Deterioro cognitivo asociado al virus de inmunodeficencia humana (VIH) e inhubidores de proteasa potenciados con ritonavir en monoterapia

Tesis doctoral inédita leída en la Universida Autónoma de Madrid, Facultad de Medicina, Departamento de Medicina. Fecha de lectura: junio-2016Introducción Se desconoce si el tratamiento con inhibidores de proteasa potenciados (IP) en monoterapia (MT) es capaz de preservar la función neurocognitiva de los pacientes VIH+. Métodos Estudio longitudinal diseñando para evaluar la función neurocognitiva en pacientes VIH+ avirémicos y sin comorbilidades neuropsiquiátricas graves, tratados con un IP en MT o asociado a 2 nucleósidos (TT). A todos los pacientes se les realizó, basalmente y al año de seguimiento, una evaluación neurocognitiva (14 tests, 7 dominios) y un control analítico en sangre y en el liquido cefalorraquídeo (LCR), si presentaban deterioro neurocognitivo (DNC). Se compararon entre la MT y la TT: la prevalencia, la incidencia y el perfil del DNC; así como los niveles de inflamación y de carga viral de VIH en LCR. Igualmente se evaluó mediante por ANCOVA si la MT era factor de riesgo de DNC de forma cruda o ajustada por aquellas covariables que modificaban esta relación >15%. Resultados Basalmente se incluyeron 96 pacientes en MT y 95 en TT. De ellos 67 completaron el protocolo en cada grupo de tratamiento. En comparación, los pacientes en TT eran mas jóvenes, tenían recuentos de linfocitos CD4 (basal y nadir) menores y llevaban menos tiempo infectados por VIH, en tratamiento y suprimidos que los pacientes en MT. Los pacientes en MT y en TT presentaron un funcionamiento basal y una evolución neurocognitiva, global y por dominios cognitivos, similar. Sus tasas de deterioro y de declinar cognitivo fueron igualmente equiparables. Los niveles de carga viral de VIH y de inflamación en el subgrupo de pacientes diagnosticados basalmente de DNC en MT o TT fueron también similares. La MT no demostró ser un factor de riesgo, crudo o ajustado, de DNC. Conclusiones En base a los resultados obtenidos, la evolución del funcionamiento neurocognitivo y el riesgo de deterioro neurocognitivo, en pacientes VIH sin comorbilidades graves, es independiente de que la supresión virológica se mantenga con un IP en MT o asociado con 2 nucleósido

Seroreversion of IgG anti-HEV in HIV cirrhotic patients: A long-term multi-sampling longitudinal study

The aim of our study was to evaluate HEV antibody kinetics in HIV/HCV-coinfected patients with cirrhosis. A longitudinal retrospective study was designed. Patients were followed up every 6 months; anti-HEV IgG and IgM antibodies levels and HEV-RNA by qPCR were analysed. The prevalence and incidence of every HEV infection marker were calculated. The kinetics of anti-HEV IgG and IgM during the follow-up were evaluated. Seventy-five patients comprised the study population. The seroprevalence observed was 17.3%. None showed IgM antibodies or HEV-RNA at baseline. None showed detectable HEV viral load during the study period. After a median follow-up of 5.1 years, two of 62 seronegative patients (3.2%) seroconverted to IgG antibody. The incidence for IgM was 2.7%. Of the 13 patients with IgG seropositivity at baseline, five (38.5%) seroreverted. Meanwhile, of the two patients who exhibited IgM positivity during the study, one (50%) showed intermittent positivity. We found that HEV seropositivity is common in HIV/HCV-coinfected cirrhotic patients. A remarkable rate of IgG seroreversions and IgM intermittence was found, limiting the use of antibodies for the diagnosis of HEV infection in this population

Agrupación de ranuras alimentadas por una novedosa guía semi-modo en Gap Waveguide

Comunicación presentada en el XXXVII Simposio Nacional de la URSI, Málaga, 5-7 septiembre 2022.This paper presents a novel antenna feed network that significantly facilitates the design and fabrication in Gap Waveguide technology. In particular, a 1x4 linearly polarized Ka-band antenna array with a novel corporate distribution network using a half-mode groove-gap waveguide (HM-GGW). The good simulated results obtained from 29 GHz to 31 GHz by this breadboard give the first validity to this new development for GW.Este trabajo forma parte de los proyectos PID2019-107688RB-C22 y PID2019-103982RB-C43 financiados por el Ministerio de Ciencia e Innovación MCIN/AEI/10.13039/501100011033

Correlation of hepatitis E and rat hepatitis E viruses urban wastewater monitoring and clinical cases

Background Wastewater pathogen monitoring is useful for surveillance of enteric pathogens. Information about the presence of Paslahepevirus balayani (HEV) and emergent Rocahepevirus ratti (RHEV) in untreated water and their correlation with clinical cases is scarce. Aim To longitudinally monitor HEV and RHEV in wastewater and to evaluate their possible correlation with human cases. Methods This study was carried out in the city of Cordoba (southern Spain) from March 2021 to March 2023. HEV and RHEV occurrence were evaluated by PCR in three sample types: i) sera from patients with acute hepatitis attended at the reference hospital, ii) liver and faeces from urban rodents, and iii) grab sewage samples collected weekly from the municipal wastewater treatment plant. Results We analysed 106 untreated wastewater samples, 304 individuals with acute hepatitis, and 20 rodents. HEV and RHEV were detected in only one (0.9 %) and almost all samples (94.3 %) of wastewater samples, respectively. A total of 22 cases of acute HEV infection (7.2 %) and two cases of RHEV (0.7 %) were detected from all acute hepatitis cases observed. Only RHEV was found in rodents, with a positive frequency of 55 %. The presence of HEV in wastewater coincided with the detection of one case in which the same HEV genotype was isolated. A concentration of HEV clinical cases between June and July of 2022 was observed but not detected in water. Both RHEV clinical cases were detected in summer 2022, but no correlation was found with wastewater detection. Conclusions Our study shows that there is no correlation between clinical cases and wastewater detection of HEV or RHEV

Innovative compounds to battle multirresistance to antibiotics: use of pva-tannic acid nano- particles to inhibit staphylococcus pseudintermedius growth

Antibiotic resistance is an increasing public health problem that affects to numerous pathogens, including Staphylococcus pseudintermedius, which has a high prevalence of methicillin resistance and can be transmitted to humans. The development of new compounds to prevent the appearance of antibiotic resistances and find alternatives to classic therapies is essential to health protection. The main objective of the present study is to determine whether the nanoparticles of polyvinyl alcohol and tannic acid “PVA-TA NPs” are effective to inhibit Staphylococcus pseudintermedius and can be considered as an alternative therapy. The study includes increasing concentration essays of the nanoparticles and establishes, using the determination of turbidity by refractometry that could be a useful tool to inhibit bacterial growth, resulting successful. Nonetheless, further studies to identify the underlying action mechanisms of these nano-particles are going on in our group

Looking for new compounds to battle antibiotic resistance: optimization of organic solvents

A high number of pathogens have shown the capacity of resist to the action of antibiotics. This fact presents a very important problem to public health and highlights the necessity of looking for new substances as alternative to antibiotics. Since some of these substances have a hydrophobic nature they need to be solved in organic solvents. Some of these solvents are also toxic to bacteria, mainly affecting membranes. For these reasons it is necessary to perform a study of the toxicity of organic solvents to bacteria, which has been the aim of this work. Five organic solvents, DMF (dimethylformamide), TBME (tert-butyl methyl ether), THF (tetrahydrofuran), DMSO (dimethyl sulfoxide) and CH2Cl2 (dichloromethane), have been tested, using two of the most prevalent pathogens (Staphylococcus pseudintermedius and Pseudomonas aeruginosa,) both in animals and humans. The results show that, when possible, DMSO followed by TBME are the best options for testing new compounds in Staphylococcus pseudintermedius, whether DMF followed by TBME are the preferred solvents for testing hydrophobic compounds in Pseudomonas aeruginosa

Una Experiencia de unificación de asignaturas para desplegar PBL (y las quejas que originó)

En esta ponencia se describen los aspectos esenciales de una experiencia de unificación de parejas de asignaturas con el objetivo de crear un escenario más adecuado para el despliegue de Aprendizaje Basado en Proyectos. Como guía para el repaso de esos aspectos esenciales se utiliza una carta que elaboraron los estudiantes de la primera edición para protestar por el funcionamiento de las asignaturas. El análisis de las quejas de los estudiantes puede ser de mucha utilidad para otros que se planeen retos similares.SUMMARY -- This paper describes the key aspects of an experience of unification of pairs of subjects in order to create a more suitable scenario for deployment of Project Based Learning. To guide the review of these essential aspects we use a letter that students from the first edition wrote to protest against the organization of the subjects. The analysis of the complaints of the students can be very helpful for others who are planning similar innovations

Wind kinetic energy climatology and effective resolution for the ERA5 reanalysis

Producción CientíficaERA5 represents the state of the art for atmospheric reanalyses and is widely used in meteorological and climatological research. In this work, this dataset is evaluated using the wind kinetic energy spectrum. Seasonal climatologies are generated for 30° latitudinal bands in the Northern Hemisphere (periodic domain) and over the North Atlantic area (limited-area domain). The spectra are also assessed to determine the effective resolution of the reanalysis. The results present notable differences between the latitudinal domains, indicating that ERA5 is properly capturing the synoptic conditions. The seasonal variability is adequate too, being winter the most energetic, and summer the least energetic season. The limited area domain results introduce a larger energy density and range. Despite the good results for the synoptic scales, the reanalysis’ spectra are not able to properly reproduce the dissipation rates at mesoscale. This is a source of uncertainties which needs to be taken into account when using the dataset. Finally, a cyclone tropical transition is presented as a case study. The spectrum generated shows a clear difference in energy density at every wavelength, as expected for a highly-energetic status of the atmosphere.Ministerio de Asuntos Económicos y Transformación Digital y Universidad Complutense de Madrid (projects: (PID2019-105306RB-I00 (IBER - CANES), CGL2016-78702 (SAFEFLIGHT), PCIN-2016-080 and FEI-EU-17-16)Publicación en abierto financiada por el Consorcio de Bibliotecas Universitarias de Castilla y León (BUCLE), con cargo al Programa Operativo 2014ES16RFOP009 FEDER 2014-2020 DE CASTILLA Y LEÓN, Actuación:20007-CL - Apoyo Consorcio BUCL

Randomized trial evaluating the neurotoxicity of dolutegravir/abacavir/lamivudine and Its reversibility after switching to elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide: GESIDA 9016

Background: Despite evidence shown of dolutegravir (DTG)-related neurotoxicity, which may be more common when combined with abacavir (ABC), its reversibility has not been explored in a clinical trial. Methods: We conducted a randomized, multicenter, open-label, pilot trial to evaluate the reversibility of patient-reported neuropsychiatric symptoms, developed or worsened on DTG/ABC/lamivudine (DTG/ABC/3TC), in virologically suppressed patients switched to cobicistat-boosted-elvitegravir/emtricitabine/tenofovir-alafenamide (EVG/COBI/FTC/TAF). Participants were randomized to immediate switch (baseline) or to defer switch (week 4), and then all completed 24 weeks of follow up on EVG/COBI/FTC/TAF. At each visit, participants completed Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression (HAD) scales and were interviewed about 11 neuropsychiatric symptoms potentially related with DTG through a questionnaire. At baseline and at the end of follow up, they also performed neurocognitive testing. Our primary objective was to compare changes in neuropsychiatric symptoms and PSQI and HAD scales between arms at week 4. Secondary objectives were to evaluate changes in neuropsychiatric symptoms and PSQI and HAD scales at weeks 4, 12, and 24 after switching to EVG/COBI/FTC/TAF and in neurocognitive performance and magnetic resonance imaging biomarkers at end of follow up. Results: Thirty-eight participants were included. Study arms were similar at baseline. At week 4, neuropsychiatric symptoms and PSQI and HAD scores remained unchanged in participants receiving DTG/ABC/3TC and improved significantly in participants receiving EVG/COBI/FTC/TAF. These significant improvements were also observed at weeks 4, 12, and 24 after all participants switched to EVG/COBI/FTC/TAF. In addition, global neurocognitive performance improved (NPZ-7) after switching to EVG/COBI/FTC/TAF. Conclusions: Neuropsychiatric symptoms in patients on DTG/ABC/3TC could resolve or improve after switching to EVG/COBI/FTC/TAFThis work was funded through a grant from Gilead Sciences made to the SEIMC-GESIDA Foundation (IN-ES-292-2119