Use of antibiotics in respiratory viral infections

Besides the intrinsic complications caused by SARS-CoV-2 infection, other conditions, such as bacterial infections pose an additional risk to COVID-19 patients. The study published in this issue by Moreno-Torres et al. [1] assessed the rate and predictors of bacterial infections in patients consecutively admitted with COVID-19 to a tertiary hospital in Madrid, Spain, during the first wave of COVID-19. Among 1594 hospitalized patients with COVID-19, 135 (8.5%) experienced bacterial infectious events, distributed as follows: urinary tract infections (32.6%), bacteremia (31.9%), pneumonia (31.8%), intra-abdominal infections (6.7%) and skin and soft tissue infections (6.7%). Independent predictors of bacterial infections were older age, neurological disease, prior immunosuppression, and admission to intensive care units (ICU)

Long-term treatment of patients with HIV-1: the role of atazanavir

Miguel Ángel Artacho1, Pablo Barreiro2, José Vicente Fernández-Montero21Department of Internal Medicine, Hospital Universitario Gregorio Marañón, Madrid, Spain; 2Department of Infectious Diseases, Hospital Carlos III, Madrid, SpainBackground: The introduction of highly-active antiretroviral therapy (HAART) remains a major milestone in the management of HIV-infected patients. Protease inhibitors (PI) are commonly used as part of triple combinations, given that to antiviral potency, better tolerance and convenience has been achieved in recent years.Objective: To summarize and update evidence-based information about atazanavir (ATV) on initial, simplification, and rescue interventions in HIV patients.Methods: Review of observational and randomized trials reported in medical conferences, peer-reviewed journals, and treatment guidelines.Results: ATV is a second-generation PI, which has shown across studies potent antiviral activity and high genetic barrier, both in HAART-naïve patients or after virological failure. Indulgent metabolic profile, in terms of insulin glucose and lipid levels, adds value to this drug for the long-term management of HIV infection.Keywords: atazanavir, HAART, protease inhibitor

Sistemas de innovación en la evaluación de la disciplina de Derecho Mercantil

En las asignaturas obligatorias y optativas anudadas al Derecho Mercantil, el principal instrumento de evaluación ha sido el examen oral. Se trata de un sistema que está cayendo en desuso en las facultades de Derecho por la masificación de los alumnos y por el rechazo que provocan entre el alumnado. No obstante, la utilización de esta técnica, seguramente con variantes, resulta todavía de utilidad para medir aquellos objetivos de aprendizaje relacionados con la expresión oral, fundamental en la práctica forense. Ahora bien, el punto de partida es que no puede ser el instrumento con mayor peso. De ahí, que haya pasado en las diferentes guías a ser de un 40%, introduciendo otros métodos alternativos, como los controles objetivos y los controles prácticos. En cuanto al examen oral, y al objeto de que cumpla con los objetivos señalados, se plantea el diseño de nuevos ítems tanto en relación con el contenido, estructura, y expresión oral. En cuanto al control objetivo, se formula una propuesta sobre diferentes tipos de cuestiones dirigidas a constatar si las y los estudiantes son capaces de aprehender los conceptos y cuestiones claves

Sistema de Posicionamiento para Vehículos Autónomos

Uno de los objetivos más importantes de los Sistemas Inteligentes de Transporte (ITS) es evitar la pérdida de precisión en el posicionamiento y guiado del vehículo, debido a la disminución en la calidad de la señal del Sistema de Posicionamiento Global (GPS). En este artículo, se presenta un sistema de posicionamiento formado por la combinación de un GPS con una unidad de medida inercial ayudada por los sensores embarcados en el coche para realizar el guiado. En función de la precisión proporcionada por el GPS, el sistema discrimina entre tres posibles comportamientos: 1) Si la precisión es centimétrica, el GPS se encarga en solitario del guiado. 2) Si no se recibe la señal GPS, el control lo toma la unidad inercial. 3) Si la precisión de la señal del GPS no es centimétrica, la posición del vehículo se calcula mediante una combinación de ambas medidas. El sistema se ha instalado en un Citroën C3 Pluriel. Los resultados muestran un correcto comportamiento del vehículo en diferentes situaciones y prueban la necesidad de integrar la información sensorial para realizar un control de navegación óptimo

Autoimmune Diseases and COVID-19 as Risk Factors for Poor Outcomes: Data on 13,940 Hospitalized Patients from the Spanish Nationwide SEMI-COVID-19 Registry

(1) Objectives: To describe the clinical characteristics and clinical course of hospitalized patients with COVID-19 and autoimmune diseases (ADs) compared to the general population. (2) Methods: We used information available in the nationwide Spanish SEMI-COVID-19 Registry, which retrospectively compiles data from the first admission of adult patients with COVID-19. We selected all patients with ADs included in the registry and compared them to the remaining patients. The primary outcome was all-cause mortality during admission, readmission, and subsequent admissions, and secondary outcomes were a composite outcome including the need for intensive care unit (ICU) admission, invasive and non-invasive mechanical ventilation (MV), or death, as well as in-hospital complications. (3) Results: A total of 13,940 patients diagnosed with COVID-19 were included, of which 362 (2.6%) had an AD. Patients with ADs were older, more likely to be female, and had greater comorbidity. On the multivariate logistic regression analysis, which involved the inverse propensity score weighting method, AD as a whole was not associated with an increased risk of any of the outcome variables. Habitual treatment with corticosteroids (CSs), age, Barthel Index score, and comorbidity were associated with poor outcomes. Biological disease-modifying anti-rheumatic drugs (bDMARDs) were associated with a decrease in mortality in patients with AD. (4) Conclusions: The analysis of the SEMI-COVID-19 Registry shows that ADs do not lead to a different prognosis, measured by mortality, complications, or the composite outcome. Considered individually, it seems that some diseases entail a different prognosis than that of the general population. Immunosuppressive/immunoregulatory treatments (IST) prior to admission had variable effects

Sedimentation and biomineralization processes in Las Eras Lake (Coca-Olmedo wetland)

La Laguna de Las Eras es uno de los pequeños y someros cuerpos de agua, que forman el humedal de la zona Coca-Olmedo (cuenca del Duero), caracterizado por su elevada alcalinidad, lo que constituye un rasgo singular dentro de Europa. La laguna presenta una salmuera de tipo Na-Mg-ClSO4 y su superficie está colonizada por tapices microbianos, donde se desarrollan estructuras sedimentarias inducidas por los microorganismos (MISS). Se reconocen diversos minerales autigénicos asociados a los tapices: thenardita, hidromagnesita,sulfatos y fosfatos magnésicos, azufre y halita. Junto a éstos destacan, por ser carbonatos atípicos en Europa, natrón y trona. El estudio petrográfico de los precipitados revela que éstos guardan una estrecha relación con las estructuras microbianas, sugiriendo cierta influencia de los microorganismos en la precipitación mineral.Los tapices microbianos de la laguna de Las Eras constituyen buenos análogos para comprender los procesos geobiológicos y ahondar en la reconstrucción paleoambiental de los lagos alcalinos que han existido desde el Arcaico.Las Eras Lake is one of the small and shallow bodies of water, which form the highly alkaline Coca-Olmedo wetland (Duero Basin), a unique feature within Europe. The lake brine is a Na-Mg-Cl-SO4 type. The lake hosts benthic microbial mats and its surface shows microbially influenced sedimentary structures (MISS). Associated with the microbial mats, several authigenic minerals are recognized such as thenardite, hydromagnesite, magnesium-bearing sulphate and phosphate, halite and sulphur.Among these we highlight the occurrence of natron and trona because the sodium-bearing carbonates are uncommon in the european region. The scanning electron microscopy study reveals that the minerals are closely related to microbial structures,suggesting some influence of microorganisms in the mineral precipitation. Recent microbial mats as those hosted in Las Eras Lake are good analogues for understanding geobiological processes. Knowledge of these processes provides a model for paleoenvironmental reconstruction of alkaline endorheic lakes that have existed since the Archean.Depto. de Biodiversidad, Ecología y EvoluciónFac. de Ciencias BiológicasTRUEMinisterio de Economía y Competitividad (MINECO)pu

Impact of empirical treatment in extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella spp. bacteremia. A multicentric cohort study

BACKGROUND: The objective of this study is to analyze the factors that are associated with the adequacy of empirical antibiotic therapy and its impact in mortality in a large cohort of patients with extended-spectrum β-lactamase (ESBL)--producing Escherichia coli and Klebsiella spp. bacteremia. METHODS: Cases of ESBL producing Enterobacteriaceae (ESBL-E) bacteremia collected from 2003 through 2008 in 19 hospitals in Spain. Statistical analysis was performed using multivariate logistic regression. RESULTS: We analyzed 387 cases ESBL-E bloodstream infections. The main sources of bacteremia were urinary tract (55.3%), biliary tract (12.7%), intra-abdominal (8.8%) and unknown origin (9.6%). Among all the 387 episodes, E. coli was isolated from blood cultures in 343 and in 45.71% the ESBL-E was multidrug resistant. Empirical antibiotic treatment was adequate in 48.8% of the cases and the in hospital mortality was 20.9%. In a multivariate analysis adequacy was a risk factor for death [adjusted OR (95% CI): 0.39 (0.31-0.97); P = 0.04], but not in patients without severe sepsis or shock. The class of antibiotic used empirically was not associated with prognosis in adequately treated patients. CONCLUSION: ESBL-E bacteremia has a relatively high mortality that is partly related with a low adequacy of empirical antibiotic treatment. In selected subgroups the relevance of the adequacy of empirical therapy is limited

Radar on RAIA: High frequency radars in the RAIA Observatory

The RADAR ON RAIA project aims to update and extend beyond the Galician border the High Frequency (HF) radar network that has been operating since 2011 in the framework of the RAIA Observatory. The Project is allowing the establishment of a cross-border collaboration beyond the physical infrastructure itself, developing a sharing strategy of maintenance procedures, validation and data processing on both sides of the border, as well as an easy and public access to all the information. In addition, new products are being developed to exploit the potential of the HF radar technology.Peer Reviewe

IgA vasculitis: influence of CD40, BLK and BANK1 gene polymorphisms

CD40, BLK and BANK1 genes involved in the development and signaling of B-cells are identified as susceptibility loci for numerous inflammatory diseases. Accordingly, we assessed the potential influence of CD40, BLK and BANK1 on the pathogenesis of immunoglobulin-A vasculitis (IgAV), predominantly a B-lymphocyte inflammatory condition. Three genetic variants within CD40 (rs1883832, rs1535045, rs4813003) and BLK (rs2254546, rs2736340, rs2618476) as well as two BANK1 polymorphisms (rs10516487, rs3733197), previously associated with inflammatory diseases, were genotyped in 382 Caucasian patients with IgAV and 955 sex- and ethnically matched healthy controls. No statistically significant differences were observed in the genotype and allele frequencies of CD40, BLK and BANK1 when IgAV patients and healthy controls were compared. Similar results were found when CD40, BLK and BANK1 genotypes or alleles frequencies were compared between patients with IgAV stratified according to the age at disease onset or to the presence/absence of gastrointestinal or renal manifestations. Moreover, no CD40, BLK and BANK1 haplotype differences were disclosed between patients with IgAV and healthy controls and between patients with IgAV stratified according to the clinical characteristics mentioned above. Our findings indicate that CD40, BLK and BANK1 do not contribute to the genetic background of IgAV.Funding: This study was supported by European Union FEDER funds and “Fondo de Investigaciones Sanitarias” (grants PI18/00042 and PI21/00042) from “Instituto de Salud Carlos III” (ISCIII, Health Ministry, Spain). D.P.-P. is a recipient of a Río Hortega program fellowship from the ISCIII, co-funded by the European Social Fund (ESF, “Investing in your future”) (grant number CM20/00006). F.G. is supported by funds of the RICORS Program from ISCIII, co-funded by the European Union (grant number RD21/0002/0025). V.P.-C. is supported by funds of PI18/00042. S.R.-M. is supported by funds of the RETICS Program (RD16/0012/0009) (ISCIII, co-funded by the European Regional Development Fund (ERDF)). O.G. is a staff member of Xunta de Galicia (Servizo Galego de Saude (SERGAS)) through a research-staff stabilization contract (ISCIII/SERGAS) and his work is funded by ISCIII and the European Union FEDER fund (grant numbers RD16/0012/0014 (RIER) and PI17/00409). He is a beneficiary of project funds from the Research Executive Agency (REA) of the European Union in the framework of MSCA-RISE Action of the H2020 Program, project 734899—Olive-Net. R.L.-M. is a recipient of a Miguel Servet type II program fellowship from the ISCIII, co-funded by ESF (“Investing in your future”) (grant number CPII21/00004). Acknowledgments: We are indebted to the patients and healthy controls for their essential collaboration on this study. We also thank the National DNA Bank Repository (Salamanca) for supplying part of the control samples