Role of biomarkers in early infectious complications after lung transplantation

Background Infections and primary graft dysfunction are devastating complications in the immediate postoperative period following lung transplantation. Nowadays, reliable diagnostic tools are not available. Biomarkers could improve early infection diagnosis. Methods Multicentre prospective observational study that included all centres authorized to perform lung transplantation in Spain. Lung infection and/or primary graft dysfunction presentation during study period (first postoperative week) was determined. Biomarkers were measured on ICU admission and daily till ICU discharge or for the following 6 consecutive postoperative days. Results We included 233 patients. Median PCT levels were significantly lower in patients with no infection than in patients with Infection on all follow up days. PCT levels were similar for PGD grades 1 and 2 and increased significantly in grade 3. CRP levels were similar in all groups, and no significant differences were observed at any study time point. In the absence of PGD grade 3, PCT levels above median (0.50 ng/ml on admission or 1.17 ng/ml on day 1) were significantly associated with more than two- and three-fold increase in the risk of infection (adjusted Odds Ratio 2.37, 95% confidence interval 1.06 to 5.30 and 3.44, 95% confidence interval 1.52 to 7.78, respectively). Conclusions In the absence of severe primary graft dysfunction, procalcitonin can be useful in detecting infections during the first postoperative week. PGD grade 3 significantly increases PCT levels and interferes with the capacity of PCT as a marker of infection. PCT was superior to CRP in the diagnosis of infection during the study period

Moscatel de grano menudo rosa

6 Pags.- 6 Tabls.- Fots.Resultado de los trabajos de recuperación de variedades antiguas de vid. En torno al proyecto INIA RF2012-00027-C5-02 para la prospección y recuperación de variedades antiguas de vid, se han localizado en 17 comunidades autónomas, más de 300 variedades desconocidas o minoritarias entre las que se encuentra el Moscatel de Grano Menudo Rosa. EVENA ha desarrollado un trabajo de recuperación de cepajes de esta variedad cuyos detalles y resultados se recogen en este artículo. Gracias a este estudio ha sido posible recuperar en el viñedo antiguo de Navarra individuos de Moscatel de Grano Menudo Rosa.Los resultados moleculares junto con el color de la baya nos identifican este material como Moscatel de Grano Menudo Rosa, mutación somática del Moscatel de Grano menudo Blanco. Ha sido posible recuperar en el viñedo antiguo de Navarra individuos de Moscatel de Grano Menudo Rosa, una rareza vitícola, de la cual se están desarrollando los tres biotipos seleccionados. Estos tres biotipos pasan a formar parte del conservatorio de cepas de Olite, donde su comportamiento tanto agronómico como enológico está siendo validado según el protocolo establecido. Finalmente, se busca incluir esta variedad en la relación de variedades autorizadas para su cultivo en la Comunidad Foral de Navarra. A partir de los resultados del estudio, el material genuino de Moscatel de Grano Menudo Rosa recuperado puede ser utilizado para la implantación de futuros viñedos y la elaboración de vinos rosados originales, de calidad, manteniendo siempre la tipicidad de los vinos de Moscatel de Grano Menudo navarros.La ca racter izac i ón molecular en es te t rabajo ha sido f inanciada por el IN IA a través de l p royecto RF2012-00027-C5-02, titulado Documentación, caract erización y racionalización del germoplasma de vid prospectado y conservado en España. Creación de una colección nuclearPeer reviewe

Ten Issues to Update in Nosocomial or Hospital-Acquired Pneumonia: An Expert Review

Nosocomial pneumonia, or hospital-acquired pneumonia (HAP), and ventilator-associated pneumonia (VAP) are important health problems worldwide, with both being associated with substantial morbidity and mortality. HAP is currently the main cause of death from nosocomial infection in critically ill patients. Although guidelines for the approach to this infection model are widely implemented in international health systems and clinical teams, information continually emerges that generates debate or requires updating in its management. This scientific manuscript, written by a multidisciplinary team of specialists, reviews the most important issues in the approach to this important infectious respiratory syndrome, and it updates various topics, such as a renewed etiological perspective for updating the use of new molecular platforms or imaging techniques, including the microbiological diagnostic stewardship in different clinical settings and using appropriate rapid techniques on invasive respiratory specimens. It also reviews both Intensive Care Unit admission criteria and those of clinical stability to discharge, as well as those of therapeutic failure and rescue treatment options. An update on antibiotic therapy in the context of bacterial multiresistance, in aerosol inhaled treatment options, oxygen therapy, or ventilatory support, is presented. It also analyzes the out-of-hospital management of nosocomial pneumonia requiring complete antibiotic therapy externally on an outpatient basis, as well as the main factors for readmission and an approach to management in the emergency department. Finally, the main strategies for prevention and prophylactic measures, many of them still controversial, on fragile and vulnerable hosts are reviewed.30 página