Comparación del test directo de anticuerpos fluorescentes y el cultivo bacteriológico para detección de Brucella suis

Methods available for detection of Brucella sp from different specimens include bacteriological culture or detection of specific DNA fragments by polymerase chain reaction. The use of fluorescein-labeled anti-Brucella globulin for demonstrating this antigen in animal tissues is a simple, easy, reproducible, cheap and fast technique. The aim of this work was to evaluate the gamma globulin fraction of polyclonal anti-Brucella abortus serum labeled with fluorescein iso-tio-cyanate (FITC-labeled antibody): 1) against different smooth and rough Brucella sp, 2) against bacterium of other genus, and 3) to compare direct fluorescent antibody test results with bacteriological culture for the detection of B. suis in different tissues from infected animals. This conjugate stained all Brucella sp with different intensities but it did not stain any heterologous bacterium tested. Background fluorescence associated with its use on smears from infected sources of different specimens was particularly low. Most of the infected tissues showed the presence of yellowish-green fluorescent organisms with brucella morphology. The tested FITC-labeled antibody allows a quick, effective and inexpensive diagnosis of brucellosis.El diagnóstico de brucelosis se apoya en el cultivo bacteriológico o en la detección de fragmentos de ADN de la bacteria mediante la reacción en cadena de la polimerasa. El empleo de una inmunoglobulina anti-Brucella conjugada a fluoresceína para la detección de este antígeno en tejidos constituye una técnica simple, fácil, reproducible, económica y rápida. El objetivo de este trabajo fue evaluar la fracción gammaglobulínica de un suero policlonal anti-Brucella abortus marcada con isotiocianato de fluoresceína (FITC), 1) contra distintas especies lisas y rugosas de Brucella sp, 2) contra bacterias de otros géneros, y 3) comparar los resultados obtenidos con la inmunofluorescencia directa y el cultivo bacteriológico para la detección de B. suis en distintos tejidos de porcinos infectados. Este conjugado detectó todas las brucelas con distinta intensidad de fluorescencia, pero no hubo fluorescencia inespecífica cuando se ensayaron las bacterias de otros géneros. La fluorescencia de fondo en muestras de los distintos tejidos infectados fue baja. La mayoría de los tejidos infectados mostraron la presencia de microorganismos verde-fluorescentes con la morfología de las brucelas. El anticuerpo conjugado a FITC permitió un diagnóstico de brucelosis rápido, efectivo y económico

Perceived Social Support and Risk of Cyberbullying in Adolescents: A Systematic Review

This article analyzes the main findings of studies investigating the relationship between perceived social support and cyberbullying in adolescents. We reviewed research papers published between January 2015 and January 2020, included in the Web of Science, Scopus, PUBMED, and Science Direct databases. The protocol was previously registered on the PROSPERO International Systematic Reviews database (CRD42020176938). The article follows the PRISMA guidelines for systematic reviews (Moher et al., 2015). Out of 1929 surveyed articles, 23 met the inclusion criteria and quality standards of scientific evidence set by Downs and Black (1998). Results reveal the types and characteristics of studies and instruments used in assessing social support and cyberbullying and show the relationship between social support and cyberbullying

Hipocalcemia severa o sintomática secundaria a hipoparatiroidismo posoperatorio en cirugía de tiroides: experiencia en un hospital universitario de Medellín, Colombia

Objetivo: caracterizar la población de pacientes que presentan hipocalcemia severa o sintomática después de una tiroidectomía total y que requieren calcio parenteral. Diseño: estudio observacional retrospectivo realizado en un centro especializado de Medellín, Colombia. Marco de referencia: la hipocalcemia posoperatoria (POP) es una complicación bien reconocida de la tiroidectomía, que se caracteriza por la presencia de hipocalcemia, con niveles de hormona paratiroidea (Parathyroid hormone, PTH) bajos o inadecuadamente normales. La hipocalcemia sintomática o severa (calcio corregido <7,5 mg/dL) es una verdadera emergencia médica, que requiere un rápido diagnóstico y tratamiento con calcio parenteral. Pacientes: pacientes en POP de tiroidectomía que presentan hipocalcemia severa o sintomática. Intervenciones: reposición con calcio parenteral. Resultados: la hipocalcemia severa o sintomática se presentó en el 8 % de los pacientes llevados a una tiroidectomía total, con predominio en el sexo femenino. La patología tiroidea maligna se constituyó en la indicación más frecuente de la cirugía. En estos pacientes, la media de la PTH fue de 11,3 pg/ mL, mientras que los valores de calcio más bajos se presentaron a las 48 horas POP. Solo se visualizaron las paratiroides en cirugía en una tercera parte de los casos y un paciente tuvo una reintervención en las primeras 24 horas; hasta el 18 % tuvieron hipomagnesemia concomitante. Conclusión: la hipocalcemia por hipoparatiroidismo POP es una complicación frecuente después de la cirugía de tiroides, y en un grupo de pacientes será severa o sintomática, razón por la cual requiere uso de calcio parenteral. En consecuencia, esta complicación tendrá que identificarse y tratarse como una emergencia médica para disminuir la morbilidad y la potencial mortalidad asociadas

Nomogram-based prediction of survival in patients with advanced oesophagogastric adenocarcinoma receiving first-line chemotherapy: a multicenter prospective study in the era of trastuzumab

Background: To develop and validate a nomogram and web-based calculator to predict overall survival (OS) in Caucasian-advanced oesophagogastric adenocarcinoma (AOA) patients undergoing first-line combination chemotherapy. Methods: Nine hundred twenty-four AOA patients treated at 28 Spanish teaching hospitals from January 2008 to September 2014 were used as derivation cohort. The result of an adjusted-Cox proportional hazards regression was represented as a nomogram and web-based calculator. The model was validated in 502 prospectively recruited patients treated between October 2014 and December 2016. Harrell's c-index was used to evaluate discrimination. Results: The nomogram includes seven predictors associated with OS: HER2-positive tumours treated with trastuzumab, Eastern Cooperative Oncology Group performance status, number of metastatic sites, bone metastases, ascites, histological grade, and neutrophil-to-lymphocyte ratio. Median OS was 5.8 (95% confidence interval (CI), 4.5–6.6), 9.4 (95% CI, 8.5–10.6), and 14 months (95% CI, 11.8–16) for high-, intermediate-, and low-risk groups, respectively (P<0.001), in the derivation set and 4.6 (95% CI, 3.3–8.1), 12.7 (95% CI, 11.3–14.3), and 18.3 months (95% CI, 14.6–24.2) for high-, intermediate-, and low-risk groups, respectively (P<0.001), in the validation set. The nomogram is well-calibrated and reveals acceptable discriminatory capacity, with optimism-corrected c-indices of 0.618 (95% CI, 0.591–0.631) and 0.673 (95% CI, 0.636–0.709) in derivation and validation groups, respectively. The AGAMENON nomogram outperformed the Royal Marsden Hospital (c-index=0.583; P=0.00046) and Japan Clinical Oncology Group prognostic indices (c-index=0.611; P=0.03351). Conclusions: We developed and validated a straightforward model to predict survival in Caucasian AOA patients initiating first-line polychemotherapy. This model can contribute to inform clinical decision-making and optimise clinical trial design

Assessment of a Genomic Assay in Patients with ERBB2 -Positive Breast Cancer Following Neoadjuvant Trastuzumab-Based Chemotherapy with or Without Pertuzumab

Importance: Biomarkers to guide the use of pertuzumab in the treatment of early-stage ERBB2 (formerly HER2)-positive breast cancer beyond simple ERBB2 status are needed. Objective: To determine if use of the HER2DX genomic assay (Reveal Genomics) in pretreatment baseline tissue samples of patients with ERBB2-positive breast cancer is associated with response to neoadjuvant trastuzumab-based chemotherapy with or without pertuzumab. Design, Setting, and Participants: This is a retrospective diagnostic/prognostic analysis of a multicenter academic observational study in Spain performed during 2018 to 2022 (GOM-HGUGM-2018-05). In addition, a combined analysis with 2 previously reported trials of neoadjuvant cohorts with results from the assay (DAPHNe and I-SPY2) was performed. All patients had stage I to III ERBB2-positive breast cancer, signed informed consent, and had available formalin-fixed paraffin-embedded tumor specimens obtained prior to starting therapy. Exposures: Patients received intravenous trastuzumab, 8 mg/kg, loading dose, followed by 6 mg/kg every 3 weeks in combination with intravenous docetaxel, 75 mg/m2, every 3 weeks and intravenous carboplatin area under the curve of 6 every 3 weeks for 6 cycles, or this regimen plus intravenous pertuzumab, 840 mg, loading dose, followed by an intravenous 420-mg dose every 3 weeks for 6 cycles. Main Outcome and Measures: Association of baseline assay-reported pathologic complete response (pCR) score with pCR in the breast and axilla, as well as association of baseline assay-reported pCR score with response to pertuzumab. Results: The assay was evaluated in 155 patients with ERBB2-positive breast cancer (mean [range] age, 50.3 [26-78] years). Clinical T1 to T2 and node-positive disease was present in 113 (72.9%) and 99 (63.9%) patients, respectively, and 105 (67.7%) tumors were hormone receptor positive. The overall pCR rate was 57.4% (95% CI, 49.2%-65.2%). The proportion of patients in the assay-reported pCR-low, pCR-medium, and pCR-high groups was 53 (34.2%), 54 (34.8%), and 48 (31.0%), respectively. In the multivariable analysis, the assay-reported pCR score (as a continuous variable from 0-100) showed a statistically significant association with pCR (odds ratio [OR] per 10-unit increase, 1.43; 95% CI, 1.22-1.70; P &lt;.001). The pCR rates in the assay-reported pCR-high and pCR-low groups were 75.0% and 28.3%, respectively (OR, 7.85; 95% CI, 2.67-24.91; P &lt;.001). In the combined analysis (n = 282), an increase in pCR rate due to pertuzumab was found in the assay-reported pCR-high tumors (OR, 5.36; 95% CI, 1.89-15.20; P &lt;.001) but not in the assay-reported pCR-low tumors (OR, 0.86; 95% CI, 0.30-2.46; P =.77). A statistically significant interaction between the assay-reported pCR score and the effect of pertuzumab in pCR was observed. Conclusions and Relevance: This diagnostic/prognostic study demonstrated that the genomic assay predicted pCR following neoadjuvant trastuzumab-based chemotherapy with or without pertuzumab. This assay could guide therapeutic decisions regarding the use of neoadjuvant pertuzumab