Infección por Listeria monocytogenes en paciente con sarcoma pélvico

Listeria monocytogenes is a gram-positive bacillus. Infection in humans is unusual, mainly affecting immunosuppressed patients. However, there has been a notable increase in cases recently. This case is of a 75-yearold female treated with hemipelvectomy and subsequent reconstruction with a prosthesis anchored to the iliac crest; she later suffered post-surgical infection with Listeria monocytogenes. We discuss the treatment followed and post-operative evolution. The patient fully recovered, normal blood tests 40 days after discharge from hospital and asymptomatic 2 years after surgery. Although infection with Listeria monocytogenes after prosthetic surgery is an uncommon complication, it is important to bear it in mind and be prepared for treating it, both from a surgical perspective and in terms of proper management with antibiotics.Listeria monocytogenes es un bacilo grampositivo. La afección en humanos es rara, afectando principalmente a pacientes inmunodeprimidos. No obstante, se ha apreciado un aumento de incidencia reciente. Presentamos el caso de una paciente de 75 años tratada mediante hemipelvectomía y una reconstrucción con una prótesis de anclaje ilíaco, que sufrió posteriormente una infección posquirúrgica por Listeriamonocytogenes. Se argumenta el tratamiento seguido y la evolución posoperatoria. La paciente presentó una recuperación completa, con normalización de valores analíticos a los 40 días del alta hospitalaria y 2 años después de la intervención continúa asintomática. Aunque la infección por Listeria monocytogenes tras una cirugía protésica es una complicación infrecuente, es importante tenerla en cuenta y estar preparados para su tratamiento, tanto desde un punto de vista quirúrgico, como para el correcto manejo antibiótico

Addressing the unmet needs in patients with type 2 inflammatory diseases: when quality of life can make a difference

BackgroundPatients with asthma (AS), atopic dermatitis (AD), allergic rhinitis (AR), eosinophilic esophagitis (EoE), chronic rhinosinusitis with nasal polyps (CRSwNP), chronic urticaria (CU), non-steroidal anti-inflammatory drugs-exacerbated respiratory disease (N-ERD), and certain phenotypes of chronic obstructive pulmonary disease (COPD), among others, have a common underlying pathogenesis known as Type 2 inflammation (T2i). These diseases often coexist with other T2i conditions and have a substantial impact on the quality of life (QoL) of patients. However, limited data on patients’ experiences, perspectives, and current management of T2i diseases have been published thus far.AimsThis survey, promoted by the patient-driven T2i Network Project, aimed at identifying the common drivers and challenges related to the QoL of patients with T2i diseases by putting the patient's perspective at the force and including it in the design of new care strategies.MethodologyAn anonymous online survey was carried out through convenience sampling between May and June 2023. The survey was codesigned by members of different patient associations, healthcare professionals and healthcare quality experts, and implemented using EUSurvey and distributed through eight patient associations from Spain. The survey consisted of 29 questions related to the participant's sociodemographic features, a series of self-reported multiple choice or rating scale questions, including diagnosis, QoL measures, disease severity, healthcare resource utilization, and quality of care.ResultsThe survey included 404 participants, members from eight patient associations, the majority of whom had moderate-to-severe self-reported disease severity (93%) and one or more coexisting pathologies related to T2i (59%). Patients with more than one pathology had a significantly greater impact on QoL than those with only one pathology (p < .001). Participants with self-reported severe symptoms reported significantly worse QoL than those with mild-to-moderate severity (p < .001). More than half of the patients (56%) felt constantly bothered by the unpredictability of their illness caused by potential exposure to known or unknown disease triggers. The lack of coordination between specialists and primary care was also expressed as an area of dissatisfaction by participants, with 52% indicating a complete lack of coordination and 21% indicating an average coordination.ConclusionThis article reports the initial findings of a patient-led initiative, which highlights the common QoL challenges faced by individuals with type 2 inflammation-related diseases and emphasizes the importance of further clinical research to improve the management of this patient group. Considering the significant impact on QoL, a multidisciplinary approach integrated into new healthcare protocols has the potential to improve patient management and QoL, shorten the time to diagnosis and reduce healthcare resource utilization

Influence of material structure on air-borne ultrasonic application in drying

[EN] This work aims to contribute to the understanding of how the properties of the material being dried affect air-borne ultrasonic application. To this end, the experimental drying kinetics (40 C and 1 m/s) of cassava (Manihot esculenta) and apple (Malus domestica var. Granny Smith) were carried out applying different ultrasonic powers (0, 6, 12, 19, 25 and 31 kW/m3). Furthermore, the power ultrasound-assisted drying kinetics of different fruits and vegetables (potato, eggplant, carrot, orange and lemon peel) already reported in previous studies were also analyzed. The structural, textural and acoustic properties of all these products were assessed, and the drying kinetics modeled by means of the diffusion theory. A significant linear correlation (r > 0.95) was established between the identified effective diffusivity (DW) and the applied ultrasonic power for the different products. The slope of this relationship (SDUP) was used as an index of the effectiveness of the ultrasonic application; thus the higher the SDUP, the more effective the ultrasound application. SDUP was well correlated (rP0.95) with the porosity and hardness. In addition, SDUP was largely affected by the acoustic impedance of the material being dried, showing a similar pattern with the impedance than the transmission coefficient of the acoustic energy on the interface. Thus, soft and open-porous product structures exhibited a better transmission of acoustic energy and were more prone to the mechanical effects of ultrasound. However, materials with a hard and closed-compact structure were less affected by acoustic energy due to the fact that the significant impedance differences between the product and the air cause high energy losses on the interfaceThe authors acknowledge the financial support of the Spanish Ministerio de Economia y Competitividad (Ref. DPI2012-37466-C03-03, DPI2012-37466-C03-03 and DPI2011-22438) and the assistance with the microstructural analysis provided by Dra. Ana Puig from Departamento de Tecnologia de Alimentos of Universitat Politecnica de Valencia (UPV). The author Cesar Ozuna thanks UPV for an FPI Grant (Ref. 2009-02).Ozuna López, C.; Gomez Alvarez-Arenas, T.; Riera, E.; Cárcel Carrión, JA.; García Pérez, JV. (2014). Influence of material structure on air-borne ultrasonic application in drying. Ultrasonics Sonochemistry. 21(3):1235-1243. https://doi.org/10.1016/j.ultsonch.2013.12.015S1235124321

Pulmonary vascular remodeling and prognosis in patients evaluated for heart transplantation: insights from the OCTOPUS-CHF study

[Abstract] Objective: In patients with advanced heart failure, the intravascular optical coherence tomography (OCT) of subsegmental pulmonary artery measurements is correlated with right heart catheterization parameters. Our aim was to study the prognostic value of pulmonary OCT, right heart catheterization data, and the echocardiographic estimation of pulmonary pressure in patients studied for elective heart transplants. Methods: This research is an observational, prospective, multicenter study involving 90 adults with a one-year follow-up. Results: A total of 10 patients (11.1%) died due to worsening heart failure before heart transplantation, 50 underwent a heart transplant (55.6%), and 9 died in the first year after the transplant. The patients with and without events (mortality or heart failure-induced hospitalization) had similar data regarding echocardiography, right heart catheterization, and pulmonary OCT (with a median estimated pulmonary artery systolic pressure of 42.0 mmHg, interquartile range (IQR) of 30.3-50.0 vs. 47.0 mmHg, IQR 34.6-59.5 and p = 0.79, median pulmonary vascular resistance of 2.2 Wood units, IQR 1.3-3.7 vs. 2.0 Wood units, IQR 1.4-3.2 and p = 0.99, and a median pulmonary artery wall thickness of 0.2 ± 0.5 mm vs. 0.2 ± 0.6 mm and p = 0.87). Conclusion: Pulmonary vascular remodeling (evaluated with echocardiography, right heart catheterization, and pulmonary OCT) was not associated with prognosis in a selected sample of adults evaluated for elective heart transplants. Pulmonary OCT is safe and feasible for the evaluation of these patients.Instituto de Salud Carlos III; PI18/00254European Regional Development Fund; CB16/11/0050

Pulmonary Vascular Remodeling and Prognosis in Patients Evaluated for Heart Transplantation: Insights from the OCTOPUS-CHF Study

Objective: In patients with advanced heart failure, the intravascular optical coherence tomography (OCT) of subsegmental pulmonary artery measurements is correlated with right heart catheterization parameters. Our aim was to study the prognostic value of pulmonary OCT, right heart catheterization data, and the echocardiographic estimation of pulmonary pressure in patients studied for elective heart transplants. Methods: This research is an observational, prospective, multicenter study involving 90 adults with a one-year follow-up. Results: A total of 10 patients (11.1%) died due to worsening heart failure before heart transplantation, 50 underwent a heart transplant (55.6%), and 9 died in the first year after the transplant. The patients with and without events (mortality or heart failure-induced hospitalization) had similar data regarding echocardiography, right heart catheterization, and pulmonary OCT (with a median estimated pulmonary artery systolic pressure of 42.0 mmHg, interquartile range (IQR) of 30.3-50.0 vs. 47.0 mmHg, IQR 34.6-59.5 and p = 0.79, median pulmonary vascular resistance of 2.2 Wood units, IQR 1.3-3.7 vs. 2.0 Wood units, IQR 1.4-3.2 and p = 0.99, and a median pulmonary artery wall thickness of 0.2 +/- 0.5 mm vs. 0.2 +/- 0.6 mm and p = 0.87). Conclusion: Pulmonary vascular remodeling (evaluated with echocardiography, right heart catheterization, and pulmonary OCT) was not associated with prognosis in a selected sample of adults evaluated for elective heart transplants. Pulmonary OCT is safe and feasible for the evaluation of these patients

Convenience or Necessity? The Formation of the Working Class in the Universidades Laborales of Franco’s Spain (1955-1978)

La política educativa franquista tuvo como uno de sus principales objetivos la formación de la clase obrera, por lo que una de las principales instituciones educativas creadas en la época fueron las Universidades Laborales. Este artículo se centra en analizar las finalidades que perseguían estas macroinstituciones al formar los futuros obreros españoles, empleando para su estudio diversas fuentes primarias —documentales, archivísticas, gráficas y jurídicas—. Las conclusiones señalan que los objetivos de las Universidades Laborales fueron, por un lado, la formación profesional especializada y, por el otro lado, su adoctrinamiento en los principios ideológicos propugnados por el régimen.One of the main objectives of Franco’s educational policy was the training of the working class, which is why one of the principal educational institutions created during that period were the Universidades Laborales. This article is focused on analyzing the ends sought by these macroinstitutions in preparing the future workers of Spain, and it makes use of a variety of primary sources —documentary, archival, graphic and juridical— in order to study the subject. The conclusions indicate that the objectives of the Universidades Laborales were, on the one hand, specialized professional training and, on the other hand, their indoctrination in the ideological principles advocated by the regime

La modernización del campo y la globalización económica

El presente libro incluye las ponencias presentadas en el del XIV Seminario de Economía Agrícola del Tercer Mundo, en el cual participan distinguidos especialistas nacionales y extranjeros, atentos a la dinámica y a la problemática actual de la producción primaria y el desarrollo rural de México y el mundo. El interés se centró en la elaboración de análisis críticos y propositivos en torno a los cambios ocurridos durante los últimos años en el sector rural mexicano a la luz del proceso de modernización y globalización económica en que está inmerso nuestro país. Los trabajos presentados en el Seminario muestran un consenso básico en torno a la importancia estratégica del sector agropecuario y rural para la construcción de un proyecto de desarrollo nacional sostenido, equilibrado y democrático

Deregulated cellular circuits driving immunoglobulins and complement consumption associate with the severity of COVID-19 patients

SARS-CoV-2 infection causes an abrupt response by the host immune system, which is largely responsible for the outcome of COVID-19. We investigated whether the specific immune responses in the peripheral blood of 276 patients were associated with the severity and progression of COVID-19. At admission, dramatic lymphopenia of T, B, and NK cells is associated with severity. Conversely, the proportion of B cells, plasmablasts, circulating follicular helper T cells (cTfh) and CD56–CD16+ NK-cells increased. Regarding humoral immunity, levels of IgM, IgA, and IgG were unaffected, but when degrees of severity were considered, IgG was lower in severe patients. Compared to healthy donors, complement C3 and C4 protein levels were higher in mild and moderate, but not in severe patients, while the activation peptide of C5 (C5a) increased from the admission in every patient, regardless of their severity. Moreover, total IgG, the IgG1 and IgG3 isotypes, and C4 decreased from day 0 to day 10 in patients who were hospitalized for more than two weeks, but not in patients who were discharged earlier. Our study provides important clues to understand the immune response observed in COVID-19 patients, associating severity with an imbalanced humoral response, and identifying new targets for therapeutic interventionThe study was funded by grants SAF2017- 82886-R to FS-M from the Ministerio de Economía y Competitividad, and from “La Caixa Banking Foundation” (HR17-00016) to FS-M. Grant PI018/01163 to CMC and grant PI19/00549 to AA were funded by Fondo de Investigaciones Sanitarias, Ministerio de Sanidad y Consumo, Spain. SAF2017-82886-R, PI018/01163 and PI19/00549 grants were also co-funded by European Regional Development Fund, ERDF/FEDER. This work has been funded by grants Fondo Supera COVID (CRUE-Banco de Santander) to FSM, and “Ayuda Covid 2019” from Comunidad de Madri

Impact of late presentation of HIV infection on short-, mid- and long-term mortality and causes of death in a multicenter national cohort: 2004–2013

SummaryObjectivesTo analyze the impact of late presentation (LP) on overall mortality and causes of death and describe LP trends and risk factors (2004–2013).MethodsCox models and logistic regression were used to analyze data from a nation-wide cohort in Spain. LP is defined as being diagnosed when CD4 < 350 cells/ml or AIDS.ResultsOf 7165 new HIV diagnoses, 46.9% (CI95%:45.7–48.0) were LP, 240 patients died.First-year mortality was the highest (aHRLP.vs.nLP = 10.3[CI95%:5.5–19.3]); between 1 and 4 years post-diagnosis, aHRLP.vs.nLP = 1.9(1.2–3.0); and >4 years, aHRLP.vs.nLP = 1.5(0.7–3.1).First-year's main cause of death was HIV/AIDS (73%); and malignancies among those surviving >4 years (32%). HIV/AIDS-related deaths were more likely in LP (59.2% vs. 25.0%; p < 0.001). LP declined from 55.9% (2004–05) to 39.4% (2012–13), and reduced in 46.1% in men who have sex with men (MSM) and 37.6% in heterosexual men, but increased in 22.6% in heterosexual women.Factors associated with LP: sex (ORMEN.vs.WOMEN = 1.4[1.2–1.7]); age (OR31–40.vs.<30 = 1.6[1.4–1.8], OR41–50.vs.<30 = 2.2[1.8–2.6], OR>50.vs.<30 = 3.6[2.9–4.4]); behavior (ORInjectedDrugUse.vs.MSM = 2.8[2.0–3.8]; ORHeterosexual.vs.MSM = 2.2[1.7–3.0]); education (ORPrimaryEducation.vs.University = 1.5[1.1–2.0], ORLowerSecondary.vs.University = 1.3[1.1–1.5]); and geographical origin (ORSub-Saharan.vs.Spain = 1.6[1.3–2.0], ORLatin-American.vs.Spain = 1.4[1.2–1.8]).ConclusionsLP is associated with higher mortality, especially short-term- and HIV/AIDS-related mortality. Mid-term-, but not long-term mortality, remained also higher in LP than nLP. LP decreased in MSM and heterosexual men, not in heterosexual women. The groups most affected by LP are low educated, non-Spanish and heterosexual women