Rate and duration of hospitalisation for acute pulmonary embolism in the real-world clinical practice of different countries : Analysis from the RIETE registry

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The occurrence of Dictyota canariensis (Dictyotales, Phaeophyceae) in the Gulf of Mexico

The brown alga Dictyota canariensis (Grunow) Tronholm has so far been reported only from the eastern Atlantic Ocean (Canary Islands, Cape Verde, Madeira). In the present work, we record the species for the first time from the shores of the Gulf of Mexico, occurring in Montepio, Veracruz. The specimens were collected in December 2011 and October 2013, growing in the intertidal zone on moderately exposed rocky shores. To confirm the identification, we conducted phylogenetic analyses, combining the partial sequences of psbA and cox1 genes of l7 taxa. The low uncorrected "p" distance values obtained between Mexican and Canary Island specimens for each gene (0.3% for psbA and 1.8% for cox1) are indicative that these specimens most likely belong to the same species. The low genetic divergence is corroborated by morphological observations, which show that the Mexican specimens share the presence of rectangular pigmented patches near the rounded to obtuse apices, margins with triangle-shaped teeth, and a monostromatic medulla with D. canariensis. Additionally, male reproductive structures are described for the first time for this species

Immobilization of trypsin on spent grains for whey protein hydrolysis

The aims of this work were to establish an efficient protocol for trypsin immobilization on spent grains and to assess the influence of the chosen protocol on whey protein hydrolysis. Trypsin was immobilized onto spent grain or modified spent grain, through adsorption and covalent attachment. The efficiency of immobilization and operation and storage stabilities of free and immobilized enzyme on the supports were studied. The enzyme activity, kinetic parameters and the peptide profile of the protein hydrolysates from free and immobilized enzyme were also analysed. The best activity retention was achieved with the immobilization on spent grains through multipoint covalent attachment using glycidol. This carrier showed also very good storage and operational stability (above 90%). Trypsin immobilized on spent grains showed significant activity towards whey proteins. The immobilized enzyme was slightly more stable than the free enzyme at temperatures between 50 °C and 60 °C allowing its use at a broader range of temperatures. The peptides formed with free enzyme and enzyme immobilized on spent grains were generally similar. However, significant differences existed in the amount of native proteins in the hydrolysates and in the relative amount of smaller peptides

Venous Thromboembolism in Patients with Liver Cirrhosis: Findings from the RIETE (Registro Informatizado de la Enfermedad TromboEmbolica) Registry

Patients with cirrhosis are not only at an increased risk of bleeding but also at risk of venous thromboembolism (VTE). We sought to determine the clinical characteristics, management, and outcomes after VTE in patients with cirrhosis. We used the data from RIETE (Registro Informatizado de la Enfermedad TromboEmbolica), an international registry of patients with VTE, to compare the outcomes in patients with and without cirrhosis. Main outcomes included all-cause mortality, pulmonary embolism (PE)-related mortality, recurrent VTE, and bleeding. Among 43,611 patients with acute VTE, 187 (0.4%) had cirrhosis. Of these, 184 (98.4%) received anticoagulation for a median of 109 days (interquartile range [IQR]: 43-201 days), most commonly with enoxaparin (median dose: 1.77 [IQR: 1.38-2.00] mg/kg/day). Compared with patients without cirrhosis, those with cirrhosis had a higher rate of all-cause mortality (10.7 vs. 3.4%; odds ratio [OR]: 3.41; 95% confidence interval [CI]: 2.03-5.46) and fatal bleeding (2.1 vs. 0.2%; OR: 13.94; 95% CI: 3.65-37.90) but similar rates of fatal PE (0.5 vs. 0.5%; OR: 1.17; 95% CI: 0.03-6.70). Patients with cirrhosis had a higher rate of all-cause mortality per 100 patient-years of follow-up (58.9 vs. 16.0; hazard ratio [HR]: 3.70; 95% CI: 2.69-4.91). One-year hazard ratio of clinically relevant bleeding (HR: 2.86; 95% CI: 1.91-4.27), fatal bleeding (HR: 8.51; 95% CI: 3.5-20.7), or recurrent VTE (HR: 2.08; 95% CI: 1.00-4.36) was higher in patients with cirrhosis. Cirrhosis is a challenging comorbidity in patients with VTE. Most patients were treated with anticoagulation and had an elevated risk of recurrence, similar risk of fatal PE, and a very high risk of bleeding including fatal bleeds.status: publishe

Value of Serial Quantification of Fungal DNA by a Real-Time PCR-Based Technique for Early Diagnosis of Invasive Aspergillosis in Patients with Febrile Neutropenia ▿

A study was designed to assess the reliability of the serial detection of Aspergillus sp. DNA to diagnose invasive aspergillosis (IA) in patients with febrile neutropenia. Two blood and two serum samples were taken weekly from 83 patients. A total of 2,244 samples were analyzed by real-time quantitative PCR. Twelve (14.4%) patients were diagnosed with IA. Taking two consecutive positive results as the diagnostic criterion, PCR detected 11 cases, with 4 false positives, giving sensitivity, specificity, positive, and negative predictive values of 91.6%, 94.4%, 73.3%, and 98.5%, respectively. On analyzing in conjunction with high-resolution chest tomography (HRCT) and galactomannan (GM) testing, the combination of serial PCR and GM detected 100% of aspergillosis cases, with a positive predictive value of 75.1%. This diagnostic strategy presented, according to CART analysis, a receiver-operator curve with an area under the curve of 0.97 (95% confidence interval, 0.895 to 1.032; P < 0.01), with a relative risk of IA 6.92 times higher than the control population and with predictive success of 95.2%. As regards early diagnosis, the serial detection of Aspergillus DNA took on average 21 days less than HRCT and 68 days less than GM. The serial detection of Aspergillus DNA using real-time quantitative PCR has great diagnostic applicability, which increases when combined with GM quantification