Spanish cohort of VEXAS syndrome : clinical manifestations, outcome of treatments and novel evidences about UBA1 mosaicism

The vacuoles, E1-enzyme, X linked, autoinflammatory and somatic (VEXAS) syndrome is an adult-onset autoinflammatory disease (AID) due to postzygotic UBA1 variants. To investigate the presence of VEXAS syndrome among patients with adult-onset undiagnosed AID. Additional studies evaluated the mosaicism distribution and the circulating cytokines. Gene analyses were performed by both Sanger and amplicon-based deep sequencing. Patients' data were collected from their medical charts. Cytokines were quantified by Luminex. Genetic analyses of enrolled patients (n=42) identified 30 patients carrying UBA1 pathogenic variants, with frequencies compatible for postzygotic variants. All patients were male individuals who presented with a late-onset disease (mean 67.5 years; median 67.0 years) characterised by cutaneous lesions (90%), fever (66.7%), pulmonary manifestations (66.7%) and arthritis (53.3%). Macrocytic anaemia and increased erythrocyte sedimentation rate and ferritin were the most relevant analytical abnormalities. Glucocorticoids ameliorated the inflammatory manifestations, but most patients became glucocorticoid-dependent. Positive responses were obtained when targeting the haematopoietic component of the disease with either decitabine or allogeneic haematopoietic stem cell transplantation. Additional analyses detected the UBA1 variants in both haematopoietic and non-haematopoietic tissues. Finally, analysis of circulating cytokines did not identify inflammatory mediators of the disease. Thirty patients with adult-onset AID were definitively diagnosed with VEXAS syndrome through genetic analyses. Despite minor interindividual differences, their main characteristics were in concordance with previous reports. We detected for the first time the UBA1 mosaicism in non-haematopoietic tissue, which questions the previous concept of myeloid-restricted mosaicism and may have conceptual consequences for the disease mechanisms

Colombian consensus recommendations for diagnosis, management and treatment of the infection by SARS-COV-2/ COVID-19 in health care facilities - Recommendations from expert´s group based and informed on evidence

La Asociación Colombiana de Infectología (ACIN) y el Instituto de Evaluación de Nuevas Tecnologías de la Salud (IETS) conformó un grupo de trabajo para desarrollar recomendaciones informadas y basadas en evidencia, por consenso de expertos para la atención, diagnóstico y manejo de casos de Covid 19. Estas guías son dirigidas al personal de salud y buscar dar recomendaciones en los ámbitos de la atención en salud de los casos de Covid-19, en el contexto nacional de Colombia

Spatiotemporal Characteristics of the Largest HIV-1 CRF02_AG Outbreak in Spain: Evidence for Onward Transmissions

Background and Aim: The circulating recombinant form 02_AG (CRF02_AG) is the predominant clade among the human immunodeficiency virus type-1 (HIV-1) non-Bs with a prevalence of 5.97% (95% Confidence Interval-CI: 5.41–6.57%) across Spain. Our aim was to estimate the levels of regional clustering for CRF02_AG and the spatiotemporal characteristics of the largest CRF02_AG subepidemic in Spain.Methods: We studied 396 CRF02_AG sequences obtained from HIV-1 diagnosed patients during 2000–2014 from 10 autonomous communities of Spain. Phylogenetic analysis was performed on the 391 CRF02_AG sequences along with all globally sampled CRF02_AG sequences (N = 3,302) as references. Phylodynamic and phylogeographic analysis was performed to the largest CRF02_AG monophyletic cluster by a Bayesian method in BEAST v1.8.0 and by reconstructing ancestral states using the criterion of parsimony in Mesquite v3.4, respectively.Results: The HIV-1 CRF02_AG prevalence differed across Spanish autonomous communities we sampled from (p < 0.001). Phylogenetic analysis revealed that 52.7% of the CRF02_AG sequences formed 56 monophyletic clusters, with a range of 2–79 sequences. The CRF02_AG regional dispersal differed across Spain (p = 0.003), as suggested by monophyletic clustering. For the largest monophyletic cluster (subepidemic) (N = 79), 49.4% of the clustered sequences originated from Madrid, while most sequences (51.9%) had been obtained from men having sex with men (MSM). Molecular clock analysis suggested that the origin (tMRCA) of the CRF02_AG subepidemic was in 2002 (median estimate; 95% Highest Posterior Density-HPD interval: 1999–2004). Additionally, we found significant clustering within the CRF02_AG subepidemic according to the ethnic origin.Conclusion: CRF02_AG has been introduced as a result of multiple introductions in Spain, following regional dispersal in several cases. We showed that CRF02_AG transmissions were mostly due to regional dispersal in Spain. The hot-spot for the largest CRF02_AG regional subepidemic in Spain was in Madrid associated with MSM transmission risk group. The existence of subepidemics suggest that several spillovers occurred from Madrid to other areas. CRF02_AG sequences from Hispanics were clustered in a separate subclade suggesting no linkage between the local and Hispanic subepidemics

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

Extraction of new bioactives from Neochloris oleoabundans using pressurized technologies and food grade solvents

Trabajo presentado a la III Iberoamerican Conference on Supercritical Fluids celebrada en Cartagena de Indias (Colombia) del 1 al 5 de abril de 2013.In the last years there has been an increasing interest in functional food ingredients due to their capacity to promote our health. Thus, one of the main areas in Food Science and Technology is the extraction and characterization of new bioactive compounds of natural origin. Considering the huge biodiversity of microalgae it is easy to understand that they represent one of the most important biological sources for novel biological compounds. In fact, it has been suggested that secondary metabolites produced by these organisms under certain extreme conditions (temperature, nutrients, UV-vis irradiation), provide with unique structures with important activities for human health such as antioxidant. As an example, beta-carotene and astaxanthin produced by Dunaliella salina and Haematococcus pluvialis respectively, have important application in the nutraceutical market. In the search of new bioactives from microalgae, another important aspect to be considered is the development of fast and environmental-friendly extraction processes to isolate the bioactive compounds. The purpose of this work was to develop a methodology to extract and characterize the carotenoids of N. Oleoabundans to demonstrate for the first time the potential of this microalga as a source of antioxidants. Thus, pressurized liquid extraction (PLE) was optimized by means of an experimental design considering food grade solvents such as ethanol and limonene; the chemical characterization of the extracts was carried out by means of HPLC-MS. The main carotenoids accumulated by the microalgae were lutein, cantaxanthin, zeaxanthin, or monoester and diester of astaxanthin.This work was financed thanks to AGL2011-29857-C03-01 (Ministerio de Economía y Competitividad (MINECO)) and ALIBIRD, S2009/AGR-1469 (Comunidad de Madrid) projects. M.C.P. and M.H. would like to thank MINECO for their respective “Juan de la Cierva” and “Ramón y Cajal” research contracts.Peer Reviewe

Pressurized liquids as an alternative process to antioxidant carotenoids' extraction from Haematococcus pluvialis microalgae

El pdf del artículo es la versión pre-print.In this work, extraction of antioxidant carotenoids from Haematococcus pluvialis microalga, has been studied combining pressurized liquid extraction (PLE), using hexane and ethanol as extracting solvents, and analytical techniques such as thin layer chromatography (TLC) and HPLC with DAD. The effect of the extraction temperature (50, 100, 150 and 200 °C) and the polarity of the solvent have been studied in terms of in vitro antioxidant activity and chemical composition considering two different morphological cells (green vegetative cells and red cysts). Results demonstrate that the extraction temperature had a positive influence in the extraction yield while its effect in the antioxidant activity was negative, lowering the activity of the extracts with an increase of the extraction temperature. The best yields were obtained with ethanol at the higher extraction temperature while the best antioxidant activity was also achieved using ethanol but at lower temperatures. Chemical composition was determined by TLC and HPLC with DAD. Several compounds were identified in the samples and concentration of astaxanthin was obtained. Results pointed out that the extracts contained different carotenoids in both, the green and the red phase, and that depending on its contribution a stronger antioxidant activity would be expected. © 2009 Elsevier Ltd. All rights reserved.Peer Reviewe

Aspectos imagenológicos del Laringocele Externo. A propósito de un caso

El laringocele es una condición relativamente poco frecuente caracterizada por una expansión quística sacular a nivel del ventrículo laríngeo. Es presentado un caso del sexo femenino portadora de esa entidad en su variedad externa con hallazgos clínicos típicos. Son mostrados los aspectos imagenológicos, resaltando el valor de la Tomografía Axial Computarizada en su adecuada caracterización y señalando la importancia de considerar dicha entidad entre el diagnóstico diferencial de las masas cervicales.Palabras clave: laringocele, tomografía axial computarizada, piolaringocele.</p

Revalorization of Neochloris oleoabundans biomass as source of biodiesel by concurrent production of lipids and carotenoids

The production of valuable co-products is considered a suitable pathway to reduce the cost of biofuel production from microalgae. With that purpose, we studied the effect of different culture factors on the production of triacylglycerides (TAG) and carotenoids by Neochloris oleoabundans. The highest TAG productivity (up to 154mgL-1d-1) was achieved in cultures supplemented with 3mM nitrate, and after six days of nitrogen starvation. Increasing the nitrate concentration led to a decrease in TAG productivity caused by a sharp reduction in the cell TAG content. Lack of carbon hampered TAG accumulation, thus decreasing its productivity to 20mgL-1d-1, and light intensity did not affect the TAG productivity. Under culture conditions leading to maximum TAG productivity, carotenoids comprised 2% of dry biomass achieving productivities close to 9mgL-1d-1. High-value carotenoids (lutein and astaxanthin) accounted for up to 60% of total carotenoids. Although the optimal culture conditions for the production of carotenoids did not match with those for the optimized generation of TAG, data herein reported show the potential of N. oleoabundans for the production of both products and support the co-production of carotenoids as a possible way to pay off the cost of biodiesel production from this strain.This research was funded by the Departamento de Desarrollo Económico y Competitividad-Gobierno Vasco (Spain).Peer Reviewe