Significado clínico de los aislados de Streptococcus bovis en orina

Objective: Streptococcus bovis includes variants related to colorectal cancer and non-urinary infections. Its role as urinary pathogen is unknown. Our objective was to assess the presence of urinary infection by S. bovis, analysing the patients and subsequent clinical course. Methods: Observational study, with longitudinal data collection, performed at our centre between all the cultures requested between February and April 2015. Clinical course of the patients and response to treatment were analysed. Results: Two thousand five hundred and twenty urine cultures were analysed, of which 831 (33%) had a significant microbial count. S. bovis was isolated in 8 patients (0.96%). In 75% of these cases the urine culture was requested because of urinary tract infection symptoms; the remaining 25% because of fever of uncertain source; during the follow-up period no evidence of cancer or endocarditis was detected. S. gallolyticus subspecie pasteurianus was the only variant observed (100%). The clinical response to initial treatment was favourable in all cases. Conclusions: S. bovis bacteriuria may have clinical significance, especially when S. gallolyticus subspecies pasteurianus is isolated in cases with underlying urinary tract disease.Introducción. Streptococcus bovis comprende multitud de variantes de especie relacionados con infecciones no uri narias y cáncer colorrectal. Su papel como patógeno urinario es desconocido. Nuestro objetivo fue valorar la presencia de infección urinaria por S. bovis, analizando los pacientes y su evolución clínica posterior. Material y métodos. Estudio observacional, con obten ción de datos longitudinal, realizado en nuestro centro entre todos los urocultivos solicitados durante entre los meses de febrero y abril de 2015. Se analizó la evolución clínica y la respuesta al tratamiento. Resultados. Se analizaron 2.520 urocultivos, de los que en 831 (33%) hubo un recuento microbiano significativo. Se aisló S. bovis en 8 (0,96%) pacientes. En el 75% de estos casos el uro cultivo fue solicitado por clínica de infección del tracto urina rio. El 25% restante por fiebre sin foco evidente clínicamente, no objetivando historia de cáncer y/o endocarditis durante el periodo seguimiento. La única variante presente fue S. gallo lyticus subespecie pasteurianus (100%). La respuesta clínica al tratamiento inicial fue favorable en todos los casos. Conclusiones. La bacteriuria por S. bovis puede tener significación clínica, sobre todo cuando se aísla S. gallolyticus subespecie pasteurianus, en pacientes con patología previa del aparato urinari

Molecular Recognition of Surface Trans-Sialidases in Extracellular Vesicles of the Parasite Trypanosoma cruzi Using Atomic Force Microscopy (AFM)

Trans-sialidases (TS) are important constitutive macromolecules of the secretome present on the surface of Trypanosoma cruzi (T. cruzi) that play a central role as a virulence factor in Chagas disease. These enzymes have been related to infectivity, escape from immune surveillance and pathogenesis exhibited by this protozoan parasite. In this work, atomic force microscopy (AFM)-based single molecule-force spectroscopy is implemented as a suitable technique for the detection and location of functional TS on the surface of extracellular vesicles (EVs) released by tissue-culture cell-derived trypomastigotes (Ex-TcT). For that purpose, AFM cantilevers with functionalized tips bearing the anti-TS monoclonal antibody mAb 39 as a sense biomolecule are engineered using a covalent chemical ligation based on vinyl sulfonate click chemistry; a reliable, simple and efficient methodology for the molecular recognition of TS using the antibody-antigen interaction. Measurements of the breakdown forces between anti-TS mAb 39 antibodies and EVs performed to elucidate adhesion and forces involved in the recognition events demonstrate that EVs isolated from tissue-culture cell-derived trypomastigotes of T. cruzi are enriched in TS. Additionally, a mapping of the TS binding sites with submicrometer-scale resolution is provided. This work represents the first AFM-based molecular recognition study of Ex-TcT using an antibody-tethered AFM probe.ERANet program ERANet17/HLH-0142Spanish Government PGC2018-099424-B-I0

PARP inhibition attenuates histopathological lesion in ischemia/reperfusion renal mouse model after cold prolonged ischemia

We test the hypothesis that PARP inhibition can decrease acute tubular necrosis (ATN) and other renal lesions related to prolonged cold ischemia/reperfusion (IR) in kidneys preserved at 4°C in University of Wisconsin (UW) solution. Material and Methods. We used 30 male Parp1+/+ wild-type and 15 male Parp10/0 knockout C57BL/6 mice. Fifteen of these wild-type mice were pretreated with 3,4-dihydro-5-[4-(1-piperidinyl)butoxyl]-1(2H)-isoquinolinone (DPQ) at a concentration of 15 mg/kg body weight, used as PARP inhibitor. Subgroups of mice were established (A: IR 45 min/6 h; B: IR + 48 h in UW solution; and C: IR + 48 h in UW solution plus DPQ). We processed samples for morphological, immunohistochemical, ultrastructural, and western-blotting studies. Results. Prolonged cold ischemia time in UW solution increased PARP-1 expression and kidney injury. Preconditioning with PARP inhibitor DPQ plus DPQ supplementation in UW solution decreased PARP-1 nuclear expression in renal tubules and renal damage. Parp10/0 knockout mice were more resistant to IR-induced renal lesion. In conclusion, PARP inhibition attenuates ATN and other IR-related renal lesions in mouse kidneys under prolonged cold storage in UW solution. If confirmed, these data suggest that pharmacological manipulation of PARP activity may have salutary effects in cold-stored organs at transplantation.Funding: This research was supported by CTS no. 138 Research Group and from the Carlos III Health Institute of the Spanish Ministery of Health and Consumer Affairs (Red de Investigación Renal, REDinREN 012/0021/0025). “FEDER una manera de hacer Europa”

Enfermedad renal crónica: la carga sanitaria invisible para los organismos que

REDINREN RD16/0009.The uptake of the current concept of chronic kidney disease (CKD) by the public, physicians and health authorities is low. Physicians still mix up CKD with chronic kidney insufficiency or failure. In a recent manuscript, only 23% of participants in a cohort of persons with CKD had been diagnosed by their physicians as having CKD while 29% has a diagnosis of cancer and 82% had a diagnosis of hypertension. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. A prevalent view is that for those in whom kidneys fail, the problem is "solved" by dialysis or kidney transplantation. However, the main burden of CKD is accelerated aging and all-cause and cardiovascular premature death. CKD is the most prevalent risk factor for lethal COVID-19 and the factor that most increases the risk of death in COVID-19, after old age. Moreover, men and women undergoing KRT still have an annual mortality which is 10-100-fold higher than similar age peers, and life expectancy is shortened by around 40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth global cause of death by 2040 and the second cause of death in Spain before the end of the century, a time when 1 in 4 Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded CIBER network research structure in Spain. Leading Spanish kidney researchers grouped in the kidney collaborative research network REDINREN have now applied for the RICORS call of collaborative research in Spain with the support of the Spanish Society of Nephrology, ALCER and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true. However, only the highest level of research funding through the CIBER will allow to adequately address the issue before it is too late.El impacto del concepto actual de enfermedad renal crónica (ERC) en la población, médicos y autoridades sanitarias ha sido bajo. Los médicos aún confunden la ERC con la insuficiencia renal crónica. En un manuscrito reciente, en una cohorte de personas con ERC, solo el 23% de los participantes fueron diagnosticados de ERC por sus médicos mientras que el 29% estaban diagnosticados de cáncer y el 82% de hipertensión. Para el público en general y las autoridades sanitarias, la ERC evoca la terapia de reemplazo renal (TRR). En España, la prevalencia de TRR es del 0,13%. La opinión predominante es que para aquellos en los que fallan los riñones, el problema se “resuelve” mediante diálisis o trasplante de riñón. Sin embargo, la principal carga sanitaria de la ERC es el envejecimiento acelerado y la muerte prematura de causa cardiovascular o de cualquier causa. La ERC es el factor mas prevalente de riesgo de mortalidad por COVID-19 después de la edad avanzada. Además, los hombres y mujeres que se someten a TRR todavía tienen una mortalidad anual que es de 10 a 100 veces superior a sus pares de edades similares, y la esperanza de vida se reduce en alrededor de 40 años para jóvenes en diálisis y en 15 años para jóvenes con un injerto renal funcionante. Se espera que la ERC se convierta en la quinta causa mundial de muerte para 2040 y la segunda causa de muerte en España antes de fin de siglo, época en la que 1 de cada 4 españoles tendrá ERC. Sin embargo, para 2022, la ERC se convertirá en la única causa de muerte entre las 15 principales a nivel mundial que no cuenta con el respaldo de una estructura de investigación CIBER en España. Los Principales grupos de investigación renal en España agrupados en la red de investi- gación colaborativa renal REDINREN han solicitado la convocatoria RICORS de investigación colaborativa en España con el apoyo de la Sociedad Española de Nefrología, ALCER y ONT: RICORS 040 tiene como objetivo evitar que se hagan realidad las terribles predicciones sobre la carga mundial de ERC para 2040. Sin embargo, solo el más alto nivel de financiación de la investigación a través del CIBER permitirá abordar adecuadamente el problema antes de que sea demasiado tarde.REDINREN RD16/000

Resistance of hyperhomocysteinemia in renal patients to treatment with supra-physiological doses of parenteral folic acid

Los pacientes en hemodiálisis presentan un aumento de homocisteína plasmática (Hcy), debido a la alteración en la metilación causada por la uremia y déficit de los cofactores necesarios (vitamina B, ácido fólico). Esto se correlaciona con un mayor desarrollo de la enfermedad vascular prematura. El tratamiento, no está consensuado, siendo escasa la respuesta a la administración oral de dosis convencionales de ácido fólico. En este trabajo valoramos la respuesta de la hiperhomocisteinemia de 73 pacientes en programa de hemodiálisis periódica tras la administración de 50 mg de ácido folínico parenteral durante 18 meses. La homocisteína plasmática de los pacientes en el momento de inicio del estudio presentaba unos valores medios de 22,67 (μmol/l). Durante el primer año de suplementación mantuvieron el valor medio de 20 μmol/l. A partir del primer año de tratamiento, y hasta finalizar los 18 meses de observación, los niveles medios de homocisteína fueron de 19,58 μmol/l. Aunque con el tiempo de tratamiento encontramos una clara tendencia al descenso de sus valores plasmáticos, no existieron diferencias estadísticamente significativas. Los valores de homocisteína no se normalizaron en ninguno de los pacientes tratados.Hemodialysis patients present an increase in plasma homocysteine (Hcy) due to methylation impairment caused by uremia and the deficiency of the co-factors needed (vitamin B, folic acid). This correlates with a more common development of premature vascular disease. There is no consensus on the therapy, with a poor response to oral administration of conventional doses of folic acid. In this work, we assessed the response of hyperhomocysteinemia in 73 regular hemodialysis patients after the administration of 50 mg of parenteral folinic acid for 18 months. Plasma homocysteine of the patients at the time of the study beginning presented mean values of 22.67 (μmol/L). During the first year of supplementation the mean value was kept at 20 μmol/L. From the first year to the end of the 18-months observation period the mean homocysteine levels were 19.58 μmol/L. Although we found a clear trend towards a decrease in plasma homocysteine levels during the treatment period, there were no significant differences. Homocysteine levels did not come back to normal in none of the patients treated

Evolution of nutritional biochemical parameters in hemodialysis patients during a one-year follow-up period

La elevada supervivencia actual del paciente en hemodiálisis (52% hasta 5 años), ha hecho que se pongan de manifiesto complicaciones crónicas como la elevada prevalencia de malnutrición en los enfermos, así como la importancia de la situación nutricional en la morbi-mortalidad que presentan. La causa de desnutrición proteico-calórica es multifactorial, aunque procesos de inflamación crónica asociada a la técnica de diálisis cobran cada vez más relevancia. Se han evaluado las variaciones de distintos parámetros bioquímicos nutricionales (proteínas totales, albúmina plasmática, transferrina y colesterol total) de 73 pacientes en hemodiálisis durante un año de seguimiento. La edad media de los pacientes era de 53,3 ± 18,69 años, con 43 varones y 30 mujeres. El tiempo en programa de hemodiálisis ha sido de 43 ± 33 meses, con una duración media de la sesión de 246 ± 24 minutos y dosis media de hemodiálisis administrada de 1,37 ± 0,27 (KT/V) (Daurgidas 2ª generación). Se ha observado un descenso en todos los parámetros bioquímicos evaluados, con diferencias estadísticamente significativas: Proteínas totales (p < 0,001), albúmina (p < 0,00001), colesterol total (p < 0,05) y transferrina (p < 0,01). La evolución de los parámetros bioquímicos nutricionales evaluados mostró un importante deterioro nutricional de los pacientes estables con el tratamiento.Current high survival in hemodialysis patients (52% at 5 years) have made the chronic manifestations to emerge such as the high hyponutrition prevalence of these patients, as well as the importance of the nutritional status in their morbimortality. The reason for protein-caloric hyponutrition is multifactorial, although chronic inflammatory conditions associated to the dialysis technique are becoming more and more relevant. The variations in several nutritional biochemical parameters (total proteins, plasma albumin, transferrin, and total cholesterol) have been assessed in 73 hemodialysis patients for one year. The mean age of the patients was 53.3 ± 18.69 years (43 males and 30 females). The average on hemodialysis program was 43 ± 33 months, with a mean session duration of 246 ± 24 minutes, and mean hemodialysis dose administered of 1.37 ± 0.27 (KT/V) (second generation Daurgidas). A decrease in all the biochemical parameters assessed has been observed, with statistically significant differences: total proteins (p < 0.001), albumin (p < 0.00001), total cholesterol (p < 0.05), and transferrin (p < 0.01). The evolution of the nutritional biochemical parameters assessed showed an important nutritional deterioration of the patients remaining stable with the therapy

Recommendations for ophthalmologic practice during the easing of COVID-19 control measures

In the context of the COVID-19 pandemic, this paper provides recommendations for medical eye care during the easing of control measures after lockdown. The guidelines presented are based on a literature review and consensus among all Spanish Ophthalmology Societies regarding protection measures recommended for the ophthalmologic care of patients with or without confirmed COVID-19 in outpatient, inpatient, emergency and surgery settings. We recommend that all measures be adapted to the circumstances and availability of personal protective equipment at each centre and also highlight the need to periodically update recommendations as we may need to readopt more restrictive measures depending on the local epidemiology of the virus. These guidelines are designed to avoid the transmission of SARS-CoV-2 among both patients and healthcare staff as we gradually return to normal medical practice, to prevent postoperative complications and try to reduce possible deficiencies in the diagnosis, treatment and follow-up of the ophthalmic diseases. With this update (5th) the Spanish Society of Ophthalmology is placed as one of the major ophthalmology societies providing periodic and systematized recommendations for ophthalmic care during the COVID-19 pandemic

Usos del e‐learning en las Universidades Andaluzas: estado de la situación y análisis de buenas prácticas. (Resumen ejecutivo).

Secretaría General de Universidades, Investigación y Tecnología P07-SE-J.0267

Usos del e-learning en las Universidades Andaluzas: Estado de la situación y análisis de buenas prácticas. (Versión completa)

Secretaría General de Universidades, Investigación y Tecnología P07-SE-J.0267

Measurement of the top quark-pair production cross section with ATLAS in pp collisions at \sqrt{s}=7\TeV

A measurement of the production cross-section for top quark pairs(\ttbar) in $pp$ collisions at \sqrt{s}=7 \TeV is presented using data recorded with the ATLAS detector at the Large Hadron Collider. Events are selected in two different topologies: single lepton (electron $e$ or muon $\mu$) with large missing transverse energy and at least four jets, and dilepton ($ee$, $\mu\mu$ or $e\mu$) with large missing transverse energy and at least two jets. In a data sample of 2.9 pb-1, 37 candidate events are observed in the single-lepton topology and 9 events in the dilepton topology. The corresponding expected backgrounds from non-\ttbar Standard Model processes are estimated using data-driven methods and determined to be $12.2 \pm 3.9$ events and $2.5 \pm 0.6$ events, respectively. The kinematic properties of the selected events are consistent with SM \ttbar production. The inclusive top quark pair production cross-section is measured to be \sigmattbar=145 \pm 31 ^{+42}_{-27} pb where the first uncertainty is statistical and the second systematic. The measurement agrees with perturbative QCD calculations.Comment: 30 pages plus author list (50 pages total), 9 figures, 11 tables, CERN-PH number and final journal adde