[Rapidly progressive dementia as the initial presentation of human immunodeficiency virus infection].

Dementia associated with human immunodeficiency virus (HIV) is currently a rare cause of rapidly progressive dementia. Its appearance is not only limited to the late phases of the disease, but can sometimes be the presenting symptom. We present the case of a patient who debuted with anxious-depressive symptoms and rapid cognitive deteri-oration with early repercussions on his daily functionality. HIV was detected in the study, with a higher viral load in cerebrospinal fluid than in plasma. Despite a torpid course at the beginning, antiretroviral therapy brought about a progressive improvement in the cognitive sphere, consistent with the decrease in the viral load. Although rare, HIV continues to be a cause of dementia that primary care and hospital care professionals should not forget. The relevance of its early diagnosis lies in its potentially reversible nature.

Demencia rápidamente progresiva como forma de presentación de infección por el virus de la inmunodeficiencia humana / Rapidly progressive dementia as the initial presentation of human immunodeficiency virus infection

La demencia asociada a virus de la inmunodeficiencia humana (VIH) es una causa de demencia rápidamente progresiva poco frecuente en la actualidad. Su aparición no se limita a las fases tardías de la enfermedad, sino que en ocasiones puede ser el síntoma de presentación. Presentamos el caso de un paciente que debutó con síntomas ansioso-depresivos y un rápido deterioro cognitivo con repercusión precoz en su funcionalidad diaria. En el estudio se detectó VIH con mayor carga viral en líquido cefalorraquídeo que en plasma. La terapia antirretroviral logró, a pesar de la tórpida evolución inicial, una mejora progresiva en la esfera cognitiva, congruente con la disminución de la carga viral. Aunque poco frecuente, el VIH sigue siendo una causa de demencia que los profesionales de atención primaria y hospitalaria no debemos olvidar. La importancia de su diagnóstico precoz radica en su carácter potencialmente reversible.(AU)

Dementia associated with human immunodeficiency virus (HIV) is currently a rare cause of rapidly progressive dementia. Its appearance is not only limited to the late phases of the disease, but can sometimes be the presenting symptom. We present the case of a patient who debuted with anxious-depressive symptoms and rapid cognitive deterioration with early repercussions on his daily functionality. HIV was detected in the study, with a higher viral load in cerebrospinal fluid than in plasma. Despite a torpid course at the beginning, antiretroviral therapy brought about a progressive improvement in the cognitive sphere, consistent with the decrease in the viral load. Although rare, HIV continues to be a cause of dementia that primary care and hospital care professionals should not forget. The relevance of its early diagnosis lies in its potentially reversible nature.(AU)

Carbon Nanostructures Doped with Transition Metals for Pollutant Gas Adsorption Systems.

The adsorption of molecules usually increases capacity and/or strength with the doping of surfaces with transition metals; furthermore, carbon nanostructures, i.e., graphene, carbon nanotubes, fullerenes, graphdiyne, etc., have a large specific area for gas adsorption. This review focuses on the reports (experimental or theoretical) of systems using these structures decorated with transition metals for mainly pollutant molecules' adsorption. Furthermore, we aim to present the expanding application of nanomaterials on environmental problems, mainly over the last 10 years. We found a wide range of pollutant molecules investigated for adsorption in carbon nanostructures, including greenhouse gases, anticancer drugs, and chemical warfare agents, among many more.

[Neurocognitive screening in a population with acquired immunodeficiency virus]. / Cribado neurocognitivo en población con virus de inmunodeficiencia adquirida.

INTRODUCTION: Neurocognitive impairment associated to human immunodeficiency virus (HIV) is a current problem despite the effectiveness of antiretroviral treatment. The screening tests which best suit to Spanish population are Brief Neuro-cognitive Scale (BNCS) and Neu Screening. We are unaware of our HIV population' neurocognitive impairment magnitude. AIMS: To verify if association between HIV and neurocognitive impairment does exist and to know its prevalence. SUBJECTS AND METHODS: An observational, descriptive and transversal study comparing 24 HIV-outpatients and 21 non-HIV-healthy control matched by age, gender and educational level. Hospital Anxiety and Depression Scale, Neu Screening and BNCS were used as neurocognitive impairment screening. Positive screening was considered with one or more abnormal test. RESULTS: 33.3% of VIH+ and 33.3% of healthy controls had positive screening without significant difference between both populations. Positive screening was significantly associated with anxiety-punctuation and depression-punctuation. A lineal correlation between CD4-nadir-levels and Digit Symbol and between CD4-nadir-levels and verbal fluency results were found. There was no significant relationship between HIV serology and screening result. CONCLUSIONS: HIV-patients clinically controlled had no significantly different neurocognitive profile compared to control population. CD4-nadir levels may be a predictor variable in terms of neurocognitive impairment development. BNCS and Neu Screening are reasonable alternatives for neurocognitive impairment screening. A concomitant psychiatric and neuro-psychological assessment is necessary. Further studies with bigger samples are necessary in order to confirm the alternative hypothesis.

TITLE: Cribado neurocognitivo en población con virus de inmunodeficiencia adquirida.Introducción. El trastorno neurocognitivo asociado al virus de la inmunodeficiencia humana (VIH) es un problema emergente a pesar del tratamiento antirretroviral. Los test de cribado que mejor se adaptan a la población española son la Brief Neurocognitive Scale (BNCS) y el Neu Screening. Desconocemos la magnitud del trastorno neurocognitivo en la población con VIH. Objetivos. Comprobar si existe asociación entre la infección por el VIH y el trastorno neurocognitivo, y conocer su prevalencia. Sujetos y métodos. Estudio observacional, descriptivo y transversal que compara a 24 pacientes con VIH y a 21 controles sanos, pareados por sexo, edad y nivel de estudios. Se utilizó la Hospital Anxiety and Depression Scale, el Neu Screening y la BNCS para el cribado neuropsicológico. Se consideró positivo un cribado con una alteración en uno o más test. Resultados. Un 33,3% de los pacientes con VIH y un 33,3% de los controles sanos tuvieron un cribado positivo, sin diferencias significativas entre ambos grupos. El cribado positivo presentó una relación significativa con ansiedad y depresión. Existe una correlación lineal positiva entre niveles nadir de CD4 y resultados del Digit Symbol, y entre nadir de CD4 y fluencia verbal. No hubo relación significativa entre VIH positivo y cribado positivo. Conclusiones. Los pacientes con VIH con buen control clínico presentan un perfil neurocognitivo sin diferencias significativas frente a la población control. Los niveles de CD4 son posiblemente una variable predictora para el desarrollo de trastorno neurocognitivo. La BNCS y el Neu Screening son buenas alternativas, pero resulta necesario un abordaje neuropsiquiátrico concomitante. Se precisan estudios con muestras mayores para confirmar la hipótesis alternativa.

Agreements and uncertainties in autologous haematopoietic stem cell mobilization and collection. A Spanish consensus document.

Although many experts position statements on autologous stem cell mobilization have been published, there are some aspects that are still under discussion. A Spanish Hematologist expert group was summoned to settle on agreements and uncertainties on PBSCs mobilization, including factors not always considered; as apheresis and cytometry key factors that determine a successful PBSC collection. This document reviews critical factors that define poor mobilizer patients and the tools to better collect the desired stem cells for a successful autologous haematopoietic stem cell transplant.

Molecular dynamics study of nanoconfined TIP4P/2005 water: how confinement and temperature affect diffusion and viscosity.

In the past few decades great effort has been devoted to the study of water confined in hydrophobic geometries at the nanoscale (tubes and slit pores) due to the multiple technological applications of such systems, ranging from drug delivery to water desalination devices. To our knowledge, neither numerical/theoretical nor experimental approaches have so far reached a consensual understanding of structural and transport properties of water under these conditions. In this work, we present molecular dynamics simulations of TIP4P/2005 water under different nanoconfinements (slit pores or nanotubes, with two degrees of hydrophobicity) within a wide temperature range. It has been found that water is more structured near the less hydrophobic walls, independently of the confining geometries. Meanwhile, we observe an enhanced diffusion coefficient of water in both hydrophobic nanotubes. Finally, we propose a confined Stokes-Einstein relation to obtain the viscosity from diffusivity, whose result strongly differs from the Green-Kubo expression that has been used in previous works. While viscosity computed with the Green-Kubo formula (applied for anisotropic and confined systems) strongly differs from that of the bulk, viscosity computed with the confined Stokes-Einstein relation is not so much affected by the confinement, independently of its geometry. We discuss the shortcomings of both approaches, which could explain this discrepancy.

Brentuximab vedotin and ESHAP is highly effective as second-line therapy for Hodgkin lymphoma patients (long-term results of a trial by the Spanish GELTAMO Group).

BACKGROUND: In this work, we assessed the efficacy and safety of brentuximab vedotin (BV) plus ESHAP (BRESHAP) as second-line therapy for Relapsed/Refractory Hodgkin lymphoma (RRHL) to improve the results before autologous stem-cell transplantation (ASCT). PATIENTS AND METHODS: This was a multicenter, open-label, phase I-II trial of patients with RRHL after first-line chemotherapy. Treatment had three 21-day cycles of etoposide, solumedrol, high-dose AraC, and cisplatin. BV was administered at three dose levels (0.9, 1.2, and 1.8 mg/kg) intravenous on day ‒1 to 3 + 3 cohorts of patients. Final BV dose was 1.8 mg/kg. Responding patients proceeded to ASCT, followed by three BV courses (1.8 mg/kg, every 21 days). Main end points for evaluation were maximum tolerable dose and overall and complete response (CR) before ASCT. RESULTS: A total of 66 patients were recruited (median age 36 years; range 18-66): 40 were primary refractory, 16 early relapse and 10 late relapse. There were 39 severe adverse events were reported in 22 patients, most frequently fever (n = 25, 35% neutropenic), including 3 deaths. Grade 3-4 hematological toxicity presented in 28 cases: neutropenia (n = 21), thrombocytopenia (n = 14), and anemia (n = 7). Grade ≥3-4 extrahematological adverse events (≥5%) were non-neutropenic fever (n = 13) and hypomagnesaemia (n = 3). Sixty-four patients underwent stem-cell mobilization; all collected >2×10e6/kg CD34+ cells (median 5.75; range 2.12-33.4). Overall response before transplant was 91% (CI 84% to 98%), including 70% (CRs 95% CI 59% to 81%). 60 patients were transplanted with no failure engraftments. Post-transplant response was CR in 49 patients (82% CI 73% to 91%) and partial responses in six (10% CI 5% to 15%). After a mean follow-up of 27 months, the 30-month time to treatment to failure was 74% (95% CI 68% to 80%), progression-free survival 71% (95% CI 65% to 77%), and overall survival 91% (CI 84% to 98%). CONCLUSION: BRESHAP looks a safe and effective pre-transplant induction regimen, does not jeopardize transplant and allows long-term remissions and survival.

Interfacial electron transfer between Geobacter sulfurreducens and gold electrodes via carboxylate-alkanethiol linkers: Effects of the linker length.

Geobacter sulfurreducens (Gs) attachment and biofilm formation on self-assembled monolayers (SAMs) of carboxyl-terminated alkanethiol linkers with varied chain length on gold (Au) was investigated by electrochemical and microscopic methods to elucidate the effect of the surface modification on the current production efficiency of Gs cells and biofilms. At the initial stage of the cell attachment, the electrochemical activity of Gs cells at a submonolayer coverage on the SAM-Au surface was independent of the linker length. Subsequently, multiple potential cyclings indicated that longer linkers provided more biocompatible conditions for Gs cells than shorter ones. For Gs biofilms, on the other hand, the turnover current decreased exponentially with the linker length. During the biofilm formation, bacteria need to adjust from the initial planktonic state to an electrode-respiring state, which was triggered by a strong electrochemical stress found for shorter linkers, resulting in the formation of mature biofilms. Our results suggest that the initial cell attachment and the biofilm formation are two inherently different processes. Therefore, the effects of linker molecules, electron transfer efficiency and biocompatibility, must be explored simultaneously to understand both processes to increase the current production of electrogenic microorganisms in microbial fuel cells.

Larval development of the symbiotic pea crab Pinnaxodes chilensis (H. Milne Edwards, 1837) (Decapoda, Brachyura, Pinnotheridae) reared in laboratory.

The complete larval development of Pinnaxodes chilensis (including four zoeal stages and a megalopa stage) is described and illustrated in detail for the first time. The descriptions are based on laboratory-reared larvae obtained from ovigerous females found inside specimens of the sea urchin Loxechinus albus collected in the coast of Valparaíso, Chile. In order to allow the correct differentiation of specimens from plankton samples, the larval stages of P. chilensis are compared with those from other Pinnotheridae species, whose larval development is known for the Chilean continental waters (Calyptraeotheres politus). The morphological characters described for P. chilensis larvae, as well as the comparison with the remaining larval development descriptions available for the genus Pinnaxodes, are used to discuss the heterogeneity within this genus.

IN VIVO AND IN VITRO ANTILEISHMANIAL EFFECTS OF METHANOLIC EXTRACT FROM BARK OF BURSERA APTERA.

BACKGROUND: Cutaneous leishmaniasis lacks effective and well-tolerated treatments. The current therapies mainly rely on antimonial drugs that are inadequate because of their poor efficacy. Traditional medicine offers a complementary alternative for the treatment of various diseases. Additionally, several plants have shown success as anti-leishmanial agents. Therefore, we sought to evaluate the in vitro and in vivo activity of MEBA against Leishmania mexicana. MATERIALS AND METHODS: Methanolic extract of B. aptera was obtained by macetration, after we determined in vitro anti-leishmanial activity of MEBA by MTT assay and the induced apoptosis in promastigotes by flow cytometry. To analyze the in vivo anti-leishmanial activity, we used infected mice that were treated and not treated with MEBA and we determined the levels of cytokines using ELISA. The phytochemical properties were determined by CG-MS and DPPH assay. RESULTS: We determined of LC50 of 0.408 mg/mL of MEBA for in vitro anti-leishmanial activity. MEBA induced apoptosis in promastigotes (15.3% ± 0.86). Treated mice exhibited smaller lesions and contained significantly fewer parasites than did untreated mice; in addition, we found that IFN-γ and TNF-α increased in the sera of MEBA-treated mice. GC-MS analysis showed that podophyllotoxin was the most abundant compound. Evaluation of the activity by DPPH assay demonstrated an SC50 of 11.72 µg/mL. CONCLUSION: Based on the above data, it was concluded that MEBA is a good candidate in the search for new anti-leishmanial agents.

Interaction of a Ti-doped semi-fullerene (TiC30) with molecules of CO and CO2.

Using density functional theory (DFT) and molecular dynamics (MD), we studied the interaction of a titanium atom with a half of a C60 fullerene (i.e., C30), formed from the corannulene structure with a pentagonal base. We considered atmospheric pressure and 300 K. We found that the most stable adsorption of the titanium atom on C30 occurs in the concave surface of the molecule. Afterward, we investigated the interaction of the system C30-titanium with carbon monoxide and carbon dioxide molecules, respectively. We found that each of these molecules is chemisorbed, with no dissociation. The value of the adsorption energy for the carbon monoxide molecule varies from -0.897 to -1.673 eV, and for the carbon dioxide molecule, it is between -1.065 and -1.274 eV. These values depend on the initial orientation of these molecules with respect to TiC30. Graphical Abstract The TiC30 system chemisorbs CO or CO2ᅟwith no dissociation at atmospheric pressure and 300K.

Can customized implants correct enophthalmos and delayed diplopia in post-traumatic orbital deformities? A volumetric analysis.

The purpose of this study was to determine whether orbital reconstruction with customized implants can correct post-traumatic orbital deformities such as late enophthalmos and delayed diplopia. The hypothesis proposed was that an overcorrection of the orbital volume is needed to resolve enophthalmos. A retrospective observational descriptive study was conducted. Patients with a major trauma who required customized orbital implants for the delayed treatment of unilateral orbital fractures that had initially been operated on using titanium mesh and/or osteosynthesis plates were included. The orbital volumes of the unaffected contralateral side, of the affected orbit after initial reconstruction with mesh, and of the affected orbit subsequently reconstructed with the customized implant were calculated. All of the patients included in this study had diplopia in the gaze position prior to the installation of the implant. In addition, they all had severe enophthalmos. After surgery, no patient with a customized implant showed diplopia. The enophthalmos was corrected in all but one case. On average, orbits reconstructed with customized implants had lower volumes compared to the unaffected contralateral side. In cases where the enophthalmos was resolved, the volume was reduced by an average of 8.55%. Further studies using a larger number of cases and with controlled volumetric corrections using CAD/CAM are needed.

Central nervous system prophylaxis with intrathecal liposomal cytarabine in a subset of high-risk patients with diffuse large B-cell lymphoma receiving first line systemic therapy in a prospective trial.

The dissemination in the central nervous system (CNS) is an uncommon but fatal complication occurring in patients with diffuse large B-cell lymphoma (DLBCL). Standard prophylaxis has been demonstrated to reduce CNS relapse and improve survival rates. Intrathecal (IT) liposomal cytarabine allows maintaining elevated drug levels in the cerebrospinal fluid for an extended period of time. Data on the efficacy and safety of liposomal cytarabine as CNS prophylaxis in patients with DLBCL are still insufficient. The objective of the present study was to evaluate the effectiveness and safety of the prophylaxis with IT liposomal cytarabine in prevention of CNS relapse in high-risk patients with DLBCL who were included in a trial of first line systemic therapy with 6 cycles of dose-dense R-CHOP every 14 days. Twenty-four (18.6 %) out of 129 patients were identified to have risk factors for CNS involvement, defined as follows: >30 % bone marrow infiltration, testes infiltration, retroperitoneal mass ≥10 cm, Waldeyer ring, or bulky cervical nodes involvement. Liposomal cytarabine (50 mg) was administered by lumbar puncture the first day of the 1st, 2nd, and 6th cycle of R-CHOP14 scheme. Among 70 IT infusions, grade 3-4 adverse events reported were headache (one patient) and nausea/vomiting (one patient). With a median follow-up of 40.1 months, no CNS involvement by DLBCL was observed in any patient. In conclusion, IT liposomal cytarabine is safe, feasible, and effective for CNS prophylaxis, causing few associated risks and little discomfort to patients with DLBCL.

Sensitivity analysis of a sediment dynamics model applied in a Mediterranean river basin: global change and management implications.

Climate change and land-use change are major factors influencing sediment dynamics. Models can be used to better understand sediment production and retention by the landscape, although their interpretation is limited by large uncertainties, including model parameter uncertainties. The uncertainties related to parameter selection may be significant and need to be quantified to improve model interpretation for watershed management. In this study, we performed a sensitivity analysis of the InVEST (Integrated Valuation of Environmental Services and Tradeoffs) sediment retention model in order to determine which model parameters had the greatest influence on model outputs, and therefore require special attention during calibration. The estimation of the sediment loads in this model is based on the Universal Soil Loss Equation (USLE). The sensitivity analysis was performed in the Llobregat basin (NE Iberian Peninsula) for exported and retained sediment, which support two different ecosystem service benefits (avoided reservoir sedimentation and improved water quality). Our analysis identified the model parameters related to the natural environment as the most influential for sediment export and retention. Accordingly, small changes in variables such as the magnitude and frequency of extreme rainfall events could cause major changes in sediment dynamics, demonstrating the sensitivity of these dynamics to climate change in Mediterranean basins. Parameters directly related to human activities and decisions (such as cover management factor, C) were also influential, especially for sediment exported. The importance of these human-related parameters in the sediment export process suggests that mitigation measures have the potential to at least partially ameliorate climate-change driven changes in sediment exportation.

Diagnóstico y seguimiento del mieloma extraóseo mediante tomografía por emisión de positrones/tomografía computarizada con 18F-fluorodeoxiglucosa / Diagnosis and follow-up with 18F-fluorodeoxiglucose positron emission tomography/computed tomography of extraosseous myeloma

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Detección de segundos tumores en estudios de la PET/TC con 11C-colina realizados por recurrencia bioquímica de cáncer de próstata / Detection of second tumors in 11C-choline PET/CT studies performed due to biochemical recurrence of prostate cancer

La aplicación clínica más aceptada de la PET/TC con 11C-colina es la localización precoz de la recidiva bioquímica en pacientes tras un tratamiento radical de cáncer de próstata. Su uso generalizado ha hecho evidente la existencia de localizaciones infrecuentes de incidentalomas, lesiones metastásicas, así como falsos positivos y negativos en la exploración. En los últimos 6 años, de un total de 454 estudios de la PET/TC con 11C-colina realizados en nuestro servicio para localizar la recidiva bioquímica de un cáncer de próstata hemos detectado un segundo tumor en 7 casos (1,54%): 3 de pulmón, 2 colorrectales, uno de esófago y uno esofagogástrico. Si bien es conocida la utilidad de la PET/TC con 11C-colina en la detección de otros tipos de tumores diferentes al cáncer de próstata, en los pacientes en los que se realiza la exploración por esta indicación aceptada su diagnóstico muestra un importante cambio en el manejo terapéutico de estos pacientes (AU)

Early localization of biochemical recurrence in patients after radical treatment of prostate cancer is a widely accepted clinical indication of 11C-choline PET/CT. Its widespread clinical use has prompted the depiction of incidentalomas, unusual sites of metastatic lesions, as well as false positive and negative cases. Over the last 6 years, a total of 454 11C-choline PET/CT studies have been performed in our institution to locate biochemical recurrence of patients with prostate cancer. With these studies, a second neoplasm has been found in 7 patients (1.54%): 3 lung, 2 colorectal, 1 esophagus and 1 esophageal junction, respectively. Although the clinical usefulness of this technique for detecting cancer lesions other than prostate origin is known for those patients who undergo this technique in the accepted indication, the diagnosis of a second tumor has a significant impact on their therapeutic management (AU)