Inflammatory response in mixed viral-bacterial community-acquired pneumonia

Background The role of mixed pneumonia (virus¿+¿bacteria) in community-acquired pneumonia (CAP) has been described in recent years. However, it is not known whether the systemic inflammatory profile is different compared to monomicrobial CAP. We wanted to investigate this profile of mixed viral-bacterial infection and to compare it to monomicrobial bacterial or viral CAP. Methods We measured baseline serum procalcitonin (PCT), C reactive protein (CRP), and white blood cell (WBC) count in 171 patients with CAP with definite etiology admitted to a tertiary hospital: 59 (34.5%) bacterial, 66 (39.%) viral and 46 (27%) mixed (viral-bacterial). Results Serum PCT levels were higher in mixed and bacterial CAP compared to viral CAP. CRP levels were higher in mixed CAP compared to the other groups. CRP was independently associated with mixed CAP. CRP levels below 26 mg/dL were indicative of an etiology other than mixed in 83% of cases, but the positive predictive value was 45%. PCT levels over 2.10 ng/mL had a positive predictive value for bacterial-involved CAP versus viral CAP of 78%, but the negative predictive value was 48%. Conclusions Mixed CAP has a different inflammatory pattern compared to bacterial or viral CAP. High CRP levels may be useful for clinicians to suspect mixed CAP

Evaluación integrada de parámetros de resistencia, geofísica y sondeos en terrenos de baja compacidad afectados por procesos kársticos sobreimpuestos

A sinkhole collapse on November 10th 2003 affected the Casa Azul from Calatayud, which produced the later building tear down. Many analyses were carried out to identify the affected area, to look for potential solutions and to evaluate the conditioning and triggering collapse factors. Documentation review, years later, can permit to get some considerations about the representativeness, meaning and obtained results in such moment and to infer conclusions about the potential future urban development of the area. These results permit to identify the contribution from paleokarstic activity reducing the materials compactness in the units located between the substratum and the Quaternary, the later affection to such materials of karst processes and the size and extension of the karstic collapse that affected the analyzed area. The high density of different types of research approaches can permit to evaluate the representativeness of the obtained results from different discrete essays and the interest of the feedback evaluation of such data to define survey campaigns for the geological-geotechnical-geophysical characterization in similar contexts where low resistance materials exist and are affected by current karst activity. El colapso ocurrido el 10 de noviembre de 2003 y que produjo el posterior derribo de la Casa Azul de Calatayud fue objeto de estudios encaminados a la identificación de la extensión de la cavidad original que lo originó, la búsqueda de soluciones que permitieran la estabilización del edificio, y la evaluación de los factores precondicionantes y detonantes del evento ocurrido. La revisión de dicha documentación, años después, permite realizar algunas consideraciones sobre la representatividad, significado y resultados obtenidos en dicho momento e inferir conclusiones para el desarrollo urbano futuro de la zona. Los resultados permiten identificar la contribución de la actividad paleokárstica en la pérdida de compacidad del material transicional substrato-cuaternario, la afección posterior a los materiales recientes localizados en su vertical y la extensión y origen del evento kárstico posterior que afecta a la serie previa de la zona. La amplia densidad de datos en la zona permite también realizar una evaluación de la representatividad de los resultados obtenidos por aproximaciones discretas y el interés de la retroalimentación entre ellos para definir campañas de caracterización geológico-geotécnica-geofísica en contextos de baja resistencia con procesos asociados de karst actual

Language attitudes, linguistic authority and independence in 21st century Catalonia

peer-reviewedIn a context of increasing linguistic and cultural diversity and political uncertainty in Catalonia, this article reports on a research project which set out to explore the attitudes of members of independence organisations operating in the city of Girona toward the Catalan and Spanish languages. This study approaches language attitudes through the theoretical lens of linguistic authority, in particular, the concepts of anonymity and authenticity. The data, gathered from six focus groups, provide an insight on the nature of linguistic authority in contemporary Catalonia. Two themes emerge in the informants’ discussion of Catalan and Spanish: ‘twenty-first Century Catalanisme’ and ‘Embracing Linguistic Diversity’. The comments of the respondents indicate that, against the backdrop of the independence process in the region, bilingualism and multilingualism have become highly valued in the territory. In addition, this study suggests that a fuller understanding of the situation in Catalonia may be facilitated by qualitative approaches, which explore attitudes in-depth

Inflammatory response in mixed viral-bacterial community-acquired pneumonia

BACKGROUND: The role of mixed pneumonia (virus + bacteria) in community-acquired pneumonia (CAP) has been described in recent years. However, it is not known whether the systemic inflammatory profile is different compared to monomicrobial CAP. We wanted to investigate this profile of mixed viral-bacterial infection and to compare it to monomicrobial bacterial or viral CAP. METHODS: We measured baseline serum procalcitonin (PCT), C reactive protein (CRP), and white blood cell (WBC) count in 171 patients with CAP with definite etiology admitted to a tertiary hospital: 59 (34.5%) bacterial, 66 (39.%) viral and 46 (27%) mixed (viral-bacterial). RESULTS: Serum PCT levels were higher in mixed and bacterial CAP compared to viral CAP. CRP levels were higher in mixed CAP compared to the other groups. CRP was independently associated with mixed CAP. CRP levels below 26 mg/dL were indicative of an etiology other than mixed in 83% of cases, but the positive predictive value was 45%. PCT levels over 2.10 ng/mL had a positive predictive value for bacterial-involved CAP versus viral CAP of 78%, but the negative predictive value was 48%. CONCLUSIONS: Mixed CAP has a different inflammatory pattern compared to bacterial or viral CAP. High CRP levels may be useful for clinicians to suspect mixed CAP

Double-balloon catheter for induction of labour in women with a previous cesarean section, could it be the best choice?

INTRODUCTION: We analysed the efficacy and safety of double-balloon catheter for cervical ripening in women with a previous cesarean section and which were the most important variables associated with an increased risk of repeated cesarean delivery. MATERIALS AND METHODS: We designed an observational retrospective study of 418 women with unfavourable cervices (Bishop Score <5), a prior cesarean delivery, and induction of labour with a double-balloon catheter. Baseline maternal data and perinatal outcomes were recorded for a descriptive, bivariate, and multivariate analysis. A p value <0.05 was considered statistically significant. RESULTS: Most women improved their initial Bishop Score (89.5%) although only a 20.8% of them went into spontaneous active labour. Finally, 51.4% of the women achieved a vaginal delivery. Five cases of intrapartum uterine rupture (1.2%) occurred. After multivariate analysis, main risk factors for repeated cesarean section were dystocia in the previous pregnancy (OR 1.744; CI 95% 1.066–2.846), the absence of previous vaginal delivery (OR 2.590; CI 95% 1.066–6.290), suspected fetal macrosomia (OR 2.410; CI 95% 0.959–6.054), and duration of oxytocin induction period (OR 1.005; CI 95% 1.004–1.006). The area under the curve was 0.789 (p < 0.001). CONCLUSIONS: Double-balloon catheter seems to be safe and effective for cervical ripening in women with a previous cesarean delivery and unfavourable cervix. In our study, most women could have a vaginal delivery in spite of their risk factors for cesarean delivery. A multivariate model based on some clinical variables has moderate predictive value for intrapartum cesarean section

Nanoecotoxicity effects of engineered silver and gold nanoparticles in aquatic organisms

Engineered nanoparticles (ENPs) are increasingly being incorporated into commercial products. A better understanding is required of their environmental impacts in aquatic ecosystems. This review deals with the ecotoxicity effects of silver and gold ENPs (AgNPs and AuNPs) in aquatic organisms, and considers the means by which these ENPs enter aquatic environments, their aggregation status and their toxicity. Since ENPs are transported horizontally and vertically in the water column, we discuss certain factors (e.g., salinity and the presence of natural organic materials), as they cause variations in the degree of aggregation, size range and ENP toxicity. We pay special attention to oxidative stress induced in organisms by ENPs. We describe some of the main analytical methods used to determine reactive oxygen species, antioxidant enzyme activity, DNA damage, protein modifications, lipid peroxidation and relevant metabolic activities. We offer an overview of the mechanisms of action of AgNPs and AuNPs and the ways that relevant environmental factors can affect their speciation, agglomeration or aggregation, and ultimately their bio-availability to aquatic organisms. Finally, we discuss similarities and differences in the adverse effects of ENPs in freshwater and salt-water systems.The authors thank the Regional Government of Andalusia (P09-FQM-4554) and the Spanish national government [CSIC (201060E005 NPHIPER)] for financial support.Peer reviewe

Assesing toxicity of citrate-gold nanoparticles at different marine trophic levels (microalgae, copepods and bivalve mollusks)

Ponencia presentada en la NanoSpain Conference, celebrada en Santander del 27 de febrero al 1 de marzo de 2012.Engineered nanoparticles (ENPs) may offer benefits to society in general, although they sometimes inherently have unintended effects on ecosystems. As a consequence, assessment of the environmental safety of ENPs has become a major issue worldwide [1]. Within the metallic ENPs, gold nanoparticles have been used extensively in drug delivery, gene therapy, biosensing and contrast agent for imaging [2]. However, studies about the effects of gold nanoparticles are limited and they are specially focused on ¿in vitro¿ experiments rather than ¿in vivo¿ systems. Additionally, estuaries and coastal ecosystems are the final receptors of substances dumped in the environment wherefore the effects of these substances should be tested in representative site specific organisms. In order to assess the effect of gold-citrate nanoparticles on aquatic ecosystems, toxicity tests were carried out in three groups of model organisms belonging to different trophic levels: the marine microalgae species Cylindrotheca closterium, Chlorella autotrophyca, Phaeodactylum tricornutum, Pleurochrysis pseudoroscoffensis and Rhodomonas salina (Fig. 1), the copepod, Tisbe battagliai (Fig. 2) and the clam Ruditapes philippinarum (Fig. 3). The gold-citrate NPs employed were citrate reduced AuNPs in the range of 20 ¿ 30 nm, or soluble gold, H(AuCl4) as positive control. For the toxicity test with microalgae, the selected endpoint was population growth after 72 hours of exposure. The cells were incubated in batch cultures of 50 mL in artificial seawater enriched with simple medium (nitrate, phosphate, silica) and exposed under continuous light conditions at 20±1ºC to different dissolved Au or NPs concentrations. Growths of experimental populations were compared with controls, and concentrations which imply an inhibition of 50% respect the controls (EC50%) are calculated (Fig. 4). Dissolved Au toxicity ranged from 0.052 ± 0.001 mg¿L-1 for Rhodomonas salina to 0.50 ± 0.15 mg¿L-1 for Chlorella autotrophyca. Concentrations at ecologically significant values for NPs (up to 0.3 mg¿L-1) did not imply growth inhibitions over 50%. For copepods, nauplii (< 24 h-old) were exposed (48 h) to increasing concentrations of Au-NPs in 12-well plates (5 ml/well, 4 nauplii/well and 5 replicates/concentration) under the above described laboratory conditions [3]. The results are shown in Figure 5. The clam, Ruditapes philippinarum was exposed for 28 days to two Au-NPs concentrations: 6 and 30 ¿g·L-1. Clams were collected different at sampling points and target tissues (gills, digestive gland and mantel) were dissected and stored at -80ºC until their analysis. No significant mortality was recorded during the experiment and bioaccumulation in the digestive gland along the experiment was measured (Figure 6). In summary, no acute toxicity was recorded at ecological relevant concentrations for assayed Au-NPs. Nevertheless, further research should be necessary to know the effect of chronic exposure to these NPs and to improve the knowledge about their environmental risk assessment.Peer Reviewe