Clinical experience of cefiderocol

Infections by antibiotic-resistant microorganisms could be considered a "stealth pandemic" that we fight daily in most hospitals. Some estimates suggest that today 700,000 deaths per year can be attributed to antimicrobial resistance. By the year 2050, it is estimated that this will increase to ten million deaths per year as a result of infections by multidrug-resistant microorganisms. In this context, the availability of antimicrobial therapy that is effective against these pathogens is essential to be able to "save the lives" of our patients. Cefiderocol, a new cephalosporin with a different mechanism of action, will be an essential treatment in many infections caused by resistant aerobic gram-negative bacteria. Cefiderocol has been used to treat patients with complicated urinary tract infections (cUTI); hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), healthcare-associated pneumonia (HAP); in patients with sepsis and bacteremia, some without an identified primary focus of infection

Factors influencing the airborne sporangia concentration of Phytophthora infestans and its relationship with potato disease severity

Financiado para publicación en acceso aberto: Universidade de Vigo/CISUGForecasting systems are widely used to predict the application of fungicides for managing late blight. However, airborne inoculum has rarely been included in these forecasting systems. Monitoring the sporangia in crop environments may offer an opportunity to improve late blight forecast systems by integrating pathogen pressure. Hence, this experiment aiming to analyze relationships between weather based risk systems and sporangia levels in the atmosphere of potato crops. The experiments were conducted during two growing seasons in a potato field. During the study, the concentration of Phytophthora infestans in the air, the weather conditions, the phenology of cultivars and r-AUPDC during the crop cycle were recorded. The weather-based risk of late blight was estimated using infection pressure (IP) and the daily risk value (DRV) based on hourly relative humidity (RH) and temperature (T). The effect of weather parameters on sporangia levels was analyzed. IP and DRV showed a strong positive correlation with sporangia concentration, standing out the pronounced effect of RH on the sporangia levels. Analysis of the hourly sporangia concentration within a day showed an increase in the sporangia concentration from 9 h to 18 h. This increase in sporangia was linked to an increase in T, spore release, and a decrease in RH. Our results identified a T of 10 ◦C and RH of 80% as the minimum threshold for significant sporangia concentration in the air. However, maximum sporangia level was found in the air at 88% (average relative humidity) and 17 ◦C (average temperature). Finally, the effect of weekly P. infestans sporangia was observed on cultivars with different susceptibility to late blight.Ministerio de Educación, Cultura y Deporte | Ref. FPU 17/0026

Screening pulmonary arteriovenous malformations in a large cohort of Spanish patients with hemorrhagic hereditary telangiectasia

39 p.-1 fig.-7 tab.Background and objectives Because of the serious nature of potential complications, screening for pulmonary arteriovenous malformations is required in patients with hereditary hemorrhagic telangiectasia. The aim of this study was to evaluate the utility of contrast echocardiography and compare the performance of two contrast agents: agitated saline and Gelofusine.Material and methods Two hundred and five patients screened for PAVMs using TTCE and computed tomography (CT) performed with an interval of less than 180 days. Contrast echocardiography studies were graded on a 4-point semiquantitative scale based on the amount of microbubbles seen in left heart chambers.Results Positive TTCE findings were seen in 137 (66.8%) patients, whereas CT confirmed PAVMs in 59 (43.1%). Two of 67 grade 1 patients; 18 of 42 grade 2; 17 of 22 grade 3 and all grade 4 had PAVMs on CT. Embolotherapy was feasible in 38.9% patients in grade 2 and 82.3% and 95.2% in grades 3–4. No patients in grade 1 were embolized. The mean cardiac cycle in which bubbles were first seen in the left heart in patients without and with PAVMs on CT was 6.1 and 3.9 (p < 0.0001). Compared to saline, Gelofusine produced an overall increase in grade.Conclusions No grade 1 patients had treatable PAVMs. There is a need for improvement in the selection of patients for CT in grade 2, where less than half have PAVMs on CT. The cardiac cycle may help to differentiate between patients with and without PAVMs. Gelofusine was not better than saline for PAVM screening.This study has been supported by grants from Instituto de Salud Carlos III (ISCIII; PI11/0246 to JAP), FEDER (to JAP), Ministerio de Economía y Competitividad of Spain (SAF2011-23475 to LMB and SAF2013-43421-R to CB), and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER; ISCIIICB06/ 07/0038 to CB).Peer reviewe

Importance of meteorological parameters and airborne conidia to predict risk of alternaria on a potato crop ambient using machine learning algorithms

Secondary infections of early blight during potato crop season are conditioned by aerial inoculum. However, although aerobiological studies have focused on understanding the key factors that influence the spore concentration in the air, less work has been carried out to predict when critical concentrations of conidia occur. Therefore, the goals of this study were to understand the key weather variables that affect the hourly and daily conidia dispersal of Alternaria solani and A. alternata in a potato field, and to use these weather factors in different machine learning (ML) algorithms to predict the daily conidia levels. This study showed that conidia per hour in a day is influenced by the weather conditions that characterize the hour, but not the hour of the day. Specifically, the relative humidity and solar radiation were the most relevant weather parameters influencing the conidia concentration in the air and both in a linear model explained 98% of the variation of this concentration per hour. Moreover, the dew point temperature three days before was the weather variable with the strongest effect on conidia per day. An improved prediction of Alternaria conidia level was achieved via ML algorithms when the conidia of previous days is considered in the analysis. Among the ML algorithms applied, the CART model with an accuracy of 86% were the best to predict daily conidia level.Ministerio de Educación, Cultura y Deportes | Ref. FPU 17/0026

Clinical management of cUTI, cIAI, and HABP/VABP attributable to carbapenem-resistant Gram-negative infections in Spain

Carbapenemasa; Infeccions gramnegatives; Infeccions associades a l'assistència sanitàriaCarbapenemasa; Infecciones gramnegativas; Infecciones asociadas a la asistencia sanitariaCarbapenemase; Gram-negative infections; Healthcare-associated infectionsIntroduction. Carbapenem-resistant Gram-negative (CRGN) infections are a major public health problem in Spain, often implicated in complicated, healthcare-associated infections that require the use of potentially toxic antibacterial agents of last resort. The objective of this study was to assess the clinical management of complicated infections caused by CRGN bacteria in Spanish hospitals. Methods. The study included: 1) a survey assessing the GN infection and antibacterial susceptibility profile in five participating Spanish hospitals and 2) a non-interventional, retrospective single cohort chart review of 100 patients with complicated urinary tract infection (cUTI), complicated intra-abdominal infection (cIAI), or hospital-acquired bacterial pneumonia/ventilator-associated bacterial pneumonia (HABP/VABP) attributable to CRGN pathogens. Results. In the participating hospitals CRGN prevalence was 9.3% amongst complicated infections. In the retrospective cohort, 92% of infections were healthcare-associated, and Klebsiella pneumoniae and Pseudomonas aeruginosa were the most common pathogens. OXA was the most frequently detected carbapenemase type (71.4%). We found that carbapenems were frequently used to treat cUTI, cIAI, HABP/VABP caused by CRGN pathogens. Carbapenem use, particularly in combination with other agents, persisted after confirmation of carbapenem resistance. Clinical cure was 66.0%, mortality during hospitalization 35.0%, mortality at the time of chart review 62.0%, and 6-months-post-discharge readmission 47.7%. Conclusion. Our results reflect the high burden and unmet needs associated with the management of complicated infections attributable to CRGN pathogens in Spain and highlight the urgent need for enhanced clinical management of these difficult-to-treat infections.Funding for this research was provided by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA

Rapid estimation of potato quality parameters by a portable near-infrared spectroscopy device

The aim of the present work was to determine the main quality parameters on tuber potato using a portable near-infrared spectroscopy device (MicroNIR). Potato tubers protected by the Protected Geographical Indication (PGI “Patata de Galicia”, Spain) were analyzed both using chemical methods of reference and also using the NIR methodology for the determination of important parameters for tuber commercialization, such as dry matter and reducing sugars. MicroNIR technology allows for the attainment/estimation of dry matter and reducing sugars in the warehouses by directly measuring the tubers without a chemical treatment and destruction of samples. The principal component analysis and modified partial least squares regression method were used to develop the NIR calibration model. The best determination coefficients obtained for dry matter and reducing sugars were of 0.72 and 0.55, respectively, and with acceptable standard errors of cross-validation. Near-infrared spectroscopy was established as an effective tool to obtain prediction equations of these potato quality parameters. At the same time, the efficiency of portable devices for taking instantaneous measurements of crucial quality parameters is useful for potato processors.Xunta de Galicia | Ref. FEADER 2017/045BMinisterio de Educación, Cultura y Deporte | Ref. FPU 17/0026

Características de la retinopatía de la prematuridad en Villa Clara

Retinopathy of prematurity is the most  common  cause  of childhood blindness, It is a vasoproliferative disease of the retina and vitreous that occurs in premature infants. It is due to abnormal  pathologic,  in which  the  retinal  blood  vessels stop growing and developing normally. A retrospective longitudinal study was performed on retinopathy of prematurity in Villa Clara province, on 37 newborns diagnosed with the disease, from October 2002 to September 2006, with the purpose of describing the features thereof, as well as risk factors that affected the prevalence. 271 children were examined presenting disease 13.7%, with a predominance of female sex, birth weight between 1001 to 1350 and 1351 grams and 1700 grams , gestational age between 30 - 34 weeks and one birth. Predominated in the risk factors administering oxygen, the use of steroids, respiratory distress syndrome, blood transfusions and sepsis. The most affected area was the 3 for 78.4 % and 13.5 % were stage III plus. Laser treatment and cryotherapy was applied to patients who reached stage III plus and stage III.La retinopatía de la prematuridad es la causa más frecuente de ceguera infantil, es una enfermedad vasoproliferativa de la retina y el vítreo que ocurre en niños prematuros y que se debe a una angiogénesis anormal en la que los vasos sanguíneos retinianos dejan de crecer y desarrollarse normalmente. Se realizó un estudio descriptivo longitudinal retrospectivo sobre retinopatía de la prematuridad en la Provincia de Villa Clara en 37 recién nacidos diagnosticados con la enfermedad desde octubre de 2002 a septiembre de 2006 con el propósito de describir sus características, así como los factores de riesgo que incidieron en su prevalencia. Se examinaron 271 niños -37 (13.7%) con la enfermedad- y predominaron el sexo femenino, el peso al nacer entre 1001-1350 gramos y 1351-1700 gramos, la edad gestacional entre de 30-34 semanas, el nacimiento único y, entre los factores de riesgo, la administración de oxígeno; la zona más afectada fue la tres (78.4%). Se aplicó tratamiento con láser y crioterapia a los pacientes que alcanzaron estadio III plus y estadio III

Biospeciation of tungsten in the serum of diabetic and healthy rats treated with the antidiabetic agent sodium tungstate

It is known that oral administration of sodium tungstate preserves the pancreatic beta cell function in diabetic rats. Healthy and streptozotocin-induced diabetic rats were treated with sodium tungstate for one, three or six weeks, after which the species of W in serum, were analysed. An increase in serum W with treatment time was observed. After six weeks, the serum W concentration in diabetic rats (70 mg L−1) was about 4.6 times higher than in healthy specimens. This different behaviour was also observed for Cu accumulation, while the Zn pattern follows the contrary. The patterns observed in the retention of Cu and Zn may be attributable to a normalization of glycaemia. The speciation analysis of W was performed using 2D separations, including an immunoaffinity packing and a SEC (Size Exclusion Chromatography) column coupled to an ICP-MS (Inductively Coupled Plasma Mass Spectrometry) for elemental detection. Ultrafiltration data together with SEC-ICP-MS results proved that around 80% of serum W was bound to proteins, the diabetic rats registering a higher W content than their healthy counterparts. Most of the proteinbound W was due to a complex with albumin. An unknown protein with a molecular weight higher tan 100 kDa was also found to bind a small amount of W (about 2%). MALDI-TOF (Matrix-Assisted Laser Desorption Ionization Time-of-Flight) analysis of the desalted and concentrated chromatographic fractions confirmed albumin as the main protein bound to tungstate in rat serum, while no binding to transferrin (Tf) was detected. The interaction between glutathione and W was also evaluated using standard solutions; however, the formation of complexes was not observed. The stability of the complexes between W and proteins when subjected to more stringent procedures, like those used in proteomic methodologies (denaturing with urea or SDS, boiling, sonication, acid media, reduction with -mercaptoethanol (BME) or DTT (dithiotreitol) and alkylation with iodoacetamide (IAA), was also evaluated. Our results indicate that the stability of the complexes between W and proteins is not too high enough to remain unaltered during protein separation by SDS–PAGE in denaturing and reducing conditions. However, the procedures for in-solution tryptic digestion and for ESI-MS analysis in MeOH/H2O/with 0.1% formic acid could be used for protein identification without large loss of binding between W and proteins

Percepciones que tiene la comunidad educativa acerca de la importancia de la Educación Infantil para el desarrollo y aprendizaje de los niños y niñas del III nivel, del colegio público “Las Américas” del distrito VI del municipio de Managua, durante el II semestre del año 2021

En el presente trabajo investigativo, consiste en determinar la percepción que tiene la comunidad educativa acerca de la importancia de la educación inicial en el desarrollo y aprendizaje de los niños del III nivel del preescolar del colegio Las América de la ciudad de managua en el segundo semestre del año 2021. La atención que se le da a los niños de educación inicial en el centro es responsabilidad principal de la docente con el apoyo de los padres de familia pues ello son los principales formadores, esto incluye en los valores, hábitos y estimulando en ellos el respeto por sí mismo y la importancia que le deben de dar a la educación inicial para el desarrollo y aprendizaje de los niños y niñas. Es precisamente en la etapa de la primera infancia en la cual se amplía extraordinariamente la esfera de experiencias del niño o niña, se adquieren diversos conocimientos y se desarrollan habilidades. Es aquí donde podemos señalar que las impresiones afectivas positivas que se adquieren durante la primera infancia, por supuesto dentro de la escuela infantil, estabilizan el desarrollo cognitivo, motriz, psicológico y emocional para que el niño siente las bases de su aprendizaje y pueda seguir aprendiendo durante el resto de su vida, enfrentando positivamente las diferentes situaciones. Consideramos importante el desarrollo de esta investigación ya que con esto podemos indagar la forma en que los padres le dan importancia a la educación inicial de sus hijos, así como la forma en que se involucran en sus aprendizajes y poder comprender el problema de las constantes ausencias a la sala educativa por parte de los niños y a la ausencia de los padres en las diferentes actividades en que son llamados. Palabras clave: percepciones, educación inicial, desarrollo y aprendizaj