y chicos en la valoración otorgada a los respectivos valores, nó aparecieron diferencias significativas entre ambos grupos (AU)

Hypodermosis of red deer in Spain.

From February 1998 to January 1999, 106 red deer in the Autonomic Organism National Park "Quintos de Mora" (Toledo, central Spain) were evaluated to determine the prevalence and dynamics of infection with Hypoderma sp. by detection of subcutaneous larvae. Between six and 13 deer shot in selective hunting were examined monthly. Hypoderma sp. larvae were detected throughout the period except in June, July and August of 1998. Excluding the period during which no subcutaneous larvae were detected, the number of animals sampled was 80 (52 males and 28 females), belonging to three age classes: 12 calves (<1-yr-old), 19 yearlings (1-yr-old), and 49 adults (2- to 10-yr-old). All the third instar (L3) collected were identified as H. actaeon. Total prevalence during the period of larval detection was 61%. Prevalence in yearling and adult deer shot during the official hunting season was 89%. Monthly prevalence increased from September to January and decreased from February to May. In September and October, a small percentage of larvae were classified as first instar (L1). The rest of larvae collected between September and December were second instar (L2). Third instar (L3) predominated in January and February and was the only stage collected from March to May. Intensity ranged from 1 to 145 larvae. Intensities were >100 larvae in 6% of animals. Possible relationships of intensity or prevalence of infection with sex or age of the animals were evaluated. Significant differences in prevalence were observed among different host age classes. Prevalence was higher in yearlings (84%) than in adults (63%) and lowest in calves (17%).

Pathological alterations caused by Anoplocephala perfoliata infection in the ileocaecal junction of equids.

The pathological alterations caused by Anoplocephala perfoliata in the ileocaecal junction of 28 equids slaughtered in an abattoir in Madrid (Central Spain) are described. The lesions were scored in grades based on the intensity of the damage and were related to the tapeworm number observed. The first grade (grade I) of alterations consisted of a slight enteritis associated with focal erosions observed in 43% of parasitized animals with low parasitic burden (1-26 tapeworms). The second grade (grade II) was a focal pseudomembranous enteritis, present in the ileocaecal junctions of 36% infected animals with moderate to high burden (23-188 tapeworms), and the third grade (grade III) was a regional necrotizing enteritis, present in the animals (21%) with the highest burden (72-248 tapeworms). The possible role of the lesions caused by this parasite in the aetiology of colic is discussed.

Cryptosporidium and concurrent infections with other major enterophatogens in 1 to 30-day-old diarrheic dairy calves in central Spain.

Faeces samples from 218, 1 to 30-day-old, diarrheic dairy calves in 65 dairy herds were screened for the presence of Cryptosporidium and concurrent infections with rotavirus, coronavirus, F5 Escherichia coli and Salmonella spp. Calves were grouped according to their age as follows: 1-7, 8-14, 15-21 and 22-30 days. Cryptosporidium infection was detected in 43.8%, 71.9%, 63.2% and 6.9% of the calves in the respective age groups. Significant differences in the detection rate of Cryptosporidium were found between the age group 22-30 days and all other age groups, and between the age group 1-7 days and the age groups 8-14 days and 15-21 days. Cryptosporidium was the only enteropathogen detected in 60 of the 114 (52.6%) diarrheic calves. Concurrent infections with other enteropathogen(s) were detected in 64.3%, 46.3%, 39.5% and 0% of the Cryptosporidium-infected calves in the age groups 1-7, 8-14, 15-21 and 22-30 days, respectively. A significant age-associated decrease in the detection rate of mixed infections (p < 0.05) was found. The detection rates of the other enteropathogens considered in calves with Cryptosporidium infection were 87% for rotavirus, 11.1% for coronavirus, 27.8% for F5+ E. coli and 1.8% for Salmonella.

Proportional morbidity rates of enteropathogens among diarrheic dairy calves in central Spain.

Faecal samples from 218 diarrheic dairy calves in 65 dairy herds, selected by convenience, were screened for the presence of rotavirus, coronavirus, Cryptosporidium spp., F5+ Escherichia coli and Salmonella spp. Animals surveyed were from 1 to 30 days old. Cryptosporidium and rotavirus were the most commonly detected agents (52.3% and 42.7% of the samples positive, respectively). F5+ E. coli was detected in the faeces of 11.9% of the calves and bovine coronavirus was detected in the faeces of 7.3% of the calves. Salmonella spp. was only found in the faeces of two calves (0.9%). Mixed infections with two or more agents occurred in 28% of the calves. Concurrent infection of rotavirus and Cryptosporidium was found in 21.6% of the calves. Two tests were used for the detection of rotavirus (a commercial ELISA and PAGE), F5+ E. coli (ELISA and bacterial culture) and Cryptosporidium (ELISA and microscopy). The validity of the commercial ELISA for the detection of rotavirus, F5+ E. coli and Cryptosporidium in faeces from diarrheic calves was evaluated using PAGE, bacterial culture and microscopy as gold standard, respectively. The ELISA showed a very low sensitivity (28.6%) for the detection of F5+ E. coli compared to bacterial culture.

Reliability of coprological diagnosis of Anoplocephala perfoliata infection.

Three coprological methods were tested to establish the reliability of in vivo diagnosis of Anoplocephala perfoliata. A total of 107 faecal samples were analyzed, and the presence of tapeworms were confirmed postmortem in 24 animals with burdens that ranged from 1 to 248 worms; most of them (71%) with less than 100 parasites. Best results were obtained with a combination of two sedimentation/flotation methods, detecting only half the parasitized animals (54% sensitivity). No relationship could be established between tapeworm burden and egg detection, but results indicate that coprological methods have a lower likelihood of diagnosing cestode infection when horses have less than 100 tapeworms.

[Serologic diagnosis of Lyme disease in patients with undifferentiated arthritis. Diagnostic problems]. / Diagnóstico serológico de la enfermedad de Lyme en pacientes con artritis indiferenciada. Problemas diagnósticos.

BACKGROUND: Arthritis is a frequent manifestation of Lyme disease. The diagnosis of this disease is especially supported by serological techniques which however have false positives or negatives. The aim of this study was to establish the frequency of serologies positive to Borrelia burgdorferi in patients with non-filiated arthritis and in other well defined rheumatic diseases. METHODS: A prospective study was performed to detect antibodies (AB) versus Borrelia burgdorferi in 43 patients with undifferentiated arthritis and in 100 patients with articular disease of precise diagnosis (rheumatoid arthritis, systemic lupus erythematosus, psoriasis arthropathy, and reactive arthritis/Reiter's syndrome). The technique was performed by indirect immunofluorescence and was repeated by enzymoimmunoassay in doubtful or positive results. Titers greater than 1/256 were considered as positive. RESULTS: Positive serology was found in two patients with undifferentiated arthritis and in one patient with Reiter's syndrome. None of the three patients referred the antecedent of erythema chronicum migrans. Positive serology was not observed in any of the patients with rheumatoid arthritis, systemic lupus erythematosus or psoriatic arthritis. CONCLUSIONS: A small proportion of patients with undifferentiated arthritis or Reiter's syndrome presented positive serology at low titers versus Borrelia burgdorferi with the interpretation of these results being difficult. The frequency of seropositivity in rheumatoid arthritis and systemic lupus erythematosus is very low.