Efectos de la punción seca en la función del sistema nervioso autónomo en sujetos sanos: ensayo clínico aleatorio controlado a Simple Ciego

Marco Teórico: Uno de los posibles mecanismos analgésicos de la punción seca (PS) es la analgesia inducida por estrés, producida por una activación del sistema nervioso simpático (SNS). Aunque se conoce que en técnicas como la acupuntura se producen cambios en el sistema nervioso autónomo (SNA), existe aún una laguna de conocimiento sobre la relación existente entre la PS y el SNA. Objetivo: Determinar si la aplicación de la técnica de punción seca produce la activación del SNS generando un efecto analgésico por estrés en sujetos sanos. Metodología: Se realizó un ensayo clínico aleatorizado a simple ciego controlado en la Universidad de Alcalá, contando con una muestra de 65 sujetos sanos voluntarios que cumplían con los criterios de selección, con una media de edad de 27,78 (DT = 8,41) años, de los cuales el 50,8% fueron hombres y el 49,2% mujeres. Los participantes fueron aleatoriamente asignados a participar en el Grupo 1, a los que se les realizó una única intervención de punción seca profunda; o en el Grupo 2, a los que se les aplicó una técnica de punción placebo. La técnica de intervención se realizó en ambos grupos en el músculo aductor del pulgar de la mano izquierda. Para evaluar la activación del SNS, se han medido antes, durante y en dos momentos posteriores a la intervención, la conductancia de la piel, la frecuencia cardiaca, la temperatura de la piel y la frecuencia respiratoria mediante el equipo de biofeedback Nexus 10 MK-II, además del nivel de cortisol en la saliva antes y después. Se ha procedido a recoger el umbral de dolor a la presión en el músculo aductor del pulgar izquierdo y en el tibial derecho, mediante un algómetro manual, antes y después de la intervención. También se ha registrado el dolor producido durante la punción mediante una Escala Numérica Verbal del dolor y las respuestas de espasmo local elicitadas. Resultados: En ambas intervenciones con PS se produce una activación del SNS, comportándose de forma similar para todas las variables. En el grupo de Punción seca profunda se ha observado un incremento significativo de la frecuencia cardiaca durante la punción y del umbral de dolor a la presión, tanto a nivel local como central con respecto al grupo Placebo. Conclusiones: Se ha observado un efecto hipoalgésico a corto plazo en sujetos sanos, sugiriendo que la PS puede producir una modulación inhibitoria descendente del dolor producida por una respuesta excitatoria del SNS. Aún hace falta más investigación científica para explicar los posibles mecanismos analgésicos que produce la técnica de PS

Antimicrobial Resistance Determinants in Genomes and Plasmids from Acinetobacter baumannii Clinical Isolates

Acinetobacter baumannii is a Gram-negative coccoid rod species, clinically relevant as a human pathogen, included in the ESKAPE group. Carbapenem-resistant A. baumannii (CRAB) areconsidered by the Worl Health Organization (WHO) as a critical priority pathogen for the research and development of new antibiotics. Some of the most relevant features of this pathogen are its intrinsic multidrug resistance and its ability to acquire rapid and effective new resistant determinants against last-resort clinical antibiotics, mostly from other ESKAPE species. The presence of plasmids and mobile genetic elements in their genomes contributes to the acquisition of new antimicrobial resistance determinants. However, although A. baumannii has arisen as an important human pathogen, information about these elements is still not well understood. Current genomic analysis availability has increased our ability to understand the microevolution of bacterial pathogens, including point mutations, genetic dissemination, genomic stability, and pan- and core-genome compositions. In this work, we deeply studied the genomes of four clinical strains from our hospital, and the reference strain ATCC®19606TM, which have shown a remarkable ability to survive and maintain their effective capacity when subjected to long-term stress conditions. With that, our aim was presenting a detailed analysis of their genomes, including antibiotic resistance determinants and plasmid composition.This research was funded by ‘Plan Nacional de I+D+i and Instituto de Salud Carlos III (Fondo de Investigaciones Sanitarias PI16/01103 to J.R.-V.), Subdirección General de Redes y Centros de Investigación Cooperativa, Spanish Ministry of Economy and Competitiveness, Spanish Network for Research in Infectious Diseases (REIPI RD12/0015) and (REIPI RD16/0016) co-financed by the European Development Regional Fund “A way to achieve Europe” ERDF and Ministerio de Ciencia e Innovación, Acciones de dinamización «Redes de Investigación» RED2018-102469-T

PERCUTANEOUS ETHANOL INJECTION IN BENIGN NONTOXIC MULTINODULAR GOITER

Introduction: Benign non-toxic multinodular goiter is one of the most common endocrine diseases that affect the current population, and it is, in turn, the endocrine disease that most frequently requires surgical intervention. Objective: To show the results of percutaneous ethanol injection in the treatment of patients with benign non-toxic multinodular goiter in the short and medium term. Methods: A prospective longitudinal study was conducted in patients with benign nontoxic multinodular goiter treated with percutaneous ethanol injection. The categorical variables were described by absolute frequencies and percentages, and for the numerical variables the mean, standard deviation, as well as the minimum and maximum values were calculated. To evaluate the changes between the initial and final volumes of the nodules, the Student's t-test for related samples was used. Results: The mean percentage reduction in the volume of the nodules was 48.23 ± 9.55; 58.05 ± 11.79 and 69.49 ± 13.11; a month, 3 months and 6 months after the treatment, respectively. Clinical success was complete in 67.3%, 75.5%, and 87.8% of the patients, at 1, 3, and 6 months of post-treatment follow-up, respectively. There were no complications. Conclusions: Percutaneous ethanol injection is an alternative to surgery for the treatment of patients with benign non-toxic multinodular goiter, it is safe, effective, with transient adverse effects and very rare complications in the short and medium term.RESUMENIntroducción: El bocio multinodular no tóxico benigno es una de las enfermedadesendocrinas más comunes que afectan a la población actual, y es a su vez la enfermedadendocrina que con mayor frecuencia requiere intervención quirúrgica.Objetivo: Mostrar los resultados de la inyección percutánea de etanol en el tratamiento depacientes con bocio multinodular no tóxico benigno a corto y mediano plazo.Métodos: Se realizó un estudio longitudinal, prospectivo, en pacientes con bociomultinodular no tóxico benigno, tratados con inyección percutánea de etanol. Las variablescategóricas se describieron por frecuencias absolutas y porcentajes y para las numéricas secalculó la media, la desviación estándar, así como el valor mínimo y el máximo. Paraevaluar los cambios entre los volúmenes inicial y final de los nódulos se utilizó la prueba t deStudent para muestras relacionadas.Resultados: La media del porciento de reducción del volumen de los nódulos fue de 48,23 ±9,55; 58,05 ± 11,79 y 69,49 ± 13,11; al mes, 3 meses y 6 meses de realizado el tratamientorespectivamente. El éxito clínico fue completo en el 67,3 %, 75,5 % y el 87,8 % de lospacientes, al mes, 3 meses y 6 meses de seguimiento post tratamiento respectivamente. Nose presentaron complicaciones.Conclusiones: La inyección percutánea de etanol es una alternativa a la cirugía para el tratamiento de los pacientes con bocio multinodular no tóxico benigno, es segura, efectiva, con efectos adversos transitorios y complicaciones muy poco frecuentes a corto y mediano plazo.Introdução: O bócio multinodular benigno não tóxico é uma das doenças endócrinas mais comuns que afetam a população atual, sendo, por sua vez, a doença endócrina que mais frequentemente requer intervenção cirúrgica. Objetivo: Mostrar os resultados da injeção percutânea de etanol no tratamento de pacientes com bócio multinodular benigno não tóxico a curto e médio prazo. Métodos: Foi realizado um estudo longitudinal prospectivo em pacientes com bócio multinodular benigno não tóxico tratados com injeção percutânea de etanol. As variáveis ​​categóricas foram descritas por frequências absolutas e percentuais, e para as variáveis ​​numéricas foram calculados a média, desvio padrão, bem como os valores mínimo e máximo. Para avaliar as mudanças entre os volumes inicial e final dos nódulos, foi utilizado o teste t de Student para amostras relacionadas. Resultados: A redução percentual média no volume dos nódulos foi de 48,23 ± 9,55; 58,05 ± 11,79 e 69,49 ± 13,11; um mês, 3 meses e 6 meses após o tratamento, respectivamente. O sucesso clínico foi completo em 67,3%, 75,5% e 87,8% dos pacientes, em 1, 3 e 6 meses de acompanhamento pós-tratamento, respectivamente. Não houve complicações. Conclusões: A injeção percutânea de etanol é uma alternativa à cirurgia para o tratamento de pacientes com bócio multinodular benigno não tóxico, é segura, eficaz, com efeitos adversos transitórios e complicações muito raras a curto e médio prazo

Acinetobacter Baumannii Maintains Its Virulence After Long-Time Starvation

Acinetobacter baumannii is a cause of healthcare-associated infections. Although A. baumannii is an opportunistic pathogen, its infections are notoriously difficult to treat due to intrinsic and acquired antimicrobial resistance, often limiting effective therapeutic options. A. baumannii can survive for long periods in the hospital environment, particularly on inanimate surfaces. Such environments may act as a reservoir for cross-colonization and infection outbreaks and should be considered a substantial factor in infection control practices. Moreover, clothing of healthcare personnel and gadgets may play a role in the spread of nosocomial bacteria. A link between contamination of hospital surfaces and A. baumannii infections or between its persistence in the environment and its virulence has not yet been established. Bacteria under stress (i.e., long-term desiccation in hospital setting) could conserve factors that favor infection. To investigate whether desiccation and/or starvation may be involved in the ability of certain strains of A. baumannii to retain virulence factors, we have studied five well-characterized clinical isolates of A. baumannii for which survival times were determined under simulated hospital conditions. Despite a considerable reduction in the culturability over time (up to 88% depending on strain and the condition tested), some A. baumannii strains were able to maintain their ability to form biofilms after rehydration, addition of nutrients, and changing temperature. Also, after long-term desiccation, several clinical strains were able to grow in the presence of non-immune human serum as fine as their non-stressed homologs. Furthermore, we also show that the ability of bacterial strains to kill Galleria mellonella larvae does not change although A. baumannii cells were stressed by long-term starvation (up to 60 days). This means that A. baumannii can undergo a rapid adaptation to both the temperature shift and nutrients availability, conditions that can be easily found by bacteria in a new patient in the hospital setting.Research in our laboratory is supported by the Spanish Instituto de Salud Carlos III, Spain (grant PI16/01103 to José Ramos-Vivas) and the Plan Nacional de I+D+i 2008-2011 and Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Economía y Competitividad, Spanish Network for Research in Infectious Diseases (REIPI RD12/0015) - co-financed by European Development Regional Fund "A way to achieve Europe" ERDF. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Evaluating the cancer therapeutic potential of cardiac glycosides

Cardiac glycosides, also known as cardiotonic steroids, are a group of natural products that share a steroid-like structure with an unsaturated lactone ring and the ability to induce cardiotonic effects mediated by a selective inhibition of the Na(+)/K(+)-ATPase. Cardiac glycosides have been used for many years in the treatment of cardiac congestion and some types of cardiac arrhythmias. Recent data suggest that cardiac glycosides may also be useful in the treatment of cancer. These compounds typically inhibit cancer cell proliferation at nanomolar concentrations, and recent high-throughput screenings of drug libraries have therefore identified cardiac glycosides as potent inhibitors of cancer cell growth. Cardiac glycosides can also block tumor growth in rodent models, which further supports the idea that they have potential for cancer therapy. Evidence also suggests, however, that cardiac glycosides may not inhibit cancer cell proliferation selectively and the potent inhibition of tumor growth induced by cardiac glycosides in mice xenografted with human cancer cells is probably an experimental artifact caused by their ability to selectively kill human cells versus rodent cells. This paper reviews such evidence and discusses experimental approaches that could be used to reveal the cancer therapeutic potential of cardiac glycosides in preclinical studie

Whole-genome sequence of Acinetobacter pittii HUMV-6483 isolated from human urine

Acinetobacter pittii strain HUMV-6483 was obtained from urine from an adult patient. We report here its complete genome assembly using PacBio singlemolecule real-time sequencing, which resulted in a chromosome with 4.07 Mb and a circular contig of 112 kb. About 3,953 protein-coding genes are predicted from this assembly

Immediate effects of dry needling on the autonomic nervous system and mechanical hyperalgesia: a randomized controlled trial

Background: Dry needling (DN) is often used for the treatment of muscle pain among physiotherapists. However, little is known about the mechanisms of action by which its effects are generated. The aim of this randomized controlled trial was to determine if the use of DN in healthy subjects activates the sympathetic nervous system, thus resulting in a decrease in pain caused by stress. Methods: Sixty-five healthy volunteer subjects were recruited from the University of Alcala, Madrid, Spain, with an age of 27.78 (SD = 8.41) years. The participants were randomly assigned to participate in a group with deep DN in the adductor pollicis muscle or a placebo needling group. The autonomic nervous system was evaluated, in addition to local and remote mechanical hyperalgesia. Results: In a comparison of the moment at which the needling intervention was carried out with the baseline, the heart rate of the dry needling group significantly increased by 20.60% (SE = 2.88), whereas that of the placebo group increased by 5.33% (SE = 2.32) (p = 0.001, d = 1.02). The pressure pain threshold showed significant differences between both groups, being significantly higher in the needling group (adductor muscle p = 0.001; d = 0.85; anterior tibialis muscle p = 0.022, d = 0.58). Conclusions: This work appears to indicate that dry needling produces an immediate activation in the sympathetic nervous system, improving local and distant mechanical hyperalgesia

Initiators, states and passives in Spanish psych verbs

The goal here is twofold: the first one is to point out the existence of at least two classes of Object Experiencer psychological verbs (henceforth, OEPV) in Spanish with respect to their passive behavior, casting doubt on Landau (2010), who proposes that passivization of OEPVs correlates with the availability of pseudo-passives in a language. The second one is to argue that passives of OEPVs match the aspectual and argumental properties of verbs in such a way that the verbs which do not satisfy the condition that passives must involve events in Spanish must build those events through a repetitive, pluractional interpretation

Hepatitis D double reflex testing of all hepatitis B carriers in low-HBV- and high-HBV/HDV-prevalence countries

Hepatitis D virus (HDV) infection occurs as a coinfection with hepatitis B and increases the risk of hepatocellular carcinoma, decompensated cirrhosis, and mortality compared to hepatitis B virus (HBV) monoinfection. Reliable estimates of the prevalence of HDV infection and disease burden are essential to formulate strategies to find coinfected individuals more effectively and efficiently. The global prevalence of HBV infections was estimated to be 262,240,000 in 2021. Only 1,994,000 of the HBV infections were newly diagnosed in 2021, with more than half of the new diagnoses made in China. Our initial estimates indicated a much lower prevalence of HDV antibody (anti-HDV) and HDV RNA positivity than previously reported in published studies. Accurate estimates of HDV prevalence are needed. The most effective method to generate estimates of the prevalence of anti-HDV and HDV RNA positivity and to find undiagnosed individuals at the national level is to implement double reflex testing. This requires anti-HDV testing of all hepatitis B surface antigen-positive individuals and HDV RNA testing of all anti-HDV-positive individuals. This strategy is manageable for healthcare systems since the number of newly diagnosed HBV cases is low. At the global level, a comprehensive HDV screening strategy would require only 1,994,000 HDV antibody tests and less than 89,000 HDV PCR tests. Double reflex testing is the preferred strategy in countries with a low prevalence of HBV and those with a high prevalence of both HBV and HDV. For example, in the European Union and North America only 35,000 and 22,000 cases, respectively, will require anti-HDV testing annually