[Type 2 diabetes mellitus and coronary artery disease: features of perfusion volume computed tomography of the heart in a pharmacological test with adenosine triphosphate].

AIM: To study myocardial perfusion in patients with coronary artery disease (CAD) with and without type 2 diabetes mellitus (DM) using volumetric computed tomography (VCT) of the heart with a pharmacological test with adenosine triphosphate (ATP). MATERIALS AND METHODS: The study included 93 patients, of which 18 had CAD with DM, and 50 had CAD without DM. All patients underwent one of the stress tests, cardiac VCT with ATP test, invasive coronary angiography, or CT coronary angiography. Left ventricle (LV) myocardial perfusion was evaluated for hypoperfusion zones and the calculation of semi-quantitative indices: decrease of LV myocardial density, LV myocardial perfusion index, transmural perfusion coefficient, and our proposed new indicator - myocardial perfusion reserve (MPR). RESULTS: The MPR index value in the hypoperfusion zones in patients with CAD and DM was 0.64 [0.62-0.66], in patients with CAD without diabetes 0.65 [0.63-0.66]; p=0.4; the value of the transmural perfusion coefficient in the areas of abnormal LV myocardial perfusion in patients with CAD and DM was 0.81 [0.80-0.86] versus 0.83 [0.80-0.85] in patients with CAD without DM (p=0.6). More hypoperfusion segments were observed in patients with CAD and DM (33.3%) compared to those without DM (14%; p=0.029). The MPR index in the hypoperfusion zones in patients with CAD with intact coronary arteries (CA) and DM was 0.56 [0.54-0.60] versus 0.55 [0.54-0.62] in patients with CAD with intact CA without DM; p=0.2. CONCLUSION: In patients with CAD and type 2 DM, according to the VCT with ATP test, more foci hypoperfusion areas were detected, regardless of the severity of coronary artery involvement, compared with patients with CAD without DM, which may be due to the microangiopathy in the myocardium. The similarity of the MPR parameters in the hypoperfusion zones associated with hemodynamic stenosis of the CA and with intact CAs indicates the ischemic genesis of these zones. For citation: Soboleva GN, Minasyan AA, Gaman SA, Rogoza AN, Molina LP, Soboleva TV, Shariya MA, Ternovoy SK, Karpov YuA. Type 2 diabetes mellitus and coronary artery disease: features of perfusion volume computed tomography of the heart in a pharmacological test with adenosine triphosphate. Terapevticheskii Arkhiv (Ter. Arkh.). 2023;95(4):309-315. DOI: 10.26442/00403660.2023.04.202158.

Validation of electrodeposited 241Am alpha-particle sources for use in liquified gas detectors at cryogenic temperatures.

This paper describes a procedure for the validation of alpha-particle sources (exempt unsealed sources) to be used in experimental setups with liquefied gases at cryogenic temperatures (down to -196 °C) and high vacuum. These setups are of interest for the development and characterization of neutrino and dark matter detectors based on liquid argon, among others. Due to the high purity requirements, the sources have to withstand high vacuum and cryogenic temperatures for extended periods. The validation procedure has been applied to 241Am sources produced by electrodeposition.

Farmacovigilancia de las vacunas frente a la COVID-19 en farmacias comunitarias. Resultados tras la segunda dosis y comparación entre ambas / Pharmacovigilance of vaccines against COVID-19 in community pharmacies. Results after the second dose and comparison between both

Objetivos: detección y seguimiento de sospechas de reacciones adversas (RA) en farmacias comunitarias tras la segunda dosis de vacunas frente a la COVID-19. Comparación entre dosis.Material y métodos: diseño: estudio observacional prospectivo.Sujetos: vacunados frente a la COVID-19, mayores de edad, que consintieron participar.Variables: número y porcentaje de participantes con RA. Su número, tipo y frecuencia. Repercusión en su vida diaria. Relaciones entre variables.Aprobado por CEIm-G.Resultados: 693 participantes con la 2ª dosis, 63,6 % mujeres. Edad media 56,8 años. 312 (45,0 %) vacunados, 49,4 % de mujeres y 37,3 % de hombres (p<0,0001), refirieron al menos una RA: 43,9 % con Comirnaty®, 37,7 % con Vaxzevria®, 63,0 % con Spikevax®.Se registraron 972 RA, 75,2 % en mujeres y 24,8 % en hombres (p<0,0001). Media 1,4/vacunado (máximo 11). Las más prevalentes: dolor en punto de inyección 197 (28,4 %), cansancio/fatiga 141 (20,3 %), mialgia 112 (16,2 %), cefalea 95 (13,7 %), fiebre 84 (12,1 %).51 encuestados con RA necesitaron ayuda profesional: 10 del médico, 6 en urgencias, 3 en hospital (1 derivado), 33 en la farmacia. A 70 (15,1 %) les impidió su actividad diaria. Se comunicaron RA de 201 vacunados.Los vacunados con RA y su número fueron menos tras la administración de la 2ª dosis (p<0,05).Relación inversa (p<0,05) entre “edad” y “número de vacunados con RA”, “necesidad de atención profesional” e “impidió la actividad diaria”.Conclusiones: el número de vacunados con RA y su número fue alto también con la segunda dosis, aunque menor que tras la primera. Mujer y menor edad son predictores de riesgo de sufrir RA tras la vacunación frente a COVID-19.(AU)

Research-based flow cytometry assays for pathogenic assessment in the human B-cell biology of gene variants revealed in the diagnosis of inborn errors of immunity: a Bruton's tyrosine kinase case-study.

Introduction: Inborn errors of immunity (IEI) are an expanding group of rare diseases whose field has been boosted by next-generation sequencing (NGS), revealing several new entities, accelerating routine diagnoses, expanding the number of atypical presentations and generating uncertainties regarding the pathogenic relevance of several novel variants. Methods: Research laboratories that diagnose and provide support for IEI require accurate, reproducible and sustainable phenotypic, cellular and molecular functional assays to explore the pathogenic consequences of human leukocyte gene variants and contribute to their assessment. We have implemented a set of advanced flow cytometry-based assays to better dissect human B-cell biology in a translational research laboratory. We illustrate the utility of these techniques for the in-depth characterization of a novel (c.1685G>A, p.R562Q) de novo gene variant predicted as probably pathogenic but with no previous insights into the protein and cellular effects, located in the tyrosine kinase domain of the Bruton's tyrosine kinase (BTK) gene, in an apparently healthy 14-year-old male patient referred to our clinic for an incidental finding of low immunoglobulin (Ig) M levels with no history of recurrent infections. Results and discussion: A phenotypic analysis of bone marrow (BM) revealed a slightly high percentage of pre-B-I subset in BM, with no blockage at this stage, as typically observed in classical X-linked agammaglobulinemia (XLA) patients. The phenotypic analysis in peripheral blood also revealed reduced absolute numbers of B cells, all pre-germinal center maturation stages, together with reduced but detectable numbers of different memory and plasma cell isotypes. The R562Q variant allows Btk expression and normal activation of anti-IgM-induced phosphorylation of Y551 but diminished autophosphorylation at Y223 after anti IgM and CXCL12 stimulation. Lastly, we explored the potential impact of the variant protein for downstream Btk signaling in B cells. Within the canonical nuclear factor kappa B (NF-κB) activation pathway, normal IκBα degradation occurs after CD40L stimulation in patient and control cells. In contrast, disturbed IκBα degradation and reduced calcium ion (Ca2+) influx occurs on anti-IgM stimulation in the patient's B cells, suggesting an enzymatic impairment of the mutated tyrosine kinase domain.

Unmet needs in patients with moderate-to-severe plaque psoriasis treated with methotrexate in real world practice: FirST study.

BACKGROUND: Methotrexate (MTX) is frequently used in the treatment of moderate-to-severe psoriasis, however, there is limited data on health-related quality-of-life (HRQoL), psoriasis clinical outcomes and hepatic fibrosis in MTX-treated patients in routine clinical practice. OBJECTIVES: To investigate the impact of moderate-to-severe psoriasis in MTX-treated patients in Spain regarding to HRQoL, psoriasis clinical data and risk of hepatic fibrosis. METHODS: Observational, non-interventional, cross-sectional, retrospective, multicentre study, performed in Spain in moderate-to-severe plaque psoriasis patients treated with MTX > 16 weeks prior to inclusion. RESULTS: Despite ongoing treatment, 17.1% of 457 evaluable patients reported moderate-to-extreme impact on HRQoL (DLQI > 5); 21.4% BSA > 5 and 35.2% moderate-to-severe pruritus (VAS ≥ 4). Persistent severe psoriasis (PASI ≥ 10 and/or DLQI ≥ 10) was observed in 10.7%. Hepatic steatosis was identified in 64.1% of patients (HSI ≥ 36) and 37.2% of the patients were at-risk of advanced fibrosis which was associated to the MTX treatment duration. CONCLUSIONS: The study identified unmet needs in moderate-to-severe plaque psoriasis patients treated with MTX, revealing a significant proportion of sub-optimally controlled patients in terms of HRQoL and different domains of the disease. This study also found patients at-risk of advanced fibrosis, with evidence suggesting a correlation between longer exposures to MTX and higher risk of advanced fibrosis.

Encefalitis autoinmune por pembrolizumab en anciano con carcinoma no microcítico avanzado de pulmón. Caso clínico / Pembrolizumab-associated autoimmune encephalitis in an elderly patient with advanced non-small cell lung cancer. A clinical case

Los objetivos terapéuticos en el paciente geriátricoson la mejora de su calidad de vida y de su capacidadfuncional frente al mero incremento de su supervivencia. En patología neoplásica, la decisión de iniciar tratamiento curativo, especialmente inmunoterapia, deberealizarse tras una completa valoración de los riesgospotenciales. El paciente geriátrico es más susceptiblea desarrollar reacciones adversas y de mayor gravedadque el paciente más joven.Se presenta el caso de un anciano octogenario concarcinoma no microcítico pulmonar que desarrolló toxicidad neurológica tras tratamiento con pembrolizumab. Se realiza un diagnóstico diferencial de encefalitisy una revisión de los casos de encefalitis autoinmunepor pembrolizumab para mejorar nuestro conocimiento de esta infrecuente toxicidad. El trabajo interdisciplinar y la valoración geriátrica integral son elementosesenciales para prevenir el deterioro funcional del anciano.(AU)

Therapeutic objectives for the geriatric patient areimprovement of quality of life and functional capacityrather than a mere increase in survival. In neoplasticdisease, the decision to initiate administration of curative therapies, especially immunotherapy, shouldbe taken only after any potential risks have been takeninto account. Geriatric patients are more susceptibleto developing more serious adverse reactions than theyounger population.We report the case of an octogenarian patient withnon-small cell lung cancer who developed neurologictoxicity following pembrolizumab therapy. We carryout a differential diagnosis of encephalitis and providea literature review of pembrolizumab-associated au-toimmune encephalitis cases in order to improve ourknowledge of this unusual toxicity. An interdisciplinaryapproach and comprehensive geriatric assessment areessential components to prevent functional decline inthe elderly.(AU)

[Pembrolizumab-associated autoimmune encephalitis in an elderly patient with advanced non-small cell lung cancer. A clinical case].

Therapeutic objectives for the geriatric patient are improvement of quality of life and functional capacity rather than a mere increase in survival. In neoplastic disease, the decision to initiate administration of curative therapies, especially immunotherapy, should be taken only after any potential risks have been taken into account. Geriatric patients are more susceptible to developing more serious adverse reactions than the younger population. We report the case of an octogenarian patient with non-small cell lung cancer who developed neurologic toxicity following pembroli-zumab therapy. We carry out a differential diagnosis of encephalitis and provide a literature review of pembrolizumab-associated auto-immune encephalitis cases in order to improve our knowledge of this unusual toxicity. An interdisciplinary approach and comprehensive geriatric assessment are essential components to prevent functional decline in the elderly.

Defective Bcl-2 expression in memory B cells from common variable immunodeficiency patients.

Common variable immunodeficiency (CVID) is a primary immunodeficiency characterized by hypogammaglobulinemia and different degrees of B cell compartment alteration. Memory B cell differentiation requires the orchestrated activation of several intracellular signaling pathways that lead to the activation of a number of factors, such as nuclear factor kappa B (NF-κB) which, in turn, promote transcriptional programs required for long-term survival. The aim of this study was to determine if disrupted B cell differentiation, survival and activation in B cells in CVID patients could be related to defects in intracellular signaling pathways. For this purpose, we selected intracellular readouts that reflected the strength of homeostatic signaling pathways in resting cells, as the protein expression levels of the Bcl-2 family which transcription is promoted by NF-κB. We found reduced Bcl-2 protein levels in memory B cells from CVID patients. We further explored the possible alteration of this crucial prosurvival signaling pathway in CVID patients by analysing the expression levels of mRNAs from anti-apoptotic proteins in naive B cells, mimicking T cell-dependent activation in vitro with CD40L and interleukin (IL)-21. BCL-XL mRNA levels were decreased, together with reduced levels of AICDA, after naive B-cell activation in CVID patients. The data suggested a molecular mechanism for this tendency towards apoptosis in B cells from CVID patients. Lower Bcl-2 protein levels in memory B cells could compromise their long-term survival, and a possible less activity of NF-κB in naive B cells, may condition an inabilityto increase BCL-XL mRNA levels, thus not promoting survival in the germinal centers.

Insuficiencia respiratoria aguda como forma de debut de una anomalía congénita (doble arco aórtico) / Acute respiratory failure as a form of debut of a congenital anomaly (double aortic arch)

El doble arco aórtico es una anomalía vascular poco frecuente que provoca compresión traqueal y esofágica, habitualmente en losprimeros meses de vida. La estenosis traqueal asociada con el doble arco aórtico conlleva un alto riesgo de morbilidad, mortalidady reestenosis. Presentamos el caso de un paciente en que su anomalía no fue diagnosticada, y permaneció en silencio hasta la edad adulta cuando comenzó a padecer clínica compresiva. (AU)

The double aortic arch is a rare vascular anomaly that usually causes tracheal and esophageal compression in the first months oflife. Tracheal stenosis associated with double aortic arch carries a high risk of morbidity, mortality, and restenosis. We present thecase of a patient in whom his anomaly was not diagnosed, and he remained silent until adulthood when he began to suffer from compression symptoms. (AU)

The Bacterial Community Associated with the Amarillo Zamorano Maize (Zea mays) Landrace Silage Process.

Maize silage is used in the diet of dairy cows, with suitable results in milk yield. In this study, the composition and diversity of the bacterial communities of the silage process of Amarillo Zamorano (AZ) Mexican maize landrace with relation to the Antilope (A) commercial hybrid are described. From both types of maize, seeds were sown in experimental plots, plants harvested at the reproductive stage, chopped, and packed in laboratory micro-silos. Physicochemical parameters were evaluated, and DNA was extracted from the juice in the micro-silos. The bacterial communities were analyzed by next-generation sequencing (NGS) of seven hypervariable regions of the 16S rRNA gene. The composition of both bacterial communities was dominated by Lactobacillales and Enterobacteriales, Lactobacillales mainly in A silage and Enterobacteriales in AZ silage; as well, the core bacterial community of both silages comprises 212 operational taxonomic units (OTUs). Sugar concentration showed the highest number of significant associations with OTUs of different phyla. The structure of the bacterial communities was different in both silage fermentation processes, showing that AZ silage has a shorter fermentation process than A silage. In addition, NGS demonstrated the effect of the type of maize and local conditions on silage fermentation and contributed to potential strategies to improve the quality of AZ silage.

Adipocyte-conditioned medium induces resistance of breast cancer cells to lapatinib.

BACKGROUND: The existence of a cross-talk between peritumoral adipocytes and cancer cells has been increasingly investigated. Several studies have shown that these adipocytes protect tumor cells from the effect of anticancer agents. METHODS: To investigate a potential protective effect of adipocyte-conditioned medium on HER2 positive breast cancer cells exposed to tyrosine kinase inhibitors (TKI) such as lapatinib, we analyzed the sensitivity of HER2 positive breast cancer models in vitro and in vivo on SCID mice in the presence or absence of adipocytes or adipocyte-conditioned medium. RESULTS: Conditioned medium from differentiated adipocytes reduced the in vitro sensitivity of the HER2+ cell lines BT474 and SKBR3 to TKI. Particularly, conditioned medium abrogated P27 induction in tumor cells by lapatinib but this was observed only when conditioned medium was present during exposure to lapatinib. In addition, resistance was induced with adipocytes derived from murine NIH3T3 or human hMAD cells but not with fibroblasts or preadipocytes. In vivo studies demonstrated that the contact of the tumors with adipose tissue reduced sensitivity to lapatinib. Soluble factors involved in this resistance were found to be thermolabile. Pharmacological modulation of lipolysis in adipocytes during preparation of conditioned media showed that various lipolysis inhibitors abolished the protective effect of conditioned media on tumor cells, suggesting a role for adipocyte lipolysis in the induction of resistance of tumor cells to TKI. CONCLUSIONS: Overall, our results suggest that contact of tumor cells with proximal adipose tissue induces resistance to anti HER2 small molecule inhibitors through the production of soluble thermolabile factors, and that this effect can be abrogated using lipolysis inhibitors.

Potencial reprodutivo (PR) de touros Nelore avaliados por parâmetros andrológicos e comportamento sexual. Classificação por pontos: nova proposição / [Reproductive potential of Nelore bulls evaluated by andrological parameters and sexual behavior. Classification by points - a new proposition]

Este estudo teve por objetivo comparar variações de parâmetros andrológicos e comportamentais de touros Nelore de diferentes faixas etárias, calcular seu potencial reprodutivo (PR) e propor uma nova tabela de classificação por pontos, de acordo com as médias atualmente alcançadas por eles nas características estudadas. Foram utilizados dados de 6162 exames andrológicos de touros da raça Nelore, entre 12 e 80 meses de idade, em regime de monta natural. O número de touros classificados como aptos consistiu em 88,9% dos animais avaliados (n=5480), sendo 51,6% desses considerados excelentes (n=2827), 41,2% muito bons (n=2257) e 7,2% considerados bons (n=394). Entre os animais questionáveis (n=682; 11,1%), 79,6% foram classificados como inaptos temporários (n=542) e 20,4% (n=139) como animais descarte, de acordo com o exame andrológico, independentemente do teste da libido. O número de touros classificados como excelentes se reduziu para 752 (12,2%) quando dados de comportamento sexual foram incluídos para definição do seu PR. Concluiu-se que o uso de tabelas de classificação andrológica por pontos com atualizações técnicas beneficia a seleção mais apurada de touros Nelore. O teste da libido é ferramenta importante para a determinação do PR, o qual permite melhor aproveitamento dos reprodutores.(AU)

This study aimed to compare variations of andrological and behavioral parameters from Nelore bulls of different ages, to calculate their reproductive potential (RP) and propose a new classification table by points, considering current averages in each reproductive trait studied. Data were collected from 6162 breeding soundness examinations of Nelore bulls aged between 12 and 80 months, under natural mating. According to andrological parameters, regardless of the libido test, the number of bulls classified as approved was 88.9% (n= 5480), being 51.6% considered as excellent (n= 2827), 41.2% very good (n= 2257) and 7.2% considered as good (n= 394). Among the animals considered as questionable (n= 682; 11.1%), 79.6% were classified as temporarily reproved (n= 542) and 20.4% (n= 139) as discarded animals. The number of bulls classified as excellent decreased to 752 (12.2%) when sexual behavior data were included to define their RP. It was concluded that the use of tables for andrological classification by points with technical updates improves the reproductive selection of Nelore bulls. The libido test is an important tool for RP determination which provides better utilization of the sires.(AU)

Kallikrein-related Peptidase 5 (KLK5) Expression and Distribution in Canine Cutaneous Squamous Cell Carcinoma.

Cutaneous squamous cell carcinoma (cSCC) is one of the most common types of malignant skin cancer in dogs, representing 3.9-10.4% of all canine skin tumours. Although the metastatic potential of cSCC is debated, it appears to mimic that observed in man. In man, predictive histopathological features for metastasis include tumour depth, lesions >5-6 mm in depth, and invasion of muscle, cartilage or bone. In dogs, some reports have focused on the clinical features and long-term progression of cSCC, but a gold standard treatment has not yet been developed. We explored the protein expression of kallikrein-related peptidase 5 (KLK5), an important modulator of skin homeostasis, in normal canine skin and in examples of cSCC. KLK5 was highly expressed in the upper stratum granulosum, stratum corneum, hair follicles and sweat glands, skin sites where human KLK5 has been shown to be involved in physiological processes including keratinocyte desquamation, antimicrobial defence, lipid permeability and pigmentation. In cSCC, tumour cells at the deep margin, as well as those in the centre of keratin pearls, displayed cytoplasmic expression of KLK5. Some of the KLK5 immunoreactive cells also expressed vimentin, suggesting that they may be undergoing epithelial-mesenchymal transition and therefore have a more invasive behaviour than those expressing only KLK5. KLK5 may be a novel molecular biomarker useful for predicting prognosis of cSSC in dogs.

Nanobiofertilization as a novel technology for highly efficient foliar application of Fe and B in almond trees.

Nanofertilization is postulated as a new technology to deal with the environmental problems caused by the intensive use of traditional fertilizers. One of the aims of this new technology is to improve foliar fertilization, which has many environmental advantages, but currently there are numerous factors that limit its efficiency. In this research, the objective was to study the potential of membrane vesicles derived from plant material as nanofertilizers of iron (Fe) and boron (B) for foliar application in almond trees (Prunus dulcis L.). The results show that the application of vesicles caused invaginations in the plasma membrane of the leaf cells. Also, the increase in leaf B and Fe was greater when these elements were applied in an encapsulated form rather than in a non-encapsulated form. The distribution of these elements in leaf tissues indicated the existence of an intracellular element transport pathway and accumulation areas, enabling greater element entry and mobility.

Validation of Delphi procedure consensus criteria for defining fetal growth restriction.

OBJECTIVE: Recently, a Delphi procedure was used to establish new criteria for defining fetal growth restriction (FGR). These criteria require clinical validation. We sought to validate the Delphi consensus criteria by comparing their performance with that of our current definition (estimated fetal weight (EFW) < 10th percentile) in predicting adverse neonatal outcome (ANO). METHODS: This was a secondary analysis of data from a prospective cohort study of women referred for fetal growth assessment between 26 and 36 weeks' gestation. The current standard definition of FGR used in our clinical practice is EFW < 10th percentile using Hadlock's fetal growth standard. The Delphi consensus criteria for FGR include either a very small fetus (abdominal circumference (AC) or EFW < 3rd percentile) or a small fetus (AC or EFW < 10th percentile) with additional abnormal Doppler findings or a decrease in AC or EFW by two quartiles or more. The primary outcome was the prediction of a composite of ANO including one or more of: admission to the neonatal intensive care unit, cord pH < 7.1, 5-min Apgar score < 7, respiratory distress syndrome, intraventricular hemorrhage, neonatal seizures or neonatal death. The discriminatory capacities of the two definitions of FGR for composite ANO and delivery of a small-for-gestational-age (SGA) neonate, defined as birth weight < 10th percentile, were compared using area under the receiver-operating-characteristics curve (AUC). The sensitivity, specificity and predictive values of the methods were also compared. RESULTS: Of 1055 pregnancies included in the study, composite ANO occurred in 139 (13.2%). There were only two cases of early FGR (before 32 weeks); therefore, the study focused on late FGR. Our current FGR diagnostic criterion of EFW < 10th percentile was not associated significantly with composite ANO (relative risk (RR), 1.1 (95% CI, 0.6-1.8)), while the Delphi FGR criteria were (RR, 2.0 (95% CI, 1.2-3.3)). Our current definition of FGR showed higher discriminatory ability in the prediction of a SGA neonate (AUC, 0.69 (95% CI, 0.65-0.73)) than did the Delphi definition (AUC, 0.64 (95% CI, 0.60-0.67)) (P = 0.001). The AUCs of both definitions were poor for the prediction of composite ANO, despite slightly improved performance using the Delphi consensus definition of FGR (AUC, 0.53 (95% CI, 0.50-0.55)) compared with that of our current definition (AUC, 0.50 (95% CI, 0.48-0.53)) (P = 0.02). CONCLUSION: The newly postulated criteria for defining FGR based on a Delphi procedure detects fewer cases of neonatal SGA than does our current definition of EFW < 10th percentile, but is associated with a slight improvement in predicting ANO. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.

Staphylococcus aureus: generalidades, mecanismos de patogenicidad y colonización celular / Staphylococcus aureus: generalities, mechanisms of pathogenicity and cell colonization

Resumen Staphylococcus aureus se caracteriza por ser la principal causa de bacteriemia nosocomial en el mundo, debido al incremento en la resistencia, a los diferentes factores de patogenicidad y virulencia y la expresión de una gran variedad de proteínas las cuales pertenecen a las moléculas de la matriz adhesiva (MSCRAMM), presentes en la superficie de la bacteria cuya función es la colonización e invasión celular al hospedero y favorecer la formación de biopelícula, El conjunto de estos mecanismos de patogenicidad y virulencia, le permiten a la bacteria persistir en el huésped y en el ambiente, sobreviviendo a factores adversos, al sistema inmune y a los antimicrobianos.

Abstract Staphylococcus aureus is a microorganism characterized by being the main cause of nosocomial bacteremia in different places of the world, due to the different virulence and pathogenicity factors. One of the most important is the biofilm formation, which greatly favors bacterial resistance. For the adhesion of the biofilm to biotic and abiotic surfaces, the microbial surface components recognizing adhesive matrix molecules (MSCRAMM), these proteins play a key role in host cell colonization and invasion by the bacteria.

Oportunidades perdidas en la detección de la tuberculosis: análisis de las visitas a Urgencias antes del diagnóstico / Missed opportunities for detecting tuberculosis: An analysis of emergency department visits before the diagnosis

Objetivo: Evaluar en pacientes diagnosticados de tuberculosis pulmonar la frecuencia de asistencias en Urgencias en los 6meses previos al diagnóstico, conocer los motivos de la asistencia, el grado de sospecha en Urgencias y los factores a los que se asociaba esta sospecha. Método: Estudio retrospectivo de los casos de tuberculosis pulmonar atendidos en un servicio de Urgencias generales entre 2011 y 2017. Resultados: De los 54 pacientes incluidos, 38 (70%) habían sido atendidos en el servicio de Urgencias en los 6meses previos al diagnóstico: 6 (16%) por procesos sin relación con la tuberculosis y 32 (84%) con relación potencial. En 12 (38%) de estos pacientes se sospechó en Urgencias la posibilidad del diagnóstico de tuberculosis pulmonar, y no se sospechó en los restantes 20 pacientes (62%). El grupo en el que se sospechó tenía más frecuencia de síntomas generales y respiratorios y más frecuencia de cavitación en la radiografía. Conclusiones: Un elevado porcentaje de pacientes con tuberculosis pulmonar han consultado en Urgencias en los 6meses previos al diagnóstico, y con mucha frecuencia esta posibilidad diagnóstica no se sospecha

Objective: To assess the frequency of care in an emergency department in the 6months prior to the diagnosis of tuberculosis and to determine the reasons for the care, the degree of suspicion in the emergency department and the factors associated with this suspicion. Method: A retrospective study was conducted on patients with pulmonary tuberculosis treated in the general emergency department between 2011 and 2017. Results: Of the 54 included patients, 38 (70%) had been treated in the emergency department in the 6months prior to the diagnosis: 6 (16%) patients had been treated for processes unrelated to the tuberculosis, and 32 (84%) were treated for processes that were potentially related to the tuberculosis. Pulmonary tuberculosis was suspected in the emergency department for 12 (38%) of these patients and not suspected in the remaining 20 patients (62%). The group in which pulmonary tuberculosis was suspected had a higher rate of general and respiratory symptoms and cavitation in the radiography. Conclusions: A high percentage of patients with pulmonary tuberculosis were admitted to the emergency department in the 6months prior to the diagnosis, and this diagnostic possibility was often not suspected

[Qualitative analysis of the social and family impact of human transmissible spongiform encephalopathies]. / Analisis cualitativo del impacto social y familiar de las encefalopatias espongiformes transmisibles humanas.

INTRODUCTION: Human transmissible spongiform encephalopathies are pathologies related to the misfolding of the cellular prion protein. When these diseases manifest, they are characterized by a rapid and invariably fatal neurodegeneration. AIM: To gain insight on the social, personal and family reality of the people in close contact with these disorders. PATIENTS AND METHODS: Qualitative interviews were conducted online through semi-structured questionnaires open to carriers and first-degree relatives of those affected. The information was anonymous and the responses were requested to be broad. RESULTS: The sample consisted on 47 interviewees, seven confirmed carriers and 40 relatives that might be carriers or not. The majority of the informants were women aged between 30 and 50. The discourse analysis focused on their perception of the disease, time to diagnosis, and their uncertainties/needs allowed establishing four semantic fields: suffering/loss, temporality, medical/clinical and daily life. However, other important elements were also found. Only eight relatives considered necessary to increase research efforts. Relatives also presented a higher rate of uncertainty, while confirmed carriers did not show such uncertainty about their future. CONCLUSIONS: Socio-biomedical studies related to prion pathologies are rare. In this work, our knowledge on the social reality of the affected people and their close relatives is extended. These pathologies lead those in close contact with them to extremely complicated social situations with utmost psychosocial management difficulties.

TITLE: Analisis cualitativo del impacto social y familiar de las encefalopatias espongiformes transmisibles humanas.Introduccion. Las encefalopatias espongiformes transmisibles humanas son patologias relacionadas con el plegamiento incorrecto de la proteina prionica celular. Cuando estas se manifiestan, la neurodegeneracion producida es rapida y siempre letal. Objetivo. Describir y comprender la realidad social, personal y familiar de las personas afectadas. Pacientes y metodos. Se realizaron entrevistas cualitativas en linea a traves de cuestionarios semiestructurados abiertos a portadores y a las familias de afectados. La informacion fue anonima y se solicito que las respuestas fuesen amplias. Resultados. La muestra fue de 47 entrevistados, siete portadores confirmados y 40 familiares que podrian ser portadores o no. La mayoria de los informantes eran mujeres, con una edad comprendida, sobre todo, entre 30 y 50 años. El analisis del discurso, centrado en la percepcion de la propia enfermedad, el tiempo transcurrido hasta el diagnostico, y las incertidumbres y necesidades, ha permitido establecer cuatro campos semanticos: sufrimiento/perdida, temporalidad, medico/clinica y cotidianidad. No obstante, tambien se han encontrado otros elementos importantes. Solo ocho familiares consideran necesario incrementar la investigacion. Las familias presentan una alta tasa de incertidumbre; en cambio, los portadores no muestran tal incertidumbre ante su futuro. Conclusiones. Los estudios sociobiomedicos sobre patologias prionicas son poco habituales. En el trabajo se amplia el conocimiento sobre la realidad social de las personas y de las familias afectadas. Estas patologias ubican a los afectados en situaciones sociales muy complicadas y de dificil gestion psicosocial.