A 5-year study of bloodstream infections caused by carbapenemase-producing Gram-negative bacilli in southern Spain.

OBJECTIVE: The aim of this study was to evaluate the microbiological epidemiology of carbapenemase-producing Gram-negative bacilli (CPGNB) isolated from blood during a 5-year period. METHODS: A total of 80 isolates from 78 patients were finally included; fifty-five (70.5%) were men and the mean age was 60 years. Detection of carbapenemase production was performed by immunocromatography (IC) and polymerase chain reaction (PCR). Genotyping was carried-out by pulsedfield gel electrophoresis (PFGE) and multi-locus sequence typing (MLST), and characterization of carbapenemase-producing isolates was performed by whole genome sequencing (WGS). RESULTS: The main microorganisms isolated were K. pneumoniae (29.4%), E. cloacae (28.2%), A. baumannii (17.9%) and P. aeruginosa (15.3%). Overall, the most common carbapenemase in Enterobacterales was OXA-48 group (57.7%). The most common carbapenemase in non-fermenting bacilli was OXA-23 (60.8%). The most common ST in K. pneumoniae producing OXA-48 types was ST45 and in E. cloacae ST114, while in E. cloacae producing VIM types was ST78. In OXA-23 types, the most common clone in A. baumannii was ST2, whereas in P. aeruginosa producing IMP types was ST253. CONCLUSIONS: There was an increase in cases recorded in the years of highest incidence and severity of the SARS-CoV-2 pandemic, with a significant number of cases in patients admitted to the ICU. All bacteremias caused by A. baumannii were caused by the same clone, and 12 of the 14 cases caused by A. baumannii were part of outbreaks in the ICU.

Papel de N-acetilcisteína (NAC) en pacientes con tabaquismo / Role of N-acetylcysteine (NAC) in patients with smoking

Antecedentes y objetivo. El tabaquismo es el principal factor de riesgo de la enfermedad pulmonar obstructiva crónica (EPOC). N-acetilcisteína (NAC) es un agente mucolítico con propiedades antioxidantes y antiinflamatorias que ha demostrado ser eficaz en la reducción de la tasa de exacerbaciones y mejoría clínica de los pacientes con EPOC. El objetivo del trabajo es conocer la opinión de terapeutas expertos acerca del perfil o perfiles de los pacientes fumadores que pueden ser candidatos al uso de NAC. Métodos. Se efectuó una encuesta distribuida a las unidades de tabaquismo de España y una Reunión de Expertos en tabaquismo y EPOC, en la que los Expertos pudieron debatir abiertamente los tópicos seleccionados. Resultados. Los expertos reconocieron el papel del tabaquismo en la generación de estrés oxidativo y concordaron en emplear la terapia mucolítica/antioxidante para fumadores o exfumadores con síntomas respiratorios. Se debatió la necesidad de ampliar las indicaciones de esta terapia a otros perfiles de pacientes. Se señaló también el potencial efecto preventivo de la NAC sobre el daño pulmonar por su acción antioxidante, aunque se necesitaría más evidencia en este ámbito específico del tabaquismo. Se puso énfasis en diferenciar la dosis de NAC como mucolítico (600 mg/día)o antioxidante (1.200 mg/día). Conclusiones. Los expertos valoraron a NAC como un fármaco bien tolerado, de sencillo uso, con un conocido buen perfil de seguridad y un gran potencial para lograr los objetivos terapéuticos por su alta capacidad antioxidante. (AU)

Background and objective. The smoking habit is the main risk factor for chronic obstructive pulmonary disease (COPD). N-Acetylcysteine (NAC) is a mucolytic agent with antioxidant and anti-inflammatory properties that has been demonstrated to be effective in the reduction of the rate of exacerbations and clinical improvement of patients with COPD. This study aims to know the opinion of the expert therapists on the profile(s) of the patients who smoke and who may be candidates for the use of NAC. Methods. A survey was performed, distributing it to the smoking units in Spain and to a Meeting of Experts on the smoking habit and COPD in which the Experts could openly debate on the selected topics. Results. The experts recognized the role of the smoking habit in the generation of oxidative stress and agreed to use the mucolytic/antioxidant treatment for smokers or ex-smokers with respiratory symptoms. The need to extend the indications of this therapy to other patient profiles was debated. The potential preventive effect of NAC on lung damage due to its antioxidant action was also pointed out, although more evidence in this special area of the smoking habit would be necessary. Emphasis was placed on differentiating the NAC dose as a mucolytic (600 mg/day) or as an antioxidant (1,200 mg/day). Conclusions. The experts evaluated NAC as a drug that is well-tolerated, easy-to-use, with a known good safety profile and having great potential to achieve the therapeutic objectives due to its high antioxidant capacity. (AU)

In Vitro Activity of Cefiderocol Compared to Other Antimicrobials against a Collection of Metallo-Beta-Lactamase-Producing Gram-Negative Bacilli from Southern Spain.

In this study, we aimed to comparatively evaluate the in vitro activity of cefiderocol versus other antimicrobials against a well-characterized collection of metallo-beta-lactamase (MBL)-producing Gram-negative bacilli (MBL-GNB) isolates from hospitals in Andalusia, Spain. We recovered 232 MBL-GNB from Andalusian hospitals, including 160 Enterobacterales and 72 nonfermenting Gram-negative bacilli belonging to 44 different clones (2015 to 2020). Cefiderocol and comparator MICs were determined with commercial methods (UMIC [Bruker] and EUMDROXF [Sensititre; Thermo Fisher], respectively). EUCAST breakpoints were used for all antimicrobials tested, and CLSI also was used for cefiderocol. Control strains used were E. coli ATCC 25922 and Pseudomonas aeruginosa ATCC 27853. Cefiderocol showed potent in vitro activity against isolates tested, regardless of breakpoint (susceptibility rates, 85.3% for EUCAST versus 96.6% for CLSI, P < 0.001). MIC ranges for Enterobacterales and nonfermenting Gram-negative bacilli (NF-GNB) were ≤0.03 to 1 mg/L and 0.06 to 2 (IMP), 0.06 to 8 mg/L and 0.06 to 16 (VIM), 0.25 to 16 mg/L and 2 to 16 mg/L (NDM), respectively, and 0.25 to 8 mg/L for double MBL-producing Enterobacterales. By species, all cefiderocol-susceptible rates were over 90%, except Klebsiella oxytoca, Enterobacter cloacae, Escherichia coli, and Acinetobacter spp. Significant differences were observed comparing resistant isolates between Enterobacterales and NF-GNB by EUCAST (19.4% versus 4.2%, P < 0.01), but not by CLSI (4.4% versus 1.4%, P = 0.2). Cefiderocol was the most active antimicrobial tested. Cefiderocol showed excellent in vitro activity against MBL-GNB, especially NF-GNB; almost all isolates resistant to comparators were susceptible. IMPORTANCE This article demonstrates the efficacy of cefiderocol against a large collection of well-characterized metallo-beta-lactamase-producing isolates, some of them even producing double carbapenemases. Furthermore, cefiderocol activity is compared to other novel broad-spectrum antimicrobials with activity against carbapenemases.

La prematuridad: un antecedente de obligada consideración a la hora de valorar el complejo de células ganglionares de la retina / Prematurity: a medical history of obligatory consideration when assessing the retinal ganglion cell complex

Introducción: La supervivencia de los niños prematuros es cada vez más frecuente siendo cada vez más habitual encontrar pacientes con este antecedente en las consultas de oftalmología. El parto prematuro puede conllevar cambios estructurales a nivel ocular, pudiéndose afectar entre otras estructuras el complejo de células ganglionares (CCG), que puede ser estudiado mediante la tomografía de coherencia óptica.Materiales y métodosRealizar una revisión bibliográfica de los estudios que analizan el CCG en pacientes con antecedente de prematuridad y lo comparan con pacientes nacidos a término.ResultadosSe referencian varios estudios que analizan el CCG en población con antecedente de prematuridad y se estudian los distintos resultados obtenidos.ConclusionesEn nuestra práctica clínica, conocer el antecedente de prematuridad es fundamental en la valoración del CCG medido por tomografía de coherencia óptica ya que el grosor de esta capa es distinta en la población con antecedente de prematuridad comparada con la población a término. (AU)

Introduction: Premature children birth and survival is becoming more frequent due to the improvement in obstetric and neonatal care. This makes it increasingly common to find patients with history of preterm birth in ophthalmology clinics, both in pediatric and adult ages. Premature birth can lead to ocular structural changes, being possible to affect the ganglion cell complex (GCC), among other structures, which can be studied using optical coherence tomography.Materials and methodsTo carry out a bibliographic review of the studies that analyze GCC in patients with a history of prematurity compared with patients born at term.ResultsSeveral studies that analyze GCC in patients with a history of prematurity are referenced and their results are studied.ConclusionsIn our clinical practice, knowing the history of prematurity is fundamental in the assessment of GCC measured by optical coherence tomography, since this layer is different in the patients with a history of prematurity compared to patients born at term. (AU)

Prematurity: A medical history of obligatory consideration when assessing the retinal ganglion cell complex.

INTRODUCTION: Premature children birth and survival is becoming more frequent due to the improvement in obstetric and neonatal care. This makes it increasingly common to find patients with history of preterm birth in ophthalmology clinics, both in pediatric and adult ages. Premature birth can lead to ocular structural changes, being possible to affect the ganglion cell complex (GCC), among other structures, which can be studied using optical coherence tomography. MATERIALS AND METHODS: To carry out a bibliographic review of the studies that analyze GCC in patients with a history of prematurity compared with patients born at term. RESULTS: Several studies that analyze GCC in patients with a history of prematurity are referenced and their results are studied. CONCLUSIONS: In our clinical practice, knowing the history of prematurity is fundamental in the assessment of GCC measured by optical coherence tomography, since this layer is different in the patients with a history of prematurity compared to patients born at term.

Manifestaciones oftalmológicas en 6 pacientes con síndrome de Williams-Beuren y revisión de la literatura / Ophthalmological manifestations in 6 patients diagnosed with Williams-Beuren syndrome and literature review

Se revisó la historia clínica de 6 pacientes diagnosticados de síndrome de Williams-Beuren en la edad pediátrica. Todos los pacientes presentaron la facies de elfo característica y anomalías cardiovasculares. Todos presentaron buena agudeza visual, excepto un caso de ambliopía unilateral. El error refractivo más frecuente fue la hipermetropía (n=6; 100%) y el astigmatismo (n=5; 83,3%). En 2 pacientes se encontraron alteraciones de la motilidad ocular (un caso de exoforia con hiperfunción de oblicuo inferior derecho y otro de endotropía congénita con hiperfunción del oblicuo inferior bilateral). Cognitivamente un 66,7% (n=4) tenía alteraciones visoperceptivas. Otros hallazgos fueron epicantus (n=6; 100%) y obstrucción congénita del conducto nasolagrimal con epífora unilateral (n=1; 16,7%). El síndrome de Williams-Beuren es un trastorno poco frecuente con manifestaciones oftalmológicas y sistémicas complejas. Por ello, es recomendable realizar un seguimiento oftalmológico a estos niños (AU)

Medical history of 6 patients diagnosed with Williams-Beuren Syndrome (SWB) in pediatric age was revised. All the patients presented characteristic elf facies and cardiovascular abnormalities. All presented good visual acuity, except one case of unilateral amblyopia. The most frequent refractive error was hyperopia (n=6; 100%) and astigmatism (n=5; 83.3%). Ocular motility alterations were found in 2 patients (1 case of exophoria with hyperfunction of right inferior oblique and another of congenital endotropia with bilateral hyperfunction of inferior oblique). On the cognitive function, 66.7% (n=4) had visoperceptive disorders. Other findings were epicanthus (n=6; 100%) and congenital obstruction of the nasolacrimal duct with unilateral epiphora (n=1; 16.7%). SWB is a rare disorder with complex ophthalmological and systemic manifestations. For this reason, ophthalmological follow-up of these children is recommended (AU)

Ophthalmological manifestations in 6 patients diagnosed with Williams-Beuren syndrome and literature review.

Medical history of 6 patients diagnosed with Williams-Beuren Syndrome (SWB) in pediatric age was revised. All the patients presented characteristic elf facies and cardiovascular abnormalities. All presented good visual acuity, except one case of unilateral amblyopia. The most frequent refractive error was hyperopia (n = 6; 100%) and astigmatism (n = 5; 83.3%). Ocular motility alterations were found in 2 patients (1 case of exophoria with hyperfunction of right inferior oblique and another of congenital endotropia with bilateral hyperfunction of inferior oblique). On the cognitive function, 66.7% (n = 4) had visoperceptive disorders. Other findings were epicanthus (n = 6; 100%) and congenital obstruction of the nasolacrimal duct with unilateral epiphora (n = 1; 16.7%). SWB is a rare disorder with complex ophthalmological and systemic manifestations. For this reason, ophthalmological follow-up of these children is recommended.

Septo-optic dysplasia: Ophthalmological abnormalities in a series of 5 cases.

Septo-optic dysplasia (SOD) is a rare congenital condition of unknown cause, with a characteristic triad that includes optic nerve hypoplasia, pituitary function abnormalities and midline brain defects, in addition to a broad spectrum of symptoms and associations. A total of five clinical cases are presented, four of which met the complete classic triad. All of them showed a wide variety of ophthalmological, endocrinological and neurological alterations. Within the ophthalmological spectrum of SOD, papillary hypoplasia and ocular motility alterations (nystagmus, strabismus) stand out. Other less frequent ones may also appear, such as pupillary alterations, microphthalmia and coloboma. Given the suspicion of SOD, brain MRI scan should be performed, as well as consultation with the paediatric department in order to complete the study and indicate, if necessary, systemic treatment.

Displasia septoóptica: alteraciones oftalmológicas en una serie de 5 casos / Septo-optic dysplasia: ophthalmological abnormalities in a series of 5 cases

La displasia septoóptica (DSO) es una entidad congénita, rara, de causa desconocida, con una tríada característica que incluye hipoplasia de nervio óptico, anomalías en la función hipofisaria y defectos en la línea media cerebral, además de un amplio espectro de manifestaciones y asociaciones.Se presenta una serie de cinco casos clínicos, de los cuales cuatro presentaron la tríada clásica completa. Todos mostraron gran variedad de alteraciones oftalmológicas, endocrinológicas y neurológicas.Dentro del espectro oftalmológico de la DSO, destacan la hipoplasia papilar y las alteraciones de la motilidad ocular (nistagmos estrabismo). También pueden aparecer otras menos frecuentes, como son alteraciones pupilares, microftalmia y coloboma.Ante la sospecha de DSO, conviene realizar una resonancia magnética cerebral y una interconsulta con el servicio de pediatría para completar el estudio e indicar, si fuera preciso, tratamiento sistémico.

Septo-optic dysplasia (SOD) is a rare congenital condition of unknown cause, with a characteristic triad that includes optic nerve hypoplasia, pituitary function abnormalities and midline brain defects, in addition to a broad spectrum of symptoms and associations.A total of five clinical cases are presented, four of which met the complete classic triad. All of them showed a wide variety of ophthalmological, endocrinological and neurological alterations.Within the ophthalmological spectrum of SOD, papillary hypoplasia and ocular motility alterations (nystagmus, strabismus) stand out. Other less frequent ones may also appear, such as pupillary alterations, microphthalmia and coloboma.Given the suspicion of SOD, brain MRI scan should be performed, as well as consultation with the paediatric department in order to complete the study and indicate, if necessary, systemic treatment.

O-serotype distribution of Escherichia coli bloodstream infection isolates in critically ill patients in The Netherlands.

OBJECTIVES: Invasive infections by extra-intestinal pathogenic Escherichia coli (ExPEC) strains are increasing. We determined O-serogroups of E. coli isolates from ICU patients having bloodstream infections (BSI) and the potential coverage of a 10-valent O-polysaccharide conjugate vaccine currently in development for the prevention of invasive ExPEC disease. METHODS: We studied E. coli BSI among patients admitted to a tertiary ICU in the Netherlands between April 2011 and November 2016. O-serogroups were determined in vitro by agglutination and whole genome sequencing. RESULTS: Among 714 ICU patients having BSI, 70 (10%) had an E. coli BSI. Among 68 (97%) isolates serogrouped, the most common serogroups were O25 (n = 11; 16%), O8 (n = 5; 7%), O2 (n = 4; 6%), O6 (n = 4; 6%), and O15 (n = 4; 6%). The theoretical coverage of a 10-valent ExPEC vaccine was 54% (n = 37). CONCLUSIONS: A multi-valent ExPEC O-polysaccharide conjugate vaccine in development could potentially aid in the prevention of E. coli BSI in Dutch ICU patients.

Microftalmia bilateral asociada con quistes orbitarios. Manejo individualizado según el potencial visual. Reporte de caso clínico / Bilateral microphthalmos with bilateral orbital cysts: individualising the treatment according to the visual potential. A case report

Niño de tres meses diagnosticado de microftalmia y quistes orbitarios bilaterales. En la resonancia magnética se objetivó una microftalmia bilateral con quiste moderado en ojo derecho (OD) y quiste severo en ojo izquierdo. La exploración sugería un posible potencial visual del OD. Se decidió solo observación. A los dos años, la exploración mostraba una disminución significativa de los quistes con una agudeza visual de movimiento de manos gracias a la visión residual del OD. La microftalmia con quistes orbitarios es una anomalía congénita rara. Los quistes tienden a crecer con el tiempo. Actualmente no existe un protocolo estandarizado de manejo de esta enfermedad. A diferencia de nuestro caso, la agudeza visual en estos pacientes es normalmente de no percepción de la luz. La observación puede ser una alternativa terapéutica en casos severos ya que existe la posibilidad de una disminución, desplazamiento o regresión espontánea de los quistes

The case is presented of a 3-month-old infant diagnosed with microphthalmos and orbital cysts. Magnetic Resonance Imaging revealed a bilateral microphthalmia with a moderate right cyst and a severe left cyst. Visual potential of the right eye was uncertain. Non-surgical treatment was decided. At the age of 2 years old, physical examination showed a significant decrease of the cysts and visual acuity of hand movements due to the residual vision of his right eye. Microphthalmos with orbital cyst is a rare congenital anomaly. Cysts tend to enlarge with time. At the moment, no standard protocol for the management of this pathology has been described. Unlike in our patient, visual acuity in these patients is usually of no-light perception. The observation could be an alternative in severe cases, since there is a possibility of spontaneous reduction, displacement, or regression of the cysts

Bilateral microphthalmos with bilateral orbital cysts: individualising the treatment according to the visual potential. A case report. / Microftalmia bilateral asociada con quistes orbitarios. Manejo individualizado según el potencial visual. Reporte de caso clínico.

The case is presented of a 3-month-old infant diagnosed with microphthalmos and orbital cysts. Magnetic Resonance Imaging revealed a bilateral microphthalmia with a moderate right cyst and a severe left cyst. Visual potential of the right eye was uncertain. Non-surgical treatment was decided. At the age of 2 years old, physical examination showed a significant decrease of the cysts and visual acuity of hand movements due to the residual vision of his right eye. Microphthalmos with orbital cyst is a rare congenital anomaly. Cysts tend to enlarge with time. At the moment, no standard protocol for the management of this pathology has been described. Unlike in our patient, visual acuity in these patients is usually of no-light perception. The observation could be an alternative in severe cases, since there is a possibility of spontaneous reduction, displacement, or regression of the cysts.

Association between vitamin D deficiency and common variants of Vitamin D binding protein gene among Mexican Mestizo and indigenous postmenopausal women.

PURPOSE: Vitamin D deficiency (VDD) and polymorphisms in the group-specific component (GC) gene are known to be associated in different populations. However, the effects of such genetic variants may vary across different populations. Thus, the objective of this study was to estimate the association between Vitamin D-Binding Protein (VDBP) haplotypes and VDD in mestizo postmenopausal women and Mexican Amerindian ethnic groups. METHODS: This was a cross-sectional study of 726 postmenopausal Mexican women from the Health Workers Cohort Study (HWCS) and 166 postmenopausal women from the Metabolic Analysis in an Indigenous Sample (MAIS) cohort in Mexico. GC polymorphisms (rs7045 and rs4588) were analyzed by TaqMan probes. Serum 25-hydroxyvitamin D [25(OH)D] levels were measured by Chemiluminescent Microparticle Immuno Assay. RESULTS: The prevalence of VDD serum 25(OH)D < 20 ng/mL was 43.7% in mestizo women and 44.6% in indigenous women. In HWCS, the single nucleotide polymorphisms (SNPs) rs7041 and rs4588 were associated with VDD. In addition, women from the HWCS, carrying the haplotypes GC2/2 and GC1f/2 had higher odds of VDD (OR = 2.83, 95% CI 1.14, 7.02; and OR = 2.30, 95% CI 1.40, 3.78, respectively) compared to women with haplotype 1f/1 s. These associations were not statistically significant in the MAIS cohort. CONCLUSIONS: Our results show genetic association of the analyzed SNPs and related haplotypes, on the GC gene, with VDD in mestizo Mexican postmenopausal women. Moreover, a high prevalence of VDD with high genetic variability within the country was observed. Our results support the need for national policies for preventing VDD.

Bases de datos normativas en edad pediátrica para tomografía de coherencia óptica: una clara necesidad / Paediatric optical coherence tomography normative databases: A real need

INTRODUCCIÓN: La tomografía de coherencia óptica (OCT) se ha convertido en una herramienta imprescindible en las consultas de oftalmología pediátrica. Sin embargo, las OCT disponibles en la actualidad no incluyen ninguna base de datos normativa para población pediátrica, lo que puede conllevar errores importantes de interpretación. OBJETIVO: Realizar una revisión bibliográfica sobre las bases de datos normativas para OCT realizadas en población pediátrica. MATERIAL Y MÉTODOS: Se revisan las aplicaciones e implicaciones del uso de las bases de datos normativas pediátricas para OCT. RESULTADOS: Se referencian varios estudios realizados para extraer estas bases de datos con diferentes modelos de OCT en población española y europea con el fin de disponer de ellos de manera resumida. CONCLUSIONES: En nuestra práctica clínica diaria es muy importante el conocimiento y manejo de las bases de datos normativas pediátricas para la correcta interpretación de los mapas de grosores de OCT

INTRODUCTION: Optical coherence tomography (OCT) has become an essential tool in paediatric ophthalmology. However, none of the currently available OCT devices include any kind of normative database for the paediatric population, which can lead to important interpretation errors. OBJECTIVE: To review the paediatric OCT normative databases. MATERIAL AND METHODS: The applications and implications of the use of paediatric OCT normative databases are reviewed. RESULTS: The paediatric normative databases that have been published so far in scientific literature with different OCT devices for Spanish and European population are presented. CONCLUSIONS: The knowledge and interpretation of paediatric OCT normative databases in our daily clinical practice is crucial in order for the correct interpretation of OCT thickness maps

Paediatric optical coherence tomography normative databases: A real need. / Bases de datos normativas en edad pediátrica para tomografía de coherencia óptica: una clara necesidad.

INTRODUCTION: Optical coherence tomography (OCT) has become an essential tool in paediatric ophthalmology. However, none of the currently available OCT devices include any kind of normative database for the paediatric population, which can lead to important interpretation errors. OBJECTIVE: To review the paediatric OCT normative databases. MATERIAL AND METHODS: The applications and implications of the use of paediatric OCT normative databases are reviewed. RESULTS: The paediatric normative databases that have been published so far in scientific literature with different OCT devices for Spanish and European population are presented. CONCLUSIONS: The knowledge and interpretation of paediatric OCT normative databases in our daily clinical practice is crucial in order for the correct interpretation of OCT thickness maps.

Función visual y deficiencia visual cerebral (cerebral visual impairment) en niños. La importancia de entenderla y atenderla / Visual function and CVI in children (cerebral visual impairment): The importance of understanding and treating it

No disponible

Desarrollo de un sistema de telemetría para el seguimiento postoperatorio de procedimientos en cirugía vascular: modelo in vitro / Development of a telemetry system for the post-operative follow-up of vascular surgery procedures: An in vitro model

Introducción: Debido a las características electromagnéticas únicas del microhilo amorfo magnetoelástico, los cambios en la presión de un fluido provocarán una variación de la tensión mecánica sobre el sensor, lo que supondrá una variación de su imanación que será detectable de forma inalámbrica. Utilizando esta tecnología, se podrá desarrollar un sistema inalámbrico para el seguimiento de procedimientos en cirugía vascular. Métodos: El sensor diseñado consiste en un anillo de microhilo magnetoelástico que se integró en un modelo in vitro con flujo pulsátil. Se simularon distintos grados de estenosis en distintas localizaciones, tanto en arteria bovina como en un segmento de PTFE. Se realizó el análisis de Fourier de las señales registradas, y se emplearon el test de correlación de Pearson y curvas COR para el análisis de la información. Resultados: Se obtuvo un índice de correlación de Pearson de 0,945 (p < 0,001) entre la presión invasiva del fluido y la potencia de la señal emitida por el microhilo magnetoelástico en arteria bovina. Se obtuvieron unas excelentes curvas COR, tanto en el caso de las estenosis preanastomóticas (AUC 0,98; IC 95%: 0,97-1) y anastomóticas (AUC 0,93; IC 95%: 0,86-0,99), como en el caso de las estenosis distales (AUC 0,88; IC 95%: 0,79-0,98), comparadas con un grupo control. Conclusiones: El microhilo magnetoelástico es capaz de detectar, localizar y cuantificar el grado de estenosis en arteria bovina, así como en una anastomosis latero-terminal, con una elevada potencia estadística. Por primera vez se ha desarrollado un sensor inalámbrico in vitro para el seguimiento postoperatorio de los procedimientos en cirugía vascular (AU)

Introduction: Due to the unique electromagnetic characteristics of the magnetoelastic microwire, the changes in the pressure of a fluid will lead to changes in the mechanical pressure on the sensor, which will then cause a variation of its magnetisation which will be detectable wirelessly. Thus, a wireless system can be developed for following-up vascular surgery procedures. Methods: The sensor consists of a magnetoelastic microwire ring which was integrated into an in vitro model with pulsatile flow. Different degrees of stenosis were simulated in different locations in bovine artery, as well as in a polytetrafluoroethylene anastomosis. A Fourier analysis of the registered signals was performed, with a statistical analysis using Pearson test and ROC curves. Results: A Pearson index of .945 (P < .001) was obtained between the invasive pressure of the fluid and the power of the signal transmitted by the sensor in bovine artery. The sensor obtained very good ROC curves in the analysis of the registered the signals, in the case of pre-anastomotic stenosis (AUC .98; 95% CI: .97-1), anastomosis (AUC .93; 95% CI: .86-.99), as well as distal (AUC .88; 95% CI: .79-.98), compared to the control group. Conclusions: The magnetoelastic microwire has shown that it is capable of detecting, locating and quantifying the degree of stenosis in bovine artery, as well as in a latero- terminal anastomosis, with a high statistical power. For the first time, a wireless in vitro sensor has been developed for the post-operative follow-up of vascular surgery procedures (AU)

The effect of crack cocaine addiction and age on the microstructure and morphology of the human striatum and thalamus using shape analysis and fast diffusion kurtosis imaging.

The striatum and thalamus are subcortical structures intimately involved in addiction. The morphology and microstructure of these have been studied in murine models of cocaine addiction (CA), showing an effect of drug use, but also chronological age in morphology. Human studies using non-invasive magnetic resonance imaging (MRI) have shown inconsistencies in volume changes, and have also shown an age effect. In this exploratory study, we used MRI-based volumetric and novel shape analysis, as well as a novel fast diffusion kurtosis imaging sequence to study the morphology and microstructure of striatum and thalamus in crack CA compared to matched healthy controls (HCs), while investigating the effect of age and years of cocaine consumption. We did not find significant differences in volume and mean kurtosis (MKT) between groups. However, we found significant contraction of nucleus accumbens in CA compared to HCs. We also found significant age-related changes in volume and MKT of CA in striatum and thalamus that are different to those seen in normal aging. Interestingly, we found different effects and contributions of age and years of consumption in volume, displacement and MKT changes, suggesting that each measure provides different but complementing information about morphological brain changes, and that not all changes are related to the toxicity or the addiction to the drug. Our findings suggest that the use of finer methods and sequences provides complementing information about morphological and microstructural changes in CA, and that brain alterations in CA are related cocaine use and age differently.