Tegumentary leishmaniasis and coinfections other than HIV

<div><p>Background</p><p>Tegumentary leishmaniasis (TL) is a disease of skin and/or mucosal tissues caused by <i>Leishmania</i> parasites. TL patients may concurrently carry other pathogens, which may influence the clinical outcome of TL.</p><p>Methodology and principal findings</p><p>This review focuses on the frequency of TL coinfections in human populations, interactions between <i>Leishmania</i> and other pathogens in animal models and human subjects, and implications of TL coinfections for clinical practice. For the purpose of this review, TL is defined as all forms of cutaneous (localised, disseminated, or diffuse) and mucocutaneous leishmaniasis. Human immunodeficiency virus (HIV) coinfection, superinfection with skin bacteria, and skin manifestations of visceral leishmaniasis are not included. We searched MEDLINE and other databases and included 73 records: 21 experimental studies in animals and 52 studies about human subjects (mainly cross-sectional and case studies). Several reports describe the frequency of <i>Trypanosoma cruzi</i> coinfection in TL patients in Argentina (about 41%) and the frequency of helminthiasis in TL patients in Brazil (15% to 88%). Different hypotheses have been explored about mechanisms of interaction between different microorganisms, but no clear answers emerge. Such interactions may involve innate immunity coupled with regulatory networks that affect quality and quantity of acquired immune responses. Diagnostic problems may occur when concurrent infections cause similar lesions (e.g., TL and leprosy), when different pathogens are present in the same lesions (e.g., <i>Leishmania</i> and <i>Sporothrix schenckii</i>), or when similarities between phylogenetically close pathogens affect accuracy of diagnostic tests (e.g., serology for leishmaniasis and Chagas disease). Some coinfections (e.g., helminthiasis) appear to reduce the effectiveness of antileishmanial treatment, and drug combinations may cause cumulative adverse effects.</p><p>Conclusions and significance</p><p>In patients with TL, coinfection is frequent, it can lead to diagnostic errors and delays, and it can influence the effectiveness and safety of treatment. More research is needed to unravel how coinfections interfere with the pathogenesis of TL.</p></div

7th Drug hypersensitivity meeting: part two

No abstract availabl

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background: Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods: The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results: A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P &lt; 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion: Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)

XXVI Congreso Nacional y II Congreso Internacional de SEDEM

Organizan: Sociedad Española de Educación Médica y Facultad de Medicina y Enfermería, Universidad del País Vasco (UPV/EHU)Comunicaciones aceptadas en el XXVI Congreso de la Sociedad Española de Educación Médica, celebrado en Bilbao del 28 al 30 de noviembre de 2024

Validity and reliability of an instrument for assessing the social, and corporal sexual behaviors among school adolescents [Validaci�n de un cuestionario para el estudio del comportamiento sexual, social y corporal, de adolescentes escolares]

Objective. To validate a self-administered questionnaire about social and corporal sexual behaviors among adolescents, by school level and gender. Material and Methods. The data collection instrument was constructed according to DeVellis and consisted of 26 items. It was used in a prospective longitudinal study conducted in 1994 in Guadalajara, Mexico, among 1243 secondary and high school students. The construct validity of the instrument - was established using exploratory factorial analysis, and its reliability using the Cronbach's alpha test. Results. Five factors were obtained in males and an equal number in women, using eigenvalues >1 and by forcing the best solution. The explained variance was 59.3-70.6%; the factorial weight average was 0.63-0.75, and 13 different factors were selected. The Cronbach's alpha mean was 0.87-0.93 and 16 factors had Cronbach's alpha over 0.70. Conclusions. The instrumen has an acceptable validity and reliability for studying the sexual, social, and corporal behaviors in adolescents similar populations

Biological underpinnings and genetic predisposition to schizophrenia within microrna-137 regulatory pathways across brain development

Previous studies have evaluated the role of the microRNA-137 (miRNA137) regulatory pathway in schizophrenia by using in silico or in vitro predicted target genes. These approaches do not capture the dynamic spatiotemporal nature of the miRNA137 regulatory pathway or tend to overestimate direct miRNA binding sites. To provide a more accurate representation of the miRNA137 pathway during human brain development, we evaluated the biological functionality of direct ex vivo miRNA137 targets previously documented in the early prenatal and adult brain. We studied the role of differential expression and genetic predisposing variation to schizophrenia and related disorders within these miRNA137 targets by gene set enrichment analyses (GSEA) and gene-set based polygenic score predictions in an independent schizophrenia case-control cohort. All results were compared to those from in silico or in vitro predicted targets. Only direct miRNA137 targets at prenatal and adult human brain displayed significant enrichments in synaptic and neuronal functions and captured the transcriptomic and genetic predisposing variation to schizophrenia. Furthermore, while adult target genes showed a more consistent enrichment in predisposing variation to schizophrenia and bipolar disorder in case/control polygenic models, prenatal target genes predicted negative symptomatology in schizophrenia patients. Our results suggest that using direct, temporally specific miRNA137 targets significantly improved the detection of biological mechanisms underlying its relationship with psychosis, clarified the association between schizophrenia and related conditions, and suggested association with specific symptomatology domains at different developmental stages of the disorder.Peer reviewe

Anales de Edafología y Agrobiología Tomo 42 Número 5-6

Suelos. Retención de Parathión en Bentonitas Homoiónicas. II. Isotermas de retención y magnitudes termodinámicas relacionadas, por F. del Rey Bueno, E. González Pradas, C. Valenzuela Calahorro y J. D. López González.-- Formaciones edáficas de la región de Ocaña (Toletlo ). l. Entisoles., por José Gumuzzio Fernández y José B. Alvarez Martín.-- Caracterización hidrodinámica de un suelo de olivar. Fundamento teórico y métodos experimentales, por F. Moreno, G. Vachaud y J. Martín Aranda.-- Niveles de influencia de la vegetación en los horizontes superficiales de los suelos. II. Características morfológicas, análisis granulométrico, por Hoyos de Castro, A., Hernando Costa, J., Egido Rodríguez, J. A. y de la Cruz Caravaca, M. T.-- Estudio geológico e identificación de minerales interestratificados clorita-esmectita, mediante sorción interlaminar de aminas. Triásico de la cordillera iberia. l. por M. Doval, M. Rodas, A. Ruiz Amil y F. Aragón.—Fertilidad del Suelo. Niveles foliares de las plantaciones de aguacates de las Islas Canarias occidentales, por V. García, A. Díaz, M. Altares, J. J. Bravo Rodríguez y M. Fernández.-- Caracterización y valor fertilizante de los purines de vacuno en Galicia.t. por M. C. Leiros de la Peña, M. C. Villar Celorio, A. Cabaneiro, T. Carballas, F. Díaz-Fierros, F. Gil Sotres y C. Gómez lbarlucea.—Nutrición y Fisiología Vegetal. Efecto del azufre, nitrógeno y Rhizobium sobre la cosecha, nodulación y contenido de nutrientes en Phaseolus Vulgaris, por Lluch, C., Campos, J.A. y Ligero, F.-- Influencia de la presión osmótica sobre podredumbre apical del tomate (Lycopersicum esculentum), por Ma P. Sánchez Conde.-- Efecto de las giberelinas producidas por Rhizobium Meliloti en la nodulación de alfalfa (Medicago sativa L.), por Lluc, C., Ligero, F. y Olivares, J.-- Bases para el diagnóstico del exceso de boro en limonero, por A. León, A. Torrecillas, F. del Amor y M.a R. Monllor.-- Influencia del hospedador en la infección de las raíces de leguminosas por Rhizobium por M. A. Herrera, L. Mejías, E. Martínez-Molina y J. Olivares.-- Efectos de la irradiación con UV cercano sobre la evolución del contenido de apigenina y quercetol en ononis spinosa L., por J. Baztan.-- Composición mineral y estudio estructural de los tejidos sanos y afectados de podredumbre apical en dos variedades de tomate, (Lycopersicum Esculentum L.), por Ma P. Sánchez Conde y Ma R. de Felipe.—Trabajos recapitulativos. Aplicación de la isoterma de langmuir al estudio de las interacciones sólido-disolución en suelo, por M. Suárez y J. Sánchez-Andreu .-- Evaluación de la erosión hídrica de los suelos, por P. Sanroque, J. L. Rubio y J. Sánchez.-- Nota prioritaria. Criterios ecológicos en el uso de plaguicidas, por Eugenio Laborda.-- NotasPeer reviewe

Anales de Edafología y Agrobiología Tomo 40 Número 11-12

Suelos. Características de los suelos forestales del valle de El Jerte, por J. E. Gallardo, S. Cuadrado y M.I.M. González. III. Procesos de alteración de minerales en suelos de la Sierra de Guadarrama (Xerochrept y Xerumbrept), por T. Aleixandre, A. Pinilla y M. T. García-González.-- Estudio experimental de la alteración de biotitas de la fracción arena gruesa de los suelos empardecidas desarrollados sobre granodioritas, por A. Hoyos de Castro, J. Hernando Costa, J.A. Egido Rodríguez y A. Moro Valverde.- Contribución al estudio de los suelos del Calar del mundo (Albacete) I. Características generales de los Haploxerolls cumúlicos de dolinas y de los Xerorthents líticos circundantes, por L. J. Alias Pérez, Ma. T. Fernández Tapia y J. Hernández Bastida.-- Estudio de los suelos de la Sierra del Barbanza (Galicia). I. Factores de formación, por F. Gil Sotres y F. Diaz-Fierros Viqueira.-- Estudio de los suelos de la Sierra del Barbanza (Galicia). II Propiedades y distribución de los suelos en el espacio, por F. Gil Sotres y F. Diaz-Fierros Viqueira.-- Estudio de los suelos de la Sierra del Barbanza (Galicia). III Procesos edáficos y discusión global, por F. Gil So tres y F. Diaz-Fierros Viqueira.-- Estudio de los suelos de la Sierra del Barbanza ( Galicia). IV Condiciones de fertilidad de los suelos, por F. Gil Sotres y F. Diaz-Fierros Viqueira.-- Estudio sobre la caracterización, génesis y evolución de suelos desarrollados en la Alcarria conquense.I Entisoles, por J. L. Martín de Vidales, R. Jiménez Ballesta y A. Guerra Delgado.-- Estudio sobre la caracterización, génesis y evolución de suelos en la Alcarria conquense. Il. In ceptisoles, por J. L. Martín de Vida/es y R. Jiménez Ballesta.-- Estudio sobre la caracterización, génesis y evolución de suelos en la Alcarria conquense. III Mollisoles, por J. L. Martín de Vidales y R. Jiménez Ballesta.-- Estudio sobre la caracterización, génesis y evolución de suelos en la Alcarria conquense. IV Al fisoles, por J. L. Martín de Vidales y R. Jiménez Ballesta.-- Influencia de los factores formadores en la génesis de suelos de montaña en la provincia de Teruel I. Características generales, por A. Hoyos, Ma. L. Palomar, A. Ma. Moreno y C. Fernández Bermejo.-- Influencia de los factores formadores en la génesis de suelos de montaña en la provincia de Teruel. II Mineralogía de la fracción arena, por A. Hoyos, Ma. L. Palomar, A. Moreno y C. Fernández Bermejo.-- Influencia de los factores formadores en la génesis de suelos de montaña en la provincia de Teruel. III Estudio químico y físico-químico de los suelos, por A. Hoyos, M.L. Palomar, A. Moreno y C. Fernandez Bermejo.-- Influencia de los factores formadores en la génesis de suelos de montaña en la provincia de Teruel. IV Estudio de la montaña orgánica, por A. Hoyos, M. Palomar, A. Moreno y C. Fernández Bermejo.-- Influencia del catión asociado en la cinética de la reacción del ión fluoruro con arcillas alofanicas, por J.M. Hernández Moreno, A. González Batista, O. G. Cabrera y E. Fernández Galdos. Predicción de Parametros climáticos de interés ecológico en Galicia. I. Relación Clima Topografía, por A. Carballeira, J. Juste, A.M. Molina, R. Retuerto y F. Ucieda.-- Aportación al estudio de suelos con horizonte textura en las facies Madrid, por J.B. Alvarez Martín, J. Gumuzzio Fernández y J. Batlle Sales.-- Observaciones sobre algunas malas hierbas recogidas en el Valle del Tietar (A vila), por M. L. Martín Mateo y E. Laborda.-- Sorción interlaminar de aminas alifáticas en minerales interestratificados Mica-Montmorillonita II., Por A. Ruiz Ami/, M. R. de Miguel Rodríguez y F. Aragón de la Cruz.-- IV Procesos de alteración en suelos caracterizados por fenómenos de empardecimiento y movi• lización de arcilla (Haploxeralf), por T. Aleixandre, M. T. García-González y A. Pinilla.-- Modelo experimental de alteración de magnetita. Aplicación al reconocimiento microscopico de minerales opacos, por A. Hoyos de Castro, l. Hernando Massanet, J. Hernando Costa y C. Cañas Alcocer.-- Modelo experimental de alteración de Ilmenita. Aplicación al reconocimiento microscopico de minerales opacos, por A. Hoyos de Castro, J. Hernando Costa, l. Hernando Massanet y C. Cañas Alcocer.—Fertilidad de Suelo. Propiedades físico-químicas de los suelos de aguacates de las Islas Canarias occidentales por V. García, J. Bravo Rodríguez, A. Rodríguez y C.E. Alvarez. Tolerancia del girasol (Helianthus Annus L.) Al boro, por A. Cerda, R.M. Salinas y M. Romero.-- Nutrición y Fisilogía Vegetal. Composición mineral y relaciones fisiológicas en pastizales de zona semiárida, por M.. Montalvo y B. García.-- La composición química mineral del trigo de un campo de experimentación, por L. Sánchez de la Puente y V. J. Mangas Martín.-- La composición química mineral del trigo de un campo de experimentación, por L. Sánchez de la Puente y V. J. Mangas Martín.-- Nota previa. Visual a id for the estimation of grain sizes in thin sections, por G. Stoops.—Trabajo recapitulativos. Perspectivas actuales de la cartografía y evaluación de suelos, por D. de la Rosa.-- La química agrícola en España (1979-1980), por O. Carpena y C. Cadahia. Ciclo del fósforo. l. Formas el elemento en los suelos y su disponibilidad para plantas y microorganismos, por F. Borie y J. M. Barea.-- Ciclo del fósforo. Il. Papel de los microorganismos y su repercusión en nutrición vegetal, por F. Borie y J. M. Barea.-- Estudios básicos de fertilidad por un sistema de electro-ultrafiltración (EUF), por O. Carpena, C. Cadahia, A. Gárate y J. Sánchez Andreu.-- Notas.--BibliografíaPeer reviewe