Inmunopatogenia de la neumonía vírica

La neumonía adquirida en la comunidad es una de las patologías que causa más morbimortalidad a nivel mundial, aproximadamente el 10% de los pacientes con neumonía desarrollan enfermedad grave que requiere el ingreso en UCI. Un tercio de las neumonías son producidas por virus, siendo el más frecuente el virus de la gripe, aunque los nuevos métodos de diagnóstico molecular están permitiendo diagnosticar cada vez más neumonías causadas por virus distintos al gripal (rinovirus, virus respiratorio sincitial, etc.) En el año 2009 apareció un nuevo virus gripal, el virus A/H1N1pdm09, el cual causo una pandemia durante la temporada 2009-10 y en la temporada siguiente se estacionalizó siendo el responsable de la epidemia anual gripal en Europa. En este trabajo se reclutaron pacientes con neumonía viral grave durante la temporada postpandémica (2010-2011) con el objetivo de estudiar el papel que juega el sistema inmune en la gravedad y mortalidad de la neumonía vírica grave, así como analizar los factores diferenciales según la etiología de la neumonía. Para lograr estos objetivos se midieron los niveles de diversas citoquinas, de todos los isotipos de inmunoglobulinas y de todas las subclases de la IgG en el plasma de los pacientes. Los pacientes con neumonía gripal grave presentan frecuentemente inmunosupresión previa. Los niveles de citoquinas en el plasma de los pacientes se encuentran elevados mientras que por el contrario, sus niveles de inmunoglobulinas están disminuidos. Dentro de las inmunoglobulinas, la IgM y la IgG2 juegan un papel protector, ya que los pacientes con menores niveles de estas inmunoglobulinas muestran menor tiempo de supervivencia. Además los niveles de IgM en plasma son un factor predictor de mortalidad. La neumonía grave por virus distintos al gripal ha sido escasamente estudiada. Este trabajo ha permitido definir importantes características sobre los pacientes afectados por esa patología, como son que presentan mayor edad que los pacientes infectados por el virus gripal y un peor estado basal con numerosas comorbilidades, pese a lo cual la tasa de mortalidad es muy inferior a la de la neumonía gripal. Por primera vez se han identificado dos citoquinas, MCP-1 y MIP-1ß, y una inmunoglobulina, IgA, cuyos niveles permiten diferenciar si el paciente está infectado por el virus de la gripe u otro virus.Departamento de Anatomía Patológica, Microbiología, Medicina Preventiva y Salud Pública, Medicina legal y Forens

Clinical Study First Attempt to Implement Ophthalmia Neonatorum Prophylaxis in Angola: Microorganisms, Efficacy, and Obstacles

properly cited. Purpose. To determine the efficacy of povidone-iodine (P-I) prophylaxis for ophthalmia neonatorum (ON) in Angola and to document maternal prevalence and mother-to-child transmission rates. Methods. Endocervical samples from mothers ( = 317) and newborn conjunctival smears ( = 245) were analysed by multiplex polymerase chain reaction (PCR) for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Mycoplasma genitalium (MG). Newborns were randomized into a noninterventional group and an interventional group that received a drop of P-I 2.5% bilaterally after conjunctival smear collection. Mothers were trained to identify signs of ON and attend a follow-up visit. Results. Forty-two newborns had ocular pathology, and 11 (4.4%) had clinical signs of ON at the time of delivery. Maternal PCR was positive for MG ( = 19), CT ( = 8), and NG ( = 2). Six newborns were positive for CT ( = 4), MG ( = 2), and NG ( = 1). Mother-to-child transmission rates were 50% for CT and NG and 10.5% for MG. Only 16 newborns returned for follow-up. Conclusions. Lack of maternal compliance prevented successful testing of prophylactic P-I efficacy in ON prevention. Nevertheless, we documented the prevalence and mother-to-child transmission rates for CT, NG, and MG. These results emphasize the need to develop an effective Angolan educational and prophylactic ON program

First Attempt to Implement Ophthalmia Neonatorum Prophylaxis in Angola: Microorganisms, Efficacy, and Obstacles

Purpose. To determine the efficacy of povidone-iodine (P-I) prophylaxis for ophthalmia neonatorum (ON) in Angola and to document maternal prevalence and mother-to-child transmission rates. Methods. Endocervical samples from mothers n=317 and newborn conjunctival smears n=245 were analysed by multiplex polymerase chain reaction (PCR) for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Mycoplasma genitalium (MG). Newborns were randomized into a noninterventional group and an interventional group that received a drop of P-I 2.5% bilaterally after conjunctival smear collection. Mothers were trained to identify signs of ON and attend a follow-up visit. Results. Forty-two newborns had ocular pathology, and 11 (4.4%) had clinical signs of ON at the time of delivery. Maternal PCR was positive for MG n=19, CT n=8, and NG n=2. Six newborns were positive for CT n=4, MG n=2, and NG n=1. Mother-to-child transmission rates were 50% for CT and NG and 10.5% for MG. Only 16 newborns returned for follow-up. Conclusions. Lack of maternal compliance prevented successful testing of prophylactic P-I efficacy in ON prevention. Nevertheless, we documented the prevalence and mother-to-child transmission rates for CT, NG, and MG. These results emphasize the need to develop an effective Angolan educational and prophylactic ON program

Viral Etiology of Chronic Obstructive Pulmonary Disease Exacerbations during the A/H1N1pdm09 Pandemic and Postpandemic Period

Viral infections are one of the main causes of acute exacerbations of chronic obstructive pulmonary disease (AE-COPD). Emergence of A/H1N1pdm influenza virus in the 2009 pandemic changed the viral etiology of exacerbations that were reported before the pandemic. The aim of this study was to describe the etiology of respiratory viruses in 195 Spanish patients affected by AE-COPD from the pandemic until the 2011-12 influenza epidemic. During the study period (2009–2012), respiratory viruses were identified in 48.7% of samples, and the proportion of viral detections in AE-COPD was higher in patients aged 30–64 years than ≥65 years. Influenza A viruses were the pathogens most often detected during the pandemic and the following two influenza epidemics in contradistinction to human rhino/enteroviruses that were the main viruses causing AE-COPD before the pandemic. The probability of influenza virus detection was 2.78-fold higher in patients who are 30–64 years old than those ≥65. Most respiratory samples were obtained during the pandemic, but the influenza detection rate was higher during the 2011-12 epidemic. There is a need for more accurate AE-COPD diagnosis, emphasizing the role of respiratory viruses. Furthermore, diagnosis requires increased attention to patient age and the characteristics of each influenza epidemic

Eosinophil as a Protective Cell in S. aureus Ventilator-Associated Pneumonia

Cell counts of leukocytes subpopulations are demonstrating to have an important value in predicting outcome in severe infections. We evaluated here the render of leukogram counts to predict outcome in patients with ventilator-associated pneumonia (VAP) caused by Staphylococcus aureus. Data from patients admitted to the ICU of Hospital Clínico Universitario de Valladolid from 2006 to 2011 with diagnosis of VAP caused by S. aureus were retrospectively collected for the study (n=44). Leukocyte counts were collected at ICU admission and also at VAP diagnosis. Our results showed that nonsurvivors had significant lower eosinophil counts at VAP diagnosis. Multivariate Cox regression analysis performed by the Wald test for forward selection showed that eosinophil increments from ICU admission to VAP diagnosis and total eosinophil counts at VAP diagnosis were protective factors against mortality in the first 28 days following diagnosis: (HR [CI 95%], P): (0.996 [0.993–0.999], 0.010); (0.370 [0.180–0.750], 0.006). Patients with eosinophil counts <30 cells/mm3 at diagnosis died earlier. Eosinophil counts identified survivors: (AUROC [CI 95%], P): (0.701 [0.519–0.882], 0.042). Eosinophil behaves as a protective cell in patients with VAP caused by S. aureus

Vertical Transmission of Bacterial Eye Infections, Angola, 2011–2012

To determine transmission rates for neonatal conjunctivitis causative microorganisms in Angola, we analyzed 312 endocervical and 255 conjunctival samples from mothers and newborns, respectively, during 2011–2012. Transmission rates were 50% for Chlamydia trachomatis and Neisseria gonorrhoeae and 10.5% for Mycoplasma genitalium. Possible pathogenic effects of M. genitalium in children’s eyes are unknown

Ash from forestal fires in coastal environments: chemical characterization and efects in microbial communities

Oral communicationThe frequency of bushfires will enhance as a result of increasing occurrence of extreme heat and drought periods related to global warming. A fraction of the combusted matter generated during these episodes may reach coastal ecosystems while washed away by runoff waters. Nevertheless, the nature of this material and their ecological impact on the planktonic communities remains largely unknown. In this study, we investigated the impact of large fires that occurred in Galicia (NW of the Iberian Peninsula) in October 2017, with the aim of: a) chemically characterizing the materials produced during the event reaching the adjacent coastal areas and b) experimentally assessing the response of bacteria and phytoplankton to these episodic inputs. Significant increases in the concentrations of substances of pyrogenic origin, inorganic and organic nutrients together with an almost 6-fold increase in Chl a were measured at the stations located closest to the coast coinciding with the first strong rains after the fires. Ash addition experiments carried out in summer and winter showed a positive response of bacterial abundance (1.5-fold increase) and phytoplankton Chl a (2.6-fold increase) when these communities were limited by nutrients. No negative effects of the water-soluble fraction of ash were observed in any of the experiments conducted in this study.ASL

De nuestras diferencias no hagamos discriminaciones

La finalidad es dar respuesta a una situación de violencia, discriminación y racismo en el centro escolar. Sus objetivos son mantener y crear relaciones positivas con otras personas y grupos sociales, rechazar cualquier tipo de discriminación por sexo, raza, creencia o clase social, aprender la importancia de valores como igualdad, solidaridad, cooperación, tolerancia y respeto, y colaborar en la realización de actividades en grupo. Sigue una metodología basada en poner en práctica habilidades de autoestima y autocontrol, crear un clima de seguridad emocional en el aula, plantear formas no violentas de resolución de conflictos, y hacerles conocer otras culturas y formas de vivir diferentes a las suyas. Desarrolla contenidos referidos al respeto a sí mismos, intercambio comunicativo, habilidades básicas de interacción social, armonización de intereses individuales y colectivos, los conflictos y su solución. La evaluación se basa en la observación directa, cuestionarios elaborados para valorar el desarrollo de la tolerancia y los prejuicios étnicos, y cuestionarios sociométricos para evaluar la relación entre compañeros.Madrid (Comunidad Autónoma). Consejería de Educación y CulturaMadridMadrid (Comunidad Autónoma). Subdirección General de Formación del Profesorado. CRIF Las Acacias; General Ricardos 179 - 28025 Madrid; Tel. + 34915250893ES