Morbilidad y gravedad de la listeriosis en embarazadas: descripción del brote de 2019 en España

La listeriosis es una toxiinfección alimentaria infrecuente, aunque potencialmente grave, causada por la bacteria Listeria monocytogenes. Esta enfermedad suele cursar con fiebre y síntomas gastrointestinales;no obstante, el cuadro clínico se puede ver agravado en personas inmunodeprimidas, entre las que se encuentran las embarazadas.En los meses de verano del año 2019 se produjo en España el brote más importante de listeriosis registrado en el país hasta el momento, asociado a una serie de lotes de carne mechada.Durante el brote de listeriosis descrito, se notificaron 226 casos de infección por Listeria monocytogenes a nivel nacional. Los casos confirmados en embarazadas fueron 37, provocando 2 abortos, 3 muertes fetales y 6 partos prematuros. Nuestro objetivo es describir el brote de toxiinfección alimentaria provocado por Listeria monocytogenes en España durante el año 2019, y analizar la morbilidad y gravedad de los casos confirmados en mujeres embarazadas. Se ha realizado una revisión bibliográfica siguiendo un diseño descriptivo longitudinal y retrospectivo. Para ello, se ejecutó una búsqueda en diversas fuentes de información,consultando artículos científicos,páginas web institucionales y comunicados de organismos gubernamentales. Dado que la listeriosis es una enfermedad prevenible que va en aumento, sería recomendable que se realizaran mayores esfuerzos para el control de esta, potenciando los programas de Educación para la Salud e implementando nuevas investigaciones. Esta reciente alerta sanitaria del año 2019 evidenció la enorme relevancia de las medidas de prevención, tanto de higiene como de alimentación, en el control y la erradicación de la infección.Grado en Enfermerí

Endoglin Protein Interactome Profiling Identifies TRIM21 and Galectin-3 as New Binding Partners

This article belongs to the Special Issue TGF-beta/BMP Signaling PathwayEndoglin is a 180-kDa glycoprotein receptor primarily expressed by the vascular endothelium and involved in cardiovascular disease and cancer. Heterozygous mutations in the endoglin gene (ENG) cause hereditary hemorrhagic telangiectasia type 1, a vascular disease that presents with nasal and gastrointestinal bleeding, skin and mucosa telangiectases, and arteriovenous malformations in internal organs. A circulating form of endoglin (alias soluble endoglin, sEng), proteolytically released from the membrane-bound protein, has been observed in several inflammation-related pathological conditions and appears to contribute to endothelial dysfunction and cancer development through unknown mechanisms. Membrane-bound endoglin is an auxiliary component of the TGF-ß receptor complex and the extracellular region of endoglin has been shown to interact with types I and II TGF-ß receptors, as well as with BMP9 and BMP10 ligands, both members of the TGF-ß family. To search for novel protein interactors, we screened a microarray containing over 9000 unique human proteins using recombinant sEng as bait. We find that sEng binds with high affinity, at least, to 22 new proteins. Among these, we validated the interaction of endoglin with galectin-3, a secreted member of the lectin family with capacity to bind membrane glycoproteins, and with tripartite motif-containing protein 21 (TRIM21), an E3 ubiquitin-protein ligase. Using human endothelial cells and Chinese hamster ovary cells, we showed that endoglin co-immunoprecipitates and co-localizes with galectin-3 or TRIM21. These results open new research avenues on endoglin function and regulation.This work was supported by grants from Ministerio de Ciencia, Innovación y Universidades of Spain (SAF2013-43421-R to CB and SAF2017-84183-R to MQ), Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER; ISCIII-CB06/07/0038 to CB and contract CNV-234-PRF-360 to LR-L) and Consejo Superior de Investigaciones Científicas (CSIC; 201920E022 to CB). JC-V was supported by a postdoctoral contract co-funded by Consejo Superior de Investigaciones Científicas, Ministerio de Ciencia, Innovación y Universidades and the European Social Fund (ESF). CIBERER and CIBERNED are initiatives of the Instituto de Salud Carlos III (ISCIII) of Spain supported by European Regional Development (FEDER) funds

Clinicopathological and Genomic Identification of Breast Cancers with No Impact on Mortality

Background. Implementing mammogram screening means that clinicians are seeing many breast cancers that will never develop metastases. The purpose of this study was to identify subgroups of breast cancer patients who did not present events related to long-term breast cancer mortality, taking into account diagnosis at breast screening, absence of palpability and axillary involvement, and genomic analysis with PAM50. Patients and Methods. To identify them, a retrospective observational study was carried out selecting patients without any palpable tumor and without axillary involvement, and a genomic analysis was performed with PAM50. Results. The probability of distant metastasis-free interval (DMFI) of 337 patients was 0.92 (95% CI, 0.90–0.93) at 20 years and 0.96 (95% CI, 0.92–1.00) in 95 patients (28%) with available PAM50 tests. In 22 (23.15%) luminal A tumors and in 9 (9.47%) luminal B tumors smaller than 1 cm, and in HER2 and basal type tumors, there were no metastatic events (20-year DMFI of 1.00). Conclusion. Patients with nonpalpable breast cancer found at screening with negative nodes are at very low risk. It is possible to identify subgroups without metastatic events by determining the intrinsic subtype and tumor size less than 1 cm. Therefore, de-escalation of treatment should be considered

Intraoperative metabolic changes associated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

Background: Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) causes considerable hemodynamic, respiratory, and metabolic changes during the perioperative period. Objectives: To evaluate metabolic changes associated with this procedure. Understanding perioperative factors and their association with morbidity may improve the perioperative management of patients undergoing this treatment. Methods: A retrospective review of a prospectively maintained database was performed. All consecutive unselected patients who underwent CRS plus HIPEC between January 2018 and December 2020 (n = 219) were included. Results: The mean age was 58 ± 11.7 years and 167 (76.3%) were female. The most frequent histology diagnosis was serous ovarian carcinoma 49.3% (n = 108) and colon carcinoma 36.1% (n = 79). Mean peritoneal cancer index was 14.07 ± 10.47. There were significant variations in pH, lactic acid, sodium, potassium, glycemia, bicarbonate, excess bases, and temperature (p < 0.05) between the pre-HIPEC and post-HIPEC periods. The closed HIPEC technique resulted in higher levels of temperature than the open technique (p < 0.05). Age, potassium level post-HIPEC potassium level, and pre-HIPEC glycemia were identified as prognostic factors for morbidity in multivariate analysis. Conclusion: The administration of HIPEC after CRS causes significant changes in internal homeostasis. Although the closed technique causes a greater increase in temperature, it is not related to higher morbidity rates. The patient’s age, post-HIPEC potassium level, and pre-HIPEC glycemia are predictive factors for morbidity

Intraoperative oxygen tension and redox homeostasis in Pseudomyxoma peritonei: A short case series

IntroductionPseudomyxoma peritonei (PMP) is a rare malignant disease characterized by a massive multifocal accumulation of mucin within the peritoneal cavity. The current treatment option is based on complete cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy. However, the recurrence is frequent with subsequent progression and death. To date, most of the studies published in PMP are related to histological and genomic analyses. Thus, the need for further studies unveiling the underlying PMP molecular mechanisms is urgent. In this regard, hypoxia and oxidative stress have been extensively related to tumoral pathologies, although their contribution to PMP has not been elucidated.MethodsIn this manuscript, we have evaluated, for the first time, the intratumoral real-time oxygen microtension (pO2mt) in the tumor (soft and hard mucin) and surrounding healthy tissue from five PMP patients during surgery. In addition, we measured hypoxia (Hypoxia Inducible Factor-1a; HIF-1α) and oxidative stress (catalase; CAT) markers in soft and hard mucin from the same five PMP patient samples and in five control samples.ResultsThe results showed low intratumoral oxygen levels, which were associated with increased HIF-1α protein levels, suggesting the presence of a hypoxic environment in these tumors. We also found a significant reduction in CAT activity levels in soft and hard mucin compared with healthy tissue samples.DiscussionIn conclusion, our study provides the first evidence of low intratumoral oxygen levels in PMP patients associated with hypoxia and oxidative stress markers. However, further investigation is required to understand the potential role of oxidative stress in PMP in order to find new therapeutic strategies

Spatiotemporal Characteristics of the Largest HIV-1 CRF02_AG Outbreak in Spain: Evidence for Onward Transmissions

Background and Aim: The circulating recombinant form 02_AG (CRF02_AG) is the predominant clade among the human immunodeficiency virus type-1 (HIV-1) non-Bs with a prevalence of 5.97% (95% Confidence Interval-CI: 5.41–6.57%) across Spain. Our aim was to estimate the levels of regional clustering for CRF02_AG and the spatiotemporal characteristics of the largest CRF02_AG subepidemic in Spain.Methods: We studied 396 CRF02_AG sequences obtained from HIV-1 diagnosed patients during 2000–2014 from 10 autonomous communities of Spain. Phylogenetic analysis was performed on the 391 CRF02_AG sequences along with all globally sampled CRF02_AG sequences (N = 3,302) as references. Phylodynamic and phylogeographic analysis was performed to the largest CRF02_AG monophyletic cluster by a Bayesian method in BEAST v1.8.0 and by reconstructing ancestral states using the criterion of parsimony in Mesquite v3.4, respectively.Results: The HIV-1 CRF02_AG prevalence differed across Spanish autonomous communities we sampled from (p &lt; 0.001). Phylogenetic analysis revealed that 52.7% of the CRF02_AG sequences formed 56 monophyletic clusters, with a range of 2–79 sequences. The CRF02_AG regional dispersal differed across Spain (p = 0.003), as suggested by monophyletic clustering. For the largest monophyletic cluster (subepidemic) (N = 79), 49.4% of the clustered sequences originated from Madrid, while most sequences (51.9%) had been obtained from men having sex with men (MSM). Molecular clock analysis suggested that the origin (tMRCA) of the CRF02_AG subepidemic was in 2002 (median estimate; 95% Highest Posterior Density-HPD interval: 1999–2004). Additionally, we found significant clustering within the CRF02_AG subepidemic according to the ethnic origin.Conclusion: CRF02_AG has been introduced as a result of multiple introductions in Spain, following regional dispersal in several cases. We showed that CRF02_AG transmissions were mostly due to regional dispersal in Spain. The hot-spot for the largest CRF02_AG regional subepidemic in Spain was in Madrid associated with MSM transmission risk group. The existence of subepidemics suggest that several spillovers occurred from Madrid to other areas. CRF02_AG sequences from Hispanics were clustered in a separate subclade suggesting no linkage between the local and Hispanic subepidemics

Colorectal peritoneal metastases: Optimal management review.

The peritoneum is a common site of dissemination for colorrectal cancer, with a poorer prognosis than other sites of metastases. In the last two decades, it has been considered as a locoregional disease progression and treated as such with curative intention treatments. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is the actual reference treatment for these patients as better survival results have been reached as compared to systemic chemotherapy alone, but its therapeutic efficacy is still under debate. Actual guidelines recommend that the management of colorectal cancer with peritoneal metastases should be led by a multidisciplinary team carried out in experienced centers and consider CRS + HIPEC for selected patients. Accumulative evidence in the last three years suggests that this is a curative treatment that may improve patients disease-free survival, decrease the risk of recurrence, and does not increase the risk of treatment-related mortality. In this review we aim to gather the latest results from referral centers and opinions from experts about the effectiveness and feasibility of CRS + HIPEC for treating peritoneal disease from colorectal malignancies

Application of an in vitro digestion model to study the bioaccessibility and the effect of the intestinal microbiota on the red wine proanthocyanidins

Trabajo presentado en el II International Congress on Grapevine and Wine Sciences 2ICGWS-2023, celebrado en Logroño (España), del 8 al 10 de noviembre de 2023Proanthocyanidins are important phenolic fraction for wine quality, contributing to astringency, bitterness and color. Their metabolism begins in the mouth and continues throughout the gastrointestinal tract; however, most of them are accumulated in the colon where are metabolized by the intestinal microbiota, giving rise to a whole series of phenolic acids that may have greater activity at physiological level than the precursors[1]. This study aimed to evaluate in vitro the bioaccessibility of proanthocyanidins in a red wine developed by Bodegas Pradorey, as well as to evaluate the potential effect of intestinal microbiota on polyphenols metabolism identifying and quantifying secondary metabolites. The evaluation of the effects of the intestinal microbiota was carried out using an in vitro Digester of Colonic Fermentation. The fecal microbiota was inoculated, and 100 mL of red wine was added daily for 14 days. For the determination of proanthocyanidins and phenolic metabolites, related, high performance liquid chromatography coupled with mass spectrometry (UHPLC-QqQ-MS/MS) was used. The major phenolic metabolites detected were propionic and acetic acid, and the highest concentrations were detected in the transverse and descending colon, mainly at the end of fermentation process. On the other hand, the main families of microbial proanthocyanidin metabolites detected were valerolactones and benzoic acids mainly between 10-14 days of wine fermentation

Endoglin Protein Interactome Profiling Identifies TRIM21 and Galectin-3 as New Binding Partners

Co-IPs for proteomic analysis (mass spectrometry) were carried out by incubation of 1 mg of protein lysates with protein G-coated magnetic beads coupled with either the monoclonal antibody P4A4 anti-endoglin (Developmental Studies Hybridoma Bank, The University of Iowa, US) or an isotype-matched (IgG2b) control antibody (Immunostep, Salamanca, Spain). An additional control with protein G magnetic beads in the absence of antibodies was also included. After extensive washing with PBS, immunoprecipitates were then subjected to mass spectrometry analysis