Viability qPCR, a new tool for Legionella risk management.

BACKGROUND: Viability quantitative Polymerase Chain Reaction (v-qPCR) is a recent analytical approach for only detecting live microorganisms by DNA amplification-based methods This approach is based on the use of a reagent that irreversibly fixes dead cells DNA. In this study, we evaluate the utility of v-qPCR versus culture method for Legionellosis risk management. METHODS: The present study was performed using 116 real samples. Water samples were simultaneously analysed by culture, v-qPCR and qPCR methods. Results were compared by means of a non-parametric test. RESULTS: In 11.6% of samples using both methods (culture method and v-qPCR) results were positive, in 50.0% of samples both methods gave rise to negative results. As expected, equivalence between methods was not observed in all cases, as in 32.1% of samples positive results were obtained by v-qPCR and all of them gave rise to negative results by culture. Only in 6.3% of samples, with very low Legionella levels, was culture positive and v-qPCR negative. In 3.5% of samples, overgrowth of other bacteria did not allow performing the culture. When comparing both methods, significant differences between culture and v-qPCR were in the samples belonging to the cooling towers-evaporative condensers group. The v-qPCR method detected greater presence and obtained higher concentrations of Legionella spp. (p<0.001). Otherwise, no significant differences between methods were found in the rest of the groups. CONCLUSIONS: The v-qPCR method can be used as a quick tool to evaluate Legionellosis risk, especially in cooling towers-evaporative condensers, where this technique can detect higher levels than culture. The combined interpretation of PCR results along with the ratio of live cells is proposed as a tool for understanding the sample context and estimating the Legionellosis risk potential according to 4 levels of hierarchy.

[Role of the forensic doctor in the assessment of brain injury]. / Papel del médico forense en la valoración de los traumatismos craneoencefálicos.

Although the rate of brain injury remains stable, due to medical advances, many patients who have suffered serious brain injury survive the accident, but remain with very important consequences. The role of the forensic doctor is increasingly more relevant in establishing curing periods, injury stabilization, treatments received and accident consequences so that the courts can dictate the corresponding compensations, incapacity levels and penal grades.

[Legal medical evaluation of the sequels derived from moderate-serious cranioencephalic traumas]. / Valoración médico-legal de la secuelas derivadas de traumatismos craneoencefálicos moderados-graves.

Currently, the increasing number of subjects who survive a moderate to severe cranioencephalic traumatism (CET) has led to a greater number of sequels. This has made it necessary to study these sequels more specifically. Thus, we have wanted to manifest which are the most common sequels in the cases of patients who have suffered moderate to severe CET through our professional experience and current research done on this. Furthermore, we indicate the need to become aware of these deficits since these (specifically neuropsychological) are often too specific if we compare them with the generality of the standard used for their evaluation.