Evaluation of flow cytometry for the detection of bacteria in biological fluids

Objectives: Conventional microbiological procedures for the isolation of bacteria from biological fluids consist of culture on solid media and enrichment broth. However, these methods can delay the microbiological identification for up to 4 days. The aim of this study was to evaluate the analytical performance of Sysmex UF500i (Sysmex, Kobe, Japan) as a screening method for the detection of bacteria in different biological fluids in comparison with direct Gram staining and the conventional culture on solid media and enrichment broth. Methods: A total of 479 biological fluid samples were included in the study (180 ascitic, 131 amniotic, 56 synovial, 40 cerebrospinal, 36 pleural, 24 peritoneal, 9 bile and 3 pericardial fluids). All samples were processed by conventional culture methods and analyzed by flow cytometry. Direct Gram staining was performed in 339 samples. The amount of growth on culture was recorded for positive samples. Results: Bacterial and white blood cell count by flow cytometry was significantly higher among culture positive samples and samples with a positive direct Gram stain compared to culture negative samples. Bacterial count directly correlated with the amount of growth on culture (Kruskall-Wallis H χ2(3) = 11.577, p = 0.009). The best specificity (95%) for bacterial count to predict culture positivity was achieved applying a cut-off value of 240 bacteria/μL. Conclusions: Bacterial and white blood cell counts obtained with flow cytometry correlate with culture results in biological fluids. Bacterial count can be used as a complementary method along with the direct Gram stain to promptly detect positive samples and perform other diagnostic techniques in order to accelerate the bacterial detection and identification

Periglacial environments and frozen ground in the central Pyrenean high mountain area: Ground thermal regime and distribution of landforms and processes

Producción CientíficaThe periglacial belt is located in the highest parts of temperate mountains. The balance between mean air and ground temperatures and the presence of water determine the effectiveness of periglacial processes related to permafrost, the active layer or seasonally frozen ground (SFG). This study combines thermal and geomorphological data obtained in four Pyrenean massifs (Infierno‐Argualas, Posets, Maladeta and Monte Perdido) to improve knowledge on the occurrence and distribution of frozen ground. The methodology used is based on the study of landforms as frozen ground indicators, mapping processes, ground temperature analysis, basal temperature of snow, thermal mapping and geomatic surveys on rock glaciers and protalus lobes. In the Pyrenean high mountain areas the lower limit of frozen ground is at ~2,650m a.s.l., possible permafrost appears above 2,650m a.s.l. on north‐ and south‐facing slopes, and probable permafrost is dominant above 2,900m a.s.l. Unfrozen ground with cold‐associated geomorphological processes reach 2,900m a.s.l. and unfrozen and frozen ground distribution points to a patchy pattern throughout the periglacial belt. The most widespread frozen grounds are SFG. The thermal data, mean annual ground temperature, cold season temperatures, bottom temperature snow measurements, freeze/thaw cycles and distribution of landforms permit the establishment of a periglacial land system divided into three main belts: infraperiglacial, middle periglacial and supraperiglacial. The large number of processes and landforms that are involved and their altitudinal and spatial organization make up a complex environment that determines the geoecological dynamics of high mountain areas.Ministerio de Economía, Industria y Competitividad - Fondo Europeo de Desarrollo Regional (projects CGL2015-68144-R / GL2017- 82216-R

Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes

BACKGROUND The cardiovascular effects of adding once-weekly treatment with exenatide to usual care in patients with type 2 diabetes are unknown. METHODS We randomly assigned patients with type 2 diabetes, with or without previous cardiovascular disease, to receive subcutaneous injections of extended-release exenatide at a dose of 2 mg or matching placebo once weekly. The primary composite outcome was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The coprimary hypotheses were that exenatide, administered once weekly, would be noninferior to placebo with respect to safety and superior to placebo with respect to efficacy. RESULTS In all, 14,752 patients (of whom 10,782 [73.1%] had previous cardiovascular disease) were followed for a median of 3.2 years (interquartile range, 2.2 to 4.4). A primary composite outcome event occurred in 839 of 7356 patients (11.4%; 3.7 events per 100 person-years) in the exenatide group and in 905 of 7396 patients (12.2%; 4.0 events per 100 person-years) in the placebo group (hazard ratio, 0.91; 95% confidence interval [CI], 0.83 to 1.00), with the intention-to-treat analysis indicating that exenatide, administered once weekly, was noninferior to placebo with respect to safety (P<0.001 for noninferiority) but was not superior to placebo with respect to efficacy (P=0.06 for superiority). The rates of death from cardiovascular causes, fatal or nonfatal myocardial infarction, fatal or nonfatal stroke, hospitalization for heart failure, and hospitalization for acute coronary syndrome, and the incidence of acute pancreatitis, pancreatic cancer, medullary thyroid carcinoma, and serious adverse events did not differ significantly between the two groups. CONCLUSIONS Among patients with type 2 diabetes with or without previous cardiovascular disease, the incidence of major adverse cardiovascular events did not differ significantly between patients who received exenatide and those who received placebo. (Funded by Amylin Pharmaceuticals; EXSCEL ClinicalTrials.gov number, NCT01144338.