Ampicillin Plus Ceftriaxone Combined Therapy for Enterococcus faecalis Infective Endocarditis in OPAT

Cardiovascular Infectious Study Group of the Andalusian Society of Infectious Diseases.Ampicillin plus ceftriaxone (AC) is a well-recognized inpatient regimen for Enterococcus faecalis infective endocarditis (IE). In this regimen, ceftriaxone is usually administered 2 g every 2 h (AC12). The administration of AC in outpatient parenteral antibiotic treatment (OPAT) programs is challenging because multiple daily doses are required. AC regimens useful for OPAT programs include once-daily high-dose administration of ceftriaxone (AC24) or AC co-diluted and jointly administered in bolus every 4 h (ACjoined). In this retrospective analysis of prospectively collected cases, we aimed to assess the clinical effectivity and safety of three AC regimens for the treatment of E. faecalis IE. Fifty-nine patients were treated with AC combinations (AC12 n = 32, AC24 n = 17, and ACjoined n = 10). Six relapses occurred in the whole cohort: five (29.4%) treated with AC24 regimen and one (10.0%) with ACjoined. Patients were cured in 30 (93.3%), 16 (94.1%), and eight (80.0%) cases in the AC12, AC24 and ACjoined groups, respectively. Unplanned readmission occurred in eight (25.0%), six (35.3%), and two (20.0%) patients in the AC12, AC24 and ACjoined groups, respectively. The outcome of patients with E. faecalis IE treated with AC in OPAT programs relies on an optimization of the delivery of the combination. AC24 exhibit an unexpected rate of failures, however, ACjoined might be an effective alternative which clinical results should corroborate in further studies.The authors received no financial support for the research, authorship, and/or publication of this article. GVA was supported by the Instituto de Salud Carlos III, cofinanced by the European Development Regional Fund (“A way to achieve Europe”), Subprograma Miguel Servet (grant CP19/00159). HHL was supported by the Instituto de Salud Carlos III, Subprograma Rio Hortega (grant CM19/00152)

Magnetothermal properties of molecule-based materials

We critically review recent results obtained by studying the low-temperature specific heat of some of the most popular molecular magnets. Perspectives of this field are discussed as well.Comment: 12 pages text + 14 pages figures, Submitted as "feature article" to Journal of Materials Chemistr

A strategic reflection for the management and implementation of CAR-T therapy in Spain: an expert consensus paper

CAR-T cell therapy represents a therapeutic revolution in the prognosis and treatment of patients with certain types of hematological cancer. However, they also pose new challenges in the healthcare, regulatory and financial fields. The aim of the RET-A project was to undertake a strategic reflection on the management of CAR-T therapies within the Spanish National Health System, to agree on recommendations that will help to better deal with the new context introduced by these cell therapies in the present and in the future. This think tank involved 40 key agents and opinion leaders. The experts identified three great challenges for implementing advanced therapies in Spain: therapeutic individualisation, with a multidisciplinary approach; acceleration of access times, by minimizing bureaucracy; and increase in the number of centers qualified to manage the CAR-T therapies in the NHS. The experts agreed on the ideal criteria for designating those qualified centers. They also agreed on a comprehensive CAR-T care pathway with the timings and roles which would ideally be involved in each part of the process.This study was funded by Gilead Sciences, Inc.Peer reviewe

Leptin levels were negatively associated with lumbar spine bone mineral content in children with overweight or obesity

Aim: Adipokines seem to play a role in bone morphogenesis, although this also depends on the mechanical forces applied to the skeleton. The aim was to assess the relationships of resting leptin and adiponectin with bone parameters and whether high muscular fitness levels affect these relationships in children with overweight or obesity. Methods: This cross-sectional study took part from 2014 to 2016 in Granada, Spain. Participants were recruited from University Hospitals, and we also used advertisements in local media and school contacts in the city. Adipokines were analysed in plasma. Muscular fitness was assessed by one repetition maximum in bench and leg press tests. Dual-energy X-ray absorptiometry was used to measure bone parameters. Results: We included 84 children (10.0 ± 1.2y; 63% boys) in this analysis. Leptin was negatively associated with lumbar spine bone mineral content (β = −0.162, p = 0.053)

Localization by multifocal electroretinography of damaged retinal areas in retinitis pigmentosa

La electrorretinografía multifocal es una nueva técnica que permite obtener un mapa topográfico de la actividad eléctrica de la retina, lo que la hace especialmente útil para el estudio de las distrofias retinianas, como es el caso de la retinosis pigmentaria. El objetivo de este trabajo ha sido analizar la retina de 12 pacientes con retinosis pigmentaria mediante esta técnica. Se utilizó como estímulo una matriz de 61 hexágonos, con cambios de luminancia, que subtiende 60º de ángulo visual. En todos los pacientes, la densidad eléctrica de las respuestas registradas fue inferior a la obtenida en personas con visión normal. Sólo en un paciente se obtuvieron respuestas en todas las áreas estimuladas. En el resto de los pacientes se observaron áreas sin respuesta. El número de estas áreas varió según el tipo y severidad de la enfermedad. Estos resultados muestran la utilidad de la electrorretinografía multifocal para determinar objetivamente el grado y localización de las alteraciones degenerativas de la retina en los pacientes de retinosis pigmentaria.The multifocal electroretinography is a new technique that allows the obtaining of a topographic map of electrical activity of the retina that is especially useful for the study of retinal dystrophies, such as the retinitis pigmentosa. The aim of this work was to analyze the retina of 12 patients with retinitis pigmentosa through this method. A stimulus pattern of 61 hexagons, with changes in luminance that subtends 60° of visual angle, was used. In all the patients, the densities of the recordings were lower than normal. Only in one patient, responses were obtained in all areas stimulated. In the rest, we found unresponsive areas that varied according to the type and severity of the disease. These results show the usefulness of multifocal electroretinography to determine the extent and location of the retinal degeneration of the patients

Revista de Vertebrados de la Estación Biológica de Doñana

Captura de Petromyzon marinus lo en las Marismas del GuadalquivirEstudio sobre la Lagartiia de Valverde Algyroides marchi (Reptilia, Lacertidae)Dimorfismo sexual en Psammodromuus algirus (Reptilia, Lacertidae)Mecanismos de parasitización por Clamator glandarius y defensa por Pica pica.Nidificación de Cyanopica cyana en Doñana.Reproducción de la Urraca (P.pica) en DoñanaNesting relationship between Columba palambus and Milvus migransBiometría y dimorfismo sexual en el Calamón (Polphyrio porphyrio).Sobre sexo, mecanismos y proceso de reproducciónen el Buitre Leonado (Gyps fulvus)Aves anilladas por la Estación Biológica de Doñana. Informe Nº 1. (Años 1964 a 1971)Dimorfismo sexual y diferenciación de edades en Sturnus unicolor Temm.Contribución al estudio de la biología y ecología del Lirón Careto, Eliomys quercinus Linnaeus 1766, en Iberia Central, Parte 1: Crecimiento, Reproducción y Nidificación.Sobre el Lobo (Canis lupus) ibérico:1. Dimorfismo sexual en cráneosMorfología y dimorfismo sexual de la pelvis de Pitymys duodecimcostatusAlgunos aspectos del diformismo sexual en el cráneo de las Ginetas españolas, (Genetta genetta) (L.) 1758Peer reviewe

No differences of immune activation and microbial translocation among HIV-infected children receiving combined antiretroviral therapy or protease inhibitor monotherapy.

This is a cross-sectional study of 15 aviremic chronic HIV-infected children revealing no differences in immune activation (IA; HLA-DRCD38 CD4 and CD8 T cells, and sCD14) and microbial translocation (MT; lipopolysaccharides (LPS) and 16S rDNA) among HIV-infected patients under combined antiretroviral treatment (cART; n = 10) or ritonavir-boosted protease inhibitor monotherapy (mtPI/rtv; n = 5). In both cases, IA and MT were lower in healthy control children (n = 32). This observational study suggests that ritonavir boosted protease inhibitor monotherapy (mtPI/rtv) is not associated with an increased state of IA or MT as compared with children receiving cART

Dislocation-induced spin tunneling in Mn-12 acetate

Comprehensive theory of quantum spin relaxation in Mn-12 acetate crystals is developed, that takes into account imperfections of the crystal structure and is based upon the generalization of the Landau-Zener effect for incoherent tunneling from excited energy levels. It is shown that linear dislocations at plausible concentrations provide the transverse anisotropy which is the main source of tunneling in Mn-12. Local rotations of the easy axis due to dislocations result in a transverse magnetic field generated by the field applied along the c-axis of the crystal, which explains the presence of odd tunneling resonances. Long-range deformations due to dislocations produce a broad distribution of tunnel splittings. The theory predicts that at subkelvin temperatures the relaxation curves for different tunneling resonances can be scaled onto a single master curve. The magnetic relaxation in the thermally activated regime follows the stretched-exponential law with the exponent depending on the field, temperature, and concentration of defects.Comment: 17 pages, 14 figures, 1 table, submitted to PR

Chagas Disease in the New York City Metropolitan Area

Background Chagas disease, caused by the parasite Trypanosoma cruzi, once considered a disease confined to Mexico, Central America, and South America, is now an emerging global public health problem. An estimated 300 000 immigrants in the United States are chronically infected with T. cruzi. However, awareness of Chagas disease among the medical community in the United States is poor. Methods We review our experience managing 60 patients with Chagas disease in hospitals throughout the New York City metropolitan area and describe screening, clinical manifestations, EKG findings, imaging, and treatment. Results The most common country of origin of our patients was El Salvador (n = 24, 40%), and the most common detection method was by routine blood donor screening (n = 21, 35%). Nearly half of the patients were asymptomatic (n = 29, 48%). Twenty-seven patients were treated with either benznidazole or nifurtimox, of whom 7 did not complete therapy due to side effects or were lost to follow-up. Ten patients had advanced heart failure requiring device implantation or organ transplantation. Conclusions Based on our experience, we recommend that targeted screening be used to identify at-risk, asymptomatic patients before progression to clinical disease. Evaluation should include an electrocardiogram, echocardiogram, and chest x-ray, as well as gastrointestinal imaging if relevant symptoms are present. Patients should be treated if appropriate, but providers should be aware of adverse effects that may prevent patients from completing treatment