Utilización de las heparinas en la profilaxis y tratamiento del tromboembolismo venoso

La enfermedad tromboembólica venosa todavía se considera la primera causa de muerte prevenible más común en el hospital, ya que a pesar de los avances en el tratamiento anticoagulante y de las mejoras de las guías clínicas y los protocolos quirúrgicos, solamente un pequeño porcentaje de pacientes con indicación de tromboprofilaxis la reciben en la práctica clínica. Por ello, la profilaxis antitrombótica debe ser una práctica esencial en los pacientes quirúrgicos y en los pacientes médicos hospitalizados con factores de riesgo. La evaluación del riesgo y el diagnóstico precoz permiten actualmente ajustar la posología del fármaco anticoagulante indicado, siendo las heparinas de bajo peso molecular la primera opción hospitalaria y extra-hospitalaria para la profilaxis y tratamiento de esta enfermedad. Además se recomienda un recuento plaquetario y un plan de seguimiento para detectar posibles reacciones adversas, principalmente la trombocitopenia y la hemorragia. El ajuste posológico se personaliza en determinados grupos especiales (embarazadas y pacientes obesos), mientras que en el caso de pacientes con insuficiencia renal grave se sugiere el uso de HNF, al igual que en los casos en que haya una elevada probabilidad de tener que revertir el efecto anticoagulante

Possible Allergenic Role of Tropomyosin in Patients with Adverse Reactions after Fish Intake

<p>In a recent case report, patient’s anti-fish tropomyosin IgE was associated with gastrointestinal symptoms. We aimed to demonstrate on a wider scale that the panallergen tropomyosin should not be limited to invertebrate species and that clinically relevant reactions could be elicited by vertebrate tropomyosin. On the whole, 19 patients with adverse reactions after fish intake and showing negative skin tests with commercial fish extracts were included. Fish tropomyosin was recognized by 10/19 patients’ IgE by immunoblotting. All patients with gastrointestinal complaints after fish intake (6/6) showed an IgE band matching with tropomyosin. Cod, albacore, and swordfish tropomyosins were recognized by most patients although 3/10 patients did not claim adverse reactions to these fish species. Immunoblotting with a battery of antigens from different fish species have a high yield of positivity at a band matching with tropomyosin molecular weight, even if they have not been claimed to be causative agents of symptoms. Tropomyosin is therefore a good candidate to be investigated as a clinically relevant fish allergen in patients who report adverse reactions after fish intake.</p

Possible Allergenic Role of Tropomyosin in Patients with Adverse Reactions after Fish Intake

In a recent case report, patient's anti-fish tropomyosin IgE was associated with gastrointestinal symptoms. We aimed to demonstrate on a wider scale that the panallergen tropomyosin should not be limited to invertebrate species and that clinically relevant reactions could be elicited by vertebrate tropomyosin. On the whole, 19 patients with adverse reactions after fish intake and showing negative skin tests with commercial fish extracts were included. Fish tropomyosin was recognized by 10/19 patients' IgE by immunoblotting. All patients with gastrointestinal complaints after fish intake (6/6) showed an IgE band matching with tropomyosin. Cod, albacore, and swordfish tropomyosins were recognized by most patients although 3/10 patients did not claim adverse reactions to these fish species. Immunoblotting with a battery of antigens from different fish species have a high yield of positivity at a band matching with tropomyosin molecular weight, even if they have not been claimed to be causative agents of symptoms. Tropomyosin is therefore a good candidate to be investigated as a clinically relevant fish allergen in patients who report adverse reactions after fish intake.Depto. de Microbiología y ParasitologíaFac. de FarmaciaTRUEpu

Evaluation of two automated low-cost RNA extraction protocols for SARS-CoV-2 detection.

BackgroundTwo automatable in-house protocols for high-troughput RNA extraction from nasopharyngeal swabs for SARS-CoV-2 detection have been evaluated.MethodsOne hundred forty one SARS-CoV-2 positive samples were collected during a period of 10-days. In-house protocols were based on extraction with magnetic beads and designed to be used with either the Opentrons OT-2 (OT-2in-house) liquid handling robot or the MagMAXTM Express-96 system (MMin-house). Both protocols were tested in parallel with a commercial kit that uses the MagMAXTM system (MMkit). Nucleic acid extraction efficiencies were calculated from a SARS-CoV-2 DNA positive control.ResultsNo significant differences were found between both in-house protocols and the commercial kit in their performance to detect positive samples. The MMkit was the most efficient although the MMin-house presented, in average, lower Cts than the other two. In-house protocols allowed to save between 350€ and 400€ for every 96 extracted samples compared to the commercial kit.ConclusionThe protocols described harness the use of easily available reagents and an open-source liquid handling system and are suitable for SARS-CoV-2 detection in high throughput facilities