The Val158Met polymorphism of the catechol-O-methyltransference gene is not associated with long-term treatment outcomes in carpal tunnel syndrome: A randomized clinical trial

DESIGN: Randomized clinical trial. OBJECTIVE: To investigate the association of the Val158Met polymorphism with pain and function outcomes in women with carpal tunnel syndrome (CTS) who received surgery or manual therapy including desensitization manoeuvres of the central nervous system. METHODS: A pre-planned secondary analysis of a randomized controlled trial investigating the efficacy of manual therapy including desensitization manoeuvres of the central nervous system vs. surgery in 120 women with CTS was conducted. Women were randomized to receive 3 sessions of manual therapy (n = 60) or decompression of the carpal tunnel (n = 60). The primary outcome was intensity of pain (mean pain and the worst pain), and secondary outcomes included function and symptoms severity subscales of the Boston Carpal Tunnel Questionnaire. Outcomes were assessed at baseline, and 1, 3, 6, and 12 months after the intervention. Rs4680 genotypes were determined after amplifying the Val158Met polymorphism by polymerase chain reactions. We classified subjects according to their Val158Met polymorphism: Val/Val, Val/Met, or Met/Met. The primary aim (treatment group*Val158Met*time) was examined with repeated measures ANCOVA with intention-to-treat analysis. RESULTS: At 12 months, 111 (92%) women completed the follow-up. No interaction was observed between the Val158Met genotype and any outcome: mean pain intensity (F = 0.60; P = 0.69), worst pain intensity (F = 0.49; P = 0.61), function (F = 0.12; P = 0.88) or symptom severity (F = 0.01; P = 0.98). CONCLUSION: The current clinical trial did not show an association between the Val158Met polymorphism and changes in pain and function outcomes after either surgery or physical therapy in women with CTS.Funding: The study was funded by a research project grant (FIS PI11/01223) from the Health Institute Carlos III and PN I+D+I 2012-2014, Spanish Government

Susceptibility and transcriptomic response to plasma-activated water of Listeria monocytogenes planktonic and sessile cells

[EN] Plasma-Activated Water (PAW) was generated from tap water using a surface dielectric barrier discharge at different discharge power (26 and 36 W) and activation time (5 and 30 min). The inactivation of a three-strain Listeria monocytogenes cocktail in planktonic and biofilm state was evaluated. PAW generated at 36 W-30 min showed the lowest pH and the highest hydrogen peroxide, nitrates, nitrites contents and effectiveness against cells on planktonic state, resulting in 4.6 log reductions after a 15-min treatment. Although the antimicrobial activity in biofilms formed on stainless steel and on polystyrene was lower, increasing the exposure time to 30 min allowed an inactivation >4.5 log cycles. The mechanisms of action of PAW were investigated using chemical solutions that mimic its physico-chemical characteristics and also RNA-seq analysis. The main transcriptomic changes affected carbon metabolism, virulence and general stress response genes, with several overexpressed genes belonging to the cobalamin-dependent gene cluster.S

Consecuencias Neurológicas y Psiquiátricas a largo plazo (6 meses) en pacientes con COVID leve de la comunidad.: Long-term (6 months) neurological and psychiatric consequences in mild COVID community patients

Long-term neurological complications of coronavirus infection have been described in the acute episode in hospitalized patients. 63% had fatigue and muscle weakness, 26% sleep disorders; 24% gait disorders and 23% anxiety and depression. The greater the severity of the acute episode, the greater the probability of long-term neurological symptoms. The objective of this work was to study the prevalence at 6 months in a cohort of mostly mild outpatients. 96 subjects with a mean age of 48 years, 54% women, and 86% mild outpatients were evaluated by means of a telephone interview. Of these, at 6 months, 32% of the population presented neurological or psychiatric symptoms. Anxiety (31%), Fatigue (26%), Mental fog (24%), Insomnia (22%), Depression (21%), Headache (19%) among others. Conclusions: In this work with subjects who suffered from mild COVID, neurological and psychiatric symptoms were still prominent as reported in acute severs ones.Las complicaciones neurológicas a largo plazo de la infección por coronavirus han sido descriptas en los pacientes hospitalizados en el episodio agudo. De ellos el 63% presentaron fatiga y debilidad muscular, el 26% trastornos del sueño; 24% trastornos en la marcha y 23% ansiedad y depresión. A mayor severidad del episodio agudo mayor probabilidad de sintomatología neurológica a largo plazo. El objetivo de este trabajo fue estudiar la prevalencia de síntomas neurológicos y psiquiátricos a los 6 meses en una cohorte de pacientes adultos, principalmente ambulatorios. Fueron evaluados mediante una entrevista telefónica 96 sujetos con una media de edad de 48 años, 54% mujeres, y el 86 % ambulatorios leves. De ellos a los 6 meses el 32% de la población presentaba aun síntomas neurológicos o psiquiátricos. Ansiedad (31%), fatiga (26%), niebla mental (24%), insomnio (22%), depresión (21%), y cefalea (19%) entre otros. Conclusiones: en el presente trabajo con sujetos que sufrieron COVID leve los síntomas neurológicos y psiquiátricos post COVID continuaron prominentes como lo reportado en otros trabajos en las formas agudas más graves

Insights from experiences comanaging woody invasive alien plants in Argentina

ACKNOWLEDGEMENTS Thanks to a long list of organisations and colleagues who supported our work. In particular, we want to acknowledge the technical team of CONTAIN (IER), Jardín Botánico de Horco Molle, Reserva Experimental de Horco Molle y Parque Sierra de San Javier, Paititi Foundation and E. Zugasti, Secretarías de Investigación y Extensión UNCo Bariloche, S. Seijas (Parque Nacional Nahuel Huapi), and Turisur. L. lucidum management was partially funded by the CONTAIN programme under the Newton Latin American Biodiversity Programme (NE/S011641/1), with contributions from NERC (UK) and CONICET 2019-74-APN-DIR#CONICET). P.G.-D. was supported by NE/S011641/1 and 2022GCBCCONTAIN.Peer reviewedPublisher PD

Aplicaciones de herramientas de investigación acción participativa para purificación y calentamiento de agua para uso sanitario en comunidades andinas aisladas de Salta

En este trabajo se aborda la problemática de la adopción y apropiación de tecnologías para el aprovechamiento de la energía solar en comunidades campesinas aisladas. Se describe una metodología de trabajo que aplica herramientas de Investigación Acción Participativa a una experiencia que es llevada a cabo en dos comunidades rurales de Salta: Esquina de Guardia, donde las acciones se orientaron a resolver el problema de aguas arsenicales a través de destiladores solares; y Cabrerías, donde la comunidad demandaba agua caliente para uso sanitario. Un primer análisis, nos lleva a concluir que no existe un procedimiento metodológico único para abordar las experiencias de transferencia y apropiación tecnológica, estando estos condicionados al contexto en que se realizan.The problem that is focus this work is the existing difficulty to realise the adoption and appropriation of technology, with the consequent failure of many projects and the lack of methodologies that favor the participation of recipients in the transfer. This paper describes a methodology that applies tools of Participatory Action Research, which supports a process of technology transfer and ongoing ownership. This experience is conducted in two rural communities of Salta: Esquina de Guardia, where actions were aimed at solving the problem of arsenic in water through solar stills, and Cabrerías, where the community, in a process of improving quality of life, demanding hot water for sanitary use. An initial analysis leads us to conclude that there is not single methodological approach to address the experiences of technology transfer and appropriation, being those conditioned to the context in which they perform.Asociación Argentina de Energías Renovables y Medio Ambiente (ASADES

Incidence, risk factors, clinical characteristics and outcomes of deep venous thrombosis in patients with COVID-19 attending the Emergency Department: results of the UMC-19-S8

Background and importance: A higher incidence of venous thromboembolism [both pulmonary embolism and deep vein thrombosis (DVT)] in patients with coronavirus disease 2019 (COVID-19) has been described. But little is known about the true frequency of DVT in patients who attend emergency department (ED) and are diagnosed with COVID-19. Objective: We investigated the incidence, risk factors, clinical characteristics and outcomes of DVT in patients with COVID-19 attending the ED before hospitalization. Methods: We retrospectively reviewed all COVID patients diagnosed with DVT in 62 Spanish EDs (20% of Spanish EDs, case group) during the first 2 months of the COVID-19 outbreak. We compared DVT-COVID-19 patients with COVID-19 without DVT patients (control group). Relative frequencies of DVT were estimated in COVID and non-COVID patients visiting the ED and annual standardized incidences were estimated for both populations. Sixty-three patient characteristics and four outcomes were compared between cases and controls. Results: We identified 112 DVT in 74 814 patients with COVID-19 attending the ED [1.50‰; 95% confidence interval (CI), 1.23-1.80‰]. This relative frequency was similar than that observed in non-COVID patients [2109/1 388 879; 1.52‰; 95% CI, 1.45-1.69‰; odds ratio (OR) = 0.98 [0.82-1.19]. Standardized incidence of DVT was higher in COVID patients (98,38 versus 42,93/100,000/year; OR, 2.20; 95% CI, 2.03-2.38). In COVID patients, the clinical characteristics associated with a higher risk of presenting DVT were older age and having a history of venous thromboembolism, recent surgery/immobilization and hypertension; chest pain and desaturation at ED arrival and some analytical disturbances were also more frequently seen, d-dimer >5000 ng/mL being the strongest. After adjustment for age and sex, hospitalization, ICU admission and prolonged hospitalization were more frequent in cases than controls, whereas mortality was similar (OR, 1.37; 95% CI, 0.77-2.45). Conclusions: DVT was an unusual form of COVID presentation in COVID patients but was associated with a worse prognosis

CAR density influences antitumoral efficacy of BCMA CAR T cells and correlates with clinical outcome

Identification of new markers associated with long-term efficacy in patients treated with CAR T cells is a current medical need, particularly in diseases such as multiple myeloma. In this study, we address the impact of CAR density on the functionality of BCMA CAR T cells. Functional and transcriptional studies demonstrate that CAR T cells with high expression of the CAR construct show an increased tonic signaling with up-regulation of exhaustion markers and increased in vitro cytotoxicity but a decrease in in vivo BM infiltration. Characterization of gene regulatory networks using scRNA-seq identified regulons associated to activation and exhaustion up-regulated in CARHigh T cells, providing mechanistic insights behind differential functionality of these cells. Last, we demonstrate that patients treated with CAR T cell products enriched in CARHigh T cells show a significantly worse clinical response in several hematological malignancies. In summary, our work demonstrates that CAR density plays an important role in CAR T activity with notable impact on clinical response

Risk factors for developing ventilator-associated lower respiratory tract infection in patients with severe COVID-19:a multinational, multicentre study, prospective, observational study

Around one-third of patients diagnosed with COVID-19 develop a severe illness that requires admission to the Intensive Care Unit (ICU). In clinical practice, clinicians have learned that patients admitted to the ICU due to severe COVID-19 frequently develop ventilator-associated lower respiratory tract infections (VA-LRTI). This study aims to describe the clinical characteristics, the factors associated with VA-LRTI, and its impact on clinical outcomes in patients with severe COVID-19. This was a multicentre, observational cohort study conducted in ten countries in Latin America and Europe. We included patients with confirmed rtPCR for SARS-CoV-2 requiring ICU admission and endotracheal intubation. Only patients with a microbiological and clinical diagnosis of VA-LRTI were included. Multivariate Logistic regression analyses and Random Forest were conducted to determine the risk factors for VA-LRTI and its clinical impact in patients with severe COVID-19. In our study cohort of 3287 patients, VA-LRTI was diagnosed in 28.8% [948/3287]. The cumulative incidence of ventilator-associated pneumonia (VAP) was 18.6% [610/3287], followed by ventilator-associated tracheobronchitis (VAT) 10.3% [338/3287]. A total of 1252 bacteria species were isolated. The most frequently isolated pathogens were Pseudomonas aeruginosa (21.2% [266/1252]), followed by Klebsiella pneumoniae (19.1% [239/1252]) and Staphylococcus aureus (15.5% [194/1,252]). The factors independently associated with the development of VA-LRTI were prolonged stay under invasive mechanical ventilation, AKI during ICU stay, and the number of comorbidities. Regarding the clinical impact of VA-LRTI, patients with VAP had an increased risk of hospital mortality (OR [95% CI] of 1.81 [1.40-2.34]), while VAT was not associated with increased hospital mortality (OR [95% CI] of 1.34 [0.98-1.83]). VA-LRTI, often with difficult-to-treat bacteria, is frequent in patients admitted to the ICU due to severe COVID-19 and is associated with worse clinical outcomes, including higher mortality. Identifying risk factors for VA-LRTI might allow the early patient diagnosis to improve clinical outcomes. Trial registration: This is a prospective observational study; therefore, no health care interventions were applied to participants, and trial registration is not applicable