295 research outputs found
Foreword: “Irish History is not a Closed Shop”: A Multidisciplinary Approach to Ireland’s Discourses of Otherness
The Language of Evaluation in the Narratives by the Magdalene Laundries Survivors: The Discourse of Female Victimhood
La teoría de los modelos mentales y el fenómeno de la recepción dramática. Sobre el fracaso de J.M. Synge
The aim of this article is to apply Gurnham 'S mental models theory to the analysis of J. M. Synge's most controversial plays. By means of this it will be simpler to deduce through which processes of interpretation the audience at the Abbey Theatre rejected the subverted representation of a traditionally Irish rhetoric, which, on this occasion, had been embodied by the inversion of the very core of Ireland's most sacred stereotypes. The reason of the failure of this institution must be subsequently found in the clash between several coextensive mental models.En este trabajo se articula la aplicación de la teoría de los modelos mentales de Gurnham a un material tan polémico como las obras de teatro de J.M. Synge, de cuyo análisis se pueden deducir los paniculares procesos de interpretación de texto y discurso concebidos por la audiencia del Abbey Thearre a principios del siglo XX. El hecho más significativo derivado de los mismos fue su rotundo fracaso al ser llevadas a escena. La recepción por parte del público, en franca oposición a lo representado por aquella institución dramática, así lo dejó patente. Como se verá, las causas de este fenómeno se pueden reducir básicamente a las que siguen: por una parte, el choque de varios modelos mentales coexistentes y. por otra, la consiguiente inversión de estereotipos y la ruptura de la noma de una retórica tradicionalmente irlandesa que aquellas comedias supusieron
Risk factors for ≥high-grade anal intraepithelial lesions in MSM living with HIV and the response to topical and surgical treatments
The authors are grateful to MercedesA ´ lvarez Romero for coordinating patients and drawing
blood samples and to Marina Gutie´rrez and Rodrigo Lo´pez of the Pathology Department for
processing samples. The authors are grateful to the participating patients.Background
The objective of this study in MSM living with HIV was to determine the incidence of HSIL and ASCC, related factors, and the response to treatment.
Patients and methods
Data were gathered in 405 consecutive HIV-infected MSM (May 2010-December 2018) at baseline and annually on: sexual behavior, anal cytology, and HPV PCR and/or high-resolution anoscopy results. They could choose mucosectomy with electric scalpel (from May 2010) or self-administration of 5% imiquimod 3 times weekly for 16 weeks (from November 2013). A multivariate logistic regression model was developed for ≥HSIL-related factors using a step-wise approach to select variables, with a significance level of 0.05 for entry and 0.10 for exit, applying the Hosmer-Lemeshow test to assess the goodness of fit.
Results
The study included 405 patients with a mean age of 36.2 years; 56.7% had bachelor´s degree, and 52.8% were smokers. They had a mean of 1 (IQR 1–7) sexual partner in the previous 12 months, median time since HIV diagnosis of 2 years, and mean CD4 nadir of 367.9 cells/uL; 86.7% were receiving ART, the mean CD4 level was 689.6 cells/uL, mean CD4/CD8 ratio was 0.77, and 85.9% of patients were undetectable. Incidence rates were 30.86/1,000 patient-years for ≥high squamous intraepithelial lesion (HSIL) and 81.22/100,000 for anal squamous cell carcinoma (ASCC). The ≥HSIL incidence significantly decreased from 42.9% (9/21) in 2010 to 4.1% (10/254) in 2018 (p = 0.034). ≥HSIL risk factors were infection with HPV 11 (OR 3.81; 95%CI 1.76–8.24), HPV 16 (OR 2.69, 95%CI 1.22–5.99), HPV 18 (OR 2.73, 95%CI 1.01–7.36), HPV 53 (OR 2.97, 95%CI 1.002–8.79); HPV 61 (OR 11.88, 95%CI 3.67–38.53); HPV 68 (OR 2.44, CI 95% 1.03–5.8); low CD4 nadir (OR1.002; 95%CI 1–1.004) and history of AIDS (OR 2.373, CI 95% 1.009–5.577). Among HSIL-positive patients, the response rate was higher after imiquimod than after surgical excision (96.7% vs 73.3%, p = 0.009) and there were fewer re-treatments (2.7% vs 23.4%, p = 0.02) and adverse events (2.7% vs 100%, p = 0.046); none developed ASCC.
Conclusions
HSIL screening and treatment programs reduce the incidence of HSIL, which is related to chronic HPV infection and poor immunological status. Self-administration of 5% imiquimod as first-line treatment of HSIL is more effective than surgery in HIV+ MSM
ART is key to clearing oncogenic HPV genotypes (HR-HPV) in anal mucosa of HIV-positive MSM
Background: Anal squamous cell carcinoma (ASCC) is one of the most frequent non-AIDS-defining neoplasias in HIV patients, mainly in MSM, and it has been associated with chronic infection with high-risk human papilloma virus (HR-HPV). Our main objective was to determine HR-HPV clearance and acquisition rates and related factors and their relationship with the incidence of HSILs and ASCC in anal mucosa of HIV+ MSM.
Patients and methods: The study included consecutive HIV-infected MSM between May 2010 and December 2018. Data were gathered at baseline and annually on their sexual behavior, CD4 and CD8 levels, plasma HIV viral load, and results of anal cytology, HPV PCR, and high-resolution anoscopy.
Results: Out of the 405 patients studied, 34.9% of patients cleared oncogenic genotypes (IQR: 37-69) within 49 months, and 42.9% acquired new genotypes within 36 months (IQR:12-60). In multivariate analysis, clearance was only significantly influenced by the duration of antiretroviral therapy (ART) (OR: 1.016, 95% CI 1.003-1.030). The incidence of HSILs was 30.86/1,000 patient-years and that of ASCC was 81.22/100,000 patient-years; these incidences were not influenced by the acquisition (acquired: 14.9% vs. non-acquired: 10.4%; p = 0.238) or clearance (cleared 11.4% vs. non-cleared: 13.2%; p = 0.662) rates of these viruses.
Conclusions: The duration of ART appears to positively affect oncogenic genotype clearance in the anal mucosa of HIV+ MSM, although this clearance does not affect the incidence of HSILs or ASCC. The reduction in HSIL+ rate observed in our patients may be attributable to the bundle of measures adopted at our center
A Semi-Supervised Algorithm for Detecting Extremism Propaganda Diffusion on Social Media
European Social Fund, the Spanish Ministry of
Economy and Competitiveness (Project Reference:
FFI2016-79748-R)Junta de Andalucía (Project
References: P18-FR-5020 and A-HUM-250-UGR18)Spanish Ministry of Economy and
Competitiveness 2017 FPI Predoctoral Programme (Grant
Number: BES-2017-081202
BIOLOGIA DE DYSMICOCCUS TEXENSIS (TINSLEY, 1900) (HEMIPTERA: PSEUDOCOCCIDAE) EN CUATRO DIFERENTES TEMPERATURAS EN HOSPEDERO ALTERNATIVO (SOLANUM TUBEROSUM L.)
Dysmicoccus texensis Tinsley, 1900 es una plaga potencial en el cultivo banano. Con el fin de establecer medidas para su manejo integrado se requiere información básica sobre su biología. Este trabajo presenta el seguimiento de su ciclo de vida en tubérculos brotados de papa bajo cuatro tipos de condiciones de temperatura (ºC) controladas en cámaras de crecimiento (20, 25, 28 y 30ºC y 80% HR) y algunos aspectos ecológicos. En el caso de la hembra presentó los estados de huevo, ninfa (con tres estadios de desarrollo paurometábolo: ninfa I, ninfa II y ninfa III), y adulto. Mientras que para el macho se registraron los estados de huevo y ninfa (sólo los estadios ninfa I y ninfa II), luego el estado pupal (con 2 estadios pre-pupa y pupa) y estado adulto. Los datos obtenidos indicaron que 28°C, fue la temperatura óptima para el desarrollo de D. texensis, pues combinó la mayor sobrevivencia con la menor duración. A28°C se obtuvo la más alta producción de huevos por hembra con una viabilidad de 77%
Incidence, Management Experience and Characteristics of Patients with Giardiasis and Common Variable Immunodeficiency
Common variable immunodeficiency (CVID) is an antibody immunodeficiency with a
wide variety of clinical and immunological manifestations, and whose genetic cause is found in
about 25% of diagnosed cases. Giardia lamblia is one of the main causes of gastrointestinal infections
in CVID. 5-Nitroimidazoles are the most used first-line treatment, but nitroimidazole-refractory
giardiasis is increasing. Nevertheless, only a few cases of refractory giardiasis in CVID have been
reported. This study aimed to determine the incidence of Giardia infection in our CVID cohort, shows
our management experience and describes patients’ phenotypic features. Clinical data collection,
immunological, immunogenetics and microbiology assays were performed, and previous cases
of giardiasis in CVID were reviewed. The incidence of symptomatic giardiasis was 12.9%. The
main immunological features were undetectable or decreased IgA levels and reduced switched
memory B cells. A probable PTEN pathogenic variant was detected in one. Three patients responded
to metronidazole but suffered reinfections, and one was a refractory giardiasis eradicated with
innovative quinacrine plus paromomycin combination. This work could contribute to the decisionmaking
and therapeutic management of future patients with CVID and giardiasis, highlighting the
importance of the early detection and treatment of infections in patients with CVID to ensure a good
quality of life
Incidence of nephrotoxicity associated with intravenous colistimethate sodium administration for the treatment of multidrug‑resistant gram‑negative bacterial infections
Colistimethate sodium (CMS) is the inactive prodrug of colistin, CMS has a narrow antibacterial
spectrum with concentration-dependent bactericidal activity against multidrug-resistant gramnegative
bacteria, including Pseudomonas aeruginosa and Acinetobacter baumannii. This study aimed
to analyze potential correlations between clinical features and the development of CMS-induced
nephrotoxicity. This retrospective cohort study was conducted in a tertiary-care university hospital
between 1 January 2015 and 31 December 2019. A total of 163 patients received CMS therapy. 75
patients (46%) developed nephrotoxicity attributable to colistin treatment, although only 14 patients
(8.6%) discontinued treatment for this reason. 95.7% of CMS were prescribed as target therapy.
Acinetobacter baumannii spp. was the most commonly identified pathogen (72.4%) followed by
P. aeruginosa (19.6%). Several risk factors associated with nephrotoxicity were identified, among
these were age (HR 1.033, 95%CI 1.016–1.052, p < 0.001), Charlson Index (HR 1.158, 95%CI 1.0462–
1.283; p = 0.005) and baseline creatinine level (HR 1.273, 95%CI 1.071–1.514, p = 0.006). In terms of
in-hospital mortality, risk factors were age (HR 2.43, 95%CI 1.021–1.065, p < 0.001); Charlson Index
(HR 1.274, 95%CI 1.116–1.454, p = 0.043), higher baseline creatinine levels (HR 1.391, 95%CI 1.084–
1.785, p = 0.010) and nephrotoxicity due to CMS treatment (HR 5.383, 95%CI 3.126–9.276, p < 0.001).
In-hospital mortality rate were higher in patients with nephrotoxicity (log rank test p < 0.001). In
conclusion, the nephrotoxicity was reported in almost half of the patients. Its complex management,
continuous renal dose adjustment and monitoring creatinine levels at least every 48 h leads to a high
percentage of inappropriate use and treatment failure
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