Impact of region-of-interest delineation methods, reconstruction algorithms, and intra- and inter-operator variability on internal dosimetry estimates using PET

Purpose Human dosimetry studies play a central role in radioligand development for positron emission tomography (PET). Drawing regions of interest (ROIs) on the PET images is used to measure the dose in each organ. In the study aspects related to ROI delineation methods were evaluated for two radioligands of different biodistribution (intestinal vs urinary). Procedures PET images were simulated from a human voxel-based phantom. Several ROI delineation methods were tested: antero-posterior projections (AP), 3D sub-samples of the organs (S), and a 3D volume covering the whole-organ (W). Inter- and intra-operator variability ROI drawing was evaluated by using human data. Results The effective dose estimates using S and W methods were comparable to the true values. AP methods overestimated (49 %) the dose for the radioligand with intestinal biodistribution. Moreover, the AP method showed the highest inter-operator variability: 11 ± 1 %. Conclusions The sub-sampled organ method showed the best balance between quantitative accuracy and inter- and intra-operator variability.Postprint (author's final draft

Calidad y humanización de la atención de los pacientes que acuden al servicio de ayudas diagnósticas

El presente proyecto denominado “Calidad y humanización de la atención de los pacientes que acuden al servicio de ayudas diagnósticas” tiene como objetivo principal determinar la calidad y humanización de la atención de los pacientes que acuden al servicio de ayudas diagnósticas. Como metodología se han fragmentado tres fases en las cuales, en la fase I se identificaron las características en la atención de los profesionales de ayudas diagnósticas. Para la segunda fase se analizaron las características de calidad y de la humanización del servicio de ayudas diagnósticas mediante la categorización de los conceptos relacionados, finalmente se establecieron las recomendaciones propias del servicio de ayudas diagnósticas y sus principios informativos. Se concluyó que la formación en la atención en salud de los profesionales debe integrar la aplicación de saberes técnicos, sociales, personales, institucionales e integrarlos dentro del manejo de su tarea cotidiana.The main objective of this project called "Quality and humanization of the care of patients who come to the diagnostic aid service" is to determine the quality and humanization of the care of patients who come to the diagnostic aid service. As a methodology, three phases have been fragmented in which in phase I the characteristics in the care of diagnostic aid professionals were identified. For the second phase, the characteristics of quality and the humanization of the diagnostic aid service were analyzed, through the categorization of the related concepts, finally the recommendations of the diagnostic aid service and its informative principles were established. It was concluded that the training in health care professionals must integrate the application of technical, social, personal, institutional knowledge and integrate them into the management of their daily tasks. Keywords: Quality in the radiology service, Humanization of Health, Health Care

Leishmania infantum asymptomatic infection in inflammatory bowel disease patients under anti-TNF therapy

Background: In recent years anti-TNF therapy has been associated with leishmaniasis in immunocompromised patients from endemic areas. Nevertheless, data on asymptomatic Leishmania infection in such patients is scarce. The aim of this study was to determine the prevalence of asymptomatic infection in inflammatory bowel disease (IBD) patients treated with TNF inhibitors living in an endemic area (Catalonia) and to follow up them to study how the infection evolved. Methods: 192 IBD patients (143 Crohn's disease; 49 ulcerative colitis) from Catalonia (Spain), an area endemic for L. infantum, were recruited. Peripheral blood samples were collected and tested for anti-Leishmania antibodies by Western blotting (WB). Leishmania kinetoplast DNA was detected in peripheral blood mononuclear cells (PBMC) by a quantitative PCR. Results: Serology was positive in 3.1% and Leishmania DNA was found in 8.8%, with a low parasitic load and humoral response. The prevalence was 10.9%, patients being considered infected if they tested positive by at least one of the techniques. Eight out of the 21 patients with asymptomatic leishmaniasis were monitored for 3-8 months after the first test. None of them showed an increased parasitemia or humoral response, or developed leishmaniasis during the follow-up period. Conclusion: The prevalence of Leishmania asymptomatic infection detected in our IBD cohort is similar to that found in healthy population in close endemic areas. Due to the short monitoring period, it is not possible to reach a conclusion about the risk of Leishmania reactivation from this study

The Obemat2.0 Study: A Clinical Trial of a Motivational Intervention for Childhood Obesity Treatment.

The primary aim of the Obemat2.0 trial was to evaluate the efficacy of a multicomponent motivational program for the treatment of childhood obesity, coordinated between primary care and hospital specialized services, compared to the usual intervention performed in primary care. This was a cluster randomized clinical trial conducted in Spain, with two intervention arms: motivational intervention group vs. usual care group (as control), including 167 participants in each. The motivational intervention consisted of motivational interviewing, educational materials, use of an eHealth physical activity monitor and three group-based sessions. The primary outcome was body mass index (BMI) z score increments before and after the 12 (+3) months of intervention. Secondary outcomes (pre-post intervention) were: adherence to treatment, waist circumference (cm), fat mass index (z score), fat free mass index (z score), total body water (kg), bone mineral density (z score), blood lipids profile, glucose metabolism, and psychosocial problems. Other assessments (pre and post-intervention) were: sociodemographic information, physical activity, sedentary activity, neuropsychological testing, perception of body image, quality of the diet, food frequency consumption and foods available at home. The results of this clinical trial could open a window of opportunity to support professionals at the primary care to treat childhood obesity. The clinicaltrials.gov identifier was NCT02889406

Arte contemporáneo, inclusión y transformación social.

Actividad CePIAbierto (RHCD FA Nº 103/2018). El eje central del proyecto es una exposición de los procesos realizados en los talleres de artes del Centro Vida Nueva (San Juan) y el Centro Educativo Terapéutico Lihue Vidas (Córdoba), junto a una selección de sus producciones visuales. Tanto éstas producciones como su montaje se propone desde un planteo contemporáneo y ampliado de las artes visuales, donde diversas disciplinas (como pintura, fotografía, video, registro de experiencias, textos e instalaciones) y diversos campos no artísticos (como pedagógico, social, psicológico, etc) se entrecruzan y construyen de manera colaborativa la experiencia propuesta, rescatando y revalorizando sobre todo el proceso de trabajo y no sólo el resultado final. Se realizó también una charla-debate con lxs artistas que pone en cuestión ideas ejes que atraviesan el trabajo artístico de las personas con discapacidad, la valoración positiva de la diferencia, la importancia y necesidad de poner en práctica concreta la inclusión en los diferentes ámbitos educativos-artísticos-culturales. Por último, se pintó colectivamente un mural como modo de compartir una experiencia de creación colectiva, junto a lxs artistas expositorxs.Actividad CePIAbierto (RHCD FA Nº 103/2018). Una experiencia artística expositiva que propone pensar la discapacidad no como un problema, sino como una pregunta que nos despierta. Pinturas, dibujos, charlas y un mural colectivo, dan cuenta de un proceso de trabajo artístico y de encuentro entre diversas personas que comparten un mismo hacer y placer: pintar, dibujar (¡y bailar!).Fil: Tamagni, Julia. Universidad Nacional de Córdoba. Centro Educativo Terapéutico Lihue Vidas; Argentina.Fil: Bula, Nadia. Centro Vida Nueva, Institución Aleluya-ARID.Fil: Maggio, Natalia. Universidad Católica de Cuyo. Centro Vida Nueva, Institución Aleluya-ARID.Fil: Scheidegger, Emiliano. Universidad Nacional de Córdoba. Facultad de Artes; Argentina.Fil: Walter, Florencia. Universidad Nacional de Córdoba. Facultad de Artes; Argentina.Fil: Belkys Scolamieri, Delia Lozano. Universidad Católica de Córdoba. Facultad de Educación. Apukay; Argentina

Identification of regulatory variants associated with genetic susceptibility to meningococcal disease.

Non-coding genetic variants play an important role in driving susceptibility to complex diseases but their characterization remains challenging. Here, we employed a novel approach to interrogate the genetic risk of such polymorphisms in a more systematic way by targeting specific regulatory regions relevant for the phenotype studied. We applied this method to meningococcal disease susceptibility, using the DNA binding pattern of RELA - a NF-kB subunit, master regulator of the response to infection - under bacterial stimuli in nasopharyngeal epithelial cells. We designed a custom panel to cover these RELA binding sites and used it for targeted sequencing in cases and controls. Variant calling and association analysis were performed followed by validation of candidate polymorphisms by genotyping in three independent cohorts. We identified two new polymorphisms, rs4823231 and rs11913168, showing signs of association with meningococcal disease susceptibility. In addition, using our genomic data as well as publicly available resources, we found evidences for these SNPs to have potential regulatory effects on ATXN10 and LIF genes respectively. The variants and related candidate genes are relevant for infectious diseases and may have important contribution for meningococcal disease pathology. Finally, we described a novel genetic association approach that could be applied to other phenotypes

The clinical relevance of oliguria in the critically ill patient : Analysis of a large observational database

Funding Information: Marc Leone reports receiving consulting fees from Amomed and Aguettant; lecture fees from MSD, Pfizer, Octapharma, 3 M, Aspen, Orion; travel support from LFB; and grant support from PHRC IR and his institution. JLV is the Editor-in-Chief of Critical Care. The other authors declare that they have no relevant financial interests. Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis. Results: Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient - oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged - oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent - oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19-1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97-1.34], p = 0.103). Conclusions: Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome.publishersversionPeer reviewe

Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection are often non-specific, and there is no definitive test for the accurate diagnosis of infection. The 'omics' approaches to identifying biomarkers from the host-response to bacterial infection are promising. In this study, lipidomic analysis was carried out with plasma samples obtained from febrile children with confirmed bacterial infection (n = 20) and confirmed viral infection (n = 20). We show for the first time that bacterial and viral infection produces distinct profile in the host lipidome. Some species of glycerophosphoinositol, sphingomyelin, lysophosphatidylcholine and cholesterol sulfate were higher in the confirmed virus infected group, while some species of fatty acids, glycerophosphocholine, glycerophosphoserine, lactosylceramide and bilirubin were lower in the confirmed virus infected group when compared with confirmed bacterial infected group. A combination of three lipids achieved an area under the receiver operating characteristic (ROC) curve of 0.911 (95% CI 0.81 to 0.98). This pilot study demonstrates the potential of metabolic biomarkers to assist clinicians in distinguishing bacterial from viral infection in febrile children, to facilitate effective clinical management and to the limit inappropriate use of antibiotics

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries