Double-channel excitation in the XAS spectra of divalent and trivalent iron complexes in water solution.

We present a detailed analysis of XAS spectra of divalent and trivalent iron complexes in water solutions. The interpretation of the spectra has been provided by multi-channel multiple scattering approach. On this basis, good agreement between experimental data and theoretical calculations has been obtained in both cases including two excitation channels in the final state

Desarrollo de un dispositivo multicanal para la resección avanzada de tumores rectales mediante endoscopia flexible y cirugía endoscópica transanal UNI-VEC®

[ES] El Instituto de Biomecánica (IBV) ha desarrollado, junto con el Servicio Gallego de Salud (Sergas) y la empresa VECMEDICAL SPAIN S.L., un innovador dispositivo multicanal para la realización de endoscopia flexible o rígida intrarrectal y extirpación asistida por instrumentos rígidos de lesiones rectales no susceptibles de ser tratadas mediante las técnicas convencionales de endoscopia flexible. Se partió de una idea conceptual definida por el grupo clínico, liderado por el Dr. José Noguera, y se llevaron a cabo conjuntamente todas las etapas de desarrollo. Desde el diseño conceptual, análisis de riesgos, pruebas in vitro de funcionalidad, rediseño, experimentación animal, diseño para fabricación, hasta finalizar con la generación de la documentación necesaria para el marcado CE y estudio clínico en humanos.Al Sergas por promover y financiar la investigación. El plan de innovación sanitaria Código 100 se ejecuta en el marco de un convenio de colaboración entre el Sergas y el Ministerio de Economía, lndustria y Competitividad (MEIC), financiado en un 80% por Fondos FEDER 2014-2020 del Programa Operativo de Crecimiento lnteligente (POCINT).Noguera Aguilar, JF.; Gómez Herrero, JA.; Navarro Garcia, FJ.; Peris Serra, JL.; Atienza Vicente, CM.; Solera Navarro, MJ. (2021). Desarrollo de un dispositivo multicanal para la resección avanzada de tumores rectales mediante endoscopia flexible y cirugía endoscópica transanal UNI-VEC®. Revista de Biomecánica (Online). (68):1-5. http://hdl.handle.net/10251/187381156

Desarrollo de un novedoso equipo para el diagnóstico temprano del Alzheimer

[ES] La enfermedad del Alzheimer afecta a 14 millones de personas en el mundo y su detección temprana resulta vital para ayudar a la efectividad de los nuevos tratamientos. La empresa valenciana Oncovision, con la colaboración de I3M y el Instituto de Biomecánica (IBV), ha desarrollado un novedoso equipo de diagnóstico por imagen basado en la tecnología PET que permitirá la detección de la enfermedad en etapas muy tempranas y con una gran precisión.A la Comisión Europea. Este proyecto ha recibido financiación del programa de investigación e innovación Horizonte 2020 de la Unión Europea a través del contrato Nº 711323. A Oncovision y el I3M por contar con el IBV para la redacción de la propuesta de Instrumento para PYMES tanto en la Fase 1 como en la Fase 2. A MIPESA que se ha encargado de la fabricación y ensamblaje de las piezas mecánicas del equipo, en un sistema tan complejo.Gómez Herrero, JA.; Navarro Garcia, FJ.; Atienza Vicente, CM.; Peris Serra, JL.; Solera Navarro, MJ.; Catret Mascarell, J.; Benlloch Babiera, JM. (2018). Desarrollo de un novedoso equipo para el diagnóstico temprano del Alzheimer. Revista de Biomecánica (Online). 65. http://hdl.handle.net/10251/147638S6

The alpha-galactosidase A p.Arg118Cys variant does not cause a Fabry disease phenotype: data from individual patients and family studies

Lysosomal α-galactosidase A (α-Gal) is the enzyme deficient in Fabry disease (FD), an X-linked glycosphingolipidosis caused by pathogenic mutations affecting the GLA gene. The early-onset, multi-systemic FD classical phenotype is associated with absent or severe enzyme deficiency, as measured by in vitro assays, but patients with higher levels of residual α-Gal activity may have later-onset, more organ-restricted clinical presentations. A change in the codon 118 of the wild-type α-Gal sequence, replacing basic arginine by a potentially sulfhydryl-binding cysteine residue – GLA p.(Arg118Cys) –, has been recurrently described in large FD screening studies of high-risk patients. Although the Cys118 allele is associated with high residual α-Gal activity in vitro, it has been classified as a pathogenic mutation, mainly on the basis of theoretical arguments about the chemistry of the cysteine residue. However its pathogenicity has never been convincingly demonstrated by pathology criteria. We reviewed the clinical, biochemical and histopathology data obtained from 22 individuals of Portuguese and Spanish ancestry carrying the Cys118 allele, including 3 homozygous females. Cases were identified either on the differential diagnosis of possible FD manifestations and on case-finding studies (n=11; 4 males), or on unbiased cascade screening of probands’ close relatives (n=11; 3 males). Overall, those data strongly suggest that the GLA p.(Arg118Cys) variant does not segregate with FD clinical phenotypes in a Mendelian fashion, but might be a modulator of the multifactorial risk of cerebrovascular disease, since the allelic frequency in stroke patients was 0.0087 (p=0.0185 vs the general population). The Cys118 allelic frequency in healthy Portuguese adults (n=696) has been estimated as 0.001, therefore not qualifying for “rare” conditio

Assessment and ergonomic design of the couch for the mammograph MAMMI

[EN] The Instituto de Biomecánica (IBV) takes part in the development of a dedicated stretcher to be used with the new breast PET of the company ONCOVISION. This device called MAMMI is the clinical PET system with the highest spatial resolution in the market, specifically dedicated to breast cancer detection in early stages and its assessment in later phases. The IBV assessed ONCOVISION in the design, manufacturing, and mechanical tests of the stretcher, applying user centered design methodologies and ergonomic criteria.[ES] El Instituto de Biomecánica (IBV) participa en el desarrollo de una camilla para el nuevo mamógrafo MAMMI de la empresa ONCOVISION. El mamógrafo MAMMI es el sistema PET con mayor resolución y sensibilidad del mercado, dedicado específicamente a la detección de cáncer de mama en estadios tempranos y su valoración en fases posteriores. El IBV asesoró a la empresa ONCOVISION en las fases de diseño, fabricación y evaluación de la camilla, aplicando en su desarrollo metodologías de diseño orientado por las personas y criterios ergonómicos.El proyecto, con número de expediente IMPCND/2010/136, ha sido desarrollado en el marco de los Planes Sectoriales de Competitividad de la Empresa Valenciana, cofinanciado por el IMPIVA y el Fondo Europeo de Desarrollo Regional (FEDER) en el marco del Programa Operativo de la Comunidad Valenciana 2007-2013.Morales Martín, I.; Navarro Garcia, FJ.; López López, J.; Atienza Vicente, CM.; Solera Navarro, MJ.; González Martínez, AJ.; Caballero Ontanaya, L.... (2011). Asesoramiento y diseño ergonómico de la camilla para el mamógrafo MAMMI. Revista de biomecánica. (55):57-59. http://hdl.handle.net/10251/38792S57595

Impact of late presentation of HIV infection on short-, mid- and long-term mortality and causes of death in a multicenter national cohort : 2004-2013

To analyze the impact of late presentation (LP) on overall mortality and causes of death and describe LP trends and risk factors (2004-2013). Cox models and logistic regression were used to analyze data from a nation-wide cohort in Spain. LP is defined as being diagnosed when CD4 < 350 cells/ml or AIDS. Of 7165 new HIV diagnoses, 46.9% (CI:45.7-48.0) were LP, 240 patients died.First-year mortality was the highest (aHR = 10.3[CI:5.5-19.3]); between 1 and 4 years post-diagnosis, aHR = 1.9(1.2-3.0); an

Prediction of long-term outcomes of HIV-infected patients developing non-AIDS events using a multistate approach

Outcomes of people living with HIV (PLWH) developing non-AIDS events (NAEs) remain poorly defined. We aimed to classify NAEs according to severity, and to describe clinical outcomes and prognostic factors after NAE occurrence using data from CoRIS, a large Spanish HIV cohort from 2004 to 2013. Prospective multicenter cohort study. Using a multistate approach we estimated 3 transition probabilities: from alive and NAE-free to alive and NAE-experienced ("NAE development"); from alive and NAE-experienced to death ("Death after NAE"); and from alive and NAE-free to death ("Death without NAE"). We analyzed the effect of different covariates, including demographic, immunologic and virologic data, on death or NAE development, based on estimates of hazard ratios (HR). We focused on the transition "Death after NAE". 8,789 PLWH were followed-up until death, cohort censoring or loss to follow-up. 792 first incident NAEs occurred in 9.01% PLWH (incidence rate 28.76; 95% confidence interval [CI], 26.80-30.84, per 1000 patient-years). 112 (14.14%) NAE-experienced PLWH and 240 (2.73%) NAE-free PLWH died. Adjusted HR for the transition "Death after NAE" was 12.1 (95%CI, 4.90-29.89). There was a graded increase in the adjusted HRs for mortality according to NAE severity category: HR (95%CI), 4.02 (2.45-6.57) for intermediate-severity; and 9.85 (5.45-17.81) for serious NAEs compared to low-severity NAEs. Male sex (HR 2.04; 95% CI, 1.11-3.84), ag

Antimicrobial Lessons From a Large Observational Cohort on Intra-abdominal Infections in Intensive Care Units

evere intra-abdominal infection commonly requires intensive care. Mortality is high and is mainly determined by disease-specific characteristics, i.e. setting of infection onset, anatomical barrier disruption, and severity of disease expression. Recent observations revealed that antimicrobial resistance appears equally common in community-acquired and late-onset hospital-acquired infection. This challenges basic principles in anti-infective therapy guidelines, including the paradigm that pathogens involved in community-acquired infection are covered by standard empiric antimicrobial regimens, and second, the concept of nosocomial acquisition as the main driver for resistance involvement. In this study, we report on resistance profiles of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus faecalis and Enterococcus faecium in distinct European geographic regions based on an observational cohort study on intra-abdominal infections in intensive care unit (ICU) patients. Resistance against aminopenicillins, fluoroquinolones, and third-generation cephalosporins in E. coli, K. pneumoniae and P. aeruginosa is problematic, as is carbapenem-resistance in the latter pathogen. For E. coli and K. pneumoniae, resistance is mainly an issue in Central Europe, Eastern and South-East Europe, and Southern Europe, while resistance in P. aeruginosa is additionally problematic in Western Europe. Vancomycin-resistance in E. faecalis is of lesser concern but requires vigilance in E. faecium in Central and Eastern and South-East Europe. In the subcohort of patients with secondary peritonitis presenting with either sepsis or septic shock, the appropriateness of empiric antimicrobial therapy was not associated with mortality. In contrast, failure of source control was strongly associated with mortality. The relevance of these new insights for future recommendations regarding empiric antimicrobial therapy in intra-abdominal infections is discussed.Severe intra-abdominal infection commonly requires intensive care. Mortality is high and is mainly determined by diseasespecific characteristics, i.e. setting of infection onset, anatomical barrier disruption, and severity of disease expression. Recent observations revealed that antimicrobial resistance appears equally common in community-acquired and late-onset hospital-acquired infection. This challenges basic principles in anti-infective therapy guidelines, including the paradigm that pathogens involved in community-acquired infection are covered by standard empiric antimicrobial regimens, and second, the concept of nosocomial acquisition as the main driver for resistance involvement. In this study, we report on resistance profiles of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus faecalis and Enterococcus faecium in distinct European geographic regions based on an observational cohort study on intra-abdominal infections in intensive care unit (ICU) patients. Resistance against aminopenicillins, fluoroquinolones, and third-generation cephalosporins in E. coli, K. pneumoniae and P. aeruginosa is problematic, as is carbapenem-resistance in the latter pathogen. For E. coli and K. pneumoniae, resistance is mainly an issue in Central Europe, Eastern and South-East Europe, and Southern Europe, while resistance in P. aeruginosa is additionally problematic in Western Europe. Vancomycin-resistance in E. faecalis is of lesser concern but requires vigilance in E. faecium in Central and Eastern and South-East Europe. In the subcohort of patients with secondary peritonitis presenting with either sepsis or septic shock, the appropriateness of empiric antimicrobial therapy was not associated with mortality. In contrast, failure of source control was strongly associated with mortality. The relevance of these new insights for future recommendations regarding empiric antimicrobial therapy in intra-abdominal infections is discussed

Poor timing and failure of source control are risk factors for mortality in critically ill patients with secondary peritonitis

Purpose: To describe data on epidemiology, microbiology, clinical characteristics and outcome of adult patients admitted in the intensive care unit (ICU) with secondary peritonitis, with special emphasis on antimicrobial therapy and source control. Methods: Post hoc analysis of a multicenter observational study (Abdominal Sepsis Study, AbSeS) including 2621 adult ICU patients with intra-abdominal infection in 306 ICUs from 42 countries. Time-till-source control intervention was calculated as from time of diagnosis and classified into 'emergency' (&lt; 2 h), 'urgent' (2-6 h), and 'delayed' (&gt; 6 h). Relationships were assessed by logistic regression analysis and reported as odds ratios (OR) and 95% confidence interval (CI). Results: The cohort included 1077 cases of microbiologically confirmed secondary peritonitis. Mortality was 29.7%. The rate of appropriate empiric therapy showed no difference between survivors and non-survivors (66.4% vs. 61.3%, p = 0.1). A stepwise increase in mortality was observed with increasing Sequential Organ Failure Assessment (SOFA) scores (19.6% for a value ≤ 4-55.4% for a value &gt; 12, p &lt; 0.001). The highest odds of death were associated with septic shock (OR 3.08 [1.42-7.00]), late-onset hospital-acquired peritonitis (OR 1.71 [1.16-2.52]) and failed source control evidenced by persistent inflammation at day 7 (OR 5.71 [3.99-8.18]). Compared with 'emergency' source control intervention (&lt; 2 h of diagnosis), 'urgent' source control was the only modifiable covariate associated with lower odds of mortality (OR 0.50 [0.34-0.73]). Conclusion: 'Urgent' and successful source control was associated with improved odds of survival. Appropriateness of empirical antimicrobial treatment did not significantly affect survival suggesting that source control is more determinative for outcome