Cistatina C versus Creatinina como marcador del filtrado glomerular en prematuros de muy bajo peso, evolución de cero a dos años de edad

Tesis doctoral inédita leída en la Universidad Autónoma de Madrid. Facultad de Medicina, Departamento de Pediatría. Fecha de lectura: 19 de Abril de 201

Behavioral Problems and Family Impact in Congenital Cytomegalovirus Infection

We examined behavior (Child Behavior Checklist) and family functioning (Family Impact Questionnaire) in 65 children with congenital cytomegalovirus. Behavioral problems were present in 30.8%. Parents of children with moderate/severe outcomes reported strain on all areas of family functioning. Behavioral problems were associated with negative impact on parental feelings and marital/partnership relationship. Our findings inform planning support services.Sin financiación3.6 Q3 JCR 20220.888 Q1 SJR 2023No data IDR 2022UE

Clinical Outcomes of a Zika Virus Mother-Child Pair Cohort in Spain.

Zika virus (ZIKV) infection has been associated with congenital microcephaly and other neurodevelopmental abnormalities. There is little published research on the effect of maternal ZIKV infection in a non-endemic European region. We aimed to describe the outcomes of pregnant travelers diagnosed as ZIKV-infected in Spain, and their exposed children. This prospective observational cohort study of nine referral hospitals enrolled pregnant women (PW) who travelled to endemic areas during their pregnancy or the two previous months, or those whose sexual partners visited endemic areas in the previous 6 months. Infants of ZIKV-infected mothers were followed for about two years. ZIKV infection was diagnosed in 163 PW; 112 (70%) were asymptomatic and 24 (14.7%) were confirmed cases. Among 143 infants, 14 (9.8%) had adverse outcomes during follow-up; three had a congenital Zika syndrome (CZS), and 11 other potential Zika-related outcomes. The overall incidence of CZS was 2.1% (95%CI: 0.4-6.0%), but among infants born to ZIKV-confirmed mothers, this increased to 15.8% (95%CI: 3.4-39.6%). A nearly 10% overall risk of neurologic and hearing adverse outcomes was found in ZIKV-exposed children born to a ZIKV-infected traveler PW. Longer-term follow-up of these children is needed to assess whether there are any later-onset manifestations.This work was supported by the European Union’s Horizon 2020 research and innovation programme under grant agreement No 734857 (ZIKAction).S

Seroprevalence and epidemiology of hepatitis B and C viruses in pregnant women in Spain. Risk factors for vertical transmission.

BACKGROUND & AIM:Worldwide, measures are being implemented to eradicate hepatitis B (HBV) and C (HCV) viruses, which can be transmitted from the mother during childbirth. This study aims to determine the prevalence of HBV and HCV in pregnant women in Spain, focusing on country of origin, epidemiological factors and risk of vertical transmission (VT). METHODOLOGY:Multicentre open-cohort study performed during 2015. HBV prevalence was determined in 21870 pregnant women and HCV prevalence in 7659 pregnant women. Epidemiological and risk factors for VT were analysed in positive women and differences between HBV and HCV cases were studied. RESULTS:HBV prevalence was 0.42% (91/21870) and HCV prevalence was 0.26% (20/7659). Of the women with HBV, 65.7% (44/67) were migrants. The HBV transmission route to the mother was unknown in 40.3% of cases (27/67) and VT in 31.3% (21/67). Among risk factors for VT, 67.7% (42/62) of the women had viraemia and 14.5% (9/62) tested HBeAg-positive. All of the neonates born to HBV-positive mothers received immunoprophylaxis, and none contracted infection by VT. In 80% (16/20) of the women with HCV, the transmission route was parenteral, and nine were intravenous drug users. Viraemia was present in 40% (8/20) of the women and 10% (2/20) were HIV-coinfected. No children were infected. Women with HCV were less likely than women with HBV to breastfeed their child (65% vs. 86%). CONCLUSIONS:The prevalences obtained in our study of pregnant women are lower than those previously documented for the general population. Among the women with HBV, the majority were migrants and had a maternal family history of infection, while among those with HCV, the most common factor was intravenous drug use. Despite the risk factors observed for VT, none of the children were infected. Proper immunoprophylaxis is essential to prevent VT in children born to HBV-positive women

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)

Measurement of the impact-parameter dependent azimuthal anisotropy in coherent ρ0 photoproduction in Pb–Pb collisions at √sNN = 5.02 TeV

The first measurement of the impact-parameter dependent angular anisotropy in the decay of coherently photoproduced ρ0 mesons is presented. The ρ0 mesons are reconstructed through their decay into a pion pair. The measured anisotropy corresponds to the amplitude of the cos(2ϕ) modulation, where ϕ is the angle between the two vectors formed by the sum and the difference of the transverse momenta of the pions, respectively. The measurement was performed by the ALICE Collaboration at the LHC using data from ultraperipheral Pb−Pb collisions at a center-of-mass energy of sNN−−−√ = 5.02 TeV per nucleon pair. Different impact-parameter regions are selected by classifying the events in nuclear-breakup classes. The amplitude of the cos(2ϕ) modulation is found to increase by about one order of magnitude from large to small impact parameters. Theoretical calculations, which describe the measurement, explain the cos(2ϕ) anisotropy as the result of a quantum interference effect at the femtometer scale that arises from the ambiguity as to which of the nuclei is the source of the photon in the interaction

Investigating the nature of the K∗0(700) state with π±K0S correlations at the LHC

The first measurements of femtoscopic correlations with the particle pair combinations π±K0S in pp collisions at s√=13 TeV at the Large Hadron Collider (LHC) are reported by the ALICE experiment. Using the femtoscopic approach, it is shown that it is possible to study the elusive K∗0(700) particle that has been considered a tetraquark candidate for over forty years. Boson source parameters and final-state interaction parameters are extracted by fitting a model assuming a Gaussian source to the experimentally measured two-particle correlation functions. The final-state interaction is modeled through a resonant scattering amplitude, defined in terms of a mass and a coupling parameter, decaying into a π±K0S pair. The extracted mass and Breit-Wigner width, derived from the coupling parameter, of the final-state interaction are found to be consistent with previous measurements of the K∗0(700). The small value and increasing behavior of the correlation strength with increasing source size support the hypothesis that the K∗0(700) is a four-quark state, i.e. a tetraquark state. This latter trend is also confirmed via a simple geometric model that assumes a tetraquark structure of the K∗0(700) resonance

Exclusive four pion photoproduction in ultraperipheral Pb-Pb collisions at sNN=5.02\sqrt{s_{\rm NN}} = 5.02 TeV

International audienceThe intense photon fluxes from relativistic nuclei provide an opportunity to study photonuclear interactions in ultraperipheral collisions. The measurement of coherently photoproduced $\pi^+\pi^-\pi^+\pi^-$ final states in ultraperipheral Pb-Pb collisions at $\sqrt{s_{\mathrm{NN}}}=5.02$ TeV is presented for the first time. The cross section, d$\sigma$/d$y$, times the branching ratio ($\rho\rightarrow \pi^+ \pi^+ \pi^- \pi^-$) is found to be $47.8\pm2.3~\rm{(stat.)}\pm7.7~\rm{(syst.)}$ mb in the rapidity interval $|y| < 0.5$. The invariant mass distribution is not well described with a single Breit-Wigner resonance. The production of two interfering resonances, $\rho(1450)$ and $\rho(1700)$, provides a good description of the data. The values of the masses ($m$) and widths ($\Gamma$) of the resonances extracted from the fit are $m_{1}=1385\pm14~\rm{(stat.)}\pm3~\rm{(syst.)}$ MeV/$c^2$, $\Gamma_{1}=431\pm36~\rm{(stat.)}\pm82~\rm{(syst.)}$ MeV/$c^2$, $m_{2}=1663\pm13~\rm{(stat.)}\pm22~\rm{(syst.)}$ MeV/$c^2$ and $\Gamma_{2}=357 \pm31~\rm{(stat.)}\pm49~\rm{(syst.)}$ MeV/$c^2$, respectively. The measured cross sections times the branching ratios are compared to recent theoretical predictions

Studying the interaction between charm and light-flavor mesons

International audienceThe two-particle momentum correlation functions between charm mesons ($\mathrm{D^{*\pm}}$ and $\mathrm{D}^\pm$) and charged light-flavor mesons ($\pi^{\pm}$ and K$^{\pm}$) in all charge-combinations are measured for the first time by the ALICE Collaboration in high-multiplicity proton-proton collisions at a center-of-mass energy of $\sqrt{s} =13$ TeV. For $\mathrm{DK}$ and $\mathrm{D^*K}$ pairs, the experimental results are in agreement with theoretical predictions of the residual strong interaction based on quantum chromodynamics calculations on the lattice and chiral effective field theory. In the case of $\mathrm{D}\pi$ and $\mathrm{D^*}\pi$ pairs, tension between the calculations including strong interactions and the measurement is observed. For all particle pairs, the data can be adequately described by Coulomb interaction only, indicating a shallow interaction between charm and light-flavor mesons. Finally, the scattering lengths governing the residual strong interaction of the $\mathrm{D}\pi$ and $\mathrm{D^*}\pi$ systems are determined by fitting the experimental correlation functions with a model that employs a Gaussian potential. The extracted values are small and compatible with zero