Mortality trends in an ambulatory multidisciplinary heart failure unit from 2001 to 2018

To assess mortality trends at 1 and 3 years from 2001 to 2018 in a real-life cohort of HF outpatients from different etiologies with depressed and preserved LVEF. A total of 2368 consecutive patients with HF (mean age 66.4 ± 12.9 years, 71% men, 15.4% with preserved LVEF) admitted to a HF clinic from August 2001 to September 2018 were included in the study. Patients were divided into five quintiles (Q) according to the period of admission. Trends for all-cause and cardiovascular mortality from Q1 to Q5 were assessed by linear regression. Patients with LVEF < 50% had a progressive decrease in the rates of all-cause and cardiovascular death at 1 year (12.1% in Q1 to 6.5% in Q5, p = 0.003; and 8.4% in Q1 to 3.8% in Q5, p = 0.007, respectively) and 3 years (30.5% in Q1 to 17.0% in Q5, p = 0.003; and 23.9% in Q1 to 9.8% in Q5, p = 0.003, respectively). These trends remained significant after adjusting for clinical characteristics and risk. No significant trend in mortality was observed in patients with LVEF ≥ 50%. In a cohort of real-life ambulatory patients with HF, mortality progressively declined in patients with LVEF < 50%, but the same trend was not observed in patients with preserved LVEF

MicroRNA Profile of HCV Spontaneous Clarified Individuals, Denotes Previous HCV Infection

Factors involved in the spontaneous cleareance of a hepatitis C (HCV) infection are related to both HCV and the interaction with the host immune system, but little is known about the consequences after a spontaneous resolution. The main HCV extrahepatic reservoir is the peripheral blood mononuclear cells (PBMCs), and their transcriptional profile provides us information of innate and adaptive immune responses against an HCV infection. MicroRNAs regulate the innate and adaptive immune responses, and they are actively involved in the HCV cycle. High Throughput sequencing was used to analyze the miRNA profiles from PBMCs of HCV chronic naïve patients (CHC), individuals that spontaneously clarified HCV (SC), and healthy controls (HC). We did not find any differentially expressed miRNAs between SC and CHC. However, both groups showed similar expression differences (21 miRNAs) with respect to HC. This miRNA signature correctly classifies HCV-exposed (CHC and SC) vs. HC, with the has-miR-21-3p showing the best performance. The potentially targeted molecular pathways by these 21 miRNAs mainly belong to fatty acids pathways, although hippo signaling, extracellular matrix (ECM) interaction, proteoglycans-related, and steroid biosynthesis pathways were also altered. These miRNAs target host genes involved in an HCV infection. Thus, an HCV infection promotes molecular alterations in PBMCs that can be detected after an HCV spontaneous resolution, and the 21-miRNA signature is able to identify HCV-exposed patients (either CHC or SC).Funding: This work has been funded by the Instituto de Salud Carlos III (Subdirección General de Evaluación) (grant number CP14/0010) Fondo de Investigación Sanitaria (FIS) (grant numbers MPY 1404/15, MPY 1144/16, and MPY 382/18), and Integrated Projects of Excellence (grant number PIE15/00079).S

HCV-coinfection is related to an increased HIV-1 reservoir size in cART-treated HIV patients: a cross-sectional study

In HIV-1/HCV-coinfected patients, chronic HCV infection leads to an increased T-lymphocyte immune activation compared to HIV-monoinfected patients, thereby likely contributing to increase HIV-1 reservoir that is the major barrier for its eradication. Our objective was to evaluate the influence of HCV coinfection in HIV-1 viral reservoir size in resting (r) CD4+ T-cells (CD25-CD69-HLADR-). Multicenter cross-sectional study of 97 cART-treated HIV-1 patients, including 36 patients with HIV and HCV-chronic co-infection without anti-HCV treatment, 32 HIV patients with HCV spontaneous clearance and 29 HIV-monoinfected patients. rCD4+ T-cells were isolated and total DNA was extracted. HIV viral reservoir was measured by Alu-LTR qPCR. Differences between groups were calculated with a generalized linear model. Overall, 63.9% were men, median age of 41 years and Caucasian. Median CD4+ and CD8+ T-lymphocytes were 725 and 858 cells/mm 3 , respectively. CD4+ T nadir cells was 305 cells/mm 3 . Proviral HIV-1 DNA size was significantly increased in chronic HIV/HCV-coinfected compared to HIV-monoinfected patients (206.21 ± 47.38 vs. 87.34 ± 22.46, respectively; P = 0.009), as well as in spontaneously clarified HCV co-infected patients when compared to HIV-monoinfected individuals (136.20 ± 33.20; P = 0.009). HIV-1/HCV co-infected patients showed a larger HIV-1 reservoir size in comparison to HIV-monoinfected individuals. This increase could lead to a greater complexity in the elimination of HIV-1 reservoir in HIV-1/HCV-coinfected individuals, which should be considered in the current strategies for the elimination of HIV-1 reservoir.Financial support was provided by the Instituto de Salud Carlos III to VB (PI15CIII/00031), by the Spanish Ministry of Economy and Competitiveness to MC (SAF2016–78480-R) and The SPANISH AIDS Research Network RD16CIII/0002/0001, RD16CIII/0002/0002 and RD16/0025/0013 - ISCIII – FEDER. MRLP is supported by ISCIII - Subdirección General de Evaluacion and European Funding for Regional Development (FEDER) (PIE 13/00040 and RD12/0017/0017 RETIC de SIDA). C.P. is supported by the Portuguese Fundação para a Ciência e Tecnologia (FCT) (grant number SFRH/ BPD/77448/2011 is part of the EDCTP2 programme supported by the European Union). V.B., A.F.R. and N.R. are supported by the Miguel Servet programme from Fondo de Investigación Sanitaria (ISCIII) (grant number CP13/00098, CP14/CIII/00010 and CP14/00198, respectively)

Buenas prácticas lecheras : guía para la implementación en la producción de leche bovina

Las “Buenas Prácticas Agropecuarias” hacen referencia a una producción sana, segura y amigable con el ambiente, los animales y las personas. Son numerosos los temas que abarca e involucra la producción primaria de leche: las vacas y su manejo, el ambiente donde producen y las personas que cumplen distintas funciones para potenciar la producción lechera independientemente del sistema y escala, impactando directamente en toda la cadena láctea (desde la producción primaria, la industria y la comercialización) corresponsables de transformar la cosecha de la ubre y ofrecerla al consumidor de forma fluida o a través de derivados lácteos. De acuerdo a las tendencias actuales los consumidores tienen interés en adquirir productos no sólo de acuerdo a su calidad sino también a cómo fueron producidos. La calidad entonces es reconocida en el producto en sí y en todo su proceso desde la producción primaria. En respuesta a estas exigencias surge la Red de Buenas Prácticas Agropecuarias (BPA) como resultado de un proceso de intercambio entre las principales entidades públicas y privadas de Argentina, contando actualmente con más de 90 instituciones. Tiene la misión de contribuir al desarrollo sostenible promoviendo las buenas prácticas agropecuarias en diálogo con la comunidad. Dispone de diversas comisiones entre las que se encuentra la de lechería, que aborda y promueve la implementación de las BPA en los tambos. Los integrantes de la Comisión de Lechería de la Red BPA sentimos una gran satisfacción al presentar esta guía de buenas prácticas lecheras destinada a tamberos, profesionales del agro, entusiastas lecheros, operarios y aquellos inquietos, preocupados y ocupados por lograr leche sana. El presente documento contiene 13 capítulos escritos con terminología sencilla, entendible y adecuada para motivar al lector a aplicar o mejorar las BPA en todos los sectores y categorías de animales que involucra el tambo. Esta guía de buenas prácticas es una herramienta que permite el aseguramiento de la calidad de la leche en los tambos e introduce un cambio de paradigma: pasar de sistemas enfocados sólo en la calidad final de la leche a sistemas proactivos basados en el control, el orden y la mejora de procesos, trabajando en la prevención con capacidad de planificación y anticipación, y manteniendo una coherencia hacia las normas internacionales, buscando así la excelencia de su eslabón primario, el tambo.EEA PergaminoFil: Aimar, María Verónica. Universidad Nacional de Córdoba. Facultad de Ciencias Agropecuarias; ArgentinaFil: Amalfi, José María. Instituto Nacional de Asociativismo y Economía Social; ArgentinaFil: Campos Carlés, Silvina. Confederación Intercooperativa Agropecuaria - CONINAGRO; ArgentinaFil: Charlón, Verónica. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Rafaela; ArgentinaFil: Cristiano, Gabriela. Universidad Nacional del Sur. Departamento de Economía; ArgentinaFil: Delbino, Fernando. Universidad Nacional del Litoral. Facultad de Ciencias Agrarias; ArgentinaFil: Diaz Cano, Muncha. Sociedad Rural Argentina; ArgentinaFil: Estevez Acuña, Rodrigo Rubén. Ministerio de Agricultura y Ganadería de la Provincia de Córdoba. Departamento de Producción Láctea; ArgentinaFil: Gigli, Isabel. Universidad Nacional de La Pampa; ArgentinaFil: Glauber, Claudio Eduardo. Servicio Nacional de Sanidad y Calidad Agroalimentaria (SENASA); ArgentinaFil: Guillermón, José. Provincia de Santiago del Estero. Ministerio de Producción, Recursos Naturales, Forestación y Tierras. Programa Ganadero Provincial (PROCARNE); ArgentinaFil: Ibargoyen, José María. Provincia de Buenos Aires. Ministerio de Desarrollo Agrario. Dirección de Lechería; ArgentinaFil: Iorio, Jesica Daniela. Universidad de Buenos Aires. Facultad de Agronomía; ArgentinaFil: Jaureguiberry, Horacio Sebastián. Provincia de Entre Ríos. Ministerio de Producción, Turismo y Desarrollo Económico. Dirección General de Producción Animal. Coordinación de Lechería; ArgentinaFil: Jarkowsky, Andrés. Fundación para la Promoción y Desarrollo de la Cadena Láctea Argentina; ArgentinaFil: Lesman, María de los Ángeles. Universidad Nacional del Litoral. Facultad de Ciencias Agrarias; ArgentinaFil: Llano, Agustina. Ministerio de Agricultura, Ganadería y Pesca de la Nación. Dirección Nacional de Lechería; ArgentinaFil: Mazzitelli, José. Cámara Empresaria de Medio Ambiente; ArgentinaFil: Moro, Santiago. Consorcios Regionales de Experimentación Agrícola; ArgentinaFil: Mozeris, Gustavo. Fundación para la Promoción y Desarrollo de la Cadena Láctea Argentina; ArgentinaFIL: Negri Rodriguez, Livia María. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Investigación Tecnología de Alimentos; ArgentinaFil: Olivieri, Daniela Ivana. Provincia de La Pampa. Ministerio de la Producción. Dirección de Ganadería; ArgentinaFil: Osan, Oscar. Universidad Nacional del Litoral. Facultad de Ciencias Agrarias; ArgentinaFil: Pérez, Gabriela Guadalupe. Provincia de Santa Fé. Ministerio de Producción, Ciencia y Tecnología. Dirección Provincial de Producción Lechera y Apícola; ArgentinaFil: Preumayr, Fernando Martín. Proyecto Factor Humano en Tambo; ArgentinaFil: Serrano, Pedro. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Pergamino. Agencia de Extensión Rural Coronel Brandsen; ArgentinaFil: Tonero, María Eugenia. Provincia de Santa Fé. Ministerio de Producción, Ciencia y Tecnología. Dirección Provincial de Producción Lechera y Apícola; ArgentinaFil: Trombert, José María. Centro de la Industria Lechera Argentina; ArgentinaFil: Trombert, José María. Colegio de Ingenieros Agrónomos de Santa Fe; ArgentinaFil: Troya, Paula. Fundación de Investigación y Desarrollo Agropecuario; ArgentinaFil: Urruspuru, María Luz. Proyecto Factor Humano en Tambo; ArgentinaFil: Varaldo, Estefanía. Cluster Lechero Regional; Argentin

A facility and community-based assessment of scabies in rural Malawi.

Background Scabies is a neglected tropical disease of the skin, causing severe itching, stigmatizing skin lesions and systemic complications. Since 2015, the DerMalawi project provide an integrated skin diseases clinics and Tele-dermatology care in Malawi. Clinic based data suggested a progressive increase in scabies cases observed. To better identify and treat individuals with scabies in the region, we shifted from a clinic-based model to a community based outreach programme. Methodology/principal findings From May 2015, DerMalawi project provide integrated skin diseases and Tele-dermatological care in the Nkhotakota and Salima health districts in Malawi. Demographic and clinical data of all patients personally attended are recorded. Due to a progressive increase in the number of cases of scabies the project shifted to a community-based outreach programme. For the community outreach activities, we conducted three visits between 2018 to 2019 and undertook screening in schools and villages of Alinafe Hospital catchment area. Treatment was offered for all the cases and school or household contacts. Scabies increased from 2.9% to 39.2% of all cases seen by the DerMalawi project at clinics between 2015 to 2018. During the community-based activities approximately 50% of the population was assessed in each of three visits. The prevalence of scabies was similar in the first two rounds, 15.4% (2392) at the first visit and 17.2% at the second visit. The prevalence of scabies appeared to be lower (2.4%) at the third visit. The prevalence of impetigo appeared unchanged and was 6.7% at the first visit and 5.2% at the final visit. Conclusions/significance Prevalence of scabies in our setting was very high suggesting that scabies is a major public health problem in parts of Malawi. Further work is required to more accurately assess the burden of disease and develop appropriate public health strategies for its control

Higher COVID-19 pneumonia risk associated with anti-IFN-α than with anti-IFN-ω auto-Abs in children

We found that 19 (10.4%) of 183 unvaccinated children hospitalized for COVID-19 pneumonia had autoantibodies (auto-Abs) neutralizing type I IFNs (IFN-alpha 2 in 10 patients: IFN-alpha 2 only in three, IFN-alpha 2 plus IFN-omega in five, and IFN-alpha 2, IFN-omega plus IFN-beta in two; IFN-omega only in nine patients). Seven children (3.8%) had Abs neutralizing at least 10 ng/ml of one IFN, whereas the other 12 (6.6%) had Abs neutralizing only 100 pg/ml. The auto-Abs neutralized both unglycosylated and glycosylated IFNs. We also detected auto-Abs neutralizing 100 pg/ml IFN-alpha 2 in 4 of 2,267 uninfected children (0.2%) and auto-Abs neutralizing IFN-omega in 45 children (2%). The odds ratios (ORs) for life-threatening COVID-19 pneumonia were, therefore, higher for auto-Abs neutralizing IFN-alpha 2 only (OR [95% CI] = 67.6 [5.7-9,196.6]) than for auto-Abs neutralizing IFN-. only (OR [95% CI] = 2.6 [1.2-5.3]). ORs were also higher for auto-Abs neutralizing high concentrations (OR [95% CI] = 12.9 [4.6-35.9]) than for those neutralizing low concentrations (OR [95% CI] = 5.5 [3.1-9.6]) of IFN-omega and/or IFN-alpha 2

CARB-ES-19 Multicenter Study of Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli From All Spanish Provinces Reveals Interregional Spread of High-Risk Clones Such as ST307/OXA-48 and ST512/KPC-3

ObjectivesCARB-ES-19 is a comprehensive, multicenter, nationwide study integrating whole-genome sequencing (WGS) in the surveillance of carbapenemase-producing K. pneumoniae (CP-Kpn) and E. coli (CP-Eco) to determine their incidence, geographical distribution, phylogeny, and resistance mechanisms in Spain.MethodsIn total, 71 hospitals, representing all 50 Spanish provinces, collected the first 10 isolates per hospital (February to May 2019); CPE isolates were first identified according to EUCAST (meropenem MIC &gt; 0.12 mg/L with immunochromatography, colorimetric tests, carbapenem inactivation, or carbapenem hydrolysis with MALDI-TOF). Prevalence and incidence were calculated according to population denominators. Antibiotic susceptibility testing was performed using the microdilution method (EUCAST). All 403 isolates collected were sequenced for high-resolution single-nucleotide polymorphism (SNP) typing, core genome multilocus sequence typing (cgMLST), and resistome analysis.ResultsIn total, 377 (93.5%) CP-Kpn and 26 (6.5%) CP-Eco isolates were collected from 62 (87.3%) hospitals in 46 (92%) provinces. CP-Kpn was more prevalent in the blood (5.8%, 50/853) than in the urine (1.4%, 201/14,464). The cumulative incidence for both CP-Kpn and CP-Eco was 0.05 per 100 admitted patients. The main carbapenemase genes identified in CP-Kpn were blaOXA–48 (263/377), blaKPC–3 (62/377), blaVIM–1 (28/377), and blaNDM–1 (12/377). All isolates were susceptible to at least two antibiotics. Interregional dissemination of eight high-risk CP-Kpn clones was detected, mainly ST307/OXA-48 (16.4%), ST11/OXA-48 (16.4%), and ST512-ST258/KPC (13.8%). ST512/KPC and ST15/OXA-48 were the most frequent bacteremia-causative clones. The average number of acquired resistance genes was higher in CP-Kpn (7.9) than in CP-Eco (5.5).ConclusionThis study serves as a first step toward WGS integration in the surveillance of carbapenemase-producing Enterobacterales in Spain. We detected important epidemiological changes, including increased CP-Kpn and CP-Eco prevalence and incidence compared to previous studies, wide interregional dissemination, and increased dissemination of high-risk clones, such as ST307/OXA-48 and ST512/KPC-3

Pine wilt disease: what do we know from proteomics?

Abstract Pine wilt disease (PWD) is a devastating forest disease caused by the pinewood nematode (PWN), Bursaphelenchus xylophilus, a migratory endoparasite that infects several coniferous species. During the last 20 years, advances have been made for understanding the molecular bases of PWN-host trees interactions. Major advances emerged from transcriptomic and genomic studies, which revealed some unique features related to PWN pathogenicity and constituted fundamental data that allowed the development of postgenomic studies. Here we review the proteomic approaches that were applied to study PWD and integrated the current knowledge on the molecular basis of the PWN pathogenicity. Proteomics has been useful for understanding cellular activities and protein functions involved in PWN-host trees interactions, shedding light into the mechanisms associated with PWN pathogenicity and being promising tools to better clarify host trees PWN resistance/susceptibility

Characterization and proteomic profile of extracellular vesicles from peritoneal dialysis efflux

Peritoneal Dialysis (PD) is considered the best option for a cost-effective mid-term dialysis in patients with Chronic Renal Failure. However, functional failure of the peritoneal membrane (PM) force many patients to stop PD treatment and start haemodialysis. Currently, PM functionality is monitored by the peritoneal equilibration test, a tedious technique that often show changes when the membrane damage is advanced. As in other pathologies, the identification and characterization of extracellular vesicles (EVs) in the peritoneal dialysis efflux (PDE) may represent a non-invasive alternative to identify biomarkers of membrane failure. Using size-exclusion chromatography, we isolated EVs from PDE in a group of patients. Vesicles were characterized by the presence of tetraspanin markers, nanoparticle tracking analysis profile, cryo-electron microscopy and mass spectrometry. Here, we report the isolation and characterization of PDE-EVs. Based on mass spectrometry, we have found a set of well-conserved proteins among patients. Interestingly, the peptide profile also revealed remarkable changes between newly enrolled and longer-treated PD patients. These results are the first step to the identification of PDE-EVs based new markers of PM damage, which could support clinicians in their decision-making in a non-invasive manner