Actinomicosis: dos casos clínicos ginecológicos. No sólo los DIUs tienen la culpa / Actinomycosis: two gynaecological clinical cases. It's not just IUDs to blame

Introducción: La actinomicosis pélvica ha sido descrita en la literatura como asociada al uso de dispositivos intrauterinos, pero no siempre guarda relación con ellos. Hallazgos clínicos: En este artículo describimos dos casos de abscesos pélvicos en dos pacientes con cirugías previas y endometriosis, sin antecedente de uso de DIU. Diagnóstico: En ambas pacientes se aisló Actinomyces turicensis en los cultivos de los abscesos, entre otros microorganismos, siendo diagnosticadas de actinomicosis pélvica. Tratamiento: Las dos pacientes precisaron de drenaje quirúrgico de los abscesos y tratamiento antibiótico durante el ingreso y, una vez que se les dio de alta, requirieron un tratamiento de mantenimiento durante meses con amoxicilina. Resultados: Las dos pacientes mostraron resolución del cuadro clínico, analítico y radiológico durante el seguimiento posterior. Conclusión: Hacemos especial hincapié en la importancia de sospechar y tratar esta infección a tiempo, para evitar cirugías agresivas, así como realizar un adecuado diagnóstico diferencial con otros procesos que pueden presentar síntomas similares.(AU)

Introduction: Pelvic actinomycosis has been described in the literature associated with the use of intrauterine devices, but it is not always related to them. Clinical findings: In this article we describe two cases of pelvic abscesses in two patients with previous surgeries and endometriosis, without a history of IUD use. Diagnosis: Actinomyces turicensis was isolated in both patients in abscess cultures, among other microorganisms, being diagnosed with pelvic actinomycosis. Treatment: The two patients required surgical drainage of the abscesses and antibiotic treatment during admission and once they were discharged, they required maintenance treatment for months with Amoxicillin. Results: Both showed resolution of the clinical, analytical and radiological features during the subsequent follow-up. Conclusion: We place special emphasis on the importance of suspecting and treating this infection in time, to avoid aggressive surgeries and to carry out an adequate differential diagnosis with other processes that can give similar symptoms.(AU)

Risk of caesarean delivery in labour induction: a systematic review and external validation of predictive models.

BACKGROUND: Despite the existence of numerous published models predicting the risk of caesarean delivery in women undergoing induction of labour (IOL), validated models are scarce. OBJECTIVES: To systematically review and externally assess the predictive capacity of caesarean delivery risk models in women undergoing IOL. SEARCH STRATEGY: Studies published up to 15 January 2021 were identified through PubMed, CINAHL, Scopus and ClinicalTrials.gov, without temporal or language restrictions. SELECTION CRITERIA: Studies describing the derivation of new models for predicting the risk of caesarean delivery in labour induction. DATA COLLECTION AND ANALYSIS: Three authors independently screened the articles and assessed the risk of bias (ROB) according to the prediction model risk of bias assessment tool (PROBAST). External validation was performed in a prospective cohort of 468 pregnancies undergoing IOL from February 2019 to August 2020. The predictive capacity of the models was assessed by creating areas under the receiver operating characteristic curve (AUCs), calibration plots and decision curve analysis (DCA). MAIN RESULTS: Fifteen studies met the eligibility criteria; 12 predictive models were validated. The quality of most of the included studies was not adequate. The AUC of the models varied from 0.520 to 0.773. The three models with the best discriminative capacity were those of Levine et al. (AUC 0.773, 95% CI 0.720-0.827), Hernández et al. (AUC 0.762, 95% CI 0.715-0.809) and Rossi et al. (AUC 0.752, 95% CI 0.707-0.797). CONCLUSIONS: Predictive capacity and methodological quality were limited; therefore, we cannot currently recommend the use of any of the models for decision making in clinical practice. TWEETABLE ABSTRACT: Predictive models that predict the risk of cesarean section in labor inductions are currently not applicable.

SARS-CoV-2-Specific Memory T Lymphocytes From COVID-19 Convalescent Donors: Identification, Biobanking, and Large-Scale Production for Adoptive Cell Therapy.

Syndrome coronavirus 2 (SARS-CoV-2) pandemic is causing a second outbreak significantly delaying the hope for the virus' complete eradication. In the absence of effective vaccines, we need effective treatments with low adverse effects that can treat hospitalized patients with COVID-19 disease. In this study, we determined the existence of SARS-CoV-2-specific T cells within CD45RA- memory T cells in the blood of convalescent donors. Memory T cells can respond quickly to infection and provide long-term immune protection to reduce the severity of COVID-19 symptoms. Also, CD45RA- memory T cells confer protection from other pathogens encountered by the donors throughout their life. It is of vital importance to resolve other secondary infections that usually develop in patients hospitalized with COVID-19. We found SARS-CoV-2-specific memory T cells in all of the CD45RA- subsets (CD3+, CD4+, and CD8+) and in the central memory and effector memory subpopulations. The procedure for obtaining these cells is feasible, easy to implement for small-scale manufacture, quick and cost-effective, involves minimal manipulation, and has no GMP requirements. This biobank of specific SARS-CoV-2 memory T cells would be immediately available "off-the-shelf" to treat moderate/severe cases of COVID-19, thereby increasing the therapeutic options available for these patients.

Large Damping-Like Spin-Orbit Torque in a 2D Conductive 1T-TaS2 Monolayer.

A damping-like spin-orbit torque (SOT) is a prerequisite for ultralow-power spin logic devices. Here, we report on the damping-like SOT in just one monolayer of the conducting transition-metal dichalcogenide (TMD) TaS2 interfaced with a NiFe (Py) ferromagnetic layer. The charge-spin conversion efficiency is found to be 0.25 ± 0.03 in TaS2(0.88)/Py(7), and the spin Hall conductivity (14.9×105ℏ2eΩ-1m-1) is found to be superior to values reported for other TMDs. We also observed sizable field-like torque in this heterostructure. The origin of this large damping-like SOT can be found in the interfacial properties of the TaS2/Py heterostructure, and the experimental findings are complemented by the results from density functional theory calculations. It is envisioned that the interplay between interfacial spin-orbit coupling and crystal symmetry yielding large damping-like SOT. The dominance of damping-like torque demonstrated in our study provides a promising path for designing the next-generation conducting TMD-based low-powered quantum memory devices.

Hiperprolactinemia inducida por psicofármacos en personas con discapacidad intelectual ingresadas en un centro residencial / Hyperprolactinemia induced by psychotropic drugs in people with intellectual disability located in a residential centre

Introducción: En personas con Discapacidad Intelectual (DI) que presentan alteración de la conductwa es frecuente el uso de psicofármacos. Estos fármacos pueden provocar efectos secundarios. Así, la elevación de prolactina está frecuentemente asociada al uso de antipsicóticos y puede generar problemas clínicos. Objetivo: Conocer el nivel de prolactina en un grupo de personas con DI y alteración de la conducta que toman psicofármacos. Conocer su relación con las distintas variables: tipo de fármaco, sexo, edad, grado de discapacidad intelectual y diagnósticos psiquiátricos concurrentes. Población: 80 personas con discapacidad intelectual y alteración de la conducta ingresadas en un centro residencial. Edad media 50 años.53 mujeres, 27 hombres. El 38.8% presentan una DI moderada, el 33.8% leve, el 25% severa y el 2.5% no especificada. Método: Prueba analítica para determinar el nivel de prolactina. Tratamiento farmacológico de cada paciente. Estudiar diferencias significativas entre nivel de prolactina y sexo, edad, grado de DI, diagnósticos psiquiátricos concurrentes, y diferentes fármacos. Resultados: El 78.8% de los pacientes estudiados toma antipsicóticos, de los que el 52.4% toma uno y el 47.6% toma dos o más. El 54% fueron tratados con antipsicóticos de 2ª generación. El nivel medio de prolactina fue en monoterapia de 38.9 ng/ml y en politerapia de 49.4 ng/ml; antipsicóticos de 2ªgeneración: 44.6 ng/ml, antipsicóticos de 1ª generación: 43.1 ng/ml. Además, el 63.8% toma benzodiacepinas y el 58.8% antiepilépticos. Existen diferencias significativas en el nivel medio de prolactina y consumo de antipsicóticos y benzodiacepinas, pero no con los diferentes tipos de antipsicóticos, o con tomar uno o más, o con cada uno de los distintos fármacos. Realizada una regresión logística para predecir niveles de prolactina elevados, las benzodiacepinas presentan una razón de odds 3.02 y tomar antipsicóticos una razón de odds de 12.70. Conclusiones: El nivel de prolactina elevado está asociado a la toma de antipsicóticos y de benzodiacepinas. La toma de antipsicóticos predice una posibilidad de elevar la prolactina de 12.7 veces, que el no tomarlos, y la toma de benzodiacepinas de 3.02 veces superior

Introduction: In people with Intellectual Disability (ID) who exhibit behavior disorders, the use of psychoactive drugs is frequent. These medications can cause side effects. Thus, the elevation of prolactin is frequently associated with the use of antipsychotics and can generate clinical problems. Objective: To know the level of prolactin in a group of people with ID and behavior alteration who take psychotropic drugs. Acknowledge the relation with different variables: type of drug, gender, age, degree of intellectual disability and comorbid psychiatric diagnoses. Population: 80 people with intellectual disabilities and behavior disorders located in a residential centre. Average age 50 years.53 women, 27 men. 38.8% have moderate ID, 33.8% mild, 25% severe and 2.5% unspecified. Method: Analytical test to determine prolactin serum levels. Pharmacological treatment of each patient. Study significant differences between prolactin level and sex, age, degree of ID, concurrent psychiatric diagnoses, and different drugs. Results: 78.8% of patients studied take antipsychotics, of which 52.4% take one and 47.6% take two or more. 54% were treated with 2nd generation antipsychotics. The mean level of prolactin was of 38.9 ng/ml in monotherapy and of 49.4 ng/ml in polytherapy; 2nd generation antipsychotics: 44.6 ng / ml, 1st generation antipsychotics: 43.1 ng / ml. In addition, 63.8% take benzodiazepines and 58.8% antiepileptic drugs. There are significant differences in the mean level of prolactin and consumption of antipsychotics and benzodiazepines, but not with the different types of antipsychotics, or with taking one or more, or with each of the different drugs. A logistic regression was performed to predict elevated prolactin levels, benzodiazepines presented an odds ratio of 3.02 and antipsychotics, an odds ratio of 12.70. Conclusions: The elevation of prolactin is associated with the taking of antipsychotics and benzodiazepines. Taking antipsychotics predicts a possibility of elevating prolactin by 12.7 times, than not taking them, and taking benzodiazepines by 3.02 times higher

Genomic sequences of five novel HLA class I alleles: A*30:129, B*08:195, B*51:01:62, C*01:147 and C*12:195:02.

Five new HLA class I alleles are described, A*30:129, B*08:195, B*51:01:62, C*01:147 and C*12:195:02.

Positioning document on incorporating point-of-care ultrasound in Internal Medicine departments. / Documento de posicionamiento sobre la incorporación de la ecografía clínica en los servicios de Medicina Interna.

This positioning document describes the most important aspects of clinical ultrasonography in the internal medicine setting, from its fundamental indications to the recommended training period. There is no question as to the considerable usefulness of this tool in the standard clinical practice of internists in numerous clinical scenarios and settings (emergencies, hospital ward, general and specific consultations and home care). Ultrasonography has a relevant impact on the practitioner's ability to resolve issues, increasing diagnostic reliability and safety and providing important information on the prognosis and progression. In recent years, ultrasonography has been incorporated as a tool in undergraduate teaching, with excellent results. The use of ultrasonography needs to be widespread. To accomplish this, we must encourage structured training and the acquisition of equipment. This document was developed by the Clinical Ultrasonography Workgroup and endorsed by the Spanish Society of Internal Medicine.

Characterization of a novel HLA-DRB1*07 allele, DRB1*07:83.

A new DRB1*07 allele, DRB1*07:83, was described in a Caucasian Spanish donor.

HLA-A*30:125 shows a new antigen binding domain created from HLA-A*30:01 and HLA-A*30:02.

A new HLA-A allele, A*30:125, was characterized in a Spanish individual.

Genomic sequences of two novel HLA-C alleles, HLA-C*15:143 and HLA-C*07:109:02.

Two novel HLA-C alleles, C*07:109:02 and C*15:143, were characterized in two Spanish individuals.

Teaching the basics of echocardiography in the undergraduate: Students as mentors. / Enseñanza de las bases de la ecocardioscopia en el pregrado: los estudiantes como mentores.

OBJECTIVE: To analyse the ability of medical students to incorporate the practical teaching of basic echocardiography planes using a peer mentoring design. METHODOLOGY: Thirty-six medical students previously trained in obtaining echocardiography planes (mentors) taught the other 5th-year students (n=126). The teaching methodology included three stages: theory (online course), basic training (three 15h sessions of practical experience in ultrasound and at least 20 echocardiographic studies per mentor) and objective structured clinical assessment (OSCA), which scored the appropriateness of the basic ultrasound planes and the correct identification of 16 cardiac structures. RESULTS: The students' weighted mean score in the OSCA was 8.66±1.98 points (out of 10). Only 10 students (8.4%) scored less than 5, and 15 (12.6%) scored less than 7. Fifty students (42%) scored 10 points. The most easily identified structure was the left ventricle in the short-axis parasternal plane, with 89.9% of correct answers. The most poorly identified structure was the mitral valve in the subxiphoid plane, with 69.7% of correct answers. CONCLUSIONS: Peer mentoring-based teaching achieves an appropriate level of training in obtaining basic echocardiography planes. The training period is relatively short. The peer mentoring system can facilitate the implementation of teaching on basic aspects of ultrasound to a large number of undergraduate students.

RNA processing and protein expression of HLA-B*07:44N.

BACKGROUND: The assignment of human leukocyte antigen (HLA) null alleles is clinically relevant in the setting of stem cell transplantation. Cell surface expression profiling and mRNA processing analysis of the HLA-B allele previously designated as B*07:44, have been performed. MATERIALS AND METHODS: Cell surface expression of HLA-B*07:44 was determined using flow cytometry. Genomic full-length and HLA-B*07-specific cDNA sequencing were carried out by Sanger procedure. RESULTS: Flow cytometric analysis confirmed previous serologic results and demonstrated a lack of cell membrane expression of the HLA-B protein. The mRNA processing, studied using direct HLA-B*07-specific cDNA sequencing, revealed the presence of a unique, aberrantly spliced mRNA, with a deletion of the last 43 bp on the 5'-end of exon 4. The substitution from T to G at genomic position 1799 compared to B*07:02:01 introduced a new and stronger splice donor site at exon 4. This alternative splicing produced an mRNA containing a premature stop codon at position 280, explaining the absence of mature HLA-B7 protein on the cell surface. CONCLUSION: These findings led us to consider this HLA-B variant as a HLA null allele. The World Health Organization (WHO) Nomenclature Committee has since renamed this variant B*07:44N .

Four new HLA class I alleles in Spaniards, HLA-A*32:01:23, HLA-B*18:01:24, HLA-B*18:72:02 and HLA-C*12:166.

Characterization of four new human leukocyte antigen (HLA) class I alleles, A*32:01:23, B*18:01:24, B*18:72:02 and C*12:166.

Description of two new HLA-A alleles, HLA-A*02:572 and HLA-A*03:225.

Characterization of two new human-leukocyte antigen (HLA)-A alleles, A*02:572 and HLA-A*03:225.

Three new HLA class II alleles: DRB1*08:70, DQA1*01:13 and DQA1*03:01:03.

Three novel HLA class II alleles, DRB1*08:70, DQA1*01:13 and DQA1*03:01:03, were characterized.

HLA-A allele dropout in sequence-specific oligonucleotide probe typing due to intronic polymorphism in the novel A*31:01:02:02 allele.

HLA-A*31:01:02:02 differs from A*31:01:02 in a single nucleotide mutation at intron 3, nucleotide position 1000 (G > A).

Characterization of two novel HLA-A null alleles: A*11:210N and A*26:107N.

Two new HLA-A null alleles were characterized, A*11:210N and A*26:107N.

A new HLA-B allele, B*18:105, identified in a Caucasian Spanish individual.

HLA-B*18:105 shows two nucleotide differences regarding B*18:22 (97 AGC>AGG, 99 TAC>TAT) and B*18:52 (94 ACC>ATC, 95 CTC>ATC).

Foliar potassium nitrate application improves the tolerance of Citrus macrophylla L. seedlings to drought conditions.

Scarcity of water is a severe limitation in citrus tree productivity. There are few studies that consider how to manage nitrogen (N) nutrition in crops suffering water deficit. A pot experiment under controlled-environment chambers was conducted to explore if additional N supply via foliar application could improve the drought tolerance of Citrus macrophylla L. seedlings under dry conditions. Two-month-old seedlings were subjected to a completely random design with two water treatments (drought stress and 100% water/field capacity). Plants under drought stress (DS) received three different N supplies via foliar application (DS: 0, DS + NH4NO3: 2% NH4NO3, DS + KNO3: 2% KNO3). KNO3-spraying increased leaf and stem DW as compared with DS + NH4NO3 and DS treatments. Leaf water potential (Ψw) was decreased by drought stress in all the treatments. However, in plants from DS + NH4NO and DS + KNO3, this was due to a decrease in the leaf osmotic potential, whereas the decrease in those from the DS treatment was due to a decrease in the leaf turgor potential. These responses were correlated with the leaf proline and K concentrations. DS + KNO3-treated plants had a higher leaf proline and K concentration than DS-treated plants. In terms of leaf gas exchange parameters, it was observed that net assimilation of CO2 [Formula: see text] was decreased by drought stress, but this reduction was much lower in DS + KNO3-treated plants. Thus, when all results are taken into account, it can be concluded that a 2% foliar-KNO3 application can enhance the tolerance of citrus plants to water stress by increasing the osmotic adjustment process.

Sequencing of the new HLA-B*44:150 allele suggests recombination between B*44:02:01:01 and B*07:02:01 alleles.

B*44:150 was identical to B*44:02:01:01 except at the 3'-end region of exon 3, where a B*07-specific sequence was identified.