Evaluación del nivel de estrés en leoncillos (Cebuella pygmaea) mediante la medición de cortisol en heces

The pygmy marmoset (Cebuella pygmaea) is the smallest platyrrhine primate. It lives in gallery forests in the Upper Amazon basin of Colombia, Ecuador, Peru, Bolivia and Brazil. Although all the Ecuadorian primate species are threatened by human activities, the pygmy marmoset is one of the most vulnerable due to its high specialization in diet and habitat. It is included in the list of vulnerable species in Ecuador. Anthropogenic alteration of the habitats is a stress factor for pygmy marmosets. In this context this study aimed to establish a protocol to measure cortisol concentration in feces (ng/g), as an indicator of the stress level of the individuals, and to make a preliminary comparison of the levels of cortisol and stress of three populations of pygmy marmosets in Amazonian Ecuador. Fifty two fecal samples from the wild populations of Tiputini and San Pablo, and one captive population from Puyo were analyzed. The samples analyzed had a dry weight between 0.05 and 0.07 g. The biological validation made with the fecal samples of an individual quarantined, showed that cortisol levels were higher in times closer to its death. The preliminary results suggest that the captive population from Puyo has higher levels of stress than the wild populations. These results have to be confirmed by analyzing a larger number of samples with information about the time of fecal deposition, the sex, age and previous activities of the individuals.El leoncillo (Cebuella pygmaea), es la especie más pequeña de primate platirrino. Habita en bosques de la Amazonía alta en Colombia, Ecuador, Perú, Bolivia y Brasil. Aunque todas las especies de primates en el Ecuador están amenazadas por las actividades humanas, ésta es una de las más vulnerables, debido a la especificidad de su alimentación y hábitat. C. pygmaea actualmente ha sido incluida en la lista de especies vulnerables en el Ecuador. La alteración antropogénica de los hábitats es un factor de estrés para los leoncillos. En este contexto, los objetivos de esta investigación fueron establecer un protocolo para medir el cortisol en heces, como un indicador del nivel de estrés de los individuos, y realizar una comparación preliminar de los niveles de cortisol y estrés de tres poblaciones de leoncillos en la Amazonía ecuatoriana. Se analizaron 52 muestras provenientes de las poblaciones silvestres de Tiputini y San Pablo y de una población en cautiverio en Puyo. Las muestras analizadas tuvieron pesos secos entre 0.05 y 0.07 g. La validación biológica realizada con muestras de heces de un individuo en cuarentena, evidenció que los niveles de cortisol fueron más elevados en los días más próximos a su muerte. Los resultados preliminares sugieren que la población en cautiverio de Puyo tiene niveles de estrés significativamente más altos que los de las poblaciones silvestres. Estos resultados deben ser confirmados analizando un mayor número de muestras de las que se tenga información completa sobre la hora de deposición y sobre los individuos de los que se tomaron las muestras

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Circulating microRNAs in sera correlate with soluble biomarkers of immune activation but do not predict mortality in ART treated individuals with HIV-1 infection: A case control study

Introduction: The use of anti-retroviral therapy (ART) has dramatically reduced HIV-1 associated morbidity and mortality. However, HIV-1 infected individuals have increased rates of morbidity and mortality compared to the non-HIV-1 infected population and this appears to be related to end-organ diseases collectively referred to as Serious Non-AIDS Events (SNAEs). Circulating miRNAs are reported as promising biomarkers for a number of human disease conditions including those that constitute SNAEs. Our study sought to investigate the potential of selected miRNAs in predicting mortality in HIV-1 infected ART treated individuals. Materials and Methods: A set of miRNAs was chosen based on published associations with human disease conditions that constitute SNAEs. This case: control study compared 126 cases (individuals who died whilst on therapy), and 247 matched controls (individuals who remained alive). Cases and controls were ART treated participants of two pivotal HIV-1 trials. The relative abundance of each miRNA in serum was measured, by RTqPCR. Associations with mortality (all-cause, cardiovascular and malignancy) were assessed by logistic regression analysis. Correlations between miRNAs and CD4+ T cell count, hs-CRP, IL-6 and D-dimer were also assessed. Results: None of the selected miRNAs was associated with all-cause, cardiovascular or malignancy mortality. The levels of three miRNAs (miRs -21, -122 and -200a) correlated with IL-6 while miR-21 also correlated with D-dimer. Additionally, the abundance of miRs -31, -150 and -223, correlated with baseline CD4+ T cell count while the same three miRNAs plus miR- 145 correlated with nadir CD4+ T cell count. Discussion: No associations with mortality were found with any circulating miRNA studied. These results cast doubt onto the effectiveness of circulating miRNA as early predictors of mortality or the major underlying diseases that contribute to mortality in participants treated for HIV-1 infection

Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study

Ristola M. on työryhmien DAD Study Grp ; Royal Free Hosp Clin Cohort ; INSIGHT Study Grp ; SMART Study Grp ; ESPRIT Study Grp jäsen.Background Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify those at greatest risk of CKD. The aims of this study were to develop a simple, externally validated, and widely applicable long-term risk score model for CKD in HIV-positive individuals that can guide decision making in clinical practice. Methods and Findings A total of 17,954 HIV-positive individuals from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study with >= 3 estimated glomerular filtration rate (eGFR) values after 1 January 2004 were included. Baseline was defined as the first eGFR > 60 ml/min/1.73 m2 after 1 January 2004; individuals with exposure to tenofovir, atazanavir, atazanavir/ritonavir, lopinavir/ritonavir, other boosted protease inhibitors before baseline were excluded. CKD was defined as confirmed (>3 mo apart) eGFR In the D:A:D study, 641 individuals developed CKD during 103,185 person-years of follow-up (PYFU; incidence 6.2/1,000 PYFU, 95% CI 5.7-6.7; median follow-up 6.1 y, range 0.3-9.1 y). Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease (CVD) predicted CKD. The adjusted incidence rate ratios of these nine categorical variables were scaled and summed to create the risk score. The median risk score at baseline was -2 (interquartile range -4 to 2). There was a 1: 393 chance of developing CKD in the next 5 y in the low risk group (risk score = 5, 505 events), respectively. Number needed to harm (NNTH) at 5 y when starting unboosted atazanavir or lopinavir/ritonavir among those with a low risk score was 1,702 (95% CI 1,166-3,367); NNTH was 202 (95% CI 159-278) and 21 (95% CI 19-23), respectively, for those with a medium and high risk score. NNTH was 739 (95% CI 506-1462), 88 (95% CI 69-121), and 9 (95% CI 8-10) for those with a low, medium, and high risk score, respectively, starting tenofovir, atazanavir/ritonavir, or another boosted protease inhibitor. The Royal Free Hospital Clinic Cohort included 2,548 individuals, of whom 94 individuals developed CKD (3.7%) during 18,376 PYFU (median follow-up 7.4 y, range 0.3-12.7 y). Of 2,013 individuals included from the SMART/ESPRIT control arms, 32 individuals developed CKD (1.6%) during 8,452 PYFU (median follow-up 4.1 y, range 0.6-8.1 y). External validation showed that the risk score predicted well in these cohorts. Limitations of this study included limited data on race and no information on proteinuria. Conclusions Both traditional and HIV-related risk factors were predictive of CKD. These factors were used to develop a risk score for CKD in HIV infection, externally validated, that has direct clinical relevance for patients and clinicians to weigh the benefits of certain antiretrovirals against the risk of CKD and to identify those at greatest risk of CKD.Peer reviewe

SEOM clinical practice guideline: management and prevention of febrile neutropenia in adults with solid tumors (2018).

Febrile neutropenia (FN) is a common dose-limiting toxicity of chemotherapy, with a profound impact on the evolution of patients with cancer, due to the potential development of serious complications, mortality, delays, and decrease in treatment intensity. This article seeks to present an updated clinical guideline, with recommendations regarding the diagnosis, prevention, and treatment of febrile neutropenia in adults with solid tumors. The aspects covered include how to properly approach the risk of microbial resistances, epidemiological aspects, considerations about the initial empirical approach adapted to the risk, special situations, and prevention of complications. A decision-making algorithm is included for use in the emergency department based on a new, validated tool, the Clinical Index of Stable Febrile Neutropenia, which can be used in patients with solid tumors who appear stable in the initial phase of neutropenic infections, and can help detect those at high risk for complications in whom early discharge must be avoided