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Hepatitis B virus (HBV) infection is estimated to affect 292 million people worldwide, 90% of them are unaware of their HBV status. The Determine HBsAg 2 (Alere Medical Co, Ltd Chiba Japan [Now Abbott]) is a rapid test that meets European Union (EU) regulatory requirements for Hepatitis B surface antigen 2 (HBsAg) analytical sensitivity, detecting the 0.1 IU/mL World Health Organization (WHO) International HBsAg Standard. This prospective, multicentre study was conducted to establish its clinical performance. 351 evaluable subjects were enrolled, 145 HBsAg-positive. The fingerstick whole blood sensitivity and specificity were 97.2% and 98.5% (15' reading, reference assay cut-off 0.05 IU/mL), sensitivity increasing to 97.9% with the prespecified cut-off 0.13 IU/mL (EU regulations). The venous whole blood, serum and plasma sensitivity was 97.2%, 97.9%, and 98.6%, respectively (15' reading); reaching 99%, 99.5% and 100% specificity. A testing algorithm following up an initial positive fingerstick test result with plasma/serum test demonstrates 100% specificity. The Determine HBsAg 2 test gives 15-minute results with high sensitivity and specificity, making it an ideal tool for point-of-care testing, with the potential to enable large-scale population-wide screening to reach the WHO HBV diagnostic targets. The evaluated test improves the existing methods as most of the reviewed rapid tests do not meet the EU regulatory requirements of sensitivity.
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The separation of CO2 from N2 remains a highly challenging task in postcombustion CO2 capture processes, primarily due to the relatively low CO2 content (3-15%) compared to that of N2 (70%). This challenge is particularly prominent for carbon-based adsorbents that exhibit relatively low selectivity. In this study, we present a successfully implemented strategy to enhance the selectivity of composite aerogels made of reduced graphene oxide (rGO) and functionalized polymer particles. Considering that the CO2/N2 selectivity of the aerogels is affected on the one hand by the surface chemistry (offering more sites for CO2 capture) and fine-tuned microporosity (offering molecular sieve effect), both of these parameters were affected in situ during the synthesis process. The resulting aerogels exhibit improved CO2 adsorption capacity and a significant reduction in N2 adsorption at a temperature of 25 °C and 1 atm, leading to a more than 10-fold increase in selectivity compared to the reference material. This achievement represents the highest selectivity reported thus far for carbon-based adsorbents. Detailed characterization of the aerogel surfaces has revealed an increase in the quantity of surface oxygen functional groups, as well as an augmentation in the fractions of micropores (<2 nm) and small mesopores (<5 nm) as a result of the modified synthesis methodology. Additionally, it was found that the surface morphology of the aerogels has undergone important changes. The reference materials feature a surface rich in curved wrinkles with an approximate diameter of 100 nm, resulting in a selectivity range of 50-100. In contrast, the novel aerogels exhibit a higher degree of oxidation, rendering them stiffer and less elastic, resembling crumpled paper morphology. This transformation, along with the improved functionalization and augmented microporosity in the altered aerogels, has rendered the aerogels almost completely N2-phobic, with selectivity values ranging from 470 to 621. This finding provides experimental evidence for the theoretically predicted relationship between the elasticity of graphene-based adsorbents and their CO2/N2 selectivity performance. It introduces a new perspective on the issue of N2-phobicity. The outstanding performance achieved, including a CO2 adsorption capacity of nearly 2 mmol/g and the highest selectivity of 620, positions these composites as highly promising materials in the field of carbon capture and sequestration (CCS) postcombustion technology.
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BACKGROUND: some patients with inflammatory bowel disease (IBD) treated with antiTNF develop drug-induced psoriasis (antiTNF-IP). Several therapeutic strategies are possible. AIMS: to assess the management of antiTNF-IP in IBD, and its impact in both diseases. METHODS: patients with antiTNF-IP from ENEIDA registry were included. Therapeutic strategy was classified as continuing the same antiTNF, stopping antiTNF, switch to another antiTNF or swap to a non-antiTNF biologic. IP severity and IBD activity were assessed at baseline and 16, 32 and 54 weeks. RESULTS: 234 patients were included. At baseline, antiTNF-IP was moderate-severe in 60 % of them, and IBD was in remission in 80 %. Therapeutic strategy was associated to antiTNF-IP severity (p < 0.001). AntiTNF-IP improved at week 54 with all strategies, but continuing with the same antiTNF showed the worst results (p = 0.042). Among patients with IBD in remission, relapse was higher in those who stopped antiTNF (p = 0.025). In multivariate analysis, stopping antiTNF, trunk and palms and soles location were associated with antiTNF-IP remission; female sex and previous surgery in Crohn´s disease with IBD relapse. CONCLUSION: skin lesions severity and IBD activity seem to determine antiTNF-IP management. Continuing antiTNF in mild antiTNF-IP, and swap to ustekinumab or switch to another antiTNF in moderate-severe cases, are suitable strategies.
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Zona occludens-2 (ZO-2) is a protein present at the tight junction and nucleus of epithelial cells. ZO-2 represses the transcription of genes regulated by the Wnt/ß-catenin pathway. This pathway plays a critical role in podocyte injury and proteinuria. Here, we analyze whether the overexpression of ZO-2 in the glomerulus, by hydrodynamics transfection, prevents podocyte injury mediated by the Wnt/ß-catenin pathway in the mouse model of adriamycin (ADR) nephrosis. By immunofluorescence and immunogold electron microscopy, we show that ZO-2 is present in mice glomerulus, not at the slit diaphragms where nephrin concentrates, but in the cytoplasm and at processes of podocytes. Our results indicate that in the glomeruli of mice treated with ADR, ZO-2 overexpression increases the amount of phosphorylated ß-catenin, inhibits the expression of the transcription factor snail, prevents nephrin and podocalyxin loss, reduces podocyte effacement and massive fusions, restrains proteinuria, and supports urea and creatinine clearance. These results suggest that ZO-2 could be a new target for the regulation of hyperactive Wnt/ß-catenin signaling in proteinuric kidney diseases.
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Glomérulos Renales/metabolismo , Podocitos/efectos de los fármacos , Podocitos/fisiología , Proteinuria/prevención & control , Proteína de la Zonula Occludens-2/fisiología , Animales , Doxorrubicina , Masculino , Ratones , Ratones Endogámicos BALB C , Nefrosis/metabolismo , Factores de Transcripción de la Familia Snail , Factores de Transcripción/biosíntesis , Vía de Señalización Wnt/efectos de los fármacos , Proteína de la Zonula Occludens-2/biosíntesis , beta Catenina/metabolismoRESUMEN
OBJECTIVES: Despite the demonstrated efficacy of physiotherapy in palliative care programmes, there are scarce data of its real-life impact on patients' and caregivers' wellness and stress. Our aim was to assess effectiveness of a 30-day physiotherapy programme in psychological wellness and health-related quality of life (HRQoL) of patients with advanced chronic diseases or cancer and in their caregivers' stress. METHODS: Quasiexperimental before-after study applying personalised kinesitherapy, exercise with curative effects, respiratory physiotherapy, therapeutic massages and ergotherapy. Psychological wellness, HRQoL and caregiver's strain outcomes were measured. RESULTS: 207 patients (60% men, with a mean age of 73.6±12 years) were included; 129 (62.3%) with advanced cancer, and the remaining 78 with advanced chronic diseases. Psychological wellness (Emotional Stress Detection Tool decreased from 12.4±3 to 11±3; p<0.0001), caregiver's strain (Caregiver Strain Index decreased from 8.5±3.2 to 7.9±3.5; p<0.0001) and HRQoL (WHO-BREF physical health domain increased from 8.3±2.6 to 9.4±2.9; p<0.0001) showed a significant improvement after the physiotherapy programme. Global satisfaction with the physiotherapy intervention was also high (Client Satisfaction Questionnaire-8 of 28.3±3.3 points). CONCLUSIONS: A personalised physiotherapy programme incorporated to integral palliative care improved psychological wellness, HRQoL and caregivers' strain of patients with advanced chronic diseases and cancer.
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Neoplasias , Medicina Paliativa , Masculino , Humanos , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Femenino , Cuidadores/psicología , Calidad de Vida/psicología , Enfermedad Crónica , Neoplasias/psicología , Modalidades de FisioterapiaRESUMEN
OBJECTIVE: To find out the views of a group of national women experts on gender and health on the key elements to consider in research with a gender perspective, and what are the resistance barriers when trying to include this perspective in the research. DESIGN: Meeting of a group of experts. Two types of analysis, discourse analysis, analysis of group outputs were used. LOCATION: Zaragoza. PARTICIPANTS: The group consists of six experts. An expert was defined as person accredited with specific training in the subject, and/or has presented her research at seminars, workshops, conferences on gender and health in recent years, or belongs to one of the networks of research on gender and heath. METHOD: Qualitative analysis. RESULTS: Research with a gender perspective should meet the health needs and problems of both men and women, with those issues that contribute to determining the influence of gender on people's health being of special interest. The methodology should reflect this perspective throughout the research process and the variables should have gender explanatory potential. The main resistance barriers that prevent the inclusion of this perspective were related to the scientific institution, to feminism, and to a lack of training. CONCLUSIONS: A project cannot be considered to have a gender perspective if it does not include the analysis of variables with a gender explanatory potential and is not designed to help reduce inequalities between men and women. Knowing the resistance barriers that hinder this approach can guide future training.
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Relaciones Interpersonales , Proyectos de Investigación/normas , Estudios de Evaluación como Asunto , Femenino , Humanos , Masculino , Factores SexualesRESUMEN
[This corrects the article DOI: 10.3389/fpsyg.2020.01728.].
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In this research, neuroscience techniques are applied to the field of marketing in the analysis of advertisements that include the COVID-19 pandemic in their stories. A study of emotion and memory in these audiovisual productions is carried out as two fundamental factors for the knowledge of consumer habits and decision making. By means of facial recognition biosensor systems (AFFDEX) and various tests, six informative and narrative, emotional and rational advertisements are presented to the subjects of the experiment to detect which emotions predominate; how they affect variables such as neuroticism, psychoticism or extroversion, among others; or what is remembered about the different works, brands and advertisers. Outstanding results are obtained in both emotional and cognitive analysis. Thus, in the field of public health, it is found that messages referring to COVID-19 included in advertisements are remembered more than other narratives or even the brands, products or services themselves. Likewise, joy is the predominant emotion, and its significance in such varied advertising stories stands out. Finally, it is clear that neuroscience research applied to marketing requires new methods and integrated applications to obtain satisfactory results in the advertising field.
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Publicidad , COVID-19 , Emociones , Humanos , Pandemias , SARS-CoV-2RESUMEN
Based on cognitive-emotional neuroscience, the effectiveness of advertisement is measured in terms of individuals' unconscious emotional responses. Using AFFDEX to record and analyze facial expressions, a combination of indicators that track both basic emotions and individual involvement is used to quantitatively determine if a spot causes high levels of ad liking in terms of attention, engagement, valence, and joy. We use as a test case a real campaign, in which a spot composed of 31 scenes (images, text, and the brand logo) is shown to subjects divided into five groups in terms of age and gender. The target group of mature women shows statistically more positive emotions and involvement than the rest of the groups, demonstrating the emotional effectiveness of the spot. Each other experimental groups show specific negative emotions as a function of their age and for certain blocks of scenes.
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Cognitive neuroscience and its applied developments have revolutionized marketing. With advances in neuroscientific techniques, marketing has needed to refocus toward understanding issues like the area of the brain that should be stimulated to transform the consumer's intention to purchase into a real decision, how information is processed when making a decision, and how personality traits affect the purchase decision. Neuroscience has opened the door to the consumer's brain. For many years, scientists have investigated the role of subliminal messages in marketing, with their findings generating a significant controversy. Many have shown that making sound decisions based on intuition rather than conscious reasoning is more common than previously thought. In fact, many studies have shown that sound intuitive decision-making depends on the association of the subliminal messages of a given situation with the limbic brain structures formed. Scientists have concluded that the brain does not consciously need to know contextual information to learn the value of this information and make the necessary linkages to make productive decisions. In this study, we consider whether unconscious perceptual processing influences decision-making and explore the influence of aspects of personality that are related to unconscious processing, such as the degree of neuroticism, extroversion, and gender of the individual, applied to the demographic cohort Generation Z, distinguishing between whether the stimuli are verbal or pictorial. The backward masking visual paradigm has been used to assess unconscious perceptual processing. To test these processes, a set of ANOVA models and logistic regressions were run where the dependent variable is whether the people perceived the stimuli or not and the independent variables were gender, the form of the stimuli (pictorial or verbal), and the personality traits extroversion, introversion, and neuroticism. The results suggest that verbal stimuli work better than pictorial stimuli, although a possible explanation is that the pictures require modification to be more effective. In the case of verbal stimuli, gender and level of neuroticism are found to be important variables that influence unconscious perceptual decision-making processes. Specifically, a female with a high level of neuroticism shows greater permeability in its unconscious perceptual processes.
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Both hepatitis C virus (HCV) infection and human immunodeficiency virus (HIV) infection are underdiagnosed, particularly in low-income countries and in difficult-to-access populations. Our aim was to develop and evaluate a methodology for the detection of HCV and HIV infection based on capillary dry blood spot (DBS) samples taken under real-world conditions. We carried out a cross-sectional study of 139 individuals (31 healthy controls, 68 HCV-monoinfected patients, and 40 HCV/HIV-coinfected patients). ELISA was used for anti-HCV and anti-HIV antibody detection; and SYBR Green RT-PCR was used for HCV-RNA detection. The HIV serological analysis revealed 100% sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). The HCV serological analysis revealed a sensitivity of 92.6%, specificity of 100%, PPV of 100%, and NPV of 79.5%. Finally, the HCV-RNA detection test revealed a detection limit of 5 copies/µl with an efficiency of 100% and sensitivity of 99.1%, specificity of 100%, PPV of 100%, and NPV of 96.9%. In conclusion, our methodology was able to detect both HCV infection and HIV infection from the same DBS sample with good diagnostic performance. Screening for HCV and HIV using DBS might be a key strategy in the implementation of national programs for the control of both infections.
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Pruebas con Sangre Seca/métodos , Infecciones por VIH/diagnóstico , Hepatitis C/diagnóstico , Sistemas de Atención de Punto , Manejo de Especímenes/métodos , Adulto , Estudios Transversales , Femenino , VIH/aislamiento & purificación , Infecciones por VIH/sangre , Hepacivirus/aislamiento & purificación , Hepatitis C/sangre , Humanos , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVE: The paucity of long-term studies makes it difficult to evaluate the sustained abstinence over time of smokers who quit. The objective of the present study was to determine to what extent the results of tobacco cessation interventions are maintained after 5 years. PATIENTS AND METHODS: This was a longitudinal prospective study of 502 smokers. The design was quasi-experimental given that therapy was allocated according to the level of the patients' nicotine dependence: routine minimum intervention for smokers with mild addiction and those not in the preparation stage, and nicotine replacement therapy for patients with moderate-to-high dependence and/or a high level of tobacco consumption. RESULTS: Of the 267 patients followed for 5 years, 29.6% quit and were still abstinent at 1 year, and 18.0% remained abstinent after 5 years. Of those who had managed to stop smoking within 2 months of starting the intervention, 47.4% were still abstinent on follow-up at 5 years while 88.1% of those who failed to quit within 2 months were still smoking 5 years later. CONCLUSIONS: The results observed during the action stage could be of use in reorienting the treatment approach, and a planned schedule of follow-up contacts could help patients maintain the abstinence achieved in the course of the intervention.
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Nicotina/uso terapéutico , Cese del Hábito de Fumar , Administración Cutánea , Adulto , Terapia Conductista , Pruebas Respiratorias , Monóxido de Carbono/análisis , Estudios de Cohortes , Terapia Combinada , Consejo , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Nicotina/administración & dosificación , Cooperación del Paciente/estadística & datos numéricos , Evaluación de Programas y Proyectos de Salud , Estudios Prospectivos , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
Virtual reality (VR) technology represents a novel and powerful tool for behavioral research in psychological assessment. VR provides simulated experiences able to create the sensation of undergoing real situations. Users become active participants in the virtual environment seeing, hearing, feeling, and actuating as if they were in the real world. Currently, the most psychological VR applications concern the treatment of various mental disorders but not the assessment, that it is mainly based on paper and pencil tests. The observation of behaviors is costly, labor-intensive, and it is hard to create social situations in laboratory settings, even if the observation of actual behaviors could be particularly informative. In this framework, social stressful experiences can activate various behaviors of attachment for a significant person that can help to control and soothe them to promote individual's well-being. Social support seeking, physical proximity, and positive and negative behaviors represent the main attachment behaviors that people can carry out during experiences of distress. We proposed VR as a novel integrating approach to measure real attachment behaviors. The first studies on attachment behavioral system by VR showed the potentiality of this approach. To improve the assessment during the VR experience, we proposed virtual stealth assessment (VSA) as a new method. VSA could represent a valid and novel technique to measure various psychological attributes in real-time during the virtual experience. The possible use of this method in psychology could be to generate a more complete, exhaustive, and accurate individual's psychological evaluation.
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Exposure to hexavalent chromium (Cr(6+)) causes mutagenic, carcinogenic, and toxic effects, some of which have been associated with its oxidative capacity. In the kidney, Cr(6+) has been claimed to provoke necrosis of the proximal tubular cells. Our aim was to assess the functional involvement of the different segments that form the nephron in a model of acute renal failure caused by potassium dichromate and the participation of oxidative damage in this process. We also studied the possible protective effect of alpha-tocopherol (alpha-TOC) against renal damage. Wistar female rats 200g body weight (bw) received potassium dichromate (15mg/kg, sc, single dose). Lipid peroxidation and renal function were evaluated on days 0, 1, 2, 3, 7, 10, and 14. A second group received alpha-TOC (125mg/kg, by gavage) 5 days before and during dichromate exposure (same dose as for the first group), and was monitored at 0, 2, and 7 days of exposure. Creatinine clearance, glucose and sodium fractional excretions, p-aminohippurate uptake, free-water and osmolal clearances were also measured. Thiobarbituric acid-reactive substances were quantified in renal cortex. The results revealed altered proximal tubule function, decreased glomerular filtration, and distal segment dysfunction, accompanied by oxidative damage 48h after exposure to dichromate. In the alpha-TOC-treated group proximal reabsorptive and secretory functions were preserved, suggesting that oxidative damage is a participating mechanism in dichromate toxicity on these functions. In contrast alpha-TOC did not prevent glomerular or distal dysfunction, indicating selectivity of the protection afforded by this compound on the toxicity of dichromate, at the several components of the nephron.
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Enfermedades Renales/prevención & control , Túbulos Renales Proximales/efectos de los fármacos , Dicromato de Potasio/toxicidad , Sustancias Protectoras/farmacología , alfa-Tocoferol/farmacología , Animales , Creatinina/sangre , Creatinina/orina , Femenino , Tasa de Filtración Glomerular/efectos de los fármacos , Enfermedades Renales/inducido químicamente , Enfermedades Renales/metabolismo , Túbulos Renales Distales/efectos de los fármacos , Túbulos Renales Distales/metabolismo , Túbulos Renales Proximales/metabolismo , Peroxidación de Lípido/efectos de los fármacos , Proteinuria/inducido químicamente , Proteinuria/prevención & control , Ratas , Ratas Wistar , Sustancias Reactivas al Ácido Tiobarbitúrico/metabolismoAsunto(s)
Estado Funcional , Neoplasias , Enfermedad Crónica , Humanos , Neoplasias/terapia , Modalidades de FisioterapiaRESUMEN
The C825T polymorphism of the beta-3 subunit of the protein G (GNB3) has been related to an increased activity of the Na+/H+ exchanger (NHE-1) through the synthesis of an anomalous hyperactive protein. Because of the important role of this system in essential hypertension (EH), we analysed the distribution of the different genotypes of this polymorphism in normotensive subjects (NS) and essential hypertensive patients (EHP), their relationship with the condition of salt sensitivity, plasma sodium and potassium concentrations and plasma renin activity (PRA) in EHP. 144 subjects (78 EHP and 76 NS) were studied. Salt sensitivity was assessed by the rapid protocol of Weinberger and genotype determination for GNB3 C825T polymorphism was performed by PCR. The distribution of the different genotypes was similar among EHP (CC 37.2%; CT 41.1%; TT 16.7%) and NS (CC 32.9%; CT 55.3%; TT 11.8%). In regard to general characteristics of EHP (including blood pressure levels) and the condition of salt sensitivity, there were no differences among the different genotypes. Plasma sodium concentration was higher and plasma potassium was lower in TT patients (141.0+/-1.7 and 3.7+/-0.1) than in CC patients (139.1+/-1.9 and 4.0+/-0.3) p<0.05. CT patients had intermediate values (139.9+/-1.9 and 3.9+/-0.2). PRA values were similar in the three genotypes as were the rest of analytical parameters studied. Our data demonstrate an association between the C825T polymorphism of the GNB3 and plasma sodium and potassium concentrations in EHP, as expression of an increase in NHE-1 activity, without modifications in PRA nor relationship with salt sensitivity.
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Predisposición Genética a la Enfermedad , Proteínas de Unión al GTP Heterotriméricas/genética , Hipertensión/genética , Polimorfismo Genético , Potasio/sangre , Sodio/sangre , Adulto , Presión Sanguínea/efectos de los fármacos , Femenino , Humanos , Hipertensión/sangre , Masculino , Natriuresis/efectos de los fármacos , Renina/sangre , Cloruro de Sodio/farmacología , Sodio en la Dieta/administración & dosificaciónRESUMEN
BACKGROUND: High-risk human Papillomavirus infection is a necessary factor for cervical squamous intraepithelial lesions and invasive cervical cancer. In HIV-1-infected women, HPV infection is more prevalent and a higher risk of cervical cancer has been identified. We aimed to calculate the prevalence of infection by HR-HPV, determine the factors associated with this infection and abnormal cytology findings and to describe the history of cervical cancer screening in HIV-1-infected women. METHODS: We enrolled 479 HIV-1-infected women from the PISCIS cohort. Each patient underwent a gynecological check-up, PAP smear, HPV AND Hybrid capture, HPV genotyping, and colposcopy and biopsy, if necessary. We applied questionnaires to obtain information on sociodemographic, behavioral, clinical, and cervical screening variables. We present a cross-sectional analysis. RESULTS: Median age was 42 years. The prevalence of HR-HPV infection was 33.2% and that of high-grade squamous intraepithelial lesions (HSIL) was 3.8%. The most common genotypes were 16(23%), 53(20.3%), and 52(16.2%). The factor associated with HR-HPV infection was age <30 years (odds ratio[OR],2.5; 95%confidence interval[CI],1.1-5.6). The factors associated with the presence of HSIL or low-grade squamous intraepithelial lesions (LSIL) were CD4T-lymphocyte count <200 cells/mm(3) versus >500 cells/mm(3) (OR,8.4; 95%CI,3.7-19.2), HIV-1 viral load >10,000 copies/mL versus <400 copies/mL (OR,2.1; 95%CI,1.0-4.4), and use of oral contraceptives (OR,2.0; 95%CI,1.0-3.9). Sixty percent of HIV-1-infected women had had one Pap smear within the last 2 years. CONCLUSIONS: The high prevalence of HPV infection and cervical lesions in the HIV-1-infected population in Catalonia, as well as the low coverage and frequency of screening in this group, means that better preventive efforts are necessary and should include vaccination against HPV, better accessibility to screening programs, training of health care professionals, and specific health education for HIV-1-infected women.
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Infecciones por VIH , Papillomaviridae , Infecciones por Papillomavirus , Infecciones Tumorales por Virus , Displasia del Cuello del Útero , Adulto , Detección Precoz del Cáncer , Femenino , Genotipo , Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Infecciones por VIH/genética , Infecciones por VIH/virología , VIH-1/patogenicidad , Humanos , Persona de Mediana Edad , Prueba de Papanicolaou , Papillomaviridae/genética , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/complicaciones , Infecciones por Papillomavirus/genética , Infecciones por Papillomavirus/virología , Embarazo , España/epidemiología , Infecciones Tumorales por Virus/complicaciones , Infecciones Tumorales por Virus/epidemiología , Infecciones Tumorales por Virus/genética , Frotis Vaginal , Displasia del Cuello del Útero/epidemiología , Displasia del Cuello del Útero/genética , Displasia del Cuello del Útero/virologíaRESUMEN
Dengue virus (DENV) circulates in human and sylvatic cycles. Sylvatic strains are both ecologically and evolutionarily distinct from endemic viruses. Although sylvatic dengue cycles occur in West African countries and Malaysia, only a few cases of mild human disease caused by sylvatic strains and one single case of dengue hemorrhagic fever in Malaysia have been reported. Here we report a case of dengue hemorrhagic fever (DHF) with thrombocytopenia (13000/µl), a raised hematocrit (32% above baseline) and mucosal bleeding in a 27-year-old male returning to Spain in November 2009 after visiting his home country Guinea Bissau. Sylvatic DENV-2 West African lineage was isolated from blood and sera. This is the first case of DHF associated with sylvatic DENV-2 in Africa and the second case worldwide of DHF caused by a sylvatic strain.